2024/10/12 更新

写真a

セキ ヨシノブ
関 義信
SEKI Yoshinobu
所属
医歯学総合病院 血液内科 特任教授
職名
特任教授
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外部リンク

学位

  • 博士(医学) ( 1996年2月   新潟大学 )

研究キーワード

  • hematological malignancy

  • thrombosis and hemostasis

  • DIC

  • hemophilia

  • prognostic improvement

経歴(researchmap)

  • 新潟県地域医療推進財団魚沼基幹病院   血液内科   部長、診療部長

    2015年

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  • 新潟大学魚沼地域医療教育センター   血液内科   特任教授

    2015年

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  • 新潟大学   血液内科   臨床准教授

    2005年

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  • 新潟県立新発田病院   血液内科   医長、部長、がん診療部長

    2001年 - 2015年

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  • エイズ予防財団リサーチレジデント   血液内科   医員

    1997年 - 1999年

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  • 新潟大学第一内科および地域病院、僻地勤務   内科   医師、医長

    1990年 - 2001年

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  • 新潟県立中央病院医師   内科   医師

    1989年 - 1990年

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  • 新潟大学医学部附属病院内科研修医他   内科   研修医

    1987年 - 1989年

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経歴

  • 新潟大学   医歯学総合病院 血液内科   特任教授

    2023年6月 - 現在

  • 新潟大学   医歯学総合病院 魚沼地域医療教育センター   特任教授

    2015年6月 - 2023年5月

学歴

  • University of South California

    2003年

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  • 新潟大学医学部大学院医学研究科   Faculty of Medicine

    1998年4月 - 2002年4月

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  • 自治医科大学   医学部   医学科

    1981年4月 - 1987年3月

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所属学協会

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論文

  • Correction to: Effects of eculizumab treatment on quality of life in patients with paroxysmal nocturnal hemoglobinuria in Japan. 査読

    Yasutaka Ueda, Naoshi Obara, Yuji Yonemura, Hideyoshi Noji, Masayoshi Masuko, Yoshinobu Seki, Katsuya Wada, Takahisa Matsuda, Hirozumi Akiyama, Takayuki Ikezoe, Shigeru Chiba, Yoshinobu Kanda, Tatsuya Kawaguchi, Tsutomu Shichishima, Hideki Nakakuma, Shinichiro Okamoto, Jun-Ichi Nishimura, Yuzuru Kanakura, Haruhiko Ninomiya

    International journal of hematology   108 ( 2 )   233 - 235   2018年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In the original publication of this article, Tables 2, 3 and 4 were published incorrectly. The corrected tables 2, 3 and 4 are given in the following pages.

    DOI: 10.1007/s12185-018-2486-3

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  • Effects of eculizumab treatment on quality of life in patients with paroxysmal nocturnal hemoglobinuria in Japan. 査読

    Yasutaka Ueda, Naoshi Obara, Yuji Yonemura, Hideyoshi Noji, Masayoshi Masuko, Yoshinobu Seki, Katsuya Wada, Takahisa Matsuda, Hirozumi Akiyama, Takayuki Ikezoe, Shigeru Chiba, Yoshinobu Kanda, Tatsuya Kawaguchi, Tsutomu Shichishima, Hideki Nakakuma, Shinichiro Okamoto, Jun-Ichi Nishimura, Yuzuru Kanakura, Haruhiko Ninomiya

    International journal of hematology   107 ( 6 )   656 - 665   2018年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    In paroxysmal nocturnal hemoglobinuria (PNH), various symptoms due to intravascular hemolysis exert a negative impact on patients' quality of life (QOL). To determine clinical factors related with improvements in QOL in PNH patients treated, we analyzed changes in QOL scales in PNH patients treated with eculizumab based on data collected from post-marketing surveillance in Japan. Summary statistics were obtained using figures from QOL scoring systems and laboratory values, and evaluated by t test. One-year administration of eculizumab improved the most QOL items in comparison with the baseline. In particular, significant improvement of EORTC QLQ-C30 was observed in fatigue, dyspnea, physical function, and global health status. Canonical correlation analysis revealed a high correlation between QOL and laboratory values. Changes in serum lactate dehydrogenase (LDH) and hemoglobin showed strong correlations with QOL improvement. Quality of life improvement was independent of patients' baseline characteristics of co-occurrence of bone marrow failure (BMF), or the degree of LDH. In this analysis, we found that the degree of QOL improvement was independent of the baseline LDH before eculizumab treatment and of co-occurrence of BMF. Paroxysmal nocturnal hemoglobinuria patients who have not received eculizumab treatment due to mild hemolysis may benefit from eculizumab treatment.

