2021/12/04 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

  • 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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  • 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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  • 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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  • 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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  • 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   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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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.

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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.

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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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  • 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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  • [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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  • 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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  • 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.

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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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  • 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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  • 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

  • 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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  • [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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  • 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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  • 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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  • 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

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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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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

  • 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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  • 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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  • [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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  • 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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  • 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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  • 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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  • 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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  • 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

  • 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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  • [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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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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  • 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  

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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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  • 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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  • 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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  • 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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  • 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)

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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.)

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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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  • 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

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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   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.

    DOI: 10.2482/haigan.49.174

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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.

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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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  • 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.

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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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  • 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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  • 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.

    DOI: 10.1016/j.hlc.2007.02.081

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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)  

    DOI: 10.1097/01.rct.0000243451.25986.10

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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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  • 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.

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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.

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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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  • 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.

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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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  • 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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  • 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.

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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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  • 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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  • 劇症型心筋炎に対する外科的補助循環治療の経験

    萱森 裕美, 柏村 健, 井神 康宏, 酒井 亮平, 大久保 健志, 保屋野 真, 柳川 貴央, 小澤 拓也, 尾崎 和幸, 南野 徹, 中村 制士, 大西 遼, 岡本 竹司, 青木 賢治, 榛澤 和彦, 名村 理, 土田 正則

    新潟医学会雑誌   131 ( 12 )   715 - 716   2017年12月

  • 6 妊娠中に深部静脈血栓症から急性肺塞栓を生じ心肺停止に至った症例の治療経験 (Ⅰ.一般演題, 第291回新潟循環器談話会)

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

    新潟医学会雑誌 = 新潟医学会雑誌   131 ( 12 )   716 - 716   2017年12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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  • Is segmentectomy indicative for small-sized non-small cell lung cancer in the basal segments with a small ground-glass opacity component?

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

    JOURNAL OF THORACIC DISEASE   9 ( 10 )   3501 - 3505   2017年10月

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    記述言語:英語   出版者・発行元:AME PUBL CO  

    DOI: 10.21037/jtd.2017.09.101

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  • 慢性心不全で体外設置型補助人工心臓を導入した1症例

    渡邊 達, 五十嵐 聖, 松尾 佑治, 南場 一美, 仲尾 政晃, 山口 祐美, 高野 俊樹, 高山 亜美, 保屋野 真, 柳川 貴央, 小澤 拓也, 柏村 健, 尾崎 和幸, 南野 徹, 中村 制士, 大久保 由華, 岡本 竹司, 青木 賢治, 名村 理, 土田 正則

    新潟医学会雑誌   131 ( 8 )   512 - 512   2017年8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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  • 体外設置型補助人工心臓治療のSSI対策

    名村 理, 大久保 由華, 中村 制士, 鳥羽 麻友子, 岡本 竹司, 青木 賢治, 榛澤 和彦, 土田 正則, 渡邊 達, 五十嵐 聖, 松尾 佑治, 仲尾 政晃, 山口 裕美, 高野 俊樹, 高山 亜美, 保谷野 真, 柳川 貴央, 小澤 拓也, 柏村 健, 尾崎 和幸, 南野 徹

    新潟医学会雑誌   131 ( 8 )   514 - 514   2017年8月

  • 3 逆行性A型急性大動脈解離TEVAR後の追加血管内治療の経験 (Ⅰ.一般演題, 第290回新潟循環器談話会)

    大久保 由華, 岡本 竹司, 中村 制士, 青木 賢治, 榛沢 和彦, 名村 理, 土田 正則

    新潟医学会雑誌 = 新潟医学会雑誌   131 ( 8 )   510 - 510   2017年8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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  • 左上下葉気管支分岐部にポリープ状に発生した炎症性偽腫瘍の1例

    清水 勇希, 佐藤 征二郎, 後藤 達哉, 小池 輝元, 土田 正則, 林 正周, 穂苅 諭, 菊池 利明, 大橋 瑠子

    気管支学   39 ( 4 )   370 - 370   2017年7月

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    記述言語:日本語   出版者・発行元:(NPO)日本呼吸器内視鏡学会  

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  • 6 リードによる右室穿孔に対する当科での治療戦略 (Ⅱ.テーマ演題, 第289回新潟循環器談話会)

    中村 制士, 青木 賢治, 鳥羽 麻友子, 大久保 由華, 長澤 綾子, 岡本 竹司, 榛沢 和彦, 名村 理, 土田 正則

    新潟医学会雑誌 = 新潟医学会雑誌   131 ( 6 )   377 - 378   2017年6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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  • Could One Define "FARD Score (Female, Aging, Respiratory & D-Dimer)" in Regard to Deep Vein Thrombosis in Cases With Immobilization?

    Koichi Sato, Kazuhiko Hanzawa, Takeshi Okamoto, Ayako Nagasawa, Kenji Aoki, Osamu Namura, Masanori Tsuchida

    ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY   37   2017年5月

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

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  • 左心系弁膜症術後遠隔期の高度三尖弁逆流に対する外科治療患者9例の検討

    柏村 健, 藤木 伸也, 渡邊 達, 林 由香, 尾崎 和幸, 南野 徹, 名村 理, 青木 賢治, 岡本 竹司, 土田 正則

    新潟医学会雑誌   131 ( 3 )   195 - 195   2017年3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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  • 10 80歳以上の高齢者における開窓型ステントグラフトを用いたTEVARの有用性 (Ⅱ.テーマ演題「高齢者循環器疾患の治療」, 第288回新潟循環器談話会)

    岡本 竹司, 佐藤 哲彰, 仲村 亮宏, 大久保 由華, 中村 制士, 長澤 綾子, 青木 賢治, 榛澤 和彦, 名村 理, 土田 正則

    新潟医学会雑誌 = 新潟医学会雑誌   131 ( 3 )   197 - 197   2017年3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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  • Repeated Lung Resection of Ipsilateral Lung Cancer That is Detected after Segmentectomy for Primary Lung Cancer

    Masanori Tsuchida, Tatsuya Goto, Akihiko Kitahara, Seijiro Sato, Terumoto Koike

    JOURNAL OF THORACIC ONCOLOGY   12 ( 1 )   S1399 - S1399   2017年1月

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

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  • 内皮のp53は、血管機能調節に重要な役割を果たす(Endothelial p53 is Crucially Involved in Regulating Vascular Function)

    長澤 綾子, 清水 逸平, 吉田 陽子, 土田 正則, 南野 徹

    Anti-aging Science   8 ( 1 )   68 - 68   2016年12月

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    記述言語:英語   出版者・発行元:(株)メディカルレビュー社  

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  • Predictive Value of Preoperative Serum Tumor Marker Levels for Pathological Characteristics of Resected Lung Adenocarcinoma

    Terumoto Koike, Akihiko Kitahara, Seijiro Sato, Takehisa Hashimoto, Shin-ichi Toyabe, Masanori Tsuchida

    CHEST   150 ( 4 )   699A - 699A   2016年10月

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

    DOI: 10.1016/j.chest.2016.08.794

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  • ホルマリン固定後パラフィン包埋肺腺癌検体からのDNA抽出濃度について : 次世代シーケンサーによる網羅的遺伝子解析のために

    佐藤 征二郎, 市川 寛, 島田 能史, 永橋 昌幸, 若井 俊文, 土田 正則, 井筒 浩, 兒玉 啓輔, 中田 光隆, Sato Seijiro, Ichikawa Hiroshi, Shimada Yoshifumi, Nagahashi Masayuki, Wakai Toshifumi, Tsuchida Masanori, Izutsu Hiroshi, Kodama Keisuke, Nakada Mitsutaka

