研究者業績
基本情報
- 所属
- 藤田医科大学 医学部 医学科 小児外科学 講師 (Senior Assistant Professor)
- 学位
- 学士（医学）
- J-GLOBAL ID
- 201501009575646720
- researchmap会員ID
- 7000012894
研究分野
1論文
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日本小児外科学会雑誌 54(7) 1351-1356 2018年12月 査読有り小児期の十二指腸潰瘍出血は成人に比して稀であるが時に止血困難な症例に遇遭する。止血処置を要した小児期の十二指腸潰瘍出血3例を経験したので報告する。症例1:10歳男児。吸血及び貧血を認め上部消化管内視鏡検査を行い十二指腸球部にDieulafoy潰瘍を認めたためクリッピングにて止血した。症例2:9歳男児。喘息発作に対しステロイド投与を連日行っていたところ、吐下血を認め上部消化管内視鏡検査を行った。十二指腸球部に潰瘍出血を認めたが止血困難であり、interventional radiology(以下IVR)を施行し止血した。症例3:14歳男児。吐下血、出血性ショックを認め上部消化管内視鏡検査を施行した。十二指腸前壁の潰瘍から出血を認め一時止血できたが、入院5日目に再出血し再度内視鏡検査を施行するも止血困難で、IVRにて止血した。小児の十二指腸潰瘍出血に対しても内視鏡治療が第一選択と考えるが、止血困難な場合はIVRも有効な手段である。(著者抄録)
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日本小児外科学会雑誌 54(7) 1347-1350 2018年12月 査読有り症例は10ヵ月、男児。胆汁性嘔吐および経口摂取不良を主訴に来院し、熱源不明の発熱およびイレウスの診断で入院した。翌日の腹部CTにて絞扼による小腸イレウスを疑い、緊急手術を行った。トライツ靱帯から約80cmの部位に捻転した重複腸管を認め先端が炎症性に大網と癒着し、付着部を閉塞起点とした小腸イレウスを来していたため、重複腸管および付着部を含む約20cmの小腸切除を施行した。病理所見では捻転部は腸管粘膜上皮や平滑筋など腸管構造を有し、重複腸管壁は捻転による絞扼で壊死を来していた。膵組織や胃粘膜の迷入は認めなかった。術後にイレウスは順調に改善したが、腹腔内感染による筋膜離開と皮下膿瘍のためドレナージ術を施行し、退院後1ヵ月で腹壁再建術を行った。重複腸管はしばしば遭遇するが本症例は捻転形式が稀で、術前診断が困難であった。今回我々は、まれな重複腸管自体の捻転によりイレウスを発症した1例を経験したので報告する。(著者抄録)
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Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation 16(6) 708-713 2018年12月 査読有りOBJECTIVES: In pediatric patients, renal dysfunction after living-donor liver transplant is a major issue that is difficult to evaluate. Recently, predictive equations for Japanese children have been introduced. MATERIALS AND METHODS: We conducted a retrospective study by prospectively collecting data on 26 patients under 16 years old who underwent living-donor liver transplant between June 2004 and March 2015. Serum creatinine and cystatin C levels were measured. Paired t tests and Bland-Altman plots were used to compare the following formulas for estimated glomerular filtration rate: the Schwartz formula and 3 formulas that were matched with Japanese children (polynomial, simple, and cystatin C formulas). RESULTS: Average estimated glomerular filtrations rates (in mL/min/1.73 m2) were 143.46, 122.90, 121.58, and 123.31 using the Schwartz, polynomial, simple, and cystatin C formulas, respectively. The estimated glomerular filtrations rate for biliary atresia was 141.53 ± 31.37 versus 109.95 ± 19.52 for other diseases, with significant differences only noted with the cystatin C formula. The formulas tailored for Japanese children showed significantly lower estimated glomerular filtrations rates than those obtained using the Schwartz formula (P < .01). CONCLUSIONS: The use of formulas for measuring estimated glomerular filtrations rates that are based on race may allow early detection of deteriorating renal function.