    DOI: 10.1007/s12185-018-2409-3

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  • [Treatment of DIC associated with hematological malignancies]. 査読

    Seki Y

    [Rinsho ketsueki] The Japanese journal of clinical hematology   59 ( 10 )   2212 - 2221   2018年

  • Evaluation of the Diagnostic Criteria for the Basic Type of DIC Established by the Japanese Society of Thrombosis and Hemostasis 査読

    Takumi Aota, Hideo Wada, Naoki Fujimoto, Yoshiki Yamashita, Takeshi Matsumoto, Kohshi Ohishi, Kei Suzuki, Hiroshi Imai, Masanobu Usui, Shuji Isaji, Toshimasa Uchiyama, Yoshinobu Seki, Naoyuki Katayama

    CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS   23 ( 7 )   838 - 843   2017年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SAGE PUBLICATIONS INC  

    We evaluated the diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH), in 232 patients with suspected DIC without hematopoietic injury or infection. The diagnoses of the patients were as follows: DIC (n = 116), pre-DIC (n = 54), and non-DIC (n = 63). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver operating characteristic analysis. The area under the curve and odds ratio for the global coagulation test (GCT) scores in the diagnosis of "DIC'' were high, whereas those for the diagnosis of "`DIC and pre-DIC'' were low, suggesting that the addition of a reduced platelet count (RPC), antithrombin (AT), and soluble fibrin (SF)/thrombin AT (TAT) complex was required to diagnose DIC and pre-DIC. When the GCT score with the RPC, AT, and TAT/SF values was used, the cutoff DIC score for the diagnosis of DIC or DIC and pre-DIC was 6 points. For predicting the outcome, a scoring system that used the GCT result was useful, but the addition of RPC, AT, or SF/TAT was not. The modified diagnostic criteria of JSTH, which included the GCT score and the RPC, AT, and TAT/SF values, were useful for diagnosing both DIC and pre-DIC.

    DOI: 10.1177/1076029616672582

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  • Pathological findings in a case of bone marrow carcinosis due to gastric cancer complicated by disseminated intravascular coagulation and thrombotic microangiopathy 査読

    Yoshinobu Seki, Kunihiko Wakaki

    INTERNATIONAL JOURNAL OF HEMATOLOGY   104 ( 4 )   506 - 511   2016年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER JAPAN KK  

    An 80-year-old man was diagnosed with disseminated intravascular coagulation (DIC) and thrombotic microangiopathy (TMA) associated with mucin-producing gastric cancer with bone marrow metastasis. He died suddenly on the third day of hospitalization before chemotherapy. Microscopic autopsy findings revealed fibrin thrombi by phosphotungstic acid hematoxylin (PTAH) staining of the renal glomeruli, and platelet thrombi by von Willebrand Factor (Factor VIII Antigen) staining of the microvessels of the bleeding intestine. Tumor cells were negative for both stains. Staining of endothelial cells (EC) of the small vessels with thrombomodulin (TM) stain revealed destruction of EC structure. This patient was thought to have had systemic dissemination of solid tumor cells associated with DIC and TMA, the clinical course of which is extremely aggressive. Different types of thrombi were observed in different organs, such as the kidneys and small intestine, which supported the co-occurrence of DIC and TMA by microscopic pathological findings. These findings provide pathological evidence for the pathology of the concurrent development of DIC and TMA and show differences in the types of thrombi according to the blood vessel localization. Furthermore, the findings were highly suggestive of the mechanisms causing organ dysfunction, such as renal dysfunction, and gastrointestinal bleeding.

