2024/10/07 更新

写真a

ツチダ マサノリ
土田 正則
TUCHIDA Masanori
所属
教育研究院 医歯学系 医学系列 教授
医学部 医学科 教授
医歯学総合研究科 生体機能調節医学専攻 器官制御医学 教授
職名
教授
外部リンク

学位

  • 医学博士 ( 1994年3月   新潟大学 )

研究キーワード

  • Transplantation Immunology

  • 移植免疫

  • 胸部外科

  • Thoracic Surgery

研究分野

  • ライフサイエンス / 呼吸器外科学

  • ライフサイエンス / 心臓血管外科学

経歴

  • 新潟大学   医歯学総合研究科 生体機能調節医学専攻 器官制御医学   教授

    2011年11月 - 現在

  • 新潟大学   医学部 医学科   教授

    2011年11月 - 現在

  • 新潟大学   医歯学総合病院   講師

    2003年10月 - 2011年11月

所属学協会

▶ 全件表示

 

論文

  • Surgical outcomes of the systemic-to-pulmonary artery shunt: risk factors of post-operative acute events and effectiveness of regulation of pulmonary blood flow with metal clips.

    Shuichi Shiraishi, Maya Watanabe, Ai Sugimoto, Masanori Tsuchida

    General thoracic and cardiovascular surgery   2024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)  

    OBJECTIVES: The aim of this study was to analyze the risk factors for acute events after systemic-to-pulmonary shunt (SPS) and to investigate the effectiveness of pulmonary blood flow regulation with a metal clip. METHODS: The case histories of 116 patients (78 biventricular [BV] and 38 single ventricle [SV] physiology) who underwent SPS between 2010 and 2021 were retrospectively reviewed. Our strategy was to delay SPS until 1 month of age; pulmonary blood flow (PBF) regulation by partial clipping of the graft, if needed. Cases of aortic cross-clamping were excluded from this study. RESULTS: CPB was used in 49 (42%) patients: the median age at SPS was 1 month (2 days to 16 years), and the sternotomy approach in 65. Discharge survival was 98.3% (114/116); hospital death occurred in 1.7% due to coronary ischemia. Inter-stage mortality occurred in 1.7% (shunt thrombosis, 1; pneumonia, 1). Pre-discharge acute events occurred in 7 patients (6.0%): thrombosis 3, pulmonary over-circulation 2, and coronary ischemia 2. Multiple logistic regression analysis revealed that pulmonary atresia with intact ventricular septum (PA/IVS) (p = 0.0253) was an independent risk factor for acute events. Partial clipping of the graft was performed in 24 patients (pulmonary atresia 15) and clip removal was performed by catheter intervention in 9 patients; no coronary ischemic events and graft injury occurred in these patients. CONCLUSION: Surgical outcomes after SPS were acceptable and metal clip regulation of pulmonary blood flow appears to be safe and effective. PA/IVS was still a significant risk factor for acute events.

    DOI: 10.1007/s11748-024-02028-8

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  • 最近のTCPC conversion術後中期成績

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 利典, 羽山 響, 土田 正則

    日本成人先天性心疾患学会雑誌   13 ( 1 )   154 - 154   2024年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 乳児期早期に高度心不全症状により発見された右肺動脈上行大動脈起始の一例

    羽山 響, 白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 利典, 土田 正則

    日本胸部外科学会定期学術集会   76回   CCPA2 - 4   2023年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • Extracardiac TCPC術後遠隔期の心外導管の形態的変化および導管狭窄の危険因子

    杉本 愛, 白石 修一, 渡辺 マヤ, 高橋 利典, 羽山 響, 土田 正則

    日本胸部外科学会定期学術集会   76回   CP2 - 7   2023年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • ファロー四徴症/肺動脈弁欠損,cervical arch,単一冠動脈を合併した低出生体重児に対する外科治療の1例

    羽山 響, 白石 修一, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本心臓血管外科学会雑誌   52 ( 5 )   305 - 309   2023年9月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

    症例は男児.在胎22週の胎児エコーで左腎嚢胞,先天性心疾患を疑われ母体紹介された.在胎36週5日体重2,282g,Apgar8/8点で出生し,ファロー四徴症,肺動脈弁欠損,肺動脈弁逆流,左上大静脈遺残,右側大動脈弓,cervical archと診断した.生直後に人工呼吸管理となったが日齢9に抜管した.日齢26頃よりSpO2の著明な低下を認め,気管支鏡検査で狭窄所見は軽度であることから,肺血流減少がチアノーゼの主因であると判断した.低体重であり単一冠動脈を認めたため姑息術を先行する方針となったが,cervical archであり通常のブラロック-タウジッヒシャント(BT shunt)は解剖学的に困難のため,日齢49にセントラルシャント(central shunt)+主肺動脈結紮術(main pulmonary artery(mPA)ligation)を行った.チアノーゼは改善し呼吸状態は安定していたが,造影computed tomography(CT)で左肺動脈拡大傾向と左主気管支の圧排所見を認め,気道症状増悪が予想されたため日齢87にRastelli型手術+両側肺動脈縫縮術を行った.術後呼吸状態は安定し術後10日に抜管した.日齢136に在宅高流量鼻カニューレを導入した上で自宅退院した.(著者抄録)

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J01122&link_issn=&doc_id=20230928260003&doc_link_id=10.4326%2Fjjcvs.52.305&url=https%3A%2F%2Fdoi.org%2F10.4326%2Fjjcvs.52.305&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • [Perioperative Management for Patients with Cardiovascular Diseases in General Thoracic Surgery].

    Terumoto Koike, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   76 ( 10 )   840 - 843   2023年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    For general thoracic surgeons, perioperative management for the prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac diseases. Some risk-scoring systems can estimate a patient's risk of perioperative cardiac complication. Surgery-specific risk for intrathoracic surgery is intermediate. Preoperative evaluation for coronary artery disease should be considered only in high-risk patients based on the risk-scoring system and surgery- specific risk. If coronary artery disease is detected in a preoperative patient, the treatment, such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) should not be preoperatively performed as much as possible, because it requires antithrombotic therapy for at least a couple of months and may cause a delay for general thoracic surgical treatment. In high-risk patients for perioperative coronary artery disease, the 12-lead electrocardiogram is recommended for part of routine clinical care during the early postoperative period. The development of perioperative heart failure after noncardiac surgery is a high risk of operative mortality and hospital readmission. Transthoracic echocardiography should not be routinely performed as a preoperative examination, it can help detect underlying heart failure and valvular diseases and contribute to more appropriate postoperative management. Frequent monitoring of vital signs, oxygen saturation, and chest X-rays are important for the early detection of postoperative heart failure.

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  • 肺動静脈瘻合併症例のFontan術後経過の検討

    高橋 利典, 白石 修一, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   59回   [II - 01]   2023年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Non-confluent PAに対しY字型人工血管でFontan手術を行った症例の遠隔期

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 利典, 羽山 響, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   59回   [II - 01]   2023年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 大動脈縫縮を同時に行なったRastelli手術の一例

    羽山 響, 白石 修一, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   59回   [II - 06]   2023年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 器質的気道狭窄を合併した先天性心疾患に対する治療戦略

    杉本 愛, 白石 修一, 渡邉 マヤ, 高橋 利典, 羽山 響, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   59回   [I - 07]   2023年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 肺動脈弁逆流を伴う新生児重症Ebstein病に対してStarnes手術変法を行った2例

    高橋 利典, 白石 修一, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本心臓血管外科学会雑誌   52 ( 4 )   216 - 220   2023年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

    Ebstein病の重症度はさまざまであるが,胎生期および生直後に発症する重症例においては循環維持が困難な危機的な状態となり,生直後に外科的介入が必要となることも多い.今回,肺動脈弁逆流を伴いcircular shuntの状態となった新生児Ebstein病の2例に対し,主肺動脈結紮術などを先行したRapid two-stage approachによるStarnes手術変法を施行した.(1)症例1.在胎39週に吸引分娩にて体重3,012gで出生.7生日に両側肺動脈絞扼術,主肺動脈結紮術,右房縫縮術を施行するも,術後に乳酸アシドーシスの進行を認めたため8生日に緊急Starnes手術を施行した.(2)症例2.胎児水腫を認めたため在胎37週に緊急帝王切開にて体重2,528gで出生.0生日に主肺動脈結紮術を施行.術後も循環動態は改善せずアシドーシスの進行を認めたため,1生日に緊急Starnes手術を施行した.どちらも良好な経過が得られたため報告する.(著者抄録)

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J01122&link_issn=&doc_id=20230731170002&doc_link_id=10.4326%2Fjjcvs.52.216&url=https%3A%2F%2Fdoi.org%2F10.4326%2Fjjcvs.52.216&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Surgical Treatment Outcomes of Patients with Non-Small Cell Lung Cancer and Lymph Node Metastases. 国際誌

    Yuki Shimizu, Terumoto Koike, Toshiki Hasebe, Masaya Nakamura, Tatsuya Goto, Shin-Ichi Toyabe, Masanori Tsuchida

    Cancers   15 ( 12 )   2023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)  

    This study aimed to investigate the appropriate subgroups for surgery and adjuvant chemotherapy in patients with non-small-cell lung cancer (NSCLC) and nodal metastases. We retrospectively reviewed 210 patients with NSCLC and nodal metastases who underwent surgery and examined the risk factors for poor overall survival (OS) and recurrence-free probability (RFP) using multivariate Cox proportional hazards analysis. Pathological N1 and N2 were observed in 114 (52.4%) and 96 (47.6%) patients, respectively. A single positive node was identified in 102 patients (48.6%), and multiple nodes were identified in 108 (51.4%). Multivariate analysis revealed that vital capacity < 80% (hazard ratio [HR]: 2.678, 95% confidence interval [CI]: 1.483-4.837), radiological usual interstitial pneumonia pattern (HR: 2.321, 95% CI: 1.506-3.576), tumor size > 4.0 cm (HR: 1.534, 95% CI: 1.035-2.133), and multiple-node metastases (HR: 2.283, 95% CI: 1.517-3.955) were significant independent risk factors for poor OS. Tumor size > 4.0 cm (HR: 1.780, 95% CI: 1.237-2.562), lymphatic permeation (HR: 1.525, 95% CI: 1.053-2.207), and multiple lymph node metastases (HR: 2.858, 95% CI: 1.933-4.226) were significant independent risk factors for recurrence. In patients with squamous cell carcinoma (n = 93), there were no significant differences in OS or RFP between those who received platinum-based adjuvant chemotherapy (n = 25) and those who did not (n = 68), at p = 0.690 and p = 0.292, respectively. Multiple-node metastases were independent predictors of poor OS and recurrence. Patients with NSCLC and single-node metastases should be considered for surgery despite N2 disease. Additional treatment with platinum-based adjuvant chemotherapy may be expected, especially in patients with squamous cell carcinoma.

    DOI: 10.3390/cancers15123098

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  • 乳児期早期に高度心不全症状により発見された右肺動脈上行大動脈起始の一例

    羽山 響, 白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 利典, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 192回 )   32 - 32   2023年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Sublobar Resection for Non-Small Cell Lung Cancer in Octogenarians: A Prospective, Multicenter Study. 国際誌

    Takahiro Mimae, Hisashi Saji, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Morihito Okada, Kenji Suzuki, Ichiro Yoshino

    The Annals of thoracic surgery   2023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: Segmentectomy is a good surgical option for peripheral, early, non-small cell lung cancer (NSCLC) ≤2 cm. However, the role of sublobar resection including wedge resection and segmentectomy remains unclear for octogenarians with >2-cm but ≤4-cm early-stage NSCLC, for which lobectomy is a standard treatment. METHODS: By use of a prospective registry, 892 patients aged ≥80 years with operable lung cancer were enrolled at 82 institutions. Of these, we analyzed the clinicopathologic findings and surgical outcomes of 419 patients with NSCLC tumors of 2 to 4 cm during a median follow-up of 50.9 months between April 2015 and December 2016. RESULTS: Five-year overall survival (OS) was slightly but not significantly worse after sublobar resection than after lobectomy in the entire cohort (54.7% [95% CI, 43.2%-93.0%] vs 66.8% [95% CI, 60.8%-72.1%]; P = .09). Multivariable Cox regression analysis of OS revealed that these surgical procedures were not independent prognostic predictors (hazard ratio, 0.8 [0.5-1.1]; P = .16). The 5-year OS was comparable between 192 patients who could tolerate lobectomy but were treated by sublobar resection or lobectomy (67.5% [95% CI, 48.8%-80.6%] vs 71.5% [95% CI, 62.9%-78.4%]; P = .79). Recurrence after sublobar resection and lobectomy was locoregional in 11 (11%) of 97 and in 23 (7%) of 322 patients, respectively. CONCLUSIONS: OS might be equivalent between sublobar resection with a secure surgical margin and lobectomy for selected patients aged ≥80 years with peripheral early-stage NSCLC tumors of 2 to 4 cm who can tolerate lobectomy.

    DOI: 10.1016/j.athoracsur.2023.02.061

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  • 未来の専門医を育てる! 新潟大学呼吸循環外科の修練 心臓血管外科と呼吸器外科のトレーニングを受ける研修

    土田 正則, 白石 修一, 小池 輝元

    胸部外科   76 ( 2 )   119 - 121   2023年2月

  • [Analysis of Surgical Margin Recurrence Following Segmentectomy for Early-stage Non-small Cell Lung Cancer].

    Tatsuya Goto, Mika Miyajima, Masaya Nakamura, Yuki Shimizu, Terumoto Koike, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   76 ( 1 )   84 - 89   2023年1月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Surgical margin recurrence following segmentectomy is a critical issue because it may have been avoided by lobectomy. METHODS: Between January 2000 and December 2018, we retrospectively investigated 199 patients who underwent segmentectomy for c-StageⅠ non-small cell lung cancer at our hospital. RESULTS: Recurrence occurred in 20 cases, of which 3 cases had surgical margin recurrence. In our previous study, the recurrence risk factor after segmentectomy was radiologic solid tumor size( cut-off value 1.5 cm). Of the 130 patients in the low-risk group with radiologic solid tumor size of less than 1.5 cm, five had any recurrence, three of which had surgical margin recurrence. In the high-risk group with radiologic solid tumor size of 1.5 cm or more, no surgical margin recurrence was observed. Three cases of surgical margin recurrence were accompanied by lepidic components, and the tumors were difficult to identify intraoperatively and were located close to adjacent areas. CONCLUSION: Surgical margin recurrence may be avoided by carefully considering the segments to be resected and improving the method for identifying the intersegmental plane.

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  • 完全大血管転位に対する心房スイッチ手術術後の遠隔期問題点

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 利典, 羽山 響, 高橋 昌, 土田 正則

    日本成人先天性心疾患学会雑誌   12 ( 1 )   152 - 152   2023年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 【肺癌縮小手術における工夫と現況】成績と予後 早期非小細胞肺癌における区域切除後断端再発

    後藤 達哉, 宮島 美佳, 中村 将弥, 清水 勇希, 小池 輝元, 土田 正則

    胸部外科   76 ( 1 )   84 - 89   2023年1月

  • ファロー四徴症/肺動脈弁欠損、cervical arch、単一冠動脈を合併した低出生体重児に対する外科治療の一例

    羽山 響, 白石 修一, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 190回 )   41 - 41   2022年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 右心系病変を有する先天性心疾患児の右室心筋におけるSplice factor 3b unit1(SF3B1)の発現傾向と心負荷との関連

    杉本 愛, 篠原 陽介, 大橋 瑠子, 白石 修一, 渡辺 マヤ, 土田 正則

    日本胸部外科学会定期学術集会   75回   EPA1 - 7   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • 成人先天性心疾患における三尖弁手術の手術成績と問題点

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 利典, 土田 正則

    日本胸部外科学会定期学術集会   75回   COP38 - 3   2022年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • 胎児エコーで発見された新生児重症Ebstein奇形および三尖弁異形成の2症例

    杉本 愛, 白石 修一, 渡邉 マヤ, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   58回   [III - 07]   2022年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 最近のBlalock-Taussigシャント手術の治療成績の検討 肺血流調整とアプローチの妥当性

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   58回   [III - 02]   2022年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Circular shuntによる胎児水腫のため緊急帝王切開後にStarnes手術を行った重症Ebstein奇形の一例

    高橋 利典, 白石 修一, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 189回 )   35 - 35   2022年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Aortic arch obstructionを合併したTBA/TGAの外科治療戦略の妥当性

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   52回   O42 - 4   2022年3月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • The C-reactive protein to albumin ratio is a prognostic factor for stage I non-small cell lung cancer in elderly patients: JACS1303.

    Takuro Miyazaki, Hisashi Saji, Hiroshige Nakamura, Takeshi Nagayasu, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Morihito Okada, Kenji Suzuki, Masayuki Chida, Ichiro Yoshino

    Surgery today   2022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)  

    PURPOSE: To establish the prognostic significance of C-reactive protein (CRP) and albumin in octogenarians with non-small cell lung cancer (NSCLC) based on the study of the Japanese Association for Chest Surgery (JACS 1303). METHODS: A total of 618 octogenarians with pathological stage I NSCLC, who underwent pulmonary resection, were included in the analysis. We conducted multivariable Cox regression analysis to evaluate the CRP to albumin ratio (CAR) as a potential prognostic factor. Other clinicopathological factors were also evaluated. RESULTS: The median age was 82 years. Operations included lobectomy (n = 388; 62.8%) segmentectomy (n = 95; 15%), and wedge resection (n = 135; 22%). Pathological stage IA was diagnosed in 380 (61.5%) patients. The 3-year (OS) and cancer-specific survival (CS) rates were 86.7% and 94.6%, respectively. OS was significantly higher for patients with low CAR (< 0.106) than for those with high CAR (≥ 0.106) (hazard ratio = 3.13, 95% confidence interval: 1.99-4.93, p < 0.0001). Univariate analysis identified sex, poor performance status, smoking status, comorbidity, solid tumor, histology, high Glasgow prognostic scale, and high CAR as significant prognostic factors. Multivariate analysis identified only the CAR as a significant prognostic factor for both OS and CS. CONCLUSIONS: Our analysis of the nationwide data demonstrated that the CAR is a useful prognostic factor for elderly patients with stage I NSCLC.

    DOI: 10.1007/s00595-022-02485-9

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  • 先天性心疾患の成人期再手術における再胸骨正中切開の危険性の検討

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本成人先天性心疾患学会雑誌   11 ( 1 )   210 - 210   2022年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Senolytic vaccination improves normal and pathological age-related phenotypes and increases lifespan in progeroid mice 査読

    Masayoshi Suda, Ippei Shimizu, Goro Katsuumi, Yohko Yoshida, Yuka Hayashi, Ryutaro Ikegami, Naomi Matsumoto, Yutaka Yoshida, Ryuta Mikawa, Akihiro Katayama, Jun Wada, Masahide Seki, Yutaka Suzuki, Atsushi Iwama, Hironori Nakagami, Ayako Nagasawa, Ryuichi Morishita, Masataka Sugimoto, Shujiro Okuda, Masanori Tsuchida, Kazuyuki Ozaki, Mayumi Nakanishi-Matsui, Tohru Minamino

    Nature Aging   1 ( 12 )   1117 - 1126   2021年12月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    DOI: 10.1038/s43587-021-00151-2

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    その他リンク: https://www.nature.com/articles/s43587-021-00151-2

  • 左上葉転位気管支領域に発生した左上葉肺癌に対して胸腔鏡下左S1+2区域切除を施行した1例

    小林 遼平, 土田 正則, 小池 輝元, 後藤 達哉, 清水 勇希, 中村 将弥, 田中 博, 瀬崎 遼

    日本胸部外科学会関東甲信越地方会要旨集   ( 187回 )   27 - 27   2021年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 漏斗部中隔への異常筋束挿入を伴うTGA3型に対しRastelli手術、異常筋束転位を施行した1例

    渡邉 マヤ, 白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 187回 )   14 - 14   2021年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 化学放射線療法後にサルベージ手術を施行したN3肺尖部胸壁浸潤癌の1例

    清水 勇希, 中村 将弥, 後藤 達哉, 小池 輝元, 土田 正則

    肺癌   61 ( 6 )   714 - 714   2021年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • IIIB期肺腺癌の化学放射線療法後の局所再発に対しサルベージ手術を施行した1症例

    中村 将弥, 田中 博, 瀬崎 遼, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    肺癌   61 ( 6 )   713 - 713   2021年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 新生児開心術中に認めた僧帽弁逆流の術後経過及び遠隔期心機能に及ぼす影響

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会定期学術集会   74回   COD41 - 5   2021年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • Prognostic Impact of Mediastinal Lymph Node Dissection in Octogenarians With Lung Cancer: JACS1303. 国際誌

    Masayuki Nakao, Hisashi Saji, Mingoyn Mun, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Tomohiro Haruki, Morihito Okada, Kenji Suzuki, Masayuki Chida

    Clinical lung cancer   2021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)  

    INTRODUCTION: The prognostic significance of mediastinal lymph node dissection (MLND) in elderly patients with non-small cell lung cancer (NSCLC) remains unclear. This post hoc analysis of a nationwide multicenter cohort study (JACS1303) evaluated the prognostic significance of MLND in octogenarians with NSCLC. MATERIALS AND METHODS: We included 622 octogenarians with NSCLC who underwent lobectomy. The median follow-up duration was 41.1 months. We compared survival and perioperative outcomes between patients who did and did not undergo MLND. RESULTS: In total, 414 (67%) patients underwent MLND (ND2 group), whereas 208 (33%) did not undergo MLND (ND0-1 group). The disease stage was more advanced in the ND2 group than in the ND0-1 group. Disease-free survival was slightly greater in the ND0-1 group with marginal significance (P= .079). In the matched cohort (N = 228), which mainly consisted of patients with clinical stage I disease (96%), there was no significant difference between the 2 groups regarding overall and disease-free survival (P= .908 and P = .916, respectively). Operative time and blood loss were significantly lower in the ND0-1 group than in the ND2 group in the entire cohort (P< .001 and P = .050, respectively) and in the matched cohort (P = .003 and P= .046, respectively). CONCLUSION: Based on a nationwide prospective database, we found limited prognostic impact of MLND, suggesting that MLND can be omitted for octogenarians with early-stage NSCLC.

    DOI: 10.1016/j.cllc.2021.09.007

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  • Maximum Standardized Uptake Value on Positron Emission Tomography is Associated With More Advanced Disease and High-risk Features in Lung Adenocarcinoma. 国際誌

    Terumoto Koike, Noriaki Sato, Yuta Hosoda, Masayuki Tazawa, Tatsuya Goto, Seijiro Sato, Motohiko Yamazaki, Shin-Ichi Toyabe, Masanori Tsuchida

    Seminars in thoracic and cardiovascular surgery   34 ( 3 )   1051 - 1060   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG-PET/CT) has been widely used for preoperative staging of lung adenocarcinomas. The aim of this study was to determine whether a high maximum standardized uptake value (SUVmax) could correlate with pathological characteristics in those patients. We retrospectively reviewed patients with clinical stage 0-IA lung adenocarcinoma who underwent preoperative 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography followed by curative anatomical resection. To identify more advanced disease and high-risk features, representing visceral pleural involvement, pulmonary metastasis, lymph node involvement, and lymphovascular involvement in resected surgical specimens, univariate and multivariate logistic regression analyses were performed. The optimal cutoff point for the SUVmax was determined by receiver operating characteristic analysis. In 2 groups divided according to the cutoff point, the disease-free survivals were calculated and compared using the Kaplan-Meier method and the log-rank test. More advanced disease and high-risk features were identified in 55 (18.9%) of the 291 patients. SUVmax was significantly correlated with more advanced disease and high-risk features, as did the consolidation/tumor ratio on computed tomography. Only 2 (1.2%) of the 169 patients with a SUVmax <3.20 showed more advanced disease and high-risk features, compared with 43.4% of patients with a SUVmax ≥3.20. The disease-free survival was significantly higher in patients with a SUVmax <3.20 than in those with a SUVmax ≥3.20 (P = 0.002). A high SUVmax correlates with more advanced disease and high-risk features in patients with clinical stage 0-IA lung adenocarcinoma. The SUVmax should be considered when deciding treatment strategy in early-stage lung adenocarcinoma.

    DOI: 10.1053/j.semtcvs.2021.07.019

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  • 完全大血管転位症スイッチ術後遠隔期の冠動脈狭窄に対して手術介入を行なった2症例

    杉本 愛, 白石 修一, 渡邉 マヤ, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   57回   [P50 - 1]   2021年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 二心室修復を目指した両側肺動脈絞扼術の治療成績と問題点

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   57回   [OR37 - 1]   2021年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 自己肺動脈壁パッチを用いた大動脈再建術

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会総会・学術集会抄録集   57回   [OR36 - 3]   2021年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 右上葉切除後の右下葉肺腺癌に対し右S8+9区域切除を施行した一例

    中村 将弥, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 186回 )   38 - 38   2021年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Surgical outcomes of ipsilateral metachronous second primary lung cancer

    Seijiro Sato, Yuki Shimizu, Tatsuya Goto, Terumoto Koike, Takahisa Koizumi, Takehiro Watanabe, Hirohiko Shinohara, Yasushi Yamato, Masanori Tsuchida

    INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY   32 ( 6 )   896 - 903   2021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:OXFORD UNIV PRESS  

    OBJECTIVES: The optimal surgical approach for metachronous second primary lung cancer (MSPLC), especially ipsilateral MSPLC, remains unclear. This study aimed to review postoperative complications and examine surgical outcomes based on the extent of resection after surgery for ipsilateral MSPLC.METHODS: Clinical data from 61 consecutive patients who underwent pulmonary resection for ipsilateral MSPLC according to the Martini-Melamed criteria between January 2005 and December 2017 in 3 institutes were retrospectively reviewed.RESULTS: Postoperative complications were identified in 12 patients (19.7%). Regarding the combination of initial and second surgery, intraoperative bleeding was significantly greater in patients with anatomic-anatomic resection than in others (P < 0.001). Operation time was significantly longer in patients with anatomic-anatomic resection than in others (P <0.001). However, postoperative complications showed no significant differences based on the combination of surgeries. Five-year overall survival rates in patients with anatomic resection and wedge resection after second surgery were 75.8% and 75.8%, respectively (P= 0.738), and 5-year recurrence-free survival rates were 54.2% and 67.6%, respectively (P = 0.368). Cox multivariate analysis identified ever-smoker status (P = 0.029), poor performance status (P = 0.011) and tumour size >20 mm (P = 0.001) as independent predictors of poor overall survival, while ever-smoker status (P = 0.040) and tumour size >20 mm (P = 0.007) were considered independent predictors of poor recurrence-free survival.CONCLUSIONS: Regarding postoperative and long-term outcomes for patients with ipsilateral MSPLC, surgical intervention is safe and offers good long-term survival. Wedge resection is an acceptable provided tumours <= 2 cm and ground-glass opacity-predominant as a second surgery for early-stage ipsilateral MSPLC.

    DOI: 10.1093/icvts/ivab025

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  • 自己肺動脈パッチで大動脈・肺動脈の口径差を調節し動脈スイッチ・大動脈弓再建を行ったDORV/CoAの一例

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 186回 )   21 - 21   2021年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Surgical outcomes of ipsilateral metachronous second primary lung cancer. 国際誌

    Seijiro Sato, Yuki Shimizu, Tatsuya Goto, Terumoto Koike, Takahisa Koizumi, Takehiro Watanabe, Hirohiko Shinohara, Yasushi Yamato, Masanori Tsuchida

    Interactive cardiovascular and thoracic surgery   32 ( 6 )   896 - 903   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)  

    OBJECTIVES: The optimal surgical approach for metachronous second primary lung cancer (MSPLC), especially ipsilateral MSPLC, remains unclear. This study aimed to review postoperative complications and examine surgical outcomes based on the extent of resection after surgery for ipsilateral MSPLC. METHODS: Clinical data from 61 consecutive patients who underwent pulmonary resection for ipsilateral MSPLC according to the Martini-Melamed criteria between January 2005 and December 2017 in 3 institutes were retrospectively reviewed. RESULTS: Postoperative complications were identified in 12 patients (19.7%). Regarding the combination of initial and second surgery, intraoperative bleeding was significantly greater in patients with anatomic-anatomic resection than in others (P < 0.001). Operation time was significantly longer in patients with anatomic-anatomic resection than in others (P < 0.001). However, postoperative complications showed no significant differences based on the combination of surgeries. Five-year overall survival rates in patients with anatomic resection and wedge resection after second surgery were 75.8% and 75.8%, respectively (P = 0.738), and 5-year recurrence-free survival rates were 54.2% and 67.6%, respectively (P = 0.368). Cox multivariate analysis identified ever-smoker status (P = 0.029), poor performance status (P = 0.011) and tumour size >20 mm (P = 0.001) as independent predictors of poor overall survival, while ever-smoker status (P = 0.040) and tumour size >20 mm (P = 0.007) were considered independent predictors of poor recurrence-free survival. CONCLUSIONS: Regarding postoperative and long-term outcomes for patients with ipsilateral MSPLC, surgical intervention is safe and offers good long-term survival. Wedge resection is an acceptable provided tumours ≤2 cm and ground-glass opacity-predominant as a second surgery for early-stage ipsilateral MSPLC.

    DOI: 10.1093/icvts/ivab025

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  • 原発性肺腺癌におけるFDG-PET/CTでのDeauville分類の有用性の検討

    田澤 勝幸, 細田 裕太, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   35 ( 3 )   MO1 - 2   2021年5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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  • 間質性肺炎合併肺癌における非癌部間質性肺炎領域が周術期に与える影響

    佐藤 征二郎, 田澤 勝幸, 細田 裕太, 後藤 達哉, 小池 輝元, 篠原 博彦, 土田 正則

    日本呼吸器外科学会雑誌   35 ( 3 )   O5 - 4   2021年5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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  • 80歳以上高齢者肺癌に対する縦隔リンパ節郭清省略の意義 JACS1303副次解析

    中尾 将之, 佐治 久, 文 敏景, 中村 廣繁, 奥村 典仁, 土田 正則, 園部 誠, 宮崎 拓郎, 青景 圭樹, 春木 朋広, 鈴木 健司, 千田 雅之

    日本呼吸器外科学会雑誌   35 ( 3 )   RO19 - 5   2021年5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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  • Survival of Octogenarians with Early-Stage Non-small Cell Lung Cancer is Comparable Between Wedge Resection and Lobectomy/Segmentectomy: JACS1303. 国際誌

    Takahiro Mimae, Hisashi Saji, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Morihito Okada, Kenji Suzuki, Masayuki Chida

    Annals of surgical oncology   2021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)  

    BACKGROUND: Anatomic resection with lymph node dissection or sampling is the standard treatment for early non-small cell lung cancer (NSCLC), and wedge resection is an option for compromised patients. This study aimed to determine whether wedge resection can provide comparable prognoses for elderly patients with NSCLC. METHODS: The study analyzed the clinicopathologic findings and surgical outcomes during a median follow-up period of 39.6 months for 156 patients with solid dominant (consolidation-to-tumor ratio > 0.5) small (whole tumor size ≤ 2 cm) NSCLC among 892 patients 80 years of age or older with medically operable lung cancer between April 2015 and December 2016. RESULTS: The 3-year overall survival (OS) rates after wedge resection and after segmentectomy plus lobectomy did not differ significantly (86.5 %; 95 % confidence interval [CI], 74.6-93.0 % vs 83.7 % 95 % CI, 74.0-90.0 %; P = 0.92). Multivariable Cox regression analysis of OS with propensity scores showed that the surgical procedure was not an independent prognostic predictor (hazard ratio [HR], 0.84; 95 % CI, 0.39-1.8; P = 0.64). The 3-year OS rates were slightly better after wedge resection for 97 patients who could tolerate lobectomy than after segmentectomy plus lobectomy (89.4 %; 95 % CI, 73.8-95.9 % vs 75.8 %; 95 % CI, 62.0-85.2 %; P = 0.14). The cumulative incidence of other causes for death was marginally higher after segmentectomy plus lobectomy than after wedge resection (P = 0.079). CONCLUSIONS: Wedge resection might be equivalent to lobectomy or segmentectomy for selected patients 80 years of age or older with early-stage NSCLC who can tolerate lobectomy.

