Updated on 2024/07/13

写真a

 
KOBAYASHI Akira
 
Organization
University Medical and Dental Hospital Perinatal Intensive Care Center Lecturer
Title
Lecturer
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Degree

  • 博士(医学) ( 2018.9   新潟大学 )

Research Areas

  • Life Science / Embryonic medicine and pediatrics

Research History (researchmap)

  • Niigata University Medical and Dental Hospital   Medical and Dental Hospital Perinatal Intensive Care Center   Lecturer

    2021.6

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Research History

  • Niigata University   Perinatal Intensive Care Center, University Medical and Dental Hospital   Lecturer

    2021.6

Education

  • Niigata University   Graduate School of Medical and Dental Sciences

    - 2018.9

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  • Niigata University   Faculty of Medicine   School of Medicine

    - 2001.3

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Papers

  • Severe Bronchopulmonary Dysplasia Adversely Affects Brain Growth in Preterm Infants. International journal

    Taiki Shimotsuma, Seiichi Tomotaki, Mitsuyo Akita, Ryosuke Araki, Hiroko Tomotaki, Kougoro Iwanaga, Akira Kobayashi, Akihiko Saitoh, Yasutaka Fushimi, Junko Takita, Masahiko Kawai

    Neonatology   1 - 9   2024.4

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    Language:English   Publishing type:Research paper (scientific journal)  

    INTRODUCTION: Bronchopulmonary dysplasia (BPD) is associated with neurodevelopmental outcomes of preterm infants, but its effect on brain growth in preterm infants after the neonatal period is unknown. This study aimed to evaluate the effect of severe BPD on brain growth of preterm infants from term to 18 months of corrected age (CA). METHODS: Sixty-three preterm infants (42 with severe BPD and 21 without severe BPD) who underwent magnetic resonance imaging at term equivalent age (TEA) and 18 months of CA were studied by using the Infant Brain Extraction and Analysis Toolbox (iBEAT). We measured segmented brain volumes and compared brain volume and brain growth velocity between the severe BPD group and the non-severe BPD group. RESULTS: There was no significant difference in brain volumes at TEA between the groups. However, the brain volumes of the total brain and cerebral white matter in the severe BPD group were significantly smaller than those in the non-severe BPD group at 18 months of CA. The brain growth velocities from TEA to 18 months of CA in the total brain, cerebral cortex, and cerebral white matter in the severe BPD group were lower than those in the non-severe BPD group. CONCLUSION: Brain growth in preterm infants with severe BPD from TEA age to 18 months of CA is less than that in preterm infants without severe BPD.

    DOI: 10.1159/000538527

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  • Cord blood granulocyte Colony-Stimulating factor level as an optimal predictor of umbilical cord arteritis associated with brain injury at term equivalent age in preterm neonates. International journal

    Jun Nirei, Akira Kobayashi, Rie Habuka, Hisanori Domon, Yutaka Terao, Akihiko Saitoh

    Cytokine   171   156369 - 156369   2023.11

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    Language:English   Publishing type:Research paper (scientific journal)  

    OBJECTIVE: The study aimed 1) to evaluate the association between the presence or absence of umbilical cord arteritis (UCA) and the cord blood cytokine levels, and 2) morbidity and mortality of preterm neonates; and 3) to identify predictive markers for UCA of preterm neonates. STUDY DESIGN: In this single-center retrospective observational cohort study, preterm neonates born at gestational age (GA) < 36 weeks were categorized pathologically according to the severity of intrauterine inflammation; those without UCA as Group 1, those with UCA as Group 2, and those without any intrauterine inflammation as Group 3 (control), and subgroup analyses classified by their GA were performed. We compared morbidity and mortality, and eight representative cytokine levels in cord blood samples between the groups. Subsequently, receiver operating characteristics (ROC) curves for UCA diagnosis for each cytokine were created, and values of areas under the curve (AUC) were calculated to determine the optimal predictive markers. RESULTS: In total, 105 patients (36, 58, and 11 in Groups 1, 2, and 3, respectively) were included. Multivariate logistic analysis revealed that patients with UCA had higher incidence of brain injury (Odds Ratio [OR] = 8.53, P = 0.0049, 95% Confidence Interval [CI]: 1.91 - 38.0), at term equivalent age in the subgroup analysis with GA < 32 weeks. Although the median value of cord blood granulocyte colony-stimulating factor (G-CSF) was significantly higher in Group 2 than in Group 1 or 3, only the G-CSF level was found to be high in the subgroup analysis with GA < 32 weeks. For UCA diagnosis, the AUC values of G-CSF were the highest among eight cytokines including interleukin 6 (IL-6). These findings were similar in the subgroup analysis with GA < 32 weeks. CONCLUSIONS: Preterm neonates, especially born at GA < 32 week, had higher morbidity from brain injury in the group with UCA. The cord blood G-CSF level was highly accurate for predicting UCA and could thus be used as an optimal biomarker.