    DOI: 10.1007/s12185-016-2051-x

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  • How to choose and understand clinical laboratory tests in daily clinical management of hematologic diseases. 査読

    Seki Y

    [Rinsho ketsueki] The Japanese journal of clinical hematology   57 ( 10 )   2151 - 2158   2016年

  • The association of level of reduction of Wilms' tumor gene 1 mRNA transcript in bone marrow and outcome in acute myeloid leukemia patients 査読

    Yasuhiko Shibasaki, Yoshinobu Seki, Tomoyuki Tanaka, Syukuko Miyakoshi, Kyoko Fuse, Takashi Kozakai, Hironori Kobayashi, Takashi Ushiki, Takashi Abe, Toshio Yano, Masato Moriyama, Takashi Kuroha, Noriatsu Isahai, Jun Takizawa, Miwako Narita, Satoru Koyama, Tatsuo Furukawa, Hirohito Sone, Masayoshi Masuko

    LEUKEMIA RESEARCH   39 ( 6 )   667 - 671   2015年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    We focused on the level of reduction of Wilms' tumor gene 1 (WT1) mRNA in bone marrow as minimal residual disease during chemotherapies in adult acute myeloid leukemia (AML) patients. Forty-eight patients were enrolled in this study. Log levels of reduction of WT1 mRNA transcript after induction therapy compared with those at diagnosis were associated with disease-free survival (DFS) (P = 0.0066) and overall survival (OS) (P = 0.0074) in patients who achieved complete remission. Also log levels of reduction of WT1 mRNA transcript after final consolidation therapy compared with those at diagnosis were associated with DFS (P = 0.015) and OS (P = 0.012). By multivariate analysis, log levels of reduction of WT1 mRNA transcript after induction therapy and after final consolidation therapy compared with those at diagnosis were extracted as risk factors for outcome. Our results suggest that early and deep reduction of tumor burden may be important for the outcome of AML patients. In addition, it may be useful for the decision to proceed with allogeneic SCT as post-remission therapy. (C) 2015 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.leukres.2015.03.021

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  • A Prospective Analysis of Disseminated Intravascular Coagulation in Patients with Infections 査読

    Yoshinobu Seki, Hideo Wada, Kazuo Kawasugi, Kohji Okamoto, Toshimasa Uchiyama, Shigeki Kushimoto, Tsuyoshi Hatada, Takashi Matsumoto, Hiroshi Imai

    INTERNAL MEDICINE   52 ( 17 )   1893 - 1898   2013年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:JAPAN SOC INTERNAL MEDICINE  

    Objective Disseminated intravascular coagulation (DIC) is often associated with infection and a poor outcome. In this study, useful markers for predicting poor outcomes were examined.
    Methods The frequency of DIC and organ failure, outcomes and hemostatic markers were prospectively evaluated in 242 patients with infections.
    Results Seventy-seven patients were diagnosed with DIC, 36 of whom recovered from the condition. The rate of DIC or resolution of DIC was highest in the patients with sepsis and lowest in the patients with respiratory infections. Mortality tended to be high in the patients with respiratory infections. The DIC score, sepsis-related organ failure assessment (SOFA) score, prothrombin time (PT) ratio and thrombin-antithrombin complex level were significantly high in the patients who did not recover from DIC. The age, DIC score, SOFA score, PT ratio and levels of thrombomodulin and plasminogen activator inhibitor (PAI)-I were significantly high in the non-survivors. Factors related to a poor outcome included resolution of DIC, the SOFA score, age and the PT ratio. Factors related to resolution of DIC included the SOFA score and age, while factors related to the SOFA score included the levels of PAI-I, leukocytes, fibrinogen, D-dimer and platelets.
    Conclusion The outcomes of septic patients primarily depend on the SOFA score and the resolution of DIC, which are related to organ failure.

    DOI: 10.2169/internalmedicine.52.0571

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  • Increased Ratio of Soluble Fibrin Formation/Thrombin Generation in Patients With DIC 査読

    Shigeki Kushimoto, Hideo Wada, Kazuo Kawasugi, Kohji Okamoto, Toshimasa Uchiyama, Yoshinobu Seki, Tsuyoshi Hatada, Hiroshi Imai, Tsutomu Nobori

    CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS   18 ( 6 )   628 - 632   2012年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SAGE PUBLICATIONS INC  

    The generation of thrombin-antithromin (AT) complex (TAT) or soluble fibrin (SF) was prospectively compared with prothrombin fragment 1 + 2 (F1 + 2) generation in patients with disseminated intravascular coagulation (DIC). The plasma levels of TAT, SF, and F1 + 2 were significantly higher in the DIC group than in the non-DIC group. The differences in these levels between the DIC group and non-DIC group were significantly related to infections and hematopoietic tumors. There were no significant differences in the TAT/F1 + 2 ratio between DIC and non-DIC patients, but the SF/F1 + 2 ratio was significantly higher in the DIC group than the non-DIC group. The plasma AT activity was significantly higher in patients with DIC with resolution than in those without resolution, and in survivors than in nonsurvivors. These findings suggest that the ratio of TAT/thrombin is constant between the patients with and without DIC but that the ratio of fibrin formation/thrombin might increase in DIC.

