2021/10/20 更新

写真a

ミウラ コウヘイ
三浦 宏平
MIURA Kouhei
所属
医歯学総合病院 消化器外科 助教
職名
助教
外部リンク

学位

  • 博士(医学) ( 2015年3月   新潟大学 )

研究分野

  • ライフサイエンス / 消化器外科学  / 移植

経歴(researchmap)

  • 新潟大学医歯学総合研究科   小児外科学分野   助教

    2017年4月 - 現在

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  • 熊本大学医学部付属病院   小児外科・移植外科学分野   助教

    2016年4月 - 2017年3月

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  • 新潟大学医歯学総合研究科   高次救命災害治療センター   助教

    2014年4月 - 2016年3月

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  • 新潟大学医歯学総合研究科   消化器・一般外科学分野   医員

    2011年10月 - 2012年3月

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  • 厚生連刈羽郡総合病院   外科   医員

    2011年4月 - 2011年9月

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  • 新潟大学医歯学総合研究科   消化器・一般外科学分野   医員

    2010年10月 - 2011年3月

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  • 鶴岡市立荘内病院   外科   医員

    2009年10月 - 2010年9月

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  • 新潟大学医歯学総合研究科   消化器・一般外科学分野   医員

    2008年10月 - 2009年9月

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  • 新潟県立新発田病院   外科   医員

    2008年4月 - 2008年9月

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  • 新潟県立新発田病院   初期臨床研修医

    2006年4月 - 2008年3月

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経歴

  • 新潟大学   医歯学総合病院 消化器外科   助教

    2021年4月 - 現在

  • 新潟大学   医歯学総合病院 高次救命災害治療センター   助教

    2020年4月 - 2021年3月

  • 新潟大学   医歯学総合研究科 生体機能調節医学専攻 機能再建医学   助教

    2017年10月 - 2020年3月

  • 新潟大学   医歯学総合病院 小児外科   助教

    2017年4月 - 2017年9月

  • 新潟大学   医歯学総合病院 消化器外科   特任助教

    2016年4月 - 2017年3月

  • 新潟大学   医歯学総合病院 高次救命災害治療センター   助教

    2014年4月 - 2016年3月

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学歴

  • 新潟大学   大学院医歯学総合研究科   博士課程

    2012年4月 - 2015年3月

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  • 鹿児島大学   臓器置換・異種移植外科学分野

    2012年4月 - 2014年3月

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  • 新潟大学   医学部   医学科

    2000年4月 - 2006年3月

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所属学協会

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論文

  • Anatomic location of residual disease after initial cholecystectomy independently determines outcomes after re-resection for incidental gallbladder cancer. 国際誌

    Takuya Ando, Jun Sakata, Tatsuya Nomura, Kabuto Takano, Kazuyasu Takizawa, Kohei Miura, Yuki Hirose, Takashi Kobayashi, Hiroshi Ichikawa, Takaaki Hanyu, Yoshifumi Shimada, Masayuki Nagahashi, Shin-Ichi Kosugi, Toshifumi Wakai

    Langenbeck's archives of surgery   406 ( 5 )   1521 - 1532   2021年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: This study aimed to elucidate the impact of anatomic location of residual disease (RD) after initial cholecystectomy on survival following re-resection of incidental gallbladder cancer (IGBC). METHODS: Patients with pT2 or pT3 gallbladder cancer (36 with IGBC and 171 with non-IGBC) who underwent resection were analyzed. Patients with IGBC were classified as follows according to the anatomic location of RD after initial cholecystectomy: no RD (group 1); RD in the gallbladder bed, stump of the cystic duct, and/or regional lymph nodes (group 2); and RD in the extrahepatic bile duct and/or distant sites (group 3). RESULTS: Timing of resection (IGBC vs. non-IGBC) did not affect survival in either multivariate or propensity score matching analysis. RD was found in 16 (44.4%) of the 36 patients with IGBC; R0 resection following re-resection was achieved in 32 patients (88.9%). Overall survival (OS) following re-resection was worse in group 3 (n = 7; 5-year OS, 14.3%) than in group 2 (n = 9; 5-year OS, 55.6%) (p = 0.035) or in group 1 (n = 20; 5-year OS, 88.7%) (p < 0.001). There was no survival difference between groups 1 and 2 (p = 0.256). Anatomic location of RD was independently associated with OS (group 2, HR 2.425, p = 0.223; group 3, HR 9.627, p = 0.024). CONCLUSION: The anatomic location of RD independently predicts survival following re-resection, which is effective for locoregional disease control in IGBC, similar to resection for non-IGBC. Not all patients with RD have poor survival following re-resection for IGBC.

    DOI: 10.1007/s00423-021-02165-1

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  • Outcome of radical surgery for gallbladder carcinoma according to TNM stage: implications for adjuvant therapeutic strategies. 国際誌

    Kizuki Yuza, Jun Sakata, Yuki Hirose, Kohei Miura, Takuya Ando, Tomohiro Katada, Kazuyasu Takizawa, Takashi Kobayashi, Hiroshi Ichikawa, Yoshifumi Shimada, Masayuki Nagahashi, Toshifumi Wakai

    Langenbeck's archives of surgery   406 ( 3 )   801 - 811   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: Outcomes following surgery for advanced gallbladder carcinoma remain unsatisfactory. This study aimed to determine the surgical outcome and effectiveness of adjuvant chemotherapy according to TNM stage in patients with gallbladder carcinoma. METHODS: A total of 200 patients undergoing surgery for gallbladder carcinoma were enrolled. Clinicopathological data were evaluated and surgical outcomes were compared between patients with and without adjuvant chemotherapy according to TNM stage. RESULTS: The 5-year overall survival (OS) after resection for patients with stage I (n = 27), IIA (n = 18), IIB (n = 28), IIIA (n = 25), IIIB (n = 43), IVA (n = 7), and IVB (n = 52) disease was 90.8%, 94.4%, 73.6%, 33.7%, 57.7%, 14.3%, and 11.8%, respectively (p < 0.001). R0 resection was performed in all patients with stage I or II disease, in 89.7% of those with stage III disease, and 69.5% of those with stage IV disease. For patients with stage III disease, adjuvant chemotherapy was associated with improved OS (5-year OS, 60.9% vs. 41.1%; p = 0.028) and was an independent prognostic factor (hazard ratio, 2.045; p = 0.039). For patients with stage IV disease, adjuvant chemotherapy appeared to affect OS (5-year OS, 25.1% vs. 5.3%; p = 0.041); R0 resection (hazard ratio, 1.882; p = 0.040) was the only independent prognostic factor. CONCLUSION: TNM stage clearly predicts survival after resection of gallbladder carcinoma. R0 resection with adjuvant chemotherapy is recommended for long-term survival in the multimodal management of patients with stage III or IV gallbladder carcinoma.

    DOI: 10.1007/s00423-020-02068-7

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  • Dysregulation of sphingolipid metabolic enzymes leads to high levels of sphingosine-1-phosphate and ceramide in human hepatocellular carcinoma. 国際誌

    Kohei Miura, Masayuki Nagahashi, Pankaj Prasoon, Yuki Hirose, Takashi Kobayashi, Jun Sakata, Manabu Abe, Kenji Sakimura, Yasunobu Matsuda, Ali L Butash, Eriko Katsuta, Kazuaki Takabe, Toshifumi Wakai

    Hepatology research : the official journal of the Japan Society of Hepatology   51 ( 5 )   614 - 626   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: Sphingosine-1-phosphate (S1P) and ceramide are bioactive sphingolipids known to be important in regulating numerous processes involved in cancer progression. The aim of this study was to determine the absolute levels of sphingolipids in hepatocellular carcinoma (HCC) utilizing data obtained from surgical specimens. In addition, we explored the clinical significance of S1P in patients with HCC and the biological role of S1P in HCC cells. METHODS: Tumors and normal liver tissues were collected from 20 patients with HCC, and sphingolipids were measured by mass spectrometry. The Cancer Genome Atlas (TCGA) cohort was utilized to evaluate gene expression of enzymes related to sphingolipid metabolism. Immunohistochemistry of phospho-sphingosine kinase 1 (SphK1), an S1P-producing enzyme, was performed for 61 surgical specimens. CRISPR/Cas9-mediated SphK1 knockout cells were used to examine HCC cell biology. RESULTS: S1P levels were substantially higher in HCC tissue compared with normal liver tissue. Levels of other sphingolipids upstream of S1P in the metabolic cascade, such as sphingomyelin, monohexosylceramide and ceramide, were also considerably higher in HCC tissue. Enzymes involved in generating S1P and its precursor, ceramide, were found in higher levels in HCC compared with normal liver tissue. Immunohistochemical analysis found that phospho-SphK1 expression was associated with tumor size. Finally, in vitro assays indicated that S1P is involved in the aggressiveness of HCC cells. CONCLUSIONS: Sphingolipid levels, including S1P and ceramide, were elevated in HCC compared with surrounding normal liver tissue. Our findings suggest S1P plays an important role in HCC tumor progression, and further examination is warranted.

    DOI: 10.1111/hepr.13625

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  • Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study. 国際誌

    Jun Sakata, Yuki Hirose, Pankaj Prasoon, Chie Kitami, Masahiro Minagawa, Tatsuya Nomura, Naoyuki Yokoyama, Takashi Aono, Kizuki Yuza, Kohei Miura, Tomohiro Katada, Kazuyasu Takizawa, Masayuki Nagahashi, Takashi Kobayashi, Toshifumi Wakai

    World journal of surgery   45 ( 5 )   1613 - 1615   2021年5月

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  • NQO1 as a Marker of Chemosensitivity and Prognosis for Colorectal Liver Metastasis. 国際誌

    Yuki Hirose, Jun Sakata, Takashi Kobayashi, Kohei Miura, Kizuki Yuza, Mae Nakano, Hiroshi Ichikawa, Masayuki Nagahashi, Yoshifumi Shimada, Hitoshi Kameyama, Toshifumi Wakai

    Anticancer research   41 ( 3 )   1563 - 1570   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND/AIM: This study aimed to evaluate how NAD(P)H: quinone oxidoreductase-1 (NQO1) affects survival after hepatectomy in patients with colorectal liver metastasis (CRLM). PATIENTS AND METHODS: A retrospective analysis was conducted of 88 consecutive patients who underwent hepatectomy for CRLM. Of the 88 patients, preoperative chemotherapy was administered to 30 patients. Immunohistochemistry of the resected specimens was conducted using monoclonal anti-NQO1 antibody. RESULTS: NQO1-positive expression in tumor cells of CRLM was associated with worse overall survival (p=0.026) and was an independent adverse prognostic factor in multivariate analysis (hazard ratio=5.296, p=0.007). Among 30 patients who received preoperative chemotherapy, patients with loss of NQO1 expression in non-neoplastic epithelial cells of the bile ducts (NQO1 polymorphism: n=19) showed significantly better response to preoperative chemotherapy for CRLM (p=0.004). CONCLUSION: NQO1-positive expression in tumor cells of CRLM may be an adverse prognostic factor after hepatectomy for CRLM.

    DOI: 10.21873/anticanres.14916

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  • ASO Author Reflections: ypTNM Stage Grouping in the 8th Edition of the AJCC Cancer Staging Manual Refines the Prognostic Prediction for Patients with Esophageal Squamous Cell Carcinoma Undergoing Neoadjuvant Chemotherapy. 国際誌

    Natsuru Sudo, Hiroshi Ichikawa, Yusuke Muneoka, Takaaki Hanyu, Yosuke Kano, Takashi Ishikawa, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Takeo Bamba, Satoru Nakagawa, Shin-Ichi Kosugi, Toshifumi Wakai

    Annals of surgical oncology   28 ( 2 )   661 - 662   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1245/s10434-020-09184-0

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  • Clinical Utility of ypTNM Stage Grouping in the 8th Edition of the American Joint Committee on Cancer TNM Staging System for Esophageal Squamous Cell Carcinoma. 国際誌

    Natsuru Sudo, Hiroshi Ichikawa, Yusuke Muneoka, Takaaki Hanyu, Yosuke Kano, Takashi Ishikawa, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Takeo Bamba, Satoru Nakagawa, Shin-Ichi Kosugi, Toshifumi Wakai

    Annals of surgical oncology   28 ( 2 )   650 - 660   2021年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The 8th edition of the American Joint Committee on Cancer (AJCC) TNM staging system provided a specific 'ypTNM' stage grouping for patients with esophageal cancer. OBJECTIVE: This study aimed to evaluate the clinical utility of the AJCC 8th edition ypTNM stage grouping for patients with esophageal squamous cell carcinoma (ESCC). METHODS: We enrolled 152 patients with ESCC who underwent surgery after neoadjuvant cisplatin plus 5-fluorouracil (CF) therapy between June 2005 and December 2011. ypStage was evaluated according to the AJCC 7th and 8th editions. Predictive performance for disease-specific survival (DSS) and overall survival (OS) was compared between both editions. The prognostic significance of ypTNM stage grouping was evaluated using univariate and multivariate analyses. RESULTS: Revision of the AJCC 7th edition to the 8th edition was associated with a change in ypStage in 96 patients (63.2%). The AJCC 8th edition revealed a better predictive performance than the 7th edition in terms of DSS (Akaike's information criterion [AIC] 499 vs. 513; Bayesian information criterion [BIC] 505 versus 519; concordance index [C-index] 0.725 versus 0.679) and OS (AIC 662 vs. 674; BIC 669 vs. 681; C-index 0.662 vs. 0.622). On univariate and multivariate analyses, ypStage in the 8th edition was an independent prognostic factor for both DSS and OS. CONCLUSIONS: ypTNM stage grouping in the AJCC 8th edition provided a better predictive performance for DSS and OS than that in the 7th edition. ypStage in the 8th edition was the most reliable prognostic factor for ESCC patients who underwent surgery after neoadjuvant CF therapy.

    DOI: 10.1245/s10434-020-09181-3

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  • Oncological outcomes of surgery for recurrent biliary tract cancer: who are the best candidates? 国際誌

    Jun Sakata, Tatsuya Nomura, Takashi Aono, Chie Kitami, Naoyuki Yokoyama, Masahiro Minagawa, Kazuyasu Takizawa, Kohei Miura, Yuki Hirose, Hiroshi Ichikawa, Masayuki Nagahashi, Yoshifumi Shimada, Takashi Kobayashi, Toshifumi Wakai

    HPB : the official journal of the International Hepato Pancreato Biliary Association   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: This study aimed to investigate the impact of surgery on outcomes in patients with recurrent biliary tract cancer (BTC) and elucidate factors affecting survival after surgery for this disease. METHODS: A single-center study was undertaken in 178 patients with recurrent BTC, of whom 24 underwent surgery for recurrence, 85 received chemotherapy, and 69 received best supportive care. Then, we carried out a multicenter study in 52 patients undergoing surgery for recurrent BTC (gallbladder cancer, 39%; distal cholangiocarcinoma, 27%; perihilar cholangiocarcinoma, 21%; intrahepatic cholangiocarcinoma, 13%). RESULTS: In the single-center study, 3-year survival after recurrence was 53% in patients who underwent surgery, 4% in those who received chemotherapy, and 0% in those who received best supportive care (p < 0.001). Surgery was an independently prognostic factor (p < 0.001). In the multicenter series, the respective 3-year and 5-year survival after surgery for recurrence was 50% and 29% in the 52 patients. Initial site of recurrence was the only independent prognostic factor (p = 0.019). Five-year survival after surgery for recurrence in patients with single distant, multifocal distant, and locoregional recurrence was 51%, 0%, and 0%, respectively (p = 0.002). Sites of single distant recurrence included the liver (n = 13, 54%), distant lymph nodes (all from gallbladder cancer, n = 7, 29%), lung (n = 2, 9%), peritoneum (n = 1, 4%), and abdominal wall (n = 1, 4%). CONCLUSION: Surgery may be an effective option for patients with less aggressive tumor biology characterized by single distant recurrence in recurrent BTC.

    DOI: 10.1016/j.hpb.2021.01.007

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  • [Amelanotic Malignant Melanoma of the Esophagogastric Junction-A Case Report].

    Ryota Magara, Yosuke Kano, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Yusuke Muneoka, Kohei Miura, Kazuyasu Takizawa, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Kaori Takamura, Hajime Umezu, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 13 )   2083 - 2085   2020年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 73-year-old man presented with anemia, and gastroscopy showed a nonpigmented tumor in the esophagogastric junction. The result of the tumor biopsy initially suspected poorly differentiated adenocarcinoma. However, additional immunohistochemical examination revealed malignant melanoma. The final diagnosis was amelanotic malignant melanoma of the esophagogastric junction with adrenal and spinal metastasis. Although immunotherapy was performed, the patient died 132 days after diagnosis.

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  • [Long-Term Survival after Surgery with Postoperative Chemotherapy for Perihilar Cholangiocarcinoma with Residual Invasive Carcinoma at Ductal Resection Margins-A Case Report].

    Tomo Oiwa, Kohei Miura, Jun Sakata, Kizuki Yuza, Koji Toge, Yuki Hirose, Kazuyasu Takizawa, Hiroshi Ichikawa, Takaaki Hanyu, Masato Nakano, Masayuki Nagahashi, Yoshifumi Shimada, Takashi Ishikawa, Takashi Kobayashi, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 13 )   1899 - 1901   2020年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 64-year-old man with liver dysfunction was given a diagnosis of perihilar cholangiocarcinoma(Bismuth type Ⅳ). The tumor was predominantly right-sided and invaded to the bifurcation of the right and left portal veins. After confirming sufficient liver functional reserve and future liver remnant, the patient underwent extended right hepatectomy, extrahepatic bile duct resection, and portal vein resection and reconstruction. Intraoperative examination of frozen sections revealed the presence of residual invasive carcinoma on both the hepatic and duodenal sides of the ductal resection margins. However, we did not perform pancreaticoduodenectomy or additional resection of the margin-positive proximal bile duct considering the curability and invasiveness of these procedures. He received postoperative chemotherapy with biweekly gemcitabine plus cisplatin for 1 year, followed by gemcitabine monotherapy for 1 year, and S-1 monotherapy has been performed since then. He remains alive and well with no evidence of disease 63 months after surgery.

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  • [A Case of Umbilical Metastasis from Pancreatic Cancer after Surgery].