    DOI: 10.1016/j.cyto.2023.156369

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  • School-Age Outcomes of Antenatal Magnesium Sulphate in Preterm Infants Reviewed

    Akira Kobayashi, Masato Ito, Erika Ota, Fumihiko Namba

    Children   10 ( 8 )   1324 - 1324   2023.7

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    Publishing type:Research paper (scientific journal)   Publisher:MDPI AG  

    Background: Antenatal magnesium sulphate (MgSO4) therapy given to women at risk of preterm birth reduced the risk of cerebral palsy in early childhood. However, its effect on longer-term neurological outcomes remains uncertain. This study aimed to assess the effects of antenatal MgSO4 therapy on school-age outcomes of preterm infants. Methods: We conducted a systematic review and meta-analysis. We searched MEDLINE, EMBASE, CENTRAL, and CINAHL for randomized controlled trials (RCTs). Two reviewers independently evaluated the eligibility for inclusion and extracted data. Results: Ten RCTs were included. Only two of them were on school-age outcomes. Antenatal MgSO4 therapy had no impact on cerebral palsy, hearing impairment, neurosensory disability, and death at school-age. Meta-analysis on mental retardation and visual impairment was not able to be performed due to different methods of evaluation. In the analysis of short-term outcomes conducted as secondary outcomes, antenatal MgSO4 therapy increased the risk of maternal adverse events with any symptom (3 RCTs; risk ratio 2.79; 95% confidence interval 1.10 to 7.05, low certainty of evidence) but was not associated with any neonatal symptoms. Conclusions: The number of cases was insufficient to determine the impact of antenatal MgSO4 therapy on school-age outcomes. Further accumulation of long-term data is required.

    DOI: 10.3390/children10081324

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  • Randomized Controlled Trial of High-Flow Nasal Cannula in Preterm Infants After Extubation. Reviewed International journal

    Atsushi Uchiyama, Kaoru Okazaki, Masatoshi Kondo, Shuntaro Oka, Yukiko Motojima, Fumihiko Namba, Nobuhiko Nagano, Kayo Yoshikawa, Kazunori Kayama, Akira Kobayashi, Yoshiki Soeno, Osamu Numata, Hideyo Suenaga, Ken Imai, Hidehiko Maruyama, Hideshi Fujinaga, Hiroyuki Furuya, Yushi Ito

    Pediatrics   146 ( 6 )   2020.12

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    Language:English   Publishing type:Research paper (scientific journal)  

    OBJECTIVES: Our aim is to compare the efficacy and safety of high-flow nasal cannula (HFNC) against those of nasal continuous positive airway pressure (NCPAP) or nasal intermittent positive-pressure ventilation (NIPPV) after extubation in preterm infants. METHODS: This prospective, randomized, noninferiority trial was conducted in 6 tertiary NICUs. Infants born at <34 weeks who needed noninvasive ventilation after extubation were enrolled. We randomly assigned infants to an HFNC group when HFNC was used or to an NCPAP/NIPPV group when NCPAP or NIPPV was used. The primary outcome was treatment failure within 7 days after extubation. We then examined clinical aspects of treatment failure with HFNC use. RESULTS: In total, 176 and 196 infants were assigned to the HFNC and NCPAP/NIPPV groups, respectively. The HFNC group showed a significantly higher rate of treatment failure than that of the NCPAP/NIPPV group, with treatment failure occurring in 54 infants (31%) compared with 31 infants (16%) in the NCPAP/NIPPV group (risk difference, 14.9 percentage points; 95% confidence interval, 6.2-23.2). Histologic chorioamnionitis (P = .02), treated patent ductus arteriosus (P = .001), and corrected gestational age at the start of treatment (P = .007) were factors independently related to treatment failure with HFNC use. CONCLUSIONS: We found HFNC revealed a significantly higher rate of treatment failure than NCPAP or NIPPV after extubation in preterm infants. The independent factors associated with treatment failure with HFNC use were histologic chorioamnionitis, treated patent ductus arteriosus, and a younger corrected gestational age at the start of treatment.

