Faculty Profiles - UCHIDA Hiroo

Papers - UCHIDA Hiroo

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Relationship between Contact Pressure and Motion Artifacts in ECG Measurement with Electrostatic Flocked Electrodes Fabricated on Textile. Reviewed International journal

Toshihiro Takeshita, Manabu Yoshida, Yusuke Takei, Atsushi Ouchi, Akinari Hinoki, Hiroo Uchida, Takeshi Kobayashi

Scientific reports Vol. 9 ( 1 ) page： 5897 - 5897 2019.4

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

To develop a wearable multi-lead electrocardiogram (ECG) measuring system, we fabricated the electrodes and wires by using electrostatic flocking technology on a textile. By using this technology, it was possible to fabricate many electrodes and wires, simultaneously. Also the flocked electrodes and wires had stretchability and washing resistance properties. To use dry electrodes, it is important to reduce the influence of motion artifacts (MAs). The results of the experiment with the skin phantom revealed that the contact pressure between the skin and the electrode is an important factor in MA reduction. Then, we conducted experiments with a human body to determine the relationship between the contact pressure and the MAs. Under the pressures of 200 Pa and 500 Pa, MAs were observed. Meanwhile, under the pressures of 1000 Pa, 2000Pa and 4000 Pa, the ECG signals under rest and deep breathing conditions were able to be measured without MAs. Considering the comfortability, the contact pressure from 1000 Pa to 2000 is preferable. Finally, we fabricated the wearable ECG measuring system and succeeded in measuring 18-lead ECG signals. The measured ECG waveform is in good agreement with the ECG waveform measured by a commercial system.

DOI： 10.1038/s41598-019-42027-x

Web of Science

PubMed

静電植毛技術を用いた心電図測定用立体ドライ電極の作製と応用 Reviewed

竹下俊弘, 吉田学, 竹井裕介, 大内篤, 檜顕成, 内田広夫, 小林健

エレクトロニクス実装学術講演大会講演論文集 Vol. 33 ( 0 ) page： 13A2-01 2019

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

内視鏡外科手術における熟練医の追体験トレーニングシステムとその評価 Reviewed

安藤英由樹, 坂井義治, 小濱和貴, 内田広夫, 出家亨一, 松田公志, 吉田健志, 早石直広

生体医工学 Vol. 57 ( 0 ) page： S198_1 - S198_1 2019

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

Spaciousness Filters for Non-contrast CT Volume Segmentation of the Intestine Region for Emergency Ileus Diagnosis

Hirohisa Oda, Kohei Nishio, Takayuki Kitasaka, Benjamin Villard, Hizuru Amano, Kosuke Chiba, Akinari Hinoki, Hiroo Uchida, Kojiro Suzuki, Hayato Itoh, Masahiro Oda, Kensaku Mori

MICCAI 2019 Vol. 11840 page： 104 - 114 2019

Nuss procedure for patients with pectus excavatum with a history of intrathoracic surgery.

Takanari K, Toriyama K, Kambe M, Nakamura Y, Uchibori T, Ebisawa K, Shirota C, Tainaka T, Uchida H, Kamei Y

Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2018.12

Air test as a simple method of screening for Hirschsprung's disease Reviewed

Sumida W, Uchida H, Ono Y, Tanaka Y, Tainaka T, Shirota C, Yokota K, Oshima K, Chiba K

Clin Radiol Vol. 73 ( 12 ) page： 1041 - 1045 2018.12

Indications for total esophagogastric dissociation in children with gastroesophageal reflux disease Reviewed

Yujiro Tanaka, Takahisa Tainaka, Hiroo Uchida

Surgery Today Vol. 48 ( 11 ) page： 971 - 977 2018.11

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

Total esophagogastric dissociation (TED) is used to treat gastroesophageal reflux (GER) after failed fundoplication in neurologically impaired patients. It is now performed for some otherwise healthy patients with severe GER. In this procedure, the gastrointestinal tract is reconstructed in a non-physiological way with a Roux-en-Y esophagojejunal anastomosis and jejuno-jejunostomy. Although TED eliminates almost all GER, some patients experience late complications. In this review, we investigated the long-term outcomes after TED to determine the best indications. In total, 147 neurologically impaired patients and 28 neurologically normal patients were identified. The total rate of complications requiring re-operation was 17.2% in neurologically impaired patients and 32.1% in normal patients, both higher than the rates associated with fundoplication. Although most authors added pyloroplasty when there was a concern of gastric emptying, this sometimes caused bile reflux. Nutritional and metabolic complications, including dumping syndrome and chronic digestive malabsorption, were also reported to occur after TED. TED is an option for the treatment of neurologically impaired patients with recurrent GER after fundoplication or who are at a high risk of recurrence of GER with fundoplication. However, neurologically normal patients who have the ability to obtain nutrition orally should consider options other than TED, as postoperative complications are frequent.