    Kazuyasu Takizawa, Jun Sakata, Hiroki Nagaro, Kizuki Yuza, Koji Toge, Yuki Hirose, Hirosuke Ishikawa, Natsuru Sudo, Kohei Miura, Hiroshi Ichikawa, Masayuki Nagahashi, Yoshifumi Shimada, Takashi Kobayashi, Takashi Ishikawa, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 13 )   2409 - 2411   2020年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    The patient was a 63-year-old woman with diagnosis of pancreatic cancer. Abdominal CT showed pancreatic head tumor and paraaortic lymph node metastasis. We performed chemotherapy with nab-paclitaxel plus gemcitabine. After 5 courses of chemotherapy, the tumor reduced in size. Pancreaticoduodenectomy followed by adjuvant chemotherapy with S-1 was performed. Fourteen months after surgery, umbilical metastasis(Sister Mary Joseph's nodule: SMJN)was found in the umbilicus near the abdominal incisional hernia. There was no evidence of metastasis except in the umbilicus, we performed the umbilical tumor resection and abdominal incisional hernia repair. Pathological diagnosis was pancreatic cancer metastasis. Although following chemotherapy, multiple skin metastases was found in the lower abdomen 3 months after umbilical resection. We performed skin metastases resection to relieve pain and symptoms of bleeding. But she died 29 months after the initial therapy(7 months after umbilical resection).

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  • A giant pelvic solitary fibrous tumor with Doege-Potter syndrome successfully treated with transcatheter arterial embolization followed by surgical resection: a case report. 国際誌

    Kizuki Yuza, Jun Sakata, Hiroki Nagaro, Takuya Ando, Yuki Hirose, Kohei Miura, Kazuyasu Takizawa, Takashi Kobayashi, Hiroshi Ichikawa, Takaaki Hanyu, Yoshifumi Shimada, Masayuki Nagahashi, Shin-Ichi Kosugi, Toshifumi Wakai

    Surgical case reports   6 ( 1 )   299 - 299   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Solitary fibrous tumor (SFT), a mesenchymal fibroblastic tumor with a hypervascular nature, rarely develops in the pelvis. Resection of a giant SFT occupying the pelvic cavity poses an increased risk of developing massive hemorrhage during resection, although surgical resection is the most effective treatment method for this tumor to achieve a potential cure. SFT rarely develops with Doege-Potter syndrome, which is known as a paraneoplastic syndrome characterized by non-islet cell tumor hypoglycemia (NICTH) secondary to SFT that secretes insulin-like growth factor-II (IGF-II). We present a case of a giant pelvic SFT with Doege-Potter syndrome, which was successfully treated with transcatheter arterial embolization (TAE) followed by surgical resection. CASE PRESENTATION: A 46-year-old woman presented with a disorder of consciousness due to refractory hypoglycemia. Images of the pelvis showed a giant and heterogeneously hypervascular mass displacing and compressing the rectum. Endocrinological evaluation revealed low serum levels of insulin and C-peptide consistent with NICTH. Angiography identified both the inferior mesenteric artery and the bilateral internal iliac artery as the main feeders of the tumor. To avoid intraoperative massive bleeding, super-selective TAE was performed for the tumor 2 days prior to surgery. Hypoglycemia disappeared after TAE. The tumor was resected completely, with no massive hemorrhage during resection. Histologically, it was diagnosed as IGF-II-secreting SFT. Partial necrosis of the rectum in the specimen was observed due to TAE. The patient was followed up for 2 years and no evidence of disease has been reported. CONCLUSIONS: Preoperative angiography followed by TAE is an exceedingly helpful method to reduce intraoperative hemorrhage when planning to resect SFT occupying the pelvic cavity. Complications related to ischemia should be kept in mind after TAE, which needs to be planned within 1 or 2 days before surgery. TAE for tumors may be an option in addition to medical and surgical treatment for persistent hypoglycemia in Doege-Potter syndrome.

    DOI: 10.1186/s40792-020-01076-5

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  • Clinicopathological Characteristics and Surgical Outcomes of Primary Cystic Duct Carcinoma: A Multi-institutional Study. 国際誌

    Jun Sakata, Yuki Hirose, Pankaj Prasoon, Chie Kitami, Masahiro Minagawa, Tatsuya Nomura, Naoyuki Yokoyama, Takashi Aono, Kizuki Yuza, Kohei Miura, Tomohiro Katada, Kazuyasu Takizawa, Masayuki Nagahashi, Takashi Kobayashi, Toshifumi Wakai

    World journal of surgery   44 ( 11 )   3875 - 3883   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The role of surgery in the management of primary cystic duct carcinoma (CDC) remains unclear especially in advanced disease. This study aimed to evaluate long-term outcomes in patients undergoing surgery for primary CDC. METHODS: From a multi-institutional database, we identified 41 patients who underwent surgery for primary CDC, defined as a part of gallbladder carcinoma with the tumor centre located in the cystic duct. RESULTS: Of the 41 patients, 31 (75.6%) underwent preoperative biliary drainage for jaundice. Twenty-eight (68.3%) patients underwent extensive resection including major hepatectomy (n = 21), pancreaticoduodenectomy (n = 4), or both procedures (n = 3). Thirty-four (82.9%) patients had ≥ pT3 tumor, while 31 (75.6%) patients had involvement of contiguous organs/structures. Nodal and distant metastasis was found in 26 (63.4%) and 7 (17.1%) patients, respectively. Most patients (90.2%) had perineural invasion. Median overall survival was 23.7 months in all 41 patients. Factors independently associated with both overall and disease-specific survival were pN (P = 0.003 and P = 0.007, respectively) and pM (P = 0.003 and P = 0.013, respectively) classification. Median survival was 75.3, 17.7, and 5.2 months for patients with pN0M0 (n = 14), pN1/2pM0 or pN0pM1 (n = 21), and pN1/2pM1 (n = 6) disease, respectively (P < 0.001). CONCLUSIONS: Primary CDC is characterized by locally advanced disease with aggressive histopathological characteristics at surgery, leading to extensive resection during treatment. Surgery provides potential benefits for patients with pN0pM0 disease, whereas pN1/2 and/or pM1 status appear to have strong adverse effects on survival.

    DOI: 10.1007/s00268-020-05656-2

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  • Primary lung squamous cell carcinoma and its association with gastric metastasis: A case report and literature review. 国際誌

    Mariko Nemoto, Pankaj Prasoon, Hiroshi Ichikawa, Takaaki Hanyu, Yosuke Kano, Yusuke Muneoka, Kenji Usui, Yuki Hirose, Kohei Miura, Yoshifumi Shimada, Masayuki Nagahashi, Jun Sakata, Takashi Ishikawa, Masanori Tsuchida, Toshifumi Wakai

    Thoracic cancer   11 ( 6 )   1708 - 1711   2020年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Nearly 50% of primary lung carcinoma patients present with distant metastasis at their first visit. However, gastrointestinal tract (GIT) metastasis is an infrequent impediment. Herein, we report a case of progressive dysphagia and epigastralgia as an initial manifestation of recurrence as gastric metastasis of primary lung squamous cell carcinoma (SCC) after curative surgery. A 64-year-old man was diagnosed with primary lung SCC of the right lower lobe, and underwent thoracoscopic lower lobectomy. One year after lobectomy, computed tomography (CT) scan showed a gastric fundal mass located in the gastric cardia which measured 5 cm. Endoscopic biopsies and histopathology subsequently confirmed that tumor was SCC. The patient then underwent proximal gastrectomy with resection of the diaphragmatic crus. Following surgery, histopathological examination revealed gastric metastasis from primary lung SCC. KEY POINTS: Gastric metastasis of primary lung carcinoma is one of the rarest phenomena. Gastrointestinal symptoms should raise suspicion of the presence of advanced metastatic disease with poor prognosis.

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  • Long-term outcomes of surgical resection for T1b gallbladder cancer: an institutional evaluation. 国際誌

    Kizuki Yuza, Jun Sakata, Pankaj Prasoon, Yuki Hirose, Taku Ohashi, Koji Toge, Kohei Miura, Masayuki Nagahashi, Takashi Kobayashi, Toshifumi Wakai

    BMC cancer   20 ( 1 )   20 - 20   2020年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: There is no comprehensive agreement concerning the overall performance of radical resection for T1b gallbladder cancer (GBC). This research focused on addressing whether T1b GBC may spread loco-regionally and whether radical resection is necessary. METHODS: A retrospective analysis was conducted of 1032 patients with GBC who underwent surgical resection at our centre and its affiliated institutions between January 1982 and December 2018. A total of 47 patients with T1b GBC, 29 (62%) of whom underwent simple cholecystectomy and 18 (38%) of whom underwent radical resection with regional lymph node dissection, were enrolled in the study. RESULTS: GBC was diagnosed pre-operatively in 16 patients (34%), whereas 31 patients (66%) had incidental GBC. There was no blood venous or perineural invasion in any patient on histology evaluation, except for lymphatic vessel invasion in a single patient. There were no metastases in any analysed lymph nodes. The open surgical approach was more prevalent among the 18 patients who underwent radical resection (open in all 18 patients) than among the 29 patients who underwent simple cholecystectomy (open in 21; laparoscopic in 8) (P = 0.017). The cumulative 10- and 20-year overall survival rates were 65 and 25%, respectively. The outcome following simple cholecystectomy (10-year overall survival rate of 66%) was akin to that following radical resection (64%, P = 0.618). The cumulative 10- and 20-year disease-specific survival rates were 93 and 93%, respectively. The outcome following simple cholecystectomy (10-year disease-specific survival rate of 100%) was equivalent to that following radical resection (that of 86%, P = 0.151). While age (> 70 years, hazard ratio 5.285, P = 0.003) and gender (female, hazard ratio 0.272, P = 0.007) had a strong effect on patient overall survival, surgical procedure (simple cholecystectomy vs. radical resection) and surgical approach (open vs. laparoscopic) did not. CONCLUSIONS: Most T1b GBCs represent local disease. As pre-operative diagnosis, including tumour penetration of T1b GBC, is difficult, the decision of radical resection is justified. Additional radical resection is not required following simple cholecystectomy provided that the penetration depth is restricted towards the muscular layer and that surgical margins are uninvolved.

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  • [A Case of Peritoneal Metastases after Radiofrequency Ablation for Liver Metastasis from a Pancreatic Neuroendocrine Tumor].

    Hiroki Nagaro, Yuki Hirose, Tomohiro Katada, Jun Sakata, Takashi Kobayashi, Kazuyasu Takizawa, Kohei Miura, Koji Toge, Takuya Ando, Kizuki Yuza, Hiroshi Ichikawa, Masayuki Nagahashi, Yoshifumi Shimada, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 13 )   2015 - 2017   2019年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 77-year-old woman presented with peritoneal metastases from a pancreatic neuroendocrine tumor(p-NET). At the age of 56 years, she underwent distal pancreatectomy for p-NET, which was pathologically diagnosed as G2. She underwent right hemihepatectomy for liver metastasis(S6)from the p-NET 10 years post-pancreatectomy. Eight years post-hepatectomy, radiofrequency ablation(RFA)was attempted for liver metastasis(S4)from the p-NET. However, RFA was not completed because of hematoma development along the needle tract of RFA. She underwent partial hepatectomy for this lesion 6 months post-RFA. Two years post-RFA, localized peritoneal metastases on the right diaphragm were detected. She underwent en bloc tumor resection with partial resection of the diaphragm. She remains alive and well with no evidence of disease 2 years post-resection of the peritoneal metastases from the p-NET.

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  • [A Case of Esophageal Primary Malignant Melanoma That Developed During the Follow-Up of Esophageal Melanocytosis].

    Daisuke Yamai, Hiroshi Ichikawa, Yosuke Kano, Takaaki Hanyu, Takashi Ishikawa, Kenji Usui, Mariko Nemoto, Yuki Hirose, Kohei Miura, Masayuki Nagahashi, Yoshifumi Shimada, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 13 )   2012 - 2014   2019年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 78-year-old woman was endoscopically followed up for benign melanocytosis in the middle thoracic esophagus that was detected 3 years prior. She presented with chest tightness, and an endoscopic examination revealed a protruding tumor at the melanotic lesion. She was histologically diagnosedwith an esophageal primary malignant melanoma. Computedtomography showedno metastatic lesions. She underwent minimally invasive esophagectomy with 2-fieldlymphad enectomy. Immunotherapy with nivolumab is ongoing for liver metastasis, which developed1 year and6 months after esophagectomy. Careful follow-up for esophageal melanocytosis is important for early diagnosis of esophageal primary malignant melanoma.

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  • [A Case of Esophageal Cancer Achieving a Pathological Complete Response after Preoperative Docetaxel, Cisplatin, and 5-Fluorouracil Therapy].

    Daisuke Motegi, Hiroshi Ichikawa, Yosuke Kano, Takaaki Hanyu, Takashi Ishikawa, Kenji Usui, Takeshi Sakai, Yuki Hirose, Kohei Miura, Masayuki Nagahashi, Yoshifumi Shimada, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 13 )   2192 - 2194   2019年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 66-year-old man with middle thoracic esophageal squamous cell carcinoma with supraclavicular lymph node metastasis visited our hospital. He underwent 3 courses of preoperative chemotherapy with docetaxel, cisplatin, and 5-FU(DCF)with a clinically-determined partial response. Minimally-invasive esophagectomy with 3-fieldlymphad enectomy was subsequently performed. Histopathologic examination revealedno viable tumor cells in the resectedesophagus andsupraclavicular lymph node. DCF is a promising preoperative chemotherapy regimen for locally advanced esophageal cancer because of its higher complete response rate comparedto that for cisplatin plus 5-FU.

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  • Early-stage T1b adenocarcinoma arising in the remnant cystic duct after laparoscopic cholecystectomy: a case report and literature review. 査読

    Prasoon P, Hirose Y, Sakata J, Yuza K, Moro K, Toge K, Miura K, Nagahashi M, Kobayashi T, Nihei K, Nakamura A, Wakai T

    BMC surgery   19 ( 1 )   183   2019年11月

  • Lymphatic spread of T2 gallbladder carcinoma: Regional lymphadenectomy is required independent of tumor location. 査読

    Toge K, Sakata J, Hirose Y, Yuza K, Ando T, Soma D, Katada T, Miura K, Takizawa K, Kobayashi T, Wakai T

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology   2019年3月

  • [Surgical Resection after Transarterial Chemoembolization for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus-Report of a Long-Term Survivor]. 査読

    Sakata J, Kobayashi T, Takizawa K, Miura K, Katada T, Hirose Y, Toge K, Ando T, Soma D, Yuza K, Ichikawa H, Nagahashi M, Shimada Y, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 2 )   297 - 299   2019年2月

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  • [A Case of Peritoneal Recurrence of Invasive Ductal Carcinoma Derived from Intraductal Papillary Mucinous Neoplasm after Surgery Treated with Palliative Radiation Therapy and Chemotherapy]. 査読

    Takizawa K, Sakata J, Ando T, Yuza K, Toge K, Hirose Y, Nakano T, Ishikawa H, Katada T, Miura K, Nagahashi M, Shimada Y, Kameyama H, Kobayashi T, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 2 )   372 - 374   2019年2月

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  • [A Case of Resistance to Systemic Therapy in Hypermutation of Colorectal Cancer].

    Kana Tanaka, Yoshifumi Shimada, Yosuke Tajima, Saki Yamada, Shinnosuke Hotta, Mae Nakano, Masato Nakano, Hitoshi Kameyama, Kohei Miura, Hiroshi Ichikawa, Masayuki Nagahashi, Hitoshi Nogami, Satoshi Maruyama, Yasumasa Takii, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 13 )   2476 - 2478   2018年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A 78-year-old man was admitted with diarrhea. Colonoscopy and computed tomography(CT)revealed rectal cancer with multiple liver metastases. Low anterior resection was performed for local control. After the operation, 5 courses of mFOLFOX6 plus bevacizumab chemotherapy were administered as first-line systemic therapy, but CT showed progressive disease with liver metastases. After the first-line systemic therapy, 2 courses of FOLFIRI plus bevacizumab chemotherapy were performed as second-line systemic therapy, but CT also revealed progressive disease with liver metastases. We retrospectively performed comprehensive genomic sequencing with a 415-gene panel and found that the patient had a hypermutation subtype. Interestingly, the panel also revealed that he had mismatch-repair(MMR)deficiency with MSH2 mutation, which is reported as a possible cause of resistance to 5-fluorouracil in colorectal cancer.

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  • [Staged Laparoscopy-Assisted Surgery Including Hand-Assisted Laparoscopic Surgery for Rectal Cancer with Synchronous Liver Metastases-A Case Report].

    Saki Yamada, Yoshifumi Shimada, Akio Matsumoto, Kaoru Abe, Kana Tanaka, Hidehito Oyanagi, Takahiro Otani, Shinnosuke Hotta, Natsuru Sudo, Kohei Miura, Yosuke Tajima, Masato Nakano, Jun Sakata, Hitoshi Kameyama, Toshifumi Wakai

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 13 )   1851 - 1853   2018年12月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Here, we reported a case of a 39-year-old woman having rectal cancer with multiple liver metastases who underwent staged laparoscopic resection. She was diagnosed with low rectal cancer and multiple liver metastases; thus, she underwent low anterior resection and diverting colostomy. Following the neoadjuvant chemotherapy, she underwent colostomy closure and subsequent hand-assisted laparoscopic partial hepatectomy using the operative site during the colostomy closure. The postoperative course was uneventful, and adjuvant chemotherapy with CapeOX was performed 3 weeks post-surgery. Minimally invasive surgery was performed using hand-assisted laparoscopy.

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  • Different Roles of Sphingosine Kinase 1 and 2 in Pancreatic Cancer Progression. 査読 国際誌

    Kizuki Yuza, Masato Nakajima, Masayuki Nagahashi, Junko Tsuchida, Yuki Hirose, Kohei Miura, Yosuke Tajima, Manabu Abe, Kenji Sakimura, Kazuaki Takabe, Toshifumi Wakai

    The Journal of surgical research   232   186 - 194   2018年12月

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    記述言語:英語  

    BACKGROUND: Pancreatic cancer is a disease with poor prognosis, and development of new treatments is necessary. Sphingosine-1-phosphate (S1P), a bioactive lipid mediator produced by sphingosine kinases (SphK1 and SphK2), plays a critical role in progression of many types of cancer. However, little is known about the role of sphingosine kinases in pancreatic cancer. This study investigated the roles of sphingosine kinases in pancreatic cancer progression. MATERIALS AND METHODS: S1P levels in pancreatic cancer and noncancerous pancreatic tissue were measured in 10 patients. We generated PAN02 murine pancreatic cancer cell lines with a clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated system genes 9 (Cas9)-mediated deletion of SphK1 or SphK2 and assessed cell growth and migration. In an animal model, we assessed the survival of mice injected with PAN02 cells intraperitoneally. RESULTS: S1P levels in the pancreatic cancer tissue were significantly higher than those in noncancerous tissue. SphK1 knockout (KO) cells showed greater proliferation and migration than wild type (WT) cells, and SphK2 KO cells showed less proliferation and migration than WT cells. Animal experiments showed that the survival of mice injected with SphK1 KO cells was significantly shorter than those injected with WT cells, and the survival of mice injected with SphK2 KO cells was longer than those injected with WT cells. Surprisingly, cytotoxic assay using gemcitabine showed that SphK1 KO cells survived less than WT cells, and SphK2 KO cells survived more than WT cells. CONCLUSIONS: S1P produced by SphK1 and SphK2 may have different functions in pancreatic cancer cells. Targeting both SphK1 and SphK2 may be a potential strategy for pancreatic cancer treatment.

