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

DOI： 10.1186/s12887-022-03207-3

Web of Science

PubMed

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

DOI： 10.1007/s00464-022-09132-x

Web of Science

PubMed

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

DOI： 10.1111/hepr.13753

Web of Science

PubMed

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

DOI： 10.18999/nagjms.84.1.148

Web of Science

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

DOI： 10.4240/wjgs.v14.i1.56

PubMed

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

DOI： 10.4103/jmas.JMAS_98_21

Web of Science

PubMed

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

DOI： 10.18999/nagjms.83.4.765

Web of Science

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Surgical Endoscopy  

Background: Most studies reporting the outcomes of laparoscopic ovarian prolapsed hernia operations with large sample sizes are based on intracorporeal closure, while studies on extraperitoneal closure have limited sample sizes. We proactively used the single-incision laparoscopic percutaneous extraperitoneal closure (SILPEC) technique and obtained favorable outcomes, which we report in this paper. Methods: We retrospectively reviewed patients who had undergone laparoscopic surgery for inguinal hernia at our institution. They were retrospectively classified into two groups based on the pre- or intraoperative diagnosis of hernia with a prolapsed ovary, namely the prolapse group and the non-prolapse group, respectively. The data were statistically analyzed and p < 0.05 was considered statistically significant. Results: A total of 771 subjects underwent SILPEC during the study period, including 400 girls. Among them, 63 girls were diagnosed with an ovarian prolapsed hernia. SILPEC was successfully performed through a single port in all cases, with a single exception, in whom the forceps was inserted directly through the right lower quadrant to pull up the ovary. The duration of surgery in the prolapse group was not higher than that in the non-prolapse group. During the SILPEC surgery, the ovaries were successfully reverted into the abdominal cavity by external compression of the inguinal area alone in 38 of the 63 patients. In the remaining 25 cases, the ovaries were reverted into the abdominal cavity by external compression of the inguinal area and traction of the round ligament with forceps. None of these cases failed to return to the ovaries. Conclusion: Our study results indicate that SILPEC may be performed safely for the treatment of ovarian prolapsed inguinal hernia. Since the ovary and fallopian tube are close to the internal inguinal ring due to the short round ligament, the procedure requires careful suturing with traction of the round ligament.

DOI： 10.1007/s00464-021-08777-4

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatrics International  

Background: Endoscopic variceal ligation (EVL) is a widely accepted treatment for esophagogastric varices in patients with portal hypertension (PHT). It is used for urgent treatment and prophylactic treatment of esophagogastric varices in pediatric as well as adult patients. However, major life-threatening adverse events such as early rebleeding can occur. Although early rebleeding after EVL among children and adolescents has been reported, the risk factors remain obscure. This study evaluated the risk factors for early rebleeding after EVL in children and adolescents. Methods: The subjects were children and adolescents (<18 years) with PHT who underwent EVL for esophagogastric varices. Early rebleeding was defined as hematemesis, active bleeding, or blood retention in the stomach, confirmed by esophagogastroduodenoscopy from 2 h to 5 days after EVL. Results: A total of 50 EVL sessions on 22 patients were eligible for this study. There were four episodes of early rebleeding. No other major adverse event has occurred. Multivariate analysis showed that EVL implemented at cardiac varices just below the esophagogastric junction (EGJ), within 5 mm from the EGJ, is the independent factor for a higher risk of early rebleeding: odds ratio 18.2 (95% confidence interval: 1.40–237.0), P = 0.02. Conclusions: Children and adolescents who undergo EVL for cardiac varices just below the EGJ have a higher risk of early rebleeding than those who do not.

DOI： 10.1111/ped.14614

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Surgery Today  

Purpose: To investigate late complications after surgery for congenital biliary dilatation (CBD). Methods: We retrospectively reviewed the patients treated for late postoperative complications of extrahepatic bile duct resection with bilioenteric anastomosis for CBD at our hospital between 1999 and 2019. Results: Twenty-seven complications, including bile duct stenosis with (n = 19) or without (n = 3) hepatolithiasis, remnant intrapancreatic bile duct (n = 2), intestinal obstruction (n = 2), and refractory cholangitis (n = 1) were treated in 26 patients. The median age at radical surgery and the initial treatment of complications was 3 years, 2 months and 14 years, 5 months, respectively. The median period from radical surgery to initial treatment of complications was 7 years, 1 month. Before 2013, bile duct stenosis was initially treated with bile duct plasty (n = 11) or hepatectomy (n = 3), and 71.4% (n = 10) of patients needed further treatment; after 2013, double-balloon endoscopic retrograde cholangiography (DBERC) was used (n = 8), and 25% (n = 2) of patients needed further treatment. Patients with remnant intrapancreatic bile duct, intestinal obstruction, and refractory cholangitis required surgery. Conclusion: Long-term follow-up is necessary after surgery for congenital biliary dilatation. DBERC is thus considered to be useful for bile duct stenosis management.

DOI： 10.1007/s00595-021-02238-0

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Surgery International  

Purpose: Tracheomalacia (TM) is a frequent complication after esophageal atresia (EA) repair. This study aimed to review patients who underwent aortopexy for TM after EA repair and to compare their imaging features. Methods: The patients who underwent thoracoscopic EA repair and contrast-enhanced computed tomography (CECT) at our hospital between 2013 and 2020 were retrospectively reviewed. The ratio of the lateral and anterior–posterior diameter of the trachea (LAR) where the brachiocephalic artery (BCA) crosses the trachea was defined. The LAR of the patients who underwent CECT for asymptomatic pulmonary disease was set as a normal reference. The Z-score of each LAR was calculated and compared between the patients that did or did not undergo aortopexy. Results: A total of 51 patients represented the controls, 5 patients underwent aortopexy, and 12 patients were discharged without surgery. The mean LARs in the patients who underwent aortopexy, did not undergo aortopexy, and controls were 3.54, 1.54, and 1.15, respectively. The mean Z-score of the aortopexy group was 21.2. After successful aortopexy, each patient’s LAR decreased to < 1.5. Conclusion: Aortopexy was preferred if the trachea was compressed by the BCA. The LAR is a useful indicator for predicting the therapeutic effect of aortopexy.

DOI： 10.1007/s00383-021-04985-0

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Surgery International  

Purpose: Minimally invasive examinations are particularly important in pediatric patients. Although the significance of urinary N1,N12-diacetylspermine (DiAcSpm) as a tumor marker (TM) has been reported in many types of adult cancers, its usefulness in pediatric cancers has not been reported. This may be due to urinary DiAcSpm level variations with age. This study aims to measure the normal levels of urinary DiAcSpm in healthy individuals and investigate its usefulness as a TM in childhood cancer. Methods: Urinary samples were collected from pediatric patients with and without cancer. The urinary DiAcSpm levels were measured, and the values were compared. Results: A total of 32 patients with cancer and 405 controls were enrolled in the study. Of the 32 patients, 13 had neuroblastoma, 9 had malignant lymphoma (ML), and 10 had leukemia. In the control group, the urinary DiAcSpm values markedly fluctuated among those with young age, especially infants; meanwhile, the values converged among those aged roughly 10 years and above. The sensitivity of DiAcSpm was significantly different among the three types of cancers: neuroblastoma (30.8%), ML (77.8%), and leukemia (40%). Conclusion: The urinary DiAcSpm value is a useful TM for both screening and follow-up of ML.