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Pediatric Transplantation 22(7) e13239 2018年11月 査読有り
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PEDIATRIC SURGERY INTERNATIONAL 33(6) 713-719 2017年6月 査読有りPurpose Neuroblastoma is a refractory pediatric malignant solid tumor. The previous studies demonstrated that Polyphyllin D, the main constituent of Paris polyphylla, a traditional Chinese medicine, exerts an anti-tumor effect on many tumors. However, its effects against neuroblastomas are unclear. Methods We examined the anti-tumor effect of polyphyllin D in human neuroblastoma using IMR-32 and LA-N-2 cells, which exhibit MYCN gene amplification, and NB-69 cells, which do not exhibit MYCN gene amplification. Results All cell lines showed reduced cell viability in response to polyphyllin D treatment. No caspase-3/-7, -8, and -9 activity was observed in IMR-32 and LA-N-2 cells treated with polyphyllin D. In contrast, activation of caspase-3/-7, and -8 activity was observed in NB-69 cells. When polyphyllin D and specific inhibitors of RIPK3 involved in necroptosis were added to IMR-32 and LA-N-2 cell lines, polyphyllin D-induced cell death was inhibited. Conclusion Together, this indicates that the underlying mechanism of polyphyllin D-induced cell death in NB-69 cells is apoptosis, whereas the cell death of IMR-32 and LA-N-2 cells occurs by necroptosis. We continue research on this topic and look forward the discovery of a new therapeutic agent for neuroblastoma.
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Journal of Pediatric Surgery Case Reports 17 42-45 2017年2月1日 査読有りWe experienced the case of an eight-month-old male with intralobar pulmonary sequestration complicated by gastric duplication. The chief complaint was an abnormal shadow on the chest radiograph the patient was diagnosed with pulmonary sequestration via chest computed tomography (CT). Intraoperative findings and postoperative histopathological examination revealed intralobar pulmonary sequestration with associated gastric duplication. Pulmonary sequestration is relatively rare although there are reports of extralobar pulmonary sequestration with gastric duplication, the present case of intralobar pulmonary sequestration with gastric duplication is extremely rare. This case is considered to be an embryologic bronchopulmonary foregut malformation, and is considered important in understanding the aetiology.
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PEDIATRIC TRANSPLANTATION 20(5) 707-710 2016年8月 査読有りMSUD is an autosomal recessive condition characterized by a deficiency in the enzyme, BCKDH, which catalyzes the breakdown of BCAAs. If left untreated, MSUD can result in mental retardation, central nervous system disorders, and even death. Most patients with MSUD are treated with a restricted protein diet and milk from which BCAAs have been removed. LT has been shown effective in patients with MSUD. This report describes the case of a 15-month-old boy who received a liver graft from his mother. Transplantation was successful, and the patient was then able to ingest a normal diet. Despite episodes of acute rejection, chylous ascites, and high fever (40 degrees C), he has shown no evidence of MSUD recurrence. These findings indicate that patients with MSUD can be successfully treated by LDLT, even when the donor is a heterozygous carrier of a mutated BCKDH gene.
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Case Reports in Clinical Pathology 3(2) 22-25 2016年6月 査読有り
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日本小児外科学会雑誌 51(7) 1173-1176 2015年12月小児鼠径ヘルニア嵌頓は小児外科領域で緊急手術の必要な急性腹症の1 つである．虫垂嵌頓例はAmyand's hernia と称され稀である．今回我々が経験した2 例を報告する．症例1：1 か月25日男児．哺乳力低下と繰り返す嘔吐で当院小児科を紹介され腹部レントゲンでニボーがあり外科紹介となった．診察時に右鼠径部から陰囊に腫大あり．用手還納試みるも整復不十分であり，他のイレウスの原因も考慮し緊急手術にて臍部より腹腔鏡で観察したところ，右鼠径輪に虫垂・回盲部が嵌頓していた．腹腔内からの牽引と用手圧迫により整復した．症例2：11 か月男児．以前より左鼠径ヘルニアあり．待機手術の予定であったが，クループを発症して当院小児科へ入院となった．入院中に嵌頓し，用手整復困難なため緊急手術となった．鼠径法でアプローチし，ヘルニア囊内から虫垂・回盲部が認められた．
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Journal of Pediatric Surgery Case Reports 3(6) 239-241 2015年6月 査読有り
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移植 50(1) 78-84 2015年A portosystemic shunt remaining after a living-donor liver transplantation sometimes causes a postoperative portal venous flow drop. It is diagnosed with Doppler ultrasound, angiography, contrast-enhanced computed tomography or magnetic resonance angiography. We report a case in which a contrast-enhanced ultrasound was useful to find out a portosystemic shunt. The patient is an 8-year-old girl who had undergone a portoenterostomy for biliary atresia and a living-donor liver transplantation for a hepatopulmonary syndrome at that age of 8 years. Because of an ABO incompatible transplant, a catheter was inserted into the portal vein for local infusion therapy. At first, a Doppler ultrasound showed a normal portal venous flow. On the next day of removal of the portal venous catheter, however, her portal venous flow was not able to be confirmed. We supposed a portal thrombosis, but we were unable to confirm it by the contrast-enhanced CT scan. After a contrast-enhanced ultrasound was performed, we could confirm the portal venous flow and the steal of the portal blood through the remaining portosystemic shunt. In conclusion, a contrast-enhanced ultrasound is useful for the blood flow evaluation after a living-donor liver transplantation.