    DOI: 10.1245/s10434-021-09835-w

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  • 右肺下葉切除術後左主気管支食道瘻に対して上部消化管内視鏡的クリッピングで治癒し得た一例

    細田 裕太, 田澤 勝幸, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 185回 )   20 - 20   2021年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Mutational signatures in squamous cell carcinoma of the lung. 国際誌

    Atsushi Osoegawa, Kazuki Takada, Tatsuro Okamoto, Seijiro Sato, Masayuki Nagahashi, Tetsuzo Tagawa, Masanori Tsuchida, Eiji Oki, Shujiro Okuda, Toshifumi Wakai, Masaki Mori

    Journal of thoracic disease   13 ( 2 )   1075 - 1082   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: Tumor mutational burden (TMB) has been identified as one of the predictors for the response to anti-programmed cell death-1 (anti-PD-1) antibody therapy and reported to correlate with smoking history in lung adenocarcinoma. However, in squamous cell carcinoma of the lung, the association between TMB and clinicopathological background factors, such as smoking history, has not been reported, including in our previous study. The mutational signature is a tool to identify the mutagens that are contributing to the mutational spectrum of a tumor by investigating the pattern of DNA changes. Here, we analyzed the mutational signature in lung squamous cell carcinoma to identify mutagens affecting the TMB. Methods: Seven representative mutational signatures including signature 7 (SI7) [ultraviolet (UV)-related], SI4 (smoking), SI6/15 [mismatch repair (MMR)], SI2/13 [apolipoprotein B mRNA editing enzyme, catalytic polypeptide-like (APOBEC)], and SI5 (clock-like) were analyzed in Japanese patients with lung squamous cell carcinoma (n=67) using data generated by next-generation sequencing consisting of a 415-gene panel. The relationships between signatures and clinico-pathological data including TMB and programmed death-ligand 1 (PD-L1) expression were analyzed. Results: Although the reconstructed mutational counts were small with targeted sequencing (median: 30.1, range: 13.3-98.7), the distributions of signatures were comparable among samples, with 56 cases containing more than four signatures. The smoking-related SI4 was found in 45 cases and was significantly related with pack-year index (PYI) (P=0.026). The reconstructed mutation counts were highly correlated with SI4 (r=0.51, P<0.0001), whereas the correlation was weak with SI6/15 (MMR-related) and SI2/13 (APOBEC-related). There was no mutational signature related with PD-L1 expression. Some patients exhibited unique signatures; the patient with the highest mutational counts had a MMR signature, and another patient with a prominent UV signature had occupational exposure to UV, as he was employed as a neon sign engineer. Conclusions: Mutational signatures can predict the cause of lung squamous cell carcinoma. Tobacco smoking is the mutagen most related with TMB.

    DOI: 10.21037/jtd-20-2602

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  • Frequent Germline and Somatic Single Nucleotide Variants in the Promoter Region of the Ribosomal RNA Gene in Japanese Lung Adenocarcinoma Patients

    Riuko Ohashi, Hajime Umezu, Ayako Sato, Tatsuya Abé, Shuhei Kondo, Kenji Daigo, Seijiro Sato, Norikazu Hara, Akinori Miyashita, Takeshi Ikeuchi, Teiichi Motoyama, Masashi Kishi, Tadahiro Nagaoka, Keiko Horiuchi, Atsushi Shiga, Shujiro Okuda, Tomoki Sekiya, Aya Ohtsubo, Kosuke Ichikawa, Hiroshi Kagamu, Toshiaki Kikuchi, Satoshi Watanabe, Jun-Ichi Tanuma, Peter Schraml, Takao Hamakubo, Masanori Tsuchida, Yoichi Ajioka

    Cells   9 ( 11 )   2409 - 2409   2020年11月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:MDPI AG  

    Ribosomal RNA (rRNA), the most abundant non-coding RNA species, is a major component of the ribosome. Impaired ribosome biogenesis causes the dysfunction of protein synthesis and diseases called “ribosomopathies,” including genetic disorders with cancer risk. However, the potential role of rRNA gene (rDNA) alterations in cancer is unknown. We investigated germline and somatic single-nucleotide variants (SNVs) in the rDNA promoter region (positions −248 to +100, relative to the transcription start site) in 82 lung adenocarcinomas (LUAC). Twenty-nine tumors (35.4%) carried germline SNVs, and eight tumors (9.8%) harbored somatic SNVs. Interestingly, the presence of germline SNVs between positions +1 and +100 (n = 12; 14.6%) was associated with significantly shorter recurrence-free survival (RFS) and overall survival (OS) by univariate analysis (p &lt; 0.05, respectively), and was an independent prognostic factor for RFS and OS by multivariate analysis. LUAC cell line PC9, carrying rDNA promoter SNV at position +49, showed significantly higher ribosome biogenesis than H1650 cells without SNV. Upon nucleolar stress induced by actinomycin D, PC9 retained significantly higher ribosome biogenesis than H1650. These results highlight the possible functional role of SNVs at specific sites of the rDNA promoter region in ribosome biogenesis, the progression of LUAC, and their potential prognostic value.

    DOI: 10.3390/cells9112409

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  • 気管原発腺様嚢胞癌に対しV-V ECMO下で気管切除・再建を施行した一例

    細田 裕太, 後藤 達哉, 田澤 勝幸, 佐藤 哲彰, 大久保 由華, 佐藤 征二郎, 三島 健人, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 184回 )   18 - 18   2020年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • BTシャント手術を先行したファロー四徴症修復術の中期成績 肺動脈弁機能と遺残右室流出路狭窄

    白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   36 ( Suppl.2 )   s2 - 384   2020年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Fontan(Lateral tunnel)術後23年目に肝細胞癌を発症した一例

    佐藤 哲彰, 白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 184回 )   26 - 26   2020年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 二心室治療を目指した経過中、左上大静脈の経路変更を要した両側上大静脈を有する2症例

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   36 ( Suppl.2 )   s2 - 396   2020年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Salvage surgery to treat tumor regrowth after stereotactic body radiotherapy in primary non-small cell lung cancer. 国際誌

    Takahisa Koizumi, Tadashi Aoki, Masayuki Saito, Yasushi Yamato, Go Furuyashiki, Akihiko Kitahara, Takehisa Hashimoto, Takehiro Watanabe, Masanori Tsuchida

    Journal of thoracic disease   12 ( 10 )   5289 - 5298   2020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)  

    Background: Stereotactic body radiotherapy (SBRT) is considered to be an effective and safe treatment in patients with primary lung cancer. If local recurrence is confirmed following SBRT, surgical treatment is a possibility. The present study aimed to clarify the safety and survival outcomes of salvage surgery in primary lung cancer patients with local recurrence following SBRT. Methods: All subjects were patients with primary lung cancer who underwent surgical treatment for local recurrence following SBRT during the period from July 2005 to July 2015. We evaluated the reason for SBRT selection, the surgical procedure, postoperative complications, and prognosis. Results: Of 932 patients underwent SBRT as treatment for primary lung cancer, 48 patients (5.2%) had local recurrence alone and 19 patients (2.0%) underwent salvage surgery. SBRT was selected in eight medically operable patients who refused surgery, and in 11 patients considered medically inoperable by their pulmonologist. Lobectomy was performed in 15 patients. Postoperative complications were documented in 4 patients (21.1%). Incomplete resection was performed in 2 patients. Stage progression was confirmed in 7 patients (36.8%). The 5-year overall survival (OS) was 72.5% and the 5-year disease-free survival (DFS) was 65.2%. Conclusions: We evaluated patients who underwent salvage surgery due to local recurrence of lung cancer following SBRT. We found that salvage surgery could be performed safely without affecting SBRT outcomes. We further infer that cases of complete resection are likely to be associated with good prognosis, and that SBRT should be selected only after careful consideration because complete resection is not possible in all cases.

    DOI: 10.21037/jtd-20-2253

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  • 肺癌切除に起因する術後早期胸腔内合併症に対する緊急残存肺全摘の経験

    土田 正則, 田澤 勝幸, 細田 裕太, 後藤 達哉, 佐藤 征二郎, 小池 輝元

    日本胸部外科学会定期学術集会   73回   LOO14 - 35   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • 非小細胞肺癌根治切除症例において術後末梢血好中球/リンパ球比の意義の検討

    田澤 勝幸, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会定期学術集会   73回   LOO15 - 10   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • Radical segmentectomy as a potential alternative surgical treatment with curative intent in early-stage non-small cell lung cancer. 国際誌

    Terumoto Koike, Tatsuya Goto, Seijiro Sato, Masanori Tsuchida

    Journal of thoracic disease   12 ( 10 )   6115 - 6119   2020年10月

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    記述言語:英語  

    DOI: 10.21037/jtd-20-1582

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  • 慢性閉塞性肺疾患合併非小細胞肺癌における気腫病変の意義

    佐藤 征二郎, 田澤 勝幸, 細田 裕太, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    日本胸部外科学会定期学術集会   73回   LOO1 - 24   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • TOFの初回手術介入方針 Primary or Staged? 中期・長期成績から見たファロー四徴症に対する段階的治療の妥当性 年代による比較

    白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会定期学術集会   73回   CPD4 - 2   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • 小児冠動脈バイパス術後の中期遠隔期予後

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本胸部外科学会定期学術集会   73回   COO13 - 13   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本胸部外科学会  

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  • Characteristics and risk factors of recurrence in clinical stage I non-small cell lung cancer patients undergoing anatomic segmentectomy.

    Terumoto Koike, Akihiro Nakamura, Yuki Shimizu, Tatsuya Goto, Seijiro Sato, Shin-Ichi Toyabe, Masanori Tsuchida

    General thoracic and cardiovascular surgery   68 ( 9 )   1011 - 1017   2020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)  

    OBJECTIVE: Although lobectomy is the standard surgical procedure for small-sized non-small cell lung cancer (NSCLC), segmentectomy has been performed for various reasons. The aim of this study was to investigate the characteristics of and risk factors for recurrence in early-stage NSCLC patients undergoing segmentectomy. METHODS: We retrospectively reviewed 179 patients with clinical stage I NSCLC who underwent segmentectomy. Preoperative factors were analyzed using the log-rank test for univariate analyses. Multivariate analyses were performed using a Cox proportional hazards regression model to identify independent risk factors for recurrence. For the significant factors, optimal cutoff points were determined by receiver operating characteristic (ROC) analysis. RESULTS: During the follow-up period of 51 months, 18 patients developed recurrence; 5 had locoregional (including 2 with margin recurrences only), 9 had distant, and 4 had both locoregional and distant recurrence. Multivariate and ROC analysis identified radiologic solid tumor size with a cutoff point of 1.5 cm as an independent risk factor for recurrence. Three patients in the solid size < 1.5 cm group (n = 119) developed recurrence, 2 of whom had surgical margin recurrence, compared to 15 patients in the solid size ≥ 1.5 cm group (n = 60). CONCLUSIONS: The indication for segmentectomy should be decided upon with caution, and the segments to be resected should be carefully considered to secure an appropriate surgical margin in this low-risk subgroup of patients because they may have a relatively higher risk of surgical margin recurrence, despite being at decreased risk.

    DOI: 10.1007/s11748-020-01338-x

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  • 右房・無名静脈バイパスが開存していたGlenn手術原法・Bjoerk手術後遠隔期の蛋白漏出性胃腸症に対しTCPC転換術を施行した1例

    白石 修一, 杉本 愛, 土田 正則

    日本心臓血管外科学会雑誌   49 ( 5 )   257 - 260   2020年9月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

    症例は37歳男性。三尖弁閉鎖の診断で左Blalock Taussigシャント手術原法、Glenn手術原法、左肺動脈形成術の既往あり。10歳時にBjoerk手術を施行したが、術後に循環不全となり心肺補助装置を装着された。上下大静脈間の著明な圧較差を認めたため、人工血管による右房・無名静脈バイパス術を追加し心肺補助装置を離脱し得た。術後他院にて経過観察されていたが、30歳頃より心房頻拍が出現、36歳時より蛋白漏出性胃腸症を発症した。内科的治療でも改善を認めないため当院再診した。心臓カテーテル検査にて右房・無名静脈間の人工血管の開存が確認され、左肺動脈が低形成のため下大静脈血流は一部が人工血管経由に無名静脈から右肺動脈へ還流しており、上下大静脈間の圧較差を認めた。手術は人工心肺・心停止下に右房アブレーション、心外導管を用いたTCPC転換術、大動脈前方での左肺動脈再建、右房-心外導管間のfenestration作成および心外膜ペースメーカーリード装着術を行った。術後34日に退院した。蛋白漏出性胃腸症は軽快し3年経過した現在も再発は認めていない。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J01122&link_issn=&doc_id=20200928350003&doc_link_id=10.4326%2Fjjcvs.49.257&url=https%3A%2F%2Fdoi.org%2F10.4326%2Fjjcvs.49.257&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 血管平滑筋p53の大動脈解離発症機構への関与

    長澤 綾子, 清水 逸平, 吉田 陽子, 土田 正則, 南野 徹

    日本外科学会定期学術集会抄録集   120回   SF - 7   2020年8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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  • TNM分類に基づく胸腺上皮性腫瘍に対する外科治療成績

    清水 勇希, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   34 ( 3 )   MO46 - 1   2020年8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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  • 上肺静脈心嚢内結紮を行った左肺上葉切除症例の検討

    北原 哲彦, 清水 勇希, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   34 ( 3 )   MO4 - 3   2020年8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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  • A Case Report of Reconstruction of the Left Superior Vena Cava Using the Right Superior Vena Cava Autograft at Bilateral Bidirectional Superior Cavopulmonary Anastomosis. 国際誌

    Shuichi Shiraishi, Ai Sugimoto, Jiyong Moon, Masashi Takahashi, Masanori Tsuchida

    World journal for pediatric & congenital heart surgery   11 ( 4 )   NP63-NP65   2020年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The choice of graft material for reconstruction of the vena cava in pediatric patients remains controversial. We successfully treated an eight-month-old female patient with single ventricle physiology and long segment obstruction of the left superior vena cava using the right superior vena cava autograft at the time of bilateral bidirectional superior cavopulmonary anastomosis. Postoperative computed tomography confirmed the patency of the reconstruction.

    DOI: 10.1177/2150135117706951

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  • Impact of postoperative complications on outcomes of second surgery for second primary lung cancer.

    Seijiro Sato, Masaya Nakamura, Yuki Shimizu, Tatsuya Goto, Akihiko Kitahara, Terumoto Koike, Masanori Tsuchida

    Surgery today   50 ( 11 )   1452 - 1460   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)  

    PURPOSE: The best surgical approach for second primary lung cancer remains a subject of debate. The purpose of this study was to review the postoperative complications after second surgery for second primary lung cancer and to investigate the outcomes based on these complications. METHODS: The clinical data of 105 consecutive patients who underwent pulmonary resection for multiple primary lung cancers between January, 1996 and December, 2017, were reviewed according to the Martini-Melamed criteria. RESULTS: After the second surgery, low body mass index (BMI) (< 18.5 kg/m2) (P = 0.004) and high Charlson comorbidity index (CCI) (P = 0.002) were independent predictors of postoperative complications. Survival analysis revealed the 5-year overall survival rates of 74.5% and 61.4% for patients without postoperative complications and those with postoperative complications (P = 0.044), respectively, but the 5-year cancer-specific survival rates of 82.5% and 80.0% (P = 0.926), respectively. During this period, there were significantly more respiratory-related deaths of patients with complications than of those without complications (P = 0.011). CONCLUSION: Surgical intervention is feasible and potentially effective for second primary lung cancer but may not achieve positive perioperative and long-term outcomes for patients with a low BMI or a high CCI. Treatment options should be considered carefully for these patients.

    DOI: 10.1007/s00595-020-02038-y

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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.

    DOI: 10.1111/1759-7714.13410

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  • Adverse impact of univentricular pacing for the patient with functional single ventricle: successful conversion to cardiac resynchronization therapy. 国際誌

    Ai Sugimoto, Kiyohiro Takigiku, Shuichi Shiraishi, Masashi Takahashi, Masanori Tsuchida

    Surgical case reports   6 ( 1 )   101 - 101   2020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: In a Fontan candidate, univentricular pacing may cause delay in interventricular conduction, which induces asynchronous contraction. Cardiac resynchronization therapy is expected to be an effective mode of therapy in such a case. CASE PRESENTATION: A 7-month-old girl, diagnosed with dextrocardia, congenitally corrected transposition of the great artery [situs solitus, L-loop, and L-transposition], ventricular septal defect, infundibular and pulmonary valvular stenosis, and straddling of the tricuspid valve, was considered as a candidate for the Fontan procedure. She had undergone Blalock-Taussig shunt, and epicardial univentricular pacemaker implantation for persistent complete atrioventricular block. She underwent a bidirectional cavopulmonary shunt concomitant with ventricular lead translocation from the morphological left ventricle to the morphological right ventricle. After discharge, ventricular dyssynchrony was noted and cardiac failure persisted. She was converted to cardiac resynchronization therapy (CRT) at 13 months of age. Two-dimensional speckle tracking imaging was used by cardiologists to determine the most suitable pacing site. CRT rapidly corrected the heart failure; thus, she underwent the Fontan procedure after 1.5 years. Five years have passed since the cardiac resynchronization therapy; her interventricular synchrony is maintained well and the level of brain natriuretic peptide remains within normal range. CONCLUSION: We describe the successful conversion from single ventricular pacing to CRT, in a case of congenitally corrected transposition of the great artery indicated for the Fontan procedure. The long-term prognosis of cardiac resynchronization therapy is undetermined in the pediatric population; therefore, further follow-up is required.

    DOI: 10.1186/s40792-020-00863-4

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  • Generation of Lungs by Blastocyst Complementation in Apneumic Fgf10-Deficient Mice. 査読 国際誌

    Akihiko Kitahara, Qingsong Ran, Kanako Oda, Akihiro Yasue, Manabu Abe, Xulu Ye, Toshikuni Sasaoka, Masanori Tsuchida, Kenji Sakimura, Yoichi Ajioka, Yasuo Saijo, Qiliang Zhou

    Cell reports   31 ( 6 )   107626 - 107626   2020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)  

    The shortage of donor lungs hinders lung transplantation, the only definitive option for patients with end-stage lung disease. Blastocyst complementation enables the generation of transplantable organs from pluripotent stem cells (PSCs) in animal models. Pancreases and kidneys have been generated from PSCs by blastocyst complementation in rodent models. Here, we report the generation of lungs using mouse embryonic stem cells (ESCs) in apneumic Fgf10 Ex1mut/Ex3mutmice by blastocyst complementation. Complementation with ESCs enables Fgf10-deficient mice to survive to adulthood without abnormalities. Both the generated lung alveolar parenchyma and the interstitial portions, including vascular endothelial cells, vascular and parabronchial smooth muscle cells, and connective tissue, largely originate from the injected ESCs. These data suggest that Fgf10 Ex1mut/Ex3mutblastocysts provide an organ niche for lung generation and that blastocyst complementation could be a viable approach for generating whole lungs.

    DOI: 10.1016/j.celrep.2020.107626

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  • A novel suture technique in closing the single drainage tube hole in uni-portal video-assisted thoracoscopic surgery. 国際誌

    Terumoto Koike, Seijiro Sato, Masanori Tsuchida

    Annals of translational medicine   8 ( 7 )   424 - 424   2020年4月

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  • 【循環器症候群(第3版)-その他の循環器疾患を含めて-】先天性心・大血管疾患 大動脈左室トンネル

    白石 修一, 杉本 愛, 土田 正則

    日本臨床   別冊 ( 循環器症候群IV )   367 - 369   2020年3月

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    記述言語:日本語   出版者・発行元:(株)日本臨床社  

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  • 【循環器症候群(第3版)-その他の循環器疾患を含めて-】先天性心・大血管疾患 部分肺静脈還流異常症

    白石 修一, 杉本 愛, 土田 正則

    日本臨床   別冊 ( 循環器症候群IV )   303 - 305   2020年3月

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    記述言語:日本語   出版者・発行元:(株)日本臨床社  

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  • Fontan(Lateral tunnel)術後遠隔期、肝細胞癌切除術中に心停止し、左側開胸にてPM移植を行った一例

    斉藤 広大, 白石 修一, 杉本 愛, 北原 武尊, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 182回 )   25 - 25   2020年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 新生児開心術中に経食道心エコーで同定された僧帽弁逆流の術後推移と臨床的意義

    白石 修一, 杉本 愛, 北原 武尊, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   50回   P43 - 1   2020年3月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 小児胸骨正中切開後縦隔炎に対する治療戦略 洗浄ドレナージ+一期的胸骨閉鎖

    杉本 愛, 白石 修一, 北原 武尊, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   50回   PR1 - 5   2020年3月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • ファロー四徴症術後遠隔期での肺動脈弁置換術後の三尖弁機能

    白石 修一, 杉本 愛, 北原 武尊, 高橋 昌, 土田 正則

    日本成人先天性心疾患学会雑誌   9 ( 1 )   257 - 257   2020年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Swing-back and trap-door technique repair for interrupted aortic arch with right-sided descending aorta. 国際誌

    Shuichi Shiraishi, Ai Sugimoto, Masanori Tsuchida

    Interactive cardiovascular and thoracic surgery   29 ( 5 )   818 - 819   2019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)  

    A right-sided descending aorta with a left aortic arch is a rare congenital anomaly in which the aortic arch crosses the midline from the left side of the trachea coursing to the descending aorta in the right thoracic cavity. The surgical repair of an interrupted aortic arch with a right-sided descending aorta carries great risks of bronchial and oesophageal obstruction. Herein, we describe a case of successful surgical repair of an interrupted aortic arch with a right-sided descending aorta using the swing-back and trap-door techniques.

    DOI: 10.1093/icvts/ivz175

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  • Resection of Multiple Thymic Carcinomas of the Thymus

    Yasuko Hosaka, Akihiko Kitahara, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   72 ( 12 )   993 - 996   2019年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NLM (Medline)  

    The patient was a 70-year-old woman who was found to have 2 mediastinal tumors on chest computed tomography(CT). One was located in the anterior mediastinum, and the other was in the upper mediastinum. Based on previous imaging studies, it was revealed that the 2 tumors had been increasing in size for 5 years. Thymectomy via median sternotomy was performed. Histopathologically, 3 tumors revealed to be in the thymus without direct invasion of the adjacent organs. All were thymic squamous cell carcinomas of 3.0×1.8×1.6 cm, 2.5×1.6×1.2 cm and 0.7 cm in size. No lymphatic invasion was observed and all tumors were pathologically stage I. Thus, we considered the 3 tumors were multi-centric primary tumors.

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  • 右側下行大動脈を伴った大動脈離断症に対してmodified swing-back法を施行した一例

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 181回 )   21 - 21   2019年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Dedifferentiated Liposarcoma of the Anterior Mediastinum;Report of a Case

    Yasuko Hosaka, Akihiko Kitahara, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   72 ( 11 )   958 - 961   2019年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:NLM (Medline)  

    A 69-year-old man was pointed out the anterior mediastinal mass on chest computed tomography (CT). Since the thymoma was suspected, thymectomy was performed through median sternotomy. The tumor was encapsulated and did not directly invade adjacent organs. The tumor was 8.3×5.3×8.2 cm in size. Histological examination of the resected specimen showed a large mucinous component and a small fibrous component, both containing many atypical spindle cells and multinuclear giant cells, and fat cells and atypical lipoblasts observed in a small part of the specimen. The postoperative pathological diagnosis was dedifferentiated liposarcoma. No relapse is observed without adjuvant therapy at 1 year after surgery.

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  • 胸腔鏡下ICG蛍光ナビゲーション手術が有用であった不全分葉を有する小児肺葉内肺分画症の1例

    平山 裕, 小池 輝元, 飯沼 泰史, 土田 正則

    小児外科   51 ( 10 )   1047 - 1051   2019年10月

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    記述言語:日本語   出版者・発行元:(株)東京医学社  

    12歳女児。腹痛にて近医を受診した際、X線検査にて右下肺野の嚢胞陰影が指摘された。その後は前医へ紹介され、CT検査にて不全分葉を有する肺葉内肺分画症と診断され、手術目的で当科へ紹介となった。当科では腹腔鏡下ICG蛍光ナビゲーション手術を計画し、適切な葉間切離線を設定することで肺切除を行うことが可能であった。術後は経過良好で、術後第4病日に退院となった。

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  • Superior Vena Cava Flap to Reroute Partial Anomalous Pulmonary Venous Connection. 国際誌

    Ai Sugimoto, Shuichi Shiraishi, Masashi Takahashi, Masanori Tsuchida

    World journal for pediatric & congenital heart surgery   10 ( 5 )   645 - 647   2019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)  

    A 46-year-old man who had undergone atrial septal defect closure during childhood was referred for surgery for residual partial anomalous pulmonary venous connection. The anomalous pulmonary veins were connected to the higher (cephalad) segment of the superior vena cava. As the usual caval division technique was not applicable, we chose to utilize the anterior wall of the superior vena cava as a flap for anomalous pulmonary vein rerouting. Bovine pericardium was used to reconstruct the systemic venous pathway. Systemic or pulmonary venous stenosis was not detected. The patient was discharged with a sinus rhythm.

    DOI: 10.1177/2150135119862596

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  • 新潟県中越沖地震被災地域一般住民における貼り付け型プローブを用いた総頸動脈のhigh intensity transient signalsと脳・心血管疾患との関連

    榛沢 和彦, 伊倉 真衣子, 岡本 竹司, 大久保 由華, 土田 正則, 中島 孝, 品田 恭子, 岡村 治

    Neurosonology   32 ( 2 )   46 - 52   2019年8月

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    記述言語:日本語   出版者・発行元:(一社)日本脳神経超音波学会  

    深部静脈血栓症(DVT)フォローアップ検診において、頸部貼り付け型プローブを用いた総頸動脈で検出されるhigh intensity transient signal(HITS)の検査をDVT保有者などに行い、DVTや脳・心血管疾患(CCVDs)などとの関連について検討した。新潟県中越沖地震DVTフォローアップ検診を受診した一般住民のうち522人(男性101人、女性421人)を対象とした。頸動脈HITSが39人(7.5%)で検出され、39人中12人(30.8%)にCCVDsが見つかった。頸動脈HITS検出において統計的に有意な危険因子はvelocity pulse index(AVI)、CCVDsの既往、心房細動(AF)/発作性心房細動(PAF)であった。一方、CCVDsの有無による背景因子では、年齢、HITS、糖尿病で有意差を認めた。頸動脈HITSが検出された場合にCCVDsに対する感度は19%、特異度は94%、陽性的中率31%、陰性的中率89%、AF/PAFに対する感度は24%、特異度は94%、陽性的中率は21%、陰性的中率は95%であった。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J02558&link_issn=&doc_id=20190909400002&doc_link_id=10.2301%2Fneurosonology.32.46&url=https%3A%2F%2Fdoi.org%2F10.2301%2Fneurosonology.32.46&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • [Thoracoscopic Left Upper Division Segmentectomy for Multiple Ground-glass Nodules Using Preoperative Virtual-assisted Lung Mapping].

    Yuki Shimizu, Masaya Nakamura, Tatsuya Goto, Seijiro Sato, Terumoto Koike, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   72 ( 7 )   528 - 533   2019年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Associated with an increase of small-sized lung cancer or metachronous second primary lung cancer, we have more opportunities to perform sublobar resection. Difficulties of identifying tumor location and appropriate surgical margin for small-sized ground-glass opacity (GGO) dominant lesions in thoracoscopic surgery is the big issue of sublobar resection. Virtual-assisted lung mapping (VAL-MAP) that makes markings on the lung surface through some peripheral bronchi by bronchoscopically projects intrapulmonary anatomy on the lung surface and literally draw a map. We report a case of thoracoscopic left upper division segmentectomy for multiple ground-glass nodules (GGNs) using preoperative VAL-MAP. A 65-year-old women who had undergone right upper lobectomy for primary lung cancer, and had multiple GGNs in the bilateral lungs was followed up as an outpatient. Eleven years after initial pulmonary resection, 2 lesions in the left upper division became bigger, and we decided to perform surgery for 4 GGNs in the left upper division including these 2 lesions. We preoperatively made bronchoscopic dye markings through B1+2c, B3a and B4a for in the left upper lobe. The 3 markings were intraoperatively identified. We decided the resection line based on the markings and performed thoracoscopic left upper division segmentectomy. The pathological diagnosis was minimally invasive adenocarcinoma, adenocarcinoma in situ and pneumonitis. Surgical margins were negative. VAL-MAP will assume an important role as an intraoperative navigation system for sublobar resection.