DOI： 10.1007/s00383-021-04987-y

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Surgery International  

Purpose: The effectiveness of laparoscopic Kasai portoenterostomy (Laparoscopic-KPE) for biliary atresia (BA) has been reported but remains controversial. We reviewed our own cases and cases described in previous studies of liver transplantation (LT) for BA after Laparoscopic-KPE to investigate the efficacy of Laparoscopic-KPE. Methods: Subjects were children of ≤ 2 years old with LT for BA after KPE who underwent Laparoscopic-KPE (n = 10) or Open-KPE (n = 115) between 2009 and 2020. Propensity score matching was performed to reduce the effect of treatment selection bias. The clinical data regarding the preoperative characteristics and surgical results were compared. Results: The rates of hypoplastic portal vein and retrograde portal vein flow were lower in the Laparoscopic-KPE group than in the Open-KPE group (0 vs. 40.0%, p = 0.02 and 0 vs. 35.0%, p = 0.04). There was no marked difference in the operation time or duration of hepatectomy. For portal vein reconstruction, a vein graft was not required in the Laparoscopic-KPE group (0 vs. 35.0%, p = 0.03). No patients in the Laparoscopic-KPE group developed portal vein complications or required re-laparotomy for bowel perforation or re-bleeding, in contrast to the Open-KPE group (0 vs. 15.0% and 0 vs. 10.0%, respectively). Conclusion: Laparoscopic-KPE may reduce postoperative complications that necessitate re-laparotomy in LT.

DOI： 10.1007/s00383-021-04994-z

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Surgery International  

Background: Minimally invasive surgery (MIS) is appropriate for the treatment of some neuroblastomas (NBs); however, the indications and technical issues are unclear. This study aimed to clarify the current status of MIS for mediastinal NB in Japan. Methods: Preliminary questionnaires requesting the numbers of neuroblastoma cases in which MIS was performed from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery. Secondary questionnaires were sent to institutions with MIS cases to collect detailed data. Results: One hundred thirty-four (84.2%) institutions returned the preliminary questionnaire and 83 institutions (52.2%) reported a total of 1496 operative cases. MIS was performed for 175 (11.6%) cases. Among the 175 cases, completed forms of 140 patients were returned and 40 (male, n = 28; female, n = 12) cases had mediastinal NB. Fourteen patients received thoracoscopic biopsy, none were converted to thoracotomy. Twenty-eight patients received MIS for radical resection, none were converted to thoracotomy. Perioperative complications (Horner’s syndrome) were recognized after radical resection in one (2.5%) case. Conclusions: MIS was performed in a limited number of mediastinal NB cases. A thoracoscopic approach would be feasible for mediastinal NB.

DOI： 10.1007/s00383-021-04998-9

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Surgery International  

Purpose: The features of right-sided congenital diaphragmatic hernias (RCDHs) are quite different from those of left-sided CDHs (LCDHs). We have summarized the features of RCDHs experienced in our institution. Methods: This retrospective study analyzed the cases of patients with CDH registered at our institution between 2011 and 2020. Defects on each side were compared based on prenatal diagnosis, medical treatment, type of surgery, and outcomes. Results: A total of 101 patients underwent surgery at our institution during the neonatal period, and 11 had RCDHs. RCDHs and LCDHs were significantly different in terms of extracorporeal membrane oxygenation (36% vs. 6%, p = 0.002), patch repair (81% vs. 28%, p < 0.001), recurrence rate (36% vs. 11%, p = 0.022), and length of hospital stay (117 days vs. 51 days, p = 0.012). The severity of the fetal diagnosis did not reflect postnatal severity. All patients with RCDH survived to discharge, and there was no significant difference in survival rate between the right and left sides. Conclusion: Neonates with RCDH required more intensive treatments; however, the survival rate was comparable between RCDH and LCDH. RCDH was significantly different from LCDH and an optimal treatment strategy for RCDHs should be established.

DOI： 10.1007/s00383-021-04999-8

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Nagoya Journal of Medical Science  

A 45-year-old female was admitted to the hospital with a diagnosis of acute pancreatitis. A computed tomography scan showed two extrahepatic bile ducts. Magnetic resonance cholangiopancreatography suggested a stone in one of the bile ducts. Endoscopic retrograde cholangiopancreatography revealed two extrahepatic bile ducts joining at the hilum of the liver accompanied with pancreaticobiliary maljunction. Sphincterotomy was performed and a protein plug was drained from the bile duct. Several treatment options were discussed, and the patient was treated with laparoscopic cholecystectomy without extrahepatic bile duct resection and planned to be followed up considering the risk of carcinogenesis in the bile ducts.

DOI： 10.18999/nagjms.83.3.655

Web of Science

Scopus

PubMed

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

Web of Science

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Familial Cancer  

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is caused by heterozygous germline variants in the fumarate hydratase (FH) gene and is associated with increased susceptibility to cutaneous leiomyomas, uterine leiomyomas, and renal cell carcinoma (RCC). HLRCC-associated RCC usually occurs in the middle age, with the median age being 40–44 years. This report describes a seven-year-old (84-month-old) male who developed a large right kidney tumor with multiple cystic lesions that contained enhanced solid components. There was no evidence of distant metastasis. The male patient underwent right nephrectomy and has been recovering well without metastasis or recurrence. Pathological examination revealed that tumor cells with relatively prominent nucleoli and surrounded by halos, were located in a limited area. Immunohistochemical staining was negative for FH. Whole-exome sequencing identified his germline variant in the FH gene and its loss of heterozygosity in the tumor. At nine years (114 months) of age, the male patient showed no recurrence of the tumor. This was the youngest-onset case of HLRCC-associated RCC to date. This report may affect the starting age for future RCC-surveillance programs for patients with HLRCC.

DOI： 10.1007/s10689-021-00268-8

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Surgical Endoscopy  

Background: Some neuroblastoma (NB) cases are suitable for minimally invasive surgery (MIS), but indication and technical issue are unclear. We assessed the current status of MIS for abdominal NB after mass screening period in Japan. Methods: Preliminary questionnaires requesting the numbers of NB cases that underwent MIS from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery. The secondary questionnaires were then sent to the institutions that reported MIS cases of NB in order to collect detailed data. Results: One hundred and thirty-four (84.2%) institutions responded to the preliminary questionnaires, and 83 (52.2%) reported managing operative cases. The total number of operative cases was 1496. MIS was performed for 175 (11.6%) cases, of which the completed forms of 140 patients were returned, including 100 abdominal NB cases. The male/female ratio was 51/49. Forty-seven cases underwent a laparoscopic biopsy, and 2 (4.3%) cases were converted to laparotomy due to bleeding. Sixty-five cases underwent MIS for radical resection, and 7 (10.8%) were converted to laparotomy. The reasons for open conversion were bleeding and severe adhesion. Regarding open conversion, there were no significant relationships between conversion and neo-adjuvant chemotherapy, biopsies, stage, size, or MYCN amplification. We found no relationship between resectability and vascular encasement in this study. There was relationship between the resected tumor size and the patients’ height, which was expressed using the following formula: y= 0.0316 x+ 1.4812 (x, patients height, y, tumor size; p = 0.004219, SE: 1.55566). Postoperative complications after radical resection were recognized in 7 (10.8%) cases. Conclusions: MIS was performed in limited cases of abdominal NB. A laparoscopic biopsy with careful attention to bleeding is feasible. The resected tumor size was shown to correlate with the patients’ height. Tumor size within 6 cm of maximum diameter can be resected safely.

DOI： 10.1007/s00464-021-08599-4

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Pediatric Surgery International  

A correction to this paper has been published: https://doi.org/10.1007/s00383-021-04873-7.

DOI： 10.1007/s00383-021-04873-7

Web of Science

Scopus

PubMed

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

Web of Science

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Scientific Reports  

Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. This retrospective study included 28 patients who underwent DBERC (44 procedures) after radical surgery for CBD between January 2011 and December 2019. Strictures were diagnosed as “bile duct strictures” if endoscopy confirmed the presence of bile duct mucosa between the stenotic and anastomotic regions, and as “anastomotic strictures” if the mucosa was absent. The median patient age was 4 (range 0–67) years at the time of primary surgery for CBD and 27.5 (range 8–76) years at the time of DBERC. All anastomotic strictures could be treated with only by 1–2 courses of balloon dilatation of DBERC, while many bile duct strictures (41.2%) needed ≥ 3 treatments, especially those who underwent operative bile duct plasty as the first treatment (83.3%). Although the study was limited by the short follow-up period after DBERC treatment, DBERC is recommended as the first-line treatment for hepatolithiasis associated with biliary and anastomotic strictures in CBD patients, and it can be safely performed multiple times.

