Faculty Profiles - CHEN-YOSHIKAWA Toyofumi

Papers - CHEN-YOSHIKAWA Toyofumi

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Diagnostic yield of electromagnetic navigational bronchoscopy: Results of initial 35 cases in a Japanese institute Reviewed

Toshihiko Sato, Yojiro Yutaka, Yuichiro Ueda, Masatsugu Hamaji, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toyofumi Fengshi Chen-Yoshikawa, Makoto Sonobe, Hiroshi Date

Journal of Thoracic Disease Vol. 10 ( Suppl 14 ) page： S1615 - S1619 2018.6

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

Background: Electromagnetic navigational bronchoscopy (ENB) is a new bronchoscopic technique for navigational transbronchial lung biopsy (TBLB) that guides the sheath to the target lesion in real time. Herein, we report our experience with this navigational system, its diagnostic yields, and associated complications. Methods: A single-center, single-operator retrospective chart review was performed. We included 35 consecutive patients who underwent ENB with superDimension™ (Medtronic, MN, USA) for the diagnosis of pulmonary lesions from February 2016 to May 2017 in Kyoto University Hospital. The size of the target lesion varied from 8 to 25 mm (median, 15.28±5.48 mm). All ENB procedures were performed under conscious sedation using 2 to 10 mg midazolam and 1 to 10 mg morphine hydrochloride. No fluoroscopic guide was employed except in three cases. Results: A total of 25 patients were diagnosed via ENB, yielding a diagnostic rate of 71.4% (25/35). The average lesion size of the diagnosed group was 16.44±5.44 mm (range, 8-25 mm). Eighteen cases were diagnosed as primary lung cancer, 3 were metastatic lung cancer, and 4 were inflammatory diseases. The average lesion size of the 10 undiagnosed cases was 12.40±5.21 mm (range, 8-24 mm). The lesion size of the undiagnosed group was significantly smaller than that of the diagnosed group (P=0.02). The average time required for the procedure was 16.78±9.57 minutes (range, 3-46 minutes), independent of the diagnosis, the lesion size, and the tumor location. We encountered one pneumothorax which required chest drainage and one hemopneumothorax which required non-elective thoracotomy and wedge resection. One patient developed high fever over 38 ° for one day following the procedure. Conclusions: In our initial series of 35 cases, ENB-guided TBLB showed an acceptable diagnostic yield.

DOI： 10.21037/jtd.2018.04.123

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Lung transplantation after haematopoietic stem cell transplantation for Wiskott-Aldrich syndrome Reviewed

Satoshi Ueda, Toyofumi F. Chen-Yoshikawa, Kyoko Hijiya, Hiroshi Date

European Journal of Cardio-thoracic Surgery Vol. 53 ( 6 ) page： 1286 - 1287 2018.6

Language：English Publishing type：Research paper (scientific journal) Publisher：European Association for Cardio-Thoracic Surgery

The authors report the first case involving a patient with Wiskott-Aldrich syndrome who underwent single living-donor lobar lung transplantation after haematopoietic stem cell transplantation. Haematopoietic stem cell transplantation was performed at 1 year of age
however, he developed severe pulmonary complications. Although lung transplantation is generally contraindicated in patients with immunodeficiency disease, the patient was able to undergo living-donor lobar lung transplantation because his immunodeficiency and thrombocytopenia were well controlled as a result of haematopoietic stem cell transplantation. Currently, the patient is doing well and is free from oxygen supplementation.