    DOI: 10.1177/1076029612451648

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  • Analysis of the Cutoff Values in Fibrin-Related Markers for the Diagnosis of Overt DIC 査読

    Tsuyoshi Hatada, Hideo Wada, Kazuo Kawasugi, Kohji Okamoto, Toshimasa Uchiyama, Shigeki Kushimoto, Yoshinobu Seki, Takashi Okamura, Hiroshi Imai, Toshihiro Kaneko, Tsutomu Nobori

    CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS   18 ( 5 )   495 - 500   2012年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SAGE PUBLICATIONS INC  

    Fibrin-related markers (FRMs) such as fibrin and fibrinogen degradation products (FDPs), D-dimer, and soluble fibrin monomer complex (SFMC) were prospectively evaluated in 522 patients using the overt disseminated intravascular coagulation (DIC) diagnostic criteria. The differences in all FRMs between the DIC group and the non-DIC group, and those between the survivors and nonsurvivors were significant in the patients with infections. In an analysis of all patients, DIC score cutoff values of 2 and 3 points for FDP, D-dimer, and SFMC were recommended to be 8.3 and 42.0 mu g/mL, 2.4 and 22.0 mu g/mL, and 3.4 and 138.0 mu g/mL, respectively. In conclusion, the adequate cutoff value is thus considered to be useful for both making a diagnosis of DIC and for predicting the outcome. Fibrin-related markers are therefore thought to be more useful for making a diagnosis of DIC based on infections than based on any other underlying disorders.

    DOI: 10.1177/1076029611429786

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  • Prospective evaluation of hemostatic abnormalities in overt DIC due to various underlying diseases 査読

    Kazuo Kawasugi, Hideo Wada, Tsuyoshi Hatada, Kohji Okamoto, Toshimasa Uchiyama, Shigeki Kushimoto, Yoshinobu Seki, Takashi Okamura, Tsutomu Nobori

    THROMBOSIS RESEARCH   128 ( 2 )   186 - 190   2011年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    Patients with suspected disseminated intravascular coagulation (DIC) were prospectively evaluated for various types of underlying diseases, and the usefulness of hemostatic markers were examined for each patient with DIC due to various underlying diseases.
    The main underlying disease of DIC was infectious diseases, hematologic malignancies, and solid tumors, and a high resolution rate from DIC was observed in obstetric diseases and hematologic malignancies. The diagnosis of DIC was related to a poor outcome in trauma/burn victims and those with infectious disease. In the main underlying disease, it is suggested that DIC would be excluded in patients with hematologic malignancies or solid tumors with a platelet count of more than 100,000/mu l and in the patients with an FDP of less than 10 mu g/ml, and fibrinogen of less than 100 mg/dl, suggesting the presence of DIC. The prothrombin time was a sensitive marker, but fibrinogen levels were not sensitive for DIC due to infectious diseases. The plasmin plasmin inhibitor complex in hematologic malignancy, and soluble fibrin monomer complex, antithrombin and thrombomodulin in patients with infectious disease, were sensitive markers for the diagnosis of DIC.
    Although hemostatic markers were useful for the diagnosis of DIC, the usefulness varied depending on the different underlying diseases. (C) 2011 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.thromres.2011.02.015

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  • Clinical value of assessing the response to imatinib monitored by interphase FISH and RQ-PCR for BCR-ABL in peripheral blood for long-term survival of chronic phase CML patients: results of the Niigata CML-multi-institutional co-operative clinical study 査読

    Tatsuo Furukawa, Miwako Narita, Tadashi Koike, Kazue Takai, Koichi Nagai, Masashi Kobayashi, Satoru Koyama, Yoshinobu Seki, Hoyu Takahashi, Masahiro Fujiwara, Kenji Kishi, Koji Nikkuni, Noriatsu Isahai, Wataru Higuchi, Nobuhiko Nomoto, Souichi Maruyama, Masayoshi Masuko, Takashi Kuroha, Takashi Abe, Ken Toba, Masuhiro Takahashi, Yoshifusa Aizawa, Akira Shibata