DOI： 10.1038/s41598-021-90550-7

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Scientific Reports  

Diagnosis of biliary atresia (BA) can involve uncertainties. In the present prospective multicenter study, we considered whether urinary oxysterols represent a useful marker for diagnosis of BA in Japanese children. Subjects under 6 months old at 7 pediatric centers in Japan were prospectively enrolled, including patients with cholestasis and healthy controls (HC) without liver disease. Patients with cholestasis constituted 2 groups representing BA patients and others with cholestasis from other causes (non-BA). We quantitatively analyzed 7 oxysterols including 4β-, 20(S)-, 22(S)-, 22(R)-, 24(S)-, 25-, and 27-hydroxycholesterol by liquid chromatography/electrospray ionization-tandem mass spectrometry. Enrolled subjects included 14 with BA (median age 68 days; range 26–170) and 10 non-BA cholestatic controls (59; 14–162), as well as 10 HC (57; 25–120). Total urinary oxysterols were significantly greater in BA (median, 153.0 μmol/mol creatinine; range 24.1–486.7; P < 0.001) and non-BA (36.2; 5.8–411.3; P < 0.05) than in HC (2.7; 0.8–7.6). In patients with BA, urinary 27-hydroxycholesterol (3.61; 0.42–11.09; P < 0.01) was significantly greater than in non-BA (0.71; 0–5.62). In receiver operating characteristic (ROC) curve analysis for distinguishing BA from non-BA, the area under the ROC curve for urinary 27-hydroxycholesterol was 0.83. In conclusion, this first report of urinary oxysterol analysis in patients with BA indicated that 27-hydroxycholesterol may be a useful marker for distinguishing BA from other causes of neonatal cholestasis.

DOI： 10.1038/s41598-021-84445-w

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Scientific Reports  

Urine is a complex liquid containing numerous small molecular metabolites. The ability to non-invasively test for cancer biomarkers in urine is especially beneficial for screening child patients. This study attempted to identify neuroblastoma biomarkers by comprehensively analysing urinary metabolite samples from children. A total of 87 urine samples were collected from 54 participants (15 children with neuroblastoma and 39 without cancer) and used to perform a comprehensive analysis. Urine metabolites were extracted using liquid chromatography/mass spectrometry and analysed by Metabolon, Inc. Biomarker candidates were extracted using the Wilcoxon rank sum test, random forest method (RF), and orthogonal partial least squares discriminant analysis (OPLS-DA). RF identified three important metabolic pathways in 15 samples from children with neuroblastoma. One metabolite was selected from each of the three identified pathways and combined to create a biomarker candidate (3-MTS, CTN, and COR) that represented each of the three pathways; using this candidate, all 15 cases were accurately distinguishable from the control group. Two cases in which known biomarkers were negative tested positive using this new biomarker. Furthermore, the predictive value did not decrease in cases with a low therapeutic effect. This approach could be effectively applied to identify biomarkers for other cancer types.

DOI： 10.1038/s41598-021-83619-w

Web of Science

Scopus

PubMed

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00383-020-04791-0

Web of Science

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00383-020-04793-y

Web of Science

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Nagoya Journal of Medical Science  

Early detection of diseases is critical in infants. This study evaluates the usefulness of web searches in predicting diseases in order to encourage guardians to consult a doctor promptly if their children are ill. We collected six months of search queries from Yahoo! JAPAN Search between October 2016 and March 2017. Using a machine learning model, we investigated the accuracy of the search query’s ability to predict the diagnosis of biliary atresia and hypertrophic pyloric stenosis. Both diseases were modeled with an accuracy of approximately 80&, and symptoms related to the disease were significant features in the model. These findings suggest the possibility of detecting diseases from web search queries performed by guardians. Through future research, we intend to propose a method that uses web search queries for early detection of these diseases by providing appropriate and timely information to support the guardians of patients.

DOI： 10.18999/nagjms.83.1.107

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

<p>The patient was a newborn female with colonic atresia and gastroschisis. A silo was placed immediately after birth and surgery was scheduled the following day. Adhesive detachment was performed by washing the intestinal tract with saline. The oral and anal segments of the colonic atresia were identified, and functional end-to-end anastomosis was performed. Severe edema precluded the immediate return of the intestines to the abdominal cavity and required ongoing treatment with a silo. The intestines gradually returned to the abdominal cavity during the following week. The abdominal wall was closed on postnatal day 9 by a sutureless method. The patient's postoperative course was good, and full feeding was initiated on postnatal day 19. The patient was discharged from the hospital on postnatal day 32 and recovered without complications. In cases of gastroschisis with colonic atresia, a two-stage surgical procedure is commonly employed. However, functional end-to-end anastomosis using a linear stapler is also an effective method because anastomoses can be performed without regard to differences in intestinal caliber.</p>

DOI： 10.11164/jjsps.57.1_22

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

<p>A 21-month-old girl with chief complaints of vomiting and fever was admitted to a hospital and diagnosed as having congenital biliary dilatation. Magnetic resonance imaging performed on the sixth day of hospitalization revealed bile duct perforation, and the patient was transferred to our department for further treatment. A perforation approximately 2 cm in diameter was found at the confluence of the common bile duct and cystic duct. We concluded that biliary drainage and repair of the perforation would not improve her pathophysiology. Therefore, laparoscopic one-stage radical surgery was performed. In addition, bile duct plasty was performed to treat the severe intrahepatic bile duct membranous stenosis that were observed in the right and left bile ducts of the hepatic hilum. The patient was discharged without complications on the tenth postoperative day.</p><p>Two-stage surgery is the recommended treatment method for congenital biliary dilatation with biliary perforation. However, in recent years, there have been few reports showing that one-stage open radical surgery is useful. In this case, we successfully performed laparoscopic one-stage radical surgery for congenital biliary dilatation with biliary perforation. If laparoscopic radical surgery for congenital biliary dilatation is established at the institution, and the patient is in good general condition, laparoscopic one-stage radical surgery may be an effective modality for treating this condition.</p>

DOI： 10.11164/jjsps.57.5_855

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

<p><i>Purpose</i>: The treatment outcomes of patients with laparoscopic surgery for biliary atresia (laparoscopic portoenterostomy) were retrospectively evaluated to determine whether to limit the laparoscopic surgery for biliary atresia to fully experienced surgeons.</p><p><i>Methods</i>: We included 37 patients with laparoscopic portoenterostomy for biliary atresia at our institution from 2014 to 2018. Twelve patients were treated by a surgeon fully experienced in laparoscopic portoenterostomy (Group A) and 23 patients were treated by other surgeons (Group B). Jaundice reduction and jaundice-free survival of patients with the native liver in the two groups were compared.</p><p><i>Results</i>: Differences in age at the time of surgery, body weight, perioperative blood loss, time of drain removal, and time that milk or formula feeding resumed in both groups were not significant. The duration of surgery was significantly shorter in Group A than in Group B. The jaundice-free survival rates of patients with the native liver were 58.3% in Group A and 60.9% in Group B at 6 months after surgery, 66.7% in Group A and 65.2% in Group B at 1 year after surgery, and 58.3% in Group A and 56.5% in Group B at 2 years after surgery. No significant difference was observed.</p><p><i>Conclusions</i>: In this study, no significant difference in the rate of jaundice-free survival of patients with the native liver depending on the amount of surgical experience was observed under the guidance of an operator who was skilled in laparoscopic portoenterostomy.</p>

DOI： 10.11164/jjsps.57.3_596

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Progress in Biomedical Optics and Imaging - Proceedings of SPIE  

This paper proposes an intestinal region reconstruction method from CT volumes of ileus cases. Binarized intestine segmentation results often contain incorrect contacts or loops. We utilize the 3D U-Net to estimate the distance map, which is high only at the centerlines of the intestines, to obtain regions around the centerlines. Watershed algorithm is utilized with local maximums of the distance maps as seeds for obtaining "intestine segments". Those intestine segments are connected as graphs, for removing incorrect contacts and loops and to extract "intestine paths", which represent how intestines are running. Experimental results using 19 CT volumes showed that our proposed method properly estimated intestine paths. These results were intuitively visualized for understanding the shape of the intestines and finding obstructions.