DOI： 10.1007/s00595-018-1636-9

Web of Science

Scopus

PubMed

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

A new laparoscopic triangle fixation technique for gastrostomy: a safe and effective procedure for reduction of the wound infection rate. Reviewed

Michimasa Fujiogi, Yujiro Tanaka, Hizuru Amano, Kyoichi Deie, Keisuke Suzuki, Hiroshi Kawashima, Naruhiko Murase, Hiroo Uchida

Nagoya journal of medical science Vol. 80 ( 4 ) page： 497 - 503 2018.11

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

Gastrostomy is often performed with fundoplication in handicapped children. We devised a new laparoscopic triangle fixation technique for gastrostomy. In this study, 100 patients underwent gastrostomy with fundoplication between January 2008 and January 2016. We retrospectively reviewed the early postoperative results between the new laparoscopic procedure (NLP) group (n = 63) and conventional procedure (CP) group (n = 37). In the CP, the gastrostomy tube was inserted with a purse-string ligature at the gastric wall, and the gastric wall was sutured to the peritoneum under a small laparotomy. In NLP, three sutures were placed on the gastric wall, forming the three sides of a triangle, and the tube was inserted into the center of the triangle. The ends of each suture were pulled directly through the abdominal wall using a laparoscopic percutaneous extraperitoneal closure needle to join the gastric wall and peritoneum. Both groups showed no significant differences in age, body weight, and external leakage rate. The wound infection rate was significantly lower in the NLP group. In conclusions, the NLP is straightforward and can achieve firm fixation between the stomach and abdominal wall by suturing in the form of a triangle. The NLP was associated with a lower complication rate, especially concerning infection.

DOI： 10.18999/nagjms.80.4.497

Web of Science

Scopus

PubMed

Laparoscopically Assisted Anorectoplasty for Intermediate-Type Imperforate Anus: Comparison of Surgical Outcomes with the Sacroperineal Approach

Ishimaru Tetsuya, Kawashima Hiroshi, Tainaka Takahisa, Suzuki Keisuke, Takami Shohei, Kakihara Tomo, Katoh Reiko, Aoyama Tomohiro, Uchida Hiroo, Iwanaka Tadashi

JOURNAL OF LAPAROENDOSCOPIC & ADVANCED SURGICAL TECHNIQUES 2018.10

Oral administration of eicosapentaenoic acid suppresses liver fibrosis in postoperative patients with biliary atresia

Sumida Wataru, Uchida Hiroo, Tainaka Takahisa, Shirota Chiyoe, Hinoki Akinari, Kato Takazumi, Yokota Kazuki, Oshima Kazuo, Shirotuki Ryo, Chiba Kosuke, Tanaka Yujiro

PEDIATRIC SURGERY INTERNATIONAL Vol. 34 ( 10 ) page： 1059-1063 2018.10

Long-term outcomes and complications after laparoscopic-assisted anorectoplasty vs. posterior sagittal anorectoplasty for high- and intermediate-type anorectal malformation. Reviewed International journal

Takahisa Tainaka, Hiroo Uchida, Yujiro Tanaka, Akinari Hinoki, Chiyoe Shirota, Wataru Sumida, Kazuki Yokota, Satoshi Makita, Kazuo Oshima, Kosuke Chiba, Tetsuya Ishimaru, Hiroshi Kawashima

Pediatric surgery international Vol. 34 ( 10 ) page： 1111 - 1115 2018.10

Language：English 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

Investigation of the feasibility and safety of single-stage anorectoplasty in neonates with anovestibular fistula. Reviewed International journal