    新潟医学会雑誌 = Niigata medical journal   130 ( 10 )   601 - 611   2016年10月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    【緒言】近年,次世代シーケンス技術の開発が進み、高速シーケンサーを用いて, 微量DNAから短時間で多検体のシーケンスが可能となり,がんゲノムの網羅的解析から,がん個別化医療のバイオマーカーとして,ドライバー遺伝子変異の探索が盛んに行われるようになった.次世代シーケンサーを用いて多数の遺伝子異常を同時に検査するクリニカルシーケンスが期待されてきているが,その際に問題となるのは臨床検体の取り扱いである.従って, 本研究の目的は,次世代シーケンサーを用いた網羅的遺伝子解析を想定した際の, 肺腺癌組織より抽出したDNA量や質を組織亜型,分化度の違いから検討し、また、実際に必要とされる臨床検体(FFPEスライド)量を考察することとした.【方法】肺癌手術を施行され,凍結切片を有する肺腺癌68症例のホルマリン固定後パラフィン包哩(FFPE)検体をHE染色にて評価し,腫瘍胞巣に含まれる全細胞含有面積に占めるがん細胞含有率20%以上の63例を解析対象とした. 組織亜型の内訳は,置換性増殖優位型腺癌(lepidic)が5例,乳頭状増殖優位型腺癌(papillary)が44例,腺房状増殖優位型肺癌(acinar)が5例,充実性増殖優位型腺癌(solid)が2例,粘液腺癌(mucinous)が7例であった.各FFPEブロックから連続切片20μm, 2枚よりDNAを抽出した.単位面積当たりのDNA抽出濃度や断片化(Q-ratio : [129bp]/[41bp])について組織亜型間で比較し,また,解析に必要とされる臨床検体量 (腫瘍面積)を考察した.【結果】単位面積当たりのDNA抽出濃度は中央値4.20ng/μL(範囲:0.32ng/μL/mm^2 - 19.25ng/μL/mm^2)であった.Q-ratioについては中央値1.03 (範囲 : 0.79-1.57) とすべて基準値以上であった.組織亜型間においては抽出されたDNAの単位面積当たりの濃度では置換性増殖優位型腺癌は粘液腺癌と比較し, 単位面積当たりのDNA抽出濃度が有意に多かった(p=0.046).粘液非産生型腺癌は有意に粘液産生型腺癌より単位面積当たりのDNA抽出量は多かった(p<0.01).また,分化度間の単位面積当たりのDNA抽出量では中・低分化腺癌は有意に高分化腺癌より単位面積当たりのDNA抽出量は多かった(p=0.012).腫瘍面積とDNA抽出量につきPearsonの相関係散を算出すると, r=0.486, p<0.01と有意に正の相関を認めた.必要最低腫瘍面積の算出では30mm^2当たりのDNA抽出量は、平均29.0±23.4ngl/μL(範囲 : 3.86ng/μL-116.5ng/μL)であり,全症例において基準となる3.75ng/μLをクリアーした.【結語】肺腺癌では,粘液産生の有無,分化度がDNA抽出量に影響を与えることが分かった.腫瘍胞巣面積,瘢痕巣の割合から全細胞面積を算出しそこに含まれるがん細胞含有率(>20%)を確認し,必要最低全細胞面積をクリアー出来る切片枚数を確保することが肝要であると思われる.

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  • Surgical Resection for Solitary Myocardial Metastasis of Gastric Cancer

    Ayako Nagasawa, Terumoto Koike, Takeshi Okamoto, Osamu Namura, Masanori Tsuchida

    ANNALS OF THORACIC SURGERY   101 ( 5 )   1978 - 1980   2016年5月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Six years after primary surgical treatment for gastric cancer, fluoro-deoxy-glucose positron emission tomography/computed tomography was performed in a 72-year-old man, and demonstrated an increased fluoro-deoxyglucose uptake in the apex of the left ventricle. Magnetic resonance imaging also revealed a solitary small myocardial tumor. Under cardiopulmonary bypass, tumorectomy was performed with a macroscopically sufficient margin. Histopathologic examination showed adenocarcinoma with poor differentiation developed in the myocardium and pericardial fat; these findings were compatible with the previously resected gastric cancer. The postoperative course was uneventful; the patient has been alive for 29 months without any evidence of local recurrence or cardiac events. (C) 2016 by The Society of Thoracic Surgeons

    DOI: 10.1016/j.athoracsur.2015.06.108

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  • 睡眠呼吸障害・リハビリテーション 当院における肺切除術後の呼吸器合併症と術前呼吸リハビリテーションの現状

    穂苅 諭, 大嶋 康義, 鈴木 涼子, 小屋 俊之, 各務 博, 土田 正則, 菊地 利明

    日本呼吸器学会誌   5 ( 増刊 )   148 - 148   2016年3月

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  • 脳死両肺移植後の小腸DLBCL発症に対して化学療法施行後に気管支アスペルギローシスを発症した1例

    河本 啓介, 佐藤 征二郎, 根本 洋樹, 小林 弘典, 柴崎 康彦, 牛木 隆志, 森山 雅人, 瀧澤 淳, 成田 美和子, 土田 正則, 曽根 博仁, 増子 正義

    臨床血液   56 ( 11 )   2361 - 2361   2015年11月

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    記述言語:日本語   出版者・発行元:(一社)日本血液学会-東京事務局  

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  • 5 弁尖拡張を伴う三尖弁形成術を施行した高度三尖弁閉鎖不全症の症例(Ⅰ.一般演題, 第282回新潟循環器談話会)

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

    新潟医学会雑誌 = 新潟医学会雑誌   129 ( 10 )   608 - 608   2015年10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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  • 逆行性A型大動脈解離に対するステントグラフト内挿術の初期中期成績の検討

    青木 賢治, 土田 正則, Aoki Kenji, Tsuchida Masanori

    新潟医学会雑誌   129 ( 7 )   382 - 395   2015年7月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    【目的】Stanford分類A型大動脈解離のうち, 下行大動脈にエントリーを有し逆行性に上行大動脈まで解離した, 逆行性A型大動脈解離(RAAD)に対するステントグラフト内挿術の初期中期成績を検討した, 【対象と方法】2012年4月から2014年6月までに当科でRAADに対するステントグラフト内挿術を連続11例経験した. これらの症例を対象とし, 手術成績, 治療前後の大動脈病変の変化を評価した. ステントグラフトはTAGおよびその後継機のconformable TAG(W.L.Gore & Associates社, Flagstaff, Arizona)を使用した. 大動脈病変の変化を示す指標としてcomputed tomographyで肺動脈分岐部レベルにおける上行および下行大動脈径, 各大動脈径に対する真腔径の比率(true lumen index:TLi)および偽腔厚の比率(false lumen index:FLi)を計測した. 【結果】9例に発症24時間以内の緊急手術を実施した. 他の2例も非慢性期(発症3日目, 16日目)に予術を実施した. 全例で手技成功を得た. 手術死亡はなく, 脳梗塞, 脊髄虚血など手技に関連する合併症もなかった. 上行大動脈径の平均は術前46.5±5.6mm, 術後2週46.9±6.7mm, 術後3カ月41.9±4.4mmであり, 上行大動脈径は術前に比し術後3カ月で有意に縮小していた(P<0.01). また上行大動脈TLiの平均は術前0.63±0.16, 術後2週0.75±0.11, 術後3カ月0.90±0.10であり, 真腔は術前に比し術後2週で有意に拡大していた(P=0.037). 上行大動脈FLiの平均は術前0.35±0.16, 術後2週0.24±0.11, 術後3カ月0.10±0.09であり, 偽腔は術後2週で有意に縮小し(P=0.040), 術後3カ月ではほぼ消失していた. 下行大動脈径の平均は術前37.7±2.5mm, 術後2週38.5±3.4mm, 術後3カ月33.9±4.5mmであり, 下行大動脈径は術前に比し術後3カ月で有意に縮小していた(P<0.01). また下行大動脈TLiの平均は術前0.50±0.12, 術後2週0.71±0.07, 術後3カ月0.84±0.09であり, 真腔は術前に比し術後2週で有意に拡大していた(P<0.01). 下行大動脈FLiの平均は術前0.45±0.11, 術後2週0.25±0.06, 術後3カ月0.14±0.12であり, 偽腔は術後2週で有意に縮小していた(P<0.01). 平均14.9±8.2ヶ月, 中央値15ヶ月の観察期間において死亡例はなく, 追加治療を含む大動脈関連イベントはなかった. 【結論】急性期のRAADに対する企業製ステントグラフトを用いた血管内治療の初期中期成績はきわめて良好であった. 本法はRAADに対する第1選択的治療として発展する可能性がある.