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  • 【肺区域・亜区域・複雑区域切除の工夫と実際】VAL-MAP法 Virtual-assisted lung mapping(VAL-MAP)を用いた多発肺野限局性スリガラス結節に対する胸腔鏡下左上区切除

    清水 勇希, 中村 将弥, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    胸部外科   72 ( 7 )   528 - 533   2019年7月

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    記述言語:日本語   出版者・発行元:(株)南江堂  

    65歳女。胸部CT異常影を主訴とした。右肺上葉切除術後の多発スリガラス結節(GGN)症例であり、胸部CTでは左肺S1+2a末梢に2ヵ所、左肺S3c末梢とS3aにそれぞれGGNを認め、いずれも肺癌の可能性があったため、全ての病変を含むよう区域切除を選択した。また、S3aの病変は術中触知困難が予想され、左肺S4+5との区域間に近接していたため、切離ラインの設定補助目的でvirtual-assisted lung mapping(VAL-MAP)を用い、胸腔鏡下左上区切除を行った結果、病変からのマージンを確保しつつ、残存区域の損失を最小限にするよう胸腔鏡下に完全切除できた。術後5年で再発はなく、残存するGGN病変も著変なく経過している。VAL-MAPは触知困難病変に対する胸腔鏡下区域切除において、特に有用であった。

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J00349&link_issn=&doc_id=20190701230011&doc_link_id=1573950786545221248&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1573950786545221248&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

  • 増大する両側多発肺結節を伴った縦隔原発Growing teratoma syndromeの1切除例

    中村 将弥, 佐藤 征二郎, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    肺癌   59 ( 3 )   325 - 325   2019年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 肺分画症に対する胸腔鏡下左底区切除後の肺静脈還流障害の1例

    清水 勇希, 中村 将弥, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 180回 )   25 - 25   2019年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • VSD/MR合併例の術後MRの経過とMR残存の危険因子

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   35 ( Suppl.1 )   s1 - 179   2019年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 静脈洞型ASD閉鎖術後遠隔期に気づかれたPAPVCに対しSVC flapにてPV reroutingを行なった一例

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 180回 )   26 - 26   2019年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 直接吻合が困難な大動脈弓離断症に対する大動脈弓再建術式

    白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   35 ( Suppl.1 )   s1 - 374   2019年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • A novel parameter for pulmonary blood flow during palliative procedures: velocity time integral of the pulmonary vein†. 国際誌

    Shuichi Shiraishi, Keiko Bamba, Ai Sugimoto, Masashi Takahashi, Masanori Tsuchida

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery   55 ( 5 )   823 - 828   2019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)  

    OBJECTIVES: The main goal of palliative procedures for congenital heart defects is adequate pulmonary blood flow (PBF), but precise intraoperative PBF evaluation is sometimes difficult. The purpose of this preliminary study was to investigate the usefulness of velocity time integral of the pulmonary vein (PV-VTI) measured by transoesophageal echocardiography (TOE) at the time of palliative procedure as a parameter for PBF. METHODS: Case histories of 63 patients who underwent palliative procedures (bilateral pulmonary artery banding in 18 patients, main pulmonary artery banding in 22 patients and systemic-to-pulmonary artery shunt in 23 patients) and whose intraoperative PV-VTI was measured by TOE from 2011 to 2017 at our centre were retrospectively reviewed. Low-body-weight infants, cases in which cardiopulmonary bypass was used and cases that were anatomically difficult to measure were excluded. RESULTS: PV-VTIs measured at 4 orifices of the pulmonary veins were all significantly decreased in both the bilateral pulmonary artery banding and main pulmonary artery banding groups and increased in the systemic-to-pulmonary artery shunt group immediately after the procedure. There were significant correlations between the velocity time integrals of both right and left pulmonary veins and arterial oxygen saturation (r = 0.564 and 0.703). Nine patients (6 bilateral pulmonary artery banding and 3 systemic-to-pulmonary artery shunt) required unplanned early reoperation due to inadequate PBF; their PV-VTIs were significantly different from those of patients not requiring reoperation. No major complications related to TOE occurred postoperatively. CONCLUSIONS: The PV-VTI measured by TOE during palliative procedures reflected the change of PBF and could help identify patients at higher risk of early reoperation due to inadequate PBF. This parameter may be a useful additional tool for evaluating intraoperative PBF.

    DOI: 10.1093/ejcts/ezy465

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  • The impact of emphysema on surgical outcomes of early-stage lung cancer: a retrospective study. 国際誌

    Seijiro Sato, Masaya Nakamura, Yuki Shimizu, Tatsuya Goto, Terumoto Koike, Hiroyuki Ishikawa, Masanori Tsuchida

    BMC pulmonary medicine   19 ( 1 )   73 - 73   2019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)  

    BACKGROUND: The presence of emphysema on computed tomography (CT) is associated with an increased frequency of lung cancer, but the postoperative outcomes of patients with pulmonary emphysema are not well known. The objective of this study was to investigate the association between the extent of emphysema and long-term outcomes, as well as mortality and postoperative complications, in early-stage lung cancer patients after pulmonary resection. METHODS: The clinical records of 566 consecutive lung cancer patients who underwent pulmonary resection in our department were retrospectively reviewed. Among these, the data sets of 364 pathological stage I patients were available. The associations between the extent of lung emphysema and long-term outcomes and postoperative complications were investigated. Emphysema was assessed on the basis of semiquantitative CT. Surgery-related complications of Grade ≥ II according to the Clavien-Dindo classification were included in this study. RESULTS: Emphysema was present in 63 patients. The overall survival and relapse-free survival of the non-emphysema and emphysema groups at 5 years were 89.0 and 61.3% (P < 0.001), respectively, and 81.0 and 51.7%, respectively (P < 0.001). On multivariate analysis, significant prognostic factors were emphysema, higher smoking index, and higher histologic grade (p < 0.05). Significant risk factors for poor recurrence-free survival were emphysema, higher smoking index, higher histologic grade, and presence of pleural invasion (P < 0.05). Regarding Grade ≥ II postoperative complications, pneumonia and supraventricular tachycardia were more frequent in the emphysema group than in the non-emphysema group (P = 0.003 and P = 0.021, respectively). CONCLUSION: The presence of emphysema affects the long-term outcomes and the development of postoperative complications in early-stage lung cancer patients.

    DOI: 10.1186/s12890-019-0839-1

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  • p53 plays a crucial role in endothelial dysfunction associated with hyperglycemia and ischemia. 査読 国際誌

    Masataka Yokoyama, Ippei Shimizu, Ayako Nagasawa, Yohko Yoshida, Goro Katsuumi, Takayuki Wakasugi, Yuka Hayashi, Ryutaro Ikegami, Masayoshi Suda, Yusuke Ota, Sho Okada, Marcus Fruttiger, Yoshio Kobayashi, Masanori Tsuchida, Yoshiaki Kubota, Tohru Minamino

    Journal of molecular and cellular cardiology   129   105 - 117   2019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)  

    p53 is a guardian of the genome that protects against carcinogenesis. There is accumulating evidence that p53 is activated with aging. Such activation has been reported to contribute to various age-associated pathologies, but its role in vascular dysfunction is largely unknown. The aim of this study was to investigate whether activation of endothelial p53 has a pathological effect in relation to endothelial function. We established endothelial p53 loss-of-function and gain-of-function models by breeding endothelial-cell specific Cre mice with floxed Trp53 or floxed Mdm2/Mdm4 mice, respectively. Then we induced diabetes by injection of streptozotocin. In the diabetic state, endothelial p53 expression was markedly up-regulated and endothelium-dependent vasodilatation was significantly impaired. Impairment of vasodilatation was significantly ameliorated in endothelial p53 knockout (EC-p53 KO) mice, and deletion of endothelial p53 also significantly enhanced the induction of angiogenesis by ischemia. Conversely, activation of endothelial p53 by deleting Mdm2/Mdm4 reduced both endothelium-dependent vasodilatation and ischemia-induced angiogenesis. Introduction of p53 into human endothelial cells up-regulated the expression of phosphatase and tensin homolog (PTEN), thereby reducing phospho-eNOS levels. Consistent with these results, the beneficial impact of endothelial p53 deletion on endothelial function was attenuated in EC-p53 KO mice with an eNOS-deficient background. These results show that endothelial p53 negatively regulates endothelium-dependent vasodilatation and ischemia-induced angiogenesis, suggesting that inhibition of endothelial p53 could be a novel therapeutic target in patients with metabolic disorders.

    DOI: 10.1016/j.yjmcc.2019.02.010

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  • 臨床病期IA期非小細胞肺癌患者におけるFDG-PET/CTによる病理学的浸潤・転移の予測

    小池 輝元, 中村 将弥, 清水 勇希, 後藤 達哉, 佐藤 征二郎, 土田 正則

    日本呼吸器外科学会雑誌   33 ( 3 )   P16 - 1   2019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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  • 術後合併症リスクから考える第二原発肺癌に対する治療戦略

    佐藤 征二郎, 中村 将弥, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   33 ( 3 )   P58 - 1   2019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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  • 進行肺癌に対する分子標的治療薬使用後サルベージ手術を施行した2例

    中村 将弥, 佐藤 征二郎, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   33 ( 3 )   P70 - 5   2019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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  • 肺癌同側解剖学的手術例における周術期成績

    清水 勇希, 佐藤 征二郎, 中村 将弥, 後藤 達哉, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   33 ( 3 )   O15 - 1   2019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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  • 術前導入化学放射線療法後に気管支肺動脈一括処理および左房合併切除を施行した原発性肺癌の1例

    清水 勇希, 中村 将弥, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 179回 )   17 - 17   2019年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 体重644gで出生し、一期的修復術を施行した大動脈弓離断、大動脈肺動脈中隔欠損、右肺動脈上行大動脈起始(Berry症候群)の一例

    中村 将弥, 白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 179回 )   29 - 29   2019年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Early and mid-term outcomes of simultaneous thoracic endovascular stent grafting and combined resection of thoracic malignancies and the aortic wall.

    Seijiro Sato, Atsuhiro Nakamura, Yuki Shimizu, Tatsuya Goto, Akihiko Kitahara, Terumoto Koike, Takeshi Okamoto, Masanori Tsuchida

    General thoracic and cardiovascular surgery   67 ( 2 )   227 - 233   2019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)  

    OBJECTIVES: To aim of this study was to clarify the safety of simultaneous thoracic aortic endografting and combined resection of the aortic wall and thoracic malignancy in a one-stage procedure over the early and mid-term periods. METHODS: From March 2013 to December 2017, 6 patients underwent aortic endografting followed by one-stage en bloc resection of the tumor and aortic wall. Thoracic surgeons and cardiovascular surgeons discussed predicted tumor invasion range and resection site, stent placement position, stent length and size, and the surgical procedure, taking into account the safe margin. RESULTS: The proximal site of aortic endografting was the: aortic arch in 2 cases (subclavian artery (SCA) occlusion in one, and SCA fenestration in one); distal arch just beneath the SCA in 2; descending aorta in 2. Pulmonary resection involved lobectomy in 2 patients, pneumonectomy in 2, and completion pneumonectomy in 1. Aortic resection was limited to the adventitia in 2 cases, extended to the media in 3, and extended to the intima in 1. An endograft-related complication, external iliac artery intimal damage requiring vessel repair, was observed in one case. No complications associated with aortic resection were observed. Two postoperative complications of atrial fibrillation and chylothorax developed. There were no surgery-related deaths. During follow-up, no late endograft-related complications such as migration or endoleaks occurred. CONCLUSIONS: Early and mid-term outcomes of stent graft-related complications are acceptable. Simultaneous thoracic aortic endografting and combined resection of the aortic wall and thoracic malignancies are feasible in one stage on the same day.

    DOI: 10.1007/s11748-018-1003-1

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  • ファロー四徴症修復術後の超長期遠隔期成績と心室性不整脈の検討

    白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   49回   [OP03 - 1]   2019年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • Left colic artery aneurysm rupture after stent placement for abdominal aortic aneurysm associated with neurofibromatosis type 1. 国際誌

    Kazuki Moro, Hitoshi Kameyama, Kaoru Abe, Junko Tsuchida, Yosuke Tajima, Hiroshi Ichikawa, Masato Nakano, Mayuko Ikarashi, Masayuki Nagahashi, Yoshifumi Shimada, Kaori Kato, Takeshi Okamoto, Hajime Umezu, Emmanuel Gabriel, Masanori Tsuchida, Toshifumi Wakai

    Surgical case reports   5 ( 1 )   12 - 12   2019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: Neurofibromatosis type 1 (NF1) is an autosomal dominant disease of the skin and soft tissue. Aneurysms associated with NF1 can occur, but a secondary aneurysm rupture is very rare, with very few cases reported in literature. CASE PRESENTATION: We describe the case of a 67-year-old female with NF1 who underwent endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm (AAA) rupture. She developed a type Ib endoleak requiring a redo-EVAR. Eighteen days after her primary operation, she was found to have two new left colic artery aneurysms. She required emergency surgery consisting of a left hemicolectomy and transverse colon colostomy. Pathology showed neurofibromatous changes to the peri-vasculature tissue, consistent with her underlying disease. CONCLUSIONS: Although rare, secondary aneurysms can occur following AAA repair. Patients with soft tissue connective tissue disorders, like NF1, may be at an increased risk for development of these secondary aneurysms. Endovascular repair appears to be a safe approach for NF1 patients with AAA, but endovascular management can be challenging in the setting of NF1. Surgeons should be ready to convert to open surgery if the patient displays persistent signs of bleeding or structural changes related to connective tissue disorders like NF1.

    DOI: 10.1186/s40792-019-0570-4

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  • 心不全によるサルコペニアから離脱できた1例

    和田 理澄, 木村 新平, 尾崎 和幸, 加瀬 真弓, 西田 耕太, 久保田 直樹, 高野 俊樹, 大久保 健志, 高山 亜美, 保屋野 真, 柳川 貴央, 小澤 拓也, 柏村 健, 南野 徹, 三島 健人, 榎本 貴士, 大西 遼, 長澤 綾子, 岡本 竹司, 土田 正則

    新潟医学会雑誌   133 ( 1 )   39 - 39   2019年1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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  • ファロー四徴症術後患者に対する肺動脈弁置換術の早期成績と問題点(Early outcome and problems after pulmonary valve replacement in patients with repaired tetralogy of Fallot)

    白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本成人先天性心疾患学会雑誌   8 ( 1 )   131 - 131   2019年1月

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    記述言語:英語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • すりガラス結節とFDG陰性の充実性結節を呈した腺様嚢胞癌肺転移の一例

    本田 母映, 山崎 元彦, 八木 琢也, 石川 浩志, 吉村 宣彦, 青山 英史, 佐藤 征二郎, 小池 輝元, 土田 正則, 梅津 哉

    核医学   55 ( Suppl. )   S201 - S201   2018年11月

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    記述言語:英語   出版者・発行元:(一社)日本核医学会  

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  • 特発性肺線維症を合併した肺癌手術の安全性と予後に関する多施設前向き観察研究 新潟県呼吸器外科研究グループ

    後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 岡田 英, 須田 一晴, 古屋敷 剛, 青木 正, 吉谷 克雄, 大和 靖, 小池 輝明, 土田 正則

    日本呼吸器外科学会雑誌   32 ( 7 )   782 - 791   2018年11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  

    【対象と方法】2009年2月〜2015年3月の新潟呼吸器外科研究グループでの特発性肺線維症(IPF)合併肺癌手術例において、術後及び遠隔期の急性増悪(AE)の発生と予後を前向きに検討した。【結果】対象は48例で、男/女47/1例、平均年齢70歳。術後AEは3例(6%)に認め、その内1例が再AEで、2例が再々AEで死亡していた。単変量解析で、術後AEに対する予測因子はなく、遠隔期AEに関しては術後AE発症が予測因子であった。遠隔期AEは、平均16ヵ月で14例(29%)に発症し、8例がAEにより死亡していた。術後AE発症群と非発症群の3年全生存率(OS)は0%、70.6%で(p<0.001)、遠隔期AE発症群と非発症群の3年OSは35.7%、80.3%であった(p=0.001)。【結語】術後AE発症のみが遠隔期AE発症の予測因子であった。遠隔期AEを念頭に置いた注意深い経過観察が必要である。(著者抄録)

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  • Common driver mutations and smoking history affect tumor mutation burden in lung adenocarcinoma. 査読 国際誌

    Nagahashi M, Sato S, Yuza K, Shimada Y, Ichikawa H, Watanabe S, Takada K, Okamoto T, Okuda S, Lyle S, Takabe K, Tsuchida M, Wakai T

    The Journal of surgical research   230   181 - 185   2018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)  

    DOI: 10.1016/j.jss.2018.07.007

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  • 気腫病変の存在は肺癌手術成績を予測できるか

    中村 将弥, 佐藤 征二郎, 清水 勇希, 後藤 達哉, 小池 輝元, 土田 正則

    肺癌   58 ( 6 )   766 - 766   2018年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 術後再発形式から見る早期非小細胞肺癌に対する区域切除の妥当性の検討

    小池 輝元, 仲村 亮宏, 清水 勇希, 後藤 達哉, 佐藤 征二郎, 土田 正則

    肺癌   58 ( 6 )   532 - 532   2018年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 肺多形癌に対してペムブロリズマブが奏効した1例

    羽入 龍太郎, 岡島 正明, 朝川 勝明, 小原 竜軌, 寺田 正樹, 小池 輝元, 土田 正則, 梅津 哉

    肺癌   58 ( 6 )   750 - 750   2018年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 多臓器合併切除の新しいアプローチ/診療科をまたぐ合併切除の試み 大動脈浸潤肺癌に対する人工心肺を用いないTEVAR下大動脈合併切除

    土田 正則, 中村 将弥, 仲村 亮宏, 清水 勇希, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 岡本 竹司, 小池 輝元

    肺癌   58 ( 6 )   445 - 445   2018年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • Survival after repeated surgery for lung cancer with idiopathic pulmonary fibrosis: a retrospective study. 国際誌

    Seijiro Sato, Yuki Shimizu, Tatsuya Goto, Akihiko Kitahara, Terumoto Koike, Hiroyuki Ishikawa, Takehiro Watanabe, Masanori Tsuchida

    BMC pulmonary medicine   18 ( 1 )   134 - 134   2018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)  

    BACKGROUND: Patients with idiopathic pulmonary fibrosis (IPF) have a high risk of developing lung cancer, but few studies have investigated the long-term outcomes of repeated surgery in such patients. The purpose of this study was to evaluate the surgical outcomes of repeated lung cancer surgery in patients with IPF. METHODS: From January 2001 to December 2015, 108 lung cancer patients with IPF underwent pulmonary resection at two institutions; 13 of these patients underwent repeated surgery for lung cancer, and their data were reviewed. RESULTS: The initial procedures of the 13 patients were lobectomy in 8, segmentectomy in 2, and wedge resection in 3. The subsequent procedures were wedge resection in 10 and segmentectomy in 3. The clinical stage of the second tumor was stage IA in 12 and stage IB in 1. Postoperatively, 3 patients (23.1%) developed acute exacerbation (AE) of IPF and died. The rate of decrease in percent vital capacity was significantly higher in patients with AE than in those without AE (p = 0.011). The 3-year overall survival rate was 34.6%. The causes of death were cancer-related in 7, AE of IPF in 3, and metachronous lung cancer in 1. CONCLUSIONS: Despite limited resection, a high incidence of AE was identified. The early and long-term outcomes of repeated surgery in lung cancer patients with IPF were poor because of the high risk of AE of IPF and lung cancer recurrence. Long-term intensive surveillance will be required to determine whether surgical intervention is justified in patients with multiple primary lung cancers and IPF.

    DOI: 10.1186/s12890-018-0703-8

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  • 体重2.0kg以下の低体重児に対する両側肺動脈絞扼術の治療成績の検討

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 233   2018年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 止血用血管クリップを用いた体肺動脈シャントの血流制限の短期成績

    白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   34 ( Suppl.1 )   s1 - 328   2018年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Clinical and Genetic Implications of Mutation Burden in Squamous Cell Carcinoma of the Lung. 査読 国際誌

    Okamoto T, Takada K, Sato S, Toyokawa G, Tagawa T, Shoji F, Nakanishi R, Oki E, Koike T, Nagahashi M, Ichikawa H, Shimada Y, Watanabe S, Kikuchi T, Akazawa K, Lyle S, Takabe K, Okuda S, Sugio K, Wakai T, Tsuchida M, Maehara Y

    Annals of surgical oncology   25 ( 6 )   1564 - 1571   2018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)  

    DOI: 10.1245/s10434-018-6401-1

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  • Surgical resection of a giant polycystic seminoma of the mediastinum. 国際誌

    Tatsuya Goto, Seijiro Sato, Terumoto Koike, Masanori Tsuchida

    Journal of thoracic disease   10 ( 6 )   E438-E441   2018年6月

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  • Strategy of intentional limited resection for lung adenocarcinoma in situ. 国際誌

    Terumoto Koike, Teruaki Koike, Masaya Nakamura, Yuki Shimizu, Tatsuya Goto, Seijiro Sato, Masanori Tsuchida

    Journal of thoracic disease   10 ( Suppl 17 )   S2018-S2021   2018年6月

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  • 下大静脈腫瘍塞栓を伴う腎細胞癌に対する手術症例の検討

    名村 理, 仲村 亮宏, 鈴木 脩平, 大西 遼, 中村 制士, 長澤 綾子, 岡本 竹司, 青木 賢治, 榛澤 和彦, 土田 正則

    日本血管外科学会雑誌   27 ( Suppl. )   O24 - 3   2018年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本血管外科学会  

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  • 術前動脈塞栓術を行い切除した胸腔内巨大孤立性線維性腫瘍の1例

    清水 勇希, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 177回 )   21 - 21   2018年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Bjork-Fontan27年後にfenestrated EC-TCPC conversionを施行した三尖弁閉鎖症の1例

    杉本 愛, 白石 修一, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 177回 )   35 - 35   2018年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 左肺全摘術と右主肺動脈再建にて完全切除した左主肺動脈血管肉腫の1手術例

    北原 哲彦, 清水 勇希, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   32 ( 4 )   492 - 499   2018年5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  

    症例は64歳女性。子宮体癌の破裂により当院を受診した。緊急で子宮切除が行われたが、その際のCTで深部静脈血栓と右肺動脈血栓、左肺動脈内の塞栓子を認めた。子宮体癌術後下大静脈フィルターと抗凝固薬にて治療が行われた。抗凝固療法により右肺動脈内の血栓は消失したが、左肺動脈の塞栓子は消失しなかった。その後塞栓子は徐々に増大を認めた。PET/CTでは同病変に集積を認め、心臓カテーテル検査での腫瘍生検により血管肉腫と診断された。胸骨正中切開で体外循環を併用し、左主肺動脈切除と左肺全摘、右主肺動脈再建を行った。病理では血管内膜由来の肉腫であることが判明した。術後8ヵ月目に再発を認め、9ヵ月後に肺炎による呼吸不全で死亡した。肺動脈肉腫は稀な疾患であり、文献的考察を加え報告する。(著者抄録)

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02256&link_issn=&doc_id=20180523320010&doc_link_id=10.2995%2Fjacsurg.32.492&url=https%3A%2F%2Fdoi.org%2F10.2995%2Fjacsurg.32.492&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • A proposal for a comprehensive risk scoring system for predicting postoperative complications in octogenarian patients with medically operable lung cancer: JACS1303. 査読 国際誌

    Hisashi Saji, Takahiko Ueno, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Hiroyuki Ito, Kazuhiko Kataoka, Kazunori Okabe, Kenji Tomizawa, Kentaro Yoshimoto, Hirotoshi Horio, Kenji Sugio, Yasuhisa Ode, Motoshi Takao, Morihito Okada, Masayuki Chida

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery   53 ( 4 )   835 - 841   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)  

    OBJECTIVES: Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial. METHODS: The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications. RESULTS: Operative (30 days) and hospital mortality rates were 1.0% and 1.6%, respectively. Complications were observed in 308 (34%) patients, of whom 81 (8.4%) had Grade 3-4 severe complications. Pneumonia was the most common severe complication, observed in 27 (3.0%) patients. Five predictive factors, gender, comprehensive geriatric assessment75: memory and Simplified Comorbidity Score (SCS): diabetes mellitus, albumin and percentage vital capacity, were identified as independent predictive factors for severe postoperative complications (odds ratio = 2.73, 1.86, 1.54, 1.66 and 1.61, respectively) through univariate and multivariate analyses. A 5-fold cross-validation was performed as an internal validation to reconfirm these 5 predictive factors (average area under the curve 0.70). We developed a simplified RS system as follows: RS = 3 (gender: male) + 2 (comprehensive geriatric assessment 75: memory: yes) + 2 (albumin: <3.8 ng/ml) + 1 (percentage vital capacity: ≤90) + 1 (SCS: diabetes mellitus: yes). CONCLUSIONS: The current series shows that octogenarians can be successfully treated for lung cancer with surgical resection with an acceptable rate of severe complications and mortality. We propose a simplified RS system to predict severe complications in octogenarian patients with medically operative lung cancer. Trial Registration Number: JACS1303 (UMIN000016756).

    DOI: 10.1093/ejcts/ezx415

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  • 半定量的CT評価法に基づく気腫病変存在程度から観た原発性肺癌手術成績

    佐藤 征二郎, 清水 勇希, 後藤 達哉, 北原 哲彦, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   32 ( 3 )   O4 - 1   2018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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  • 半定量的CT評価法に基づく気腫病変存在程度から観たCOPD合併肺癌の検討

    清水 勇希, 佐藤 征二郎, 後藤 達哉, 北原 哲彦, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   32 ( 3 )   O9 - 6   2018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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  • リンパ節転移を有する扁平上皮癌患者の再発・予後に関する検討

    後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   32 ( 3 )   P11 - 2   2018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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  • 第2肺癌に対する術後合併症リスクについて考える

    佐藤 征二郎, 清水 勇希, 仲村 亮宏, 後藤 達哉, 北原 哲彦, 小池 輝元, 土田 正則

    日本外科学会定期学術集会抄録集   118回   2148 - 2148   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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  • 末梢小型肺癌における区域切除後遠隔期の課題 病理学的浸潤・転移のリスク因子を有する早期非小細胞肺癌患者に対する縮小手術の成績

    小池 輝元, 清水 勇希, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 土田 正則

    日本呼吸器外科学会雑誌   32 ( 3 )   PD2 - 6   2018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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  • 臨床病期I期原発性肺癌における区域切除後の再発に関する検討

    仲村 亮宏, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本外科学会定期学術集会抄録集   118回   2518 - 2518   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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  • SVC合併切除・グラフト置換を施行した胸腺癌の1手術例

    清水 勇希, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 176回 )   21 - 21   2018年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • HRCT texture analysis for pure or part-solid ground-glass nodules: distinguishability of adenocarcinoma in situ or minimally invasive adenocarcinoma from invasive adenocarcinoma. 査読

    Yagi T, Yamazaki M, Ohashi R, Ogawa R, Ishikawa H, Yoshimura N, Tsuchida M, Ajioka Y, Aoyama H

    Japanese journal of radiology   36 ( 2 )   113 - 121   2018年2月

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  • 肺動脈塞栓として初期治療を受け、18F FDG-PET/CTで鑑別できた肺動脈肉腫の1例

    山田 美佳, 佐藤 卓, 石川 浩志, 堀井 陽祐, 八木 琢也, 山崎 元彦, 塩谷 基, 吉村 宣彦, 青山 英史, 佐藤 征二郎, 小池 輝元, 土田 正則, 名村 理, 大橋 瑠子, 梅津 哉

    Japanese Journal of Radiology   36 ( Suppl. )   7 - 7   2018年2月

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    記述言語:日本語   出版者・発行元:(公社)日本医学放射線学会  

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  • 特異な進展を示した類基底細胞癌の1例

    鈴木 脩平, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    肺癌   58 ( 1 )   69 - 69   2018年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • Impact of Concurrent Genomic Alterations Detected by Comprehensive Genomic Sequencing on Clinical Outcomes in East-Asian Patients with EGFR-Mutated Lung Adenocarcinoma. 査読 国際誌

    Sato S, Nagahashi M, Koike T, Ichikawa H, Shimada Y, Watanabe S, Kikuchi T, Takada K, Nakanishi R, Oki E, Okamoto T, Akazawa K, Lyle S, Ling Y, Takabe K, Okuda S, Wakai T, Tsuchida M

    Scientific reports   8 ( 1 )   1005 - 1005   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)  

    DOI: 10.1038/s41598-017-18560-y

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  • Efficacy and Safety of Pancreas-Targeted Hydrodynamic Gene Delivery in Rats 査読

    Kohei Ogawa, Kenya Kamimura, Yuji Kobayashi, Hiroyuki Abe, Takeshi Yokoo, Norihiro Sakai, Takuro Nagoya, Akira Sakamaki, Satoshi Abe, Kazunao Hayashi, Satoshi Ikarashi, Junji Kohisa, Masanori Tsuchida, Yutaka Aoyagi, Guisheng Zhang, Dexi Liu, Shuji Terai

    MOLECULAR THERAPY-NUCLEIC ACIDS   9   80 - 88   2017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:CELL PRESS  

    Development of an effective, safe, and convenient method for gene delivery to the pancreas is a critical step toward gene therapy for pancreatic diseases. Therefore, we tested the possibility of applying the principle of hydrodynamic gene delivery for successful gene transfer to pancreas using rats as a model. The established procedure involves the insertion of a catheter into the superior mesenteric vein with temporary blood flow occlusion at the portal vein and hydrodynamic injection of DNA solution. We demonstrated that our procedure achieved efficient pancreas-specific gene expression that was 2,000-fold higher than that seen in the pancreas after the systemic hydrodynamic gene delivery. In addition, the level of gene expression achieved in the pancreas by the pancreas-specific gene delivery was comparable to the level in the liver achieved by a liver-specific hydrodynamic gene delivery. The optimal level of reporter gene expression in the pancreas requires an injection volume equivalent to 2.0% body weight with flow rate of 1 mL/s and plasmid DNA concentration at 5 mu g/mL. With the exception of transient expansion of intercellular spaces and elevation of serum amylase levels, which recovered within 3 days, no permanent tissue damage was observed. These results suggest that pancreas-targeted hydrodynamic gene delivery is an effective and safe method for gene delivery to the pancreas and clinically applicable.

    DOI: 10.1016/j.omtn.2017.08.009

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  • Characteristics and timing of recurrence during postoperative surveillance after curative resection for lung adenocarcinoma 査読

    Terumoto Koike, Tatsuya Goto, Akihiko Kitahara, Seijiro Sato, Masayuki Saitoh, Takehisa Hashimoto, Osamu Namura, Masashi Takahashi, Shin-ichi Toyabe, Masanori Tsuchida

    SURGERY TODAY   47 ( 12 )   1469 - 1475   2017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:SPRINGER  

    To establish the most effective methods of postoperative surveillance to detect early recurrence of lung adenocarcinoma.
    The subjects of this retrospective study were 485 patients with p-stage I-III lung adenocarcinoma, who underwent postoperative surveillance. We examined the sites and detection modes of recurrence and calculated the recurrence-free probabilities. Patients with stage I disease were divided into low- and high-risk recurrence groups using a risk score calculated by assigning points proportional to risk factor regression coefficients.
    Of the 112 patients with recurrence, 86 had intrathoracic recurrence. Routine computed tomography (CT) revealed recurrence in 60 patients. The recurrence-free probability curves showed that 95% of recurrences were identified within the first 4 years after resection in patients with stage II/III disease. In patients with stage I disease, the predictors of recurrence included male sex, positive pleural lavage cytology, moderate-to-poor differentiation, and visceral pleural invasion. Postoperative recurrences were detected throughout the follow-up period in the high-risk group.
    Routine chest CT plays an important role in the postoperative surveillance of lung adenocarcinoma. We recommend intensive follow-up during the early post-resection period for patients with advanced stage disease and long-term follow-up for high-risk patients with stage I disease.

