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Takezoe T, Watanabe T, Ogawa K, Tomonaga K, Nomura M, Ohno M, Tahara K, Hishiki T, Fujino A, Ishimaru T, Kanamori Y. Primary thymic germinoma in an 11-year-old male with Lowe syndrome. Pediatr Blood Cancer 2024; 71:e30962. [PMID: 38532276 DOI: 10.1002/pbc.30962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Affiliation(s)
- Toshiko Takezoe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Ogawa
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kotaro Tomonaga
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Mioko Nomura
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Michinobu Ohno
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kazunori Tahara
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoro Hishiki
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Fujino
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Tetsuya Ishimaru
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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Tsukamoto J, Miyazaki O, Saito Y, Irahara S, Okamoto R, Miyasaka M, Tsutsumi Y, Itoh Y, Sago H, Kanamori Y, Mikami M, Hayashida Y, Aoki T, Nosaka S. Assessment of mediastinal shift angles in congenital pulmonary airway malformation: a new fetal magnetic resonance imaging indicator of congenital lung disease. Pediatr Radiol 2024; 54:715-724. [PMID: 38285191 DOI: 10.1007/s00247-024-05852-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The mediastinal shift angle is a new fetal magnetic resonance imaging (MRI) index that is reportedly correlated with postnatal survival in fetuses with congenital diaphragmatic hernia. However, its correlation in patients with congenital pulmonary airway malformation (CPAM) has not been assessed. OBJECTIVE This study aimed to establish a normal range for the right/left mediastinal shift angles, to evaluate the mediastinal shift angle in fetuses with CPAM, to compare the mediastinal shift angle with the CPAM volume ratio, and to evaluate the predictive value of the mediastinal shift angle measurements. MATERIALS AND METHODS To establish the normal range, we measured the mediastinal shift angle bilaterally in 124 fetuses without any lung abnormality (the control group). Subsequently, the mediastinal shift angle was measured in 32 fetuses pathologically diagnosed with CPAM. Moreover, the mediastinal shift angle and CPAM volume ratio were compared using fetal MRI. RESULTS The mean values for the right/left mediastinal shift angles were 18.6°/26.3° and 39.2°/35.9° for control fetuses and fetuses with CPAM, respectively. The mediastinal shift angle and the CPAM volume ratio showed a positive statistical correlation. The area under the curve demonstrated high discriminatory accuracy for the mediastinal shift angle (0.76). CONCLUSION The mediastinal shift angle has potential to replace the CPAM volume ratio for evaluating the severity of CPAM in fetal MRI.
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Affiliation(s)
- Jun Tsukamoto
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan.
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, 807-8555, Japan.
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Yuki Saito
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Saho Irahara
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Okamoto
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Mikiko Miyasaka
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiyuki Tsutsumi
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Yushi Itoh
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Masashi Mikami
- Department of Data Science, Clinical Research Center, Biostatistics Unit, National Center for Child Health and Development, Tokyo, Japan
| | - Yoshiko Hayashida
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Takatoshi Aoki
- Department of Radiology, University of Occupational and Environmental Health School of Medicine, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu, Fukuoka, 807-8555, Japan
| | - Shunsuke Nosaka
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
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Hashizume N, Yoneda A, Ozeki G, Saito T, Fujiogi M, Kano M, Yamamoto Y, Ishimaru T, Kanamori Y, Fujino A. Outcomes of nonrejection in weakly fluorescent intestine detected by indocyanine green fluorescence angiography: a case series of infants. Surg Case Rep 2024; 10:97. [PMID: 38653822 DOI: 10.1186/s40792-024-01885-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Indocyanine green fluorescence angiography, a validated noninvasive imaging technique, is used to assess tissue vascularization. Here, we report three infant patients who underwent intraoperative indocyanine green fluorescence angiography and suffered from postoperative complications caused by the lack of weak fluorescent intestinal resection and assessed residual intestinal perfusion. CASE PRESENTATION We observed the clinical characteristics and operative findings of patients treated from January 2022 to December 2022. Indocyanine green (0.5 mg/kg) was intravenously injected. The first patient was a 29-day-old girl with surgical necrotizing enterocolitis who underwent intraoperative indocyanine green fluorescence angiography at the first- and second-look operations. The proximal jejunum was difficult to diagnose to detect blood flow during the second-look operation. The second patient was a 32-day-old boy with surgical necrotizing enterocolitis. A part of the antimesenteric mucosa of the patient that exhibited weak fluorescence was preserved; however, it formed postoperative hematomas. The third patient was a 30-day-old boy with midgut volvulus. Weak fluorescence in the intestinal wall was observed 5 cm of the small intestine from the ileocecal valve was preserved, but it formed a stricture, and the patient underwent ileocecal resection after 30 days. CONCLUSIONS Weak fluorescence in the intestine in infants by performing indocyanine green fluorescence angiography is associated with a high risk of non-recovering ischemic lesions and postoperative complications.