    INTERNATIONAL JOURNAL OF HEMATOLOGY   93 ( 3 )   336 - 343   2011年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    This retrospective analysis investigated the prognostic value of monitoring the response to imatinib using peripheral blood (PB) samples and the impact of the response on outcome in 133 patients with chronic myeloid leukemia (CML). We divided the response into 3 categories according to the results of neutrophil (N)-FISH and BCR-ABL transcript levels in PB; more than a 3-log reduction [major molecular response (MMR)], between a 2-log and 3-log reduction or negative with N-FISH [complete cytogenetic response equivalent (CCyRe)], N-FISH positive or less than a 2-log reduction (non-CCyRe). The median follow-up was 5.46 years. At 5 years, the overall survival (OS) rate and progression-free survival (PFS) rate were 94.4 and 92.0%, respectively. The estimated rate of the CCyRe and MMR were 81.7 and 67.1%, respectively. 106 patients achieving the CCyRe had significantly better OS and PFS than 27 patients without achieving the CCyRe. Patients with MMR had significantly better survival free from death, progression, imatinib withdrawal and a loss of the CCyRe, than patients whose response level remained in the CCyRe without achieving MMR until 18 months. Our observation suggests that the response level of the CCyRe on PB serve as a prognostic indicator, and achieving MMR provides stable long-term survival.

    DOI: 10.1007/s12185-011-0774-2

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  • [Unfractionated heparin]. 査読

    Seki Y

    Rinsho byori. The Japanese journal of clinical pathology   Suppl 147   142 - 146   2011年2月

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  • [Low-molecular-weight heparin]. 査読

    Seki Y

    Rinsho byori. The Japanese journal of clinical pathology   Suppl 147   159 - 163   2011年2月

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  • Modified non-overt DIC diagnostic criteria predict the early phase of overt-DIC 査読

    Hideo Wada, Tsuyoshi Hatada, Kohji Okamoto, Toshimasa Uchiyama, Kazuo Kawasugi, Toshihiko Mayumi, Satoshi Gando, Shigeki Kushimoto, Yoshinobu Seki, Seiji Madoiwa, Takashi Okamura, Cheng Hock Toh

    AMERICAN JOURNAL OF HEMATOLOGY   85 ( 9 )   691 - 694   2010年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-LISS  

    Diagnostic criteria for non-overt disseminated intravascular coagulation (DIC) have been proposed by the International Society of Thrombosis and Hemostasis, but are not useful for the diagnosis of early phase of overt-DIC (pre-DIC). Therefore, in the current study the non-overt DIC diagnostic criteria were modified using the global coagulation tests, the change rate in the global coagulation tests and molecular hemostatic markers to detect the pre-DIC state and were prospectively evaluated in 613 patients with underlying DIC disease. The frequencies of patients with DIC (DIC positive), late onset DIC, and without DIC (DIC absent) were 29.5%, 7.2%, and 63.3%, respectively. The modified non-overt-DIC criteria can correctly predict 43/44 patients (97.7%) who were DIC absent at admission and became DIC positive, within a week (late onset DIC state). The mortality rate was higher in DIC positive compared with pre-DIC (37.6% vs. 22.7%, P < 0.05) or DIC negative (37.6 vs. 13.7%, P < 0.01). It was also significantly higher in pre-DIC compared with DIC negative (P < 0.05). Thus, these modified non-overt DIC diagnostic criteria might therefore be useful for the diagnosis of early-phase DIC. Am. J. Hematol. 85:691-694, 2010. (C) 2010 Wiley-Liss, Inc.