DOI： 10.1117/12.2581261

Web of Science

Scopus

Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12893-020-00986-3

Web of Science

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

Web of Science

Publishing type：Research paper (scientific journal)  

DOI： 10.1186/s12887-020-02183-w

Web of Science

Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s10147-020-01620-1

Web of Science

Publishing type：Research paper (scientific journal)  

DOI： 10.1016/j.compbiomed.2019.103471

Web of Science

Publishing type：Research paper (scientific journal)  

Web of Science

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本膵・胆管合流異常研究会  

DOI： 10.34410/jspbm.43.0_84

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本膵・胆管合流異常研究会  

DOI： 10.34410/jspbm.43.0_36

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Progress in Biomedical Optics and Imaging - Proceedings of SPIE  

This paper presents a visualization method of intestine (the small and large intestine) regions and their stenosed parts caused by ileus from CT volumes. Since it is difficult for non-expert clinicians to find stenosed parts, the intestine and its stenosed parts should be visualized intuitively. Furthermore, the intestine regions of ileus cases are quite hard to be segmented. The proposed method segments intestine regions by 3D FCN (3D U-Net). Intestine regions are quite difficult to be segmented in ileus cases since the inside the intestine is filled with liquids. These liquids have similar intensities with intestinal wall on 3D CT volumes. We segment the intestine regions by using 3D U-Net trained by a weak annotation approach. Weak-annotation makes possible to train the 3D U-Net with small manually-traced label images of the intestine. This avoids us to prepare many annotation labels of the intestine that has long and winding shape. Each intestine segment is volume-rendered and colored based on the distance from its endpoint in volume rendering. Stenosed parts (disjoint points of an intestine segment) can be easily identified on such visualization. In the experiments, we showed that stenosed parts were intuitively visualized as endpoints of segmented regions, which are colored by red or blue.

DOI： 10.1117/12.2548910

Web of Science

Scopus

Publishing type：Research paper (scientific journal)  

Web of Science

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

DOI： 10.1038/s41598-019-51123-x

PubMed

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

DOI： 10.1007/s00383-019-04541-x

Web of Science

PubMed

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

DOI： 10.1007/s00383-019-04537-7

Web of Science

PubMed

Publishing type：Research paper (scientific journal)  

Web of Science

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

DOI： 10.1007/s00464-019-07108-y

PubMed

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

DOI： 10.1111/hepr.13381

PubMed

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

DOI： 10.1038/s41598-019-42027-x

Web of Science

PubMed

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

DOI： 10.1002/jhbp.594

Web of Science

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：一般社団法人エレクトロニクス実装学会  

<p>心電図モニタリング用のドライ電極の開発を行った。ドライ電極を用いた心電図モニタリングにおいての課題は皮膚-電極間の安定した接触である。我々は立体構造の樹脂に銀メッキ加工を施した繊維を静電植毛することにより、体の形状に沿った形状であり、皮膚-電極間の安定した接触を実現した、ドライ電極の作製を行った。また作製したドライ電極を用いて心電図モニタリングウェアを作製し、医療的意義のある心電図測定に成功した。</p>

DOI： 10.11486/ejisso.33.0_13a2-01

CiNii Research

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：公益社団法人 日本生体医工学会  

<p>腹腔鏡手術は低侵襲性であることから普及が進んでいる。しかしながら、カメラを通じた状況把握、ポート留置部を支点とするため移動方向が手の動きと逆になる腹腔鏡用鉗子の利用など、手術の難易度が高く、習得に時間がかかることことから熟練者不足が問題となっている。また熟練医の不足は修練者のための教育に当てる時間も不足するという悪循環を生んでいる。従って、熟練者を短期間で養成し増やすための術式教育そのものが重要な課題である。本研究では、内視鏡外科手術は術野像がモニタによって同じ視野が「共有される」という特性を利用して、段階的な学習ステップに応じた、熟練者の適切かつスムースな動きを修練者が追体験することで、非言語的なスキルの伝達を行い、効果的なトレーニングを行うシステムである「追いトレ」を用いた場合の効果について、妥当性、効果の範囲、適応可能な範囲を明らかし、製品化・実用化・普及を実現するエビデンスを獲得するために、様々な内視鏡外科分野で十分な検証実験を踏まえたデータ取得とデータ解析を行なうことを目的とした。</p>

DOI： 10.11239/jsmbe.Annual57.S198_1

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

DOI： 10.1016/j.bjps.2018.12.027

PubMed

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

DOI： 10.1016/j.crad.2018.08.008

Web of Science

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

DOI： 10.18999/nagjms.80.4.497

Web of Science

Scopus

PubMed

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

DOI： 10.1007/s00595-018-1636-9

Web of Science

PubMed

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

DOI： 10.1089/lap.2018.0330

Web of Science

PubMed

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

DOI： 10.1007/s00383-018-4318-1

Web of Science

PubMed

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

DOI： 10.1016/j.jpedsurg.2018.04.030

Web of Science

PubMed

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

DOI： 10.1007/s00383-018-4313-6

Web of Science

PubMed

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

PURPOSE: Laparoscopic-assisted anorectoplasty (LAARP) is a minimally invasive procedure in which the levator ani muscle is left to potentially improve postoperative fecal continence. This study aimed to retrospectively evaluate postoperative complications and long-term outcomes of fecal continence after LAARP and compare them to those after posterior sagittal anorectoplasty (PSARP). METHODS: Forty-five male patients with high and intermediate anorectal malformation (aged ≥ 4 years) who underwent LAARP or PSARP (LAARP 29, PSARP 16) from 1999 to 2013 were included. Postoperative complications and postoperative fecal continence were retrospectively evaluated and compared. Postoperative complications were also compared before and after introducing a urethroscope during fistula resection. RESULTS: Complications after LAARP and PSARP were seen in 12 vs. 2 cases (p = 0.09) of mucosal prolapse and in 9 vs. 1 case (p = 0.07) of posterior urethral diverticulum (PUD), respectively. The incidence of PUD decreased after introduction of a urethroscopy from 40% in 8/20 cases to 11% in 1/9 cases. No significant difference was found in terms of fecal continence in both groups. CONCLUSION: Through our study, greater improvement of postoperative fecal continence after LAARP has not been shown. LAARP was at higher risk for mucosal prolapse and PUD. However, precise dissection of the urethral fistula could be performed after the introduction of urethroscopy.

DOI： 10.1007/s00383-018-4323-4

Web of Science

PubMed

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

PURPOSE: Anovestibular fistula (AVF) is the most common type of anorectal malformation in females. Delayed anorectoplasty with fistula dilatation is commonly performed during infancy; however, we have been actively performing anorectoplasty in neonates. We report the surgical complications and postoperative defecation function associated with single-stage anorectoplasty performed in neonates. METHODS: Patients who underwent surgery for AVF between 2007 and 2017 at two institutions were retrospectively studied. The operation time, amount of bleeding, time to start oral intake, perioperative complications, and Kelly's score were compared among patients who underwent surgery as neonates and those who underwent surgery as infants. RESULTS: Eighteen neonates and 17 infants underwent anterior sagittal anorectoplasty. The median operation time and time to start oral intake were significantly shorter in the neonatal group (72 min; 3 days, respectively) than in the infant group (110 min, p = 0.0002; 5 days, p = 0.0024, respectively). Postoperative wound disruption was significantly more frequent in the infant group. Of the ten patients each in the neonatal and infant groups, there was no significant difference in Kelly's score at age ≥ 4 years. CONCLUSION: Single-stage anorectoplasty in neonates with AVF can be feasibly performed and does not impair postoperative defecation function. LEVELS OF EVIDENCE: III.