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    その他リンク: http://hdl.handle.net/10191/44117

  • 7 Time-resolved CT angiograrhy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(Ⅱ.テーマ演題「診断・治療に苦慮した症例」, 第280回新潟循環器談話会)

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

    新潟医学会雑誌 = 新潟医学会雑誌   129 ( 6 )   340 - 341   2015年6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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    その他リンク: http://search.jamas.or.jp/link/ui/2016020525

  • 症例報告 胸骨縦切開を追加して切除し得た無症候性進行甲状腺癌の1例

    庭野 稔之, 小山 諭, 永橋 昌幸, 長谷川 美樹, 利川 千絵, 土田 純子, 若井 俊文, 小池 輝元, 橋本 毅久, 土田 正則, Niwano Toshiyuki, Koyama Yu, Nagahashi Masayuki, Hasegawa Miki, Toshikawa Chie, Tsuchida Junko, Wakai Toshifumi, Koike Terumoto, Hashimoto Takehisa, Tsuchida Masanori

    新潟医学会雑誌   129 ( 5 )   281 - 286   2015年5月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    甲状腺癌のうち乳頭癌(papillary carcinoma)の頻度は90%と大部分を占め, 頸部リンパ節転移の頻度が高く, 高齢者では未分化癌に転化することもある. 今回, 結腸癌術後の全身検索で発見され, 胸骨縦切開を追加して切除可能であった無症候性進行甲状腺癌の1例を経験したので文献的考察を加えて報告する. 症例は76歳, 女性. 上行結腸癌手術後7年目にCA19-9値の上昇傾向を指摘され, CT検査では上縦隔へ進展した7cm大の甲状腺腫瘤と1.5cm大の右頸部リンパ節腫大を認めた. 穿刺吸引細胞診では class III であったが甲状腺癌が強く疑われたため, 手術目的に当科入院となった. 術前の頸部CTおよびMRI検査では, 甲状腺腫瘍は上縦隔まで進展していたが, 明らかな血管への浸潤所見は認めず, 気管支鏡検査では明らかな気管浸潤は認めなかった. 手術を施行し, 右頸部リンパ節を摘出し術中迅速病理診断に提出したところ乳頭癌の診断が得られたため, 甲状腺全摘術および頸部リンパ節郭清の方針となった. 術中所見では, 上縦隔内の無名静脈および右頸動脈への浸潤が疑われ, 切除可能か否かの判定が困難であった. 視野を確保し, 血管等への浸潤の有無を判定するために胸骨縦切開を追加した. その結果, 良好な視野が得られ, 無名静脈, 右左総頸動脈への直接浸潤を認めず, 腫瘍の切離が可能となり, 甲状腺全摘術および頸部リンパ節郭清を施行した. 甲状腺癌, 特に乳頭癌は10年生存率が80~90%と良好であり, また, 放置した場合に気管浸潤, 血管浸潤を伴うと, 生命予後のみならず, 患者QOLも著しく損なわれるので, 可能であるならば積極的に切除を行うことが望ましい.

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  • 当院における間質性肺炎合併肺癌例の後方視的検討

    石川 大輔, 坂上 拓郎, 朝川 勝明, 岡島 正明, 三浦 理, 渡部 聡, 小屋 俊之, 森山 寛史, 田中 純太, 各務 博, 高田 俊範, 成田 一衛, 土田 正則

    日本呼吸器学会誌   4 ( 増刊 )   201 - 201   2015年3月

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  • 幼小児期の人工心肺下心臓手術における周術期急性腎障害発症予測因子としての尿中バイオマーカーの重要性

    渡邉 マヤ, 土田 正則, Watanabe Maya, Tsuchida Masanori

    新潟医学会雑誌   128 ( 11 )   581 - 592   2014年11月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    人工心肺下心臓手術術後の急性腎障害(AKI)は, 短期, 長期の予後予測因子として注目されている. 早期治療介入のためにはAKIの早期予測が必要だが, AKI診断に用いられる「血清クレアチニン(Cre)の上昇」は腎機能障害の結果であり, 潜在的な腎機能障害を予測することはできない. 今回, 2~15歳の人工心肺下心臓手術71例を対象とし, 周術期の尿中バイオマーカーを定量し, AKIの早期予測因子としての可能性を検討した. 血清Cre, 尿中アルブミン(Alb), α1-microgrobulin(α1MG), β2-microglobulin(β2MG), neutrophil gelatinase-associated lipocalin(NGAL), N-acetyl β-D glucosaminidase(NAG)を定量し, 尿中バイオマーカーは尿中Cre補正値を用いて検討した. AKIN診断基準に基づきAKI評価を行い, AKI群(A群)と非AKI群(N群)を比較検討した. AKI発症率は30%, A群は有意に低年齢で, 手術時間, 体外循環時間が長時間であった. AKI発症はファロー四徴症手術で50%, Fontan手術で66.6%と特に高率であった. A群で術後CVPが有意に高く, 前述の疾患群で術後の循環動態維持に高いCVPを要することを反映していると考える. 高いCVPは腎鬱血や糸球体障害, 糸球体潅流圧低下をきたしAlb漏出や腎機能障害の誘因になると推察された. 尿中Alb/Creは人工心肺離脱後1時間以降, 全ての測定ポイントにおいてA群で有意に高値であり, ROC-AUC値は人工心肺離脱後3時間0.832, 6時間0.846, 12時間0.845であった. 尿中α1MG/Creは人工心肺離脱後6時間以降においてA群で有意に高値であり, ROC-AUC値は人工心肺離脱後6時間0.710, 12時間0.759であった. 尿中NAG/Creは人工心肺離脱後1, 2, 3, 18, 24時間においてA群で有意に高値であり, ROC-AUC値は人工心肺離脱後1時間0.714, 2時間0.712であった. 尿中NGAL/CreはA群で高値を示す傾向が認められたが, 尿中β2MG/Creは有意差を認めなかった. 幼小児期の心臓手術において尿中Alb/Cre, α1MG/Cre, NAG/Creの術後AKI早期診断マーカーとしての有用性が示唆された.

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    その他リンク: http://hdl.handle.net/10191/43976

  • 新生児期人工心肺下心臓手術における術後急性腎障害発症予測因子としての尿中バイオマーカーの重要性

    渡邉 マヤ, 高橋 昌, 土田 正則, 斎藤 亮彦, 西塔 毅, Watanabe Maya, Takahashi Masashi, Tsuchida Masanori, Saito Akihiko, Saito Takeshi

    新潟医学会雑誌   128 ( 11 )   593 - 602   2014年11月

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    記述言語:日本語   出版者・発行元:新潟医学会  

    人工心肺下心臓手術術後の急性腎障害(AKI)は, 短期, 長期の予後予測因子として注目されている. 早期治療介入, 予後改善のためには周術期のAKI発症を早期に予測することが必要である. しかし, AKI診断に用いられる「血清クレアチニン(Cre)の上昇」は腎機能障害の結果であり, 上昇時にはすでに一定の障害が進行しているため, 潜在的な腎機能障害を予測することはできない. 早期予測因子として各種尿中バイオマーカーが検討されているが, 新生児は発達途上の腎の未熟性, 脆弱性があり, 血清Creや各種バイオマーカーの動態も成人とは異なると考えられ, 成人と同等に論じることはできない. さらに, 新生児早期では出生直後の血清Creは自身の腎機能を反映せず, 母体血清Creを反映するため血清Creを用いたAKI診断自体が難しいことがある. 今回, 新生児期人工心肺下心臓手術周術期の各種尿中バイオマーカーを定量し, AKIの早期予測因子としての可能性を検討した. 2010年5月から2013年7月に当科で施行した新生児症例28例を対象とし, 周術期の血清Cre, 尿中アルブミン(Alb), α1-microgrobulin(α1MG), β2-microglobulin(β2MG), neutrophil gelatinase-associated lipocalin(NGAL), N-acetyl β-D glucosaminidase(NAG)を定量した. 尿中バイオマーカーは尿中Cre補正値を用いて検討した. AKINの診断基準に基づきAKIを評価し, AKI群(A群)と非AKI群(N群)の二群に分けて比較検討した. 対象28例中, AKI発症は13例(46.4%)であった. 手術死亡3例はいずれもAKI stage3症例であり, 背景因子では, A群において手術時間が有意に長かった. 術直後, 1病日血清Creに有意差は認められなかったが, 2病日血清CreではA群において有意に高値(p=0.014)であった. 尿中Alb/Cre, 尿中β2MG/Cre, 尿中NGAL/Cre値に両群間で統計学的有意差は認められなかった. 尿中α1M/Cre, 尿中NAG/Creは, 人工心肺離脱後3時間という早期からA群で有意に高値であった. ROC-AUC値(感度, 特異度)は, 尿中NAG/Creで人工心肺離脱後3時間:0.794(75%, 80%), 6時間:0.744(76.9%, 73.3%), 12時間:0.794(83.3%, 66.7%), 尿中α1MG/Creで人工心肺離脱後3時間:0.774(66.7%, 80%), 6時間0.731(69.2%, 73.3%), 12時間:0.761(75%, 63.3%)と比較的良好であった. 尿中NAG/Cre, 尿中α1MG/Creの二因子を組み合わせることにより診断精度を上げることができ, 新生児期人工心肺下心臓手術の術後AKIの早期診断マーカーとしての有用性が示唆された.