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Affiliation(s)
- Naoki Hashizume
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan.
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.
| | - Akihiro Yoneda
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Genta Ozeki
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Takeshi Saito
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Michimasa Fujiogi
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Motohiro Kano
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Department of Pediatric Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yuki Yamamoto
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Tetsuya Ishimaru
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Akihiro Fujino
- Division of Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan
- Department of Pediatric Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Ishimaru T, Kanamori Y, Fujino A, Yoneda A, Fujiogi M, Yamamoto Y, Kano M, Koinuma G, Deie K, Kawashima H. Comparison of Postoperative Respiratory Function Between Patients After Thoracoscopic and Open Lobectomy. J Laparoendosc Adv Surg Tech A 2024; 34:376-379. [PMID: 38407921 DOI: 10.1089/lap.2023.0244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Purpose: This study aimed to compare respiratory functions of patients after thoracoscopic lobectomy (TS) with those after thoracotomy (TR). Methods: This retrospective study was conducted in two centers, one of which adapted TS as a standard procedure in 2009 and the other performs it via TR. Data on patients who underwent lobectomy for congenital lung disease between 2009 and 2021 and underwent pulmonary function test (spirometry) were collected. Results: Ten patients underwent TS and 36 underwent TR. Distribution based on sex, prenatal diagnosis, pathological diagnosis, and resected lobe were similar between the two groups. The median [interquartile range] age at procedure in the TR group was significantly smaller than that in the TS group (13 [11-18] months versus 38 [13-79] months, P = .03). The procedure duration in the TR group was significantly shorter than that in the TS group (230 [171-264] minutes versus 264 [226-420] minutes, P = .02). Pulmonary function test was conducted at the age of eight in both groups, but the interval between the procedure, and the test was significantly shorter in the TS group (TR: 7 [5-8] years versus TS: 5 [2-7] years, P = .03). The ratio of forced vital capacity compared to predicted one (TR: 86.6 [76.6-95.3] versus TS: 88.7 [86.8-89.1], P = .58) and the ratio of forced expiratory volume in 1 second against that predicted (TR: 84.0 [80.5-88.7] versus TS: 88.7 [86.8-89.1], P = .08) were not significantly different between the two groups. Conclusions: Although TR was performed earlier than TS, respiratory function was similar between the two groups.