DOI： 10.1007/s00383-018-4324-3

Web of Science

PubMed

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

DOI： 10.1007/s00383-018-4320-7

Web of Science

PubMed

Language：English   Publishing type：Research paper (other academic)  

Language：English   Publishing type：Research paper (other academic)  

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

BACKGROUND: Postoperative chylothorax after surgery for esophageal atresia/tracheoesophageal fistula (TEF) is a rare but serious complication, especially in neonates. This study aimed to identify the thoracic duct and ligate chylous leakage sites, using thoracoscopic navigation of an indocyanine-green (ICG)-based near-infrared (NIR) fluorescence imaging system. METHODS: From November 2014 to April 2017, thoracoscopic intraoperative ICG-NIR imaging was performed in 10 newborns (11 surgeries) with first TEF operation or with persistent postoperative chylothorax after TEF operation. NIR imaging was performed 1h after an inter-toe injection of ICG. Thoracoscopic ligations against the NIR-detected leakage sites were performed with sutures. RESULTS: The thoracic duct or lymphatic leakage was directly visualized in each patient. In 8 surgeries with first thoracoscopic TEF operation, one case had suspected minor chylous leakage without postoperative chylothorax. Another case with no chylous leakage at the first operation resulted in chylothorax at postoperative day 11. In three neonates with postoperative chylothorax, leakage points were detected near the ablation site of the azygos vein during the first operation. These points were properly ligated, and postoperative chylous leakage ceased with no adverse events. CONCLUSIONS: Thoracoscopic ICG-NIR imaging encourages the repair of refractory chylothorax and seems reliable. LEVEL OF EVIDENCE: IV.

DOI： 10.1016/j.jpedsurg.2018.01.019

Web of Science

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：金原出版  

DOI： 10.18888/op.0000000707

CiNii Research

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

DOI： 10.1016/j.jpeds.2017.12.058

Web of Science

PubMed

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

DOI： 10.1089/lap.2017.0307

Web of Science

PubMed

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

DOI： 10.1186/s12887-018-1085-z

Web of Science

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japan Institute of Electronics Packaging  

DOI： 10.11486/ejisso.32.0_179

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

<p>The patient was a 5-year-old boy who had no medical history. He was referred to us with suspected acute appendicitis and complaints of fever and lower abdominal pain. Although his abdominal pain was intense, rebound tenderness and muscular protection were negative. There were no symptoms of problems in the digestive tract such as vomiting or diarrhea. His blood examination revealed an increase in inflammatory reactions, as indicated by the increased white blood cell count and C-reactive protein levels. Computed tomography (CT) revealed wall thickening of the ascending colon; therefore, we started antibiotic administration after acute enterocolitis was diagnosed. After admission, we performed CT again and found a fatty and dense mass with a swirling structure inside the mass; therefore, we diagnosed the patient as having idiopathic omental torsion. Because the symptoms were relieved, conservative management was continued and the patient was discharged on the fourth day after hospitalization. Omental torsion is a rare condition, particularly seen in children; its classical treatment option is surgery. Although conservative management was successful in this case, there are few reports on it. There are many cases where surgery is performed after an initial diagnosis of acute appendicitis is made owing to the presence of similar symptoms. However, in recent years, because of advances in imaging diagnostic techniques such as CT, more patients are being accurately diagnosed. We believe that if patients are accurately diagnosed, surgery will always be required; however, conservative management is sometimes possible.</p>

DOI： 10.11164/jjsps.54.2_302

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

DOI： 10.1007/978-3-030-00934-2_26

Web of Science

Scopus

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

DOI： 10.1016/j.jpedsurg.2017.08.056

PubMed

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

DOI： 10.1186/s12893-017-0313-z

PubMed

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

DOI： 10.1016/j.jpedsurg.2017.10.061

PubMed

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

DOI： 10.18999/nagjms.79.4.427

PubMed

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

DOI： 10.1007/s00383-017-4140-1

PubMed

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

DOI： 10.1080/08941939.2017.1366603

PubMed

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

DOI： 10.18999/nagjms.79.3.415

PubMed

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

DOI： 10.1007/s00464-017-5472-6

PubMed

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

PubMed

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

DOI： 10.12659/AJCR.903465

Web of Science

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

DOI： 10.1186/s12887-017-0826-8

PubMed

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

DOI： 10.1089/lap.2016.0207

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

<p>Reports on laparoscopic hepatectomy for malignant tumors in children are few. We present a case of pure laparoscopic partial hepatectomy for hepatoblastoma. A baby girl with Beckwith-Wiedemann syndrome underwent surgical closure of an omphalocele on the sixth day of life. At 4 months, sonographic screening revealed a liver tumor. The alpha-fetoprotein level was 23,060.69 ng/ml, and contrast-enhanced computed tomography revealed a 3.7-cm mass at the left lateral segment of the liver. A biopsy of the mass confirmed the diagnosis of hepatoblastoma (PRETEXT I). After 4 cycles of cisplatin monotherapy, the size of the tumor decreased to 2.7 cm. Laparoscopic partial hepatectomy was performed when she was 6 months old. An umbilical incision was made in an inverted Y shape, allowing for E-Z Access^TM with a Lap Protector^TM insertion through which a 1.2-cm trocar was introduced. Two 5-mm working ports were placed lateral to the rectus muscle of either side immediately superior to the umbilicus. After placing a tape around the porta hepatis for the Pringle maneuver in the case of severe bleeding, intraoperative ultrasonography was performed for the identification of the vascular tree and hepatic and portal veins, and the localization of the tumor for accurate and safe resection. Enseal^® was used to divide the hepatic parenchyma. Branched vessels and ducts were clipped and transected using Enseal^®. The surgical specimen was extracted through the umbilical incision without enlarging the incision. The patient had an uncomplicated recovery. No recurrence was observed during a 2-year follow-up.</p>

DOI： 10.11164/jjsps.53.5_1073

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

DOI： 10.1111/ped.13040

PubMed

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

DOI： 10.18999/nagjms.78.4.447

PubMed

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

DOI： 10.1007/s00595-016-1434-1

PubMed

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

Web of Science

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

DOI： 10.1007/s00383-016-3973-3

PubMed

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

DOI： 10.1016/j.jpedsurg.2016.09.017

PubMed

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

DOI： 10.1002/jhbp.395

PubMed

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

DOI： 10.1007/s00383-016-3939-5

PubMed

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

DOI： 10.1007/s00383-016-3932-z

PubMed

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

DOI： 10.4103/0972-9941.182655

PubMed

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

DOI： 10.4103/0972-9941.181771

PubMed

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

PubMed

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

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NAGOYA UNIV, SCH MED  

The purpose of this study is to examine the feasibility of single-incision laparoscopic percutaneous extraperitoneal closure (LPEC) for incarcerated inguinal hernia (IIH) repair. 6 single-incision LPEC procedures were performed for IIH repair and 60 procedures were performed for reducible inguinal hernia (RIH) in the same period of time in one hospital. The laparoscope and one pair of grasping forceps were placed through the same umbilical incision. In IIH repair, the herniated organ was gently pulled using the grasping forceps with external manual pressure. If it was difficult to reduce the herniated organ with one pair of forceps, another pair of forceps were inserted through a multi-channel port without extending the umbilical incidion. Using the LPEC needle, the hernia orifice was closed extraperitoneally. We performed a retrospective analysis to compare the outcomes of single-incision LPEC for IIH repair or reducible inguinal hernia. All procedures were completed by single-incision without open conversion. A multi-channel port with another pair of forceps was needed in three cases. The operation time and the length of stay were significantly longer with IIH repair than with RIH repair. There were no major complications and there was no evidence of early recurrence in any patient. In conclusion, single-incision LPEC with a multi-channel port is feasible and safe for IIH repair.

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Inc.  

We describe a simple and feasible procedure for single-incision laparoscopic repair of a pediatric epigastric hernia using a novel suture-assisting needle. A multichannel port was inserted through the umbilical vertical incision. After the orifice of the hernia was identified, a suture-assisting needle, which can hold a suture at its tip, with a 2-0 thread was pierced through the skin into one side of the rectus muscle sheath into the abdominal cavity. Next, after releasing the thread, the needle was pulled out to the subcutis and pierced through another side of the rectus muscle sheath. The needle, grasping the thread again, was subsequently pulled out through the abdominal wall outside, and the thread was tied extracorporeally. This knot was buried subcutaneously. Operative procedures of single-incision laparoscopic repair of an epigastric hernia have become simple and feasible with the use of a novel suture-assisting needle with an excellent cosmetic result.