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    その他リンク: http://hdl.handle.net/10191/43977

  • 19 巨大右冠動脈瘤に対する外科治療の経験(一般演題, 第275回新潟外科集談会)

    佐藤 哲彰, 青木 賢治, 名村 理, 長澤 綾子, 岡本 竹司, 榛沢 和彦, 土田 正則

    新潟医学会雑誌 = 新潟医学会雑誌   128 ( 7 )   339 - 339   2014年7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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  • 8 一期的修復術を施行したFallot四徴症・肺動脈弁閉鎖・主要体肺動脈側副動脈 (TOF / PA / MAPCA) の1例(一般演題, 第274回新潟外科集談会)

    大久保 由華, 渡邉 マヤ, 白石 修一, 高橋 昌, 土田 正則

    新潟医学会雑誌   128 ( 7 )   330 - 330   2014年7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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  • 多発性内分泌腫瘍症(MEN)I型が疑われた前縦隔神経内分泌腫瘍の1例

    坪谷 隆介, 鈴木 浩史, 植村 靖行, 山田 貴穂, 鈴木 達郎, 北澤 勝, 阿部 孝洋, 古川 和郎, 松永 佐澄志, 皆川 真一, 鈴木 亜希子, 羽入 修, 曽根 博仁, 土田 正則

    新潟医学会雑誌   128 ( 6 )   277 - 277   2014年6月

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  • 4 破裂性腹部大動脈瘤に対する手術成績の検討 : EVARの優位性とは(Ⅱ. テーマ演題, 第276回新潟循環器談話会)

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

    新潟医学会雑誌 = 新潟医学会雑誌   128 ( 4 )   186 - 187   2014年4月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2014333894

  • PS-098-4 震災被災者のDVT陽性率は避難所環境を示す : 東日本大震災後避難所におけるDVT検査結果(PS-098 末梢血管 基礎・その他,ポスターセッション,第114回日本外科学会定期学術集会)

    榛沢 和彦, 岡本 竹司, 名村 理, 青木 賢治, 土田 正則, 植田 信策, 高瀬 信也, 粕谷 元, 谷口 哲

    日本外科学会雑誌   115 ( 2 )   770 - 770   2014年3月

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  • PS-035-5 胸膜浸潤におけるupstagingの妥当性について(PS-035 肺 転移・再発,ポスターセッション,第114回日本外科学会定期学術集会)

    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 ( 2 )   645 - 645   2014年3月

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    記述言語:日本語   出版者・発行元:一般社団法人日本外科学会  

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  • OP-072-2 心臓手術後急性期の体液貯留に対するトルバプタンの有効性(OP-072 心臓 移植・心筋虚血,一般演題,第114回日本外科学会定期学術集会)

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

    日本外科学会雑誌   115 ( 2 )   442 - 442   2014年3月

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  • NUMBER OF METASTATIC LYMPH NODES AND METASTATIC LYMPH NODE RATIO PREDICT PATIENT SURVIVAL IN RESECTED NON-SMALL CELL LUNG CANCER

    Seijiro Sato, Toru Shirato, Terumoto Koike, Takehisa Hashimoto, Masanori Tsuchida

    JOURNAL OF THORACIC ONCOLOGY   8   S523 - S523   2013年11月

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

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  • INTRAPLEURAL ADMINISTRATION OF A COMBINATION OF CISPLATIN AND FIBRIN GLUE FOR PLEURAL LAVAGE CYTOLOGY-POSITIVE PATIENTS WITH NON-SMALL CELL LUNG CANCER

    Hirohiko Shinohara, Takahisa Koizumi, Tadashi Aoki, Katsuo Yoshiya, Teruaki Koike, Masanori Tsuchida

    JOURNAL OF THORACIC ONCOLOGY   8   S508 - S508   2013年11月

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

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  • POSTOPERATIVE OUTCOME OF PATIENTS WITH PULMONARY LARGE-CELL NEUROENDOCRINE CARCINOMA

    Terumoto Koike, Toru Shirato, Seijiro Sato, Takehisa Hashimoto, Masayuki Saito, Akira Okada, Takehiro Watanabe, Masanori Tsuchida

    JOURNAL OF THORACIC ONCOLOGY   8   S816 - S817   2013年11月

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

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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 = The journal of the Japanese Association for Chest Surgery   27 ( 5 )   22 - 28   2013年7月

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  • 肺癌切除後二次癌に対する再手術 (特集 胸部外科領域における再手術 : 最近の動向) -- (呼吸器領域)

    土田 正則

    胸部外科 = The Japanese journal of thoracic surgery   66 ( 8 )   703 - 707   2013年7月

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    記述言語:日本語   出版者・発行元:南江堂  

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    その他リンク: http://search.jamas.or.jp/link/ui/2013275201

  • Successful surgical removal of an intravenous leiomyoma extending to the right atrium 4 years after hysterectomy

    Chizuo Kikuchi, Fuyuki Asami, Kazuhiko Hanzawa, Masanori Tsuchida

    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY   43 ( 6 )   1262 - 1262   2013年6月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS INC  

    DOI: 10.1093/ejcts/ezs610

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  • 8 特異な経過を呈した僧帽弁形成術後感染性心内膜炎の1例(一般演題, 第272回新潟循環器談話会)

    名村 理, 岡本 竹司, 大久保 由華, 青木 賢治, 榛澤 和彦, 土田 正則

    新潟医学会雑誌 = 新潟医学会雑誌   127 ( 6 )   330 - 331   2013年6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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    その他リンク: http://search.jamas.or.jp/link/ui/2014056858

  • PS-027-1 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(PS ポスターセッション,第113回日本外科学会定期学術集会)

    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 ( 2 )   555 - 555   2013年3月

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    記述言語:日本語   出版者・発行元:一般社団法人日本外科学会  

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  • PS-258-5 深部静脈血栓症の発生頻度と予測因子の臥床入院患者における総合的検討(PS ポスターセッション,第113回日本外科学会定期学術集会)

    佐藤 浩一, 榛沢 和彦, 岡本 竹司, 名村 理, 土田 正則, Roland Hetzerl

    日本外科学会雑誌   114 ( 2 )   882 - 882   2013年3月

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    記述言語:日本語   出版者・発行元:一般社団法人日本外科学会  

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  • PS-028-2 Dual Source CTによる生体弁機能評価の有用性と発展性(PS ポスターセッション,第113回日本外科学会定期学術集会)

    青木 賢治, 堀 祐郎, 名村 理, 岡本 竹司, 大久保 由華, 榛沢 和彦, 土田 正則

    日本外科学会雑誌   114 ( 2 )   557 - 557   2013年3月

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    記述言語:日本語   出版者・発行元:一般社団法人日本外科学会  

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  • 18 ヨードアレルギーを合併した腹部大動脈瘤に対するステントグラフト治療の1例(一般演題, 第272回新潟外科集談会)

    岡本 竹司, 堀 祐郎, 榛澤 和彦, 大山 俊之, 白戸 亨, 竹久保 賢, 名村 理, 土田 正則

    新潟医学会雑誌 = 新潟医学会雑誌   127 ( 3 )   162 - 162   2013年3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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    その他リンク: http://search.jamas.or.jp/link/ui/2013333103

  • 12 未挿管下麻酔管理で行えた腹部ステントグラフト2症例(一般演題, 第273回新潟外科集談会)

    荒井 勇樹, 岡本 竹司, 大久保 由華, 堀 祐郎, 榛沢 和彦, 青木 賢治, 竹久保 賢, 名村 理, 土田 正則, 窪田 正幸

    新潟医学会雑誌 = 新潟医学会雑誌   127 ( 3 )   168 - 168   2013年3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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    その他リンク: http://search.jamas.or.jp/link/ui/2013333120

  • 14 ECMOを使用して手術を行った右気胸の1手術例(一般演題, 第273回新潟外科集談会)

    白戸 亨, 佐藤 征二郎, 小池 輝元, 橋本 毅久, 土田 正則

    新潟医学会雑誌   127 ( 3 )   169 - 169   2013年3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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  • 13 S^6を温存した肺底動脈大動脈起始症の1切除例(一般演題, 第272回新潟外科集談会)

    白戸 亨, 篠原 博彦, 橋本 毅久, 土田 正則

    新潟医学会雑誌   127 ( 3 )   160 - 161   2013年3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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    その他リンク: http://search.jamas.or.jp/link/ui/2013333098

  • 18 胸膜肺全摘術における人工物を用いない心膜, 横隔膜の再建法(一般演題, 第270回新潟外科集談会)

    橋本 毅久, 土田 正則, 北原 哲彦, 篠原 博彦, 林 純一

    新潟医学会雑誌   127 ( 2 )   113 - 113   2013年2月

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    記述言語:日本語   出版者・発行元:新潟医学会  

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    その他リンク: http://search.jamas.or.jp/link/ui/2013320262

  • 2 当科における緊急大動脈ステントグラフト内挿術の現状と課題(I.一般演題, 第271回新潟循環器談話会)

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

    新潟医学会雑誌 = 新潟医学会雑誌   127 ( 1 )   55 - 56   2013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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    その他リンク: http://search.jamas.or.jp/link/ui/2013301674

  • Impact of Trans-Esophageal Echocardiography (TEE) in Patients with Silent Cerebral Infarction