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Affiliation(s)
- Tetsuya Ishimaru
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
- Division of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Yutaka Kanamori
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Fujino
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Yoneda
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Michimasa Fujiogi
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Yuki Yamamoto
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kano
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Goro Koinuma
- Division of Pediatric Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Kyoichi Deie
- Division of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan
| | - Hiroshi Kawashima
- Division of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan
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Takezoe T, Murakami K, Fujishiro J, Horikawa M, Kubota M, Kanamori Y, Takahashi N, Nakano Y, Migita M, Matsufuji H, Sasaki S. Intake levels and main sources of nutrients for Japanese children with motor or intellectual disabilities. J Nutr Sci 2023; 12:e126. [PMID: 38155811 PMCID: PMC10753447 DOI: 10.1017/jns.2023.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/05/2023] [Accepted: 11/03/2023] [Indexed: 12/30/2023] Open
Abstract
Proper nutritional management is important for the growth and development of children with motor or intellectual disabilities; however, few studies have investigated the nutrient intake of children with disabilities. This study aimed to investigate the nutrient intake and food groups that are the main sources of nutrients for children with disabilities. This cross-sectional observational study included twenty-five children (mean age, 11⋅8 years) from five hospitals in Japan. Using a 3-d weighed dietary record, we estimated the daily nutrient intake and food and beverage sources that contributed to nutrient intake. The mean values of calcium, magnesium, iron, vitamin A, thiamine, riboflavin, and vitamin C intake were below the recommended dietary allowance, and those of dietary fiber and potassium were below the levels recommended by the Tentative Dietary Goal for Preventing Lifestyle-related Diseases (DG). In contrast, the mean intake values of fat, saturated fatty acids, and sodium were above the DG levels. Dairy products, meat, vegetables, and cereals were found to be the major contributors of nutrients. Increased intake of vegetables may help alleviate insufficient micronutrient intake in children with disabilities.
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Affiliation(s)
- Toshiko Takezoe
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Kentaro Murakami
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Jun Fujishiro
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Miwako Horikawa
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Mitsuru Kubota
- Department of General Pediatrics & Interdisciplinary Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Nagahisa Takahashi
- Department of Pediatrics, National Rehabilitation Center for Children with Disabilities, Tokyo, Japan
| | - Yuko Nakano
- Department of Pediatrics, Ashikaga Hospital, Tochigi, Japan
| | - Misato Migita
- Department of Pediatric Surgery, St. Luke's International Hospitals, Tokyo, Japan
| | - Hiroshi Matsufuji
- Department of Pediatric Surgery, St. Luke's International Hospitals, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, School of Public Health, The University of Tokyo, Tokyo, Japan
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Shinjo D, Ozawa N, Nakadate N, Kanamori Y, Matsumoto K, Noguchi T, Ohtera S, Kato H. Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method. BMJ Paediatr Open 2023; 7:e002209. [PMID: 37940343 PMCID: PMC10632888 DOI: 10.1136/bmjpo-2023-002209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUNDS Few paediatric and perinatal quality indicators (QIs) have been developed in the Japanese setting, and the quality of care is not assured or validated. The aim of this study was to develop QIs in paediatric and perinatal care in Japan using an administrative database and confirm the feasibility and applicability of the indicators using a single-site practice test. METHODS We used a RAND-modified Delphi method that integrates evidence review with expert consensus development. QI candidates were generated from clinical practice guidelines (CPGs) available in English or Japanese and existing QIs in nine selected paediatric or perinatal conditions. Consensus building was based on independent panel ratings. The performance of QIs was retrospectively assessed using data from an administrative database at the National Children's Hospital. Data between April 2018 and March 2019 were used, while data between April 2019 and March 2021 were also used for selected condition, considering the small number of patients. Each QI was calculated as follows: number of times the indicator was met/number of participants×100. RESULTS From the literature review conducted between 2010 and 2020, 124 CPGs and 193 existing indicators were identified to generate QI candidates. Through the consensus-building process, 133 QI candidates were assessed and 79 QIs were accepted. The practice test revealed wide variations in the process-level performance of QIs in four categories: patient safety: median 43.9% (IQR 16.7%-85.6%), general paediatrics: median 98.8% (IQR 84.2%-100%), advanced paediatrics: median 94.4% (IQR 46.0%-100%) and advanced obstetrics: median 80.3% (IQR 59.6%-100%). CONCLUSIONS We established 79 QIs for paediatric and perinatal care in Japan using an administrative database that can be applied to hospitals nationwide. The practice test confirmed the measurability of the developed QIs. Benchmarking these QIs will be an attractive approach to improving the quality of care.