DOI： 10.1093/ejcts/ezx461

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Successful conservative management of an anastomotic airway dehiscence at the left main bronchus following bilateral cadaveric lung transplantation Reviewed

Ryo Miyata, Toyofumi F. Chen-Yoshikawa, Masatsugu Hamaji, Fumiaki Gochi, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toshihiko Sato, Makoto Sonobe, Hiroshi Date

General Thoracic and Cardiovascular Surgery Vol. 66 ( 6 ) page： 368 - 371 2018.6

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

There is a dearth of data on management of anastomotic airway dehiscence following lung transplantation. Herein we report a case of successful conservative management of an anastomotic airway dehiscence after cadaveric donor lung transplantation. A 41-year-old woman with primary ciliary dyskinesia underwent cadaveric bilateral lung transplantation without cardiopulmonary bypass. On the postoperative day 25, left pneumothorax developed and bronchoscopy demonstrated a localized anastomotic dehiscence at the left main bronchus. The dehiscence was managed with 2 weeks of pleural drainage and was completely covered with regenerated bronchial epithelium at 4 months after transplantation. There is no finding suggestive of significant stenosis at 4 years of follow-up. Our case suggested asymptomatic and localized anastomotic dehiscence does not always require endobronchial stent placement or re-operation. Multiple factors that may contribute to the successful conservative management were discussed in this article.

DOI： 10.1007/s11748-017-0826-5

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Transition of the programmed death 1 pathway from the primary colorectal cancer to its corresponding pulmonary metastasis.

Miyamoto E, Chen-Yoshikawa TF, Ueshima C, Yoshizawa A, Hamaji M, Yamamoto T, Kawada K, Haga H, Sakai Y, Date H

Journal of surgical oncology Vol. 117 ( 7 ) page： 1405-1412 2018.6

Effect of early tracheostomy on clinical outcomes in critically ill lung transplant recipients Reviewed

Ryo Miyoshi, Toyofumi F. Chen-Yoshikawa, Masatsugu Hamaji, Atsushi Kawaguchi, Hidenao Kayawake, Kyoko Hijiya, Hideki Motoyama, Akihiro Aoyama, Hiroshi Date

General Thoracic and Cardiovascular Surgery Vol. 66 ( 9 ) page： 1 - 8 2018.5

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

Objectives: The purpose of this study was to evaluate the effect of early tracheostomy in patients following lung transplantation and to determine its optimal timing and influence on clinical outcomes. Methods: We retrospectively reviewed records of 96 adult patients who underwent lung transplantation at our institution between August 2008 and January 2016. Time-to-tracheostomy was defined based on timing of the procedure: “early” if less than 3 days or “late” if 3 or more days after lung transplantation. Results: Forty-nine patients (51%) underwent tracheostomy 3.2 ± 1.8 days after lung transplantation. Among these patients, 21 patients (42.9%) underwent early tracheostomy and 28 patients (57.1%) underwent late tracheostomy. Multivariable logistic regression analysis indicated that preoperative performance status was a significant predictor for tracheostomy (p = 0.006, odds ratio 2.72). Patients in the early tracheostomy group began walking (p = 0.003) and oral feeding (p = 0.0006) earlier and had a shorter duration of mechanical ventilation (p = 0.04) and shorter length of intensive care unit (p = 0.01) and hospital stay (p = 0.04) than patients in the late tracheostomy group. No significant differences in postoperative walking (p = 0.06), oral feeding (p = 0.17), or length of hospital stay (p = 0.37) were observed between patients who underwent early tracheostomy and those who did not undergo tracheostomy. Conclusions: Early tracheostomy following lung transplantation decreased both intensive care and hospital stay, due to improved postoperative recovery, even in patients with poor preoperative conditions. Furthermore, length of hospital stay in patients with early tracheostomy was similar to that of patients without tracheostomy after lung transplantation.

DOI： 10.1007/s11748-018-0949-3

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Nontuberculous mycobacterial and Aspergillus infections among cadaveric lung transplant recipients in Japan Reviewed

Kazunobu Tachibana, Yoshinori Okada, Yasushi Matsuda, Kentaroh Miyoshi, Takahiro Oto, Toyofumi F. Chen-Yoshikawa, Hiroshi Date, Masato Minami, Meinoshin Okumura, Akinori Iwasaki, Takeshi Shiraishi, Sumiko Maeda, Yuji Matsumura, Takahiro Nakajima, Ichiro Yoshino, Seiji Hayashi