DOI： 10.1016/j.epsc.2015.11.010

Web of Science

Scopus

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

<p>Fibrolamellar hepatocellular carcinoma (FLHCC) is rare in children. In Japan, there are only six reports of children with FLHCC. We report a case of FLHCC aggressively treated by surgery and chemotherapy. A 12-year-old girl with liver tumor was admitted to our hospital for treatment. FLHCC with lymph node metastases was suspected from various imaging studies and definitively diagnosed as FLHCC by laparotomy biopsy. One cycle of gemcitabine/oxaliplatin (GEMOX) chemotherapy was administered preoperatively because of multiple lymph node metastases. After chemotherapy, her PIVKA-II level decreased but there was no reduction in tumor size. As a result, left hepatectomy and lymphadenectomy were performed. GEMOX chemotherapy was administered as a postoperative adjuvant. After 2 cycles of GEMOX chemotherapy, she developed adhesive ileus and adhesiotomy was performed. Ten cycles of GEMOX chemotherapy were administered after adhesiotomy, and then she was discharged. To date, 3 years after surgery, there is no evidence of recurrence.</p>

DOI： 10.11164/jjsps.52.6_1251

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

DOI： 10.1111/ped.12715

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Inc.  

Patients with hepatic arteriovenous malformations rarely present with pulmonary hypertension. We report the case of a 3-month-old boy who developed severe pulmonary hypertension due to a hepatic arteriovenous malformation. The use of pulmonary vasodilators to treat the patient's pulmonary hypertension worsened his high-output heart failure. This is the first case in which emergency hepatectomy rescued a patient with hepatic arteriovenous malformations who developed pulmonary hypertension.

DOI： 10.1016/j.epsc.2015.10.017

Web of Science

Scopus

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

DOI： 10.1111/ases.12263

PubMed

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

DOI： 10.1089/lap.2015.0109

PubMed

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

DOI： 10.1111/ped.12599

PubMed

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

PubMed

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

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NAGOYA UNIV, SCH MED  

We report a case of accessory scrotum (AS) in the perineal region with peduncular lipoma, diagnosed prenatally. A male fetus of 31 weeks' gestation was referred to our department with a perineal mass. Prenatal ultrasonography and magnetic resonance imaging showed a mass of 1.0 x 1.2 cm located posterior to the scrotum. No other abnormalities were noted during pregnancy. The patient was delivered vaginally at 38 weeks of gestation. On physical examination, a soft peduncular mass with a rugged and pigmented swelling was located between the normally developed scrotum and the anus. There were no specific symptoms or any other associated congenital anomalies. We completely excised the mass at one month of age. A histological examination revealed lipoma, with tissue suggestive of scrotum, so a definite diagnosis of AS was made. AS is a rare congenital anomaly of the scrotum. We review the literature.

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NAGOYA UNIV, SCH MED  

Femoral hernias are relatively rare in children, and more than half of pediatric femoral hernias are misdiagnosed. A 3-year-old boy was treated for an indirect inguinal hernia at the age of 2, but he exhibited an inguinal bulge one month after the operation. He underwent laparoscopy, and a right femoral hernia was detected. The femoral hernia was laparoscopically repaired via two small incisions: a 1.0-cm umbilical incision for a 3-mm 30 degrees laparoscope and 3-mm grasping forceps and a 5-mm right lateral incision for 3-mm grasping forceps. After the hernia sac had been reflected into the abdominal cavity and resected, the iliopubic tract was sutured to Cooper's ligament using a laparoscopic percutaneous extracorporeal closure (LPEC) needle and 2-0 non-absorbable sutures. Laparoscopy enables the accurate diagnosis of rare and often missed pediatric femoral hernias. Our laparoscopic technique for treating femoral hernias is easy and effective. Although these early results are encouraging, more cases involving longer follow-up periods should be accumulated to confirm the efficacy of our technique.

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 10.1016/j.jpedsurg.2015.07.008

PubMed

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

DOI： 10.1111/ped.12529

PubMed

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

DOI： 10.1089/lap.2014.0250

PubMed

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

DOI： 10.1016/j.vaccine.2015.01.075

PubMed

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

DOI： 10.11477/mf.1413205164

CiNii Research

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

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NAGOYA UNIV, SCH MED  

Gastric duplication cyst is a rare anomaly, and most cases are recognized during childhood. Recently, several pediatric cases with small gastric duplication cysts treated by laparoscopic resection have been reported. Here, we describe an infant in whom we successfully performed laparoscopic partial gastrectomy for the treatment of a huge gastric duplication cyst. To the best of our knowledge, this is the largest gastric duplication cyst treated by laparoscopic surgery among infants. We introduce our procedure and some tips.

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 10.4293/JSLS.2014.00238

PubMed

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

DOI： 10.3978/j.issn.2224-4336.2015.02.01

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Surgical Association  

A baby girl delivered at the gestational age of 38 week's was referred to our department because of an intraabdominal cyst diagnosed prenatally. There were no specific symptoms after birth. USG revealed a cyst-like structure with gut signature, and CT showed a cystic mass in the abdomen containing air. A preoperative diagnosis of duplication of the alimentary tract or Meckel's diverticulum was made, and a laparoendoscopic single-site surgery was performed when the baby girl was ten months old. An inverted Y-shaped incision was made at the umbilicus, and laparoscopic exploration revealed a cystic mass sharing a common wall and blood supply with the ileum on the mesenteric side. We exteriorized the duplication cyst with normal ileum from the umbilical incision, and performed resection of the segment of the small bowel including the cystic mass. Histopathology revealed that the ileal duplication cyst was lined with gastric epithelium. The postoperative course was uneventful.

DOI： 10.3919/jjsa.76.529

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

DOI： 10.1155/2015/173014

PubMed

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

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 10.1089/lap.2014.0222

PubMed

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

DOI： 10.1007/s00383-014-3575-x

PubMed

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

DOI： 10.1007/s00383-014-3569-8

PubMed

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

PubMed

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

DOI： 10.1007/s00595-013-0605-6

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：NAGOYA UNIV, SCH MED  

Midgut volvulus is a highly life-threatening condition that carries a high risk of short gut syndrome. We report a case of catastrophic neonatal midgut volvulus in which second-look laparotomy revealed apparently non-viable remnant small intestine but with a moderate blood supply. Full-thickness small intestine necrosis was distributed in a patchy fashion, with non-viable and necrotic areas distributed so widely that no portion of the intestine could be resected. A section of full-thickness necrotic intestine preserved at surgery was able to regenerate, and normal function was restored over a period of 1 month. This case indicated that intestinal resumption may be dependent on blood flow. Even when intestinal viability is questionable, preservation enables the chance of regeneration if moderate blood flow is present.

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：一般社団法人日本外科学会  

CiNii Research

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：The Japanese Society of Pediatric Surgeons  

High-output heart failure in a neonate due to pulmonary sequestration is rare. We report a case of neonatal heart failure relieved with thoracoscopic resection of an intralobar pulmonary sequestration. A male neonate of 39-week gestational age presented with respiratory distress, chest X-ray and echocardiography revealed high-output heart failure. A computed tomography showed a left lower pulmonary sequestration with venous drainage into the azygos system. Preoperative diagnosis is an extralobar pulmonary sequestration, and high-output heart failure is caused by arteriovenous shunt in the pulmonary sequestration. We intervened with thoracoscopic resection on day-of-life 21. Intraoperative diagnosis is an intralobar pulmonary sequestration. Postoperative course was uneventful, and the patient was discharged on postoperative day 20 without any sign of heart failure.