    DOI: 10.1016/j.jss.2018.06.019

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  • [Pancreaticoduodenectomy for Recurrent Retroperitoneal Liposarcoma]. 査読

    Ishikawa H, Sakata J, Ando T, Soma D, Yuza K, Toge K, Hirose Y, Katada T, Miura K, Takizawa K, Kobayashi T, Ichikawa H, Nagahashi M, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 13 )   1845 - 1847   2018年12月

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  • [Surgical Resection for Peritoneal Metastasis in Hepatocellular Carcinoma-A Report of Three Cases]. 査読

    Nakano T, Sakata J, Ando T, Yuza K, Soma D, Hirose Y, Katada T, Miura K, Takizawa K, Kobayashi T, Ichikawa H, Nagahashi M, Shimada Y, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 13 )   1949 - 1951   2018年12月

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  • [A Case of Long-Term Survival after Reoperation for Neck Lymph Node Metastasis Occurring Seven Years after Pancreaticoduodenectomy for Pancreatic Adenocarcinoma]. 査読

    Ando T, Takizawa K, Yuza K, Soma D, Toge K, Hirose Y, Katada T, Miura K, Sakata J, Kobayashi T, Ichikawa H, Nagahashi M, Shimada Y, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 13 )   2312 - 2314   2018年12月

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  • Surgical management of carcinoma in situ at ductal resection margins in patients with extrahepatic cholangiocarcinoma. 査読

    Wakai T, Sakata J, Katada T, Hirose Y, Soma D, Prasoon P, Miura K, Kobayashi T

    Annals of gastroenterological surgery   2 ( 5 )   359 - 366   2018年9月

  • Generation of sphingosine-1-phosphate is enhanced in biliary tract cancer patients and is associated with lymphatic metastasis. 査読

    Hirose Y, Nagahashi M, Katsuta E, Yuza K, Miura K, Sakata J, Kobayashi T, Ichikawa H, Shimada Y, Kameyama H, McDonald KA, Takabe K, Wakai T

    Scientific reports   8 ( 1 )   10814   2018年7月

  • Adult living donor liver transplantation for patients with portal vein thrombosis: A single-center experience 査読

    Kohei Miura, Yasuhiko Sugawara, Koushi Uchida, Seiichi Kawabata, Daiki Yoshii, Kaori Isono, Shintaro Hayashida, Yuki Ohya, Hidekazu Yamamoto, Takashi Kobayashi, Toshifumi Wakai, Yukihiro Inomata, Taizo Hibi

    Transplantation Direct   4 ( 5 )   e341   2018年5月

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    掲載種別:研究論文(学術雑誌)  

    Copyright © 2018 The Author(s). Background. Living donor liver transplantation (LDLT) for patients with portal vein thrombosis (PVT) is associated with several technical challenges for its complicated procedures and poor outcomes. Some institutions still consider preexisting PVT as a relatively contraindication for LDLT. Methods. Between April 2010 and May 2016, 129 adults underwent LDLT at our institution, and 28 (21.7%) of whom had preexisting PVT. Portal vein thrombosis was diagnosed using preoperative imaging techniques and intraoperative findings. The characteristics and outcomes of the cases were retrospectively evaluated. Results. The type of PVT included Yerdel grade 1 in 21 (75.0%) cases, grade 2 in 3 (10.7%) cases, and grade 3 in 4 (14.3%) cases. There were no cases of Yerdel grade 4 PVT. After removing thrombus inside the vessel, we performed simple portal vein anastomosis in 25 (89.3%) cases, patch technique with vascular graft in 1 case (3.6%), and an interposition technique with vascular graft in 2 cases (7.1%). Compared with the non-PVT group, cold ischemic time was longer (P = 0.012) and the rate of postoperative PVT was higher (P = 0.001) in PVT group. In the comparison between the recipient without and with postoperative PVT, the existence of preoperative PVT was the independent risk factor in the multivariate analysis (hazard ratio, 7.511; 95% confidence interval 1.382-40.820; P = 0.020). Conclusions. Although it had a technically complicated operation, LDLT could be safely performed in the patients with PVT in our institution.

    DOI: 10.1097/TXD.0000000000000780

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  • Small bowel obstruction after ileal pouch-anal anastomosis with a loop ileostomy in patients with ulcerative colitis 査読

    Hitoshi Kameyama, Yoshifumi Hashimoto, Yoshifumi Shimada, Saki Yamada, Ryoma Yagi, Yosuke Tajima, Takuma Okamura, Masato Nakano, Kohei Miura, Masayuki Nagahashi, Jun Sakata, Takashi Kobayashi, Shin-Ichi Kosugi, Toshifumi Wakai

    Annals of Coloproctology   34 ( 2 )   94 - 100   2018年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Korean Society of Coloproctology  

    Purpose: Small bowel obstruction (SBO) remains a common complication after pelvic or abdominal surgery. However, the risk factors for SBO in ulcerative colitis (UC) surgery are not well known. The aim of the present study was to clarify the risk factors associated with SBO after ileal pouch-anal anastomosis (IPAA) with a loop ileostomy for patients with UC. Methods: The medical records of 96 patients who underwent IPAA for UC between 1999 and 2011 were reviewed. SBO was confirmed based on the presence of clinical symptoms and radiographic findings. The patients were divided into 2 groups: the SBO group and the non-SBO group. We also analyzed the relationship between SBO and computed tomography (CT) scan image parameters. Results: The study included 49 male and 47 female patients. The median age was 35.5 years (range, 14-72 years). We performed a 2- or 3-stage procedure as a total proctocolectomy and IPAA for patients with UC. SBO in the pretakedown of the loop ileostomy after IPAA occurred in 22 patients (22.9%). Moreover, surgical intervention for SBO was required for 11 patients. In brief, closure of the loop ileostomy was performed earlier than expected. A multivariate logistic regression analysis revealed that the 2-stage procedure (odds ratio, 2.850
    95% confidence interval, 1.009-8.044
    P = 0.048) was a significant independent risk factor associated with SBO. CT scan image parameters were not significant risk factors of SBO. Conclusion: The present study suggests that a 2-stage procedure is a significant risk factor associated with SBO after IPAA in patients with UC.

    DOI: 10.3393/ac.2017.06.14

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  • Effects of carbon monoxide on early dysfunction and microangiopathy following GalT-KO porcine pulmonary xenotransplantation in cynomolgus monkeys 査読

    Hisashi Sahara, Mitsuhiro Sekijima, Yuichi Ariyoshi, Akihiro Kawai, Kohei Miura, Shiori Waki, Louras Nathan, Yusuke Tomita, Takehiro Iwanaga, Kazuaki Nakano, Hitomi Matsunari, Hiroshi Date, Hiroshi Nagashima, Akira Shimizu, Kazuhiko Yamada

    Xenotransplantation   25 ( 1 )   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Blackwell Publishing Inc.  

    Background: Despite progress in the current genetic manipulation of donor pigs, most non-human primates were lost within a day of receiving porcine lung transplants. We previously reported that carbon monoxide (CO) treatment improved pulmonary function in an allogeneic lung transplant (LTx) model using miniature swine. In this study, we evaluated whether the perioperative treatment with low-dose inhalation of CO has beneficial effects on porcine lung xenografts in cynomolgus monkeys (cynos). Methods: Eight cynos received orthotopic left LTx using either α-1,3-galactosyltransferase knockout (GalT-KO
    n = 2) or GalT-KO with human decay accelerating factor (hDAF) (GalT-KO/hDAF
    n = 6) swine donors. These eight animals were divided into three groups. In Group 1 (n = 2), neither donor nor recipients received CO therapy. In Group 2 (n = 4), donors were treated with inhaled CO for 180-minute. In Group 3 (n = 2), both donors and recipients were treated with CO (donor: 180-minute
    recipient: 360-minute). Concentration of inhaled CO was adjusted based on measured levels of carboxyhemoglobin in the blood (15%-20%). Results: Two recipients survived for 3 days
    75 hours (no-CO) and 80 hours (CO in both the donor and the recipient), respectively. Histology showed less inflammatory cell infiltrates, intravascular thrombi, and hemorrhage in the 80-hour survivor with the CO treatment than the 75-hours non-CO treatment. Anti–non-Gal cytotoxicity levels did not affect the early loss of the grafts. Although CO treatment did not prolong overall xeno lung graft survival, the recipient/donor CO treatment helped to maintain platelet counts and inhibit TNF-α and IL-6 secretion at 2 hours after revascularization of grafts. In addition, lung xenografts that were received recipient/donor CO therapy demonstrated fewer macrophage and neutrophil infiltrates. Infiltrating macrophages as well as alveolar epithelial cells in the CO-treated graft expressed heme oxygenase-1. Conclusion: Although further investigation is required, CO treatment may provide a beneficial strategy for pulmonary xenografts.

    DOI: 10.1111/xen.12359

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  • Feasibility of Monotherapy by Rituximab Without Additional Desensitization in ABO-incompatible Living-Donor Liver Transplantation 査読

    Hidekazu Yamamoto, Koshi Uchida, Seiichi Kawabata, Kaori Isono, Kohei Miura, Shintaro Hayashida, Yuki Oya, Yasuhiko Sugawara, Yukihiro Inomata

    Transplantation   102 ( 1 )   97 - 104   2018年1月

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    掲載種別:研究論文(学術雑誌)  

    Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved. Background Rituximab is a cornerstone in the regimens of desensitization for ABO-incompatible living-donor liver transplantation (ABO-i LDLT) that makes this modality an acceptable option for liver transplantation. Plasmapheresis (PP) to reduce anti-ABO antibody titer and local infusion (LI) therapy were practiced as the strategies for desensitization before the application of rituximab and were reported as additional treatments. The aim of this study was to clarify the feasibility of monotherapy by rituximab without any additional desensitization treatments in ABO-i LT. Methods Forty patients receiving ABO-i LDLT with rituximab were enrolled in this retrospective study. The patients were divided into 2 groups: the rituximab with pretransplant PP and posttransplant LI (RPL) group (n = 20) and the rituximab monotherapy (RM) without any additional treatment group (n = 20). The groups were then compared in terms of the rates of patient survival, antibody-mediated rejection (AMR), and infection. Results The 1-, 3-, and 5-year patient survival rates were 85%, 85%, and 85% in the RPL group and 89%, 80%, and 80% in the RM group, respectively. There was no significant difference in patient survival between the 2 groups. There were no episodes of AMR in either group. The RM group had a lower rate of fungal and viral infections than the RPL group. Conclusions Pretransplant rituximab without additional treatments yielded satisfactory outcomes comparable to that with additional treatments, such as PP and LI.

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  • Six National University Consortium in Liver Transplant Professionals Training (SNUC-LT) Program in Japan 査読

    K. Takagi, K. Miura, S. Nakanuma, S. Sakamoto, H. Yamamoto, T. Yagi, S. Eguchi, T. Ohta, T. Wakai, M. Ohtsuka, S. Uemoto, M. Kasahara, Y. Inomata

    Transplantation Proceedings   50 ( 1 )   168 - 174   2018年

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    掲載種別:研究論文(学術雑誌)  

    © 2017 Elsevier Inc. Background: There has been no public structured training program for transplant surgeons in Japan. However, such a program is crucial for optimizing liver transplant surgery and training young professionals in liver transplant surgery. A comprehensive training program was recently developed and the underlying concepts, structure and curriculum, and results of this program are described here. Methods: We developed a 3-year training program in 2014 called the Six National University Consortium in Liver Transplant Professionals Training (SNUC-LT) program supported by the Ministry of Education, Culture, Sports, Science, and Technology. This program is based on strong cooperation among 6 national universities (Kumamoto, Okayama, Nagasaki, Kanazawa, Niigata, and Chiba Universities). The program includes various courses to help trainees learn transplant theory and practice as well as to teach surgical skills required to safely perform transplant surgery. Results: Three trainees completed the specially designed 3-year curriculum. They attended lectures on transplant theory for an average of 59 hours and participated in an average of 44 liver transplant surgeries and 51 liver resections for transplant practice. Trainees from low-volume centers had sufficient opportunities to attend operations in high-volume centers because of the cooperative agreement among the universities. After finishing the program, the trainees were certified as talent-proven liver transplant surgeons. Conclusions: The SNUC-LT program is the first national program in Japan to have strong professional support. Our multicenter program enables young surgeons to have more abundant knowledge, more extensive experience, better surgical skills, and smoother communication skills in the field of liver transplantation.

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  • The outcomes of pediatric liver retransplantation from a living donor: a 17-year single-center experience 査読

    Kohei Miura, Seisuke Sakamoto, Keita Shimata, Masaki Honda, Takashi Kobayashi, Toshifumi Wakai, Yasuhiko Sugawara, Yukihiro Inomata

    SURGERY TODAY   47 ( 11 )   1405 - 1414   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Liver retransplantation is the only therapeutic option for patients with graft failure after liver transplantation. The aim of this study is to evaluate the outcomes of pediatric retransplantation from living donor at a single center.
    Between December 1998 to August 2015, retransplantation from a living donor was performed for 14 children (&lt; 18 years of age) at Kumamoto University Hospital. The characteristics of the retransplantation recipient and the clinicopathological factors between primary transplantation and retransplantation were analyzed to detect the prognostic factors.
    In retransplantation, the operative time was longer and the amount of blood loss was greater in comparison to primary transplantation. The 1-, 3-, and 5-year survival rates from the date of retransplantation were 85.7, 85.7, and 78.6%, respectively. The rates of re-laparotomy after primary transplantation, bile leakage and postoperative bleeding after retransplantation were higher than after primary transplantation. Among the three patients who died after retransplantation, the operative time, the rate of re-laparotomy after primary transplantation and the incidence of gastrointestinal complications were higher in comparison to the surviving patients.
    Pediatric retransplantation from a living donor is an acceptable procedure that could save the lives of recipients with failing allografts when organs from deceased donors are scarce. To ensure good results, it is essential to make an appropriate assessment of the cardiopulmonary function and the infectious state of the patients before Re-LDLT.

    DOI: 10.1007/s00595-017-1533-7

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  • [Mixed Type Liposarcoma with Intra-Abdominal Bleeding - Report of a Case]. 査読

    Miura Y, Sakata J, Ando T, Soma D, Yuza K, Hirose Y, Ishikawa H, Miura K, Takizawa K, Kobayashi T, Ichikawa H, Nagahashi M, Shimada Y, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   44 ( 12 )   1155 - 1157   2017年11月

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  • Intravenous Carnitine Administration in Addition to Parenteral Nutrition With Lipid Emulsion May Decrease the Inflammatory Reaction in Postoperative Surgical Patients. 査読

    Koyama Y, Moro K, Nakano M, Miura K, Nagahashi M, Kosugi SI, Tsuchida J, Ikarashi M, Nakajima M, Ichikawa H, Hanyu T, Shimada Y, Sakata J, Kameyama H, Kobayashi T, Wakai T

    Journal of clinical medicine research   9 ( 10 )   831 - 837   2017年10月

  • Hand-assisted laparoscopic Hassab's procedure for esophagogastric varices with portal hypertension. 査読

    Kobayashi T, Miura K, Ishikawa H, Soma D, Zhang Z, Ando T, Yuza K, Hirose Y, Katada T, Takizawa K, Nagahashi M, Sakata J, Kameyama H, Wakai T

    Surgical case reports   3 ( 1 )   111   2017年10月

  • Outcomes of treatment with daclatasvir and asunaprevir for recurrent hepatitis C after liver transplantation 査読

    Masaki Honda, Yasuhiko Sugawara, Takehisa Watanabe, Masakuni Tateyama, Motohiko Tanaka, Koushi Uchida, Seiichi Kawabata, Daiki Yoshii, Kouhei Miura, Kaori Isono, Shintaro Hayashida, Yuki Ohya, Hidekazu Yamamoto, Yutaka Sasaki, Yukihiro Inomata

    HEPATOLOGY RESEARCH   47 ( 11 )   1147 - 1154   2017年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Aim: The development of direct-acting oral agents has dramatically changed the treatment strategy of hepatitis C virus (HCV) infection. Here we aimed to reveal the efficacy and safety of daclatasvir (DCV) and asunaprevir (ASV) for recurrent HCV genotype 1 infection after liver transplantation (LT).
    Methods: A retrospective study was undertaken on nine patients who underwent a 24-week DCV/ASV treatment regimen for recurrent HCV genotype 1 infection. Five of the patients were men; four had failed treatment with pegylated interferon (Peg-IFN)/ribavirin, two had failed simeprevir/Peg-IFN/ribavirin, one had the resistance-associated variant Y93H in the NS5A region, and one underwent maintenance dialysis.
    Results: Median time to treatment initiation following LT was 70months. Of the nine patients treated with DCV/ASV, eight (88.9%) achieved a sustained viral response 12weeks after completion of therapy (SVR12). The patient with virologic failure had failed simeprevir/Peg-interferon/ribavirin therapy 4months before undergoing the DCV/ASV treatment regimen. In addition, a resistance-associated variant D168E in the NS3 region was detected in the patient after discontinuation of the DCV/ASV regimen. The trough level of tacrolimus tended to decrease, and renal function showed no significant changes during treatment. Adverse events occurred in two patients (22.2%), but no severe adverse events occurred during treatment.
    Conclusions: The DCV/ASV regimen was well tolerated, resulting in high rates of sustained viral response 12weeks after completion of therapy for LT patients with recurrent HCV genotype 1 infection.

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  • Relevance of Dissection of the Posterior Superior Pancreaticoduodenal Lymph Nodes in Gallbladder Carcinoma 査読

    Jun Sakata, Takashi Kobayashi, Yosuke Tajima, Taku Ohashi, Yuki Hirose, Kabuto Takano, Kazuyasu Takizawa, Kohei Miura, Toshifumi Wakai

    ANNALS OF SURGICAL ONCOLOGY   24 ( 9 )   2474 - 2481   2017年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Background. This study was designed to evaluate the prognostic value of positive posterior superior pancreaticoduodenal lymph nodes to clarify the need for dissection of these nodes.
    Methods. A total of 148 patients with gallbladder carcinoma who underwent radical resection including dissection of the posterior superior pancreaticoduodenal nodes were enrolled. The incidence of metastasis and the survival rates among patients with metastasis to each lymph node group were calculated.
    Results. Of the 148 patients, 70 (47%) had nodal disease. The incidences of metastasis in the cystic duct, pericholedochal, retroportal, and hepatic artery node groups, defined as regional nodes in the UICC TNM staging system, ranged from 8.3 to 24.3% with 5-year survival rates of 12.5-46.4% in patients with positive nodes. The incidence of metastasis to the posterior superior pancreaticoduodenal nodes was 12.8% with a 5-year survival rate of 31.6% in patients with positive nodes. Survival after resection was significantly better in patients with distant nodal disease affecting only the posterior superior pancreaticoduodenal nodes (5-year survival, 55.6%) than in patients with distant nodal disease beyond these nodes (5-year survival, 15.0%; p = 0.046), whereas survival after resection was comparable between the former group and patients with regional nodal disease alone (5-year survival, 40.7%; p = 0.426).
    Conclusions. In gallbladder carcinoma, involvement of the posterior superior pancreaticoduodenal nodes is similar to that of regional nodes in terms of both the incidence of metastasis and the impact on survival. Inclusion of the posterior superior pancreaticoduodenal nodes among the regional nodes should be considered.