    DOI: 10.1542/peds.2020-1101

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  • Thyroid function in asphyxiated newborns who received hypothermia therapy. Reviewed International journal

    Akira Kobayashi, Touhei Usuda, Masaki Wada, Takayuki Kaneko, Kinuko Kojima, Akihiko Saitoh

    Pediatrics international : official journal of the Japan Pediatric Society   60 ( 5 )   433 - 437   2018.5

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    Language:English   Publishing type:Research paper (scientific journal)  

    BACKGROUND: Thyroid function in asphyxiated newborns who received hypothermia therapy and its relation to neurological outcome are not well described. METHODS: We performed a prospective study to measure thyroid function in 12 asphyxiated newborns who received hypothermia therapy. We measured serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) on admission, at 24, 72, and 96 h after birth, and at discharge (range, 17-54 days). The 12 newborns were divided into two groups based on the presence of brain injury on head magnetic resonance imaging (six in the abnormal imaging group and six in the normal imaging group), and thyroid function was compared between the two groups. RESULTS: Serum TSH was within the normal range in the 12 newborns. Serum FT3 and FT4 remained low at 24, 72, and 96 h after birth, and returned to normal range at discharge in the 12 newborns. There was no significant difference in serum TSH between the two groups, but serum FT3 at 96 h after birth, and serum FT4 at 72 and 96 h after birth, were significantly lower in the abnormal imaging group than in the normal imaging group (P = 0.02; P = 0.03; and P = 0.01, respectively). CONCLUSIONS: Asphyxiated newborns have transient low thyroid hormone levels at 24-96 h after birth. Serum FT3 and FT4 between 72 and 96 h after birth may predict brain injury in asphyxiated newborns.

    DOI: 10.1111/ped.13534

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  • Human parechovirus type 3 infection: Cause of apnea in infants born prematurely. International journal

    Jun Nirei, Yuta Aizawa, Minoru Okazaki, Akira Kobayashi, Junya Onozuka, Osamu Numata, Tomohiro Oishi, Akihiko Saitoh

    Pediatrics international : official journal of the Japan Pediatric Society   58 ( 5 )   400 - 402   2016.5

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    Language:English  

    Four infants born prematurely presented with multiple apnea episodes caused by human parechovirus type 3 (HPeV3) infection. All patients required oxygen supplementation, and one patient required mechanical ventilation. HPeV3 infection might be included in the differential diagnosis of apnea in neonates and young infants, especially those born prematurely.

    DOI: 10.1111/ped.12869

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  • Interleukin-6 polymorphism and bronchopulmonary dysplasia risk in very low-birthweight infants. International journal

    Touhei Usuda, Takehiro Kobayashi, Seiichi Sakakibara, Akira Kobayashi, Takayuki Kaneko, Masaki Wada, Junya Onozuka, Osamu Numata, Katsumi Torigoe, Hajime Yamazaki, Takashi Sato, Yoshihisa Nagayama, Makoto Uchiyama

    Pediatrics international : official journal of the Japan Pediatric Society   54 ( 4 )   471 - 5   2012.8

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    BACKGROUND: The aim of the present study was to evaluate the role of interleukin (IL)-6-634 polymorphism in neonatal disorders such as bronchopulmonary dysplasia (BPD) and periventricular leukomalacia (PVL) in very low-birthweight (VLBW) infants. METHODS: This prospective cohort study included 202 infants (gestational age at birth, 23-34 weeks; birthweight, 500-1499 g). Genotypic analysis (polymerase chain reaction-restriction fragment length polymorphism) was performed with DNA extracted from whole-blood samples. RESULTS: Genotype distribution (66.8% CC, 28.2% CG, 5.0% GG) was similar to that in the adult Japanese population. BPD occurred in 85 infants (42.1%) among 202 VLBW infants. The duration of O(2) therapy in infants with CG/GG genotypes was significantly longer than that in infants with the CC genotype (CG/GG vs CC: 40.3 ± 52.2 days vs 28.4 ± 32.6 days, P < 0.05), but the prevalence of BPD was not associated with the CG/GG genotype (CG/GG, 40.0%; CC, 46.3%, P= 0.24). Infants with CG/GG genotypes were more likely to have received postnatal corticosteroid therapy for BPD than those with the CC genotype (CG/GG vs CC: 20.9% vs 11.1%, P = 0.05). PVL occurred in six infants (3.0%). There was no significant difference in the prevalence of PVL among IL-6-634 polymorphisms (CG/GG, 3.0%; CC, 3.0%, P = 0.65). CONCLUSIONS: IL-6-634 polymorphism is associated with duration of oxygen therapy in VLBW infants. This suggests that the IL-6-634 polymorphism G allele is an aggravating factor of BPD. IL-6-634 polymorphism is not associated with PVL.

    DOI: 10.1111/j.1442-200X.2012.03625.x

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Teaching Experience

  • 周産期病態論

    2023
    Institution name:新潟大学

  • 助産学特論

    2023
    Institution name:新潟大学