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Affiliation(s)
- Daisuke Shinjo
- Department of Health Policy and Informatics, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Department of Information Technology and Management, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Nobuaki Ozawa
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Naoya Nakadate
- Division of Medical Security and Patient Safety, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Takashi Noguchi
- Department of Information Technology and Management, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Shosuke Ohtera
- Department of Health Economics, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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Yamada Y, Mori T, Takahashi N, Fujimura T, Kano M, Kato M, Takahashi M, Shimojima N, Watanabe T, Yoshioka T, Kanamori Y, Kuroda T, Fujino A. Historical Cohort Study of Congenital Isolated Hypoganglionosis of the Intestine: Determining the Best Surgical Interventions. Biomolecules 2023; 13:1560. [PMID: 37892242 PMCID: PMC10605557 DOI: 10.3390/biom13101560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 10/09/2023] [Accepted: 10/15/2023] [Indexed: 10/29/2023] Open
Abstract
No standard diagnostic method or surgical treatment for congenital isolated hypoganglionosis (CIHG) has been established. This study aimed to analyze the clinical outcomes of patients with CIHG and identify the best surgical interventions provided thus far. Data on surgical interventions in 19 patients were collected between 1992 and 2020, including the type of enterostomy, type of revision, and length of the intestines. Ganglion cells in the myenteric plexus were enumerated using Hu C/D staining. The ratio of the length of the small intestine to its height was defined as the intestinal ratio (IR). The outcomes were assessed using the stoma output, growth parameters including the body mass index (BMI), and parenteral nutrition (PN) dependency. All patients required a diverting enterostomy. The IR ranged from 0.51 to 1.75 after multiple non-transplant surgeries. The stoma types were tube-stoma, end-stoma, Santulli-type, and Bishop-Koop (BK)-type. Patients with Santulli- or BK-type stomas had better BMIs and less PN dependency in terms of volume than those with end-stomas or tube-stomas. Two patients with BK-type stomas were off PN, and three who underwent an intestinal transplantation (Itx) achieved enteral autonomy. The management of CIHG involves a precise diagnosis using Hu C/D staining, neonatal enterostomy, and stoma revision using the adjusted IR and Itx if other treatments do not enable enteral autonomy.
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Affiliation(s)
- Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (M.K.); (A.F.)
| | - Teizaburo Mori
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-8535, Japan; (T.M.); (M.K.); (M.T.); (Y.K.)
| | - Nobuhiro Takahashi
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (M.K.); (A.F.)
| | - Takumi Fujimura
- Department of Pediatric Surgery, National Hospital Organization Saitama National Hospital, Saitama 351-0102, Japan;
| | - Motohiro Kano
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-8535, Japan; (T.M.); (M.K.); (M.T.); (Y.K.)
| | - Mototoshi Kato
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (M.K.); (A.F.)
| | - Masataka Takahashi
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-8535, Japan; (T.M.); (M.K.); (M.T.); (Y.K.)
| | - Naoki Shimojima
- Department of Surgery, Tokyo Metropolitan Children’s Medical Center, Tokyo 183-8561, Japan;
| | - Toshihiko Watanabe
- Department of Pediatric Surgery, Tokai University School of Medicine, Kanagawa 259-1193, Japan;
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo 157-8535, Japan;
| | - Yutaka Kanamori
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-8535, Japan; (T.M.); (M.K.); (M.T.); (Y.K.)
| | - Tatsuo Kuroda
- Kanagawa Children’s Medical Center, Yokohama 232-0066, Japan;
| | - Akihiro Fujino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan; (N.T.); (M.K.); (A.F.)