DOI： 10.11164/jjsps.50.5_946

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

DOI： 10.1016/j.jpedsurg.2013.08.010

Web of Science

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

DOI： 10.1089/lap.2013.0127

PubMed

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

DOI： 10.1007/s00383-013-3383-8

PubMed

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

DOI： 10.1007/s00383-013-3373-x

PubMed

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

DOI： 10.1089/lap.2013.0110

PubMed

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

DOI： 10.1007/s00595-012-0426-z

PubMed

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

DOI： 10.1089/lap.2013.0130

PubMed

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

DOI： 10.1111/j.1442-200X.2012.03663.x

Web of Science

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

DOI： doi: 10.1111/j.1442-200X.2012.03663.x.

PubMed

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

DOI： 10.1016/j.jpedsurg.2012.08.028

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Inc.  

Pediatric patients with large extraovarian teratomas with a significant solid component are usually treated using open surgery because the size of the intracorporeal cavity does not facilitate the manipulation of large tumors. Here, we describe the cases of 3 children who underwent minimally invasive surgery for large extraovarian teratomas (diameter &gt
10 cm), including 2 cases of retroperitoneal teratoma and 1 case of a thoracic teratoma. All tumors had a large amount of sebaceous material that displaced other surrounding organs. Tumor volumes were reduced by intraoperative needle aspiration using a SAND balloon catheter with a double balloon that is designed to minimize the risk of spillage. Intraoperative needle aspiration of cystic content can provide sufficient working space and facilitates safe separation of the major vessels from the tumor. Treatment of large extraovarian teratomas by minimally invasive surgery involving skin incisions that result in a less noticeable scar, such as a Pfannenstiel incision or axillary incision, can achieve improved cosmetic outcomes. © 2013 The Authors.

DOI： 10.1016/j.epsc.2013.07.003

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 10.1007/s00383-012-3146-y

PubMed

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

DOI： 10.1007/s00383-011-3008-z

PubMed

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

DOI： 10.1016/j.jpedsurg.2010.09.097

PubMed

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

DOI： 10.1016/j.jpedsurg.2010.08.037

PubMed

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

DOI： 10.1016/j.jpedsurg.2010.03.013

PubMed

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

DOI： 10.1055/s-2008-1038590

PubMed

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

DOI： 10.1016/j.jpedsurg.2008.10.056

PubMed

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

DOI： 10.1007/s00467-008-0839-5

PubMed

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

DOI： 10.1053/j.sempedsurg.2007.06.008

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Japan Association for Medical Informatics  

Information and communication technology has been introduced rapidly into health-care field, and can contribute to system complexity and new human errors. Nielsen has defined 5 facets of usability: learnability, efficiency, memorability, errors and satisfaction. The more the usability progress, the more likely patient safety will be achieved, however, there is the trade-off relationship between safety ensuring and efficiency seeking. Technology needs to be designed and improved to support real workflow and care processes.

DOI： 10.14948/jami.27.29

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

DOI： 10.1016/j.jpedsurg.2005.08.008

PubMed

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

PubMed

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

PubMed

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

PubMed

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

DOI： 10.1007/s00383-003-1097-z

PubMed

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

DOI： 10.1007/s00247-003-1052-0

PubMed

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

DOI： 10.1016/S0966-3274(03)00008-X

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Background: Intestinal grafts greatly affect nutrition and immunology in the host. The growth of the recipient and incidence of graft-versus-host disease depend on graft length. A larger graft may affect the host immune system, but little is known about how the length of the intestinal graft severely affects surgical intervention. We developed a cervical small bowel transplantation (SBT) rat model that minimized technical variations using a cuff method and studied the effects of graft length on surgical damage in SBT. Materials and methods: We transplanted a whole (70 cm) or partial (15 cm) intestine into a syngeneic rat combination of LEW (MHC haplotype: RT1(1)) to LEW and evaluated changes in perioperative hemodynamics and the endogenous endotoxin level. Natural killer (NK) cell activity in the peripheral blood and the immunologic response of the recipient spleen were also studied. Results: In the whole SBT model, body weight loss was more severe than in the segmental SBT model; the rats in the former model often died, while all in the latter survived indefinitely. The systemic blood pressure markedly decreased in the whole SBT group immediately after reperfusion. The proliferative activity of splenic lymphocytes stimulated by concanavalin A was also more severely inhibited in the former model than in the latter postoperatively. NK cell activity in the whole SBT rats declined more severely than the segmental SBT rats 3 days postoperatively. Conclusion: The longer graft severely induced surgical intervention; and influenced host immunosuppression, resulting in the higher mortality in rats undergoing whole SBT. (C) 2003 Elsevier Science B.V. All rights reserved.

Web of Science

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

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0041-1345(02)03794-6

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

PubMed

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

Web of Science

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

DOI： 10.1002/micr.21731

PubMed

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

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 10.1053/jpsu.2001.28843

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：W B SAUNDERS CO  

Background/Purpose: University of Wisconsin (UW) solution is one of the most superior organ preservation solutions for liver, kidney, and pancreas; however, it still is controversial for intestinal preservation. Here, the authors studied the efficacy of preservation with 2 kinds of solutions, UW and modified TOM (m-TOM) solutions in our experimental newborn intestinal transplantation model. UW solution was used as a standard intracellular and m-TOM solution as an extracellular preservation solution. Lactated ringer (LR) solution was used as a control.
Methods. Newborn intestine, which were preserved in these solutions for 24 or 48 hours, were transplanted in the subcutaneous spaces of the syngeneic recipients without surgical vascular anastomosis and histologically examined 14 days after grafting. The preserved grafts were evaluated histologically by use of light and electron microscopy just after preservation. The biochemical parameters such as LDH and serotonin also were measured in the supernatants of preservation solutions.
Results: Fresh newborn grafts were revascularized successfully at a rate of 80% (16 of 20). After 24 hours of preservation, 65% (13 of 20), 75% (15 of 20), and 85% (17 of 20) of the grafts were observed to be revascularized in LR, m-TOM, and UW solutions, respectively. After 48 hours of preservation, 60% (12 of 20), 80% (16 of 20), and 80% (16 of 20) of the grafts also were revascularized in the respective solutions (no statistic difference among the groups). The cold-preservation did not affect the neovascularization of newborn intestine until 48 hours. Histologic findings of the preserved intestine and biochemical analyses showed that UW and m-TOM solutions kept villous architectures of the preserved grafts, however, might be harmful to enterochromaffin cells.
Conclusion: Long-time preservation of newborn intestine did not interfere with neovascularization and maturation. Copyright (C) 2001 by W.B. Saunders Company.

Web of Science

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

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE BV  

Pancreas grafts do not survive for lengthy periods, especially in a high-responder rat combination. Recent data indicated that a combined spleen/pancreas graft protects against acute graft rejection and induces donor-specific tolerance. In this study, we performed a combination spleen/pancreas transplantation using high-dose tacrolimus in a high-responder rat combination of DA (RTla) to LEW(RT1(l)) and induced permanent survival in the few recipient rats. In these recipients, there was no difference in the mixed lymphocyte reaction (MLR) of the recipients when compared with that of the naive LEW splenic cells, but MLR inhibition by the serum from the recipients was significantly decreased. We also performed immunoblotting and detected a protein that has an affinity for the anti-DA class antibody. This protein may be an anti-idiotypic antibody and contribute to donor- and tissue-specific tolerance. (C) 2001 Elsevier Science BN. All rights reserved.