    DOI: 10.1007/s00595-017-1537-3

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  • Predictors of ventricular tachyarrhythmia occurring late after intracardiac repair of tetralogy of Fallot: combination of QRS duration change rate and tricuspid regurgitation pressure gradient. 国際誌

    Shuichi Shiraishi, Masashi Takahashi, Ai Sugimoto, Masanori Tsuchida

    Journal of thoracic disease   9 ( 12 )   5112 - 5119   2017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)  

    Background: To determine potential predictors of ventricular tachyarrhythmia and sudden cardiac death (SCD) occurring late after repair of tetralogy of Fallot (TOF). Methods: Since 1964, 415 patients had undergone total repair for TOF at Niigata University Hospital. Of these, 89 patients who were followed for more than 10 years at our institute were retrospectively reviewed. Results: The mean follow-up period was 24.3 years. During the study period, one patient died of cerebral bleeding, and two patients had SCD. The overall survival rates at 20, 30, and 40 years were 100%, 94.6%, and 94.6%, respectively. Eight (9.0%) patients required re-intervention during the late period associated with right ventricular outflow (n=4), tricuspid valve (n=3), aortic valve (n=2), and others (n=2). Ten (11.2%) patients had a history of ventricular tachycardia (VT) or ventricular fibrillation (VF), and six underwent implantation of an implantable cardiac defibrillator. Multivariate analysis selected the change rate of QRS duration [ms/year; odds ratio (OR), 2.44; 95% confidence interval (CI): 1.28-4.65; P=0.007] and the pressure gradient at tricuspid valve regurgitation on echocardiography (OR, 1.12; 95% CI: 1.02-1.22; P=0.017) as risk factors for VT/VF or SCD. Trans-annular patch (TAP) repair was not an independent risk factor for ventricular arrhythmia. Conclusions: The combination of rapid change rate of QRS duration and higher-pressure gradient at tricuspid regurgitation were risk factors for ventricular tachyarrhythmia late after TOF repair. Adequate surgical or catheter intervention for pressure and volume load in the right ventricle might decrease the prevalence of VT/VF and SCD.

    DOI: 10.21037/jtd.2017.11.53

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  • Endothelial p53 Regulates Vascular Function Under Hyperglycemic and Hypoxic Conditions 査読

    Nagasawa Ayako, Shimizu Ippei, Yoshida Yohko, Tsuchida Masanori, Minamino Tohru

    CIRCULATION   136   2017年11月

  • One-stage surgery in combination with thoracic endovascular grafting and resection of T4 lung cancer invading the thoracic aorta and spine 査読

    Seijiro Sato, Tatsuya Goto, Terumoto Koike, Takeshi Okamoto, Hirokazu Shoji, Masayuki Ohashi, Kei Watanabe, Masanori Tsuchida

    JOURNAL OF THORACIC DISEASE   9 ( 11 )   E1009 - E1012   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:AME PUBL CO  

    A novel strategy of one-stage surgery in combination with thoracic endovascular grafting and resection for T4 lung cancer invading the thoracic aorta and spine is described. A 56-year-old man with locally advanced lung cancer infiltrating the aortic wall and spine underwent neoadjuvant chemotherapy and thoracic irradiation, followed by en bloc resection of the aortic wall and spine with thoracic endovascular grafting. He developed postoperative chylothorax, but there were no stent graft-related events. After 3 months, computed tomography (CT) did not show aortic stent graft stenosis, migration, or deformation.

    DOI: 10.21037/jtd.2017.10.101

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  • 単尖弁による大動脈弁閉鎖不全症に対する弁形成術の経験

    大西 遼, 國原 孝, 青木 賢治, 中村 制士, 岡本 竹司, 名村 理, 榛澤 和彦, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 175回 )   7 - 7   2017年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • N2-IIIA期肺腺癌に対して術前導入療法によって左肺全摘を回避しえた1例

    仲村 亮宏, 後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 175回 )   16 - 16   2017年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 縦隔原発malignant peripheral nerve sheath tumorの1切除例

    清水 勇希, 佐藤 征二郎, 後藤 達哉, 小池 輝元, 土田 正則, 梅津 哉

    肺癌   57 ( 6 )   801 - 801   2017年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 臨床試験から視た肺癌手術 日本呼吸器外科学会の主導による臨床研究・前向き登録研究 高齢者肺癌前向き登録研究JACS1303の取り組み

    佐治 久, 上野 隆彦, 中村 廣繁, 奥村 典仁, 土田 正則, 園部 誠, 宮崎 拓郎, 青景 圭樹, 中尾 将之, 春木 朋広, 岡田 守人

    日本臨床外科学会雑誌   78 ( 増刊 )   333 - 333   2017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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  • 生体肺移植遠隔期の高度BOSにおける繰り返す無気肺の1例

    後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    移植   52 ( 2-3 )   246 - 246   2017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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  • 次世代シーケンサーを用いた併存遺伝子変異の影響

    佐藤 征二郎, 後藤 達哉, 北原 哲彦, 小池 輝元, 高田 和樹, 岡本 龍郎, 土田 正則

    肺癌   57 ( 5 )   555 - 555   2017年9月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • [Perioperative Management for Prevention of Cardiac Complications in General Thoracic Surgery].

    Terumoto Koike, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   70 ( 8 )   639 - 642   2017年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    For general thoracic surgeons, perioperative management for prevention of cardiac complications is important because patients undergoing general thoracic surgery often have risk factors for cardiac disease. Sever cardiac failure should be detected and treated prior to surgery, and coronary artery may be examined in patients with risk factors for ischemic heart disease. Pulmonary resection sometimes causes right-sided heart failure due to reducing pulmonary vascular bed. In high-risk patients for rightsided heart failure, pulmonary artery pressure monitoring by right heart catheterization should be considered in addition to blood pressure and central venous pressure monitoring, and precise fluid management is required. Because perioperatively occurred myocardial infarction is sometimes lethal, patients with preoperatively identified significant coronary artery stenosis, percutaneous coronary intervention or coronary artery bypass grafting should be considered although surgeons need to be careful for the timing of surgery and anticoagulant therapy. Even if patients have no typical symptoms, perioperative myocardial infarction can be diagnosed 12-lead electrocardiogram and serum biomarkers. Cooperation with cardiologists is necessary for the treatment of perioperative myocardial infarction. Although arrhythmia is one of the major complications after general thoracic surgery, arrhythmia with hemodynamic instability should be immediately treated. Early diagnosis and management of cardiovascular events can minimize the consequences of these complications.

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  • 【胸部外科領域における合併症予防のための周術期管理】呼吸器領域 心機能障害による合併症予防のための術中・術後管理の要点

    小池 輝元, 土田 正則

    胸部外科   70 ( 8 )   639 - 642   2017年7月

  • 両大血管右室起始症に対する外科治療成績と遠隔期問題点

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   33 ( Suppl.1 )   s1 - 326   2017年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 成人先天性心疾患根治術後症例に対する肺動脈弁置換術の中期遠隔成績

    杉本 愛, 白石 修一, 渡邉 マヤ, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   33 ( Suppl.1 )   s1 - 364   2017年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 左上葉切除後の異時多発肺がんSBRT後再発に対する残存肺全摘、大動脈合併切除の1例

    田代 啓太, 仲村 亮宏, 後藤 達哉, 中村 制士, 佐藤 征二郎, 岡本 竹司, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 174回 )   8 - 8   2017年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 両側両方向グレン手術時に右上大静脈組織を用いて左上大静脈再建を行った一例

    白石 修一, 杉本 愛, 文 智勇, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 174回 )   27 - 27   2017年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Progerin impairs vascular smooth muscle cell growth via the DNA damage response pathway 査読

    Daisuke Kinoshita, Ayako Nagasawa, Ippei Shimizu, Takashi K. Ito, Yohko Yoshida, Masanori Tsuchida, Atsushi Iwama, Toshiya Hayano, Tohru Minamino

    ONCOTARGET   8 ( 21 )   34045 - 34056   2017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:IMPACT JOURNALS LLC  

    Mutations of the lamin A gene cause various premature aging syndromes, including Hutchinson-Gilford progeria syndrome (HGPS) and atypical Werner syndrome. In HGPS (but not atypical Werner syndrome), extensive loss of vascular smooth muscle cells leads to myocardial infarction with premature death. The underlying mechanisms how single gene mutations can cause various phenotypes are largely unknown. We performed an interactome analysis using mutant forms of lamin A involved in progeroid syndromes. We found that the mutant lamin A responsible for HGPS, known as progerin, could not bind to proteins related to the DNA damage response, including DNA-dependent protein kinase (DNA-PK). In contrast, wild-type lamin A and lamin A mutants causing atypical Werner syndrome were able to bind to these molecules. We also found that forced expression of progerin in vascular smooth muscle cells led to activation of DNA-PK and cellular growth arrest, while knockdown of DNA-PK attenuated this. Deletion of p53 also improved the inhibition of cell growth due to forced expression of progerin. These findings suggested that progerin activates the DNA damage response pathway and that dysregulation of this pathway may be responsible for the development of cardiovascular pathology in patients with HGPS.

    DOI: 10.18632/oncotarget.15973

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  • A highly specific and sensitive massive parallel sequencer-based test for somatic mutations in non-small cell lung cancer 査読

    Yoshiaki Inoue, Jun Shiihara, Hitoshi Miyazawa, Hiromitsu Ohta, Megumi Higo, Yoshiaki Nagai, Kunihiko Kobayashi, Yasuo Saijo, Masanori Tsuchida, Mitsuo Nakayama, Koichi Hagiwara

    PLOS ONE   12 ( 4 )   e0176525   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:PUBLIC LIBRARY SCIENCE  

    Molecular targeting therapy for non-small cell lung cancer (NSCLC) has clarified the importance of mutation testing when selecting treatment regimens. As a result, multiple-gene mutation tests are urgently needed. We developed a next-generation sequencer (NGS)-based, multi-gene test named the MINtS for investigating driver mutations in both cytological specimens and snap-frozen tissue samples. The MINtS was used to investigate the EGFR, KRAS, BRAF genes from DNA, and the ERBB2, and the ALK, ROS1, and RET fusion genes from RNA. We focused on high specificity and sensitivity (&gt;= 0.99) and even included samples with a cancer cell content of 1%. The MINtS enables testing of more than 100 samples in a single run, making it possible to process a large number of samples submitted to a central laboratory, and reducing the cost for a single sample. We investigated 96 cytological samples and 190 surgically resected tissues, both of which are isolated in daily clinical practice. With the cytological samples, we compared the results for the EGFR mutation between the MINtS and the PNA-LNA PCR clamp test, and their results were 99% consistent. In the snap-frozen tissue samples, 188/190 (99%) samples were successfully analyzed for all genes investigated using both DNA and RNA. Then, we used 200 cytological samples that were serially isolated in clinical practice to assess RNA quality. Using our procedure, 196 samples (98%) provided high-quality RNA suitable for analysis with the MINtS. We concluded that the MINtS test system is feasible for analyzing ''druggable'' genes using cytological samples and snap-frozen tissue samples. The MINtS will fill a needs for patients for whom only cytological specimens are available for genetic testing.

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  • 巨大anterior mediastinal cystic seminomaの1手術例

    北原 哲彦, 仲村 亮宏, 後藤 達哉, 佐藤 征二郎, 小池 輝元, 土田 正則

    肺癌   57 ( 2 )   131 - 131   2017年4月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 左肺全摘術+右主肺動脈再建にて完全切除した左主肺動脈intimal sarcomaの1手術例

    後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   31 ( 3 )   RV1 - 3   2017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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  • 局所進行T4肺癌に対する大動脈遠位弓部合併切除および椎体合併切除再建術

    佐藤 征二郎, 後藤 達哉, 北原 哲彦, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   31 ( 3 )   RV4 - 6   2017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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  • NSCLC切除例におけるPET/CTを用いたMetabolic tumor volumeとTotal lesion glycolysisの有用性の検討

    後藤 達哉, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   31 ( 3 )   P82 - 3   2017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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  • 周囲臓器の高度圧排を認めた巨大右肺癌の1手術例

    後藤 達哉, 佐藤 征二郎, 小池 輝元, 名村 理, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 173回 )   24 - 24   2017年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 心臓再同期療法により心機能改善を得て、Fontan手術に到達した房室不一致、両大血管右室起始症の1例

    仲村 亮宏, 白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則, 瀧聞 浄宏

    日本胸部外科学会関東甲信越地方会要旨集   ( 173回 )   32 - 32   2017年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 多発肺結節を呈したメトトレキセート関連リンパ増殖性疾患の1例

    山名 加菜子, 山崎 元彦, 石川 浩志, 八木 琢也, 吉村 宣彦, 青山 英史, 坂上 拓郎, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則, 大橋 瑠子, 梅津 哉

    Japanese Journal of Radiology   35 ( Suppl. )   8 - 8   2017年2月

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    記述言語:日本語   出版者・発行元:(公社)日本医学放射線学会  

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  • 若年者に発症し副結節をともなった硬化性血管腫の1例

    押金 智哉, 山崎 元彦, 石川 浩志, 八木 琢也, 吉村 宣彦, 青山 英史, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則, 大橋 瑠子, 梅津 哉

    Japanese Journal of Radiology   35 ( Suppl. )   8 - 8   2017年2月

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    記述言語:日本語   出版者・発行元:(公社)日本医学放射線学会  

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  • 持続グルコースモニタを用いた心臓手術中の糖変動の解析

    佐藤 裕喜, 青木 賢治, 石川 友美, 細島 康宏, 長澤 綾子, 岡本 竹司, 名村 理, 榛沢 和彦, 土田 正則

    日本心臓血管外科学会学術総会抄録集   47回   920 - 920   2017年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 治療介入を要する肺高血圧を合併した成人心房中隔欠損症の検討

    渡邉 マヤ, 白石 修一, 杉本 愛, 佐藤 哲彰, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   47回   550 - 550   2017年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 両側肺動脈絞扼手術の治療成績と術中経食道心エコーによる肺静脈血流量評価の検討

    白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   47回   81 - 81   2017年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • ファロー四徴症術中右室圧と術後遠隔期に及ぼす影響

    白石 修一, 高橋 昌, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本成人先天性心疾患学会雑誌   6 ( 1 )   156 - 156   2017年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Glucose Variability Based on Continuous Glucose Monitoring Assessment Is Associated with Postoperative Complications after Cardiovascular Surgery 査読

    Hiroki Sato, Michihiro Hosojima, Tomomi Ishikawa, Kenji Aoki, Takeshi Okamoto, Akihiko Saito, Masanori Tsuchida

    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY   23 ( 5 )   239 - 247   2017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:MEDICAL TRIBUNE INC  

    Purpose: This purpose of this prospective study was to use a continuous glucose monitoring (CGM) system to evaluate the suitability of our institution's glucose management protocol after cardiovascular surgery and to clarify the impact of glycemic variability on postoperative complications.
    Methods: In all, 76 patients who underwent elective cardiovascular surgery and were monitored perioperatively using a CGM system were evaluated. Postoperative glucose management consisted of continuous intravenous insulin infusion (CIII) in the intensive care unit, and subcutaneous insulin injections (SQII) after oral food intake started. CIII and subcutaneous injections were initiated when blood glucose level exceeded 150 mg/dL. CGM data were used to analyze perioperative glycemic variability and association with postoperative complications.
    Results: Target glucose levels (71-180 mg/dL) were achieved during 97.1 +/- 5.5% and 86.4 +/- 19.0% of the continuous insulin infusion and subcutaneous injection periods, respectively. Major postoperative complications were surgical site infections, found in 6.6% of total patients, and atrial fibrillation, found in 44% of patients with off-pump coronary artery bypass grafting. High glycemic variability during SQII was associated with increased risk for both complications.
    Conclusion: Data analysis revealed that our glucose management protocol during CIII was adequate. However, the management protocol during SQII required improvement.

    DOI: 10.5761/atcs.oa.17-00045

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  • Non-bacterial thrombotic endocarditis in the right atrium caused by pectus excavatum. 国際誌

    Ai Sugimoto, Shuichi Shiraishi, Maya Watanabe, Jiyong Moon, Riuko Ohashi, Masashi Takahashi, Masanori Tsuchida

    Surgical case reports   2 ( 1 )   105 - 105   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)  

    BACKGROUND: Non-bacterial thrombotic endocarditis (NBTE) is an uncommon pathological situation, which involves the presence of bland, fibrin-platelet thrombi. It usually occurs at the endocardium of cardiac valves, in association with endothelial injury and a hypercoagulative state. However, NBTE on the endocardium at the right atrial free wall in a patient without any apparent hypercoagulative background is rarely reported. CASE PRESENTATION: A girl aged 4 years with severe pectus excavatum was referred to our hospital for treatment of a recurrent right atrial tumor. The tumor was removed concomitant with pectus excavatum repair. The tumor was revealed as recurrent thrombus. Pathological findings showed that NBTE caused by an operative scar on the endocardium of the right atrium and sustained rheological stress in the right atrium due to compression from pectus excavatum lead to recurrent thrombus formation. Three years after the discontinuation of anticoagulation therapy, no sign of thrombus formation was found. CONCLUSIONS: To our knowledge, this is the first report of NBTE related to an interaction between sustained rheological stress from cardiac compression and endocardial injury. In such patients, we recommend concomitant chest wall repair when the operative scar is present at the site of the rheological force.

    DOI: 10.1186/s40792-016-0236-4

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  • Inhibition of Glutaminolysis Inhibits Cell Growth via Down-regulating Mtorc1 Signaling in Lung Squamous Cell Carcinoma 査読

    Ye Xulu, Zhou Qiliang, Matsumoto Yoshifumi, Moriyama Masato, Kageyama Shun, Komatsu Masaaki, Satoh Seijiro, Tsuchida Masanori, Saijo Yasuo

    ANTICANCER RESEARCH   36 ( 11 )   6021 - 6029   2016年11月

  • Lobectomy and limited resection in small-sized peripheral non-small cell lung cancer. 査読 国際誌

    Koike T, Koike T, Sato S, Hashimoto T, Aoki T, Yoshiya K, Yamato Y, Watanabe T, Akazawa K, Toyabe SI, Tsuchida M, Niigata Chest, Surgery Research Group

    Journal of thoracic disease   8 ( 11 )   3265 - 3274   2016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)  

    DOI: 10.21037/jtd.2016.11.106

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  • Coronary Ostioplasty for Congenital Atresia of the Left Main Coronary Artery Ostium in a Teenage Boy. 国際誌

    Ai Sugimoto, Shuichi Shiraishi, Jiyong Moon, Masashi Takahashi, Masanori Tsuchida

    World journal for pediatric & congenital heart surgery   7 ( 6 )   773 - 776   2016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)  

    Atresia of the left coronary artery ostium is extremely rare. We report the case of a 13-year-old boy who played volleyball in school and collapsed with severe chest pain during practice. He was referred to our hospital, and imaging modalities showed atresia of the left main coronary artery ostium. Urgent coronary ostioplasty was performed using a patch of 0.6% glutaraldehyde-treated autologous pericardium. His postoperative course was uneventful, and he has had a normal everyday life without chest pain 8 months postoperatively. Physicians should be aware of the patient's history, as in this case, because prompt imaging diagnosis is essential when there is a high likelihood that the event is related to myocardial ischemia. Since long-term outcome is uncertain even after successful surgical revascularization, close follow-up is required.

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  • 次世代シーケンサーを用いた原発性肺腺癌切除例の網羅的遺伝子発現解析に基づく治療

    佐藤 征二郎, 後藤 達哉, 北原 哲彦, 小池 輝元, 高田 和樹, 岡本 龍郎, 前原 喜彦, 土田 正則

    肺癌   56 ( 6 )   515 - 515   2016年11月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 術前生検にて診断がついた左主肺動脈血管肉腫の1手術例

    後藤 達哉, 仲村 亮宏, 大久保 由華, 佐藤 征二郎, 小池 輝元, 白石 修一, 名村 理, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 172回 )   21 - 21   2016年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • [Fatal Respiratory Failure Developed during Chemotherapy for Diffuse Large B Cell Lymphoma that Occurred Late after Lung Transplantation].

    Akihiko Kitahara, Seijiro Sato, Terumoto Koike, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   69 ( 11 )   941 - 945   2016年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report here a case of fatal respiratory failure developed during chemotherapy for diffuse large B cell lymphoma that occurred late after lung transplantation. 25-year- old man underwent lung transplantation from brain death donor for respiratory failure due to interstitial pneumonia at the age of 16 years old. Two years after transplantation, his respiratory function decreased gradually. Chronic lung allograft dysfunction including bronchiolitis obliterans( BOS) and restrictive allograft syndrome was suspected and immunosuppression was enhanced. Nine years after transplantation, he had abdominal pain and physical examination suggested intestinal obstruction. Small intestine endoscopy revealed an ulcer at jejunum and diffuse large B cell lymphoma( DLBCL) was finally diagnosed by biopsy. Chemotherapy was planned for lymphoma, but respiratory failure progressed just before chemotherapy. Chest computed tomography showed infiltrative shadow in right lung, so we suspected presence of lymphoma and chemotherapy was carried out. After chemotherapy, abnormal shadow in the right lung disappeared. Although chemotherapy was effective, respiratory failure progressed and he died. Pathological examination from autopsy showed mixture of BOS, diffuse alveolar damage, invasion of aspergillus and acute fibrinoid organizing pneumonia but no residual DLBCL was found in the lung.

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  • 【肺移植における周術期・遠隔期の課題】慢性期移植肺機能不全と悪性腫瘍 肺移植後遠隔期発症のびまん性大細胞型B細胞リンパ腫に併発した致死的呼吸不全

    北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    胸部外科   69 ( 11 )   941 - 945   2016年10月

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    記述言語:日本語   出版者・発行元:(株)南江堂  

    25歳男。幼少期より間質性肺炎にて加療されるも呼吸不全が進行し、16歳時に海外で脳死両側肺移植を受けていた。その後、閉塞性細気管支炎とrestrictive allograft syndromeの混在した慢性期移植肺機能不全の状態となり、免疫抑制剤の投与にて経過観察されていた。今回、腹痛、嘔吐が出現し、小腸内視鏡で空腸に潰瘍性病変を認めた。生検の結果、びまん性大細胞型B細胞リンパ腫と診断され、化学療法待機中に呼吸不全の進行を認めた。胸部CTでは右肺門部を中心とした浸潤影を認め、臨床経過よりリンパ腫の肺病変と判断し、化学療法を行う方針とした。化学療法直前に呼吸不全が進行したため、人工呼吸器管理下に抗真菌薬を併用して化学療法を開始した。1コース目終了時に右肺門部浸潤影はほぼ消失したが、その後、真菌感染症と呼吸不全を来たし43日目(両側肺移植後9年8ヵ月目)に死亡した。

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J00349&link_issn=&doc_id=20161011120016&doc_link_id=1390002209966314112&url=https%3A%2F%2Fcir.nii.ac.jp%2Fcrid%2F1390002209966314112&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_2.gif

  • Effects of Fibrotic Tissue on Liver-targeted Hydrodynamic Gene Delivery 査読

    Yuji Kobayashi, Kenya Kamimura, Hiroyuki Abe, Takeshi Yokoo, Kohei Ogawa, Yoko Shinagawa-Kobayashi, Ryo Goto, Ryosuke Inoue, Masato Ohtsuka, Hiromi Miura, Tsutomu Kanefuji, Takeshi Suda, Masanori Tsuchida, Yutaka Aoyagi, Guisheng Zhang, Dexi Liu, Shuji Terai

    MOLECULAR THERAPY-NUCLEIC ACIDS   5 ( 8 )   e359   2016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)   出版者・発行元:CELL PRESS  

    Hydrodynamic gene delivery is a common method for gene transfer to the liver of small animals, and its clinical applicability in large animals has been demonstrated. Previous studies focused on functional analyses of therapeutic genes in animals with normal livers and little, however, is known regarding its effectiveness and safety in animals with liver fibrosis. Therefore, this study aimed to examine the effects of liver fibrosis on hydrodynamic gene delivery efficiency using a rat liver fibrosis model. We demonstrated for the first time, using pCMV-Luc plasmid, that this procedure is safe and that the amount of fibrotic tissue in the liver decreases gene delivery efficiency, resulting in decrease in luciferase activity depending on the volume of fibrotic tissue in the liver and the number of hepatocytes that are immunohistochemically stained positive for transgene product. We further demonstrate that antifibrotic gene therapy with matrix metalloproteinase-13 gene reduces liver fibrosis and improves efficiency of hydrodynamic gene delivery. These results demonstrate the negative effects of fibrotic tissue on hydrodynamic gene delivery and its recovery by appropriate antifibrotic therapy.

    DOI: 10.1038/mtna.2016.63

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  • 肺移植後びまん性大細胞性B細胞性リンパ腫を発症し、治療中に致死的肺アスペルギルス症を合併した1例

    北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    移植   51 ( 2-3 )   240 - 240   2016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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  • 若年女性に発症した多発肺硬化性血管腫の1例

    仲村 亮宏, 佐藤 征二郎, 後藤 達哉, 北原 哲彦, 小池 輝元, 土田 正則, 梅津 哉

    肺癌   56 ( 4 )   326 - 326   2016年8月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 劇症型心筋炎に対する体外式膜型人工肺の使用経験

    文 智勇, 白石 修一, 杉本 愛, 額賀 俊介, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   32 ( Suppl.1 )   s1 - 312   2016年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 非小児専門病院における来院時心肺停止小児例の実際と保護者に対する小児の蘇生講習の取り組み

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   32 ( Suppl.1 )   s1 - 237   2016年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 当院における先天性心疾患術後患者の妊娠出産の現状

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   32 ( Suppl.1 )   s1 - 157   2016年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 橈骨動脈外膜嚢腫の1手術例

    梅澤 麻衣子, 青木 賢治, 長澤 綾子, 佐藤 裕喜, 岡本 竹司, 榛沢 和彦, 名村 理, 土田 正則, 渡邉 佳緒里, 渡辺 玄

    日本血管外科学会雑誌   25 ( Suppl. )   468 - 468   2016年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本血管外科学会  

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  • 反復する気管支粘表皮癌再発に対する4回目の開胸切除例

    北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 171回 )   16 - 16   2016年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • ファロー四徴症根治術44年後にPVRを施行した1例

    文 智勇, 白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 171回 )   26 - 26   2016年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • Pneumocephalus and subcutaneous scalp emphysema in a neonate on a low-flow nasal cannula.

    Ai Sugimoto, Masashi Takahashi, Shuichi Shiraishi, Maya Watanabe, Moon Jiyong, Masanori Tsuchida

    General thoracic and cardiovascular surgery   64 ( 5 )   277 - 9   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)  

    A 15-day-old boy after intracardiac repair was discharged from the intensive care unit with a low-flow nasal cannula for oxygen administration. The cannula was a 4-Fr multi-purpose tube with a side hole that was inserted into his left nostril. Next day, he suddenly developed pneumocephalus emerging from the right periorbital swelling and extending to his face and subcutaneous scalp over the next 6 h. A computed tomography (CT) scan revealed massive air pockets in the orbit, subdural space, subcutaneous scalp, and face. The nasal cannula was found to have been inserted deeper than we thought and was thus presumed to be the source of the air pockets. We immediately removed the cannula. Follow-up CTs revealed rapid resolution of the intracranial and subcutaneous air. The subcutaneous emphysema completely disappeared over the next 4 days, and he was discharged without any incident.

    DOI: 10.1007/s11748-014-0454-2

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  • A Case of Ectopic ACTH-Producing Pulmonary Carcinoid Arising in an Extralobar Pulmonary Sequestration 査読

    Seijiro Sato, Akihiko Kitahara, Terumoto Koike, Takehisa Hashimoto, Riuko Ohashi, Yoichi Kameda, Masanori Tsuchida

    INTERNATIONAL JOURNAL OF SURGICAL PATHOLOGY   24 ( 2 )   130 - 134   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:SAGE PUBLICATIONS INC  

    Ectopic adrenocorticotrophic hormone (ACTH)-producing bronchopulmonary carcinoid arising in a bronchopulmonary sequestration is extremely rare. The case of a 67-year-old woman with a 1.7-cm nodule in the mediastinal side of the left lower lobe is presented. At 52 years of age, she was diagnosed as having ACTH-dependent Cushing's syndrome (CS). However, no ectopic source of ACTH-secretion was detected. Seven years later, she underwent a bilateral adrenalectomy because of aggravation of her health condition. This time, tumor excision was performed by thoracoscopic surgery. The tumor adhered sparsely to the mediastinal pleura and the left lower lobe and was bluntly separated from these tissues. Pathologically, the tumor was a typical carcinoid arising in an extralobar pulmonary sequestration. Immunohistochemical staining confirmed the secretion of ACTH by bronchopulmonary carcinoid tumor cells. After surgery, the serum ACTH level was almost normalized, and the dexamethasone (1 mg) suppression test showed significant suppression of ACTH.

    DOI: 10.1177/1066896915605615

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  • Lobectomy Versus Segmentectomy in Radiologically Pure Solid Small-Sized Non-Small Cell Lung Cancer 査読

    Terumoto Koike, Akihiko Kitahara, Seijiro Sato, Takehisa Hashimoto, Tadashi Aoki, Teruaki Koike, Katsuo Yoshiya, Shin-ichi Toyabe, Masanori Tsuchida

    ANNALS OF THORACIC SURGERY   101 ( 4 )   1354 - 1360   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. The indication for limited resection of radiologically pure solid non-small cell lung cancer (NSCLC) is controversial owing to its invasive pathologic characteristics. This study was performed to compare the outcomes after lobectomy and segmentectomy in these NSCLC patients.
    Methods. We retrospectively reviewed 251 patients with radiologically pure solid cT1a NO MO NSCLC who underwent lobectomy or segmentectomy, and the preoperative characteristics of the patients treated with the two operative techniques were matched using propensity score methods. Overall survival (OS) and disease-free survival (DFS) curves were compared using the log rank test, and differences in survival were also evaluated by the McNemar test. The preoperative factors and surgical procedure were analyzed with the multivariate Cox proportional hazards regression model to identify independent predictors of poor OS and DFS.
    Results. In the propensity score matched lobectomy and segmentectomy groups (87 patients per group), the 5-year and 10-year OS rates were 85% versus 84% and 66% versus 63%, respectively; and the 5-year and 10-year DFS rates were 80% versus 77% and 64% versus 58%, respectively. There were no significant differences between the two groups in OS or DFS by the log rank test, and also no significant differences in 3-year, 5-year, or 7-year OS or DFS by the McNemar test. Although age, smoking status, pulmonary function, and carcinoembryonic antigen were identified as significant predictors of both OS and DFS, the surgical procedure was not identified.
    Conclusions. Similar oncologic outcomes after lobectomy and segmentectomy were indicated among patients with radiologically pure solid small-sized NSCLC. (C) 2016 by The Society of Thoracic Surgeons

    DOI: 10.1016/j.athoracsur.2015.10.048

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  • [Endovascular Repair for Acute Phase of Retrograde Type A Aortic Dissection with an Entry in the Descending Aorta].

    Kenji Aoki, Takeshi Okamoto, Hiroki Sato, Osamu Namura, Ryo Onishi, Kazuhiko Hanzawa, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   69 ( 4 )   276 - 81   2016年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Endovascular repair for retrograde type A aortic dissection with an entry in the descending aorta (RAAD) is challenging. We present early and mid- term results of endovascular repair for acute phase of RAAD by using commercially-available device. METHODS: From April 2012 to June 2014, 10 consecutive patients with acute phase of RAAD underwent endovascular repair in our hospital. Of them, 9 patients had emergency surgery within 24 hours after the onset. The other one patient had urgent surgery 3 days after the onset. In all patients, the entry tear was covered with TAG or conformable TAG. RESULTS: Technical success was achieved in all patients. No in-hospital mortality was experienced. In all patients, follow-up computed tomography images showed significant remodeling in the ascending aorta 3 months after surgery. During a median follow-up period of 19.5 months, no patients died and no re-intervention occurred. CONCLUSIONS: In patients with acute phase of RAAD, endovascular repair with commercially-available device can be safely performed and it provides sufficient remodeling in the ascending aorta early after surgery. This technique is an alternative to open repair in these patients.