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  • Prognostic heterogeneity of the seventh edition of UICC Stage III gallbladder carcinoma: Which patients benefit from surgical resection? 査読

    J. Sakata, T. Kobayashi, T. Ohashi, Y. Hirose, K. Takano, K. Takizawa, K. Miura, H. Ishikawa, K. Toge, K. Yuza, D. Soma, T. Ando, T. Wakai

    EJSO   43 ( 4 )   780 - 787   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCI LTD  

    Background: This study sought to evaluate the prognostic heterogeneity of Stage III (Union for International Cancer Control, seventh edition) gallbladder carcinoma.
    Methods: Of 175 patients enrolled with gallbladder carcinoma who underwent radical resection, 22 were classified with Stage IIIA disease (T3N0M0) and 46 with Stage IIIB disease (T2N1M0 [n = 23] and T3N1M0 [n = 23]). The median number of retrieved lymph nodes per patient was 18.
    Results: This staging system failed to stratify outcomes between Stages IIIA and IIIM; survival after resection was better for patients with Stage In disease than for patients with Stage IIIA disease, with 5-year survival of 54.9% and 41.0%, respectively (p = 0.366). Multivariate analysis for patients with Stage III disease revealed independently better survival for patients with T2N1M0 than for patients with T3N0M0 (p = 0.016) or T3N1M0 (p = 0.001), with 5-year survival of 77.0%, 41.0%, and 31.0%, respectively. When N1 status was subdivided according to the number of positive nodes, 5-year survival in patients with T2M0 with 1-2 positive nodes, T2M0 with &gt;= 3 positive nodes, T3M0 with 1-2 positive nodes, and T3M0 with &gt;= 3 positive nodes was 83.3%, 50.0%, 45.8%, and 0%, respectively (p &lt; 0.001).
    Conclusions: The prognosis of T2N1M0 disease was better than that of T3N0/1M0 disease, suggesting that not all node-positive patients will have uniformly poor outcomes after resection of gallbladder carcinoma. T2M0 with 1-2 positive nodes leads to a favorable outcome after resection, whereas T3M0 with &gt;= 3 positive nodes indicates a dismal prognosis. (C) 2017 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

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  • Low fat-containing elemental formula is effective for postoperative recovery and potentially useful for preventing chyle leak during postoperative early enteral nutrition after esophagectomy 査読

    Kazuki Moro, Yu Koyama, Shin-ichi Kosugi, Takashi Ishikawa, Hiroshi Ichikawa, Takaaki Hanyu, Kohei Miura, Masayuki Nagahashi, Masato Nakajima, Kumiko Tatsuda, Junko Tsuchida, Chie Toshikawa, Mayuko Ikarashi, Yoshifumi Shimada, Jun Sakata, Takashi Kobayashi, Hitoshi Kameyama, Toshifumi Wakai

    CLINICAL NUTRITION   35 ( 6 )   1423 - 1428   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:CHURCHILL LIVINGSTONE  

    Background and aims: Transthoracic esophagectomy using 3-field lymphadenectomy (TTE-3FL) for esophageal cancer is one of the most aggressive gastrointestinal surgeries. Early enteral nutrition (EN) for TTE-3FL patients is useful and valid for early recovery; however, EN using a fat-containing formula risks inducing chyle leak. In the present study, we retrospectively examined esophageal cancer patients treated byTTE-3FL and administered postoperative EN to elucidate the validity of lowering the fat levels in elemental formulas to prevent postoperative chyle leak and improve postoperative recovery.
    Methods: A total of 74 patients who received TTE-3FL for esophageal cancer were retrospectively examined. Patients were classified into two groups according to the type of postoperative EN: Group LF patients received a low-fat elemental formula, and Group F patients received a standard fat-containing polymeric formula. The following clinical factors were compared between the groups: EN start day, maximum EN calories administered, duration of respirator use, length of ICU stay, incidence of postoperative infectious complications, use of parenteral nutrition (PN), and incidence of postoperative chyle leak.
    Results: Patients in Group LF were started on EN significantly earlier after surgery and they consumed significantly higher maximum EN calories compared to Group F patients (P &lt; 0.01). Duration of respirator use and length of ICU stay were also significantly shorter, and TPN was used significantly less in Group LF compared to Group F (P &lt; 0.05). Postoperative chyle leak was observed in six patients in total (8.1%); five patients in Group F and one patient in Group LF, although there was no significant difference in frequency of chyle leak per patient between Group LF and Group F.
    Conclusions: Early EN using low-fat elemental formula after esophagectomy with three-field lymphadenectomy was safe and valid for postoperative recovery and potentially useful in preventing chyle leak. (C) 2016 The Authors. Published by Elsevier Ltd.

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  • Staged laparotomies based on the damage control principle to treat hemodynamically unstable grade IV blunt hepatic injury in an eight-year-old girl. 査読

    Kobayashi T, Kubota M, Arai Y, Ohyama T, Yokota N, Miura K, Ishikawa H, Soma D, Takizawa K, Sakata J, Nagahashi M, Kameyama H, Wakai T

    Surgical case reports   2 ( 1 )   134   2016年12月

  • [A Case of Long-Term Survival after Repeated Peritoneal Recurrences of Perforated Sigmoid Colon Cancer Treated with Systemic Chemotherapy and R0 Resection of Peritoneal Tumors]. 査読

    Watanabe T, Kobayashi T, Wakai A, Yagi R, Tanaka K, Miura K, Tajima Y, Nagahashi M, Shimada Y, Sakata J, Kameyama H, Kobayashi T, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2139 - 2141   2016年11月

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  • [Long-Term Survival after Reoperation for Lung Metastasis of Resected Pancreatic Adenocarcinoma - A Case Report]. 査読

    Ishikawa H, Takano K, Ando T, Soma D, Yuza K, Hirose Y, Katada T, Miura K, Ohashi T, Takizawa K, Nagahashi M, Sakata J, Kameyama H, Kobayashi T, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2199 - 2201   2016年11月

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  • [A Systematic Analysis of Oncogene and Tumor Suppressor Genes for Panitumumab-Resistant Rectal Cancer with Wild RAS Gene - A Case Report]. 査読

    Tajima Y, Shimada Y, Yagi R, Okamura T, Nakano M, Kameyama H, Nogami H, Maruyama S, Takii Y, Miura K, Ichikawa H, Nagahashi M, Sakata J, Kobayashi T, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2280 - 2282   2016年11月

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  • [A Case of Metastatic Colorectal Cancer with HER2 Overexpression/Amplification]. 査読

    Matsumoto A, Shimada Y, Yagi R, Miura K, Tajima Y, Okamura T, Nakano M, Kameyama H, Nogami H, Maruyama S, Takii Y, Ichikawa H, Sakata J, Kobayashi T, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2307 - 2309   2016年11月

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  • [Resection for a Locally Advanced Duodenal Adenocarcinoma with Obstructive Jaundice and Hepatic and Pancreatic Invasion - A Case Report]. 査読

    Hirose Y, Sakata J, Soma D, Katada T, Ishikawa H, Miura K, Ohashi T, Takizawa K, Takano K, Kobayashi T, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2077 - 2079   2016年11月

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  • [Lymph Node Recurrence of Small Cell Carcinoma of the Extrahepatic Bile Ducts Effectively Treated with Cisplatin plus Irinotecan Chemotherapy - Report of a Case]. 査読

    Katada T, Sakata J, Ando T, Soma D, Yuza K, Toge K, Hirose Y, Ishikawa H, Miura K, Ohashi T, Takizawa K, Takano K, Kobayashi T, Kameyama H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2083 - 2085   2016年11月

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  • [Surgical Resection for Carcinoma Arising from the Remnant Intrapancreatic Bile Duct after Excision of a Congenital Choledochal Cyst - A Case Report]. 査読

    Shimada T, Sakata J, Ando T, Yuza K, Toge K, Hirose Y, Katada T, Ishikawa H, Miura K, Ohashi T, Takizawa K, Takano K, Kobayashi T, Tomita H, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   2101 - 2102   2016年11月

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  • [A Case of Advanced Gastric Cancer Resected for Rebleeding after Palliative Radiotherapy for Hemostasis]. 査読

    Muneoka Y, Ichikawa H, Ishikawa T, Hanyu T, Sato Y, Kano Y, Usui K, Otani T, Hishiki M, Miura K, Nagahashi M, Sakata J, Kobayashi T, Kameyama H, Kosugi S, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   1936 - 1938   2016年11月

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  • [Surgical Resection after Gemcitabine plus Cisplatin Chemotherapy for Intrahepatic Cholangiocarcinoma with Multiple Lymph Node Metastases - Report of a Case]. 査読

    Otani T, Sakata J, Kameyama H, Otani A, Hirose Y, Tamura H, Morimoto Y, Miura K, Yoshino K, Kido T, Kobayashi T, Endo K, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   1764 - 1766   2016年11月

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  • [A Case of Metastatic Colon Cancer Dramatically Affected by Anti-EGFR Antibody Therapy]. 査読

    Yagi R, Shimada Y, Miura K, Tajima Y, Okamura T, Nakano M, Ichikawa H, Nagahashi M, Sakata J, Kobayashi T, Kameyama H, Wakai T, Nogami H, Maruyama S, Takii Y

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 12 )   1800 - 1802   2016年11月

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  • Study of Immune Tolerance Cases in Adult Living Donor Liver Transplantation 査読

    K. Miura, T. Kobayashi, Z. Zhang, D. Soma, Y. Hirose, H. Ishikawa, K. Takizawa, M. Nagahashi, J. Sakata, H. Kameyama, M. Minagawa, S. Kosugi, Y. Koyama, T. Wakai

    TRANSPLANTATION PROCEEDINGS   48 ( 4 )   1119 - 1122   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Background. Complete immune tolerance is the chief goal in organ transplantation. This study aimed to evaluate patients who successfully withdrew from immunosuppressive (IS) agents after living donor liver transplantation (LDLT).
    Materials and Methods. A retrospective review of all adult LDLT from July 1999 to March 2012 was conducted. In patients who acquired immune tolerance after LDLT, their background and the course of surgical procedures were evaluated.
    Results. Of a total of 101 adult LDLT patients, 8 patients were completely free of IS agents. Six of these patients (75%) were female, and the median age at the time of transplantation was 56 years (range, 31-66 years). The primary disease causing liver failure was type C liver cirrhosis (50%), fulminant hepatitis (25%), type B liver cirrhosis (12%), and alcoholic liver cirrhosis (12%). The median Child-Pugh score and MELD score were 13 points (range, 8-15 points) and 19 points (range, 10-18 points), respectively. The living related donor was the recipient's child (75%), sibling (12%), or parent (12%). ABO compatibility was identical in 62%, compatible in 25%, and incompatible in 12%.
    Conclusions. In this study, we evaluated the adult patients who successfully withdrew from IS agents after LDLT. In most cases, it took more than 5 years to reduce IS agents. Because monitoring of the serum transaminase level is not adequate to detect chronic liver fibrosis in immune tolerance cases, further study is required to find appropriate protocols for reducing IS agent use after LDLT.

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  • Successful Endoscopic Management of Acute Necrotic Pancreatitis and Walled Off Necrosis After Auxiliary Partial Orthotopic Living-Donor Liver Transplantation: A Case Report 査読

    T. Kobayashi, K. Miura, H. Ishikawa, D. Soma, Z. Zhang, K. Yuza, Y. Hirose, K. Takizawa, M. Nagahashi, J. Sakata, H. Kameyama, S. Kosugi, T. Wakai

    TRANSPLANTATION PROCEEDINGS   48 ( 4 )   1212 - 1214   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Endoscopic management of acute necrotic pancreatitis and walled off necrosis is less invasive than surgical treatment and has become the 1st choice for treating pancreatic necrosis and abscess. We treated a case of acute necrotic pancreatitis and walled off necrosis after auxiliary partial orthotopic living-donor liver transplantation (APOLT). A 24-year-old woman was admitted to our university hospital for removal of the internal biliary stent, which had already been placed endoscopically for the treatment of biliary stricture after APOLT. She had been treated for acute liver failure by APOLT 10 years before. After we removed the internal stent with the use of an endoscopic retrograde approach, she presented with severe abdominal pain and a high fever. Her diagnosis was severe acute pancreatitis after endoscopic retrograde cholangiography (ERC). Her symptoms worsened, and she had multiple organ failure. She was transferred to the intensive care unit (ICU). Immunosuppression was discontinued because infection treatment was necessary and the native liver had already recovered sufficiently. After she had been treated for 19 days in the ICU, she recovered from her multiple organ failure. However, abdominal computerized tomography demonstrated the formation of pancreatic walled off necrosis and an abscess on the 20th day after ERC. We performed endoscopic ultrasonography-guided abscess drainage and repeated endoscopic necrosectomy. The walled off necrosis diminished gradually in size, and the symptoms disappeared. The patient was discharged on the 87th day after ERC. This is the 1st report of a case of acute necrotic pancreatitis and walled off necrosis that was successfully treated by endoscopic management after APOLT.

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  • Successful Re-resection for Locally Recurrent Retroperitoneal Liposarcoma at Four Years After Ex Vivo Tumor Resection and Autotransplantation of the Liver: A Case Report. 査読

    Kobayashi T, Miura K, Ishikawa H, Soma D, Zhang Z, Yuza K, Hirose Y, Takizawa K, Nagahashi M, Sakata J, Kameyama H, Kosugi S, Wakai T

    Transplantation proceedings   48 ( 4 )   1215 - 1217   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1016/j.transproceed.2016.01.026

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  • Development of the Intestinal Transplantation Model With Major Histocompatibility Complex Inbred CLAWN Miniature Swine 査読

    K. Miura, H. Sahara, S. Waki, A. Kawai, M. Sekijima, T. Kobayashi, Z. Zhang, T. Wakai, A. Shimizu, K. Yamada

    TRANSPLANTATION PROCEEDINGS   48 ( 4 )   1315 - 1319   2016年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Background. Clinical intestinal transplantation (Int-Tx) is associated with some problems such as rejection, infection, graft-versus-host disease, and ischemia-reperfusion injury (IRI). To determine mechanisms of rejection as well as to develop treatment strategies for Int-Tx, this study was designed to establish both heterotopic and orthotropic Int-Tx models using major histocompatibility antigen complex (MHC) inbred CLAWN miniature swine.
    Materials and Methods. Eleven CLAWN miniature swine received MHC matched but minor antigen mismatched allogenic intestinal grafts. Four animals received intestinal grafts heterotopically and kept host intestine intact. The remaining 7 animals received intestinal grafts orthotopically and resected host small intestine. Continuous infusion of tacrolimus was given from day 0 for 12 days.
    Results. Heterotopically transplanted small intestine were well perfused after revascularization; however, grafts easily underwent ischemic changes during or soon after abdomen closure due to oppression of the grafts in the limited abdominal space. In contrast, all of 7 orthotopically transplanted intestinal grafts in which recipients' small intestine was removed from the jejunum to the ileum had no signs of severe ischemia associated with compartment syndrome. Elevation of the serum concentration of inflammatory cytokines and the progression of lethal acidosis seen in recipients of heterotipic transplantation were markedly less in the case of orthotopic transplantation. Two recipients survived more than 30 days, and 1 long-term survivor showed no evidence of rejection at day 90 despite the fact that tacrolimus was stopped at day 12.
    Conclusions. In this study, we demonstrated the establishment of a clinically relevant orthotopic Int-Tx model with long survival in MHC inbred CLAWN miniature swine. We believe that this unique MHC inbred swine Int-Tx model is useful for developing treatment strategies for clinical Int-Tx.

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  • Six-Year Graft Survival After Partial Pancreas Heterotopic Auto-Transplantation: A Case Report 査読

    T. Kobayashi, K. Miura, H. Ishikawa, D. Soma, Z. Zhang, K. Yuza, Y. Hirose, K. Takizawa, M. Nagahashi, J. Sakata, H. Kameyama, S. -I. Kosugi, T. Tada, H. Hirukawa, T. Wakai

    TRANSPLANTATION PROCEEDINGS   48 ( 3 )   988 - 990   2016年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Background. Long-term graft survival of partial pancreas auto-transplantation after total pancreatectomy has not been clarified. The clinical implications of repeat completion pancreatectomy for locally recurrent pancreatic carcinoma in the remnant pancreas after initial pancreatectomy also have not been clarified.
    Methods. We have previously reported a 61-year-old woman presenting with re-sectable carcinoma of the remnant pancreas at 3 years after undergoing a pylorus-preserving pancreaticoduodenectomy for invasive ductal carcinoma of the pancreas head. We also performed distal pancreas auto-transplantation with the use of a part of the resected pancreas to preserve endocrine function.
    Results. The patient was discharged at 20 days after surgery without any complications. She had been followed regularly in our outpatient clinic. She had been treated with S-1 as adjuvant chemotherapy; 72 months after the completion total pancreatectomy with distal partial pancreas auto-transplantation, the patient was alive without any evidence of the pancreatic carcinoma recurrence. The pancreas graft was still functioning with a blood glucose level of 112 mg/dL, HbA1C of 6.7%, and serum C-peptide of 1.2 ng/mL; and urinary C-peptide was 11.6 mu g/d.
    Conclusions. Our patient demonstrated that repeated pancreatectomies can provide a chance for survival after a locally recurrent pancreatic carcinoma if the disease is limited to the remnant pancreas. An additional partial pancreas auto-transplantation was successfully performed to preserve endocrine function. However, the indications for pancreas auto transplantation should be decided carefully in the context of pancreatic carcinoma recurrence.

