医学部

hara fujio

  (原 普二夫)

Profile Information

Affiliation
School of Medicine Faculty of Medicine, Fujita Health University
Degree
医学博士(名古屋市立大学)

J-GLOBAL ID
200901066895779503
researchmap Member ID
1000054985

Papers

 11
  • Toshihiro Yasui, Tatsuya Suzuki, Fujio Hara, Shunsuke Watanabe, Naoko Uga, Atsuki Naoe, Tetsushi Yoshikawa, Tetsuya Ito, Yoko Nakajima, Hiroki Miura, Atsushi Sugioka, Yutaro Kato, Takamasa Tokoro, Yoshinao Tanahashi, Mureo Kasahara, Akinari Fukuda, Hiroki Kurahashi
    PEDIATRIC TRANSPLANTATION, 20(5) 707-710, Aug, 2016  Peer-reviewed
    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.
  • 安井 稔博, 鈴木 達也, 原 普二夫, 渡邉 俊介, 宇賀 菜緒子, 直江 篤樹
    日本小児外科学会雑誌, 51(7) 1173-1176, Dec, 2015  
    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ヵ月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嚢に腫大あり、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ヵ月男児。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、ヘルニア嚢内から虫垂・回盲部が認められた。(著者抄録)
  • 渡邉 俊介, 鈴木 達也, 安井 稔博, 加藤 充純, 日比 将人, 原 普二夫
    日本小児外科学会雑誌, 51(7) 1153-1157, Dec, 2015  
    下腹部腫瘤とイレウス症状による急性腹症にて発症した腸間膜原発脂肪腫の6歳4ヵ月女児例を経験した。腹部造影CTにより、腸間膜の捻転を伴った長径10cmの脂肪成分よりなる腫瘍が疑われ、腹腔鏡補助下の緊急手術を施行した。腫瘍は小腸間膜内に存在し、腫瘍を原因とした小腸捻転を認めた。腫瘍は腸管壁に接し腸管を圧迫していたため小腸とともに腫瘍を摘出した。病理組織診断は成熟脂肪細胞からなる脂肪腫であった。小児期における腸間膜腫瘍は脂肪芽腫の報告は見られるも、脂肪腫は非常に稀である。そのため術前の画像検査では鑑別は困難であった。術後7ヵ月経過した現在、再発は認めていない。(著者抄録)
  • 安井 稔博, 鈴木 達也, 原 普二夫, 渡邉 俊介, 宇賀 菜緒子, 直江 篤樹, 冨重 博一
    小児外科, 47(6) 621-623, Jun, 2015  
  • Tomishige H, Morise Z, Suzuki T, Hara F, Hibi M, Kato T, Hashimoto T
    World journal of clinical cases, 2(5) 157-159, May, 2014  Peer-reviewed
    The location of an ingested foreign object is often difficult to determine by X-ray if gastric air bubbles are not clear in the image. Methods that provide negative contrast can facilitate precise object localization, which is important for object retrieval and treatment of the patient. This case report describes a male child, 2 years and 2 mo of age, who accidentally swallowed a lithium battery while playing at home. A plain X-ray showed that the battery was in the abdomen, but it was unclear whether the object was still inside the stomach. A second X-ray examination performed after oral administration of a bloating agent to produce expansion of the stomach and provide negative contrast confirmed that the ingested battery was still in the stomach. The battery was then carefully removed using magnetic and balloon catheters under fluoroscopic guidance. This case report describes the successful use of an orally administered bloating agent without pain to the child in order to determine the precise location of a foreign object in the abdomen.

Misc.