Respiratory Investigation Vol. 56 ( 3 ) page： 243 - 248 2018.5

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

Background: Lung transplantation is an effective treatment modality for respiratory failure. Chronic lung infections, including infections caused by nontuberculous mycobacteria (NTM) and Aspergillus, are difficult to control, and uncontrolled infections are relative contraindications for lung transplantation. However, few reports have documented the incidence and outcome of these infections in lung transplant recipients. Methods: To quantify the incidence and outcomes of colonization and disease caused by NTM and aspergillosis in recipients before and after lung transplantation, we reviewed the medical records and microbiology data from 240 consecutive cadaveric lung transplant recipients between 2000 and 2014. Results: Before lung transplantation, NTM and Aspergillus species were isolated from five (2.1%) and six (2.5%) patients, respectively, out of the total 240 recipients. All patients with NTM infection received treatment, resulting in culture conversion. They had no recurrence after lung transplantation. All patients with aspergillosis received treatment, one of whom had recurrence after lung transplantation. Over a median follow-up period of 3.3 years, NTM species were isolated after transplantation from eight of 240 patients (3.3%). Five of these patients met the criteria for NTM disease, and four of them received treatment. Four patients survived without a worsening of NTM disease. Over the same median follow-up period, Aspergillus species were isolated from seven of 240 patients (2.9%), six of whom received treatment. Conclusions: Isolation of NTM or Aspergillus species from lung transplant recipients is uncommon. Adequate pre-transplant control and post-transplant management of NTM and Aspergillus infections allows for safe lung transplantation.

DOI： 10.1016/j.resinv.2017.12.010

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Second malignancy versus recurrence after complete resection of thymoma. Reviewed

Hamaji M, Sozu T, Machida R, Omasa M, Menju T, Aoyama A, Sato T, Chen-Yoshikawa TF, Sonobe M, Date H

Asian cardiovascular & thoracic annals Vol. 26 ( 4 ) page： 290 - 295 2018.5

Inverted Lobes Have Satisfactory Functions Compared With Noninverted Lobes in Lung Transplantation Reviewed

Hidenao Kayawake, Toyofumi F. Chen-Yoshikawa, Hideki Motoyama, Masatsugu Hamaji, Kyoko Hijiya, Akihiro Aoyama, Yasufumi Goda, Hiromi Oda, Satoshi Ueda, Hiroshi Date

Annals of Thoracic Surgery Vol. 105 ( 4 ) page： 1044 - 1049 2018.4

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

Background: To overcome the problem of small-for-size grafts in standard living-donor lobar lung transplantation (LDLLT), we developed inverted LDLLT, in which a right lower lobe from 1 donor is implanted as a right graft and another right lower lobe from another donor is implanted as a left graft. We retrospectively analyzed the functions of inverted grafts vs noninverted grafts. Methods: Between 2008 and 2015, 64 LDLLTs were performed. Included were 35 LDLLTs whose recipients were adults and monitored for more than 6 months without developing chronic lung allograft dysfunction. Among them, 65 implanted lobes were eligible for this analysis. There were 31 right lower lobes implanted as right grafts (right-to-right group), 7 right lower lobes as inverted left grafts (right-to-left group), and 27 left lower lobes as left grafts (left-to-left group). We evaluated the graft forced vital capacity (G-FVC) and graft volume of the 65 lobes before and 6 months after LDLLT and compared them among the three groups. Results: Preoperatively, G-FVC in the right-to-left group (1,050 mL) was comparable to that in the right-to-right group (1,177 mL) and better than that in the left-to-left group (791 mL, p &lt
0.01). Six months after LDLLT, G-FVC in the right-to-left group (1,015 mL) remained comparable to that in the right-to-right group (1,001 mL) and better than that in the left-to-left group (713 mL, p = 0.047). The ratio of graft volume 6 months after LDLLT to the preoperative value was comparable. Conclusions: The functions of inverted grafts in inverted LDLLTs were satisfactory compared with those of noninverted grafts.