    Kazuhiko Hanzawa, Atsushi Morishita, Terutaka Nishimatsu, Masanori Tsuchida

    CEREBROVASCULAR DISEASES   34   56 - 56   2012年

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

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  • USEFULNESS OF ECG-GATED MULTI DETECTION COMPUTED TOMOGRAPHY (MDCT) FOR EVALUATION OF CARDIOVASCULAR INVASION IN THORACIC MASS

    Masanori Tsuchida, Takehisa Hashimoto, Hirohiko Shinohara, Hiroyuki Ishikawa

    JOURNAL OF THORACIC ONCOLOGY   6 ( 6 )   S363 - S364   2011年6月

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

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  • FACTORS INFLUENCING SURVIVAL OF PATIENT WITH PATHOLOGICAL PROVEN N1 NON-SMALL CELL LUNG CANCER

    Hirohiko Shinohara, Takehisa Hashimoto, Masanori Tsuchida

    JOURNAL OF THORACIC ONCOLOGY   6 ( 6 )   S886 - S887   2011年6月

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

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  • Long-term results of prospective study of limited resection for bronchioloalveolar adenocarcinoma of the lung

    Masanori Tsuchida, Takehisa Hashimoto, Hirohiko Shinohara, Jun-ichi Hayashi

    JOURNAL OF THORACIC ONCOLOGY   4 ( 9 )   S569 - S569   2009年9月

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

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  • 肺手術のための臨床局所解剖--外科医に必要な開胸操作の解剖と手技 (特集 手術のための臨床局所解剖)

    土田 正則, 青木 正, 橋本 毅久

    臨床外科   61 ( 5 )   573 - 578   2006年5月

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    記述言語:日本語   出版者・発行元:医学書院  

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    その他リンク: http://search.jamas.or.jp/link/ui/2006208631

  • 間質性肺炎に著明な気腫性病変を伴った慢性関節リウマチの1例

    金澤 雅人, 佐藤 瑞穂, 森山 寛史, 大井 秀美, 鈴木 栄一, 下条 文武, 磯田 学, 斎藤 正幸, 土田 正則, 梅津 哉

    日本胸部臨床   61 ( 6 )   528 - 536   2002年6月

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    記述言語:日本語   出版者・発行元:克誠堂出版(株)  

    39歳男.2年前の職場検診の胸部X線像にて両側上肺野の気腫性変化を指摘されていた.今回,多関節痛,朝の手のこわばりと労作時呼吸困難を自覚して来院,胸部CTにて両側肺下葉の間質性病変が認められ,関節症状から慢性関節リウマチ(RA)と診断された.胸腔鏡下生検では間質性肺炎(IP)と気腫性変化が認められ,気道病変は認めなかったが,細気管支領域から肺胞腔内に泡沫細胞の集簇を認めた.これ迄に気道病変を伴わない気腫性変化とRAに伴うIPとの関連についての報告はないが,泡沫細胞の出現がみられたことから,び漫性汎細気管支炎類似の細気管支病変の潜在的な合併の可能性が考えられた.明らかな呼吸器症状を呈さないRA症例においても,早期から呼吸機能検査や胸部CTを含む肺病変の精査を行うことが重要であると考えられた

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  • Complications associated with pulmonary resection in lung cancer patients on dialysis

    M Tsuchida, Y Yamato, T Aoki, T Watanabe, T Hashimoto, H Shinohara, J Hayashi

    ANNALS OF THORACIC SURGERY   71 ( 2 )   435 - 438   2001年2月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Background. There are few studies available investigating the perioperative problems experienced by lung cancer patients on dialysis undergoing pulmonary resection.
    Methods. A retrospective review of 7 patients on dialysis undergoing pulmonary resection for lung cancer was performed.
    Results. The patient population consisted of 7 men, with a mean age of 59.9 years. The underlying kidney disease was glomerulonephritis in 5 patients and nephrosclerosis in 2. The mean levels of blood urea nitrogen and serum creatinine were 70.7 mg/dL and 9.4 mg/dL, respectively. Histologic diagnoses were adenocarcinoma in 2 patients and squamous cell carcinoma in 5. Standard lobectomy with lymph node dissection was performed in all cases. There was one operation related death due to pulmonary edema and subsequent development of pneumonia. There were two cases of sputum retention and four of hyperkalemia. One patient died of cerebral bleeding that occurred during dialysis 2 months postoperatively.
    Conclusions. In patients on dialysis who undergo pulmonary resection, there is a high incidence of pulmonary complications, in addition to hyperkalemia, hemodynamic instability, and a tendency for postoperative dialysis-associated bleeding. (C) 2001 by The Society of Thoracic Surgeons.

    DOI: 10.1016/S0003-4975(00)02226-8

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  • Costimulatory signal blockade by anti-CD2 monoclonal antibody in combination with 15-deoxyspergualin prolongs concordant xenograft survival

    M Haga, H Hirahara, M Tsuchida, T Watanabe, M Takekubo, J Hayashi

    TRANSPLANTATION PROCEEDINGS   32 ( 5 )   1006 - 1008   2000年8月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/S0041-1345(00)01086-1

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  • Synergistic effect of anti-T cell receptor monoclonal antibody and 15-deoxyspergualin on cardiac xenograft survival in a mouse-to-rat model

    M Haga, M Tsuchida, H Hirahara, T Watanabe, JI Hayashi, H Watanabe, Y Matsumoto, T Abo, S Eguchi

    TRANSPLANTATION   69 ( 12 )   2613 - 2621   2000年6月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Background. Successful xenograft transplantation faces several obstacles including the presence of xenoantibodies, natural killer cell- and macrophage-mediated rejection, and T lymphocyte activation.
    Methods. A mouse-to-rat cardiac xenograft model was used to examine the synergistic effect of anti-T cell receptor (TCR) monoclonal antibodies (mAb) and 15-deoxyspergualin (DSG) on graft survival.
    Results. Pretransplantation injections (days -5, -3, and -1) of anti-TCR mAb (500 mu g/kg/day) combined with continuous i.p. infusion of DSG (5 mg/kg/day) from day -7 to 28 significantly prolonged graft survival compared to untreated controls (3.3+/-0.5 vs. 44.2+/-5.6 days, P&lt;0.001). Postoperative splenectomy combined with discontinuation of all other treatment on day 28 enhanced graft survival in rats treated with anti-TCR mAb and DSG to 71.0+/-2.5 days. Histological examination of grafts showed characteristic signs of vascular rejection: interstitial edema and hemorrhage, and polymorphonuclear cell infiltration. Anti-mouse antibody titers in recipients were increased upon rejection in each group that received a xenograft. Flow cytometry analysis showed a markedly decreased T cell population and a relatively increased mature B cell population (IgM(bright)/IgD(dull)) in spleens of rats treated with anti-TCR mAb and DSG on day 28.
    Conclusions. The mechanism of prolonged xenograft survival in this model may include inhibition of antibody production by arrest of B-cell maturation during development from IgMd(dull)/IgD(bright) mature a cells to antibody producing cells, and inhibition of T cell activation. The rejection seen in our model may be caused by xenoreactive antibodies and may be associated with T cells, natural killer cells, and macrophages.

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  • Thymectomy for elderly myasthenia gravis patients - Reply

    M Tsuchida, Y Yamato, J Hayashi

    ANNALS OF THORACIC SURGERY   69 ( 1 )   314 - 314   2000年1月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:ELSEVIER SCIENCE INC  

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  • CT-guided agar marking for localization of nonpalpable peripheral pulmonary lesions

    M Tsuchida, Y Yamato, T Aoki, T Watanabe, N Koizumi, Emura, I, J Hayashi

    CHEST   116 ( 1 )   139 - 143   1999年7月

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    記述言語:英語   出版者・発行元:AMER COLL CHEST PHYSICIANS  

    Background: Small pulmonary lesions with ground-glass opacity (GGO) are increasingly detected by CT; however, intraoperative localization of such lesions is difficult because these lesions are often invisible and nonpalpable.
    Study objectives: To localize and resect nonpalpable and invisible small pulmonary lesions, a new marking technique that we call "agar marking" was developed.
    Methods and patients: Powdered agar was dissolved in distilled water at a concentration of 5% and kept at &gt; 50 degrees C to maintain its liquid form. Agar was injected through an 18-gauge needle and placed near the target lesion with CT. lifter animal experiments, agar marking was applied to the nine patients who had lesions &lt; 20 mm in diameter and lesions with GGO. The mean diameter of these lesions was 11 mm, with a mean depth of 19 mm from the pleural surface on CT.
    Results: Agar could be detected as a hard nodule by manual palpation, and the lesion was resected during thoracotomy in all cases. There were no complications associated with the agar injection, aside from one case of slight pneumothorax.
    Conclusions: Agar marking may represent a feasible alternative technique for localizing nonpalpable occult lesions located away from the pleural surface.