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  • Endovascular Repair for Acute Phase of Retrograde Type A Aortic Dissection with an Entry in the Descending Aorta

    Kenji Aoki, Takeshi Okamoto, Hiroki Sato, Osamu Namura, Ryo Onishi, Kazuhiko Hanzawa, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   69 ( 4 )   276 - 281   2016年4月

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    掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Endovascular repair for retrograde type A aortic dissection with an entry in the descending aorta (RAAD) is challenging. We present early and mid- term results of endovascular repair for acute phase of RAAD by using commercially-available device.

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  • 気管支形成術を併用して右S6区域切除術をおこなった定型カルチノイドの1例

    橋本 毅久, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   30 ( 3 )   O18 - 5   2016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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  • CPFE合併多発肺癌に区域切除と中葉支・B8-10区域枝Double barrel型気管支再建を施行した1例

    佐藤 征二郎, 北原 哲彦, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   30 ( 3 )   V9 - 6   2016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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  • 気管支管状切除を要した肺癌手術症例の検討

    北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   30 ( 3 )   P27 - 1   2016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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  • 非小細胞肺癌術後再発例に対する治療成績 遺伝子検索の有用性

    佐藤 征二郎, 北原 哲彦, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   30 ( 3 )   P75 - 7   2016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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  • 繰り返す右房内血栓に胸郭変形の関与が疑われた一例

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 170回 )   9 - 9   2016年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 弁輪部膿瘍を伴う大動脈弁位感染性心内膜炎手術症例の特徴

    名村 理, 青木 賢治, 佐藤 裕喜, 岡本 竹司, 長澤 綾子, 榛澤 和彦, 土田 正則

    日本心臓血管外科学会学術総会抄録集   46回   OP5 - 2   2016年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 当院における完全房室中隔欠損症術後の遠隔期成績と左側房室弁機能の評価

    文 智勇, 白石 修一, 杉本 愛, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   46回   PP - 007   2016年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 心筋電極を用いた小児期ペースメーカー移植後リード関連予後の検討

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   46回   PP - 157   2016年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • Jatane術後の長期遠隔成績 大血管スイッチ術後の大動脈形態に関連した予後の検討

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本心臓血管外科学会学術総会抄録集   46回   PR20 - 5   2016年2月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • Effective Prevention of Liver Fibrosis by Liver-targeted Hydrodynamic Gene Delivery of Matrix Metalloproteinase-13 in a Rat Liver Fibrosis Model 査読

    Hiroyuki Abe, Kenya Kamimura, Yuji Kobayashi, Masato Ohtsuka, Hiromi Miura, Riuko Ohashi, Takeshi Yokoo, Tsutomu Kanefuji, Takeshi Suda, Masanori Tsuchida, Yutaka Aoyagi, Guisheng Zhang, Dexi Liu, Shuji Terai

    MOLECULAR THERAPY-NUCLEIC ACIDS   5   e276   2016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:NATURE PUBLISHING GROUP  

    Liver fibrosis is the final stage of liver diseases that lead to liver failure and cancer. While various diagnostic methods, including the use of serum marker, have been established, no standard therapy has been developed. The objective of this study was to assess the approach of overexpressing matrix metalloproteinase-13 gene (MMP13) in rat liver to prevent liver fibrosis progression. A rat liver fibrosis model was established by ligating the bile duct, followed by liver-targeted hydrodynamic gene delivery of a MMP13 expression vector, containing a CAG promoter-MMP13-IRES-tdTomato-polyA cassette. After 14 days, the serum level of MMP13 peaked at 71.7 pg/ml in MMP13-treated group, whereas the nontreated group only showed a level of similar to 5 pg/ml (P &lt; 0.001). These levels were sustained for the next 60 days. The statistically lower level of the hyaluronic acids in treated group versus the nontreated group (P &lt; 0.05) reveals the therapeutic effect of MMP13 overexpression. Quantitative analysis of tissue stained with sirius red showed a statistically larger volume of fibrotic tissue in the nontreated group compared to that of MMP13-treated rats (P &lt; 0.05). These results suggest that the liver-targeted hydrodynamic delivery of MMP13 gene could be effective in the prevention of liver fibrosis.

    DOI: 10.1038/mtna.2015.49

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  • Fallot四徴症修復術後患者の長期遠隔期における肝機能

    白石 修一, 高橋 昌, 杉本 愛, 文 智勇, 土田 正則

    日本成人先天性心疾患学会雑誌   5 ( 1 )   113 - 113   2016年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • Resection of a large ectopic parathyroid adenoma: A case report. 査読 国際誌

    Sato S, Kitahara A, Koike T, Hashimoto T, Ohashi R, Motoi N, Tsuchida M

    International journal of surgery case reports   23   8 - 11   2016年

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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.ijscr.2016.04.007

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  • Surgical Outcomes of Lung Cancer Patients with Combined Pulmonary Fibrosis and Emphysema and Those with Idiopathic Pulmonary Fibrosis without Emphysema 査読

    Seijiro Sato, Terumoto Koike, Takehisa Hashimoto, Hiroyuki Ishikawa, Akira Okada, Takehiro Watanabe, Masanori Tsuchida

    ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY   22 ( 4 )   216 - 223   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:MEDICAL TRIBUNE INC  

    Objectives: Combined pulmonary fibrosis and emphysema (CPFE) is a unique disorder. The aim of this study was to compare the surgical outcomes of lung cancer patients with CPFE and those with idiopathic pulmonary fibrosis (IPF) without emphysema.
    Methods: A total of 1548 patients who underwent surgery for primary lung cancer between January 2001 and December 2012 were retrospectively reviewed.
    Results: Of the 1548 patients, 55 (3.6%) had CPFE on computed tomography (CT), and 45 (2.9%) had IPF without emphysema. The overall and disease-free 5-year survival rates for patients with CPFE were not significantly worse than those for patients with IPF without emphysema (24.9% vs. 36.8%, p = 0.814; 39.8% vs. 39.3%, p = 0.653, respectively). Overall, 21 (38.1%) patients with CPFE and nine patients (20.0%) with IPF without emphysema developed postoperative cardiopulmonary complications. Patients with CPFE had significantly more postoperative cardiopulmonary complications involving pulmonary air leakage for &gt; 6 days, hypoxemia, and arrhythmia than patients with IPF without emphysema (p = 0.048).
    Conclusions: There was no significant difference in survival after surgical treatment between CPFE patients and IPF patients without emphysema, but CPFE patients had significantly higher morbidity than IPF patients without emphysema.

    DOI: 10.5761/atcs.oa.15-00315

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  • 蛋白漏出性胃腸症を呈した開心術後収縮性心膜炎の1手術例

    名村 理, 岡本 竹司, 長澤 綾子, 佐藤 裕喜, 青木 賢治, 榛澤 和彦, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 169回 )   38 - 38   2015年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 肺癌術後に発症した慢性出血性膿胸の1例

    梅澤 麻以子, 佐藤 征二郎, 北原 哲彦, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 169回 )   28 - 28   2015年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 心臓再同期療法によって心機能の改善をみた房室不一致、両大血管右室起始症の一例

    文 智勇, 白石 修一, 杉本 愛, 高橋 昌, 土田 正則, 瀧聞 浄宏

    日本胸部外科学会関東甲信越地方会要旨集   ( 169回 )   31 - 31   2015年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • ステントグラフト合併症に対する治療 大動脈解離に対して施行したTEVARの追加治療

    岡本 竹司, 横井 良彦, 長澤 綾子, 佐藤 裕喜, 青木 賢治, 榛澤 和彦, 名村 理, 土田 正則

    人工臓器   44 ( 2 )   S - 63   2015年10月

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    記述言語:日本語   出版者・発行元:(一社)日本人工臓器学会  

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  • 合併症を有する肺癌に対する外科的治療戦略 高齢者肺癌の外科治療戦略 高齢者総合機能評価の必要性

    佐治 久, 中村 廣繁, 土田 正則, 奥村 典仁, 園部 誠, 青景 圭樹, 中尾 将之, 宮崎 拓郎, 春木 朋広

    肺癌   55 ( 5 )   358 - 358   2015年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 非小細胞肺癌pN1症例における外科治療成績

    佐藤 征二郎, 北原 哲彦, 小池 輝元, 橋本 毅久, 土田 正則

    肺癌   55 ( 5 )   482 - 482   2015年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 病理病期I-III期肺腺癌患者における至適術後経過観察法の検討

    小池 輝元, 北原 哲彦, 佐藤 征二郎, 土田 正則

    肺癌   55 ( 5 )   494 - 494   2015年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 肺扁平上皮癌におけるCEA、SCC測定の意義

    北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    肺癌   55 ( 5 )   708 - 708   2015年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 大腸癌術後の転移性肺腫瘍切除断端に発生した原発性肺扁平上皮癌の1例

    佐藤 征二郎, 北原 哲彦, 小池 輝元, 土田 正則

    肺癌   55 ( 4 )   298 - 298   2015年8月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 術前に胸壁腫瘍が疑われた肺葉外肺分画症の1切除例

    北原 哲彦, 佐藤 征二郎, 梅澤 麻以子, 小池 輝元, 橋本 毅久, 土田 正則

    気管支学   37 ( 4 )   480 - 480   2015年7月

  • 右室二腔症修復術の遠隔成績

    白石 修一, 高橋 昌, 杉本 愛, 文 智勇, 土田 正則

    日本小児循環器学会雑誌   31 ( Suppl.1 )   s1 - 393   2015年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 60歳以上の高齢患者に対する心房中隔欠損閉鎖術の遠隔期成績

    文 智勇, 白石 修一, 杉本 愛, 渡邉 マヤ, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   31 ( Suppl.1 )   s1 - 370   2015年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • 左冠動脈起始部病変に対する3手術例

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本小児循環器学会雑誌   31 ( Suppl.1 )   s1 - 260   2015年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • Brevibacterium luteolumによる弁輪部膿瘍を伴う大動脈弁位感染性心内膜炎の1例

    志賀 優, 名村 理, 佐藤 裕喜, 岡本 竹司, 青木 賢治, 長澤 綾子, 榛澤 和彦, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 168回 )   29 - 29   2015年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 内腸骨動脈瘤合併肺癌に対し肺切除・ステントグラフト内挿術を一期的に施行した1例

    梅澤 麻以子, 北原 哲彦, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 168回 )   27 - 27   2015年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 左冠動脈入口部閉鎖に対する一治験例

    杉本 愛, 白石 修一, 文 智勇, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 168回 )   8 - 8   2015年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 外腸骨静脈に発生した平滑筋肉腫の1切除例

    佐藤 哲彰, 名村 理, 岡本 竹司, 大西 遼, 佐藤 裕喜, 青木 賢治, 榛澤 和彦, 土田 正則

    日本血管外科学会雑誌   24 ( 3 )   622 - 622   2015年5月

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    記述言語:日本語   出版者・発行元:(NPO)日本血管外科学会  

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  • Effect of Fibrotic Tissue on Liver-Targeted Hydrodynamic Gene Delivery 査読

    Kobayashi Yuji, Kamimura Kenya, Abe Hiroyuki, Ohtsuka Masato, Miura Hiromi, Yokoo Takeshi, Kanefuji Tsutomu, Suda Takeshi, Zhang Guisheng, Tsuchida Masanori, Aoyagi Yutaka, Liu Dexi, Terai Shuji

    MOLECULAR THERAPY   23   S141   2015年5月

  • Effective Prevention of Liver Fibrosis by Liver-Targeted Hydrodynamic Gene Delivery of Matrix Metalloproteinase-13 in Rat Liver Fibrosis Model 査読

    Hiroyuki Abe, Kenya Kamimura, Yuji Kobayashi, Masato Ohtsuka, Hiromi Miura, Riuko Ohashi, Takeshi Yokoo, Tsutomu Kanefuji, Takeshi Suda, Masanori Tsuchida, Yutaka Aoyagi, Guisheng Zhang, Dexi Liu, Shuji Terai

    MOLECULAR THERAPY   23   S234 - S234   2015年5月

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    記述言語:英語   出版者・発行元:NATURE PUBLISHING GROUP  

    DOI: 10.1016/S1525-0016(16)34197-1

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  • [Simultaneous pulmonary resection and endovascular repair for patients with coexisting primary lung cancer and aneurysm].

    Terumoto Koike, Hiroki Sato, Seijiro Sato, Takeshi Okamoto, Takehisa Hashimoto, Kazuhiko Hanzawa, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   68 ( 4 )   293 - 7   2015年4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 surgical strategy for coexisting lung cancer and aneurysm is controversial owing to the risk of aneurysm rupture during the perioperative period of pulmonary resection. We performed simultaneous pulmonary resection and endovascular repair in 2 patients with coexisting lung cancer and aneurysm. Case 1:A 74-year-old man presented at our hospital with cT2aN0M0 lung cancer and a 5.0 cm abdominal aortic aneurysm. Because computed tomography indicated the possibility of advanced lung cancer, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right lower lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 12. Case 2:A 72-year-old man presented at our hospital with cT2aN1M0 lung cancer, a 5.0 cm left internal iliac artery aneurysm, and right renal cell carcinoma( RCC). Because the lung cancer was advanced and the patients needed following surgical treatment for RCC, we decided to perform simultaneous surgery for lung cancer and the aneurysm. Under general anesthesia, endovascular aneurysm repair was performed before right upper lobectomy with lymphadenectomy. The postoperative course was uneventful, and the patient was discharged on postoperative day 11.

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  • 心臓血管 持続グルコースモニタを用いた心臓手術中の血糖変動に関する検討

    佐藤 裕喜, 石川 友美, 細島 康宏, 青木 賢治, 岡本 竹司, 名村 理, 榛澤 和彦, 土田 正則

    日本外科学会定期学術集会抄録集   115回   OP - 6   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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  • 触知困難小型肺癌病変に対するVirtual-assisted Lung Mappingを用いた胸腔鏡補助下肺区域切除の初期経験

    小池 輝元, 佐藤 征二郎, 橋本 毅久, 佐藤 雅昭, 土田 正則

    日本呼吸器外科学会雑誌   29 ( 3 )   O16 - 6   2015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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  • pN2 III期非小細胞肺癌における縦隔リンパ節転移様式による病期細分化の検討

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    日本呼吸器外科学会雑誌   29 ( 3 )   O35 - 3   2015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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  • 右下葉気管支管状切除・気管支形成術

    橋本 毅久, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   29 ( 3 )   V2 - 3   2015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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  • 呼吸器 間質性肺炎合併肺癌に対する再手術の意義

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 北原 哲彦, 渡辺 健寛, 土田 正則

    日本外科学会定期学術集会抄録集   115回   PLS - 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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  • Time-resolved CT angiographyが診断に有用であった上行大動脈置換術後大動脈基部破裂の手術例

    大西 遼, 青木 賢治, 名村 理, 佐藤 裕喜, 岡本 竹司, 榛澤 和彦, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 167回 )   11 - 11   2015年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 診断に苦慮した縦隔内異所性副甲状腺腫の1切除例

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 167回 )   29 - 29   2015年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 【呼吸器外科の手術看護パーフェクトマニュアル】(第2章)実践編 術式別の術中看護マニュアル 肺癌に対する肺楔状切除術

    橋本 毅久, 土田 正則

    オペナーシング   ( 2015臨時増刊 呼吸器外科の手術看護パーフェクトマニュアル )   111 - 117   2015年3月

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    記述言語:日本語   出版者・発行元:(株)メディカ出版  

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  • Mee法を用いて冠動脈移植を行った完全大血管転位shaher 5aの1例

    文 智勇, 白石 修一, 渡邉 マヤ, 杉本 愛, 高橋 昌, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 167回 )   24 - 24   2015年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma 査読

    Motohiko Yamazaki, Hiroyuki Ishikawa, Ryosuke kunii, Akiko Tasaki, Suguru Sato, Yohei Ikeda, Norihiko Yoshimura, Takehisa Hashimoto, Masanori Tsuchida, Hidefumi Aoyama

    EUROPEAN JOURNAL OF RADIOLOGY   84 ( 1 )   178 - 184   2015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:ELSEVIER IRELAND LTD  

    Objectives: To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma.
    Methods: This retrospective study included 250 consecutive patients who underwent complete resection for &lt;= 3-cm pathological stage I (T1-2aNOMO) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC).
    Results: Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (P &lt; 0.05). A combination of these three findings had a greater accuracy in predicting 5-year disease-free survival than did %solid alone (AUC = 0.853 versus 0.792; P = 0.023), with a sensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were &gt;= 48% and &gt;= 3.7 ng/mL, respectively.
    Conclusion: Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

    DOI: 10.1016/j.cjrad.2014.10.009

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  • Posterior TGA型両大血管右室起始症に対する動脈スイッチ術(Jatene原法)と心室内血流路作成の1例

    白石 修一, 高橋 昌, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本心臓血管外科学会雑誌   44 ( 1 )   21 - 24   2015年1月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

    症例は男児。在胎38週3日、体重2,880gで仮死なく出生し、生直後より高度のチアノーゼを認め心エコー検査にて両大血管右室起始(DORV)と診断され同日当院NICUへ緊急搬送された。大血管関係は大動脈がやや右後方、肺動脈がやや左前方であり、心室中隔欠損は肺動脈弁下に存在するposterior TGA型DORVであった。漏斗部中隔は三尖弁側の心室漏斗部皺襞(VIF)側に挿入し、心室中隔にほぼ整列していた。手術は日齢25に胸骨正中切開・体外循環下に行った。心停止下に三尖弁経由に心室中隔欠損(secondary IVF)を閉鎖(心室内血流路作成)し、次に動脈スイッチ手術を行った。冠動脈パターンは1R2LCXのShaher 9型であり、trap-door法を用いた冠動脈移植を行った。肺動脈再建は前方転位を行わないJatene原法を行った。術後血行動態は早期から安定し、術後2日に人工呼吸器離脱、術後19日に退院した。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J01122&link_issn=&doc_id=20150128260005&doc_link_id=10.4326%2Fjjcvs.44.21&url=https%3A%2F%2Fdoi.org%2F10.4326%2Fjjcvs.44.21&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • 小児胸骨正中切開後縦隔炎に対する洗浄・一期的胸骨閉鎖ドレナージ

    杉本 愛, 高橋 昌, 白石 修一, 渡邉 マヤ, 文 智勇, 土田 正則

    日本心臓血管外科学会雑誌   44 ( Suppl. )   389 - 389   2015年1月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • Surgical resection for a second primary lung cancer originating close to the initial surgical margin for lung squamous cell carcinoma. 国際誌

    Seijiro Sato, Terumoto Koike, Takehisa Hashimoto, Masanori Tsuchida

    Case reports in surgery   2015   462193 - 462193   2015年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Few reports have described surgical resection for second primary lung cancers originating close to the initial surgical margin for lung cancer. A 64-year-old man had undergone left segmentectomy with lymph node dissection for small peripheral squamous cell lung cancer using video-assisted thoracic surgery, with pathology confirming a small tumor 12 mm in diameter identified about 3 cm from the surgical margin. Eighteen months after initial surgery, computed tomography revealed a 30 mm pulmonary nodule close to the initial surgical margin in the residual left upper lobe and the serum level of carcinoembryonic antigen was found to be increased. Local recurrence on the staple-line of the surgical margin was suspected, and completion left upper lobectomy was performed. Histological examination identified not only a squamous cell carcinoma component but also a small cell carcinoma component. The immunohistochemical staining pattern of the second tumor differed from that of the initial resected lung squamous cell carcinoma. The final pathological diagnosis was a second primary tumor with mixed small cell carcinoma and squamous cell carcinoma histology.

    DOI: 10.1155/2015/462193

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  • Foregut cystに発生した異所性ACTH産生カルチノイドの1例

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則, 大橋 瑠子, 梅津 哉

    肺癌   54 ( 7 )   1003 - 1003   2014年12月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • IEに対するAVR後6年目に発症したMicrococcus roseusによるPVEの1手術例

    大西 遼, 名村 理, 佐藤 哲彰, 佐藤 裕喜, 岡本 竹司, 青木 賢治, 榛澤 和彦, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 166回 )   16 - 16   2014年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 大動脈弁下狭窄および大動脈縮窄を合併した右側相同に対して段階的Norwood手術を行った一例

    杉本 愛, 高橋 昌, 白石 修一, 渡邉 マヤ, 文 智勇, 大西 遼, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 166回 )   33 - 33   2014年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • [Detection of the communication site by dye injection method at the surgery for pleuroperitoneal communication].

    Seijiro Sato, Terumoto Koike, Takehisa Hashimoto, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   67 ( 11 )   967 - 70   2014年10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 65-year-old male with end stage renal failure due to IgA nephritis commenced continuous ambulatory peritoneal dialysis (CAPD). Three weeks after initiation of CAPD, right hydrothorax developed. Then, we strongly assumed pleuroperitoneal communication( PPC) although the pleural effusion did not show high concentration of glucose. He underwent thoracoscopic surgery for PPC. On the inner, central tendons part of the diaphragm, there were a few blebs. One hour after 3 l of peritoneal dialysis solution containing 15 ml indigocarmine was instilled into the abdomen through a CAPD catheter, the blebs were tense and colored blue by the dye solution. The blebs were directly sutured and diaphragm was covered by polyglycolic acid sheet and fibrin glue all over. Since then, he resumed CAPD, without recurrence of hydrothorax. Then we investigated the treatment outcome of video-assisted thoracic surgery (VATS) for PPC in Japan. The outcome was poorer in cases in which communication was not detected intraoperatively. These patients should be given sufficient consideration for surgical procedure.

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  • 間質性肺炎合併肺癌切除後再手術の経験

    土田 正則, 橋本 毅久, 小池 輝元, 佐藤 征二郎

    肺癌   54 ( 5 )   568 - 568   2014年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 慢性血液透析患者に対する肺癌手術周術期及び長期予後の検討

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    肺癌   54 ( 5 )   683 - 683   2014年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • V-V ECMO使用下胸骨正中切開アプローチにて切除した気管原発MALTリンパ腫の1例

    小池 輝元, 佐藤 征二郎, 橋本 毅久, 土田 正則

    肺癌   54 ( 5 )   380 - 380   2014年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 巨大な胸壁腫瘍が主体の胸壁浸潤肺癌に対し、高位後側方切開(後方アプローチ)にて切除した1例

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    肺癌   54 ( 5 )   373 - 373   2014年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 両側肺動脈絞扼術後に根治手術(大動脈弓再建+動脈スイッチ手術+心室内血流路作成)を施行した両大血管右室起始・大動脈弓離断症の1例

    白石 修一, 高橋 昌, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本心臓血管外科学会雑誌   43 ( 5 )   265 - 269   2014年9月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

    症例は男児。在胎40週0日、体重3,465gで仮死なく出生した。生直後より高度のチアノーゼを認め心エコー検査にて両大血管右室起始・大動脈弓離断症と診断された。同日よりプロスタグランディン製剤の持続静注が開始され、当院NICUへ緊急搬送された。高肺血流に伴う急性心不全状態であったため、4生日に両側肺動脈絞扼術を施行した。術後に利尿が得られ全身状態は改善したが心不全状態が継続したため、9生日時に根治手術を行った。胸骨再正中切開下に上下半身分離体外循環を確立し、三尖弁経由にVSDから心室内血流路を作成し、次にtrap door法を用いて冠動脈移植を行った。Lecompte maneuverの後に大動脈弓再建(直接吻合)を行った。さらに右室流出路をパッチで拡大し、大動脈遮断解除後に肺動脈再建を行った。人工心肺離脱はとくに問題なく、開胸状態で手術を終了し4病日に閉胸し14病日に人工呼吸器を離脱した。術後に肺炎・乳び胸などを合併したが内科的治療にて改善し、78病日に退院した。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J01122&link_issn=&doc_id=20140924140004&doc_link_id=10.4326%2Fjjcvs.43.265&url=https%3A%2F%2Fdoi.org%2F10.4326%2Fjjcvs.43.265&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Fontan operation in a paediatric patient with a history of Takotsubo cardiomyopathy. 国際誌

    Maya Watanabe, Shuichi Shiraishi, Masashi Takahashi, Masanori Tsuchida

    Interactive cardiovascular and thoracic surgery   19 ( 2 )   326 - 8   2014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)  

    Takotsubo cardiomyopathy is very rare in the paediatric population and has not been described in a single-ventricle patient yet. We report the case of a 4-year old boy with a history of Takotsubo cardiomyopathy in whom we performed a Fontan operation. After coil embolization of the minor aortopulmonary collateral arteries, the patient developed Takotsubo cardiomyopathy. His cardiac function largely recovered over 3 months. He subsequently progressed to a Fontan operation and was weaned uneventfully off cardiopulmonary bypass, on minimal doses of dopamine and milrinone; he was sedated using a dexmedetomidine infusion and a midazolam bolus. There were no signs of recurrent Takotsubo cardiomyopathy over the subsequent 2 years.

    DOI: 10.1093/icvts/ivu108

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  • [Adult endocardial blood cyst; report of a case]

    Yuka Okubo, Kenji Aoki, Osamu Namura, Takeshi Okamoto, Kazuhiko Hanzawa, Hisanaga Moro, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   67 ( 7 )   571 - 574   2014年7月

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    掲載種別:研究論文(学術雑誌)  

    We report herein a rare case of endocardial blood cyst (EBC) in an adult patient. A 63-year-old asymptomatic woman underwent echocardiography, which incidentally detected a cardiac tumor in the right atrium. On echocardiography, the tumor was revealed to be a 30-mm round mass with thin, hyperechogenic walls and heterogeneously hypoechogenic contents. The lesion was attached to the septum. On computed tomography, the tumor appeared partly calcified and showed poor contrast-enhancement. On magnetic resonance imaging, the lesion appeared isointense or slightly hyperintense in T1 and T2-weighted sequences. Myxoma was strongly suspected based on these preoperative imaging findings. The tumor was successfully excised under cardiopulmonary bypass. Gross examination confirmed that the cyst was filled with blood. The cystic walls comprised thin-layered fibrous tissue lined with endocardial cells. No tumor cells were found. The diagnosis of EBC was confirmed based on histopathological examination, and the postoperative course was uneventful.

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  • [Adult endocardial blood cyst; report of a case].

    Yuka Okubo, Kenji Aoki, Osamu Namura, Takeshi Okamoto, Kazuhiko Hanzawa, Hisanaga Moro, Masanori Tsuchida

    Kyobu geka. The Japanese journal of thoracic surgery   67 ( 7 )   571 - 4   2014年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    We report herein a rare case of endocardial blood cyst (EBC) in an adult patient. A 63-year-old asymptomatic woman underwent echocardiography, which incidentally detected a cardiac tumor in the right atrium. On echocardiography, the tumor was revealed to be a 30-mm round mass with thin, hyperechogenic walls and heterogeneously hypoechogenic contents. The lesion was attached to the septum. On computed tomography, the tumor appeared partly calcified and showed poor contrast-enhancement. On magnetic resonance imaging, the lesion appeared isointense or slightly hyperintense in T1 and T2-weighted sequences. Myxoma was strongly suspected based on these preoperative imaging findings. The tumor was successfully excised under cardiopulmonary bypass. Gross examination confirmed that the cyst was filled with blood. The cystic walls comprised thin-layered fibrous tissue lined with endocardial cells. No tumor cells were found. The diagnosis of EBC was confirmed based on histopathological examination, and the postoperative course was uneventful.

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  • 胸壁浸潤病変が腫瘍の主体であった肺扁平上皮癌の一例

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 165回 )   27 - 27   2014年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 区域切除後の断端近傍に発生した異時多発肺癌の1切除例

    佐藤 征二郎, 白戸 亨, 小池 輝元, 橋本 毅久, 土田 正則

    肺癌   54 ( 3 )   166 - 166   2014年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • Original Taussig-Bing奇形とposterior TGAの中間型と思われた症例に対しoriginal Jatene手術を施行した一例

    杉本 愛, 高橋 昌, 白石 修一, 渡辺 マヤ, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 165回 )   18 - 18   2014年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • ファロー四徴症においてBlalock-Taussig shuntが肺動脈弁輪径および肺動脈成長に及ぼす影響

    杉本 愛, 高橋 昌, 白石 修一, 渡邉 マヤ, 土田 正則

    日本小児循環器学会雑誌   30 ( Suppl. )   s337 - s337   2014年6月

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    記述言語:日本語   出版者・発行元:(NPO)日本小児循環器学会  

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  • MDCTが有用であった大動脈基部置換術後仮性動脈瘤に対する再手術の2症例

    名村 理, 岡本 竹司, 青木 賢治, 佐藤 裕喜, 榛澤 和彦, 土田 正則

    日本血管外科学会雑誌   23 ( 2 )   507 - 507   2014年4月

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    記述言語:日本語   出版者・発行元:(NPO)日本血管外科学会  

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  • 若年性肺気腫に伴う巨大ブラを切除し著明な呼吸機能改善を得た1例

    小池 輝元, 白戸 亨, 佐藤 征二郎, 橋本 毅久, 土田 正則

    日本呼吸器外科学会雑誌   28 ( 3 )   1 - 8   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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  • 肺扁平上皮癌における幹細胞関連マーカー発現の検討

    佐藤 征二郎, 白戸 亨, 小池 輝元, 橋本 毅久, 土田 正則

    日本呼吸器外科学会雑誌   28 ( 3 )   O16 - 4   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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  • 嚢胞内吸引療法により人工呼吸器を離脱し手術することができた巨大気腫性肺嚢胞の1例

    橋本 毅久, 白戸 亨, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   28 ( 3 )   RV4 - 2   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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  • Kommerell憩室に対するTEVARの経験

    岡本 竹司, 横井 良彦, 佐藤 裕喜, 青木 賢治, 名村 理, 榛澤 和彦, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 164回 )   15 - 15   2014年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 胸膜浸潤におけるupstagingの妥当性について

    佐藤 征二郎, 白戸 亨, 小池 輝元, 橋本 毅久, 土田 正則

    日本外科学会雑誌   115 ( 臨増2 )   645 - 645   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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  • 化学療法後に完全切除した混合型胚細胞腫瘍の小児切除例

    土田 正則, 白戸 亨, 佐藤 征二郎, 小池 輝元, 橋本 毅久

    日本胸部外科学会関東甲信越地方会要旨集   ( 164回 )   27 - 27   2014年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 新生児期開心術後に気脳症を呈した一例

    杉本 愛, 高橋 昌, 白石 修一, 渡邉 マヤ, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 164回 )   16 - 16   2014年3月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 左側心臓弁術後の高度三尖弁閉鎖不全症再手術の問題点

    名村 理, 青木 賢治, 岡本 竹司, 上原 彰史, 佐藤 裕喜, 榛澤 和彦, 土田 正則

    日本心臓血管外科学会雑誌   43 ( Suppl. )   395 - 395   2014年1月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 小型非小細胞肺癌に対する標準手術としての根治縮小手術の妥当性に関する研究

    小池 輝元, 佐藤 征二郎, 橋本 毅久, 土田 正則

    新潟県医師会報   ( 766 )   8 - 9   2014年1月

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    記述言語:日本語   出版者・発行元:新潟県医師会  

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  • 側方開胸による体肺動脈短絡手術の手術成績の検討

    白石 修一, 高橋 昌, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本心臓血管外科学会雑誌   43 ( Suppl. )   487 - 487   2014年1月

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    記述言語:日本語   出版者・発行元:(NPO)日本心臓血管外科学会  

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  • 植え込み型除細動器(ICD)植え込みを行ったFallot四徴症術後症例の検討

    白石 修一, 高橋 昌, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本成人先天性心疾患学会雑誌   3 ( 1 )   61 - 61   2014年1月

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    記述言語:日本語   出版者・発行元:(一社)日本成人先天性心疾患学会  

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  • 2.血痰による無気肺にて呼吸不全に陥り人工呼吸管理を要した原発性気管支動脈蔓状血管腫の1例(第58回 日本呼吸器内視鏡学会北陸支部会)

    佐藤 美由紀, 野嵜 幸一郎, 朝川 勝明, 三浦 理, 茂呂 寛, 各務 博, 成田 一衛, 鈴木 榮一, 佐藤 征二郎, 小池 輝元, 土田 正則, 高野 徹

    気管支学   36 ( 4 )   441 - 441   2014年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.36.4_441_2

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  • ペメトレキセドを含むプラチナ併用化学療法により長期生存が得られた原発性心膜悪性中皮腫の1例 査読

    田中知宏, 才田優, 庄子聡, 野嵜幸一郎, 五十嵐夏恵, 佐藤昂, 岡島正明, 三浦理, 田中純太, 青木信将, 小屋俊之, 各務博, 成田一衛, 渡部聡, 吉澤弘久, 篠原博彦, 土田正則, 清水崇

    新潟医学会雑誌   127 ( 12 )   689 - 696   2013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)   出版者・発行元:新潟医学会  

    症例は71歳男性. 上縦隔腫瘤, 左胸水, 心嚢液貯留の精査目的に当科を紹介され入院した. 心嚢水セルブロック法による組織学的診断で上皮型原発性心膜悪性中皮腫と診断された. ペメトレキセドとプラチナ併用化学療法を計4コース施行し, stable diseaseが得られた. 2013年5月現在, 抗癌剤の最終投与日から約18か月間が経過し無増悪生存中である. 原発性心膜悪性中皮腫は稀であり, 標準治療は確立されていない. 本症例から, ペメトレキセドを含むプラチナ併用化学療法が有効である可能性が示唆された.