DOI： 10.1016/j.athoracsur.2017.11.034

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Surgery for metachronous second primary lung cancer versus surgery for primary lung cancer: A propensity score-matched comparison of postoperative complications and survival outcomes Reviewed

Yusuke Muranishi, Makoto Sonobe, Masatsugu Hamaji, Atsushi Kawaguchi, Kyoko Hijiya, Hideki Motoyama, Toshi Menju, Akihiro Aoyama, Toyofumi F Chen-Yoshikawa, Toshihiko Sato, Hiroshi Date

Interactive Cardiovascular and Thoracic Surgery Vol. 26 ( 4 ) page： 631 - 637 2018.4

Language：English Publishing type：Research paper (scientific journal) Publisher：Oxford University Press

OBJECTIVES: Surgical treatments for metachronous second primary lung cancer (MSPLC) may be increasing. It was thought that surgery for MSPLC is associated with high mortality and morbidity. However, recent diffusion of minimally invasive surgical procedures may improve the safety of surgery for MSPLC. The aim of this study was to clarify the safety and prognosis of surgery for MSPLC compared with that for primary lung cancer (PLC). METHODS: We reviewed medical records of 1340 patients who underwent pulmonary resection for non-small-cell lung cancer between 2006 and 2013. We identified patients with PLC and those with MSPLC, and surgical parameters and survival outcome were compared. To eliminate selection bias between the MSPLC group and the PLC group, propensity score-matched analysis on the basis of clinicopathological factors was performed. RESULTS: Fifty-three patients underwent resection for MSPLC. Propensity score matching identified 50 patients from each treatment group. Of the 50 MSPLC patients, 41 (82.0%) underwent segmentectomy or wedge resection, 44 (82.0%) had clinical Stage I tumour and 36 (72.0%) received resection via video-assisted thoracoscopic surgery approach. Postoperative complications with a severity of Grade II or more occurred in 11 (22.0%) patients. The incidence of postoperative complications in the MSPLC group was not different from that of the PLC group (P = 0.4894). The 5-year overall survival rates were 68.7% and 83.0% in the PLC and the MSPLC groups, respectively. There was no significant difference between the PLC and the MSPLC groups in terms of overall survival (P = 0.2018, log-rank test). CONCLUSIONS: Pulmonary resection for MSPLC was safely performed with low short-term morbidity similar to that of PLC, and its longterm overall survival was acceptable.

DOI： 10.1093/icvts/ivx389

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Salvage Pulmonary Metastasectomy for Local Relapse After Stereotactic Body Radiotherapy. Reviewed

Hamaji M, Mitsuyoshi T, Yoshizawa A, Sato T, Matsuo Y, Chen-Yoshikawa TF, Sonobe M, Mizowaki T, Date H

The Annals of thoracic surgery Vol. 105 ( 4 ) page： e165 - e168 2018.4

Late-onset chest wall abscess due to a biodegradable rib pin infection after lung transplantation Reviewed

Yasufumi Goda, Toyofumi F. Chen-Yoshikawa, Masaaki Kusunose, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hiroshi Date

General Thoracic and Cardiovascular Surgery Vol. 66 ( 3 ) page： 175 - 178 2018.3

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

A 55-year-old man with end-stage emphysema underwent a right single-lung transplantation through a posterolateral thoracotomy. The fifth rib was divided and fused back using a biodegradable pin made of polylactide acid and hydroxyapatite. Two weeks postoperatively, he suffered from central vein catheter-related sepsis due to methicillin-sensitive Staphylococcus aureus. After being successfully treated for sepsis, he was discharged. However, 3 months later, computed tomography revealed multiple loculated abscesses in the chest wall and the right pleural space. Reoperative thoracotomy revealed abscesses mainly located around the fifth rib, where the pin was inserted. Both cultures of the abscess and the fifth rib were positive for methicillin-sensitive S. aureus, which suggested that the rib pin was the cause of the secondary infection. This case suggests the rib pins, even if they are biodegradable, could have a risk of infections side effect especially for the immunosuppressed patients.

