研究者詳細 - 内田　広夫

Postoperative intestinal obstruction in patients with biliary atresia impedes biliary excretion and results in subsequent liver transplantation (vol 37, pg 229, 2021) 査読有り

Takimoto Aitaro, Sumida Wataru, Amano Hizuru, Shirota Chiyoe, Tainaka Takahisa, Yokota Kazuki, Makita Satoshi, Yasui Akihiro, Kanou Yoko, Hinoki Akinari, Uchida Hiroo

PEDIATRIC SURGERY INTERNATIONAL 37 巻 ( 6 ) 頁： 835 - 835 2021年6月

NOVEL BIOMARKER DISCOVERY FOR CHILDHOOD RHABDOMYOSARCOMA USING URINARY METABOLITES 査読有り

Amano Hizuru, Hinoki Akinari, Uchida Hiroo, Yokota Kazuki, Ishigaki Takashi, Sakairi Minoru, Abe Mayumi, Terui Yasushi, Oda Hirohisa, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Makita Satoshi, Takimoto Aitaro, Kano Yoko, Okamoto Masamune, Yasui Akihiro, Nakagawa Yoichi

PEDIATRIC BLOOD & CANCER 68 巻頁： S46 - S46 2021年6月

胆道閉鎖症におけるオキシステロール及び胆汁酸分析の有用性 a pilot study 査読有り

小西健一郎, 水落建輝, 橋詰直樹, 八木実, 松浦俊治, 田口智章, 眞田幸弘, 田井中貴久, 内田広夫, 佐々木英之, 仁尾正記, 藤代準, 武井一, 入戸野博, 木村昭彦

日本小児外科学会雑誌 57 巻 ( 4 ) 頁： 786 - 787 2021年6月

Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation 査読有り

Shirota Chiyoe, Kawashima Hiroki, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Amano Hizuru, Takimoto Aitaro, Hinoki Akinari, Uchida Hiroo

SCIENTIFIC REPORTS 11 巻 ( 1 ) 頁： 11052 2021年5月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：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

特集シミュレーションとナビゲーション精索静脈瘤査読有り

田井中貴久, 田中裕次郎, 檜顕成, 城田千代栄, 住田亙, 横田一樹, 牧田智, 内田広夫

小児外科 53 巻 ( 5 ) 頁： 560 - 563 2021年5月

Urinary biomarkers for monitoring treatment response in neuroblastoma patients. 査読有り

Amano, H; Hinoki, A; Uchida, H; Yokota, K; Ishigaki, T; Sakairi, M; Abe, M; Takahashi, Y; Narita, A; Tainaka, T; Shirota, C; Sumida, W; Makita, S; Takimoto, A; Kano, Y; Yasui, A; Okamoto, M; Nakagawa, Y

JOURNAL OF CLINICAL ONCOLOGY 39 巻 ( 15 ) 2021年5月

手術経験数による腹腔鏡下胆道閉鎖症手術成績の検討査読有り

藏野結衣, 城田千代栄, 檜顕成, 田井中貴久, 住田亙, 横田一樹, 牧田智, 滝本愛太朗, 内田広夫

日本小児外科学会雑誌 57 巻 ( 3 ) 頁： 596 - 599 2021年4月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：特定非営利活動法人日本小児外科学会

【目的】腹腔鏡下胆道閉鎖症手術（腹腔鏡下肝門部空腸吻合術）の執刀を熟練した術者に限定する必要性の有無を明らかにすることを目的として，自施設での治療成績を後方視的に検討した．【方法】2014年4月から2018年8月の期間中，胆道閉鎖症に対して当院で腹腔鏡下肝門部空腸吻合術を施行した35例を対象とした．腹腔鏡下肝門部空腸吻合術を5例以上経験した術者が執刀した患者（A群：12例）と執刀経験4例以下の術者が執刀した患者（B群：23例）とに分類し，手術，術後経過と術後6か月，1年，2年の各時点における無黄疸自己肝生存についてそれぞれ統計学的解析を行い比較，検討した．【結果】A群とB群で手術日齢，体重，出血量，ドレーン抜去時期，経口開始時期に有意差は認められなかったが，手術時間はA群が有意に短かった（p＝0.0049）．無黄疸自己肝生存率は術後6か月（A群58.3％，B群60.9％，p＝0.506），術後1年（A群66.7％，B群65.2％，p＝0.932），術後2年（A群58.3％，B群56.5％，p＝0.918）でいずれの時点でも有意差は認められなかった．【結論】今回の検討では，腹腔鏡下胆道閉鎖症手術に熟練した術者の指導の下では，執刀経験量による減黄率の有意な差は認められなかった．

DOI： 10.11164/jjsps.57.3_596

CiNii Research

A Japanese prospective multicenter study of urinary oxysterols in biliary atresia 査読有り

Konishi Ken-ichiro, Mizuochi Tatsuki, Takei Hajime, Yasuda Ryosuke, Sakaguchi Hirotaka, Ishihara Jun, Takaki Yugo, Kinoshita Masahiro, Hashizume Naoki, Fukahori Suguru, Shoji Hiromichi, Miyano Go, Yoshimaru Koichiro, Matsuura Toshiharu, Sanada Yukihiro, Tainaka Takahisa, Uchida Hiroo, Kubo Yumiko, Tanaka Hiromu, Sasaki Hideyuki, Murai Tsuyoshi, Fujishiro Jun, Yamashita Yushiro, Nio Masaki, Nittono Hiroshi, Kimura Akihiko