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    その他リンク: http://hdl.handle.net/10191/36221

  • 左巨大ブラを有する再発気胸に対する1手術例

    白戸 亨, 佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 163回 )   15 - 15   2013年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 両側肺動脈絞扼術後に根治術(動脈スイッチ+大動脈弓再建+心室内血流路作成)を行った両大血管右室起始・大動脈弓離断症の一例

    白石 修一, 高橋 昌, 渡邉 マヤ, 杉本 愛, 土田 正則

    日本胸部外科学会関東甲信越地方会要旨集   ( 163回 )   24 - 24   2013年11月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 小型肺癌に対する縮小手術の長期予後 CT上充実陰影を呈する小型非小細胞肺癌に対する肺葉切除と区域切除の長期予後比較

    小池 輝元, 白戸 亨, 佐藤 征二郎, 橋本 毅久, 篠原 博彦, 青木 正, 小池 輝明, 吉谷 克雄, 土田 正則

    肺癌   53 ( 5 )   380 - 380   2013年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 左肺上葉切除から12年後に同側再々手術として残存肺全摘術を施行した1例

    白戸 亨, 佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    肺癌   53 ( 5 )   675 - 675   2013年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 胸腺腫術後再発症例に対する治療経験

    佐藤 征二郎, 白戸 亨, 小池 輝元, 橋本 毅久, 土田 正則

    肺癌   53 ( 5 )   494 - 494   2013年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 抗GAD抗体陽性重症筋無力症合併胸腺腫の1解

    佐藤 征二郎, 土田 正則

    日本臨床外科学会雑誌 = The journal of the Japan Surgical Association   74 ( 8 )   2101 - 2105   2013年8月

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    記述言語:日本語   出版者・発行元:Japan Surgical Association  

    症例は75歳,男性.眼瞼下垂,複視,口周囲違和感を自覚し近医受診.抗Ach-R抗体陽性,テンシロンテスト陽性,胸部CTで前縦隔に56×30mm大の腫瘤を認め,重症筋無力症合併胸腺腫と診断された.また,短期間にて血糖値の上昇を認めたため,精査したところ血清抗GAD抗体51,000u/mlと強陽性であり1型糖尿病の合併と考えられた.重症筋無力症合併胸腺腫に対しては拡大胸腺摘出術を施行し,左腕頭静脈に浸潤を呈する正岡III期であった.病理組織学的にはtype B1胸腺腫であり,免疫染色ではGAD抗体に陽性を示した.術後はステロイドを導入し,筋無力症状の消失,抗Ach-R抗体および抗GAD抗体はともに減少傾向であるが,糖尿病の改善は認めていない.胸腺腫は重症筋無力症をはじめ種々の自己免疫疾患を合併するが,代表的な自己免疫疾患である1型糖尿病の合併は稀であり,過去の症例と併せて報告する.

    DOI: 10.3919/jjsa.74.2101

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    その他リンク: http://search.jamas.or.jp/link/ui/2014115092

  • Risk factor analysis of locoregional recurrence after sublobar resection in patients with clinical stage IA non-small cell lung cancer.

    Koike Terumoto, Koike Teruaki, Yoshiya Katsuo, Tsuchida Masanori, Toyabe Shin-ichi

    J Thorac Cardiovasc Surg   146 ( 2 )   372 - 378   2013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)  

    OBJECTIVE: Although lobectomy is the standard surgical procedure for operable non-small cell lung cancer (NSCLC), sublobar resection also has been undertaken for various reasons. The aim of this study was to identify risk factors of locoregional recurrence and poor disease-specific survival in patients with clinical stage IA NSCLC undergoing sublobar resection. METHODS: We retrospectively reviewed 328 patients with clinical stage IA NSCLC who underwent segmentectomy or wedge resection. Demographic, clinical, and pathologic factors were analyzed using the log-rank test as univariate analyses, and all factors were entered into a Cox proportional hazards regression model for multivariate analyses to identify independent predictors of locoregional recurrence and poor disease-specific survival. RESULTS: The 5- and 10-year locoregional recurrence-free probabilities were 84.8% and 83.6%, respectively, and the 5- and 10-year disease-specific survivals were 83.6% and 73.6%, respectively. Four independent predictors of locoregional recurrence were identified: wedge resection (hazard ratio [HR], 5.787), microscopic positive surgical margin (HR, 3.888), visceral pleural invasion (HR, 2.272),

    DOI: 10.1016/j.jtcvs.2013.02.057

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  • Risk factor analysis of locoregional recurrence after sublobar resection in patients with clinical stage IA non-small cell lung cancer 査読

    Terumoto Koike, Teruaki Koike, Katsuo Yoshiya, Masanori Tsuchida, Shin-ichi Toyabe

    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY   146 ( 2 )   372 - 378   2013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)   出版者・発行元:MOSBY-ELSEVIER  

    Objective: Although lobectomy is the standard surgical procedure for operable non-small cell lung cancer (NSCLC), sublobar resection also has been undertaken for various reasons. The aim of this study was to identify risk factors of locoregional recurrence and poor disease-specific survival in patients with clinical stage IA NSCLC undergoing sublobar resection.
    Methods: We retrospectively reviewed 328 patients with clinical stage IA NSCLC who underwent segmentectomy or wedge resection. Demographic, clinical, and pathologic factors were analyzed using the log-rank test as univariate analyses, and all factors were entered into a Cox proportional hazards regression model for multivariate analyses to identify independent predictors of locoregional recurrence and poor disease-specific survival.
    Results: The 5- and 10-year locoregional recurrence-free probabilities were 84.8% and 83.6%, respectively, and the 5- and 10-year disease-specific survivals were 83.6% and 73.6%, respectively. Four independent predictors of locoregional recurrence were identified: wedge resection (hazard ratio [HR], 5.787), microscopic positive surgical margin (HR, 3.888), visceral pleural invasion (HR, 2.272), and lymphatic permeation (HR, 3.824). Independent predictors of poor disease-specific survival were identified as follows: smoking status (Brinkman Index; HR, 1.001), wedge resection (HR, 3.183), microscopic positive surgical margin (HR, 3.211), visceral pleural invasion (HR, 2.553), and lymphatic permeation (HR, 3.223). All 4 predictors of locoregional recurrence also were identified as independent predictors of poor disease-specific survival.
    Conclusions: Segmentectomy should be the surgical procedure of first choice in patients with clinical stage IA NSCLC who are being considered for sublobar resection. Patients having tumors presenting with no suspicious of pleural involvement would be suitable candidates for sublobar resection.

    DOI: 10.1016/j.jtcvs.2013.02.057

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  • 間質性肺炎合併肺癌の術後急性増悪予測因子としての肺動脈圧評価

    小池 輝元, 湯山 聡子, 佐藤 征二郎, 橋本 毅久, 土田 正則

    日本呼吸器外科学会雑誌   27 ( 5 )   562 - 568   2013年7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  

    間質性肺炎(IP)合併肺癌手術例における肺動脈圧評価による術後IP急性増悪予測の可能性につき検討した。2001-12年に術前画像上IPを認めた肺癌切除例53例を対象とし、CT上肺動脈径(PA径)、肺動脈径/大動脈径比(PA/Ao比)、また、術前心エコーを行った14例では、推定肺動脈圧による肺動脈圧評価を行った。術後急性増悪を認めたAE(+)群5例と、認めなかったAE(-)群48例に分けて比較検討した。術前CT上PA径、PA/Ao比は2群間で差を認めなかったが、IPなしの対照症例と比較しPA径、PA/Ao比ともIP合併例で有意に高値であり、また、急性増悪後のPA径の拡大、PA/Ao比の増加が示された。心エコーによる推定肺動脈圧はAE(+)群で有意に高値であった。IP合併肺癌におけるCT上PA径、PA/Ao比の継時的変化の評価、心エコーでの肺動脈圧評価による術後急性増悪予測の可能性が示された。(著者抄録)

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J02256&link_issn=&doc_id=20130723260005&doc_link_id=10.2995%2Fjacsurg.27.562&url=https%3A%2F%2Fdoi.org%2F10.2995%2Fjacsurg.27.562&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  • Fontan completion after external stenting of the left bronchus and intrapulmonary artery septation for left pulmonary artery hypoplasia. 国際誌

    Shuichi Shiraishi, Masashi Takahashi, Maya Watanabe, Masanori Tsuchida

    Interactive cardiovascular and thoracic surgery   16 ( 5 )   698 - 700   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)  

    Tracheobronchial obstruction and unilateral hypoplasia of the pulmonary artery are serious barriers to successful Fontan completion. We describe a 5-year old girl with left bronchial obstruction, hypoplasia of the left pulmonary artery and a single ventricle (double inlet left ventricle). She had undergone external stenting to treat left bronchial stenosis at 3 years of age, bidirectional cavopulmonary anastomosis and Damus-Kaye-Stansel anastomosis at 4 years of age, intrapulmonary artery septation 1 year later and, finally, completion of the Fontan operation with excellent postoperative haemodynamics.

    DOI: 10.1093/icvts/ivt038

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  • 脈管浸潤(VI)とリンパ管浸潤(Ly)の組織分類別検討

    佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    日本呼吸器外科学会雑誌   27 ( 3 )   P07 - 04   2013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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  • 虚血性心疾患・心房細動合併肺癌患者の周術期管理と合併症

    橋本 毅久, 佐藤 征二郎, 小池 輝元, 土田 正則

    日本呼吸器外科学会雑誌   27 ( 3 )   P68 - 10   2013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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  • 充実陰影を呈する肺野末梢cT1aN0M0非小細胞肺癌に対する外科治療成績

    小池 輝元, 佐藤 征二郎, 橋本 毅久, 白戸 亨, 篠原 博彦, 吉谷 克雄, 小池 輝明, 鳥谷部 真一, 土田 正則

    日本外科学会雑誌   114 ( 臨増2 )   555 - 555   2013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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  • Surgical repair of aortico-left ventricular tunnel: report of two cases. 国際誌

    Shuichi Shiraishi, Masashi Takahashi, Maya Watanabe, Masanori Tsuchida

    Asian cardiovascular & thoracic annals   21 ( 1 )   67 - 70   2013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)  

    Two girls aged 1 and 15 years with heart murmurs were diagnosed with aortico-left ventricular tunnel. In the 1-year-old, the tunnel had an intracardiac aneurysm within the right ventricular outflow tract; both openings were closed The 15-year-old had no aneurysmal dilatation, but she had mild aortic regurgitation; the aortic opening of the tunnel was closed with a patch. Both girls had uneventful postoperative courses with excellent early results.

    DOI: 10.1177/0218492312443529

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  • Neuroprotection following mild hypothermia after spinal cord ischemia in rats 査読

    Takeshi Saito, Shino Saito, Hiroshi Yamamoto, Masanori Tsuchida

    JOURNAL OF VASCULAR SURGERY   57 ( 1 )   173 - 181   2013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:MOSBY-ELSEVIER  

    Objective: We examined the hypothesis that a 1 C reduction in body temperature would reduce gray and white matter injury induced by spinal cord ischemia in rats. In addition, we evaluated the relationship between reactive astrogliosis and gray or white matter injury after spinal cord ischemia with a 1 C reduction in body temperature or normothermia.
    Methods: Rats were randomly divided into hypothermia (1 C decrease in body temperature to 36.3 degrees C), normothermia (37.3 degrees C), and sham surgery groups (n = 6/group). Hypothermia was induced 15 minutes before ischemia and maintained during ischemia. Animals were then rewarmed to normothermia. Spinal cord ischemia was induced by a balloon catheter in the thoracic aorta, and the proximal mean arterial blood pressure was maintained at 40 mm Hg for 14 minutes. Hind limb motor function was assessed at 2, 7, 14, 21, and 28 days after reperfusion. At 28 days after reperfusion, gray matter damage was assessed by counting the number of normal motor neurons and white matter damage by the extent of vacuolation. The glial fibrillary acidic protein (GFAP)-positive area fraction (GFAP%) was determined in white and gray matter structures to measure reactive astrogliosis.
    Results: Compared with normothermia, hypothermia significantly improved hind limb function at all assessments (P &lt; .01) and increased numbers of normal gray matter motor neurons (39 +/- 20 vs 99 +/- 13, respectively; P &lt; .001), decreased the percentage area of white matter vacuolation (9.0% +/- 2.7% vs 1.6% +/- 1.3%, respectively; P = .001), and decreased the GFAP% in gray (P = .003) and white matter (P = .009).
    Conclusions: Prophylactic mild hypothermia (1 C reduction in body temperature) preserved hind limb motor function and reduced neuronal death, white matter vacuolation, and astrogliosis in gray and white matter induced by spinal cord ischemia in rats. Thus, mild hypothermia may be useful for perioperative management of thoracoabdominal aortic surgery. (J Vasc Surg 2013;57:173-81.)
    Clinical Relevance: Hypothermia (3 degrees-4 degrees C decrease in temperature) is known to protect the spinal cord from ischemia-reperfusion injury; however, hypothermia can also cause serious secondary complications. In this study, a 1 degrees C reduction in body temperature induced before spinal cord ischemia provided marked and persisting neuroprotection and reduced gliosis, without adverse effects. These data suggest that very mild hypothermia may be applied clinically to avoid systemic complications.

    DOI: 10.1016/j.jvs.2012.05.101

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  • 1.難治性気胸を合併した特発性肺線維症に, EWSを用いた気管支充填術を行った1例(第56回 日本呼吸器内視鏡学会北陸支部会)

    月岡 啓輔, 森山 寛史, 青木 信将, 岡島 正明, 小屋 俊之, 中山 秀章, 各務 博, 高田 俊範, 成田 一衛, 星野 芳史, 佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則, 鈴木 栄一, 大橋 和政, 小林 義昭

    気管支学   35 ( 4 )   460 - 460   2013年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.35.4_460_1

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  • 遠位弓部、下行大動脈、胸腹部大動脈瘤の重複瘤に対して開窓付きstentgraftを用いて一期的にTEVARを行った1症例

    岡本 竹司, 大久保 由華, 横井 良彦, 堀 祐郎, 青木 賢治, 名村 理, 榛澤 和彦, 土田 正則

    日本血管外科学会雑誌   21 ( 7 )   858 - 858   2012年12月

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    記述言語:日本語   出版者・発行元:(NPO)日本血管外科学会  

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  • 臨床病期IA期非小細胞肺癌に対する縮小手術後の局所再発関連因子解析

    小池 輝元, 佐藤 征二郎, 橋本 毅久, 土田 正則, 白戸 亨, 篠原 博彦, 吉谷 克雄, 小池 輝明

    肺癌   52 ( 5 )   578 - 578   2012年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 定位放射線治療後の転移性肺腫瘍再増大に対する1切除例

    橋本 毅久, 佐藤 征二郎, 小池 輝元, 土田 正則, 川口 弦

    肺癌   52 ( 6 )   978 - 978   2012年10月

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  • 抗凝固・抗血小板療法中の肺癌患者の周術期管理

    橋本 毅久, 佐藤 征二郎, 小池 輝元, 土田 正則

    肺癌   52 ( 5 )   679 - 679   2012年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • 肺大細胞神経内分泌癌に対する外科治療

    小池 輝元, 佐藤 征二郎, 橋本 毅久, 斎藤 正幸, 吉谷 克雄, 小池 輝明, 土田 正則

    肺癌   52 ( 5 )   598 - 598   2012年10月

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    記述言語:日本語   出版者・発行元:(NPO)日本肺癌学会  

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  • ECMOを使用した呼吸器外科手術症例の経験

    白戸 亨, 篠原 博彦, 橋本 毅久, 土田 正則

    日本呼吸器外科学会雑誌   26 ( 3 )   P36 - 06   2012年4月

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  • 肺分画症に対する区域切除術

    橋本 毅久, 白戸 亨, 篠原 博彦, 土田 正則

    日本呼吸器外科学会雑誌   26 ( 3 )   V20 - 05   2012年4月

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  • 7. 血管塞栓用コイルにて治癒した術後気管支断端瘻の1例(第54回 日本呼吸器内視鏡学会北陸支部会)

    篠原 博彦, 橋本 毅久, 白戸 亨, 土田 正則

    気管支学   34 ( 4 )   408 - 408   2012年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.34.4_408_2

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  • O2-3 当科での肺切除における気管支断端瘻発症例の検討(外科手術1,一般口演2,第35回日本呼吸器内視鏡学会学術集会)

    篠原 博彦, 橋本 毅久, 白戸 亨, 土田 正則

    気管支学   34   S139   2012年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.34.Special_S139_3

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  • 6.右肺癌に対し下葉切除後,早期に気管浮腫による狭窄を来し気管切開を要した1例(第53回 日本呼吸器内視鏡学会北陸支部会)

    篠原 博彦, 橋本 毅久, 白戸 亨, 土田 正則

    気管支学   34 ( 1 )   89 - 89   2012年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.34.1_89

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  • 新潟県における肺がんの解析

    小池 輝明, 吉谷 克雄, 篠原 博彦, 白戸 亨, 横山 晶, 竹之内 辰也, 土田 正則, 鳥谷 部真一, 山崎 理, 若月 道秀

    肺癌   52 ( 7 )   1001 - 1006   2012年

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    記述言語:日本語   出版者・発行元:The Japan Lung Cancer Society  

    <b>目的</b>.本邦肺がんの罹患,治療成績,生存率に関する統計は,それぞれ異なる集団を対象としている.一定の対象集団における罹患・病態・治療成績・生存率について検討した.<b>対象と方法</b>.新潟県地域がん登録資料と肺がん手術登録資料より1991年以降の変動を解析した.<b>結果</b>.新潟県は本邦と同様,悪性新生物が死亡原因の第一位で,臓器別死亡原因でも肺がんが第一位であり,年齢調整罹患率も全国値と近似していた.肺がん全体の生存率は年代とともに上昇し,2000~'04年診断例では29.0%に改善した.生存率の改善は,小型で早期の肺がんが増加し,これらを外科治療で対処したことが主たる要因と推察された.<b>結語</b>.新潟県においては,年代に伴い小型で早期の肺がん増加による生存率の改善傾向を認めた.<br>

    DOI: 10.2482/haigan.52.1001

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  • Reduction of Spinal Cord Ischemia/Reperfusion Injury with Simvastatin in Rats 査読

    Takeshi Saito, Masanori Tsuchida, Shino Umehara, Tatsuro Kohno, Hiroshi Yamamoto, Jun-ichi Hayashi

    ANESTHESIA AND ANALGESIA   113 ( 3 )   565 - 571   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:LIPPINCOTT WILLIAMS & WILKINS  

    BACKGROUND: Surgery of the thoracic or thoracoabdominal aorta may cause spinal cord ischemia and subsequent paraplegia. However, conventional strategies for preventing paraplegia due to spinal cord ischemia provide insufficient protection and cause additional side effects. We hypothesized that simvastatin, a drug recently shown to be neuroprotective against brain ischemia/reperfusion, would be neuroprotective in a rat spinal cord ischemia/reperfusion model.
    METHODS: Rats were randomly assigned to simvastatin, vehicle, or sham-surgery (sham) groups (n = 6 per group). Simvastatin (10 mg/kg) or vehicle was administered subcutaneously once daily for 7 days before aortic balloon occlusion, and once at 24 hours after reperfusion. Spinal cord ischemia was induced by balloon inflation of a 2F Fogarty catheter in the thoracic aorta, and the proximal mean arterial blood pressure was maintained at 40 mm Hg for 12 minutes. The sham group received the same operation without inflation of the balloon. Ischemic injury was assessed by hindlimb motor function using the Motor Deficit Index score at 6 to 48 hours after ischemic reperfusion, and histological assessment of the spinal cord was performed 48 hours after reperfusion.
    RESULTS: The Motor Deficit Index scores at 24 and 48 hours after reperfusion were significantly improved in the simvastatin group compared with the vehicle group (P = 0.021 and P = 0.023, respectively). Furthermore, there were significantly more normal motor neurons in the simvastatin group than in the vehicle group (P = 0.037). The percentage area of white matter vacuolation was significantly smaller in the simvastatin group than in the vehicle group (P = 0.030).
    CONCLUSIONS: Simvastatin treatment can attenuate hindlimb motor dysfunction and histopathological changes in spinal cord ischemia/reperfusion injury in rats. (Anesth Analg 2011; 113: 565-71)

    DOI: 10.1213/ANE.0b013e318224ac35

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  • 当科での胸膜肺全摘術症例の検討

    篠原 博彦, 土田 正則, 橋本 毅久, 林 純一

    日本呼吸器外科学会雑誌   25 ( 3 )   P52 - 06   2011年4月

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  • 同時性両側肺癌に対する右上葉切除後の左胸腔鏡下上区切除術 3DCTによる血管把握の有用性

    橋本 毅久, 土田 正則, 三村 慎也, 篠原 博彦, 林 純一

    日本呼吸器外科学会雑誌   25 ( 3 )   RV07 - 01   2011年4月

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  • Operative treatment for metachronous pulmonary metastasis from esophageal carcinoma 査読

    Hiroshi Ichikawa, Shin-ichi Kosugi, Satoru Nakagawa, Tatsuo Kanda, Masanori Tsuchida, Teruaki Koike, Otsuo Tanaka, Katsuyoshi Hatakeyama

    SURGERY   149 ( 2 )   164 - 170   2011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)   出版者・発行元:MOSBY-ELSEVIER  

    Background. The clinical significance of operative treatment for metachronous pulmonary metastasis from esophageal carcinoma is unclear.
    Methods. We retrospectively reviewed 23 consecutive patients who underwent operative resection for metachronous pulmonary metastasis from esophageal carcinoma from 1991 to 2008. Patient baseline characteristics, survival probability, and prognostic factors were analyzed. The median follow-up period was 31 months for surviving patients.
    Results. There were 19 men and 4 women, with a median age of 66 years at the time of pulmonary resection. The median disease-free interval was 15.5 months. Cervical or mediastinal lymph node metastases preceded pulmonary metastases in 4 patients. Seven patients (30.4%) had multiple metastases with a maximum number of 4. The median operative time and blood loss were 94.5 minutes and 18 mL, respectively. The median length of postoperative stay was 12.5 days. The predicted 1-, 3-, and 5-year survival rates using the Kaplan-Meier method were 73.9%, 43.5%, and 43.5%, respectively, with a median survival time of 28.7 months. Univariate analysis revealed that an extrapulmonary metastasis as the initial recurrence site was an unfavorable prognostic factor (P = .0411). Multivariate analyses, however, did not identify the initial recurrence site as an independent prognostic factor (P =. 0542).
    Conclusion. Operative resection for metachronous pulmonary metastasis from esophageal carcinoma is an acceptable treatment. This study of a limited number of patients may have created a constitutional selection bias. An antecedent extrapulmonary metastasis was found to be an unfavorable prognostic factor. (Surgery 2011;149:164-70.)

    DOI: 10.1016/j.surg.2010.07.047

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  • The predominant expression of hepatocyte nuclear factor 4α (HNF4α) in thyroid transcription factor-1 (TTF-1)-negative pulmonary adenocarcinoma. 査読

    Kunii R, Jiang S, Hasegawa G, Yamamoto T, Umezu H, Watanabe T, Tsuchida M, Hashimoto T, Hamakubo T, Kodama T, Sasai K, Naito M

    Histopathology   58 ( 3 )   467 - 476   2011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)   出版者・発行元:3  

    DOI: 10.1111/j.1365-2559.2011.03764.x

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  • [Surgical treatment for metachronous lung cancer]. 査読

    Shinohara H, Tsuchida M, Hashimoto T, Hayashi J

    Kyobu geka. The Japanese journal of thoracic surgery   63 ( 11 )   952 - 955   2010年10月

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  • Primary thymic adenocarcinoma coexisting with type AB thymoma: A rare case with long-term survival 査読

    Yasuko Hosaka, Masanori Tsuchida, Hajime Umezu, Tadaaki Eimoto, Takehisa Hashimoto, Hirohiko Shinohara, Jun-Ichi Hayashi

    General Thoracic and Cardiovascular Surgery   58 ( 9 )   488 - 491   2010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:9  

    Thymic carcinoma is a rare tumor. The most common histological subtype is squamous cell carcinoma, and only a few cases of thymic adenocarcinoma have been reported. A case of papillary adenocarcinoma of thymic origin that coexisted with type AB thymoma as a separate nodule is presented herein. The patient was found to have an abnormal mediastinal shadow on chest X-ray. A computed tomography scan revealed a round, 6.5-cm-diameter mass in the right anterior mediastinum. The preoperative diagnosis was thymoma, and thymothymectomy was performed. On pathological examination, two tumors, which were diagnosed as papillary adenocarcinoma and type AB thymoma, respectively, were present in the thymus without any connection with each other. The patient has been alive without any signs of recurrence for 11 years after surgery. We diagnosed the adenocarcinoma in this case was a primary thymic carcinoma. © 2010 The Japanese Association for Thoracic Surgery.

    DOI: 10.1007/s11748-009-0580-4

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  • Endobronchial metastasis from adenocarcinoma of gastric cardia 7 years after potentially curable resection. 査読 国際誌

    Hanyu T, Kanda T, Matsuki A, Hasegawa G, Yajima K, Tsuchida M, Kosugi S, Naito M, Hatakeyama K

    World journal of gastrointestinal surgery   2 ( 8 )   270 - 274   2010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)   出版者・発行元:8  

    DOI: 10.4240/wjgs.v2.i8.270

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  • 閉塞性換気障害を合併した肺門型扁平上皮癌に対して気管支形成を伴う区域切除を行った3例

    長澤 綾子, 土田 正則, 橋本 毅久, 篠原 博彦, 林 純一

    日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery   24 ( 2 )   229 - 235   2010年3月

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    記述言語:日本語   出版者・発行元:The Japanese Association for Chest Surgery  

    閉塞性換気障害を有する肺門型扁平上皮癌3症例に対して,気管支形成を伴う区域切除を行った.全例男性で年齢は66~72歳.術前1秒量(1秒率)は各々1,070ml(37.8%),1,020ml(41.0%),1,240ml(51.2%)で,標準手術では術後予測1秒量が700ml/m<SUP>2</SUP>以下と予測されたため呼吸機能温存を目的として縮小手術を選択した.右下葉B<SUP>6</SUP>病変には気管支形成を伴うS<SUP>6</SUP>区域切除を,左上区病変には上区管状区域切除を,左B<SUP>1+2</SUP>病変には左S<SUP>1+2</SUP>管状区域切除を行った.術後病期は各々I B,II B,I Aで,予後は術後81ヵ月,50ヵ月非担癌生存,36ヵ月他病死で局所再発はなかった.