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  • Histologic determination of primary site of perihilar cholangiocarcinoma based on microscopi'c tumor invasion of the vasculo-biliary sheaths 査読

    Yuki Hirose, Jun Sakata, Makoto Inoue, Zhengkun Zhang, Taku Ohashi, Kohei Miura, Kazuyasu Takizawa, Hiroshi Ichikawa, Masayuki Nagahashi, Takashi Kobayashi, Shin-ichi Kosugi, Hitoshi Kameyanna, Toshifumi Wakai

    INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY   9 ( 2 )   627 - 638   2016年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:E-CENTURY PUBLISHING CORP  

    This study aimed to histologically characterize microscopic tumor invasion of the vasculo-biliary sheaths in perihilar cholangiocarcinoma so as to determine the primary tumor site and to clarify clinicopathologic differences according to the primary site. A retrospective analysis was conducted of 52 patients who underwent resection for perihilar cholangiocarcinoma involving both the hepatic hilus and the liver, verified histologically. Histologic features of the vasculo-biliary sheath invasion were evaluated by double staining with hematoxylin-eosin to assess general morphology and Victoria Blue to detect the elastic fibers of the vasculo-biliary sheaths. The perihilar cholangiocarcinomas were classified into extrahepatic-type (34 patients), featuring an extrahepatic component involving the liver, and intrahepatic-type (18 patients), featuring an intrahepatic component involving the hepatic hilus. Hemihepatectomy with extrahepatic bile duct resection was the most common surgical procedure. Tumor size (p = 0.002), pN classification (p = 0.005), and pM classification (p = 0.023) were significant independent prognostic factors. The primary site was not significantly associated with survival after resection (p = 0.214), as patients with extrahepatictype tumors had a cumulative 5-year survival rate of 32%, compared with 28% for patients with intrahepatic-type tumors. Double staining with hematoxylin-eosin and Victoria Blue permits histologic discrimination between tumors of extrahepatic and intrahepatic origin, and thereby determination of the primary tumor site in clinical cases of perihilar cholangiocarcinoma. Combining extrahepatic-type and intrahepatic-type tumors under the term perihilar cholangiocarcinoma is valid clinically, as these tumors show comparable surgical outcomes with similar clinical management.

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  • [A Case of Solitary Paraaortic Lymph Node Recurrence after Surgical Resection for Combined Hepatocellular and Cholangiocarcinoma]. 査読

    Hirose Y, Sakata J, Yuza K, Soma D, Sudo N, Ishikawa H, Tatsuda K, Miura K, Takizawa K, Takano K, Nagahashi M, Kobayashi T, Kameyama H, Kosugi S, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   42 ( 12 )   1860 - 1862   2015年11月

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  • [Repeated Pancreatic Resections with Parenchymal Preservation for Pancreatic Metastases of Renal Cell Carcinoma--Report of a Case]. 査読

    Ishikawa H, Sakata J, Soma D, Yuza K, Ando T, Hirose Y, Miura K, Tatsuda K, Ohashi T, Takizawa K, Nagahashi M, Kameyama H, Kobayashi T, Kosugi S, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   42 ( 12 )   2254 - 2255   2015年11月

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  • [A Case of Rectal Carcinoma with Recurrence around the Drainage Site Complicated by Fournier's Gangrene]. 査読

    Abe K, Kameyama H, Shimada Y, Yamada S, Soma D, Yagi R, Miura K, Tatsuda K, Tajima Y, Okamura T, Nakano M, Nakano M, Kobayashi T, Kosugi S, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   42 ( 12 )   2291 - 2293   2015年11月

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  • [A Case of Radical Resection for Locally Advanced Pancreatic Cancer with Positive Peritoneal Cytology Treated with Chemoradiotherapy]. 査読

    Sato R, Takizawa K, Yuza K, Soma D, Hirose Y, Morimoto Y, Miura K, Nagahashi M, Takano K, Sakata J, Kameyama H, Kobayashi T, Minagawa M, Kosugi S, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   42 ( 12 )   2385 - 2387   2015年11月

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  • [Signet-Ring Cell Carcinoma of the Ampulla of Vater--Report of a Case]. 査読

    Yuza K, Sakata J, Soma D, Ando T, Hirose Y, Ishikawa H, Miura K, Tatsuda K, Ohashi T, Takizawa K, Nagahashi M, Kameyama H, Kobayashi T, Kosugi S, Wakai T

    Gan to kagaku ryoho. Cancer & chemotherapy   42 ( 12 )   1767 - 1769   2015年11月

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  • Protective Effect of Neutralization of the Extracellular High-Mobility Group Box 1 on Renal Ischemia-Reperfusion Injury in Miniature Swine 査読

    Kohei Miura, Hisashi Sahara, Mitsuhiro Sekijima, Akihiro Kawai, Shiori Waki, Hiroaki Nishimura, Kentaro Setoyama, Eric S. Clayman, Akira Shimizu, Kazuhiko Yamada

    TRANSPLANTATION   98 ( 9 )   937 - 943   2014年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background Strategies that reduce ischemia-reperfusion injury (IRI) have the potential to expand the numbers of available organs for transplantation. Recent reports in rodent models have demonstrated that high-mobility group box 1 (HMGB1) acts as an alarm in initiating the inflammatory response resulting from ischemic injury. The aim of this study was to evaluate the cytoprotective effects of anti-HMGB1 antibodies on renal IRI in preclinical large animals.
    Methods One hundred twenty minutes of warm and 60 min of cold renal ischemia were induced in 8 CLAWN miniature swine. Three of eight animals received intravenous anti-HMGB1 antibody at 1 mg/kg just before the reperfusion of renal blood flow. Renal function was assessed by serum creatinine and renal biopsy. Serum levels of interleukin (IL)-1, IL-6, and HMGB1 were measured.
    Results The concentration of HMGB1 increased as early as 30 min after reperfusion and before the elevation of IL-1 and IL-6. Serum creatinine levels were markedly elevated, peaking at a median of 5 days (peak creatinine levels: 11.61.6 mg/dL) and recovering by day 14. Anti-HMGB1 antibody injection dramatically decreased renal damage as well as serum levels of HMGB1 associated with IRI. Renal function returned to near normal by day 9, and peak creatinine levels were markedly lower (7.4 +/- 0.2 mg/dL), and biopsies possessed fewer pathologic changes when compared to the control group.
    Conclusion In this study, we demonstrated the beneficial effects of perioperative administration of anti-HMGB1 antibody in reducing renal IRI in a clinically relevant, large animal model.

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  • Laparoscope-assisted Hassab's Operation for Esophagogastric Varices After Living Donor Liver Transplantation: A Case Report 査読

    T. Kobayashi, K. Miura, H. Ishikawa, H. Oya, Y. Sato, M. Minagawa, J. Sakata, K. Takano, K. Takizawa, H. Nogami, S. -I. Kosugi, T. Wakai

    TRANSPLANTATION PROCEEDINGS   46 ( 3 )   986 - 988   2014年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    This is the first successful report of a laparoscope-assisted Hassab's operation for esophagogastric varices after living donor liver transplantation (LDLT). A 35-year-old man underwent LDLT using a right lobe graft as an aid for primary sclerosing cholangitis (PSC) in 2005. Follow-up endoscopic and computed tomography (CT) examinations showed esophagogastric varices with splenomegaly in 2009 that increased (esophageal varices [EV]: locus superior [Ls], moderator enlarged, beady varices [F2], medium in number and intermediate between localized and circumferential red color signs [RC2]; gastric varices [GV]: extension from the cardiac orifice to the fornix [Lg-cf], moderator enlarged, beady varices [F2], absent red color signs [RC0]). A portal venous flow to the esophagogastric varices through a large left gastric vein was also confirmed. Preoperative Child-Pugh was grade B and score was 9. Because these esophagogastric varices had a high risk of variceal bleeding, we proceeded with a laparoscope-assisted Hassab's operation. Operative time was 464 minutes. Blood loss was 1660 mL. A graft liver biopsy was also performed and recurrence of PSC was confirmed histologically. It was suggested that portal hypertension and esophagogastric varices were caused by recurrence of PSC. Postoperative complications were massive ascites and enteritis. Both of them were treated successfully. This patient was discharged on postoperative day 43. Follow-up endoscopic study showed improvement in the esophagogastric varices (esophageal varices [EV]: locus superior [Ls], no varicose appearance [F0], absent red color signs [RC0], gastric varices [GV]: adjacent to the cardiac orifice [Lg-c], no varicose appearance [F0], absent red color signs [RC0]) at 6 months after the operation. We also confirmed the improvement of esophagogastric varices by serial examinations of CT.

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  • Catheter-directed continuous thrombolysis following aspiration thrombectomy via the ileocolic route for acute portal venous thrombosis: report of two cases 査読

    Kohei Miura, Yoshinobu Sato, Hideki Nakatsuka, Satoshi Yamamoto, Hiroshi Oya, Yoshiaki Hara, Hidenaka Kokai, Katsuyoshi Hatakeyama

    SURGERY TODAY   43 ( 11 )   1310 - 1315   2013年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Although acute portal venous thrombosis (PVT) is a potentially life-threatening complication that occurs after hepatobiliary surgery with portal vein (PV) reconstruction or splenectomy, no effective or universal treatments have yet been established. Transjugular or transhepatic catheter-directed thrombolysis has recently been reported to be effective for treating acute PVT. However, the efficiency of this treatment for complete PV occlusion might be limited because a poor portal venous flow prevents thrombolytic agents from reaching and dissolving thrombi. Moreover, the use of the transjugular or transhepatic route might not be suitable in patients who have undergone major hepatectomy or in those with ascites due to an increased risk of residual liver injury or intra-abdominal bleeding following puncture to the residual liver. We herein describe the cases of two patients with almost total PV occlusion caused by massive thrombi that formed after hepatobiliary surgery, who were successfully treated with catheter-directed continuous thrombolysis following aspiration thrombectomy via the ileocolic route. This treatment should be considered beneficial for treating selected patients such as the two patients described herein.

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  • Perioperative Immunological Differentiation in Liver Cirrhotic Patients who Underwent Living Related Liver Transplantation 査読

    Yoshinobu Sato, Chikako Tomiyama, Satoshi Yamamoto, Hiroshi Oya, Takashi Kobayashi, Hidenaka Kokai, Kohei Miura, Yuki Hirose, Katsuyoshi Hatakeyama

    HEPATO-GASTROENTEROLOGY   60 ( 124 )   666 - 668   2013年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:H G E UPDATE MEDICAL PUBLISHING S A  

    Background/Aims: Liver cirrhotic patients are immunological compromised hosts. Preoperative status in cirrhotic patients affects postoperative infection complications. This study investigates the perioperative immunological changes in the differentiation by MELD score. Methodology: Fifteen patients underwent LDLT and were divided two groups, Group I (n=5, MELD score &gt;= 20) and Group II (n=10, MELD score &lt;20). Immunological status of cirrhotic patients was analyzed for Th1, Th2, Treg and Th17 by flow cytometry using monoclonal antibody CD3/CD19,CD4/8, FoxP3, IL-17, IFN-gamma and TNF-alpha. Results: T cell decreased and increased gradually following LDLT. The preoperative T cell count of MELD score 33 patients was very low. CD4 and CD8 T cells also decreased after LDLT. The preoperative CD8(+) T cell count of MELD score 33 patients was very low. Th17 decreased and recovered gradually in the all patients after LDLT. However Th17 of MELD score 33 did not recover. IFN-gamma-producing cells in naive T cells decreased after LDLT. Preoperatively those in the Group I was lower than those in the Group II. The population of Treg decreased in the Group I, however, it increased in the Group II on 7 days after LDLT. Conclusions: The patients with MELD score &gt;20 showed a decrease of cytotoxic immunity with both diminution and delay of CD8+ T cells and Th17 helper T cells. The cytotoxic immunity of the patients with MELD score &lt;20 was maintained and recovered in the early period after LDLT. The patients with MELD score &gt;20 might be at high risk of infection after LDLT.

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  • Heterotopic pancreas autotransplantation with spleen for uncontrollable hemorrhagic pseudocyst and disabling pain in chronic pancreatitis 査読

    Yoshinobu Sato, Hiroshi Oya, Satoshi Yamamoto, Hidenaka Kokai, Kohei Miura, Katsuyoshi Hatakeyama

    Hepato-Gastroenterology   60 ( 123 )   425 - 427   2013年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background/Aims: In this study, we report on a heterotopic segmental pancreatic autotransplantation (HPAT) with spleen for alcoholic chronic pancreatitis with uncontrollable hemorrhagic pseudocyst and complete portal venous obstruction. The patient was a 72-year-old man who had an alcoholic chronic pancreatitis with severe abdominal pain and hemorrhagic pseudocyst. The first bleeding from a pseudoaneurism of the gastro-duodenal artery (GDA) to the cyst of pancreas head was stopped by interventional radiology (IVR) at our hospital on May 2010. The second bleeding happened with severe abdominal pain on February 15th, 2011
    he was admitted on February 17. The IVR was not successful. Methodology: There were two problems for the operation. The first was the severe inflammation and the second was the control of hemorrhage from GDA. We were afraid of the postoperative hemorrhage due to the leakage of pancreatic juice in the pancreato-duodenectomy (PD). Therefore, we chose the HPAT as a solution for postoperative hemorrhage and severe abdominal pain. After complete duodeno-pancreatectomy with spleen, we performed HPAT with spleen on March 8, 2011. The pancreatic duct reconstruction was performed by Roux-en-Y anastomosis to the jejunum. Results: The postoperative course was uneventful. The abdominal pain had resolved completely and the patient remained normoglycemic after HPAT. Conclusions: We conclude that HPAT is a useful option for hemorrhagic pseudocyst of the pancreas head with severe abdominal pain of chronic pancreatitis. © H.G E. Update Medical Publishing S.A.

    DOI: 10.5754/hge12805

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  • Successful laparoscopic division of a patent ductus venosus: report of a case 査読

    Yoshiaki Hara, Yoshinobu Sato, Satoshi Yamamoto, Hiroshi Oya, Masato Igarashi, Satoshi Abe, Hidenaka Kokai, Kohei Miura, Takeshi Suda, Minoru Nomoto, Yutaka Aoyagi, Katsuyoshi Hatakeyama

    SURGERY TODAY   43 ( 4 )   434 - 438   2013年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER  

    Patent ductus venosus (PDV) is a rare condition of a congenital portosystemic shunt from the umbilical vein to the inferior vena cava. This report presents the case of an adult patient with PDV, who was successfully treated with laparoscopic shunt division. A 69-year-old male was referred with hepatic encephalopathy. Contrast-enhanced CT revealed a large connection between the left portal vein and the inferior vena cava, which was diagnosed as PDV. The safety of a shunt disconnection was confirmed using a temporary balloon occlusion test for the shunt, and the shunt division was performed laparoscopically. The shunt was carefully separated from the liver parenchyma with relative ease, and then divided using a vascular stapler. Portal flow was markedly increased after the operation, and the liver function of the patient improved over the 3-month period after surgery. Although careful interventional evaluation for portal flow is absolutely imperative prior to surgery, a minimally invasive laparoscopic approach can be safely used for treating PDV.

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  • Successful Laparoscopic-Assisted Hemostasis of Intrathoracic Massive Vericeal Rupture During Living Related Liver Transplantation: A Case Report 査読

    Y. Sato, H. Oya, S. Yamamoto, H. Kokai, K. Miura, K. Hatakeyama

    TRANSPLANTATION PROCEEDINGS   44 ( 3 )   820 - 821   2012年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    End-stage liver disease that requires transplantation is usually accompained by esophagogastric or another collateral vessel varices. Sometimes, the esophagogastric varices rupture intraoperatively during liver transplantation. However we have reported rare case of rupture of an intercostal varicose vein, which was controlled successfully by flexible laparoscopy. The patient was a 62-year-old man, who suffered decompensated liver cirrhosis with hepatocellular carcinoma. The Child-Pugh score was 11 and the Model for End-stage Liver Diseases score was 14. Preoperative gastrointestinal fiberscopy and colon fiberscopy examinations revealed esophagogastric and rectal varices. He underwent living related liver transplantation from his son on February 10, 2010. Just after the liver transplantation, the patient's blood pressure tended to decrease. Chest radiography demonstrated a massive right pleural effusion. We drained 3000 mL of blood by thoracic puncture. Therefore we reoperated him for the question an intrathoracic variceal hemorrhage. We confirmed variceal bleeding after removal of the massive hematoma by opening the diaphragm. However, we could neigher show directly the bleeding point in the anterior thorax nor stop it because of the constriction of the diaphragm. Therefore we used a flexible laparoscope to both confirm the bleeding point and to achieve hemostasis. We believe that theoperative compression of the intercostal varicose vein by a retractor induced the vascular rupture.

    DOI: 10.1016/j.transproceed.2012.03.031

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  • Magnetic Compression Anastomosis for Bile Duct Stenosis After Donor Left Hepatectomy: A Case Report 査読

    H. Oya, Y. Sato, E. Yamanouchi, S. Yamamoto, Y. Hara, H. Kokai, T. Sakamoto, K. Miura, K. Shioji, Y. Aoyagi, K. Hatakeyama

    TRANSPLANTATION PROCEEDINGS   44 ( 3 )   806 - 809   2012年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Magnetic compression anastomosis (MCA) provides a minimally invasive treatment creating a nonsurgical, sutureless enteric anastomosis in conjunction with an interventional radiologic technique by using 2 high-power magnets. Recently, the MCA technique has been applied to bile duct strictures after living donor liver transplantation or major hepatectomy. Herein we described use of MCA for bile duct stenosis 5 months after donor left hepatectomy in a 24-year-old man who presented with a stricture at the porta hepatis and intrahepatic bile duct dilatation. Unsuccessful transpapillary biliary drainage and balloon dilatation through a percutaneous transhepatic biliary drainage (PTBD) route led to the MCA. A 4-mm-diameter cylindrical samarium-cobalt (Sm-Co) daughter magnet with a long nylon wire was placed at the superior site of the obstruction through the PTBD route. A 5-mm-diameter Sm-Co parent magnet with an attached nylon handle was endoscopically inserted into the common bile duct and placed at the inferior site of obstruction. The 2 magnets were attracted, sandwiching the stricture and establishing a reanastomosis. In conclusion, the MCA technique was a unique procedure for choledochocholedochostomy in a patient with bile duct stenosis after donor hepatectomy.

    DOI: 10.1016/j.transproceed.2012.01.021

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  • Liver Transplantation Surgical Techniques for Extensive Retroperitoneal Tumor With Major Blood Vessel Involvement: A Case Report 査読

    K. Miura, Y. Sato, H. Kokai, Y. Hara, T. Kobayashi, H. Oya, S. Yamamoto, K. Hatakeyama

    TRANSPLANTATION PROCEEDINGS   44 ( 2 )   579 - 580   2012年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    A case of a 71-year-old man with a huge retroperitoneal tumor situated behind the liver, which strongly compressed the liver inferior vena cava (IVC), and gastrointestinal tract is described. With the techniques of whole liver extraction and autologous orthotopic liver transplantation, we successfully removed the tumor. We have the surgical techniques, essential elements, and indications for this procedure.

