Faculty Profiles - UENO Harushi

Papers - UENO Harushi

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Prognostic factors of stage I thymic epithelial tumors

Fukui, T; Kadomatsu, Y; Tsubouchi, H; Nakanishi, K; Ueno, H; Sugiyama, T; Goto, M; Ozeki, N; Nakamura, S; Chen-Yoshikawa, TF

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 69 ( 1 ) page： 59 - 66 2021.1

Language：English Publisher：General Thoracic and Cardiovascular Surgery

Objective: According to the tumor-node-metastasis classification for thymic malignancies, the proportion of patients diagnosed with stage I is expected to increase significantly. However, whether those patients have homogenous clinicopathological features and survival has not been fully evaluated. Methods: We reviewed 153 consecutive patients with stage I thymic epithelial tumors (133 thymomas, 15 thymic carcinomas, and 5 neuroendocrine tumors) who underwent complete resection at our institution between 2001 and 2016 and evaluated the prognostic significance of their clinicopathological factors. Results: The stage I patients accounted for 78% of all thymic epithelial tumors. The 5-year overall survival and recurrence-free survival rates of the 153 patients were 94% and 80%, respectively. The patients with the histology of thymic carcinoma or neuroendocrine tumor and with a tumor larger than 5.0 cm showed significantly worse recurrence-free survival in multivariate analysis (p = 0.027 and 0.038, respectively). Only the tumor size was revealed as a significant prognostic factor for recurrence-free survival when limited in the 133 cases of thymoma (p = 0.048). Conclusions: Patients with large tumors showed significantly worse recurrence-free survival than those with small tumors both in stage I thymic epithelial tumors and thymomas.

DOI： 10.1007/s11748-020-01427-x

Web of Science

Scopus

PubMed

多職種チームで行う「献体を用いた臓器摘出トレーニング」in Clinical Anatomy Laboratory Nagoya (CALNA)

中村彰太, 六鹿雅登, 後藤和大, 仲西慶太, 杉山燈人, 門松由佳, 上野陽史, 後藤真輝, 尾関直樹, 福本紘一, 伊藤英樹, 小山富生, 碓氷章彦, 芳川豊史

移植 Vol. 56 ( Supplement ) page： s105 - s105 2021

Language：Japanese Publisher：一般社団法人日本移植学会

【背景】脳死ドナー臓器摘出では、外科医だけでなく臨床工学技士（ME）・看護師・コーディネーター等多職種が関わる医療で、実際の手技を知っていればよりよい連携が可能かもしれない。献体されたご遺体の固定方法は進化しており、特殊な保存液で固定された状態は生体と類似しているため、手術トレーニングに用いることが可能となった。肺移植実施施設でない当院での実施施設へのとり組みの一貫として、心臓外科医・ME・医学生と合同で臓器摘出トレーニングを実行したので報告する。【トレーニング概要】開胸・心嚢切開し臓器評価方法を全員で確認した後、心灌流液注入用と肺灌流液ドレナージ用のカテーテルを各留置し、大血管を遮断し心臓摘出、続いて肺摘出を行った。続いてバックテーブルにて肺の植え込みができる状態にまで処理を行いトレーニング終了とした。心肺摘出に際して重要となる左房の処理については、操作を止め指導医にポイントを解説してもらいつつ、心臓外科・呼吸器外科の双方の考えを伝え、解剖を確認しながら行った。また、MEと肺灌流液ドレナージ経路の方法や肺灌流のタイミングなど細やかな部分まで共有できた。【結語】本トレーニングは多職種での手技と順序の確認に有用で、臓器摘出の際互いに心がけているポイントや考えも共有・理解できた。今後はプログラムを定型化し、実践に対応できるレベルに質を高めつつ、看護師やコーディネーターも含めて行う予定である。

DOI： 10.11386/jst.56.supplement_s105

CiNii Research

Landscape of driver mutations and their clinical impacts in pediatric B-cell precursor acute lymphoblastic leukemia

Ueno H., Yoshida K., Shiozawa Y., Nannya Y., Iijima-Yamashita Y., Kiyokawa N., Shiraishi Y., Chiba K., Tanaka H., Isobe T., Seki M., Kimura S., Makishima H., Nakagawa M.M., Kakiuchi N., Kataoka K., Yoshizato T., Nishijima D., Deguchi T., Ohki K., Sato A., Takahashi H., Hashii Y., Tokimasa S., Hara J., Kosaka Y., Kato K., Inukai T., Takita J., Imamura T., Miyano S., Manabe A., Horibe K., Ogawa S., Sanada M.