    DOI: 10.1002/ajh.21783

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  • Frequency and hemostatic abnormalities in pre-DIC patients 査読

    Kohji Okamoto, Hideo Wada, Tsuyoshi Hatada, Toshimasa Uchiyama, Kazuo Kawasugi, Toshihiko Mayumi, Satoshi Gando, Shigeki Kushimoto, Yoshinobu Seki, Seiji Madoiwa, Hidesaku Asakura, Shin Koga, Toshiaki Iba, Ikuro Maruyama

    THROMBOSIS RESEARCH   126 ( 1 )   74 - 78   2010年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    Disseminated intravascular coagulation (DIC) sometimes has a poor outcome, and therefore early diagnosis and treatment are required. This study prospectively evaluated the hemostatic abnormalities and the onset of DIC in 613 patients with underlying diseases to identify a useful marker for diagnosing Pre-DIC. Pre-DIC was defined as the condition of patients within a week before the onset of DIC. Initially, 34.4% of patients were diagnosed with DIC, and about 8.5% of the patients without DIC were diagnosed as DIC within a week after registration (pre-DIC). The mortality of DIC, Pre-DIC and "without DIC" was 35.3%, 32.4% and 17.2%, respectively. All hemostatic parameters were significantly worse in "DIC" than "without DIC" and the values of the prothrombin time ratio, platelet count and fibrin monomer complex could classify the three groups; "DIC", "pre-DIC" and "without DIC". No useful marker was identified that provided an adequate cutoff value to differentiate "pre-DIC" from "without DIC". A multivariate analysis identified clinical symptoms that were related to poor outcome. DIC must be treated immediately; there is no specific marker to identify pre-DIC. (C) 2010 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.thromres.2010.03.017

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  • Expert consensus for the treatment of disseminated intravascular coagulation in Japan 査読

    Hideo Wada, Hidesaku Asakura, Kohji Okamoto, Toshiaki Iba, Toshimasa Uchiyama, Kazuo Kawasugi, Shin Koga, Toshihiko Mayumi, Kaoru Koike, Satoshi Gando, Shigeki Kushimoto, Yoshinobu Seki, Seiji Madoiwa, Ikuro Maruyama, Akira Yoshioka

    THROMBOSIS RESEARCH   125 ( 1 )   6 - 11   2010年1月

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    記述言語:英語   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    The present report from The Japanese Society of Thrombosis and Hemostasis provides an expert consensus for the treatment of disseminated intravascular coagulation (DIC) in Japan. Disseminated intravascular coagulation (DIC) may be classified as follows: asymptomatic type, marked bleeding type, and organ failure type. Although treatment of DIC is important, adequate treatment differs according to type of DIC. In asymptomatic DIC, low molecular weight heparin (LMWH), synthetic protease inhibitor (SPI), and antithrombin (AT) are recommended, although these drugs have not yet been proved to have a high degree of effectiveness. Unfractionated heparin (UFH) and danaparoid sodium (DS) are sometimes administrated in this type, but their usefulness is not clear. In the marked bleeding type, LMWH, SPI, and AT are recommended although these drugs do not have high quality of evidence. LMWH, UFH, and DS are not recommended in case of life threatening bleeding. In case of severe bleeding, SPI is recommended since it does not cause a worsening of bleeding. Blood transfusions, such as fresh frozen plasma and platelet concentrate, are also required in cases of life threatening bleeding. In the organ failure type, including sepsis, AT has been recommended based on the findings of several clinical trials. DIC is frequently associated with thrombosis and may thus require strong anticoagulant therapy, such as LMWH, UFH, and DS. (C) 2009 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.thromres.2009.08.017

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  • Successful all-trans retinoic acid treatment of acute promyelocytic leukemia in a patient with NPM/RAR fusion 査読

    Kiyoshi Okazuka, Masayoshi Masuko, Yoshinobu Seki, Hitomi Hama, Noriyuki Honma, Tatsuo Furukawa, Ken Toba, Kenji Kishi, Yoshifusa Aizawa

    INTERNATIONAL JOURNAL OF HEMATOLOGY   86 ( 3 )   246 - 249   2007年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CARDEN JENNINGS PUBL CO LTD  

    Acute promyelocytic leukemia (APL) is characterized by a reciprocal chromosomal translocation involving the gene for retinoic acid receptor alpha (RAR). Most APL patients have a t(15;17) translocation that generates the PML-RAR fusion gene, and such patients respond well to treatment with all-trans retinoic acid (ATRA). Some APL cases also involve rearrangements that fuse RAR to partner genes other than PML, including nucleophosmin (NPM), promyelocytic leukemia zinc finger (PLZF), nuclear mitotic apparatus (NUMA), and Stat5b, but the clinical characteristics of APL without PML-RAR have not been fully clarified. We describe a 64-year-old man with NPM-RAR-positive APL who was receiving hemodialysis therapy for chronic uremia. Complete remission was achieved with ATRA monotherapy and was maintained for 18 months with consolidation chemotherapy. These findings suggest that ATRA can be used to treat APL patients with NPM/RAR as well as APL with PML/RAR.