 11
  • Tatsuya Suzuki, Takashi Hashimoto, Mohamed Hamed Hussein, Fujio Hara, Masahito Hibi, Takazumi Kato
    JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, 20(5) 465-470, Jun, 2013  
    It is difficult to discriminate between choledochal cust with obstructive jaundice and biliary atresia with a cyst at the porta hepatis in neonates or young infants. This review evaluates whether it is possible to differentiate between these two diseases. We here also provide an overview of our experience with type I cyst biliary atresia patients. Among all the biliary atresia infants who we treated, the infants who were diagnosed with type I cyst biliary atresia were identified and reviewed for their management and outcome. The clinical course and management in different reports were reviewed and compared to the cases presented to our institution. Among the 220 biliary atresia cases, 11 (5 %; male/female: 4/7) were diagnosed to be type I cyst biliary atresia. Two received hepaticoenterostomy and nine received hepatic portoenteros. Three patients had severe late complications; overall, nine (81.8 %) were alive with their native liver and without jaundice. Patient with choledochal cust are likely to represent larger cysts and inversely, smaller, static, anechoic cysts are more likely to represent cystic biliary atresia. However, exceptional cases were yet presented, and a definitive diagnosis may not be reached. Thus a complete differentiation between choledochal cust from type I cyst biliary atresia is yet hard to reach.
  • Mohamed Hamed Hussein, Takashi Hashimoto, Tatsuya Suzuki, Ghada Abdel-Hamid Daoud, Tatenobu Goto, Yoko Nakajima, Takazumi Kato, Masahito Hibi, Hirokazu Tomishige, Fujio Hara, Shin Kato, Hiroki Kakita, Michi Kamei, Tetsuya Ito, Ineko Kato, Atsushi Sugioka, Hajime Togari
    Annals of Transplantation, 18(1) 63-68, 2013  
    Main indications for liver transplantation in the pediatric population include biliary atresia and inherited metabolic diseases. The present study evaluated whether there are differences between pediatric patients undergoing living-related liver transplantation due to the two diseases in terms of their oxidative and immunological status Pduring their regular outpatient follow-up visits. A clinical outpatient study measuring serum oxidative stress index (calculated as serum oxidant/antioxidant ratio, in the form of serum total hydroperoxide/serum biological antioxidative potential), serum terminal complement component 5a, as an indicator of complement activity and immunological status, and transforming growth factor-β1, as a marker of liver fibrosis, in 16 patients (6 males and 10 females, 2.5-15 years old) who received living-related liver transplantation due to inherited metabolic diseases (n=6 in the form of propionic acidemia [n=1], methylmalonic acidemia [n=1], arginase deficiency [n=1], tyrosinemia [n=2], and glycogen storage disease type 1b [n=1], with an age range of 2.4-14.6 years old) and due to biliary atresia ([n=10], with an age range of 2.9-14.5 years old). Serum oxidative stress index, complement component-5a, and transforming growth factor-β1 were significantly higher in the inherited metabolic diseases group than in the biliary atresia group. In all patients, serum oxidative stress index correlated positively with complement component-5a and transforming growth factor-β1. Patients who receive living-related liver transplantation due to inherited metabolic diseases are prone to higher oxidative stress, complement activity, and serum transforming growth factor-β1.
  • Akira Masaoka, Satoshi Kondo, Shingi Sasaki, Fujio Hara, Takeo Mizuno, Yosuke Yamakawa, Toru Kobayashi, Yoshitaka Fujii
    EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 41(2) 329-334, Feb, 2012  
    Throughout the history of surgery for pectus excavatum (PE), the Nuss procedure and open repair have been performed with many modifications, with most of these procedures using a metal bar. However, the use of a metal bar has several drawbacks. Thus, we aimed to develop a procedure that did not require a metal bar. Through our experience of 426 pediatric cases that underwent various procedures for open repair of PE at Nagoya City University, we arrived at the current procedure that we describe herein. We have evaluated this procedure by review of clinical results and deformity indices (Haller's, steepness, excavation volume, and asymmetry index). The latest and current procedure that supports the sternum with a bridge constructed by the 4th or 5th costal cartilages is associated with fewer complications, a lower re-operation rate, and striking improvement in the indices examined. Our current open-repair procedure that does not require a metal bar is recommended for correction of deformities of PE in children.