    DOI: 10.1016/j.transproceed.2012.01.074

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  • Isolated Dissection of the Superior Mesenteric Artery After Living Donor Liver Transplantation: A Case Report 査読

    H. Kokai, Y. Sato, S. Yamamoto, H. Oya, T. Kobayashi, T. Watanabe, K. Miura, K. Hatakeyama

    TRANSPLANTATION PROCEEDINGS   44 ( 2 )   588 - 590   2012年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Isolated dissection of the superior mesenteric artery (SMA) not associated with aortic dissection is rare, particularly after living donor liver transplantation (LDLT). We experienced a case of isolated dissection of the SMA after LDLT performed in a 56-year-old man diagnosed with hepatitis B virus related cirrhosis and hepatocellular carcinoma within the Milan criteria. He had no past history of hypertension or diabetes mellitus. At 6 days after LDLT, the patient underwent an emergency portal vein thrombectomy with ligation of a huge left gastric vein shunt. Thereafter anticoagulant and antiplatelet therapy were initiated. At 12 days after LDLT, a contrast-enhanced computer assisted tomography (CT) scan revealed the presence of a thrombus in a false lumen and a thin flap enlarged in the SMA. Because he presented neither abdominal pain nor biochemical data suggesting mesenteric ischemia, he was treated with antihypertensive agents in addition to anticoagulant and antiplatelet therapy. The thrombus in the false lumen was reduced and the intimal flap in the SMA disappeared according to the results of a CT scan 4 months after LDLT. He has remained free of symptoms for 4 years. The strategy to treat isolated SMA dissection is not well established. Urgent surgery is indicated for acute symptomatic forms with a suspicion of mesenteric ischemia; conservative treatment is indicated for patients with minimal, resolving, or no pain, but requires close follow-up.

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  • Regulatory T-Cell Activation among Patients Who Displayed Operational Tolerance following Intra-portal Administration of Donor-Specific Antigens in Living Donor Liver Transplantation 査読

    Y. Sato, T. Chikako, H. Oya, S. Yamamoto, H. Kokai, K. Miura, K. Hatakeyama

    TRANSPLANTATION PROCEEDINGS   44 ( 2 )   560 - 564   2012年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

    Immunologic tolerance is the goal for all transplant surgeons. We have reported that repeated donor-specific antigen transfusion (DST) via the portal vein allowed rapid reduction of immunosuppressants with decreased acute cellular rejection episodes among living donor liver transplantations (LDLT). Moreover, we demonstrated that intraportal DST induced macrochimerism of donor type CD56 T cells in the liver graft. We examined the impact of FoxP3(+)CD4 CD25(+) T cells in recipients who acquired almost tolerance after LDLT with intraportal DST. We defined the amount of immunosuppressants administered less than one time per week as "almost tolerance" after LDLT, which occurred among 14% of DST patients after adult-to-adult LDLT. Two patients (4%) have gotten been we used from immunosuppressants more than 2 years after LDLT 4 years prior. We examined the impact of FoxP3(+)CD4(+)CD25(+) T cells both in recipients with almost daily immunosuppressants and those who acquired almost tolerance. The proportion of FoxP3+/CD4+CD25 T cells in the almost tolerance group was significantly higher than that in the almost daily immunosuppressant group (P &lt;.05). The increased proportion of FoxP3(+)/CD4 CD25(+) T cells significantly correlated with time after LRLT (y = 0.0964x + 42.02, R-2 = 0.8854). Repeated intraportal DST may be a goot tool to induce immunologic tolerance after LDLT. Both donor type CD56(+) T cells and FoxP3(+)/CD4(+)CD25(+) T cells may act as important regulatory cells for tolerance. The period after LDLT is important for acquiring immunologic tolerance.

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  • A New Technique of Lateral Approach for Laparoscopy-Assisted Donor Left Hepatectomy 査読

    Hiroshi Oya, Yoshinobu Sato, Satoshi Yamamoto, Yoshiaki Hara, Takashi Kobayashi, Takaoki Watanabe, Hidenaka Kohai, Kohei Miura, Katsuyoshi Hatakeyama

    HEPATO-GASTROENTEROLOGY   58 ( 110 )   1765 - 1768   2011年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:H G E UPDATE MEDICAL PUBLISHING S A  

    This report describes laparoscopy-assisted donor left hepatectomy preserving the caudate lobe (LADLH), and a new technique for hand-assisted liver transection between the left lobe and the caudate lobe beforehand, called the "lateral approach." Four donor patients underwent LADLH. Preoperative computed tomography investigated the depth and width between the left lobe and the caudate lobe from the Arantius duct. LADLH was performed through a 9cm midline epigastric hand-port incision with four ports. The confluence of the middle and left hepatic veins was encircled with tape. Hand-assisted liver transection between the left lobe and the caudate lobe was performed using laparosonic coagulating shears after precoagulation with radio frequency ablation under ultrasonograph.ic guidance. Through the hand-port incision, the tape around the middle and left hepatic veins could be passed between the left lobe and the caudate lobe to the porta hepatis. We used the tape toward the end of the parenchymal transection to bring the transection plane closer to the surface. The liver parenchyma was divided at Cant lie's line under direct vision. The graft was extracted through the hand-port incision. All donors underwent LADLH completely without any intraoperative complication. None of the donors required transfusion or re-operation.

    DOI: 10.5754/hge11152

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MISC

  • 正中弓状靱帯症候群に伴う膵頭アーケード仮性動脈瘤破裂に対しIVR治療後に発症した気腫性胆嚢炎の1例

    滝沢 一泰, 坂田 純, 廣瀬 雄己, 堅田 朋大, 三浦 宏平, 小林 隆, 若井 俊文

    胆道   33 ( 3 )   681 - 681   2019年10月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • 胆嚢管癌に対する外科切除の術後短期および遠隔成績

    廣瀬 雄己, 坂田 純, 小林 隆, 滝沢 一泰, 大橋 拓, 三浦 宏平, 堅田 朋大, 齋藤 敬太, 油座 築, 永橋 昌幸, 若井 俊文

    胆道   33 ( 3 )   517 - 517   2019年10月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • cT2胆嚢癌の術後遠隔成績と局所進行胆嚢癌に対する術前化学療法

    坂田 純, 廣瀬 雄己, 堅田 朋大, 三浦 宏平, 滝沢 一泰, 永橋 昌幸, 小林 隆, 若井 俊文

    胆道   33 ( 3 )   577 - 577   2019年10月

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    記述言語:日本語   出版者・発行元:日本胆道学会  

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  • 鈍的外傷にて腹部動脈閉塞をきたした2例

    滝沢 一泰, 坂田 純, 廣瀬 雄己, 三浦 宏平, 若井 俊文

    Japanese Journal of Acute Care Surgery   9 ( 1 )   144 - 144   2019年10月

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    記述言語:日本語   出版者・発行元:日本Acute Care Surgery学会  

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  • 門脈圧亢進症に対する外科治療の長期成績

    小林 隆, 三浦 宏平, 坂田 純, 滝沢 一泰, 堅田 朋大, 市川 寛, 島田 能史, 永橋 昌幸, 亀山 仁史, 若井 俊文

    日本消化器外科学会総会   74回   P257 - 5   2019年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 大腸癌Hypermutated typeとミスマッチ修復蛋白質発現およびマイクロサテライト不安定性検査の関係

    島田 能史, 家守 智大, 阿部 馨, 小柳 英人, 中野 雅人, 廣瀬 雄己, 三浦 宏平, 市川 寛, 羽入 隆晃, 滝沢 一泰, 土田 純子, 永橋 昌幸, 小林 隆, 坂田 純, 亀山 仁史, 野上 仁, 丸山 聡, 瀧井 康公, 沖 英次, 若井 俊文

    日本消化器病学会甲信越支部例会抄録集   64回   56 - 56   2019年6月

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    記述言語:日本語   出版者・発行元:日本消化器病学会-甲信越支部  

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  • MHC確立クラウン系ミニブタを用いた肝・小腸移植モデルにおける免疫寛容誘導の確立

    関島 光裕, 佐原 寿史, 小川 勇一, 三木 克幸, 室川 剛廣, 三浦 宏平, 岩永 健裕, 市成 ゆりか, 渕之上 昌平, 清水 章, 山田 和彦

    移植   53 ( 総会臨時 )   504 - 504   2018年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 【胆道疾患診療の最前線】 胆嚢ポリープ・胆嚢癌

    坂田 純, 廣瀬 雄己, 油座 築, 安藤 拓也, 相馬 大輝, 峠 弘治, 堅田 朋大, 三浦 宏平, 滝沢 一泰, 永橋 昌幸, 小林 隆, 若井 俊文

    消化器外科   41 ( 10 )   1403 - 1410   2018年9月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • MHC確立クラウン系ミニブタを用いた肝・小腸移植モデルにおける免疫寛容誘導の確立

    関島 光裕, 佐原 寿史, 小川 勇一, 三木 克幸, 室川 剛廣, 三浦 宏平, 岩永 健裕, 市成 ゆりか, 渕之上 昌平, 清水 章, 山田 和彦

    移植   53 ( 総会臨時 )   504 - 504   2018年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 当院におけるBlumgart変法による膵空腸吻合術後膵液瘻の検討

    滝沢 一泰, 坂田 純, 安藤 拓也, 油座 築, 廣瀬 雄己, 堅田 朋大, 石川 博補, 三浦 宏平, 小林 隆, 若井 俊文

    日本消化器外科学会総会   73回   1000 - 1000   2018年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 胆嚢癌における根治切除後再発 再発率、再発形式、危険因子、再発治療

    坂田 純, 小林 隆, 滝沢 一泰, 三浦 宏平, 堅田 朋大, 石川 博補, 廣瀬 雄己, 油座 築, 安藤 拓也, 若井 俊文

    日本消化器外科学会総会   73回   926 - 926   2018年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 再発膵癌に対する治療戦略 再発巣切除の意義

    安藤 拓也, 滝沢 一泰, 油座 築, 廣瀬 雄己, 堅田 朋大, 石川 博補, 三浦 宏平, 坂田 純, 小林 隆, 若井 俊文

    日本消化器外科学会総会   73回   927 - 927   2018年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 同種膵島移植実験を見据えたブタ1型糖尿病モデルおよび自家膵島移植モデルの確立

    三浦 宏平, 小林 隆, 石川 博補, 相馬 大輝, 安藤 拓也, 油座 築, 廣瀬 雄己, 堅田 朋大, 滝沢 一泰, 坂田 純, 田島 陽介, 角田 知行, 市川 寛, 羽入 隆晃, 永橋 昌幸, 中島 真人, 島田 能史, 亀山 仁史, 若井 俊文

    日本外科学会定期学術集会抄録集   118回   2444 - 2444   2018年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 乳児生体肝移植後早期の門脈血栓症に対する門脈ステント留置

    大矢 雄希, 内田 皓士, 川端 誠一, 橋本 晋太朗, 三浦 宏平, 磯野 香織, 林田 信太郎, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本小児外科学会雑誌   54 ( 1 )   59 - 63   2018年1月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児外科学会  

    症例は7ヵ月の女児。生後68日に胆道閉鎖症に対して葛西手術を施行するも減黄不十分で肝不全が進行し、母親をドナーとする生体肝移植を施行した。減寸外側区域グラフトを用い、門脈はパッチグラフトで形成した。術後8日目に、浮腫の増悪と急速な腹水増加があり、腹部超音波にて肝内門脈腔は認めるものの血流確認できず本幹に血栓を認めた。そのため、同日に緊急で経皮経肝門脈造影を行い、カテーテルが血栓部位を通過したのち、上腸間膜静脈から造影すると、肝内門脈は、ほとんど造影されなかった。そのため、7mm〜4cmのメタルステントの留置を行い、肝内門脈への血流が再開した。その後、低分子ヘパリンによる抗凝固を開始し、ワーファリンに移行した。術後45日で退院となり、術後半年時点での門脈血流は良好である。乳児であり、また術後比較的早期のステント留置で適応に関する議論の余地はあるが、低侵襲で効果的な治療であった。(著者抄録)

    DOI: 10.11164/jjsps.54.1_59

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  • 小児移植・悪性腫瘍 傍腫瘍性神経症候群を呈した18歳女子神経芽腫再発の1例

    内田 皓士, 川端 誠一, 吉井 大貴, 三浦 宏平, 磯野 香織, 大矢 雄希, 林田 信太郎, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本小児外科学会雑誌   53 ( 6 )   1221 - 1221   2017年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児外科学会  

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  • 小児下部消化管、感染 膵性腹水を合併した幼児膵嚢胞の1症例

    川端 誠一, 林田 信太郎, 磯野 香織, 内田 皓士, 大矢 雄希, 三浦 宏平, 山本 栄和, 興梠 雅弘, 菅原 寧彦, 猪股 裕紀洋

    日本小児外科学会雑誌   53 ( 6 )   1223 - 1223   2017年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児外科学会  

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  • RIGHT POSTERIOR SEGMENT GRAFT IN ADULT LIVING DONOR LIVER TRANSPLANTATION: A SINGLE-CENTER EXPERIENCE

    Kohei Miura, Koushi Uchida, Seiichi Kawabata, Daiki Yoshii, Kaori Isono, Shintaro Hayashida, Yuki Ohya, Hidekazu Yamamoto, Takashi Kobayashi, Toshifumi Wakai, Yasuhiko Sugawara, Yukihiro Inomata

    TRANSPLANT INTERNATIONAL   30   261 - 261   2017年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY  

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  • 当院におけるドミノ肝移植の成績およびドミノ肝移植2次レシピエントの長期予後の検討

    三浦 宏平, 成田 泰子, 林田 信太郎, 大矢 雄希, 山本 栄和, 小林 隆, 若井 俊文, 菅原 寧彦, 猪股 裕紀洋

    日本消化器外科学会総会   72回   PN14 - 3   2017年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 肝移植手術の手技の伝承と応用 肝移植における血行再建手術手技の消化器外科手術への応用

    林田 信太郎, 三浦 宏平, 大矢 雄希, 山本 栄和, 菅原 寧彦, 近本 亮, 馬場 秀夫

    日本消化器外科学会総会   72回   O2 - 77   2017年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 安全・安心な臓器移植のために出来ること 当院における肝移植後の肝静脈狭窄の検討

    大矢 雄希, 菅原 寧彦, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 山本 栄和, 猪股 裕紀洋

    日本消化器外科学会総会   72回   SY04 - 8   2017年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 生体肝移植における尾状葉付き左葉グラフトの使用経験

    嶋田 圭太, 成田 泰子, 宇戸 啓一, 三浦 宏平, 林田 信太郎, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本消化器外科学会総会   72回   PN13 - 5   2017年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 肝移植手術の手技の伝承と応用 手術手技向上における多施設共同での肝移植医療人養成プログラムの効果と課題 六大学連携プログラム

    山本 栄和, 高木 弘誠, 中沼 伸一, 三浦 宏平, 嶋田 圭太, 菅原 寧彦, 猪股 裕紀洋

    日本消化器外科学会総会   72回   SY12 - 8   2017年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 乳児生体肝移植後早期の門脈血栓症に対する門脈ステント留置

    大矢 雄希, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本小児外科学会雑誌   53 ( 4 )   976 - 976   2017年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児外科学会  

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  • 低出生体重で出生した胆道閉鎖症児に対する治療戦略

    林田 信太郎, 内田 皓士, 川端 誠一, 吉井 大貴, 三浦 宏平, 磯野 香織, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本外科学会定期学術集会抄録集   117回   PS - 205   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 生体肝移植ドナーの長期成績の検討

    小林 隆, 三浦 宏平, 石川 博補, 相馬 大輝, 安藤 拓也, 油座 築, 峠 弘治, 大橋 拓, 滝沢 一泰, 高野 可赴, 坂田 純, 永橋 昌幸, 亀山 仁史, 島田 能史, 市川 寛, 横田 直樹, 大山 俊之, 荒井 勇樹, 窪田 正幸

    日本外科学会定期学術集会抄録集   117回   SF - 18   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 後区域グラフトを用いた成人生体肝移植症例の検討

    三浦 宏平, 内田 皓士, 川端 誠一, 吉井 大貴, 磯野 香織, 林田 信太郎, 大矢 雄希, 山本 栄和, 小林 隆, 若井 俊文, 菅原 寧彦, 猪股 裕紀洋

    日本外科学会定期学術集会抄録集   117回   PS - 204   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 生体肝移植後胆管狭窄に対する早期内視鏡的胆管造影の有用性

    相馬 大輝, 小林 隆, 三浦 宏平, 石川 博補, 安藤 拓也, 油座 築, 峠 弘治, 大橋 拓, 滝沢 一泰, 高野 可赴, 坂田 純, 永橋 昌幸, 亀山 仁史, 若井 俊文

    日本外科学会定期学術集会抄録集   117回   PS - 205   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 人工肛門近傍グラフトに腸管狭窄を来し狭窄部腸管の部分切除を施行した脳死小腸移植術後長期生存症例

    川端 誠一, 阪本 靖介, 本田 正樹, 内田 皓士, 嶋田 圭太, 吉井 大貴, 三浦 宏平, 磯野 香織, 林田 信太郎, 大矢 雄希, 山本 栄和, 直江 秀昭, 菅原 寧彦, 猪股 裕紀洋

    移植   52 ( 1 )   73 - 80   2017年4月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

    症例は18歳女性で、新生児期よりHirschsprung病類縁疾患の診断で人工肛門を造設し、中心静脈栄養(TPN)で管理していた。12歳時に脳死小腸移植術を施行した。術後、経口摂取も十分となり、中心静脈カテーテルは使用していなかった。明らかな拒絶反応なく経過し、約1年間経過が良好であった。このため、今回のエピソードの3ヵ月前(小腸移植術後5年4ヵ月時)に予防的に投与していたバルガンシクロビルとフルコナゾール投与を中止した。術後5年7ヵ月に上腹部痛が増強し、グラフト小腸内視鏡検査で人工肛門から約40cm口側までに多発する小腸潰瘍病変を認め、病理組織学的検査にてACRと診断し、ステロイドパルス療法を施行した。また免疫組織染色検査にてサイトメガロウイルス(CMV)腸炎と診断し、ガンシクロビルの投与、およびタクロリムスのトラフ値を調整した。小腸内視鏡検査では依然として人工肛門近傍グラフト腸管に狭窄した潰瘍病変が残存した。小腸潰瘍部を部分切除し、人工肛門を再造設した。術後経過は大きな問題なく経過し、経口摂取も十分可能で、腹部症状も改善したため術後13日目に退院した。

    DOI: 10.11386/jst.52.1_073

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  • 当科における、胆道閉鎖症に対する小児生体肝移植患者の術後成長・発達について

    宇戸 啓一, 川端 誠一, 内田 皓士, 吉井 大貴, 磯野 香織, 三浦 宏平, 林田 信太郎, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本小児外科学会雑誌   53 ( 1 )   197 - 197   2017年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児外科学会  