Blood Advances Vol. 4 ( 20 ) page： 5165 - 5173 2020.10

Language：Japanese Publisher：Blood Advances

Recent genetic studies using high-throughput sequencing have disclosed genetic alterations in B-cell precursor acute lymphoblastic leukemia (B-ALL). However, their effects on clinical outcomes have not been fully investigated. To address this, we comprehensively examined genetic alterations and their prognostic impact in a large series of pediatric B-ALL cases. We performed targeted capture sequencing in a total of 1003 pediatric patients with B-ALL from 2 Japanese cohorts. Transcriptome sequencing (n 5 116) and/or array-based gene expression analysis (n 5 120) were also performed in 203 (84%) of 243 patients who were not categorized into any disease subgroup by panel sequencing or routine reverse transcription polymerase chain reaction analysis for major fusions in B-ALL. Our panel sequencing identified novel recurrent mutations in 2 genes (CCND3 and CIC), and both had positive correlations with ETV6-RUNX1 and hypodiploid ALL, respectively. In addition, positive correlations were also newly reported between TCF3-PBX1 ALL with PHF6 mutations. In multivariate Cox proportional hazards regression models for overall survival, TP53 mutation/deletion, hypodiploid, and MEF2D fusions were selected in both cohorts. For TP53 mutations, the negative effect on overall survival was confirmed in an independent external cohort (n 5 466). TP53 mutation was frequently found in IGH-DUX4 (5 of 57 [9%]) ALL, with 4 cases having 17p LOH and negatively affecting overall survival therein, whereas TP53 mutation was not associated with poor outcomes among NCI (National Cancer Institute) standard risk (SR) patients. A conventional treatment approach might be enough, and further treatment intensification might not be necessary, for patients with TP53 mutations if they are categorized into NCI SR.

DOI： 10.1182/BLOODADVANCES.2019001307

Scopus

Current trends in thoracic surgery

Chen-Yoshikawa, TF; Fukui, T; Nakamura, S; Ito, T; Kadomatsu, Y; Tsubouchi, H; Ueno, H; Sugiyama, T; Goto, M; Mori, S; Ozeki, N; Hakiri, S; Kawaguchi, K

NAGOYA JOURNAL OF MEDICAL SCIENCE Vol. 82 ( 2 ) page： 161 - 174 2020.5

Language：English Publisher：Nagoya Journal of Medical Science

Thoracic surgery has evolved drastically in recent years. Although thoracic surgeons mainly deal with tumorous lesion in the lungs, mediastinum, and pleura, they also perform lung transplantation surgery in patients with end-stage lung disease. Herein, we introduce various major current topics in thoracic surgery. Minimally invasive surgical procedures include robot-assisted thoracic surgery and uniportal video-assisted thoracic surgery. Novel techniques for sublobar resection include virtual-assisted lung mapping, imageguided video-assisted thoracic surgery, and segmentectomy using indocyanine green. Three-dimensional (3D) computed tomography (CT) simulation consists of surgeon-friendly 3D-CT image analysis systems and new-generation, dynamic 3D-CT imaging systems. Updates in cadaveric lung transplantation include use of marginal donors, including donation after circulatory death, and ex vivo lung perfusion for such donors. Topics in living donor lobar lung transplantation include size matching, donor issues, and new surgical techniques. During routine clinical practice, thoracic surgeons encounter various pivotal topics related to thoracic surgery, which are described in this report.

DOI： 10.18999/nagjms.82.2.161

Web of Science

Scopus

PubMed

Clinicopathological Features, Surgical Outcomes, Oncogenic Status and PD-L1 Expression of Pulmonary Pleomorphic Carcinoma.

Nakanishi K, Sakakura N, Matsui T, Ueno H, Nakada T, Oya Y, Shimizu J, Hida T, Hosoda W, Kuroda H

Anticancer research Vol. 39 ( 10 ) page： 5789 - 5795 2019.10

Thoracoscopic lobectomy using indocyanine green fluorescence to detect the interlobar fissure in a patient with displaced B3 and absence of fissure: A case report.