    DOI: 10.1532/IJH97.07036

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  • In vitro effect of cyclosporin A, mitomycin C and prednisolone on cell kinetics in cultured human umbilical vein endothelial cells 査読

    Y Seki, K Toba, Fuse, I, N Sato, H Niwano, H Takahashi, N Tanabe, Y Aizawa

    THROMBOSIS RESEARCH   115 ( 3 )   219 - 228   2005年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    Introduction: Vascular endothelial cell damage plays an important role in microvascular thrombogenesis. In vivo administration of cyclosporin A or mitomycin C sometimes results in thrombotic microangiopathy in patients.
    Materials and methods: The effects of cyclosporin A, mitomycin C and/or prednisolone on the cell cycle in cultured human umbilical vein endothelial cells were investigated to evaluate drug-induced endothelial cell damage and the protective effect of prednisolone on endothelial cells against the damage by cyclosporin A or mitomycin C in vitro.
    Results: The addition of cyclosporin A to cultures caused proliferation arrest in the G1-phase in a dose-dependent manner, while mitomycin C inhibited DNA synthesis, which resulted in cell cycle arrest and inhibition of BrdUrd incorporation in the S-phase. The administration of prednisolone also caused cell cycle arrest in the G1 by itself, and protected the cells from the damage caused by mitomycin C. The inhibitory effects of cyclosporin A and prednisolone on the cell cycle were reversible, while mitomycin C was not. The highly phosphorylated retinoblastoma protein expressed in human umbilical vein endothelial cells decreased in the presence of mitomycin C. Soluble thrombomodulin levels in the culture supernatant were elevated by the addition of cyclosporin A.
    Conclusion: These effects of the drugs may cause the cell cycle arrest and the prolonged repair of damaged endothelial cells in patients. (C) 2004 Elsevier Ltd. All rights reserved.

    DOI: 10.1016/j.thromres.2004.09.001

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  • Cholangiocellular carcinoma with an aggressive growth and eosinophilia, which showed multiple myeloma in autopsy. 査読

    Seki Y, Sato K, Isokawa O, Hasegawa G

    Internal medicine (Tokyo, Japan)   42 ( 11 )   1149 - 1150   2003年11月

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  • Bone marrow necrosis with dyspnea in a patient with malignant lymphoma and plasma levels of thrombomodulin, tumor necrosis factor-alpha, and D-dimer 査読

    Y Seki, T Koike, M Yano, S Aoki, M Hiratsuka, Fuse, I, Y Aizawa

    AMERICAN JOURNAL OF HEMATOLOGY   70 ( 3 )   250 - 253   2002年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-LISS  

    Non-Hodgkin's lymphoma (peripheral T cell, unspecified, clinical stage IIIEA) was diagnosed in a 54-year-old male. He was treated weekly with chemotherapy consisting of pirarubicin hydrochloride, cyclophosphamide, methotrexate, vincristine sulfate, etoposide, and prednisolone. After 6 weeks of treatment in a state of partial remission, he exhibited sudden dyspnea, chest pain, fever, and drowsiness. The patient had received 100 mug/day of granulocyte colony stimulating factor (G-CSF) for 6 days before the onset. Laboratory data showed an elevated lactate dehydrogenase (LDH) level, leukoerythroblastosis in the peripheral blood, and no decrease in the serum haptoglobin level. There were no findings of acute myocardial infarction or pulmonary thromboembolism. Bone marrow specimen showed the characteristic features of necrosis without any signs of the involvement of lymphoma cells. No indications of infections were found. This patient was diagnosed as having bone marrow necrosis (BMN) during the recovery phase of bone marrow with G-CSF treatment after chemotherapy for malignant lymphoma. After conservative therapy, inhalation of oxygen and stopping the administration of G-CSF, all clinical symptoms subsided except that the elevation of LDH continued for I month. The plasma level of tumor necrosis factor-alpha (TNF-alpha) was high just after the onset of BMN. The thrombomodulin (TM) level was high just before the onset of BMN and continued to be high for 2 weeks. Cross-linked fibrin degradation products (D-dimer) were also high just after the onset of BMN and continued to be high for 3 weeks after the onset. Although dyspnea is a rare symptom of BMN, it is important to rule out in BMN during the recovery phase of bone marrow with G-CSF treatment after chemotherapy for malignant lymphoma. Activated neutrophils in the small vessels of the lung by G-CSF and microthrombl, suggested by the elevation of D-dimer, may participate in the onset of dyspnea, which is a rare symptom of the onset of BMN. Am. J. Hematol. 70:250-253, 2002. (C) 2002 Wiley-Liss, Inc.