Chiyoe Shirota, Keisuke Suzuki, Hiroo Uchida, Hiroshi Kawashima, Akinari Hinoki, Takahisa Tainaka, Wataru Sumida, Naruhiko Murase, Kazuo Oshima, Kosuke Chiba, Satoshi Makita, Yujiro Tanaka

Pediatric surgery international Vol. 34 ( 10 ) page： 1117 - 1120 2018.10

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

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PubMed

Introduction of resection of intrahepatic bile duct stenosis-causing membrane or septum into laparoscopic choledochal cyst excision. Reviewed International journal

Yujiro Tanaka, Takahisa Tainaka, Wataru Sumida, Akinari Hinoki, Chiyoe Shirota, Naruhiko Murase, Kazuo Oshima, Ryo Shirotsuki, Kosuke Chiba, Hiroo Uchida

Pediatric surgery international Vol. 34 ( 10 ) page： 1087 - 1092 2018.10

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

PURPOSE: We previously showed that meticulous probing and resection of the intrahepatic bile duct stenosis (IHBDS)-causing membrane or septum was effective in preventing hepatolithiasis after choledochal cyst excisions in open surgeries. Then, we introduced this maneuver into laparoscopic choledochal cyst excisions in 2014 and performed routine resections since then. The aim of this study was to show the feasibility of this method in laparoscopic surgery. METHODS: We retrospectively reviewed the demographics and outcomes of patients who underwent laparoscopic choledochal cyst excisions at our hospital between January 2014 and December 2017. The patients who underwent surgical treatment for IHBDS-causing membrane or septum were compared with those who did not undergo the procedure. The outcomes of the patients with IHBDS were also compared between patients who were ≥ 3 years of age and those < 3 years at operation. RESULTS: Seventeen of 35 patients underwent laparoscopic resection of IHBDS-causing membrane or septum. There were no complications related to the procedure although the operative time and intraoperative bleeding amount increased in the patients with IHBDS who were ≥ 3 years of age. CONCLUSIONS: Meticulous probing and excision of the IHBDS-causing membrane or septum is safe and feasible during laparoscopic choledochal cyst excision.

DOI： 10.1007/s00383-018-4320-7

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PubMed

The impact of body weight on stapled anastomosis in pediatric patients. Reviewed International journal

Hizuru Amano, Yujiro Tanaka, Takahisa Tainaka, Akinari Hinoki, Hiroshi Kawashima, Tomo Kakihara, Kaori Morita, Hiroo Uchida

Journal of pediatric surgery Vol. 53 ( 10 ) page： 2036 - 2040 2018.10

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

PURPOSE: The purpose of this study is to clarify the impact of body weight on outcomes of stapled anastomosis in pediatric patients. METHODS: A total of 253 pediatric patients who underwent intestinal anastomosis were classified according to body weight (<3.5 kg: light group, ≥3.5 kg: heavy group), and clinical outcomes of stapled and hand-sewn anastomoses were compared. RESULTS: The light and heavy groups included 77 (stapled: n = 13, hand-sewn: n = 64) and 176 (stapled: n = 58, hand-sewn: n = 118) patients, respectively. In both groups, stapled anastomosis was associated with reduced time to initial oral feeding (light group: 4 vs. 7 days, p = 0.006; heavy group: 3 vs. 5 days, p < 0.001) and full feeding (light group: 12 vs. 16 days, p = 0.026; heavy group: 7 vs. 9 days, p = 0.001), whereas its complication rate was not significantly different from that of hand-sewn anastomosis (light group: 30.8 vs. 12.5%, p = 0.112; heavy group: 3.4 vs. 2.5%, p = 0.665). In patients who underwent stapled anastomosis, the complication rate was significantly higher in the light group (30.8 vs. 3.4%, p = 0.009), with two cases of volvulus related to anastomotic dilatation. CONCLUSIONS: Stapled anastomosis is an effective procedure facilitating prompt oral feeding. However, the risk of complications, including volvulus related to anastomotic dilatation, should be considered among patients weighing <3.5 kg. LEVEL OF EVIDENCE: III.