DOI： 10.1007/s11748-017-0768-y

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Radiologic and Functional Analysis of Compensatory Lung Growth After Living-Donor Lobectomy. Reviewed International journal

Kei Shikuma, Toyofumi F Chen-Yoshikawa, Tsuyoshi Oguma, Takeshi Kubo, Keiji Ohata, Masatsugu Hamaji, Atsushi Kawaguchi, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Hisako Matsumoto, Shigeo Muro, Hiroshi Date

The Annals of thoracic surgery Vol. 105 ( 3 ) page： 909 - 914 2018.3

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

BACKGROUND: Whether compensatory lung growth occurs in adult humans is controversial. The aim of this study was to confirm compensatory lung growth by analyzing ipsilateral residual lung after lower lobectomy in living lung transplant donors with quantitative and qualitative computed tomography assessments. METHODS: Chest computed tomography and pulmonary function tests were performed in 31 eligible donors before and 1 year after donor lobectomy. Ipsilateral residual lung volume was measured with three-dimensional computed tomography volumetry. The computed tomography-estimated volumes of low, middle, and high attenuations in the lung were calculated. Assessment of the D value, a coefficient of the cumulative size distribution of low-density area clusters, was performed to evaluate the structural quality of the residual lung. RESULTS: Postoperative pulmonary function test values were significantly larger than preoperative estimated values. Although postoperative total volume, low attenuation volume, middle attenuation volume, and high attenuation volume of the ipsilateral residual lung were significantly larger than the preoperative volumes, with 50.2%, 50.0%, 41.5%, and 43.1% increase in the median values, respectively (all p < 0.0001), the differences in D values before and after donor lobectomy were not significant (p = 0.848). The total volume of ipsilateral residual lung was increased by more than 600 mL (50%). CONCLUSIONS: The volume of ipsilateral residual lung increased, but its structural quality did not change before and after donor lobectomy. The existence of compensatory lung growth in adult humans was suggested by quantitative and qualitative computed tomography assessments.

DOI： 10.1016/j.athoracsur.2017.09.060

PubMed

Wise surgeons learn from others' experiences.

Chen-Yoshikawa TF

The Journal of thoracic and cardiovascular surgery Vol. 155 ( 3 ) page： e115 2018.3

A long-term follow-up report on adjuvant vinorelbine and cisplatin in Japanese patients with completely resected stage II and III non-small cell lung cancer Reviewed

Sonobe M, Hamaji M, Motoyama H, Menju T, Aoyama A, Chen-Yoshikawa TF, Sato T, Date H

Surg Today 2018.3

The synergistic role of ATP-dependent drug efflux pump and focal adhesion signaling pathways in vinorelbine resistance in lung cancer Reviewed

Takao Nakanishi, Toshi Menju, Shigeto Nishikawa, Koji Takahashi, Ryo Miyata, Kei Shikuma, Terumasa Sowa, Naoto Imamura, Masatsugu Hamaji, Hideki Motoyama, Kyoko Hijiya, Akihiro Aoyama, Toshihiko Sato, Toyofumi F. Chen-Yoshikawa, Makoto Sonobe, Hiroshi Date

Cancer Medicine Vol. 7 ( 2 ) page： 408 - 419 2018.2

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

The vinorelbine (VRB) plus cisplatin regimen is widely used to treat non–small cell lung cancer (NSCLC), but its cure rate is poor. Drug resistance is the primary driver of chemotherapeutic failure, and the causes of resistance remain unclear. By focusing on the focal adhesion (FA) pathway, we have highlighted a signaling pathway that promotes VRB resistance in lung cancer cells. First, we established VRB-resistant (VR) lung cancer cells (NCI-H1299 and A549) and examined its transcriptional changes, protein expressions, and activations. We treated VR cells by Src Family Kinase (SFK) inhibitors or gene silencing and examined cell viabilities. ATP-binding Cassette Sub-family B Member 1 (ABCB1) was highly expressed in VR cells. A pathway analysis and western blot analysis revealed the high expression of integrins β1 and β3 and the activation of FA pathway components, including Src family kinase (SFK) and AKT, in VR cells. SFK involvement in VRB resistance was confirmed by the recovery of VRB sensitivity in FYN knockdown A549 VR cells. Saracatinib, a dual inhibitor of SFK and ABCB1, had a synergistic effect with VRB in VR cells. In conclusion, ABCB1 is the primary cause of VRB resistance. Additionally, the FA pathway, particularly integrin, and SFK, are promising targets for VRB-resistant lung cancer. Further studies are needed to identify clinically applicable target drugs and biomarkers that will improve disease prognoses and predict therapeutic efficacies.