    DOI: 10.1002/ajh.10136

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講演・口頭発表等

  • DIC/TMA 招待

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    2018年10月 

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    会議種別:公開講演,セミナー,チュートリアル,講習,講義等  

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  • 造血器悪性腫瘍に合併したDIC診療 教育講演43(EL-3D) 招待

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    第80回 日本血液学会総会  2018年10月 

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    会議種別:口頭発表(招待・特別)  

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  • 「APLとそれ以外のAMLによるDICの臨床像の相違

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    第12回日本血栓止血学会学術標準化委員会(SCC)シンポジウム  2018年2月 

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    会議種別:口頭発表(基調)  

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  • 骨髄増殖性腫瘍(myeloproliferative neoplasms; MPN)(特に本態性血小板血症(essential thrombocythemia; ET))と血栓症

    関 義信

    第12回日本血栓止血学会学術標準化委員会(SCC)シンポジウム  2018年2月 

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    会議種別:口頭発表(基調)  

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  • A report of clinicians’ attitude survey of acquired hemophilia A for improving its prognosis in Japan. 国際会議

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    国際血栓止血学会 2017  2017年7月 

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    記述言語:英語   会議種別:ポスター発表  

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  • 血液診療における血栓止血系検査の選択方法と解釈のしかた 招待

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    第78回 日本血液学会総会 教育講演  2016年10月 

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    会議種別:口頭発表(招待・特別)  

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  • 悪性腫瘍に合併する血栓止血異常 DIC 招待

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    第17回 日本検査血液学会学術集会  2016年8月 

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    会議種別:口頭発表(招待・特別)  

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受賞

  • TTM フォーラム(Thrombosis/Thrombolysis Marker Forum)賞

    2008年3月   TTM フォーラム(Thrombosis/Thrombolysis Marker Forum)   悪性腫瘍の骨髄転移に伴うDICとTMAの併発症例の血栓の局在について

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  • 研究助成金

    1992年4月   新潟県医師会   各種感染症における凝固線溶活性化

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共同研究・競争的資金等の研究

  • 新潟県合同輸血療法委員会による小規模医療機関を含めた地域ミーティングと各種ツールによる全県的な適正かつ安全な輸血医療の向上に関する方策研究

    2018年4月 - 2019年3月

    提供機関:平成30年度 血液製剤使用適正化方策調査研究事業

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    担当区分:研究代表者  資金種別:競争的資金

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  • 新潟県合同輸血療法委員会による地域ミーティングの再開・強化と中小施設を含めた基本的ルールの遵守徹底のための方策研究。

    2017年4月 - 2018年3月

    提供機関:平成29年度 血液製剤使用適正化方策調査研究

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    担当区分:研究代表者  資金種別:競争的資金

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  • 統合医療情報発信サイトに関する客観的評価および統合医療に関するシステマティック・レビューの実施

    2016年 - 2018年

    提供機関:日本医療研究開発機構(AMED): AMED研究費

    元雄良治

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    資金種別:競争的資金

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  • 後天性血友病Aにおける凝血学的および免疫学的機序の解明

    提供機関:科学研究費助成事業(学術研究助成基金助成金)

    嶋 緑倫

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    資金種別:競争的資金

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社会貢献活動

  • 世界CMLデーに考える白血病治療最前線

    役割:出演, コメンテーター, 講師

    BMS(株), 患者会「いずみの会」, FMラジオ新潟  2018年9月

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  • MDSの病態と薬物療法

    役割:出演, コメンテーター, 講師

    骨髄異形成症候群MDS連絡会  2017年11月

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  • 骨髄移植推進財団調整医師

    役割:助言・指導

    1997年 - 現在

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学術貢献活動

  • 新潟県血友病患者会 オブザーバー医師

    役割:企画立案・運営等

    2016年 - 現在

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