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日本臨床救急医学会雑誌 15 44-47 2012年
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Journal of Pediatric surgery case report in press 査読有り
MISC
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Pediatric surgery international 35(6) 723-728 2019年6月PURPOSE: Arctigenin has been shown to have anti-tumor effects in various types of cancers. This study was conducted to verify these effects in the human-derived hepatoblastoma cell line, HUH-6 clone 5 (hereinafter, HUH-6). METHODS: Arctigenin was added to cultured HUH-6 cells, and cellular activity was evaluated by MTS assay. To determine the relationship between reduced cellular activity and apoptosis, we measured the activities of caspase 3/7, 8, and 9 and conducted flow cytometry with Annexin V/PI staining. RESULTS: The MTS assay revealed that cellular activity decreased after arctigenin treatment in a concentration-dependent manner (IC50 = 4 µM). To investigate apoptosis induction, activity assays of caspase 3/7, 8, and 9 were performed. While caspase 3/7 and 8 exhibited high activity, caspase 9 showed no activity. Thus, apoptosis induction may have involved the action of tumor necrosis factor receptor 1 (TNFR1). Flow cytometry conducted with Annexin V/PI staining revealed the occurrence of early apoptosis. CONCLUSION: We found that arctigenin has anti-tumor effects in HUH-6 cells in a concentration-dependent manner. Arctigenin may have exerted its anti-tumor effect by inducing apoptosis via TNFR1, which recruits Complex IIa to activate caspase 8 and 3/7. These results may be useful for developing therapeutic agents for hepatoblastoma.
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Minerva pediatrica 2019年1月2日BACKGROUND: Neuroblastoma (NB) is a pediatric malignant solid tumor characterized as refractory cancer with poor prognosis. Mitosis-karyorrhexis index (MKI) is a prognostic factor but is prone to observer bias. The usefulness of MKI with Ki-67, as a marker of malignancy, was investigated. The efficacy of molecular-targeted therapeutic agents with fewer side effects in tumors has been studied. Molecular-targeted therapy targets include vascular endothelial growth factor (VEGF), involved in tumor angiogenesis; c-Kit, receptor of Kit/stem cells involved in tumor growth, vasculature, and lymphangiogenesis; platelet-derived growth factor receptor (PDGFR); and B-Raf proto-oncogene, serine/threonine kinase (BRAF), involved in the RAS protein-mediated mitogen-activated protein kinase pathway. Therefore, expression profiles of these factors and growth inhibitory effects of molecular-targeted drugs against NB were investigated. METHODS: Ten frozen NB tissue samples collected during January 1993-December 2017 were evaluated immunohistochemically for Ki-67 and VEGF. c-Kit, PDGFR, and BRAF expression levels were evaluated using enzyme-linked immunosorbent assays; relationships between these factors and clinicopathological parameters of NB were analyzed. RESULTS: Eight patients with NB showed no amplification of MYCN (MYCN proto- oncogene, bHLH transcription factor). There were two cases of ganglioneuroblastoma (GNB). More NB cells were positive for Ki-67 than for GNB cells. VEGF expression was observed in all NB specimens and was stronger in stage IIB and higher. No BRAF or c-Kit activity was observed; PDGFR activity was greater in NB than in GNB (p = 0.02). CONCLUSIONS: Thus, Ki-67 may help evaluate NB malignancy. As the first therapy for NB prevents amplification of MYCN, agents targeting PDGFR as well as VGFG can inhibit NB cell proliferation.
書籍等出版物
1講演・口頭発表等
16教育内容・方法の工夫（授業評価等を含む）
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件名-終了年月日2013/11/05概要名古屋市立大学 学びなおし講座 感染症