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  • 再移植を施行したPFIC1型の2例の検討

    大矢 雄希, 岡島 英明, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本小児栄養消化器肝臓学会雑誌   30 ( 2 )   92 - 93   2016年12月

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    記述言語:日本語   出版者・発行元:日本小児栄養消化器肝臓学会  

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  • 再移植を施行したPFIC1型の2例の検討

    大矢 雄希, 岡島 英明, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    日本小児栄養消化器肝臓学会雑誌   30 ( 2 )   92 - 93   2016年12月

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    記述言語:日本語   出版者・発行元:日本小児栄養消化器肝臓学会  

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  • 門脈血栓症例に対する肝移植の適応と成績 門脈血栓合併症例に対する成人生体肝移植術の検討

    三浦 宏平, 菅原 寧彦, 山本 栄和, 小林 隆, 若井 俊文, 猪股 裕紀洋

    日本臨床外科学会雑誌   77 ( 増刊 )   416 - 416   2016年10月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • HLAクラスIのみドナー優位のone way matchingで生体肝移植後GVHDを発症した1乳児例

    嶋田 圭太, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    移植   51 ( 総会臨時 )   373 - 373   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 小児胆道閉鎖症に対する肝移植におけるreflow直後門脈血流不十分症例の危険因子解析

    橋本 晋太朗, 内田 皓士, 川端 誠一, 吉井 大貴, 磯野 香織, 三浦 宏平, 林田 信太郎, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    移植   51 ( 総会臨時 )   259 - 259   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 成人生体肝移植における脾摘の功罪

    山本 栄和, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 大矢 雄希, 菅原 寧彦, 猪股 裕紀洋

    移植   51 ( 総会臨時 )   261 - 261   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 小児胆道閉鎖症に対する肝移植におけるreflow直後門脈血流不十分症例の危険因子解析

    橋本 晋太朗, 内田 皓士, 川端 誠一, 吉井 大貴, 磯野 香織, 三浦 宏平, 林田 信太郎, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    移植   51 ( 総会臨時 )   259 - 259   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • HLAクラスIのみドナー優位のone way matchingで生体肝移植後GVHDを発症した1乳児例

    嶋田 圭太, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 大矢 雄希, 山本 栄和, 菅原 寧彦, 猪股 裕紀洋

    移植   51 ( 総会臨時 )   373 - 373   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 成人生体肝移植における脾摘の功罪

    山本 栄和, 内田 皓士, 川端 誠一, 三浦 宏平, 吉井 大貴, 磯野 香織, 林田 信太郎, 大矢 雄希, 菅原 寧彦, 猪股 裕紀洋

    移植   51 ( 総会臨時 )   261 - 261   2016年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 生体ドナーによる小児再肝移植症例の検討

    三浦 宏平, 阪本 靖介, 嶋田 圭太, 磯野 香織, 本田 正樹, 林田 信太郎, 山本 栄和, 小林 隆, 若井 俊文, 猪股 裕紀洋

    日本消化器外科学会総会   71回   P3 - 51   2016年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 前臨床異種移植実験の進歩と今後の展開

    佐原 寿史, 関島 光裕, 三浦 宏平, 河合 彰浩, 田崎 正行, 岩永 健裕, 清水 章, 山田 和彦

    日本外科学会定期学術集会抄録集   116回   OP - 089   2016年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 「国内初の、肝臓移植を担う高度医療人養成(SNUC-LT)」への参加 第一期履修生としての活動報告

    三浦 宏平, 小林 隆, 相馬 大輝, 油座 築, 廣瀬 雄己, 滝沢 一泰, 坂田 純, 皆川 昌広, 若井 俊文

    日本臨床外科学会雑誌   77 ( 3 )   713 - 713   2016年3月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • DEVELOPMENT OF THE AUTOLOGOUS ISLET TRANSPLANTATION MODEL WITH MINIATURE SWINE

    Zhengkun Zhang, Kohei Miura, Takuya Ando, Kazuki Moro, Yuki Hirose, Masayuki Nagahashi, Jun Sakata, Hitoshi Kameyama, Takashi Kobayashi, Shinichi Kosugi, Toshifumi Wakai

    TRANSPLANTATION   99 ( 11 )   S287 - S287   2015年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • Development of the autologous islet transplantation model with miniature swine

    Zhengkun Zhang, Kohei Miura, Takuya Ando, Kazuki Moro, Yuki Hirose, Masayuki Nagahashi, Jun Sakata, Hitoshi Kameyama, Takashi Kobayashi, Shinichi Kosugi, Toshifumi Wakai

    XENOTRANSPLANTATION   22   S173 - S173   2015年11月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • 国内初の、肝臓移植を担う高度医療人養成 (6大学連携プログラム)の取り組み

    高木 弘誠, 中沼 伸一, 三浦 宏平, 今村 一歩

    移植   50 ( 4-5 )   465 - 466   2015年10月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 生体肝移植後に発症した自己免疫性肝炎の一例

    相馬 大輝, 三浦 宏平, 小林 隆, 石川 博補, 油座 築, 廣瀬 雄己, 須藤 翔, 堅田 朋大, 大橋 拓, 佐藤 良平, 滝沢 一泰, 永橋 昌幸, 坂田 純, 亀山 仁史, 若井 俊文

    日本臨床外科学会雑誌   76 ( 増刊 )   886 - 886   2015年10月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • 臓器移植における新規技術・機器の導入 高圧下過冷却状態での革新的臓器保存法 前臨床クラウン系ミニブタモデルによる開発

    佐原 寿史, 関島 光裕, 三浦 宏平, 河合 彰浩, 脇 詩織, 岩永 健裕, 市成 ゆりか, 清水 章, 山田 和彦

    移植   50 ( 総会臨時 )   240 - 240   2015年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 肝胆膵 成人生体肝移植における免疫抑制剤完全離脱症例の検討

    三浦 宏平, 小林 隆, 相馬 大輝, 油座 築, 岡部 康之, 廣瀬 雄己, 森本 悠太, 佐藤 良平, 滝沢 一泰, 永橋 昌幸, 坂田 純, 亀山 仁史, 皆川 昌広, 小杉 伸一, 小山 諭, 若井 俊文

    日本外科学会定期学術集会抄録集   115回   OP - 163   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 劇症肝炎に対する脳死肝移植の1例

    相馬 大輝, 三浦 宏平, 小林 隆, 石川 博補, 滝沢 一泰, 永橋 昌幸, 坂田 純, 皆川 昌広, 小杉 伸一, 若井 俊文

    新潟医学会雑誌   129 ( 4 )   216 - 220   2015年4月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    今回、術前に敗血症を呈した亜急性型劇症肝炎に対し脳死肝移植を施行し救命し得た症例を経験したので文献的考察を加えて報告する。症例は62歳、男性。薬剤性亜急性型劇症肝炎として近医にて加療されるも改善なく、肝移植目的に当院に転院した。転院4日目に脳症の増悪を認め緊急生体肝移植の方針となったが、カテーテル感染による敗血症性ショック、重度の呼吸不全、腎不全のため手術を延期し、保存的に加療を継続した。その後ショックから離脱し、血液培養の陰性化を確認した。転院10日目に脳死ドナーが発生したため脳死全肝移植を施行した。手術直前に採取した血液培養検査が陽性であったため結果的には菌血症状態での肝移植となった。術後早期より持続的血液濾過透析、エンドトキシン吸着療法を開始し、タクロリムス血中濃度を低値に抑えることで全身状態は比較的速やかに改善した。その後重篤な合併症なく第10病日にICU退室した。術前に敗血症を呈した症例に対する肝移植の成績は極めて不良であるが、術後の集中管理により救命し得たので報告する。(著者抄録)

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  • 肝胆膵 当院における劇症肝炎症例に対する生体肝移植の経験

    相馬 大輝, 小林 隆, 三浦 宏平, 油座 築, 岡部 康之, 廣瀬 雄己, 森本 悠太, 佐藤 良平, 滝沢 一泰, 永橋 昌幸, 坂田 純, 亀山 仁史, 皆川 昌広, 小杉 伸一, 小山 論, 若井 俊文

    日本外科学会定期学術集会抄録集   115回   RS - 16   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 肝胆膵 非アルコール性脂肪肝疾患関連肝細胞癌における肝切除の術後成績およびp27発現の臨床的意義

    廣瀬 雄己, 松田 康伸, 油座 築, 相馬 大輝, 岡部 康之, 森本 悠太, 三浦 宏平, 佐藤 良平, 滝沢 一泰, 永橋 昌幸, 坂田 純, 小林 隆, 亀山 仁史, 皆川 昌広, 小杉 伸一, 小山 諭, 若井 俊文

    日本外科学会定期学術集会抄録集   115回   YIA - 1   2015年4月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • MHC確立ならびに遺伝子ノックアウト大動物を用いた同種・異種移植前臨床実験 鹿児島大学異種移植外科での経験

    三浦 宏平

    今日の移植   28 ( 1 )   87 - 90   2015年2月

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    記述言語:日本語   出版者・発行元:(株)日本医学館  

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  • 【胆道癌外科切除 再発防止のストラテジー】 術中戦略 リンパ節郭清範囲 胆嚢癌

    坂田 純, 若井 俊文, 皆川 昌広, 小林 隆, 滝沢 一泰, 三浦 宏平, 岡部 康之, 廣瀬 雄己, 永橋 昌幸, 亀山 仁史, 小杉 伸一, 小山 諭

    臨床外科   70 ( 1 )   68 - 72   2015年1月

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    記述言語:日本語   出版者・発行元:(株)医学書院  

    <ポイント>胆嚢癌に対する至適リンパ節郭清範囲は,胆道癌取扱い規約第6版の定める領域リンパ節である.この領域リンパ節をen blocに郭清することが進行胆嚢癌の手術成績向上の鍵である.膵頭十二指腸切除は,膵頭周囲リンパ節転移陽性胆嚢癌の予後を改善する可能性がある.(著者抄録)

    DOI: 10.11477/mf.1407210613

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  • 劇症肝炎に対する脳死移植の1経験

    相馬 大輝, 小林 隆, 三浦 宏平, 石川 博補, 滝沢 一泰, 坂田 純, 皆川 昌広, 若井 俊文

    日本臨床外科学会雑誌   75 ( 12 )   3399 - 3399   2014年12月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • 消化器外科手術アトラス 胆嚢癌に対する拡大根治的胆嚢摘出術(Glenn手術変法)

    若井 俊文, 坂田 純, 田島 陽介, 廣瀬 雄己, 三浦 宏平, 滝沢 一泰, 永橋 昌幸, 亀山 仁史, 小林 隆, 皆川 昌広, 小杉 伸一, 小山 諭

    消化器外科   37 ( 13 )   1885 - 1894   2014年12月

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    記述言語:日本語   出版者・発行元:(株)へるす出版  

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  • 膵癌術後難治性リンパ瘻を外科的に治療しえた腎移植後患者の1例

    安藤 拓也, 皆川 昌広, 滝沢 一泰, 高野 可赴, 油座 築, 廣瀬 雄己, 三浦 宏平, 永橋 昌幸, 島田 能史, 坂田 純, 亀山 仁史, 小林 隆, 小杉 伸一, 小山 諭, 若井 俊文

    日本臨床外科学会雑誌   75 ( 増刊 )   660 - 660   2014年10月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • 生体肝移植後胆管結石症例の検討

    小林 隆, 坂田 純, 皆川 昌広, 三浦 宏平, 島田 能史, 亀山 仁史, 小杉 伸一, 石川 卓, 羽入 隆晃, 若井 俊文

    日本消化器外科学会総会   69回   RS - 42   2014年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • MHC確立ミニブタ前臨床腎移植モデルを用いた温虚血障害腎に対する常温臓器保存の有効性の検討

    河合 昭浩, 佐原 寿史, 関島 光裕, 三浦 宏平, 脇 詩織, 清水 章, 山田 和彦

    泌尿器科紀要   60 ( 7 )   343 - 343   2014年7月

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    記述言語:日本語   出版者・発行元:泌尿器科紀要刊行会  

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  • Hydrogen Sulfide Therapy Prolongs Survival of the Fully MHC-Disparate Lung Graft From Brain-Dead Donors in CLAWN Miniature Swine

    H. Sahara, K. Miura, A. Kawai, S. Waki, A. Shimizu, K. Yamada

    TRANSPLANTATION   98   807 - 807   2014年7月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • Establishment of Clinically Applicable Strategy of CO Therapy - Beneficial Effects of Inhaled Carbon Monoxide to Brain-Dead Donors On Prolonging Pulmonary Allograft Survival in MHC-Inbred CLAWN Miniature Swine.

    H. Sahara, K. Miura, A. Kawai, S. Waki, A. Shimizu, K. Yamada

    TRANSPLANTATION   98   32 - 32   2014年7月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • Feasibility of the Early Post-Operative Endoscopic Retrograde Cholangiography for Biliary Strictures After Adult Living Donor Liver Transplantation

    T. Kobayashi, K. Miura, H. Ishikawa, D. Soma, K. Takizawa, K. Takano, J. Sakata, M. Minagawa, T. Wakai

    TRANSPLANTATION   98   793 - 793   2014年7月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • Long-Term Follow-Up Study of Biliary Reconstructions and Complications After Adult Living Donor Liver Transplantation

    H. Ishikawa, T. Kobayashi, K. Miura, D. Soma, K. Takizawa, K. Takano, J. Sakata, M. Minagawa, Y. Koyama, T. Wakai

    TRANSPLANTATION   98   795 - 795   2014年7月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Web of Science

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  • Establishment of Clinically Applicable Strategy of CO Therapy - Beneficial Effects of Inhaled Carbon Monoxide to Brain-Dead Donors On Prolonging Pulmonary Allograft Survival in MHC-Inbred CLAWN Miniature Swined

    H. Sahara, K. Miura, A. Kawai, S. Waki, A. Shimizu, K. Yamada

    AMERICAN JOURNAL OF TRANSPLANTATION   14   32 - 32   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • Long-Term Follow-Up Study of Biliary Reconstructions and Complications After Adult Living Donor Liver Transplantation.

    H. Ishikawa, T. Kobayashi, K. Miura, D. Soma, K. Takizawa, K. Takano, J. Sakata, M. Minagawa, Y. Koyama, T. Wakai

    AMERICAN JOURNAL OF TRANSPLANTATION   14   795 - 795   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • Hydrogen Sulfide Therapy Prolongs Survival of the Fully MHC-Disparate Lung Graft From Brain-Dead Donors in CLAWN Miniature Swine.

    H. Sahara, K. Miura, A. Kawai, S. Waki, A. Shimizu, K. Yamada

    AMERICAN JOURNAL OF TRANSPLANTATION   14   807 - 807   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • Feasibility of the Early Post-Operative Endoscopic Retrograde Cholangiography for Biliary Strictures After Adult Living Donor Liver Transplantation.

    T. Kobayashi, K. Miura, H. Ishikawa, D. Soma, K. Takizawa, K. Takano, J. Sakata, M. Minagawa, T. Wakai

    AMERICAN JOURNAL OF TRANSPLANTATION   14   793 - 793   2014年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • MHC確立ミニブタ肺移植モデルを用いた新規ドナー臓器保護剤としての硫化水素の可能性評価

    佐原 寿史, 三浦 宏平, 河合 昭浩, 脇 詩織, 清水 章, 山田 和彦

    日本呼吸器外科学会雑誌   28 ( 3 )   O20 - 3   2014年4月

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    記述言語:日本語   出版者・発行元:(NPO)日本呼吸器外科学会  

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  • MHC確立クラウンミニブタ小腸移植手技の工夫

    三浦 宏平, 佐原 寿史, 脇 詩織, 河合 昭浩, 清水 章, 山田 和彦

    日本外科学会雑誌   115 ( 臨増2 )   923 - 923   2014年3月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • GalT-KOブタ・霊長類間異種腎臓移植の拒絶反応におけるブタサイトメガロウィルス(pCMV)の関与

    脇 詩織, 佐原 寿史, 三浦 宏平, 河合 昭浩, 田崎 正行, 清水 章, 山田 和彦

    移植   48 ( 総会臨時 )   373 - 373   2013年8月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • MHC確立ミニブタ前臨床腎移植モデルを用いた温虚血障害腎に対する常温臓器保存の有効性の検討

    河合 昭浩, 佐原 寿史, 関島 光裕, 三浦 宏平, 脇 詩織, 清水 章, 山田 和彦

    移植   48 ( 総会臨時 )   327 - 327   2013年8月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • ドナー臓器修復に基づく新たな移植成績向上戦略のMHC確立クラウンミニブタ肺移植モデルによる評価と有用性

    佐原 寿史, 三浦 宏平, 河合 彰浩, 脇 詩織, 清水 章, 山田 和彦

    移植   48 ( 総会臨時 )   372 - 372   2013年8月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 脳死ドナーに対する一酸化炭素(CO)吸入によるMHC完全不適合クラウンミニブタ移植肺生着延長効果

    三浦 宏平, 佐原 寿史, 脇 詩織, 河合 昭浩, 清水 章, 山田 和彦

    移植   48 ( 総会臨時 )   372 - 372   2013年8月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 超過小グラフト血液型不適合生体肝移植術後に肝動脈血栓症発症した一例

    大矢 洋, 佐藤 好信, 小林 隆, 小海 秀央, 佐藤 優, 下田 傑, 三浦 宏平, 齋藤 敬太, 八木 亮磨, 若井 俊文

    日本消化器外科学会総会   68回   P - 135   2013年7月

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    記述言語:日本語   出版者・発行元:(一社)日本消化器外科学会  

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  • 抗体関連型拒絶反応の克服に向けて 肝移植における既存抗体陽性例

    小林 隆, 大矢 洋, 佐藤 好信, 山本 智, 小海 秀央, 佐藤 優, 下田 傑, 三浦 宏平, 齋藤 敬太, 八木 亮磨, 畠山 勝義, 若井 俊文

    今日の移植   26 ( 2 )   182 - 187   2013年4月

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    記述言語:日本語   出版者・発行元:(株)日本医学館  

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  • 臓器移植医療が一般外科にもたらすもの

    佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    新潟医学会雑誌   127 ( 2 )   119 - 120   2013年2月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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  • 常温体外肺循環回路(EVLP)下での一酸化炭素吸入によるミニブタ移植肺への効果

    佐原 寿史, 脇 詩織, 関島 光裕, 三浦 宏平, 河合 昭浩, 清水 章, 山田 和彦

    今日の移植   25 ( 6 )   495 - 499   2012年11月

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    記述言語:日本語   出版者・発行元:(株)日本医学館  

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  • High-mobility group box 1(HMGB1)が腎虚血再灌流障害(IRI)進展に及ぼす役割の大動物モデルによる解明

    三浦 宏平, 佐原 寿史, 関島 光裕, 河合 昭浩, 脇 詩織, 清水 章, 山田 和彦

    移植   47 ( 総会臨時 )   212 - 212   2012年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • High-mobility Group Box-1(HMGB1)を標的とする新たな肺虚血再灌流障害(IRI)抑制戦略の大動物モデルによる検討