DOI： 10.1016/j.jpedsurg.2018.04.030

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PubMed

Single-stage laparoscopic transanal pull-through modified Swenson procedure without leaving a muscular cuff for short- and long-type Hirschsprung disease: a comparative study. Reviewed International journal

Kazuki Yokota, Hiroo Uchida, Takahisa Tainaka, Yujiro Tanaka, Chiyoe Shirota, Akinari Hinoki, Takazumi Kato, Wataru Sumida, Kazuo Oshima, Kosuke Chiba, Tetsuya Ishimaru, Hiroshi Kawashima

Pediatric surgery international Vol. 34 ( 10 ) page： 1105 - 1110 2018.10

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

PURPOSE: The Soave procedure (SO) is performed most commonly for Hirschsprung disease. SO reduces the risk of injury to the pelvic structures; however, a residual aganglionic muscle cuff could interfere with bowel movement and lead to obstructive enterocolitis. The Swenson procedure is considered ideal in terms of peristalsis. Currently, laparoscopic surgery provides better visualization and facilitates precise dissection, possibly leading to feasible performance of the laparoscopic modified Swenson procedure (SW). We present our operative technique and the efficacy of the SW compared with that of SO. METHODS: We retrospectively reviewed the records of 16 and 27 patients who underwent SW and SO, respectively, between 2012 and 2017. RESULTS: Operative time, blood loss, length of stay, and frequency of bowel movements showed no significant difference between the two groups. In the SW group, temporary dysuria occurred in one patient, postoperative enterocolitis in two, wound infection in one, and severe perianal excoriation in four, whereas in the SO group, obstructive symptoms occurred in three patients, small-bowel obstruction in one, and severe perianal excoriation in three. The complications and outcomes were comparable between both groups. CONCLUSION: Laparoscopic SW was safe and feasible for the short-term follow-up outcomes.

DOI： 10.1007/s00383-018-4318-1

Web of Science

PubMed

BESNet: Boundary-enhanced Segmentation of Cells in Histopathological Images

Hirohisa Oda, Holger Roth, Kosuke Chiba, Jure Sokolic, Takayuki Kitasaka, Masahiro Oda, Akinari Hinoki, Hiroo Uchida, Julia A Schnabel, Kensaku Mori

MICCAI 2018, LNCS 11071 page： 228-236 2018.9

Automated ganglion cell detection using fully convolutional networks and evaluation under different training losses

Hirohisa Oda, Kosuke Chiba, Holger R. Roth, Takayuki Kitasaka, Masahiro Oda, Akinari Hinoki, Hiroo Uchida, Kensaku Mori

International Journal of Computer Assisted Radiology and Surgery Vol. 13 ( 1 ) page： s104-106 2018.6

Development of multi-lead ECG measurement wear using electrostatic flocking technology Reviewed

T. Takeshita, M. Yosihda, A. Ouchi, A. Hinoki, H. Uchida, T. Kobayashi

2018 International Conference on Electronics Packaging and iMAPS All Asia Conference, ICEP-IAAC 2018 page： 145 - 146 2018.6

Language：English Publishing type：Research paper (international conference proceedings) Publisher：Institute of Electrical and Electronics Engineers Inc.

We developed textile-based multi-lead ECG measurement wear. The textile-based ECG measurement wear was fabricated by printed electronics and electrostatic flocking technology. We also developed a wireless communication system of multi-lead ECG signals. Moreover, we succeeded to get 18-lead ECG signals around heart using the ECG measurement wear and the wireless measuring system.

DOI： 10.23919/ICEP.2018.8374690

Scopus

Novel thoracoscopic navigation surgery for neonatal chylothorax using indocyanine-green fluorescent lymphography. Reviewed International journal

Ryo Shirotsuki, Hiroo Uchida, Yujiro Tanaka, Chiyoe Shirota, Kazuki Yokota, Naruhiko Murase, Akinari Hinoki, Kazuo Oshima, Kosuke Chiba, Wataru Sumida, Masahiro Hayakawa, Takahisa Tainaka

Journal of pediatric surgery Vol. 53 ( 6 ) page： 1246 - 1249 2018.6

Language：English 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

特集小児外科における消化器内視鏡外科手術胆道閉鎖症に対する腹腔鏡下肝門部空腸吻合術 Reviewed

内田広夫, 田中裕次郎, 田井中貴久, 城田千代栄, 住田亙, 村瀬成彦

手術 Vol. 72 ( 6 ) page： 861 - 870 2018.5

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Papers - UCHIDA Hiroo