  • Mohamed Hamed Hussein, Takashi Hashimoto, Ghada AbdEl-Hamid Daoud, Takazumi Kato, Masahito Hibi, Hirokazu Tomishige, Fujio Hara, Tatsuya Suzuki, Yoko Nakajima, Tatenobu Goto, Tetsuya Ito, Ineko Kato, Atsushi Sugioka, Hajime Togari
    PEDIATRIC SURGERY INTERNATIONAL, 27(3) 263-268, Mar, 2011  
    ABO-incompatible liver transplantation (LTx) is becoming more common in response to the paucity of liver allografts. Several studies have expressed concern about the effect of ABO compatibility on graft survival. To evaluate the differences in serum cytokine levels between ABO-incompatible (ABO-i) and ABO-compatible (ABO-c; includes ABO-compatible and identical) pediatric LTx recipients during regular outpatient follow-up. Note that, in the field of organ transplantation, transplants are categorized as incompatible, compatible or identical; accordingly, these are the terms we use in the paper. A clinical outpatient study measuring serum transforming growth factor (TGF)-beta 1, interferon (IFN)-gamma, interleukin (IL)-2 and IL-10 in 43 living related liver transplantation (LRLT) recipients, of whom 36 received ABO-c LRLT (34 were ABO-identical and 2 were non-identical) and 7 ABO-i LRLT. Serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, gamma-glutamyl transpeptidase, alkaline phosphatase, lactate dehydrogenase and bilirubin were measured as part of the patients' regular follow-up visits. There were no differences between the ABO-c and ABO-i groups in terms of recipient's age [mean 12.6 vs. 11.1 years (y)], post-LTx duration (mean 7.3 vs. 7.3 y), donor's age (mean 35.5 vs. 34.6 y), body weight (28.9 +/- A 2.9 vs. 27.9 +/- A 6.9 kg), or gender (19 female and 17 male vs. 4 female and 3 male). Serum TGF-beta 1, IFN-gamma and IL-2 were significantly higher in the ABO-i group than in the ABO-c group. IL-10, however, did not differ between the two groups. There was a tendency toward higher gamma GTP levels in the ABO-i group, but this difference did not reach significance. ABO-incompatible LRLTx patients have higher serum TGF-beta 1, IFN-gamma and IL-2 levels as measured at regular outpatient visits. As a result, they face a higher risk of T-helper 1 cell polarization, which could make graft rejection more likely.
  • Mohamed Hamed Hussein, Takashi Hashimoto, Ghada Abdel-Hamid Daoud, Hiroki Kakita, Shin Kato, Tatenobu Goto, Masahito Hibi, Takazumi Kato, Naotake Okumura, Hirokazu Tomishige, Fujio Hara, Tetsuya Ito, Sumio Fukuda, Ineko Kato, Tatsuya Suzuki, Satoshi Suzuki, Hajime Togari
    PEDIATRIC SURGERY INTERNATIONAL, 27(1) 17-22, Jan, 2011  
    Background Oxidative stress has been suspected to influence graft survival and prognosis in pediatric recipients of living related liver transplantation (LRLT). Purpose We determined the oxidative status of pediatric LRLT recipients during their regular outpatient follow-up visits, and looked for a relationship between oxidative status and post-liver transplantation (post-LTx) duration. Patients The study included 43 patients (20 males and 23 females) between the ages of 1.6 and 25.1 years (median 10.7 years) who had undergone LRLT from 5 months to 17.5 years (median 7 years) prior to the study, between the ages of 1.2 and 14.4 years (median 3.5 years). Methods Serum glutamic pyruvic transaminase (GPT), glutamic oxaloacetic transaminase (GOT), gamma-glutamyl transpeptidase (gamma-GTP), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), direct bilirubin and choline-esterase were measured as part of the patients' regular follow-up visits. Serum total hydroperoxide (TH) and biological anti-oxidative potential (BAP) were measured using the free radical analytic system which requires 20 mu l of serum and 10 min of processing time for each sample. Oxidative stress index (OSI) was calculated as the ratio of TH to BAP. Results Serum OSI correlated positively with serum levels of GOT, GPT, LDH, ALP, gamma-GTP and direct bilirubin. Serum OSI, TH, LDH, ALP and GOT correlated negatively with post-LTx duration. Serum BAP correlated positively with post-LTx duration. Serum TH correlated positively with serum GOT and gamma-GTP, but negatively with serum BAP. Conclusions (1) The OSI, which can be calculated based on data acquired through a simple outpatient procedure, can serve as an index of our patients' laboratory results and oxidative status. (2) The LRLT recipients in our study were at risk for oxidative stress early in the post-operative period, but this risk subsided with time.

Presentations

 19

教育内容・方法の工夫(授業評価等を含む)

 1
  • 件名(英語)
    -
    開始年月日(英語)
    2011/04
    終了年月日(英語)
    2014/03
    概要(英語)
    成長と発達小児系の講義において、小児外科疾患について、実際の症例写真を多く取り入れた視覚的な講義を心掛けている。