    脇 詩織, 佐原 寿史, 関島 光裕, 三浦 宏平, 河合 昭浩, 清水 章, 山田 和彦

    移植   47 ( 総会臨時 )   244 - 244   2012年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • MHC確立ミニブタ前臨床腎移植モデルを用いた温虚血障害腎に対する常温臓器保存の有効性の検討

    河合 昭浩, 佐原 寿史, 関島 光裕, 三浦 宏平, 脇 詩織, 清水 章, 山田 和彦

    移植   47 ( 総会臨時 )   193 - 193   2012年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 敗血症を呈した亜急性型劇症肝炎に対する脳死肝移植の経験

    三浦 宏平, 佐藤 好信, 小海 秀央, 大矢 洋

    日本肝胆膵外科学会・学術集会プログラム・抄録集   24回   491 - 491   2012年5月

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    記述言語:日本語   出版者・発行元:(一社)日本肝胆膵外科学会  

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  • MELD scoreから見た肝移植周術期の免疫動態

    大矢 洋, 佐藤 好信, 山本 智, 原 義明, 小林 隆, 渡辺 隆興, 小海 秀央, 坂本 武也, 三浦 宏平, 畠山 勝義

    日本外科学会雑誌   113 ( 臨増2 )   401 - 401   2012年3月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 生体肝移植におけるSmall-for-size 病態の解明と対策 生体肝移植 過小グラフトにおける基礎と臨床

    佐藤 好信, 山本 智, 大矢 洋, 中塚 英樹, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    日本外科学会雑誌   113 ( 臨増2 )   188 - 188   2012年3月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 次世代を目指す新しい手術手技(肝臓・胆道・膵臓) 同所性自家肝移植および異所性自家膵移植

    佐藤 好信, 山本 智, 大矢 洋, 小林 隆, 小海 秀央, 原 義明, 三浦 宏平, 畠山 勝義

    日本臨床外科学会雑誌   72 ( 増刊 )   350 - 350   2011年10月

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    記述言語:日本語   出版者・発行元:日本臨床外科学会  

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  • AMYLOID POLYNEUROPATHY RELAPSED 7 YEARS AFTER DOMINO TRANSPLANTATION WITH THE LIVER OF A 62-YEAR-OLD FAP DONOR

    Kohei Miura, Yoshinobu Sato, Satoshi Yamamoto, Hiroshi Oya, Yoshiaki Hara, Takashi Kobayashi, Hidenaka Kokai, Katsuyoshi Hatakeyama

    TRANSPLANT INTERNATIONAL   24   312 - 313   2011年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • COAGULATION BETWEEN DONOR AND RECIPIENT IN THE EARLY PERIOD AFTER LIVING DONOR LIVER TRANSPLANTATION

    Yoshinobu Sato, Satoshi Yamamoto, Hiroshi Oya, Yoshiaki Hara, Hidenaka Kokai, Takashi Kobayashi, Kohei Miura, Katsuyoshi Hatakeyama

    TRANSPLANT INTERNATIONAL   24   315 - 315   2011年9月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

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  • サイトメガロウイルス感染症 肝移植におけるテーラーメードのサイトメガロウイルス感染症対策を目指して

    佐藤 好信, 山本 智, 大矢 洋, 小林 隆, 原 義明, 小海 英央, 三浦 宏平, 冨山 智香子, 谷口 委代, 畠山 勝義

    今日の移植   24 ( 4 )   391 - 396   2011年8月

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    記述言語:日本語   出版者・発行元:(株)日本医学館  

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  • A New Technique of Lateral Approach for Laparoscopy-Assisted Donor Left Hepatectomy Preserving the Caudate Lobe

    Hiroshi Oya, Yoshinobu Sato, Satoshi Yamamoto, Yoshiaki Hara, Takashi Kobayashi, Takaoki Watanabe, Hidenaka Kokai, Kohei Miura, Katsuyoshi Hatakeyama

    LIVER TRANSPLANTATION   17 ( 6 )   S238 - S238   2011年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:WILEY-BLACKWELL  

    Web of Science

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  • 生体肝移植後食道胃静脈瘤治療例の検討

    山本 智, 佐藤 好信, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    移植   45 ( 総会臨時 )   217 - 217   2010年10月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 門脈圧亢進症と肝移植 肝移植と門脈圧亢進症 基礎と臨床

    佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    日本門脈圧亢進症学会雑誌   16 ( 2 )   64 - 64   2010年8月

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    記述言語:日本語   出版者・発行元:(一社)日本門脈圧亢進症学会  

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  • Two Living Donor Candidates for Liver Transplantation Diagnosed Asymptomatic Primary Biliary Cirrhosis in Relatives of Patient with Primary Biliary Cirrhosis

    Hiroshi Oya, Yoshinobu Sato, Satoshi Yamamoto, Takashi Kobayashi, Yoshiaki Hara, Takaoki Watanabe, Hidenaka Kokai, Kohei Miura, Satoshi Yamagiwa, Minoru Nomoto, Katsuyoshi Hatakeyama

    LIVER TRANSPLANTATION   16 ( 6 )   S235 - S235   2010年6月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:JOHN WILEY & SONS INC  

    Web of Science

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  • 食道胃静脈瘤再発症例に対するVaricos-Caval H-graftシャントの経験

    小海 秀央, 佐藤 好信, 山本 智, 大矢 洋, 小林 隆, 原 義明, 渡辺 隆興, 三浦 宏平, 畠山 勝義

    日本肝胆膵外科学会・学術集会プログラム・抄録集   22回   406 - 406   2010年5月

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    記述言語:日本語   出版者・発行元:(一社)日本肝胆膵外科学会  

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  • 肝移植における胆道・血行再建の工夫 Ligamentum teres hepatis間置Porto-cavalシャントによるnatural banding法の開発

    佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    日本肝胆膵外科学会・学術集会プログラム・抄録集   22回   208 - 208   2010年5月

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    記述言語:日本語   出版者・発行元:(一社)日本肝胆膵外科学会  

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  • 成人生体肝移植 Ligament teres hepatisによるPorto-cavalシャントnatural banding法の開発

    佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    日本外科学会雑誌   111 ( 臨増2 )   217 - 217   2010年3月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • GRWR<0.6%の超過小グラフトを用いた生体部分肝移植

    山本 智, 佐藤 好信, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 黒崎 功, 白井 良夫, 畠山 勝義

    日本外科学会雑誌   111 ( 臨増2 )   521 - 521   2010年3月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 成人生体肝移植における全肝温存異所性部分肝移植の可能性

    三浦 宏平, 佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 畠山 勝義

    日本外科学会雑誌   111 ( 臨増2 )   216 - 216   2010年3月

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    記述言語:日本語   出版者・発行元:(一社)日本外科学会  

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  • 劇症肝炎に対する治療戦略 劇症肝炎に対する生体肝移植の問題点と工夫

    佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    日本腹部救急医学会雑誌   30 ( 2 )   275 - 275   2010年2月

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    記述言語:日本語   出版者・発行元:(一社)日本腹部救急医学会  

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  • 9cm上腹部正中切開HALSによる左葉ドナー肝切除

    佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 小海 秀央, 三浦 宏平, 畠山 勝義

    日本内視鏡外科学会雑誌   14 ( 7 )   601 - 601   2009年12月

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    記述言語:日本語   出版者・発行元:(一社)日本内視鏡外科学会  

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  • 無症候性PBCと診断されたPBC生体肝移植ドナー候補の2例

    小海 秀央, 佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 渡辺 隆興, 三浦 宏平, 山際 訓, 野本 実, 畠山 勝義

    移植   44 ( 総会臨時 )   248 - 248   2009年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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  • 間質性肺炎を有する原因不明の肝硬変肝腎不全症例に対する全肝温存異所性部分肝移植の経験

    三浦 宏平, 佐藤 好信, 山本 智, 大矢 洋, 原 義明, 小林 隆, 渡辺 隆興, 小海 秀央, 畠山 勝義

    移植   44 ( 総会臨時 )   363 - 363   2009年9月

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    記述言語:日本語   出版者・発行元:(一社)日本移植学会  

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講演・口頭発表等

  • Development of the total pancreatectomy and autologous islet transplantation models as the step for allogenic islet transplantation experiments in the swine 国際会議

    三浦 宏平

    27th International Congress of The Transplantation Society  2018年7月 

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    記述言語:英語  

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  • The roles of sphingosine-1-phosphate produced by sphingosine kinases in tumor and its microenvironment 国際会議

    三浦 宏平

    13th Annual Academic Surgical Congress  2018年2月 

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    記述言語:英語  

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  • Dysregulation of sphingolipids in human hepatocellular carcinoma 国際会議

    三浦 宏平

    13th Annual Academic Surgical Congress  2018年2月 

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    記述言語:英語  

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  • Adult living donor liver transplantation for patients with portal vein thrombosis. A single-center experience 国際会議

    三浦 宏平

    15th Congress of the Asian Society of Transplantation  2017年11月 

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    記述言語:英語  

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  • Right posterior segment graft in adult living donor liver transplantation. A single-center experience 国際会議

    三浦 宏平

    18th Congress of the European Society for Organ Transplantation  2017年9月 

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    記述言語:英語  

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  • Biliary anastomotic stricture after adult living donor liver transplantation. A single-center experience 国際会議

    三浦 宏平

    6th Biennial Congress of the Asian-Pacific Hepato-Pancreato-Biliary Association  2017年6月 

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    記述言語:英語  

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  • Auxiliary partial orthotopic liver transplantation versus heterotopic auxiliary partial liver transplantation – single center experience 国際会議

    三浦 宏平

    the 26th international congress of the transplantation society  2016年8月 

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    記述言語:英語  

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  • Study of immune tolerance cases in adult living donor liver transplantation 国際会議

    三浦 宏平

    the 14th congress of asian society of transplantation  2015年8月 

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  • Development of the Intestinal transplantation model with MHC inbred CLAWN miniature swine 国際会議

    三浦 宏平

    the 14th congress of asian society of transplantation  2015年8月 

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    記述言語:英語  

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  • Beneficial effects of inhaled carbon monoxide (CO) to brain-dead (BD) donors on prolonging pulmonary allograft survival in MHC-inbred CLAWN miniature swine 国際会議

    三浦 宏平

    The 13th Congress of the Asian Society of Transplantation  2013年9月 

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共同研究・競争的資金等の研究

  • HER2陽性胆嚢癌の遺伝子異常の包括的癌関連パスウェイ解析とその臨床的意義の解明

    研究課題/領域番号:21K08770  2021年4月 - 2024年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    坂田 純, 若井 俊文, 島田 能史, 滝沢 一泰, 市川 寛, 三浦 宏平, 諸 和樹, 永橋 昌幸, 石川 博補

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    配分額:4030000円 ( 直接経費:3100000円 、 間接経費:930000円 )

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  • セラミドによる免疫制御機構を応用した膵島移植における膵島生着延長の試み

    研究課題/領域番号:20K21628  2020年7月 - 2023年3月

    日本学術振興会  科学研究費助成事業 挑戦的研究(萌芽)  挑戦的研究(萌芽)

    小林 隆, 木下 義晶, 松田 康伸, 永橋 昌幸, 三浦 宏平, 廣瀬 雄己, 油座 築, 諸 和樹

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    配分額:6500000円 ( 直接経費:5000000円 、 間接経費:1500000円 )

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  • 膵癌患者の免疫微小環境における脂質メディエーター分子の役割と臨床的意義

    研究課題/領域番号:20K09099  2020年4月 - 2023年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    滝沢 一泰, 油座 築, 廣瀬 雄己, 諸 和樹, 永橋 昌幸, 若井 俊文, 坂田 純, 三浦 宏平, 長櫓 宏規

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

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  • 生体内イメージングを応用した移植膵島可視化によるグラフト生着率改善の試み

    研究課題/領域番号:19K18108  2019年4月 - 2022年3月

    日本学術振興会  科学研究費助成事業 若手研究  若手研究

    三浦 宏平

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

    2019年度は本研究の目的である「ICG蛍光法で肝内に移植された膵島を可視化し、確実な生検を実施すること」を目指し、膵島の最適なICG標識方法、および標識膵島の安全性を検証した。
    ICG標識自家膵島移植モデルの作成:ICG標識自家膵島移植モデルを体重10kgから20kgの実験用ブタ計4頭を用いて以下の方法で作成した。全身麻酔下にブタの尾側膵切除(80%切除)を実施した。切除膵の主膵管から10mg/kgに調整したコラゲナーゼを注入し、ウミヒラチャンバーを用いて膵島を分離した。分離された膵島を2.5mg/mlのICGで単純共培養法により標識した。ICG標識膵島を脾静脈から挿入されたカテーテルより経門脈的に肝内に自家移植した。この時点でIRIシステムを用いて肝臓の蛍光確認部位と蛍光強度を記録し、タイムゼロポイントのICG標識膵島データとして記録した。
    移植後の検体採取:移植後は連日の血液検体の採取と血糖測定を実施した。また移植後7日目および14日目に全身麻酔下に開腹し、IRIシステムを用いて標識膵島を観察した。いずれのポイントにおいても蛍光強度が保たれていることを確認した。また蛍光部位を生検し組織学的に標識膵島が生着していることを確認した。更に、既存の非標識膵島による自家移植群と血液検査データ、血糖値の推移を比較し有意な差が無いことを確認した。上記実験結果より、適切なICG標識方法が確定し、またICG標識膵島による自家移植が安全に施行可能であることを確認した。
    膵島移植実験に関する情報収集:日本移植学会、ヨーロッパ移植学会、アジア移植学会に参加し、膵島移植研究に関する最新の知見を収集した。

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  • 膵島細胞症様変化に着目した糖尿病に対する次世代細胞療法の創成

    研究課題/領域番号:17H04270  2017年4月 - 2020年3月

    日本学術振興会  科学研究費助成事業 基盤研究(B)  基盤研究(B)

    小林 隆, 松田 康伸, 三浦 宏平, 窪田 正幸

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    配分額:17160000円 ( 直接経費:13200000円 、 間接経費:3960000円 )

    慢性膵炎組織でみられる膵島細胞症様変化ではストレス蛋白発現が認められ、薬剤障害モデルにおいても同様の蛋白が誘導されることが確認された。ストレス蛋白は移植組織片の生着を促進することが報告されているが、ストレス関連蛋白が膵島細胞症様変化を呈した移植片の生着にも関与している可能性は高いことが裏付けられた。また、膵島生着後の移植膵島の再生促進、血糖改善効果の可能性のある薬剤としてGLP-1の有用性が示唆された。

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  • 肝細胞癌発癌過程におけるオートファジーを介した分子制御機構の解明および臨床的意義

    研究課題/領域番号:16K10565  2016年4月 - 2019年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    坂田 純, 小林 隆, 若井 俊文, 廣瀬 雄己, 三浦 宏平, 石川 博補, 須藤 翔, 安藤 拓也

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    肝細胞癌でのNrf2の恒常的活性化は、グルコースからのUDP-グルクロン酸合成、グルタミンからのグルタチオン合成を促進させることが明らかになった。また、UDP-グルクロン酸およびグルタチオンの産生亢進によりリン酸化p62をもつ肝細胞癌細胞は抗癌剤に対する薬剤耐性を獲得し、グルタチオンの産生亢進により腫瘍の増殖が促進されることが明らかになった。さらに、ヒトの肝細胞癌の腫瘍サンプルでp62、リン酸化p62、KEAP1特異的抗体を用いた免疫組織染色および二重免疫蛍光染色を実施したところ、HCV陽性肝細胞癌でこれらのタンパク質が共局在して発現していることが示された。

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  • 周術期の脂肪乳剤投与による血清カルニチン動態およびL-カルニチン製剤投与の効果

    研究課題/領域番号:15K10047  2015年4月 - 2018年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    小山 諭, 諸 和樹, 永橋 昌幸, 若井 俊文, 三浦 宏平, 小杉 伸一, 小林 隆, 小松 雅明

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    配分額:4420000円 ( 直接経費:3400000円 、 間接経費:1020000円 )

    静脈栄養においても、経腸栄養においても基本的に不可欠な主要栄養素の1つである脂質を有効に利用できれば手術後の侵襲下においても患者の回復に役立つ。手術後静脈栄養の際、脂肪乳剤に加えL-カルニチンを投与することにより第3~7病日での炎症反応物質であるCRPが有意に低下することより、術後の炎症反応からの離脱に有用な可能性を示した。
    また、経腸栄養においては、食道癌術後経腸栄養開始の際に低脂質含有栄養剤を使用することにより、術後回復が有意に早く進み、また、術後合併上の1つである乳び胸の予防に有用である可能性を示した。

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  • マージナルグラフトに対する移植前臓器保護・機能回復戦略に関する前臨床研究

    研究課題/領域番号:26293355  2014年4月 - 2017年3月

    日本学術振興会  科学研究費助成事業 基盤研究(B)  基盤研究(B)

    日下 守, 山田 和彦, 佐原 寿史, 星長 清隆, 三浦 宏平, 河合 彰浩, 脇 詩織

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    配分額:16250000円 ( 直接経費:12500000円 、 間接経費:3750000円 )

    炎症前駆物質の活性化が組織傷害を惹起するマージナルドナー腎に対し、種々の細胞保護効果を有する薬剤に焦点を当て、詳細な免疫反応評価が可能な組織適合性抗原MHC確立ミニブタを用いた前臨床実験によって、ドナー、レシピエント、グラフト持続灌流保存中への薬物投与による臓器保護・修復効果を検討し、マージナルドナー臓器を生体臓器に匹敵しうる状態に修復・回復する戦略の確立をはかる実験を実施した。

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  • 慢性膵炎に対する自家膵島移植を併用した膵切除に関する研究

    研究課題/領域番号:25462104  2013年4月 - 2016年3月

    日本学術振興会  科学研究費助成事業 基盤研究(C)  基盤研究(C)

    小林 隆, 三浦 宏平, 亀山 仁史

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    配分額:5070000円 ( 直接経費:3900000円 、 間接経費:1170000円 )

    糖尿病に対する膵臓移植の有用性については既に確立されている一方、膵島移植に関してはその低いインスリン離脱率のため、未だ実験的医療の位置づけである。膵島移植の生着率改善のためには更なる研究が必須であり、臨床応用を目指した大動物モデルの確立が望まれる。本研究を通してミニブタを用いた膵全摘による膵性糖尿病モデルを作成することに成功し、また切除膵から分離した膵島を経門脈的に肝へ移植する自家膵島移植モデルを確立することにも成功した。臨床応用を意識し、ヒトでも応用可能な手術手技を採用した。更に海外の連携施設と協力し、膵島移植にも応用可能な膵臓移植後の長期成績に関する重要な知見を得ることに成功した。

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