DOI： 10.1002/cam4.1282

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Prognostic Factors in Lung Transplantation after Hematopoietic Stem Cell Transplantation Reviewed

Toyofumi F. Chen-Yoshikawa, Seiichiro Sugimoto, Takeshi Shiraishi, Masato Minami, Yasushi Matsuda, Masayuki Chida, Sumiko Maeda, Akihiro Aoyama, Yoshinori Okada, Meinoshin Okumura, Akinori Iwasaki, Shinichiro Miyoshi, Takahiro Oto, Hiroshi Date

Transplantation Vol. 102 ( 1 ) page： 154 - 161 2018.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Lippincott Williams and Wilkins

Background Lung transplantation is the final lifesaving option for patients with pulmonary complications after hematopoietic stem cell transplantation (HSCT). Patients undergoing HSCT for hematologic diseases are thought to be high-risk candidates for lung transplantation
therefore, few lung transplants are performed for these patients, and few studies have been reported. This study aimed to describe the characteristics and outcomes of lung transplantation in patients with pulmonary complications after HSCT. Methods We retrospectively investigated 62 patients who underwent lung transplantation after HSCT. All data were collected from 6 lung transplant centers in Japan. Results Seventeen patients underwent cadaveric lung transplantation, whereas 45 underwent living-donor lobar lung transplantation (LDLLT). In the LDLLT group, 18 patients underwent LDLLT after HSCT in which one of the donors had also served as a donor for HSCT. Seven patients underwent single LDLLT for which the donor was the same as the patient from whom stem cells were obtained for HSCT. Preoperative hypercapnia was observed in 52 patients (84%). Thirteen patients (21%) required mechanical ventilation preoperatively. Fifty-five patients underwent HSCT for hematologic malignancies, and 4 (7%) relapsed after lung transplantation. The 5-year survival rate was 64.2%. In a multivariable analysis, patients younger than 45 years and those with the same donor for both procedures exhibited significantly better survival (P = 0.012 and 0.041, respectively). Conclusions Lung transplantation for pulmonary complications after HSCT was performed safely and yielded better survival, especially in younger recipients for whom both lung transplantation and HSCT involved the same donor.

DOI： 10.1097/TP.0000000000001886

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Three-dimensional image in lung transplantation Reviewed

Toyofumi F. Chen-Yoshikawa, Hiroshi Date

General Thoracic and Cardiovascular Surgery Vol. 66 ( 1 ) page： 19 - 26 2018.1

Language：English Publisher：Springer Tokyo

Three-dimensional computed tomography (3D-CT) technologies have been developed and, recently, high-speed and high-quality 3D-CT technologies have been introduced to the field of thoracic surgery. The purpose of this manuscript is to demonstrate the clinical application of 3D-CT technologies in lung transplantation. In Japan, because of the severe donor shortage, living-donor lobar lung transplantation (LDLLT) is essential, in addition to cadaveric lung transplantation. In LDLLT, size matching is a grave issue, since ideal size matching between donor and recipient is usually difficult because of the limited population of potential donor. Size matching using pulmonary function test results has been widely used as a gold standard, but anatomical size matching using 3D-CT volumetry data has also been utilized in LDLLT. In donor lobectomy, 3D-CT images provided a variety of information regarding anatomical variation of pulmonary vessels and bronchial trees preoperatively. These images ensure surgical quality and safety, and they also affect surgical procedures for the recipient. 3D-CT images are also utilized in various aspects of postoperative care, such as detection of chronic lung allograft dysfunction and clarification of its subtypes. Furthermore, preoperative 3D-CT simulation is useful in developing and performing a special surgical procedure, such as right-to-left inverted LDLLT. In conclusion, following the introduction of 3D-CT to the field of thoracic surgery, various 3D-CT images and their application to preoperative simulations have been introduced in lung transplantation. In the near future, this technique will become more prevalent, and frequent use by thoracic surgeons will be seen worldwide in daily practice.