    DOI: 10.2995/jacsurg.24.229

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  • Masaoka Stage and Histologic Grade Predict Prognosis in Patients With Thymic Carcinoma 査読

    Yasuko Hosaka, Masanori Tsuchida, Shin-ichi Toyabe, Hajime Umezu, Tadaaki Eimoto, Jun-ichi Hayashi

    ANNALS OF THORACIC SURGERY   89 ( 3 )   912 - 917   2010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  

    Background. Thymic carcinoma is a rare tumor. Limited data are available regarding the effectiveness of treatment and the prognosis of thymic carcinoma. The present study aimed to clarify the prognostic factors in patients who underwent resection.
    Methods. The study retrospectively reviewed 21 patients (15 men, 6 women) with thymic carcinoma who had undergone resection at Niigata University Hospital.
    Results. Masaoka stage was II in 4 patients, III in 9, IVa in 2, and IVb in 6. Histologic subtypes were squamous cell carcinoma in 14 patients, adenocarcinoma in 2, atypical carcinoid in 3, and undifferentiated carcinoma in 2. Histologic grade by degree of differentiation was low in 4 tumors, intermediate in 12, and high in 5. Treatment comprised resection alone in 6 patients and resection along with multimodal therapies in 15. Complete resection was achieved in 14 (67%). Eight patients died of tumor. Recurrence was documented in 7 of 14 patients with complete resection, and 5 received additional treatment. The overall 5-year survival rate was 61.1%, and the disease-free 5-year survival rate was 66.8% for the 14 with complete resection. By multivariate analysis, Masaoka stage and histologic grade were significant independent prognostic factors for overall survival.
    Conclusions. The surgical outcome of patients with thymic carcinoma depends on the Masaoka stage and histologic grade. Patients with early Masaoka stage and low or intermediate histologic grade had favorable prognoses. (Ann Thorac Surg 2010;89:912-7) (C) 2010 by The Society of Thoracic Surgeons

    DOI: 10.1016/j.athoracsur.2009.11.057

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  • [Induction chemoradiation followed by resection through anterior approach for superior sulcus tumor]. 査読

    Tsuchida M, Hashimoto T, Shinohara H, Hosaka Y, Satoh S, Shirato T, Kitahara A, Hayashi J

    Kyobu geka. The Japanese journal of thoracic surgery   63 ( 1 )   29 - 33   2010年1月

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  • Protective mechanism of ultrafiltration against cardiopulmonary bypass-induced lung injury

    Koike T, Tsuchida M, Saitoh M, Haga M, Satoh K, Aoki T, Toyabe SI, Hayashi JI

    Transplant Proc   41 ( 9 )   3845 - 3848   2009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)  

    DOI: 10.1016/j.transproceed.2009.04.010

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  • Large bronchial granular cell tumor 査読

    Hirohiko Shinohara, Masanori Tsuchida, Takehisa Hashimoto, Seijirou Satoh, Mariko Takeshige, Jun-Ichi Hayashi

    General Thoracic and Cardiovascular Surgery   57 ( 9 )   484 - 487   2009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:9  

    We report a 20-year-old woman who underwent complete resection of a granular cell tumor (GCT). On chest computed tomography (CT) scan, a mass with a maximum diameter of 36 mm at the lower bronchus with atelectasis of the right lower lobe was noted. Bronchoscopic examination revealed a whitish mass in the truncus intermedius, and the middle and lower bronchus were unable to be seen. A cytopathological examination of the mass revealed GCT. A right middle and lower lobectomy was performed via a posterolateral thoracotomy. Microscopically, the tumor was composed of polygonal cells with oxyphilic granular cytoplasm and small ovoid nuclei. The cytoplasm of the neoplastic cells was positive for S-100 protein and neuron-specific enolase. The patient's postoperative course was uneventful, and she was asymptomatic after 4 months. A large bronchial GCT is rare, which is why we report this case. © 2009 The Japanese Association for Thoracic Surgery.

    DOI: 10.1007/s11748-009-0428-y

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  • Superior vena cava reconstruction via a posterolateral thoracotomy without venous occlusion for locally advanced lung cancer: Report of a case 査読

    Hirohiko Shinohara, Masanori Tsuchida, Takehisa Hashimoto, Seijirou Satoh, Ai Takeuchi, Mariko Takeshige, Jun-ichi Hayashi

    SURGERY TODAY   39 ( 9 )   787 - 789   2009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  

    We performed a right upper lobectomy with prosthetic replacement of the superior vena cava (SVC) through a posterolateral thoracotomy in a 65-year-old man undergoing complete resection of a locally advanced non-small-cell lung cancer with invasion of the SVC. Instead of using a vascular shunt, the right atrium and a right brachiocephalic vein (BCV) were anastomosed using a ringed polytetrafluoroethylene (PTFE) graft. During the anastomosis, vascular flow was maintained through the left BCV. By using this technique, SVC resection and reconstruction during lung cancer surgery can be safely performed through a posterolateral thoracotomy without blood flow interruption.

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  • Analysis of resected primary lung cancer in Niigata Prefecture in 2001 査読

    Masaaki Inoue, Teruaki Koike, Takehiro Watanabe, Kenichi Togashi, Atsushi Fujita, Masanori Tsuchida, Tadashi Aoki, Shinpei Yoshii, Jun-Ichi Hayashi

    Japanese Journal of Lung Cancer   49 ( 2 )   174 - 182   2009年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Objective. To improve surgical related mortality, Niigata Chest Surgery Group registered primary lung cancer patients who were operated on in 2001 and prospectively analyzed these patients. Patients. A total of 558 primary lung cancer patients underwent resection between January 2001 and December 2001. Results. There were 352 men (63.1%) and 206 women (36.9%), with an overall median age of 66.7 years. The overall 5-year survival rate was 65.1%, 55.8% in men and 80.9% in women. Complications related to operations were observed in 37 cases (6.6%) and the operative mortality was 0.7% (4 cases). The 5-year survival rates, in relation to reason for detection were as follows: Screening group (n = 284)
    75.5%, Other disease group (n = 175)
    57.3%, Symptomatic group (n = 99)
    48.8%. The 5-year survival rates estimated by p-stage were: IA (n = 297)
    79.9%, IB (n = 124)
    67.4%, IIA (n = 16)
    66.7%, IIB (n = 40)
    27.5%, IIIA (n = 47)
    32.7%, IIIB (n = 21)
    23.8%, IV (n = 13)
    0.0%. The 5-year survival rates according to histologic type were: adenocarcinoma 69.5% (n = 388), squamous cell carcinoma 52.1% (n = 128), large cell carcinoma 61.5% (n = 13), small cell carcinoma 71.4% (n = 7), carcinoid 62.5% (n = 8), and others 64.3% (n = 14). Conclusion. We determined the characteristics of lung cancer patients and the results of their operative treatment in Niigata Prefecture. We anticipate registering more lung cancer patients to expand this database of patients. The availability of this database should help to improve the lung cancer treatment in Niigata Prefecture. © 2009 The Japan Lung Cancer Society.

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  • Expression of 5-fluorouracil-related enzymes in lung cancer: ELISA characterizes enzyme activity and messenger RNA expression 査読

    Masanori Tsuchida, Yasushi Yamato, Takehisa Hashimoto, Hirohiko Shinohara, Hajime Umezu, Katsuo Yoshiya, Teruaki Koike, Jun-Ichi Hayashi

    ONCOLOGY REPORTS   21 ( 4 )   1037 - 1043   2009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:SPANDIDOS PUBL LTD  

    The enzymes thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD) and orotate phosphoribosyl transferase (OPRT) are involved in the metabolism of the anticancer drug 5-fluorouracil (FU). Expression of TS, DPD and OPRT in cancer tissue has been reported to be associated with sensitivity and/or resistance to 5-FU therapy. However, the role of TS, DPD and OPRT expression in lung cancer has not been fully established. Furthermore, among several measuring methods, it is not clear which method effectively predicts the response to 5-FU therapy. The aim of this study was to analyze the expression of 5-FU-related enzymes using enzyme-linked immunosorbent assay (ELISA) and to examine the correlation of ELISA and the results obtained using different measuring methods such as reverse transcript polymerase chain reaction (RT-PCR), immunohistochemistry, and enzymatic activity. Lung cancer specimens were obtained from 134 patients who underwent curative resection for lung cancer. As a pilot study, enzyme expression of 11 samples was measured using 4 different methods for DPD: RT-PCR, immunohistochemistry, enzymatic activity and ELISA. The relationships between pairs of results were compared, and then enzyme protein expression was measured using ELISA in 119 patients with adenocarcinoma. Of the 4 independent methods, the highest correlation was observed between protein expression measured by ELISA and enzyme activity. The correlation of gene expression and ELISA was also significant. The protein level in stage I adenocarcinoma measured using ELISA was 13.0+/-24.8 ng/mg protein for TS, 362.2+/-264.3 ng/mg protein for DPD and 4.5+/-2.0 ng/mg protein for OPRT. The predictive value of the enzymes for prognosis and the effectiveness of 5-FU was not determined as few recurrences were observed during the short follow-up period. In conclusion, ELISA is a simple and reliable method to measure key enzymes related to 5-FU therapy.

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  • Absence of gene mutations in KIT-positive thymic epithelial tumors 査読

    Masanori Tsuchida, Hajime Umezu, Takehisa Hashimoto, Hirohiko Shinohara, Terumoto Koike, Yasuko Hosaka, Tadaaki Eimoto, Jun-ich Hayashi

    LUNG CANCER   62 ( 3 )   321 - 325   2008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:ELSEVIER IRELAND LTD  

    Background: Overexpression of KIT, a tyrosine kinase receptor protein encoded by the protooncogene c-kit, is observed in human neoplasms such as gastrointestinal stromal. tumors (GISTs), myetoproliferative disorders, melanoma and seminoma. In patients with GIST, overexpression of mutated KIT within the tumor is predictive of response to molecular targeted therapy using imatinib. However, the rote of KIT expression in thymic carcinoma is not fully understood.
    Methods: Thymic epithelial. tumors from 37 patients (17 thymic carcinomas and 20 thymomas) were examined. Immunohistochemical staining with anti-KIT polyclonal antibody and anti-CD5 was performed. Mutation analyses in the juxtamembrane domains, exons 9 and 11, and in the tyrosine kinase domains, exons 13 and 17, were undertaken using polymerase chain reaction (PCR) and direct DNA sequencing in KIT-positive samples.
    Results: KIT- and CD5-positive staining was observed only in thymic carcinoma. Percentage of positive staining was 100% in squamous cell carcinoma, with no positive staining in other histologies, including atypical carcinoid. Mutation analysis of the KIT gene was performed in 11 squamous cell carcinomas, 1 adenocarcinoma and 1 adenosquamous ceit carcinoma. None of the tested samples showed mutations in any of the four exons.
    Conclusions: Squamous cell carcinoma of the thymus frequently expressed KIT and CD5 proteins, whereas other tumors did not. Unlike GIST, overexpression of KIT does not necessarily indicate gene mutation in thymic carcinoma. KIT and CD5 appear useful for evaluating and subtyping thymic epithelial, tumors. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

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  • NSAIDs胃潰瘍を併発した超高齢者における歯性降下性壊死性縦隔炎の1例

    児玉 泰光, 小野 和宏, 嵐山 貴徳, 大関 康志, 土田 正則, 高木 律男

    日本口腔外科学会雑誌   54 ( 9 )   541 - 545   2008年9月

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    記述言語:日本語   出版者・発行元:社団法人 日本口腔外科学会  

    We describe an 88-year-old woman with gas-forming submental cellulitis in whom nonsteroidal antiinflammatory drug (NSAID)-induced gastric ulcer led to hemorrhagic shock during treatment of an odontogenic infection. Hemodynamic treatment had to take priority, and intensive treatment for inflammation could not be performed. This apparently led to the development of descending necrotizing mediastinitis. During the six days of hospitalization, she took a total of 6 tablets of loxoprofen sodium (60 mg) and 1 diclofenac sodium suppository (25 mg) for analgesia after treatment.&lt;BR&gt;Retrospectively, if decisive and aggressive treatment for inflammation had been performed earlier after hospitalization, inflammation may have resolved sooner. Our experience reconfirms that the initial treatment of odontogenic infection is extremely important in very elderly patients. Even if NSAIDs are received for a short period of time in small doses, gastrointestinal hemorrhage can occur, as in our patient. Patients at high risk for gastrointestinal ulcer should receive prophylactic treatment with cyclo-oxygenase 2 inhibitors orproton pump inhibitors.Generally, very elderly patients have a high risk of complications because of considerable age-related declines in physical ability and functional reserve of organs. Very cautious treatment is therefore necessary.

    DOI: 10.5794/jjoms.54.541

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  • Segmentectomy for multiple adenocarcinoma presenting as ground-glass opacities after lung cancer surgery 査読

    Ai Takeuchi, Masanori Tsuchida, Takehisa Hashimoto, Hirohiko Shinohara, Jun-Ichi Hayashi

    General Thoracic and Cardiovascular Surgery   56 ( 8 )   410 - 412   2008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)  

    During follow-up of patients after primary lung cancer resections, small nodules or ground-glass opacities (GGOs) are sometimes detected on chest computed tomography. We report a case with multiple GGOs that were noted after primary lung cancer resection. A 76-year-old woman, who had undergone right upper lobectomy, middle lobe partial resection, and mediastinal lymph node dissection 3 years earlier, was admitted owing to five GGOs in the right lower lobe that had been increasing in size or density. A right S6+10 segmentectomy was performed. On histology, one adenocarcinoma and four bronchioloalveolar carcinomas (BACs), as well as two additional BACs that had not been detected preoperatively, were identified. No complications occurred postoperatively. Three years 4 months later, no tumor recurrence or new lesions have been found. Given the high possibility of malignancy, the appearance of new GGOs in patients with a history of lung cancer requires appropriate investigation. © 2008 The Japanese Association for Thoracic Surgery.

    DOI: 10.1007/s11748-008-0257-4

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  • A resected case of mediastinal hemangiopericytoma 査読

    Seijiro Sato, Masanori Tsuchida, Mariko Takeshige, Hirohiko Shinohara, Takehisa Hashimoto, Yoichi Ajioka, Kenzo Hiroshima

    Japanese Journal of Lung Cancer   48 ( 4 )   339 - 340   2008年8月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2482/haigan.48.339

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  • Electroporation-mediated transfer of plasmid DNA encoding IL-10 attenuates orthotopic tracheal allograft stenosis in rats 査読

    Masanori Tsuchida, Terumoto Koike, Masaru Takekubo, Hiroyuki Hirahara, Haruo Hanawa, Hiroki Maruyama, Jun-ichi Miyazaki, Jun-ichi Hayashi

    TRANSPLANT IMMUNOLOGY   19 ( 3-4 )   173 - 177   2008年7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 BV  

    Background: Electroporation has been shown to increase the efficacy of intramuscular injection of plasmid DNA, resulting in a higher level of foreign gene expression. Using this technique, we examined the effect of viral IL-10 gene transfer on the prevention of tracheal allograft stenosis in an animal model.
    Methods: On the day of tracheal transplantation, recipient Lewis rats were intramuscularly injected with either plasmid pCAGGS-LacZ or plasmid pCAGGS-viral IL-10, followed immediately by electroporation. Tracheas from Brown Norway donors were transplanted into the backs of Lewis recipients, and the histology of the grafts were assessed 2 and 4 weeks after transplantation.
    Results: The serum level of IL-10 peaked at 2000 pg/ml one day after injection: the level then slowly decreased, but was maintained above 1000 pg/ml until 8 days after injection. At Day 28, the airway lumina of the tracheal allografts were almost completely obliterated by fibroproliferative tissue in the control pCAGGS-LacZ-treated rats. In rats injected once with pCAGGS-viral IL-10, luminal obliteration was significantly decreased compared with the control pCAGGS-LacZ-treated rats (mean luminal opening 46.8% vs 0% p&lt;0.05). The loss of epithelial cells lining the airway was also decreased in the IL-10-treated group (mean epithelial coverage 42% vs 5% p&lt;0.05). Multiple injections with pCAGGS-viral IL-10 did not further improve the histological changes.
    Conclusion: IL-10 gene transfer by intramuscular injection using electroporation attenuated tracheal allograft stenosis associated with mild epithelial injury. (C) 2008 Elsevier B.V. All rights reserved.

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  • 3ヶ所の亜区域支閉塞を認めた気管支閉鎖症の1切除例

    白戸 亨, 長澤 綾子, 杉本 愛, 保坂 靖子, 小池 輝元, 篠原 博彦, 橋本 毅久, 土田 正則, 林 純一

    日本胸部外科学会関東甲信越地方会要旨集   ( 146回 )   26 - 26   2008年6月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 乳癌術後・放射線治療後の胸骨・肋骨骨髄炎に対し胸壁切除および広背筋皮弁による充填術を行った一例

    篠原 博彦, 土田 正則, 橋本 毅久, 佐藤 征二郎, 武内 愛, 竹重 麻里子, 林 純一

    日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery   22 ( 4 )   91 - 94   2008年5月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人日本呼吸器外科学会  

    症例は65歳女性,44歳時より慢性腎不全に対し透析を導入されていた.41歳時に右乳癌に対し根治的切除術および放射線治療,化学療法を施行された.その後前胸部に皮膚潰瘍が出現し,保存的に加療されていたが63歳頃より肋骨が露出し,出血と骨髄炎を認めるようになったため手術を行った.第2・3・4肋骨と胸骨の一部を切除し,広背筋皮弁を充填した.胸壁の補強は特に行わなかった.術後は筋皮弁の感染や壊死を認めず,軽快退院した.現在まで骨髄炎の再燃は認めていない.乳癌術後の放射線治療により皮膚潰瘍が生じ,時には胸壁深部に到る骨髄炎を引き起こすことが知られている.壊死組織の十分なデブリードメントと血行豊富な筋皮弁充填を行うことにより,良好な経過を得ることができた.

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  • Hydrodynamics-based delivery of plasmid DNA encoding CTLA4-Ig prolonged cardiac allograft survival in rats. 査読

    Takekubo M, Tsuchida M, Haga M, Saitoh M, Hanawa H, Maruyama H, Miyazaki J, Hayashi J

    The journal of gene medicine   10 ( 3 )   290 - 297   2008年3月

  • Influence of normothermic cardiopulmonary bypass on body oxygen metabolism during lung transplantation 査読

    Koichi Sato, Masanori Tsuchida, Masayuki Saito, Terumoto Koike, Jun-Ichi Hayashi

    ASAIO JOURNAL   54 ( 1 )   73 - 77   2008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:LIPPINCOTT WILLIAMS & WILKINS  

    Studies have demonstrated that cardiopulmonary bypass (CPB) adversely affects pulmonary circulation, which is involved in metabolism in the lung, and that pulmonary circulation after CPB can restore the prostaglandin E2 (PGE2) level mainly standing for levels of key vasostimulators augmented during CPB, which may influence systemic tissue perfusion and body oxygen metabolism. However, in lung transplantation (Lx), pulmonary circulation is restored to the graft, which might induce another CPB reaction. We prospectively examined the influence of CPB on body oxygen metabolism in Lx. Left Lx was successfully performed on 10 dogs (group-on: with normothermic CPB without cardiac arrest, group-off. without CPB; n = 5 vs. 5). At 30 minutes after graft perfusion, the right pulmonary artery and bronchus were clamped. Body weight, donor-to-recipient body weight ratio, and clinical parameters were comparable between the two groups, except for the hematocrit level during CPB. At 90 minutes after graft perfusion, mixed venous oxygen saturation (SVO2) was lower (p &lt; 0.01) and 02 extraction rate (p &lt; 0.01), PGE2 (p = 0.025), and arterial blood ketone body ratio (KBR) (p &lt; 0.01) were higher in group-on than in group-off, whereas these parameters were comparable before graft perfusion between the two groups. 02 consumption and acetic acid were higher in group-on than in group-off, whereas 0, delivery and 3-hydroxy propioic acid were comparable between the groups. In conclusion, Lx during CPB may induce a new inflammatory reaction and influence body oxygen metabolism, contrary to the restoration of pulmonary circulation after CPB.

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  • Pretreatment with olprinone hydrochloride, a phosphodiesterase III inhibitor, attenuates lipopolysaccharide-induced lung injury via an anti-inflammatory effect 査読

    Terumoto Koike, Muhammad Nadeen Qutab, Masanori Tsuchida, Masaru Takekubo, Masayuki Saito, Jun-ichi Hayashi

    PULMONARY PHARMACOLOGY & THERAPEUTICS   21 ( 1 )   166 - 171   2008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:ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD  

    Purpose: Acute respiratory distress syndrome is characterized by neutrophil accumulation in the lungs and the activation of several cytokines produced by macrophages. Olprinone hydrochloride, a specific phosphodiesterase III inhibitor, has anti-inflammatory effects and inhibits the activation of macrophages, in addition to its inotropic and vasodilatory effects. The purpose of this study was to examine the beneficial effects of olprinone on lipopolysaccharide (LPS)-induced pulmonary inflammation.
    Materials and methods: Lung inflammation was produced by intravenous LPS injection into rats. The rats were divided into four groups: it vehicle group in which normal saline wits injected, an olprinone group in which olprinone was injected at it dose of 0.2 mg/kg, a dexamethasone group in which dexamethasone was injected at a dose of 5 mg/kg, and a control group. In each group, drug was injected intraperitoneally 30 min before the intravenous administration of LPS. The blood was obtained at I h and then animals were sacrificed at 6h and blood and ling specimen were obtained for cytokine analysis and pathological examination. On another set of experiment, bronchioloalveolar lavage (BAL) was performed for cytokine analysis of BAL fluid. The macrophages isolated from normal rat by BAL were Cultured in vitro with the presence of LPS and olprinone or dexamethasone. and supernatant was collected. The levels of several cytokines in the serum, in the BAL fluid, and in the culture supernatant were determined.
    Results: The animals injected with LPS were found to have an influx of neutrophils in the lungs, and inflammatory cytokines, such as TNF-alpha and IL-6, and anti-inflammatory cytokine IL-10 were produced. Pretreatment with olprinone or dexamethasone significantly inhibited the LPS-induced neutrophil influx into the lungs, suppressed inflammatory cytokines TNF-alpha and IL-6. The level of anti-inflammatory cytokine IL-10 increased in an olprinone group. The inhibition of TNF-alpha and IL-6, and the augmentation of IL-10 release were also observed in in vitro culture of isolated rat alveolar macrophages when olprinone (10(-5) mol/ml) and LPS (10 mu g/ml) were cultured together. However, the level of IL-10 in serum and Culture Supernatant Was Suppressed in a dexamesathone group.
    Conclusion: LPS-induced lung inflammation is strongly inhibited by olprinone accompanying the enhancement of IL-10 and the inhibition of inflammatory cytokines. Results of the in vitro experiment suggest that alveolar macrophages may play an important role in ameliorating LPS-induced lung inflammation and the mechanism of its effect is different from that of steroid. (C) 2007 Published by Elsevier Ltd.

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  • 1. 縦隔リンパ節腫張を伴った好酸球性肺炎の1例(第45回日本呼吸器内視鏡学会北陸支部会)

    富士盛 文夫, 島岡 雄一, 田島 俊児, 小屋 俊之, 森山 寛史, 田中 純太, 寺田 正樹, 高田 俊範, 下条 文武, 長谷川 隆志, 鈴木 栄一, 竹重 麻里子, 篠原 博彦, 土田 正則, 櫻田 潤子, 梅津 哉

    気管支学   30 ( 1 )   49 - 49   2008年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.30.1_49_1

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  • 新潟県内の肺・心肺移植適応患者検討の現状

    土田 正則, 橋本 毅久, 篠原 博彦, 斉藤 正幸, 小池 輝元, 林 純一

    移植   42 ( 総会臨時 )   241 - 241   2007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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  • Quality of Life after Lung Cancer Surgery: Video-Assisted Thoracic Surgery versus Thoracotomy 査読

    Tadashi Aoki, Masanori Tsuchida, Takehisa Hashimoto, Masayuki Saito, Terumoto Koike, Jun-ichi Hayashi

    Heart Lung and Circulation   16 ( 4 )   285 - 289   2007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)  

    Objective: To assess the benefit of video-assisted thoracic surgery (VATS), we compared time-related quality of life (QOL) after lobectomy performed by VATS to that performed by thoracotomy. Methods: Thirty-three patients underwent surgery for lung cancer during the period April 2001 through November 2002 completed a mailed questionnaire after surgery. Results: Over time, improved QOL was reported in six dimensions by VATS patients but in only two dimensions by thoracotomy patients. There was significant improvement in bodily pain subscores in both groups during the 36 months after surgery. At 3 months after surgery, QOL scores for all eight dimensions were lower in the VATS group, but QOL scores for all eight dimensions did not differ significant between groups at 3 or 12 months after surgery. At 36 months after surgery, QOL scores for six dimensions were higher in the VATS group, and the difference was significant in scores for two dimensions. Conclusion: We found recovery was quicker in patients who underwent VATS than in those who underwent thoracotomy. © 2007 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand.

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  • Ultrasmall intrapulmonary lymph node: usual high-resolution computed tomographic findings with histopathologic correlation. 査読

    Ishikawa H, Koizumi N, Morita T, Tsuchida M, Umezu H, Sasai K

    Journal of computer assisted tomography   31 ( 3 )   409 - 413   2007年5月

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    掲載種別:研究論文(学術雑誌)  

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  • Lung resection combined with percutaneous coronary intervention using Cypher stents: A case report 査読

    Masanori Tsuchida, Takeshi Okamoto, Takehisa Hashimoto, Tadashi Aoki, Takashi Saigawa, Akira Hirono, Jun-ichi Hayashi

    Annals of Thoracic and Cardiovascular Surgery   13 ( 1 )   56 - 59   2007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)   出版者・発行元:1  

    Treatment of concomitant severe coronary artery disease and lung cancer is a complicated issue. The present study describes a case of a 65-year-old man with coronary artery disease and primary lung cancer that was successfully treated with lung resection and percutaneous coronary intervention (PCI) using Cypher stents. Prior to lung resection, the patient underwent a PCI for diffuse stenosis of the right coronary artery and the circumflex artery. Cypher stents were deployed for both lesions. Five days after stent implantation, a right lower lobectomy was performed successfully. To the best of our knowledge, this is the first report of lung resection and PCI using Cypher stents.

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  • 原発性肺癌との鑑別を要した腎移植患者におけるPET陽性肺クリプトコッカス症の1切除例

    橋本 毅久, 岡本 竹司, 青木 正, 土田 正則, 林 純一

    日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery   21 ( 1 )   80 - 84   2007年1月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人日本呼吸器外科学会  

    移植患者に胸部異常影が出現した場合には感染症の可能性を考えるとともに悪性疾患との鑑別も問題となる.症例は2回の生体腎移植を受けた53歳女性.免疫抑制剤とステロイド剤の内服にて経過中に胸部X線写真上異常影を指摘された.CTでは右S<SUP>2</SUP>に径10mmの充実性結節影を認めた.経過観察されたところ僅かに増大し,FDG-PETでstanderdized uptake value(SUV)1時間値3.7,2時間値4.2と悪性を疑わせる所見であった.胸腔鏡下肺部分切除を行い病理所見で肺クリプトコッカス症と診断された.腫瘤影を呈する肺クリプトコッカス症は画像上肺癌と類似することがある.本症例は増大傾向を示し且つFDG-PET陽性であったことからも肺癌との鑑別が困難であった.

    DOI: 10.2995/jacsurg.21.080

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  • 胸膜穿刺生検部に腫瘤を形成した悪性胸膜中皮腫の1切除例

    武内 愛, 青木 正, 橋本 毅久, 土田 正則, 林 純一

    日本呼吸器外科学会雑誌 = The journal of the Japanese Association for Chest Surgery   21 ( 1 )   85 - 88   2007年1月

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    記述言語:日本語   出版者・発行元:特定非営利活動法人日本呼吸器外科学会  

    診断目的の胸腔穿刺部に一致して胸壁腫瘤を形成した悪性胸膜中皮腫の一例を経験した.症例は57歳男性.胸部レントゲン異常を指摘され,近医で穿刺による胸水検査,胸膜生検を行われたが確定診断に至らず精査目的に入院した.入院時穿刺部胸壁に腫瘤を形成していた.腫瘤切除に引き続いて診査胸腔鏡を行い,二相性悪性胸膜中皮腫と診断した.穿刺経路以外に浸潤を認めず,臨床病期はIMIG-TNM分類でT3N0M0 stage IIIであり,右胸膜肺全摘術を施行した.

    DOI: 10.2995/jacsurg.21.085

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    その他リンク: http://search.jamas.or.jp/link/ui/2007149476

  • RV-12-3 側方アプローチ,体外循環使用下に左房合併切除を施行した原発性肺癌の1例(拡大手術(2), 第24回日本呼吸器外科学会総会号)

    橋本 毅久, 小池 輝元, 青木 正, 土田 正則, 林 純一

    日本呼吸器外科学会雑誌   21 ( 3 )   334 - 334   2007年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.21.334_3

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  • PS-047-3 当院における降下性壊死性縦隔炎に対する治療の検討(縦隔炎2, 第24回日本呼吸器外科学会総会号)

    小池 輝元, 土田 正則, 青木 正, 橋本 毅久, 本野 望, 佐藤 裕喜, 林 純一

    日本呼吸器外科学会雑誌   21 ( 3 )   426 - 426   2007年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.21.426_1

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  • VD-12-2 頚胸部領域に発生した滑膜肉腫に対して前方および後方アプローチにより切除した1例(縦隔腫瘍の手術(2), 第24回日本呼吸器外科学会総会号)

    青木 正, 土田 正則, 橋本 毅久, 小池 輝元, 本野 望, 林 純一

    日本呼吸器外科学会雑誌   21 ( 3 )   353 - 353   2007年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.21.353_4

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  • PS-050-1 自然気胸に対する胸腔鏡手術の利点と欠点(肺嚢胞性疾患2, 第24回日本呼吸器外科学会総会号)

    本野 望, 青木 正, 小池 輝元, 橋本 毅久, 土田 正則, 林 純一

    日本呼吸器外科学会雑誌   21 ( 3 )   430 - 430   2007年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.21.430_1

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  • Ultrafiltration attenuates cardiopulmonary bypass-induced acute lung injury in a canine model of single-lung transplantation 査読

    Masayuki Saitoh, Masanori Tsuchida, Terumoto Koike, Koichi Satoh, Manabu Haga, Tadashi Aoki, Shin-ichi Toyabe, Jun-ichi Hayashi

    JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY   132 ( 6 )   1447 - U28   2006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:MOSBY-ELSEVIER  

    Objective: The purpose of this study was to investigate the effects of cardiopulmonary bypass and ultrafiltration on graft function in a canine single-lung transplantation model.
    Methods: Fifteen left single-lung transplantations were done in weight-mismatched canine pairs. The animals were divided into 3 groups: group 1, in which transplantation was done without cardiopulmonary bypass; group 2, in which transplantation was done with cardiopulmonary bypass and in which the cardiopulmonary bypass flow was decreased slowly with controlled pulmonary artery pressure; and group 3, in which transplantation was done with cardiopulmonary bypass and ultrafiltration. Hemodynamic parameters and lung function were monitored for 6 hours after reperfusion. The grafts were harvested for histologic studies, myeloperoxidase assay, and real-time quantitive reverse transcription-polymerase chain reaction of mRNA encoding interleukin 6.
    Results: The hemodynamic parameters were similar among the 3 groups. In group 1 Pa-O2 and alveolar to arterial gradient for O-2 levels were excellent throughout the 6-hour observation period, but in group 2 they progressively deteriorated. However, ultrafiltration significantly (P = .02) improved the PaO2 level in group 3. On histology, interstitial edema and polynuclear cell infiltration were most marked in group 2 and significantly worse than in groups 1 and 3. Myeloperoxidase assay and real-time quantitative reverse transcription-polymerase chain reaction showed increased myeloperoxidase activity and interleukin 6 gene expression in group 2 grafts compared with group 1 grafts. Myeloperoxidase activity and interleukin 6 gene expression were suppressed with ultrafiltration.
    Conclusions: Cardiopulmonary bypass had negative effects on the graft, but ultrafiltration attenuated acute lung dysfunction by reducing the inflammatory response.