    DOI: 10.1378/chest.116.1.139

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  • Efficacy and safety of extended thymectomy for elderly patients with myasthenia gravis

    M Tsuchida, Y Yamato, T Souma, K Yoshiya, T Watanabe, T Aoki, J Hayashi

    ANNALS OF THORACIC SURGERY   67 ( 6 )   1563 - 1567   1999年6月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    Background. The number of elderly patients who are diagnosed as myasthenia gravis (MG) is increasing in Japan. Although several factors affecting thymectomy have been well documented, few studies have focused on the efficacy and safety of thymectomy for elderly patients older than 60 years.
    Methods. We evaluated 94 patients with MG who underwent extended thymectomy, and divided them into two groups: patients younger than 59 years and patients older than 60 years. Preoperative patient data, pathology of the thymus, complications, and clinical outcome were evaluated.
    Results. In 69 young patients and 25 elderly patients, we observed no significant differences between the two groups with regard to preoperative data. Thymic hyperplasia was present in 45% of the young group and 16% of the elderly group. Remission and improvement rate were 40% and 57% in the young group and 8% and 75% in the elderly group, respectively. There were no serious complications, except one early death due to gastrointestinal bleeding in the elderly group.
    Conclusions. We conclude that thymectomy is a safe and effective alternative for elderly patients with MG. (C) 1999 by The Society of Thoracic Surgeons.

    DOI: 10.1016/S0003-4975(99)00167-8

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  • A model of human anti-T-cell monoclonal antibody therapy in SCID mice engrafted with human peripheral blood lymphocytes

    M Tsuchida, SA Brown, LM Tutt, J Tan, DL Seehafer, JP Harris, CQ Xun, JS Thompson

    CLINICAL TRANSPLANTATION   11 ( 5 )   522 - 528   1997年10月

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    記述言語:英語   出版者・発行元:MUNKSGAARD INT PUBL LTD  

    A chimeric severe combined immunodeficient mouse engrafted with human peripheral blood (hu-PBL-SCID) model has been developed to test anti-T-cell monoclonal antibody (mAb) effects on systemic symptoms of the host and the survival of human skin grafts. To obtain consistent engraftment without lethal acute graft-versus-host disease (GVHD), SCID mice were pretreated with a combination of total body irradiation (2.5 Gy, day 0) and anti-asialo GM1 (anti-mouse natural killer cell) antiserum (50 mu g i.p., day 3) before the intraperitoneal injection of 40-50 x 10(6) human PBL on day 4. With this protocol, the engraftment rate was 82% with 5-98% human CD45-positive cells in the peripheral blood. Mortality at 30 days was 0% in the mice bearing 5-50% human cells compared with 70% in those with more than 50%. Using hu-PBL-SCID mice with 5-50% human cells in their peripheral blood, we demonstrated the following results: 1) Human T cells isolated from these mice proliferated in response to immobilized OKT3 stimulation in vitro. 2) Hu-PBL-SCID mice but not normal SCID mice were able to reject human skin grafts in vivo 16-21 days after grafting. 3) Both OKT3 (anti-human CD3 mAb) and T10B9 (anti-human ap T-cell receptor mAb) treatment prevented human skin graft rejection in hu-PBL-SCID mice. 4) OKT3 but not T10B9 induced first dose reactions characterized by hypothermia and hypoactivity which were consistently observed within 90 min of intravenous injection into hu-PBL-SCID mice. 5) Human cytokines were detected in the serum of the hu-PBL-SCID mice treated with anti-TT-cell mAbs. The close similarity of these responses to human clinical mAb immunosuppressive therapy suggests that the hu-PBL-SCID mouse model may be an excellent tool for investigating the immunosuppression, side effects, and mechanism of action of agents that are specific for human and higher apes and not reactive with lower animals.

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  • Effect of cardiopulmonary bypass on cytokine release and adhesion molecule expression in alveolar macrophages - Preliminary report in six cases

    M Tsuchida, H Watanabe, T Watanabe, H Hirahara, M Haga, H Ohzeki, H Hayashi, H Miyamura, T Hirono, T Abo, S Eguchi

    AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE   156 ( 3 )   932 - 938   1997年9月

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    記述言語:英語   出版者・発行元:AMER LUNG ASSOC  

    Although recent studies have shown that adhesion molecules on alveolar macrophages are important in a variety of pulmonary diseases, there have been few studies on the phenotypic and functional changes of alveolar macrophages during cardiopulmonary bypass. To investigate the possible role of alveolar macrophages in activating pulmonary immunity during cardiopulmonary bypass, we measured the expression of adhesion molecules on alveolar macrophages and peripheral blood monocytes in patients undergoing cardiopulmonary bypass. Antigens were stained with monoclonal antibodies against adhesion molecules, and the expression of antigens was quantified by flow cytometry as the ratio of specific to nonspecific linear fluorescence. On alveolar macrophages obtained after the release of aortic cross-clamp, macrophages as compared with alveolar macrophages obtained before cardiopulmonary bypass, there was a significant enhancement of CD11a, CD11b, CD11c, and CD18. In addition, alveolar macrophages, but not peripheral monocytes, produced higher levels of TNF-alpha and IL-8 when they were cultured in vitro. A higher expression of CD11 and CD18 on alveolar macrophages and enhanced production of cytokines after release of the aortic cross-clamp may contribute to immune activation in lung by macrophage-lymphocyte interaction.

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  • Delaying transplantation after total body irradiation is a simple and effective way to reduce acute graft-versus-host disease mortality after major H2 incompatible transplantation

    CQ Xun, M Tsuchida, JS Thompson

    TRANSPLANTATION   64 ( 2 )   297 - 302   1997年7月

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    記述言語:英語   出版者・発行元:WILLIAMS & WILKINS  

    Background. We have previously reported that delaying histoincompatible transplantation after total body irradiation (TBI) conditioning markedly decreased the mortality of acute graft-versus-host disease (GVHD) in severe combined immunodeficiency mice. However, it was not clear whether the delayed transplantation would affect the final engraftment and acute GVHD mortality in normal hosts. Methods. BALB/c mice (H2(d)) were lethally irradiated with 8.5 Gy TBI and transplanted with C57BL/6 (H2(d)) bone marrow plus spleen cells on the same day (TBI+day 0) or 4 days after TBI conditioning (TBI+day 4).
    Results. We again demonstrated that delaying transplantation by 4 days after TBI conditioning markedly reduced acute GVHD mortality in normal hosts after major histoincompatible transplantation. The survival rates were 66% in TBI+day 4 vs. 0% in TBI+day 0 allogeneic transplanted animals by day +60 (P&lt;0.001). Further analysis demonstrated that the 4-day rest between the TBI and allogeneic transplantation broke the interaction of cell/inflammatory tumor necrosis factor-alpha, interleukin (IL)-1 beta, and IL-6 cytokine reactions stimulated by TBI and incompatible transplantation. Flow cytometry revealed 97% donor cells in host marrow by 2 weeks in TBI+day 0 transplantation versus 57% in TBI+day 4 transplantation. There was no difference in percentage of donor CD3+ T-cell engraftment between the TBI+day 0 and TBI+day 4 allogeneic transplanted animals. In TBI+day 4 transplantation, the percentage of donor cells in host marrow steadily increased to 74% by day +60 and 93% by day +100.
    Conclusions. This 2- to 3-month early mixed chimerism in TBI+day 4 transplanted animals might be related to lower levels of tumor necrosis factor-alpha and IL-6 both of which have been shown to stimulate lymphohematopoiesis and was associated with lower acute GVHD mortality. The data again demonstrated in immunologically normal BALB/c mice that delaying allogeneic transplantation after TBI is a simple and effective way to reduce acute GVHD mortality, achieve satisfactory engraftment and significantly increase overall survival.

    DOI: 10.1097/00007890-199707270-00021

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  • T10B9 action: The effect of anti-T-cell antibody mitogenicity and graft rejection on the first dose cytokine response

    S Brown, B Lucas, T Waid, W McKeown, M Tsuchida, J Thompson

    TRANSPLANTATION PROCEEDINGS   29 ( 1-2 )   315 - 316   1997年2月

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    記述言語:英語   出版者・発行元:ELSEVIER SCIENCE INC  

    DOI: 10.1016/S0041-1345(96)00281-3

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  • Video-assisted thoracic surgery for thorascopic resection of giant bulla

    M Tsuchida, K Nakayama, M Shinonaga, S Tatebe, A Yamaguchi

    SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY   26 ( 5 )   349 - 352   1996年

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    記述言語:英語   出版者・発行元:SPRINGER VERLAG  

    This report outlines our experience of 6 patients who underwent video-assisted thoracic surgery (VATS) using a linear endoscopic stapler to remove a giant bulla from the lung, Successful treatment with VATS was carried out in 4 patients, but the procedure needed to be changed to a thoracotomy in 2 patients - in one because of difficulty in single-lung ventilation, and in the other, due to a persistent air leak, Thus, we conclude that giant bulla without any associated severe respiratory failure can be an indication for VATS.