DOI： 10.1007/s11748-017-0849-y

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Pulmonary endothelial chimerism after hematopoietic stem cell transplantation Reviewed

Kyoko Hijiya, Toyofumi Fengshi Chen-Yoshikawa, Aya Miyagawa-Hayashino, Tadakazu Kondo, Akihiro Aoyama, Hironori Haga, Akifumi Takaori-Kondo, Hiroshi Date

Surgery Today Vol. 48 ( 1 ) page： 101 - 109 2018.1

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

Purpose: Few studies have investigated pulmonary endothelial chimerism after hematopoietic stem cell transplantation. In the present study, we investigated pulmonary endothelial chimerism using the ABH histo-blood group antigen as an identifying marker in cases of ABO-incompatible hematopoietic stem cell transplantation. Methods: Sixteen lung samples were analyzed. Of these, seven were explanted lungs from lung transplant recipients with severe pulmonary chronic graft-versus-host disease (GVHD). The remaining nine were autopsy samples from patients who died from various causes, and six of these nine cases had a diagnosis of pulmonary chronic GVHD. The ABH histo-blood group antigen was used to differentiate donor cells from recipient cells immunohistochemically. We estimated the percentage of vessels positive for donor blood group antigens in comparison with the total number of vessels. Results: Donor blood group antigens were expressed in the endothelium of 13 samples, all of which were pathologically diagnosed with pulmonary chronic GVHD. The proportion of vessels with donor group antigens ranged from 0.1 to 17.5%. In contrast, no chimeric vessels were observed in the three samples without pulmonary chronic GVHD. Conclusions: Our results demonstrate that circulating stem cells engraft into the endothelium to a considerable extent in pulmonary chronic GVHD.

DOI： 10.1007/s00595-017-1562-2

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A preliminary study on analysis of deaeration deformation for ex-vivo animal lung

Kotaro Kobayashi, Megumi Nakao, Junko Tokuno, Toyofumi F. Chen-Yoshikawa, Tetsuya Matsuda

Transactions of Japanese Society for Medical and Biological Engineering Vol. 56 page： 40 - 41 2018

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Soc. of Med. Electronics and Biol. Engineering

This study aims to analyze deaeration deformation to develop intraoperative guidance of minute lung nodules. We measured lung CT data from ex-vivo animal lungs with different internal pressures, and analyzed surface displacement using Laplacian-based surface registration. We evaluated the registration results by comparing with reference points determined manually, and confirmed that the registration error was around 1mm. We found that the magnitude of surface displacement is orderly distributed based on the distance from the pulmonary hilum.

DOI： 10.11239/jsmbe.Annual56.40

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Clinical application of projection mapping technology for surgical resection of lung metastasis Reviewed

Toyofumi F. Chen-Yoshikawa, Etsuro Hatano, Atsushi Yoshizawa, Hiroshi Date

INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY Vol. 25 ( 6 ) page： 1010 - 1011 2017.12

Language：English Publisher：OXFORD UNIV PRESS

Indocyanine green fluorescent image-guided surgery was developed to identify primary and metastatic nodules of various malignancies. However, currently, surgeons need to identify the fluorescent image on a monitor, which impedes surgical procedures. Herein, we developed a novel projection mapping device that can cast the real-time fluorescent image onto the surface of the targeted organ. We performed surgical resection of a lung metastasis of hepatoblastoma using this technique. The projection mapping technique clearly detected the pulmonary lesion, and no other lesions were identified in the ipsilateral thorax. The patient is well and free of recurrence 2 years after surgery.

DOI： 10.1093/icvts/ivx247

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Papers - CHEN-YOSHIKAWA Toyofumi