    DOI: 10.1016/j.jtcvs.2006.08.020

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  • 術前CTにて診断し切除したCastleman病の1例

    佐藤 裕喜, 土田 正則, 小池 輝元, 橋本 毅久, 青木 正, 林 純一

    日本胸部外科学会関東甲信越地方会要旨集   ( 140回 )   14 - 14   2006年12月

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    記述言語:日本語   出版者・発行元:日本胸部外科学会-関東甲信越地方会  

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  • 臨床病期I期肺腺癌におけるCT濃度からみた術式の検討

    橋本 毅久, 土田 正則, 小池 輝元, 青木 正, 林 純一

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   54 ( Suppl. )   310 - 310   2006年9月

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    記述言語:日本語   出版者・発行元:シュプリンガー・ジャパン(株)  

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  • 肺癌組織中核酸代謝酵素(TS,DPD,OPRT)の測定法別発現程度とその意義

    土田 正則, 青木 正, 橋本 毅久, 小池 輝元, 林 純一, 吉谷 克雄, 大和 靖, 小池 輝明

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   54 ( Suppl. )   436 - 436   2006年9月

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    記述言語:日本語   出版者・発行元:シュプリンガー・ジャパン(株)  

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  • 体外循環下犬片肺移植における限外ろ過の酸素化能改善効果

    小池 輝元, 斉藤 正幸, 佐藤 浩一, 羽賀 学, 青木 正, 土田 正則, 林 純一

    移植   41 ( 1 )   54 - 55   2006年2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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  • Analysis of the effect of surgical lung biopsy on serum KL-6 levels in patients with interstitial pneumonia: Surgical lung biopsy does not elevate serum KL-6 levels 査読

    Jun-ichi Narita, Takashi Hasegawa, Masanori Tsuchida, Masaki Terada, Toshinori Takada, Takehisa Hashimoto, Tadashi Aoki, Hiroki Tsukada, Ichiei Narita, Jun-ichi Hayashi, Fumitake Gejyo, Eiichi Suzuki

    INTERNAL MEDICINE   45 ( 9 )   615 - 619   2006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:JAPAN SOC INTERNAL MEDICINE  

    Objective It is well known that the serum level of KL-6 can be an indicator of disease activity in patients with interstitial pneumonia (IP). However, surgical lung biopsy is often required for the diagnosis of IP, although this can result in IP exacerbation.
    Methods The effect of surgical lung biopsy on the serum level of KL-6 in patients with IP was analyzed. Thirty-two cases of IP were examined in this study. There were no cases showing exacerbation of IP.
    Results The serum level of KL-6 demonstrated 1067 +/- 550 U/ml (mean +/- SD) before lung biopsy, 991 +/- 471 U/ml a day, 824 +/- 377 U/ml 4 days and 826 +/- 384 U/ml 7 days after lung biopsy. The serum KL-6 levels on the 1st, 4th, 7th day after the lung biopsy were significantly lower than that before the lung biopsy (P &lt; 0.05, P &lt; 0.01 and P &lt; 0.01, respectively). The percent decrease of the serum KL-6 levels on the 4th day (the lowest level) was dependent on the urine volume, and the analysis of the urinary levels of KL-6 showed a transient increase in urinary KL-6 excretion, suggesting that the decrease in serum KL-6 levels associated with surgical lung biopsy may be caused by this increase in urinary KL-6 excretion.
    Conclusion Surgical lung biopsy of patients with IP has little effect on the increase in serum KL-6 levels. An elevation of serum KL-6 after surgical lung biopsy may indicate exacerbation of IP.

    DOI: 10.2169/internalmedicine.45.1606

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  • A Case of Malignant Pleural Mesothelioma Detected by Pneumothorax 査読

    Takehisa Hashimoto, Tadashi Aoki, Masanori Tsuchida, Jun-Ichi Hayashil, Hajime Umezu, Eiju Tsuchiya

    Japanese Journal of Lung Cancer   46 ( 2 )   169 - 170   2006年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.2482/haigan.46.169

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  • OP3-1 体外循環下犬片肺移植における限外ろ過の虚血再灌流障害軽減効果(一般口演03 基礎研究,世界をリードする呼吸器外科医に!,第23回日本呼吸器外科学会総会)

    小池 輝元, 土田 正則, 青木 正, 橋本 毅久, 佐藤 浩一, 篠原 博彦, 斉藤 正幸, 岡田 英, 保坂 靖子, 林 純一

    日本呼吸器外科学会雑誌   20 ( 3 )   807 - 807   2006年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.20.807_4

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  • P-044 術前合併症を有する肺癌手術における病態別の合併症頻度と周術期管理の検討(一般示説07 肺癌合併疾患,世界をリードする呼吸器外科医に!,第23回日本呼吸器外科学会総会)

    土田 正則, 青木 正, 橋本 毅久, 篠原 博彦, 斉藤 正幸, 岡田 英, 小池 輝元, 保坂 靖子, 林 純一

    日本呼吸器外科学会雑誌   20 ( 3 )   851 - 851   2006年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.20.851_4

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  • Ultrasmall pulmonary opacities on multidetector-row high-resolution computed tomography - A prospective radiologic-pathologic examination 査読

    H Ishikawa, N Koizumi, T Morita, Y Tani, M Tsuchida, H Umezu, M Naito, K Sasai

    JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY   29 ( 5 )   621 - 625   2005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:LIPPINCOTT WILLIAMS & WILKINS  

    Objective: To clarify the pathologic findings of ultrasmall pulmonary opacities (5 mm or smaller in diameter) found on multidetector-row high-resolution computed tomography (MD-HRCT).
    Methods: Ten lobes in 10 patients were included in this study. Each lobe had a primary lung tumor and was removed surgically. Two thoracic radiologists noted any tiny nonlinear opacity on preoperative MD-HRCT films (1.25-mm thickness) covering the whole lobe. Pathologic findings of detected opacities were evaluated macroscopically and microscopically.
    Results: Among 139 ultrasmall opacities 5 mm or smaller in diameter, 94 corresponded to normal anatomic structures (partial volume averaging or motion artifact), 36 corresponded to pathologic abnormalities, and 9 were unidentified. Histologic diagnoses of 36 pathologic abnormalities were inflammatory lesions (n = 16), intrapulmonary lymph nodes (IPLN; n = 7), atypical adenomatous hyperplasia (AAH; n = 7), bronchioloalveolar carcinoma (BAC; n = 5), and another neoplastic lesion (n = 1).
    Conclusion: Tiny pulmonary lesions, such as AAHs, BACs, and IPLNs, were identified among ultrasmall opacities found on MD-HRCT.

    DOI: 10.1097/01.rct.0000172672.09564.8c

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  • 初期研修医にも気胸の術者は可能か?

    青木 正, 土田 正則, 橋本 毅久, 篠原 博彦, 斉藤 正幸, 岡田 英, 小池 輝元, 林 純一

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   53 ( Suppl.II )   566 - 566   2005年9月

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    記述言語:日本語   出版者・発行元:シュプリンガー・ジャパン(株)  

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  • 長期人工呼吸管理後に手術を施行した肺葉性肺気腫の1例

    三島 健人, 青木 正, 羽入 隆晃, 土田 正則, 林 純一

    新潟医学会雑誌   119 ( 4 )   267 - 267   2005年4月

  • 犬左片肺移植における体外循環使用の影響の検討

    斉藤 正幸, 土田 正則, 青木 正, 橋本 毅久, 佐藤 浩一, 篠原 博彦, 岡田 英, 小池 輝元, 林 純一

    移植   40 ( 1 )   82 - 83   2005年2月

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  • Neutrophil elastase inhibitor ameliorates reperfusion injury in a canine model of lung transplantation 査読

    T Aoki, M Tsuchida, M Takekubo, M Saito, K Sato, J Hayashi

    EUROPEAN SURGICAL RESEARCH   37 ( 5 )   274 - 280   2005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:KARGER  

    Background: We investigated the effects of neutrophil elastase inhibitor ONO-5046 Na on lung ischemia-reperfusion injury in a canine model of single lung transplantation. Methods: 24 mongrel dogs, 12 donors and 12 recipients, were used for single lung transplantation. Lung grafts were preserved for 18 h by cold ischemia then transplanted into the left thoracic cavity of recipients. In 6 recipients (ONO group), a bolus of ONO-5046 Na (10 mg/kg) was introduced before reperfusion and followed by continuous infusion (10 mg/kg/h). The remaining 6 recipients (control group) did not receive ONO-5046 Na and thus served as controls. We evaluated lung function and respiratory parameters over 240 min. Results: The total cell number in bronchoalveolar lavage fluid increased significantly in the control group in comparison to that in the ONO group. Histologic scores after 4 h of reperfusion and myeloperoxidase activity were significantly lower in the ONO group than in the control group. Conclusion: Neutrophil elastase inhibitor ONO-5046 Na may be useful in ameliorating lung reperfusion injury after transplantation. Copyright (C) 2005 S. Karger AG, Basel.

    DOI: 10.1159/000089234

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  • 犬左片肺移植における体外循環使用の影響の検討(気道再建/肺移植, 第22回日本呼吸器外科学会総会)

    斉藤 正幸, 土田 正則, 青木 正, 橋本 毅久, 佐藤 浩一, 小池 輝元, 林 純一

    日本呼吸器外科学会雑誌   19 ( 3 )   475 - 475   2005年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.19.475_2

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  • 肺癌患者血清におけるp16癌抑制遺伝子プロモーター領域メチル化の検出と再発予後の検討(肺癌 (9), 第22回日本呼吸器外科学会総会)

    橋本 毅久, 小池 輝元, 岡田 英, 斎藤 正幸, 篠原 博彦, 渡辺 健寛, 青木 正, 土田 正則, 林 純一

    日本呼吸器外科学会雑誌   19 ( 3 )   430 - 430   2005年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.19.430_3

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  • 肺癌に対する縮小手術の功と罪 スリガラス陰影(GGO)を主体とする肺癌に対する積極的縮小手術の成績と問題点

    土田 正則, 青木 正, 橋本 毅久, 篠原 博彦, 斎藤 正幸, 岡田 英, 小池 輝元, 林 純一

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   52 ( Suppl. )   196 - 196   2004年9月

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    記述言語:日本語   出版者・発行元:シュプリンガー・ジャパン(株)  

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  • MOS 36-Item Short-Form Health Surveyを用いた肺癌術後QOLの評価 胸腔鏡手術と開胸手術の比較

    青木 正, 土田 正則, 橋本 毅久, 篠原 博彦, 斉藤 正幸, 岡田 英, 小池 輝元, 林 純一

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   52 ( Suppl. )   492 - 492   2004年9月

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  • Electorporation法を用いたnaked DNA(IL-10)遺伝子導入による閉塞性細気管支病変予防効果

    土田 正則, 青木 正, 橋本 毅久, 篠原 博彦, 竹久保 賢, 斎藤 正幸, 小池 輝元, 林 純一

    移植   39 ( 総会臨時 )   251 - 251   2004年7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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  • Electroporation法を用いたIL-10遺伝子導入による閉塞性気道病変の予防効果

    土田 正則, 青木 正, 橋本 毅久, 竹久保 賢, 篠原 博彦, 斎藤 正幸, 岡田 英, 小池 輝元, 林 純一

    移植   39 ( 2 )   206 - 207   2004年4月

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  • 頭蓋骨血管肉腫肺転移の破裂により生じた気胸に対する一手術例

    岡本 竹司, 橋本 毅久, 土田 正則, 青木 正, 斎藤 正幸, 小池 輝元, 林 純一

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   52 ( Suppl. )   77 - 77   2004年3月

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  • 【末梢型小型肺癌の手術】画像上すりガラス状陰影を呈した末梢型小型肺癌に対する縮小手術

    土田 正則, 青木 正, 橋本 毅久, 篠原 博彦, 斎藤 正幸, 岡田 英, 小池 輝元, 林 純一

    胸部外科   57 ( 1 )   38 - 43   2004年1月

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    記述言語:日本語   出版者・発行元:(株)南江堂  

    すりガラス状陰影(GGO)を主体とする細気管支肺胞型腺癌に対する縮小手術の成績とその妥当性を検討した.1996年10月から2003年4月までに細気管支肺胞型腺癌の疑いにて縮小手術を施行した症例のうち,CT上腫瘍径20mm以下かつ腫瘍全体に対するGGO領域の比率が50%以上の58例を対象とした.58例中48例に部分切除,2例に区域切除が行われ,8例は浸潤性増殖や高度線維化などにより肺葉切除へ移行した.術中迅速病理診断と術後病理標本の対比では56例の結果は一致したが2例は過小評価であった.また,術後合併症は肺胞瘻1例を認めたのみであり,術後2〜80ヵ月間の観察では肺葉切除に移行した症例を含め57例が無再発生存中である.HRCTと病理所見を野口分類で対比するとtypeA+Bでは腫瘍最大径が有意に小さく,高濃度部分や線状陰影の有無についても有意に少なかった.線状陰影のない10mm以下の病変では縮小手術の対象と考えられた

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  • Registration of resected lung cancer in Niigata Prefecture 査読

    Takehiro Watanabe, Tatsuhiko Hirono, Teruaki Koike, Masanori Tsuchida, Kenichi Togashi, Kenji Nakayama, Masatomo Yazawa, Tsuyoshi Koyashiki, Hiroshi Kanazawa

    Japanese Journal of Thoracic and Cardiovascular Surgery   52 ( 5 )   225 - 230   2004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:Japanese Association for Thoracic Surgery  

    Objectives: Our registration of surgically treated lung cancer patients in Niigata Prefecture began in 2001. The purpose of this study was to identify the characteristics of patients and surgical treatment of lung cancer. Methods: All patients who underwent resection for lung cancer in Niigata Prefecture from January 2001 to December 2002 were eligible for registration. A total of 31 medical data for each patient were registered. Results: During the 2-year period, 1,211 patients were registered. A total of 605 cases (50%) were detected by mass screening, and 874 cases (72%) were diagnosed preoperatively. There were 718 (59%) c-stage IA cases and 317 (26%) c-stage IB cases. The most common operative procedure was lobectomy
    850 patients underwent single lobectomy. Limited resection was performed in 301 patients (25%), and video-assisted thoracoscopic surgery in 193 (16%). The most common histological type was adenocarcinoma in 860 cases (71%), followed by squamous cell carcinoma in 273 (23%). Pathologic staging yielded stage IA in 635 cases (52%) and stage IB in 262 (22%). Conclusions: The results of our registration demonstrate a very high ratio of surgically treated stage IA cases in Niigata Prefecture and that limited resection was performed in many patients. Accumulation of these data will reveal the characteristics of lung cancer surgically treated in Niigata Prefecture and will provide a basis for determining the future course of surgical treatment for lung cancer. Registration is continuing, and it will provide new and useful information about lung cancer, eventually including 5-year survival data.

    DOI: 10.1007/s11748-004-0115-y

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  • P-421 遺伝子異常を利用した非小細胞肺癌微小転移の検出(基礎研究3)(一般示説43)

    橋本 毅久, 小池 輝元, 岡田 英, 斎藤 正幸, 篠原 博彦, 渡辺 健寛, 青木 正, 土田 正則, 林 純一, 土屋 永寿

    日本呼吸器外科学会雑誌   18 ( 3 )   442 - 442   2004年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器外科学会  

    DOI: 10.2995/jacsurg.18.442_1

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  • Intentional limited resection for small adenocarcinoma with ground-glass opacity component more than 50% on computed tomography

    M. Tuchida, T. Aoki, T. Hashimoto, H. Shinohara, M. Saitou, A. Okada, T. Koike, J. Hayashi

    Kyobu geka. The Japanese journal of thoracic surgery   57 ( 1 )   38 - 43   2004年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Fifty-eight patients who had small lung tumors 2 cm or less with ground-glass opacity (GGO) component more than 50% on high resolution computed tomography (HRCT) underwent intentional limited resection. After bronchioloalveolar carcinoma without both active fibroblastic proliferation and invasive sign to the stroma was confirmed, limited resection was completed in 50 patients. In 8 patients, procedure was converted lobectomy because of microscopic invasive sign in 4, active fibroblastic proliferation in 2, and other reasons in 2. Unexpected invasive sign was found by detailed post-operative examination in 2 cases. Five-year survival rate was 98% with a mean follow-up period of 48.8 months. A limitation of intra-operative diagnosis was revealed and the accuracy of diagnosis should be improved by not only intra-operative pathological diagnosis but also HRCT images.

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  • 末梢小型肺癌 治療法の選択 高濃度部分を有さないpure GGA病変に対する診断・治療方針の検討

    土田 正則, 青木 正, 橋本 毅久, 篠原 博彦, 斎藤 正幸, 岡田 央, 小池 輝元, 林 純一

    The Japanese Journal of THORACIC AND CARDIOVASCULAR SURGERY   51 ( Suppl. )   165 - 165   2003年10月

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    記述言語:日本語   出版者・発行元:シュプリンガー・ジャパン(株)  

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  • 集学的治療が奏効した胸腺癌の一例(共著) 査読

    佐野博繁, 渡部聡, 田中純太, 松山弘紀, 平田明, 広瀬貴之, 田中洋史, 各務博, 吉澤弘久, 下条文武, 渡辺マヤ, 小池輝元, 橋本毅久, 土田正則, 林純一, 笹本龍太, 笹井啓資

    新潟医学会雑誌   118 ( 7 )   347 - 354   2003年7月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Surgical strategy for clinical stage I non-small cell lung cancer in octogenarians 査読

    T Aoki, M Tsuchida, T Watanabe, T Hashimoto, T Koike, T Hirono, JI Hayashi

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   23 ( 4 )   446 - 450   2003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 BV  

    Objective: The purpose of this study was to determine whether lobectomy without radical systematic mediastinal lymphadenectomy (LA) is a satisfactory alternative surgical treatment for octogenarians with clinical stage I non-small cell lung cancer (NSCLC). Methods: From April 1985 through December 2001, 49 patients aged 80 years and older who underwent surgical treatment for clinical stage I NSCLC were reviewed. Lobectomy without radical systematic mediastinal LA was performed for 27 patients (LA0 group) and lobectomy with radical systematic mediastinal LA was performed for 22 patients (LA group). Results: The mortality rate was 0% in the LA0 group and 4.5% in the LA group. Five-year survival rate according to the type of surgery was 44.8% in the LA0 group and 55.5% in the LA group, a difference that was not significant (P = 0.88). Although there was no significant statistical difference, postoperative pulmonary complication was more frequent in the LA group than in the LA0 group (32% in the LA group versus 11% in the LA0 group P = 0.07). Five-year survival rates according to serum carcinoembryonic antigen (CEA) levels were 0% for patients with elevated CEA levels (n = 9) and 56.5% for patients with normal CEA levels (n = 40) (P &lt; 0.01). Conclusion: Lobectomy without radical systematic mediastinal LA appears to be a satisfactory surgical procedure for octogenarians with clinical stage I NSCLC. However, mediastinoscopy is necessary in such octogenarians if their serum CEA level is elevated so that the precise clinical stage can be determined and an accurate prognosis can be given. (C) 2003 Elsevier Science B.V. All rights reserved.

    DOI: 10.1016/S1010-7940(03)00014-9

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  • Microcystic variant of localized malignant mesothelioma accompanying an adenomatoid tumor-like lesion 査読

    H Umezu, K Kuwata, Y Ebe, T Yamamoto, M Naito, Y Yamato, T Ishiyama, M Tsuchida, M Okuizumi, H Ishikawa, N Koizumi

    PATHOLOGY INTERNATIONAL   52 ( 5-6 )   416 - 422   2002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:BLACKWELL PUBLISHING ASIA  

    The case of a 70-year-old man with a hitherto undescribed pleural mesothelioma is reported. The tumor was localized in the left lung apex and had invaded the parietal pleura. Histologically, the tumor was characterized by a proliferation of epithelioid cells and the formation of microcysts. The tumor cells were positive for calretinin and vimentin, and possessed abundant microvilli, indicating a mesothelial cell origin for the tumor. A high Ki-67 index and mitotic index, and the recurrence of the tumor after surgery, indicated malignancy. Based on the evidence, we propose that the tumor is a microcystic variant of a localized malignant mesothelioma.

    DOI: 10.1046/j.1440-1827.2002.01357.x

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  • 大静脈の再建を要した悪性腫瘍症例の検討

    名村 理, 島田 晃治, 竹久保 賢, 中山 卓, 榛澤 和彦, 青木 正, 土田 正則, 北村 昌也, 林 純一

    日本血管外科学会雑誌   11 ( 2 )   217 - 217   2002年4月

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    記述言語:日本語   出版者・発行元:(NPO)日本血管外科学会  

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  • 間質性肺炎症例の肺生検時における経時的血清KL-6値の変動の検討(第25回日本気管支学会総会)

    成田 淳一, 小屋 俊之, 長谷川 隆志, 森山 寛史, 土田 正則, 青木 正, 橋本 毅久, 鈴木 栄一, 林 純一, 下条 文武

    気管支学   24 ( 3 )   206 - 206   2002年

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    記述言語:日本語   出版者・発行元:特定非営利活動法人 日本呼吸器内視鏡学会  

    DOI: 10.18907/jjsre.24.3_206_1

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  • Segmental bronchial atresia of the left upper lobe treated with segmental resection under video-assisted thoracic surgery 査読

    M Tsuchida, K Aoki, T Hashimoto, Y Yamato, J Hayashi

    SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES   11 ( 3 )   217 - 220   2001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:LIPPINCOTT WILLIAMS & WILKINS  

    We report our experience of segmental bronchial atresia managed with segmental resection under video-assisted thoracic surgery. A 23-year-old woman reporting a cough, dyspnea, and back pain underwent segmental resection in which a stapling device was used under video-assisted thoracic surgery. Her postoperative course was uneventful with minimal pain and a disappearance of preoperative symptoms after surgery. Once an accurate preoperative diagnosis can be established, video-assisted thoracic segmentectomy together with the use of a stapling device is considered to be feasible.

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  • Early results of a prospective study of limited resection for bronchioloalveolar adenocarcinoma of the lung 査読

    Y Yamato, M Tsuchida, T Watanabe, T Aoki, N Koizumi, H Umezu, J Hayashi

    ANNALS OF THORACIC SURGERY   71 ( 3 )   971 - 974   2001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  

    Background. We reported that bronchioloalveolar adenocarcinoma (BAC) without active fibroblastic proliferation of the lung had no lymph node and pulmonary metastasis and had a favorable prognosis. However, there has been no prospective trial regarding limited pulmonary resection for this type of BAG. The purpose of this study is to confirm the effectiveness of limited resection for histologically confirmed BAC without active fibroblastic proliferation.
    Methods. From 1996 through 1999, 42 patients who had small peripheral lung tumors (less than or equal to 20 mm), suspected of being BAG, were enrolled in this trial. The patient population consisted of 24 men and 18 women with a mean age of 58.4 years. Limited resection was completed when BAG, without both active fibroblastic proliferation and lymph node metastasis, was con-firmed histalogically by intraoperative pathologic examination.
    Results. Limited resection was completed in 36 patients, wedge resection in 34, and segmentectomy in 2 patients. In 6 patients, the procedure was converted into lobectomy because of pathologic invasive sign in 3, active fibroblastic proliferation in 1, and for other reasons in 2 patients. All patients have been followed for a median follow-up period of 30 months and are alive without sign of recurrence.
    Conclusions. Our early results indicate that limited resection may be an acceptable alternative to lobectomy for histologically confirmed BAC without active fibroblastic proliferation (C) 2001 by The Society of Thoracic Surgeons.

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  • Pulmonary complications after surgical treatment of lung cancer in octogenarians 査読

    T Aoki, Y Yamato, M Tsuchida, T Watanabe, J Hayashi, T Hirono

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   18 ( 6 )   662 - 665   2000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:ELSEVIER SCIENCE BV  

    Objective: The purpose of this study was to analyze the risks associated with pulmonary resection for primary non-small cell lung cancer in octogenarians to help better management in these patients. Methods: We reviewed the outcome in our 35 patients aged 80 years and older who underwent pulmonary resection between 1981 and 1998. Results: The 5-year survival rate was 39.8%. The operative mortality rate was 0% and the morbidity 60%. There were ten major pulmonary complications, including respiratory insufficiency following bacterial pneumonia and sputum retention. Preoperative arterial pO(2) was significantly lower, A-aDO(2) was significantly higher, and operation time were significantly longer in patients with pulmonary complications after surgical treatment than in patients without complications (P &lt; 0.05), Conclusions: Surgical treatment was not contraindicated for octogenarians with lung cancer. However, a relatively preoperative low arterial pO(2), high A-aDO(2), and long operation time may be risk factors for postoperative pulmonary complications in such patients. Surgeons must assess the preoperative data prudently to determine appropriate surgical strategy. (C) 2000 Elsevier Science B.V. All rights reserved.

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  • Changes in graft flow pattern from the descending aorta due to intraaortic balloon pump 査読

    M Tsuchida, Y Yamato, T Watanabe, H Ohzeki, JI Hayashi

    ANNALS OF THORACIC SURGERY   70 ( 3 )   980 - 982   2000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:ELSEVIER SCIENCE INC  

    During surgery for lung cancer in a patient who had undergone coronary artery bypass grafting through the descending aorta by left thoracotomy, we measured graft bypass blood now from the descending aorta under intraaortic balloon pump (IABP) assistance. Under IABP assistance, the diastolic waveform changed to a spiky pattern with a sharp drop in blood flow of approximately 16% compared to that without LABP assistance. We report changes in graft flow pattern during IABP assistance when the graft is placed from the descending aorta. (Ann Thorac Surg 2000;70:980-2) (C) 2000 by The Society of Thoracic Surgeons.

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  • A simple and sensitive quantitative method for determining xenoreactive antibody titers in the mouse-to-rat cardiac transplantation model 査読

    R Haga, H Hirahara, M Tsuchida, T Watanabe, M Takekubo, J Hayashi

    TRANSPLANTATION PROCEEDINGS   32 ( 5 )   862 - 863   2000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)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • Successful tracheal transplantation using cryopreserved allografts in a rat model 査読

    T Aoki, Y Yamato, M Tsuchida, T Souma, K Yoshiya, T Watanabe, J Hayashi

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   16 ( 2 )   169 - 173   1999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)   出版者・発行元:ELSEVIER SCIENCE BV  

    Objectives: The purpose of this study was to determine the appropriate cryopreservation period of tracheal allografts based on morphological and immunological findings and to test the possibility of tracheal transplantation in rats using cryopreserved allografts without immunosuppression. Methods: Morphological and immunological studies were performed to compare the differences between non-cryopreserved grafts and cryopreserved grafts. Orthotopic tracheal transplantation using cryopreserved allografts, non-cryopreserved allografts, and non-cryopreserved autografts was performed and the rejection score of each group was evaluated. Results: Epithelial cells were lost when the grafts were cryopreserved for more than 20 days. Immunohistochemical staining of the trachea revealed that the MHC classII antigen was expressed on normal epithelium. These findings suggest that cryopreservation for more than 20 days decreased the antigeneicity of allografts because of epithelial desquamation. All rats that received allografts cryopreserved for more than 20 days survived until the scheduled sacrifice day. Microscopically, cryopreserved allografts that had been preserved for more than 20 days had a significantly lower rejection score than that of non-cryopreserved allografts (P &lt; 0.05). Conclusions: We conclude that the appropriate period for cryopreservation of allografts would be 20 days or more, because cryopreservation for more than 20 days depleted epithelium, which possessed the MHC classII antigen. Therefore, a longer period of cryopreservation decreases the antigeneicity of allografts. Rat tracheal transplantations using cryopreserved allografts is possible without immunosuppression when the grafts have been cryopreserved for more than 20 days. (C) 1999 Elsevier Science B.V. All rights reserved.

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  • Characterization of CD4(-)CD8(-) T cell receptor alpha beta(+) T cells appearing in the subarachnoid space of rats with autoimmune encephalomyelitis 査読

    Y Matsumoto, S Abe, M Tsuchida, H Hirahara, T Abo, T Shin, N Tanuma, T Kojima, Y Ishihara

    EUROPEAN JOURNAL OF IMMUNOLOGY   26 ( 6 )   1328 - 1334   1996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:VCH PUBLISHERS INC  

    Inflammation of the central nervous system (CNS) in experimental autoimmune encephalomyelitis (EAE) starts in the subarachnoid space (SAS) and spreads later to the adjacent CNS parenchyma. To characterize the nature of lesion-forming T cells in situ in more detail, T cells were isolated from the SAS and their surface phenotype and the nucleotide sequence of the junctional region of the T cell receptor (TCR) was determined and compared with those of the lymph node (LN) and spinal cord (SC) T cells. Characteristically, more than 70% of SAS TCR alpha beta(+) T cells isolated at the early stage of EAE lacked both CD4 and CD8 molecules, whereas those from LN and SC were either CD4(+) or CD8(+). Analysis of nucleotide sequences of the junctional region of TCR revealed that T cells bearing a sequence identical to that for encephalitogenic T cell clones were found in both SAS and SC. Furthermore, purified CD4(-)CD8(-) T cells expressed CD4 molecules after culture. At the same time, these T cells acquired reactivity to myelin basic protein and induced passive EAE in naive animals after adoptive transfer. Our results suggest that CD4(-)CD8(-) T cells in the SAS are precursors of lesion-forming T cells in the SC and that phenotype switching takes place during the process of T cell infiltration into the CNS parenchyma. The double-negative nature of these T cells may explain an escape of encephalitogenic T cells from negative selection in T cell differentiation.

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  • T-CELL RECEPTOR PEPTIDE THERAPY FOR AUTOIMMUNE ENCEPHALOMYELITIS - STRONGER IMMUNIZATION IS NECESSARY FOR EFFECTIVE VACCINATION 査読

    Y MATSUMOTO, M TSUCHIDA, H HANAWA, T ABO

    CELLULAR IMMUNOLOGY   153 ( 2 )   468 - 478   1994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)   出版者・発行元:ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS  

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  • GLUCOCORTICOID INDEPENDENCE OF ACUTE THYMIC INVOLUTION INDUCED BY LYMPHOTOXIN AND ESTROGEN 査読

    H HIRAHARA, M OGAWA, M KIMURA, T IIAI, M TSUCHIDA, H HANAWA, H WATANABE, T ABO

    CELLULAR IMMUNOLOGY   153 ( 2 )   401 - 411   1994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)   出版者・発行元:ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS  

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  • CD5+ B-CELLS IN THE THYMUS OF PATIENTS WITH MYASTHENIA-GRAVIS 査読

    M TSUCHIDA, S HASHIMOTO, T ABO, H MIYAMURA, T HIRONO, S EGUCHI

    BIOMEDICAL RESEARCH-TOKYO   14 ( 1 )   19 - 25   1993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)   出版者・発行元:BIOMED RES FOUND  

    CD5+ B and coexisting T cells in the thymus of control individuals and patients with myasthenia gravis (MG) were analyzed with monoclonal antibodies in conjunction with a two-color immunofluorescence test. Similar to findings in a mouse study, we found that, in 9 control subjects, CD5+ B cells (mean: 1.5%) were the predominant subset (approximately 80%) among thymic B cells (1.8% of thymocytes). In patients with MG (n=6), both the proportion of CD5+ B (3.2%) and total B cells (7.8%) in the thymus were significantly elevated (P=0.005). In this regard, the ratio of CD5+ B / total B cells in MG (45%) was somewhat lower than in control subjects. This raises the possibility that some CD5- B cells are a CD5-sister population of CD5+ B cells in MG, as has been shown in mouse studies. Coexisting thymic T cells in MG were somewhat different (e.g., in exhibiting a reduction in the double-positive CD4+ CD8+ population) from those in controls. The reason for this finding is discussed with reference to recent findings of medullary T cells in the thymus. The present results might be intimately related to the pathogenesis of MG.

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