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8
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Maruyama H, Amari S, Kanamori Y, Hayakawa M, Nagata K, Yazaki Y, Taniyama Y, Masahata K, Yamoto M, Terui K, Kim K, Koike Y, Okazaki T, Inamura N, Usui N. Intraoperative Transpyloric Tube Insertion for Congenital Diaphragmatic Hernia: Analysis of Japanese Study Group Data. J Pediatr Surg 2023; 58:1663-1669. [PMID: 37032194 DOI: 10.1016/j.jpedsurg.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/16/2023] [Accepted: 03/05/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND Congenital diaphragmatic hernia (CDH) is a severe congenital disease. Some CDH infants suffer from gastro-esophageal reflux disease (GERD), even after surgical correction of gastric position. A transpyloric tube (TPT) is inserted into CDH patients under direct observation intraoperatively in some hospitals in Japan to establish early enteral feeding. This strategy avoids gastric expansion to maintain a better respiratory condition. However, it is unclear whether the strategy has a secure effect for patient prognosis. This study aimed to evaluate the effectiveness of intraoperative TPT insertion on enteral feeding and postoperative weight gain. METHODS The Japanese CDH Study Group database was used to identify infants with CDH born between 2011 and 2016, who were then divided into two groups: the TPT group and gastric tube (GT) group. In the TPT group, infants underwent intraoperative TPT insertion; postoperative insertion/extraction of TPT was irrelevant to the analysis. Weight growth velocity (WGV) was calculated using the exponential model. Subgroup analysis was performed using Kitano's gastric position classification. RESULTS We analyzed 204 infants, of which 99 and 105 were in the TPT and GT groups, respectively. Enteral nutrition (EN) in the TPT and GT groups was 52 ± 39 and 44 ± 41 kcal/kg/day (p = 0.17) at age 14 days (EN14), respectively, and 83 ± 40 and 78 ± 45 kcal/kg/day (p = 0.46) at age 21 days (EN21), respectively. WGV30 (WGV from day 0 to day 30) in the TPT and GT groups was 2.3 ± 3.0 and 2.8 ± 3.8 g/kg/day (p = 0.30), respectively, and WGV60 (WGV from day 0 to day 60) was 5.1 ± 2.3 and 6.0 ± 2.5 g/kg/day (p = 0.03), respectively. In infants with Kitano's Grade 2 + 3, EN14 in the TPT and GT groups was 38 ± 35 and 29 ± 35 kcal/kg/day (p = 0.24), respectively, EN21 was 73 ± 40 and 58 ± 45 kcal/kg/day (p = 0.13), respectively, WGV30 was 2.3 ± 3.2 and 2.0 ± 4.3 g/kg/day (p = 0.76), respectively, and WGV60 was 4.6 ± 2.3 and 5.2 ± 2.3 g/kg/day (p = 0.30), respectively. CONCLUSION Intraoperative TPT insertion did not improve nutritional intake and WGV30. WGV60 in TPT was less than that in GT. In Grade 2 + 3 subgroup analysis, TPT also had no advantage. We could not recommend routine TPT insertion at surgery. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Hidehiko Maruyama
- Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
| | - Shoichiro Amari
- Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Masahiro Hayakawa
- Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
| | - Kouji Nagata
- Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yuta Yazaki
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Yoshihiko Taniyama
- Section of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kazunori Masahata
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masaya Yamoto
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Keita Terui
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kiyokazu Kim
- Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuhki Koike
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - Tadaharu Okazaki
- Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Noboru Inamura
- Department of Pediatrics, Faculty of Medicine, Kindai University, Osaka-Sayama, Japan
| | - Noriaki Usui
- Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan
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9
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Watanabe E, Hashizume N, Yoneda A, Kasahara M, Ozeki G, Saito T, Fujiogi M, Kano M, Yamamoto Y, Miyazaki O, Maekawa T, Nakano N, Yoshioka T, Fujino A, Kanamori Y. Infantile Kaposiform hemangioendothelioma in a female patient complicated with severe obstructed jaundice: a case report. Surg Case Rep 2022; 8:225. [PMID: 36580178 PMCID: PMC9800675 DOI: 10.1186/s40792-022-01581-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Kaposiform hemangioendothelioma (KHE) is a rare locally aggressive vascular neoplasm that occurs mainly in the pediatric population. KHE usually originates just underneath the skin and affects deeper tissues through infiltrative growth; however, visceral tissue involvement is quite rare. CASE PRESENTATION An 8-month-old girl with jaundice and acholic stool was referred to our hospital for further evaluation of a hepatoduodenal ligament tumor. A blood examination revealed high bilirubin and liver enzyme levels, but no signs of coagulopathy. The first attempt at a diagnostic surgical procedure did not provide sufficient diagnostic information. However, the histopathological diagnosis of the cystic duct excised in the second surgery indicated KHE. Therefore, in our case, KHE was considered a cause of obstructive jaundice. Sirolimus (rapamycin) was initiated, and the patient was discharged 7 months after admission. CONCLUSIONS In cases of atypical hypervascular lesions in the abdominal cavity, especially in the pediatric population, it is important to consider the possibility of KHE, and surgical intervention with proper strategies is required for diagnosis, followed sequentially by promising treatments.