DOI： 10.1016/S0966-3274(01)00049-1

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 10.1006/bbrc.2001.5452

PubMed

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

DOI： 10.1053/jpsu.2001.22295

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：W B SAUNDERS CO  

Background: If long-term organ cryopreservation can be attained, a significant achievement will have been made to address the problem for donor shortage. Fetal intestine has been known to revascularize naturally without vascular anastmosis. The authors have confirmed previously that the newborn intestine also could develop to maturity in the host omentum. Here, the authors examined whether the cryopreserved newborn intestine could revascularize in the syngeneic combination using the 2 different solutions and whether cryopreservation affect their antigenicity in the allogeneic combination.
Methods: Inbred rat strains of LEW (MHC haplotype; RT1(1)) and BN (RT1(n)) were used. LEW newborn intestinal grafts were stored in RPMI-1640 or University of Wisconsin solution with 10% DEMSO (n = 10 in each group). The grafts were placed into a cold (4 degreesC) preservation solution for 30 minutes and then placed into a freezing chamber and cooled to -80 degreesC at -1 degreesC/min after 12 hours quenched to -180 degreesC in liquid nitrogen for longer than 30 days. Then, the cryopreserved grafts under the 2 different solutions were transplanted syngenicaly (LEW to LEW). The cryopreserved BN grafts also were implanted into the LEW omentum pouch. The allotransplantation was received with a 14-day high-dose course of tacrolimus (0.64 mg/kg, intramuscularly). The grafts were evaluated histologically at 4 weeks after transplantation. Fresh newborn intestines implanted in this syngeneic and allogeneic combination were evaluated as each control group.
Result: In the syngeneic combination, more than 90% of the mature intestine were obtained. There was no significant difference among the different solution and the fresh group. However, in the allogeneic combination, both fresh and cryo preserved grafts were histologically poor.
Conclusions: This is the first report showing that long-term cryopreservation was not harmful for neovascularization of newborn intestine. Long-term cryopreservation did not reduce the antigenicity of the newborn intestine.

Web of Science

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

PubMed

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

PubMed

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

PubMed

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

PubMed

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

PubMed

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

Web of Science

Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-LISS  

Segmental small intestine transplantation (SIT) in rats, using a cuff technique, has achieved a high success rate. However, there have been few reports on the influence of the foreign body reaction to polyethylene cuff on vessel anastomoses and graft after SIT. This study involves the histopathological examination of the site of cuff anastomosis and grafts in the short- and long-term survival of segmental SIT. The data obtained from the suture anastomosis model also served as a control. One week after heterotopic segmental SIT using the cuff technique, orthotopic continuations were carried out in syngeneic combination. Twenty-five of 30 rats surviving &gt;200 days (83.3%) were examined for vessel anastomosis. All arterial anastomoses were patent, but the portovenous anastomoses in 10 grafts (33%) were totally occluded and were associated with the formation of collateral vessels. Histopathological examination demonstrated good patency of the artery and vein anastomotic site in the short term, but granulation, fibrosis, and neovascularization at the anastomosis site surrounding the cuffs in the long-surviving group. However, the grafts appeared to be intact, with normal features of the villi. On the contrary, the site of the sutured anastomosis in the long-survival rats showed no inflammatory reaction. Although a polyethylene cuff caused foreign body reaction, the graft blood supplies were maintained by collateral vessels. Considering the low mortality and high success rate, polyethylene cuff is good for short-term study and an alternative method for long-term SIT experiments. (C) 2001 Wiley-Liss, Inc.

Web of Science

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

Web of Science

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

PubMed

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

Hepatic lymphomyeloid cells (HLCs) are thought to contain liver stem cells. We investigated whether HLCs generated enzyme-producing cells in vivo. HLCs from normal Wistar/Shi rats and rats in which liver ischemia was induced using a portal clamp 4 days previously were studed histopathologically and characterized using flow cytometry. Splenic lymphocytes obtained from these animals were compared as a control. The proliferative activity of HLCs and splenic cells from both groups was also tested by stimulation with concanavalin A. HLCs contained a significantly higher number of NK-T cells and OV6+ cells compared with the splenic cells. The HLCs from rats in which liver ischemia was induced tended to have greater proliferative activity than those from normal rats, while the proliferative activity of splenic lymphocytes was impaired by liver ischemia. The HLCs obtained from Wistar/Shi rats with liver ischemia were then injected into hereditary hyperbilirubinemic Gunn rats to determine whether the HLCs generated enzyme-producing cells. After injection of these stimulated HLCs, the titer of serum bilirubin in the recipient rats was markedly reduced over a long time course (6.80 +/- 0.93 to 4.87 +/- 0.22 mg/dl after 1 month and 3.52 +/- 1.33 mg/dl after 6 months). The results of the present study indicate that HLCs have different populations than splenic cells, and ischemia-reperfusion of the liver increased their proliferative activity. HLC transplantation successfully reduced high bilirubin levels over a long time course. Copyright (C) 2000 S. Karger AG, Basel.

DOI： 10.1159/000008768

Web of Science

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

PubMed

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

Web of Science

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

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0041-1345(99)00948-3

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

DOI： 8768

PubMed

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

PubMed

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

DOI： 10.1016/S0041-1345(99)00838-6

Web of Science

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

PubMed

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

PubMed

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

PubMed

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

PubMed

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

PubMed

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

Web of Science

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

Web of Science

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

Web of Science

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

Web of Science

Language：English   Publishing type：Research paper (scientific journal)   Publisher：Wiley-Blackwell  

DOI： 10.1111/j.1432-2277.1999.tb00616.x

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

PubMed

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

Web of Science

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

PubMed

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

Web of Science

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

PubMed

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

Web of Science

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Background Deoxyspergualin (DSG), a potent immunosuppressive drug, has been clinically used as a rescue therapy for acute graft rejection. However, DSG has severe adverse effects that limits its use. Here, we examined the optimized therapeutic protocol for DSG using chronopharmacological profiles of it.
Methods. First, a dosing time-dependent difference in the toxicity and efficacy of DSG was determined using a heterotopic heart transplantation model. Second, chronokinetics of DSG were examined to reveal the mechanism for dosing time-dependent differences in the effect.
Results. In rats treated with DSG at the active period, bone marrow suppression and damage of small intestine were significantly severe. However, no significant difference was found in cardiac allograft survival and pharmacokinetics according to the timing of drug administration.
Conclusions. The toxicity of DSG varied with the dosing time, whereas its efficacy did not. The chronopharmacological approach may provide merits for immunosuppressive therapy with DSG in clinical organ transplantation.

DOI： 10.1097/00007890-199905150-00012

Web of Science

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

PubMed

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

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

Scopus

Other Link： http://orcid.org/0000-0002-1818-6697

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

Web of Science

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：JAPANESE SOC TRANSPLANTATION  

Web of Science

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

PubMed

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

PubMed

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

PubMed

Language：Japanese  

CiNii Books

Other Link： http://search.jamas.or.jp/link/ui/2008166216

Language：Japanese   Publisher：東京医学社  

CiNii Books

Other Link： http://search.jamas.or.jp/link/ui/2004284253

Language：Japanese   Publisher：診断と治療社  

CiNii Books

Other Link： http://search.jamas.or.jp/link/ui/2004282375

Language：Japanese   Publisher：(一社)日本移植学会  

Language：Japanese   Publisher：(一社)日本移植学会  

Language：English  

CiNii Books

Language：Japanese  

CiNii Books

Language：Japanese  

CiNii Books

Language：English   Publisher：(一社)日本移植学会  

(実験1),胸腺摘除(Tx)や脾臓摘出(Spx)をレシピエントに施した上にデオキシスパーガリン(DSG)を短期間加えアロ新生仔小腸移片の生着率を検討した.レシピエントを4群に分け(Group 1:コントロール,Group 2:DSG単独,Group 3:DSG+Spx,Group 4:DSG+Spx+Tx,グラフトの生着率を検討した.(実験2).新生仔全小腸を含む免疫組織(腸間膜リンパ節(Group 7)及び脾臓(Group 8))を移植し,レシピエントのGVH反応を症状にて判定した.(実験3)成熟グラフトのアロ拒絶反応及びGVH反応を実験1及び2と比較するため,同様のラットの組み合わせにおいて成熟小腸グラフトを頸部に移植するモデルを用いて検討した.本ラット系における新生仔小腸移植は,拒絶反応及びGVH反応の両免疫反応とも移植に有利であった

Date applied：2016.12

Announcement no：2018-105674  Date announced：2018.7

Country of applicant：Domestic   Country of acquisition：Domestic

Date applied：2016.10

Announcement no：WO 2017/061616  Date announced：2017.4

Country of applicant：Foreign country   Country of acquisition：Foreign country

Date applied：2016.9

Announcement no：WO 2018/061201  Date announced：2018.4

Country of applicant：Foreign country   Country of acquisition：Foreign country