    DOI: 10.1007/BF00311605

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  • LONG-TERM SURVIVAL OF CARDIAC ALLOGRAFTS IN RATS TREATED BEFORE AND AFTER SURGERY WITH MONOCLONAL-ANTIBODY TO CD2

    H HIRAHARA, M TSUCHIDA, T WATANABE, M HAGA, Y MATSUMOTO, T ABO, S EGUCHI

    TRANSPLANTATION   59 ( 1 )   85 - 90   1995年1月

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    記述言語:英語   出版者・発行元:WILLIAMS & WILKINS  

    The rejection of a transplanted allograft is dependent on T cell activation, which requires T cell receptor engagement by antigen and costimulatory signals delivered by T cell surface molecules such as CD2. Anti-CD2 mAbs have been shown to suppress cell-mediated immunity. The effects of anti-CD2 mAbs OX34 and OX54 on rejection of BN (RT1(n)) rat hearts transplanted heterotopically to LEW (RT1(l)) rats were investigated. Administration of OX34 (7 mg/kg/day i.p.), either for 3 consecutive days immediately before or 8 consecutive days immediately after transplantation induced indefinite allograft survival (median survival time: 7, &gt; 150, and &gt; 150 days for control, preoperative treatment, and postoperative treatment, respectively). In contrast, pre- or postoperative treatment with OX54 (40 mg/kg/day) prolonged median survival time to only 28 and 11 days, respectively. Administration of OX34 or OX54 to naive rats induced a transient depletion of T cells in the peripheral immune organs. In vitro studies revealed that whereas OX54 had no effect on the allogeneic mixed lymphocyte reaction, OX34 partially inhibited both the allogeneic mixed lymphocyte reaction, in an IL-2-reversible manner, and T cell proliferation in response to immobilized mAb to either the T cell receptor or CD3. OX34-treated rats in which the cardiac allograft had survived &gt; 100 days accepted a second heart from the donor strain. Treatment with OX34 induced an alloantigen-unresponsive state in T cells. These results suggest that treatment with an appropriate anti-CD2 mAb, especially postoperatively, may prove an effective approach for preventing cardiac allograft rejection.

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  • FLOW-CYTOMETRY ANALYSIS OF INCREASED EXPRESSION OF LFA-1 ICAM-1 IN TCR-POSITIVE LYMPHOCYTES INFILTRATING CARDIAC ALLOGRAFTS IN RATS

    M TSUCHIDA, H HIRAHARA, T HIRONO, H HANAWA, Y MATSUMOTO, T ABO, S EGUCHI

    TRANSPLANTATION PROCEEDINGS   26 ( 6 )   3727 - 3730   1994年12月

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    記述言語:英語   出版者・発行元:APPLETON & LANGE  

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  • ANTI-ALPHA-BETA T-CELL RECEPTOR ANTIBODY PREVENTS THE PROGRESSION OF EXPERIMENTAL AUTOIMMUNE MYOCARDITIS

    H HANAWA, M KODAMA, T INOMATA, T IZUMI, A SHIBATA, M TUCHIDA, Y MATSUMOTO, T ABO

    CLINICAL AND EXPERIMENTAL IMMUNOLOGY   96 ( 3 )   470 - 475   1994年6月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE LTD  

    We investigated the effects of anti-alpha beta T cell receptor antibody in rat experimental autoimmune myocarditis (EAM), using a new animal model of autoimmune myocarditis characterized by the appearance of multinucleated giant cells. EAM was induced by injecting Lewis rats subcutaneously in the footpads with 1.0 mg of human cardiac myosin in an equal volume of Freund's complete adjuvant (FCA) on days 0 and 7. In experiment 1, we evaluated the effect of long-term anti-alpha beta TCR antibody therapy on prevention of progression of EAM. Long-term administration of anti-alpha beta TCR antibody prevented progression of EAM in a dose-dependent manner. Flow cytometry performed at the time of sacrifice showed that the percentage of alpha beta T cells in lymph nodes and spleen was similar in the control group and the group in which almost no histologic evidence of myocarditis was found. In experiment 2, we examined the effects of short-term therapy. Rats were killed at different stages and pathologic specimens were examined. Short-term therapy delayed the onset of myocarditis. Results of flow cytometry suggested that impairment of antigen recognition or T cell function by occupancy of the TCR rather than depletion of TCR was the mechanism responsible for suppression of EAM.

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  • IDENTIFICATION OF CD4(-) CD8(-) ALPHA-BETA T-CELLS IN THE SUBARACHNOID SPACE OF RATS WITH EXPERIMENTAL AUTOIMMUNE ENCEPHALOMYELITIS - A POSSIBLE ROUTE BY WHICH EFFECTOR-CELLS INVADE THE LESIONS

    M TSUCHIDA, H HANAWA, H HIRAHARA, H WATANABE, Y MATSUMOTO, H SEKIKAWA, T ABO

    IMMUNOLOGY   81 ( 3 )   420 - 427   1994年3月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE LTD  

    Experimental autoimmune encephalomyelitis (EAE) was induced in Lewis rats to elucidate the origin of effector T cells and the route by which they invade lesions. Since mouse studies have suggested that some autoimmune diseases are induced by extrathymic T cells in the liver, we focused our attention on the properties of mononuclear cells (MNC) isolated from the liver and other organs in rats with EAE. A small but significant proportion of LFA-1(+) alpha beta T cells was identified in the liver as early as day 7 after immunization with myelin basic protein (MBP). Such LFA-1(+) alpha beta T cells were also abundant among MNC attached to the spinal cord (i.e. subarachnoid space), and MNC infiltrated the spinal cord in rats with EAE (day 12). In electron microscopy, MNC attached to the spinal cord were found to be quite unique in terms of their large cell size with well-developed microvilli. More importantly, they were comprised of a considerably large proportion of double-negative CD4(-) CD8(-) T cells as well as single-positive CD4(+) T cells. However, the cells which infiltrated the spinal cord were mainly CD4(+). The present results raise the possibility that the subarachnoid space might be a major site for the expansion of extrathymic T cells in rats with EAE, and that only a limited population of CD4(+) T cells invade the spinal cord directly through the outer layer and elicit EAE.

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  • SUCCESSFUL PREVENTION AND TREATMENT OF AUTOIMMUNE ENCEPHALOMYELITIS SHORT-TERM ADMINISTRATION OF ANTI-T-CELL RECEPTOR-ALPHA-BETA ANTIBODY

    Y MATSUMOTO, M TSUCHIDA, H HANAWA, T ABO

    IMMUNOLOGY   81 ( 1 )   1 - 7   1994年1月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE LTD  

    To identify an effective immunotherapy for T-cell-mediated autoimmune diseases, prevention and treatment of experimental autoimmune encephalomyelitis (EAE) induced in Lewis rats was attempted by administering a monoclonal antibody (mAb), R73, which is specific for rat T-cell receptor (TcR) alpha beta. Short-term administration of R73 at relatively low doses before immunization with encephalitogenic antigen, myelin basic protein (MBP), prevented the development of EAE. However, treatment with anti-CD4 and anti-Ia mAb in the same protocol was ineffective. Flow cytometric analysis demonstrated that short-term administration of R73 resulted in transient down-regulation of the TcR molecules, whereas the number of CD2-expressing T cells was well preserved. Furthermore, the response to MBP of T cells isolated from rats that were pretreated with R73 and then immunized with MBP was strongly suppressed. On the other hand, the T-cell response of R73-pretreated rats to a third-party antigen which was immunized at a later period was not inhibited. These findings suggest that in vivo administration of a low dose of R73 protects rats from EAE by inducing anergy of MBP-reactive encephalitogenic T cells. Furthermore, R73 treatment which started on day 10 of the immunization (shortly before the day of onset of clinical signs) completely suppressed the induction of EAE and that which started on day 11 (the day of onset) hastened recovery. Since the phenotypes of the TcR V beta chain of encephalitogenic T cells are not so limited as previously believed, immunotherapy with mAb against the TcR alpha beta framework may be one of the best methods for treatment of T-cell-mediated autoimmune diseases.