Nakanishi K, Kuroda H, Nakada T, Ueno H, Sakakura N

Thoracic cancer Vol. 10 ( 7 ) page： 1654 - 1656 2019.7

Comparison of the analgesic effects of modified continuous intercostal block and paravertebral block under surgeon's direct vision after video-assisted thoracic surgery: a randomized clinical trial

Kadomatsu, Y; Mori, S; Ueno, H; Uchiyama, M; Wakai, K

GENERAL THORACIC AND CARDIOVASCULAR SURGERY Vol. 66 ( 7 ) page： 425 - 431 2018.7

Language：English Publisher：General Thoracic and Cardiovascular Surgery

Objective: Clinical evidence comparing paravertebral (PVB) and continuous intercostal nerve (ICB) blocks for pain management post video-assisted thoracic surgery (VATS) is limited. This study confirms the analgesic effect of ICB using two catheters is not inferior to that of PVB under direct vision. Methods: Fifty patients who underwent VATS lobectomy from July 2015 to March 2016 were prospectively recruited and randomly assigned to PVB and ICB groups. Postoperative pain was assessed using the visual analog scale (VAS). VAS score at rest at 24 h was the primary endpoint. Data on time required for catheter insertion, adverse effects, and frequency of additional analgesics as secondary endpoints were also collected. Noninferiority was assessed by adding a VAS margin of 15 mm to the PVB group. Results: No significant differences were observed between the VAS scores of the two groups except at 48 h after surgery, with a margin noted for the PVB group. No significant differences were detected in the frequency of additional analgesics and occurrence of adverse effects. Conclusions: Our results could not clearly establish noninferiority of ICB to PVB. Improvements in ICB may be necessary for it to be used as an alternative method to PVB.

DOI： 10.1007/s11748-018-0936-8

Web of Science

Scopus

PubMed

A resected case of secondary racemose hemangioma of the bronchial artery with a destroyed lung

Kadomatsu Yuka, Kawasumi Yuta, Ueno Harushi, Usami Noriyasu, Uchiyama Mika, Mori Shoichi

The Journal of the Japanese Association for Chest Surgery Vol. 32 ( 4 ) page： 458 - 463 2018.5

Language：Japanese Publisher：The Japanese Association for Chest Surgery

A 60-year-old man was referred to his previous doctor for recurrent hemoptysis. He had a history of severe pneumonia in early childhood and was diagnosed with a poor function of the left lung. Chest computed tomography showed cystic change, volume reduction, and a dilated bronchus of the left lung. Several dilated and convoluted bronchial arteries traversing under the aortic arch and around the left hilum were identified. Left pneumonectomy was performed, as bronchial artery embolization was considered to be difficult owing to the marked dilation of the bronchial arteries. The procedure for the pulmonary artery and veins followed by en bloc resection of abnormal vessels reduced both the operative time and blood loss. The bronchial stump was covered by a latissimus dorsi muscle flap. The bleeding volume was 1,040 mL. The postoperative course was uneventful, and no hemoptysis was observed after the surgery. Surgery for racemose hemangioma of the bronchial artery is associated with difficulty in controlling bleeding owing to the fragility of abnormal vessels. In our case, left pneumonectomy was successfully performed with relatively minimal blood loss by devising a procedure for managing abnormal vessels.

DOI： 10.2995/jacsurg.32.458

CiNii Research

Reconstructive procedures and perioperative management in patients with thoracic malignancies and resection of superior vena cava and brachiocephalic veins

Kadomatsu Yuka, Mori Shoichi, Ueno Harushi, Fukumoto Koichi, Uchiyama Mika, Shigemitsu Kikuo, Yoshioka Hiromu, Yokoi Kohei

The Journal of the Japanese Association for Chest Surgery Vol. 31 ( 4 ) page： 446 - 452 2017

Language：Japanese Publisher：The Japanese Association for Chest Surgery

Objective: We retrospectively analyzed reconstructive procedures, kinds of grafts used, antithrombotic therapy, and graft patency in patients with thoracic malignancies and resection of the superior vena cava (SVC) and brachiocephalic veins (BCVs).Methods: From 2005 to 2014, 15 patients underwent resection and reconstruction of SVC and/or BCVs. We collected and reviewed their clinical data, surgical procedures, postoperative graft status, and perioperative antithrombotic therapy.Results: The subjective tumors were thymic epithelial tumor in 11 patients, germ cell tumor in two, and lung cancer and malignant lymphoma in one each. SVC was reconstructed in 13 patients, right BCV in 12 patients, and left BCV in 14 patients. In all patients, the adopted graft diameter was ≥10 mm and antithrombotic therapy was performed. Although occlusion of the reconstructed veins was observed in six patients, the associated symptoms were rarely observed in patients whose left and right brachiocephalic pathways were maintained.Conclusion: Procedures that require the resection of great vessels remain challenging. We did not observe perioperative deaths nor early graft occlusions in this study. In the case of graft occlusion, follow-up is possible in the absence of severe symptoms.

DOI： 10.2995/jacsurg.31.446

CiNii Research

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