SCIENTIFIC REPORTS 11 巻 ( 1 ) 頁： 4986 2021年3月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Identification of novel neuroblastoma biomarkers in urine samples 査読有り

Yokota Kazuki, Uchida Hiroo, Sakairi Minoru, Abe Mayumi, Tanaka Yujiro, Tainaka Takahisa, Shirota Chiyoe, Sumida Wataru, Oshima Kazuo, Makita Satoshi, Amano Hizuru, Hinoki Akinari

SCIENTIFIC REPORTS 11 巻 ( 1 ) 頁： 4055 2021年2月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：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

Risk factors and outcomes of bile leak after laparoscopic surgery for congenital biliary dilatation 査読有り国際誌

Tanaka Yujiro, Tainaka Takahisa, Hinoki Akinari, Shirota Chiyoe, Sumida Wataru, Yokota Kazuki, Oshima Kazuo, Makita Satoshi, Amano Hizuru, Takimoto Aitaro, Kano Yoko, Uchida Hiroo

PEDIATRIC SURGERY INTERNATIONAL 37 巻 ( 2 ) 頁： 235 - 240 2021年2月

Thoracoscopic surgery for congenital lung cysts: an attempt to limit pulmonary resection in cases of lesions involving multiple lobes 査読有り国際誌

Shirota Chiyoe, Tainaka Takahisa, Sumida Wataru, Yokota Kazuki, Makita Satoshi, Takimoto Aitaro, Amano Hizuru, Hinoki Akinari, Ono Yasuyuki, Uchida Hiroo

PEDIATRIC SURGERY INTERNATIONAL 37 巻 ( 2 ) 頁： 213 - 221 2021年2月

Usefulness of web search queries for early detection of diseases in infants 査読有り

Yamaguchi Shuji, Hinoki Akinari, Tsubouchi Kota, Amandu Hizuru, Tajima Akira, Uchida Hiroo

NAGOYA JOURNAL OF MEDICAL SCIENCE 83 巻 ( 1 ) 頁： 107 - 111 2021年2月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：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

腹壁破裂を合併した結腸閉鎖症に対して，器械吻合による一期的結腸吻合後sutureless腹壁閉鎖を施行した1例査読有り

千馬耕亮, 田中裕次郎, 城田千代栄, 田井中貴久, 住田亙, 横田一樹, 大島一夫, 牧田智, 内田広夫

日本小児外科学会雑誌 57 巻 ( 1 ) 頁： 22 - 26 2021年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：特定非営利活動法人日本小児外科学会

症例は36週4日，2,370 gで出生した腹壁破裂の女児．出生後，脱出した腸管を確認すると結腸閉鎖を合併していた．その口側盲端にはpinholeがあいていたが腹腔内の汚染はなく，一旦サイロ造設し翌日結腸閉鎖に対する手術を施行した．腸管を洗浄しながら癒着剥離を行い結腸閉鎖部の口側・肛門側を確認し，血流の十分ある部分で自動縫合器による機能的端々吻合を行った．腸管は浮腫が強く腹腔内に還納できなかったため，再度サイロを造設して手術を終了した．その後1週間かけて腸管を腹腔内に還納し，第9生日にsutureless法で腹壁閉鎖を行った．術後経過は良好で，第19生日にfull feedingとなり，第32生日に退院した．結腸閉鎖合併腹壁破裂症例では人工肛門造設が一般的であるが，自動縫合器を用いることで口径差を気にせず吻合を行うことができるため，有効な方法と考えられた．

DOI： 10.11164/jjsps.57.1_22

胆管穿孔をきたした先天性胆道拡張症に対して，腹腔鏡下に一期的根治術を施行した1例査読有り

石井宏樹, 牧田智, 安井昭洋, 滝本愛太朗, 横田一樹, 住田亙, 田井中貴久, 城田千代栄, 内田広夫

日本小児外科学会雑誌 57 巻 ( 5 ) 頁： 855 - 859 2021年

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：特定非営利活動法人日本小児外科学会

症例は1歳9か月女児，嘔吐と発熱を主訴に前医受診，先天性胆道拡張症の診断で入院となった．入院6日目に胆道穿孔が明らかになり当科に転院し，緊急手術を行った．手術では総胆管と胆囊管合流部に約2 cm大の穿孔部を認めた．胆道ドレナージや穿孔部の修復は極めて困難であり，腹腔鏡下に一期的根治術を施行した．また，肝門部の左右胆管に強い膜様狭窄を認め胆管形成も施行した．合併症なく経過し，術後10日目に軽快退院となった．胆道穿孔をきたした先天性胆道拡張症に対する治療は二期的手術が推奨されている．一方，近年は一期的根治術が有用であるという報告が散見されるが，ほとんどは開腹手術である．今回，我々は腹腔鏡下に一期的根治術を施行した1例を経験した．胆道穿孔症例でも，腹腔鏡下胆道拡張症手術に習熟した施設において，全身状態が良好な症例であれば腹腔鏡下での一期的手術は有用であると考える．

DOI： 10.11164/jjsps.57.5_855

Intestinal region reconstruction of ileus cases from 3D CT images based on graphical representation and its visualization 査読有り

Oda, H; Hayashi, Y; Kitasaka, T; Tamada, Y; Takimoto, A; Hinoki, A; Uchida, H; Suzuki, K; Itoh, H; Oda, M; Mori, K

MEDICAL IMAGING 2021: COMPUTER-AIDED DIAGNOSIS 11597 巻 2021年

記述言語：英語掲載種別：研究論文（国際会議プロシーディングス）出版者・発行元：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