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  • INDUCTION OF SPECIFIC UNRESPONSIVENESS TO CARDIAC ALLOGRAFTS BY SHORT-TERM ADMINISTRATION OF ANTI-T CELL-RECEPTOR ALPHA-BETA ANTIBODY

    M TSUCHIDA, H HIRAHARA, Y MATSUMOTO, T ABO, S EGUCHI

    TRANSPLANTATION   57 ( 2 )   256 - 262   1994年1月

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    記述言語:英語   出版者・発行元:WILLIAMS & WILKINS  

    Organ graft rejection is a T cell-dependent process in which activation of alloreactive T cells via the T cell receptor/CD3 complex is a critical step. Although treatment with anti-CD3 has been shown to prevent and reverse allograft rejection, there is little information available regarding the effects of immunotherapy using anti-TCR alpha beta mAb for rejection. In the present study, short-term preoperative treatment of rats with a mAb against alpha beta TCR (R73) completely prevented the rejection of cardiac allografts. These rats accepted second cardiac allografts from the same donor strain, but not from a third-party strain, without additional treatment. In mixed lymphocyte cultures, T cells from rats that had received cardiac grafts did not respond to donor-strain heart cells, but did respond to donor-strain spleen cells and third-party heart cells. These findings suggest that specific unresponsiveness to cardiac tissue was induced in R73-treated rats. Such unresponsiveness was induced only when rats were pretreated with the mAb and subsequently received a transplant. It is likely that administration of a small dose of R73 induced transient immunomodulation of TCR molecules, resulting in unresponsiveness to a subsequent cardiac allograft. Immunotherapy with mAb against TCR alpha beta is very effective, without apparent side effects, and may provide a new method for preventing graft rejection.

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  • PREFERENTIAL DISTRIBUTION OF V-BETA 8.2-POSITIVE T-CELLS IN THE CENTRAL-NERVOUS-SYSTEM OF RATS WITH MYELIN BASIC PROTEIN-INDUCED AUTOIMMUNE ENCEPHALOMYELITIS

    M TSUCHIDA, Y MATSUMOTO, H HIRAHARA, H HANAWA, K TOMIYAMA, T ABO

    EUROPEAN JOURNAL OF IMMUNOLOGY   23 ( 10 )   2399 - 2406   1993年10月

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    記述言語:英語   出版者・発行元:VCH PUBLISHERS INC  

    To determine the role of encephalitogenic T cells in the formation of lesions in the central nervous system (CNS), experimental autoimmune encephalomyelitis (EAE) was induced in Lewis rats by immunization with either myelin basic protein (MBP) or the synthetic peptide which corresponds to the 87-100 sequence of guinea pig MBP, and T cells expressing T cell receptor (TcR) Vbeta8.2, Vbeta8.5, Vbeta10 and Vbeta16 in the lymphoid organs and CNS were localized and quantified by flow cytometry (FCM) and immunohistochemistry. In normal rats, the percentage of T cells expressing these Vbeta phenotypes to the total number of TcR alphabeta+ T cells, as determined by FCM, ranged from 5% to 10% in the lymph node. Vbeta16+ T cells were the most predominant population among the four Vbeta subsets tested. Essentially the same findings were obtained from the analysis of the lymphoid organs of rats with EAE which had been induced by immunization with the same two antigens. In sharp contrast, 15-20% of the T cells isolated from lesions of MBP-induced EAE expressed Vbeta8.2. Thus, the percentage of Vbeta8.2+ T cells in the EAE lesions was threefold higher than that in the lymph node, while the proportions of Vbeta8.5+, Vbeta10+ and Vbeta16+ T cells were about the same in both organs. The predominance of Vbeta8.2+ T cells in EAE lesions was confirmed by counts of immunohistochemically stained T cells in the spinal cord. Moreover, it was revealed that (i) the predominance of Vbeta8.2+ T cells was greatest during the development of EAE and became less obvious at the recovery stage, and (ii) at the peak stage of EAE, approximately 85% of Vbeta8.2+ T cells were distributed in the parenchyma while 15% were in the perivascular space of the CNS vessels. These findings indicate that encephalitogenic T cells which express Vbeta8.2 infiltrate the CNS at a very early stage of EAE and become the predominant population in infiltrating T cells, and further suggest that encephalitogenic T cells, not only recruit inflammatory cells in the CNS, but also cause neural tissue damage, such as demyelination.

    DOI: 10.1002/eji.1830231004

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  • IN-SITU INACTIVATION OF INFILTRATING T-CELLS IN THE CENTRAL-NERVOUS-SYSTEM WITH AUTOIMMUNE ENCEPHALOMYELITIS - THE ROLE OF ASTROCYTES

    Y MATSUMOTO, H HANAWA, M TSUCHIDA, T ABO

    IMMUNOLOGY   79 ( 3 )   381 - 390   1993年7月

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    記述言語:英語   出版者・発行元:BLACKWELL SCIENCE LTD  

    Our previous study using bromodeoxyuridine (BrdU) has shown that T cells in lesions of experimental autoimmune encephalomyelitis (EAE) in the rat central nervous system (CNS) lose their proliferating capability immediately after infiltration into the CNS. To characterize the nature of this phenomenon in more detail, we have isolated T cells from EAE lesions and examined their surface phenotype and response to encephalitogenic antigen, myelin basic protein (MBP). By flow cytometry (FCM) analysis, it was revealed that compared with peripheral blood lymphocytes, up-regulation of interleukin-2 (IL-2) receptors (0.06% --&gt; 3.73%) and the lymphocyte function-associated antigen-I (LFA-1) molecules (0.76% --&gt; 17.6%) on spinal cord T cells (SCT) was observed. In spite of the latter finding suggesting that SCT are activated, SCT recovered from rats with full-blown EAE responded very poorly to MBP. The addition of thymocytes or thymocytes plus astrocytes did not alter the low responsiveness of SCT. More importantly, astrocytes strongly suppressed the response of lymph node T cells to MBP. Using MBP-specific T-line cells, it was revealed that T-cell suppression might be induced by incomplete presentation of MBP and release of suppressive humoral factors by astrocytes. Since the response of SCT was still poor when assayed after three and 12 rounds of stimulation with the antigen and propagation with IL-2, this phenomenon is long lasting. These findings are consistent with the findings obtained by the BrdU study that infiltrating T cells into the CNS do not proliferate vigorously. Taken together, the poor response of infiltrating T cells to MBP would be induced by co-existing cells such as astrocytes although the T cells are in an active form as judged by their surface phenotype. The present study suggests that activation of non-haematopoietic parenchymal cells in each organ by infiltrating T cells and subsequent inactivation of the T cells are important healing processes for organ-specific autoimmune diseases.

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  • PREFERENTIAL DISTRIBUTION OF NU-BETA-8.2+ T-CELLS IN THE RAT CENTRAL-NERVOUS-SYSTEM WITH MYELIN BASIC PROTEIN-AUTOIMMUNE ENCEPHALOMYELITIS

    Y MATSUMOTO, M TSUCHIDA, H HANAWA, H HIRAHARA, K TOMIYAMA, T ABO

    JOURNAL OF NEUROPATHOLOGY AND EXPERIMENTAL NEUROLOGY   52 ( 3 )   313 - 313   1993年5月

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

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  • RELATIVE RESISTANCE OF INTERMEDIATE TCR CELLS TO ANTI-CD3 MAB IN MICE INVIVO AND THEIR PARTIAL FUNCTIONAL-CHARACTERIZATION

    M TSUCHIDA, T IIAI, H WATANABE, T ABO

    CELLULAR IMMUNOLOGY   145 ( 1 )   78 - 90   1992年11月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS  

    DOI: 10.1016/0008-8749(92)90314-F

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受賞

  • がん集学的治療研究財団

    1999年  

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    受賞国:日本国

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  • 上原記念生命科学財団海外留学助成リサーチフェローシップ

    1994年  

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    受賞国:日本国

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  • 新潟県医師会研究助成

    1993年  

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    受賞国:日本国

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  • 新潟大学医学部塚田医学助成

    1992年  

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    受賞国:日本国

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共同研究・競争的資金等の研究

  • Surgery of lung cancer

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    資金種別:競争的資金

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  • Induction of spectific tolerance to allograft

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    資金種別:競争的資金

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  • Change of immunclogical response during and after cardiopulmonary bypass

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    資金種別:競争的資金

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  • 肺癌の外科治療

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    資金種別:競争的資金

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  • 同種移植における免疫寛容誘導の研究

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    資金種別:競争的資金

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  • 体外循環に伴う免疫反応の変化

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    資金種別:競争的資金

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  • 臓器別講義・演習Ⅱ

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    機関名:新潟大学

  • 臓器別講義・演習Ⅰ

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    機関名:新潟大学

  • 臨床医学講義(集中)

    2018年
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    機関名:新潟大学

  • 臨床実習II(clinical clerkship)

    2018年
    機関名:新潟大学

  • 臨床実習ⅡA(clinical clerkship)

    2018年
    機関名:新潟大学

  • 日本事情自然系B

    2007年
    機関名:新潟大学

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