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Affiliation(s)
- Eiichiro Watanabe
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Naoki Hashizume
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Akihiro Yoneda
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan ,grid.63906.3a0000 0004 0377 2305Division of Pediatric Surgical Oncology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Mureo Kasahara
- grid.63906.3a0000 0004 0377 2305Organ Transplantation Center, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Genta Ozeki
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Takeshi Saito
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Michimasa Fujiogi
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Motohiro Kano
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Yuki Yamamoto
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Osamu Miyazaki
- grid.63906.3a0000 0004 0377 2305Department of Radiology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Takanobu Maekawa
- grid.63906.3a0000 0004 0377 2305Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Noriyuki Nakano
- grid.63906.3a0000 0004 0377 2305Department of Pathology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Takako Yoshioka
- grid.63906.3a0000 0004 0377 2305Department of Pathology, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Akihiro Fujino
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
| | - Yutaka Kanamori
- grid.63906.3a0000 0004 0377 2305Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Setagaya-Ku, Tokyo, Japan
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10
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Higashio A, Yoshioka T, Kanamori Y, Fujino A, Morotomi Y, Shibata T, Nakaoka T. Relationships Between Histopathological Findings in the Liver and Prognosis in Patients With Biliary Atresia. Clin Pathol 2022; 15:2632010X221132686. [PMID: 36339922 PMCID: PMC9629564 DOI: 10.1177/2632010x221132686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/26/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Biliary atresia (BA) is a progressive obstructive hepatic disease that requires early diagnosis and the prompt initiation of treatment. Although portoenterostomy (PES) is usually performed as the initial surgical procedure, the liver damage may subsequently progress, such that liver transplantation (LTx) may be required. In this study, we comprehensively evaluated the histopathology of liver samples collected during PES and retrospectively evaluated its relationship with prognosis. METHODS Forty-seven patients with BA who underwent PES between 2002 and 2021 were included. Their biopsy samples were semi-quantitatively graded according to the severity of liver fibrosis, bile duct proliferation, cholestasis, ductal plate malformation, and inflammatory cell infiltration; and the expression of cluster of differentiation (CD)3, CD20, human leukocyte antigen II-DR, and α-smooth muscle actin (α-SMA). The relationships of each with the prevalence of survival with native liver (SNL) were evaluated to identify prognostic markers. RESULTS The median postoperative duration of follow-up was 11.8 years (maximum, 18.0 years; minimum, 3.5 years). There were no deaths during this period, but LTx was performed in 31 patients and the final prevalence of SNL was 34.0% (16/47). There were negative correlations of liver fibrosis and α-SMA with SNL, and a positive correlation between CD20 and SNL. Multivariate analysis using a proportional hazards regression model showed that only CD20 expression was significant. CONCLUSIONS Comprehensive histopathological analysis of liver biopsy samples obtained at the time of PES showed a positive correlation between CD20 expression and SNL, suggesting that this may represent a useful prognostic marker. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Atsushi Higashio
- Department of Surgery, Osaka Metropolitan University School of Medicine, Osaka, Japan,Atsushi Higashio, Department of Surgery, Osaka Metropolitan University School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Yutaka Kanamori
- Department of Pediatric Surgery, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, National Center for Child Health and Development, Setagaya-ku, Tokyo, Japan
| | - Yoshiki Morotomi
- Department of Pediatric Surgery, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Toshihiko Shibata
- Department of Surgery, Osaka Metropolitan University School of Medicine, Osaka, Japan
| | - Tatsuo Nakaoka
- Department of Surgery, Osaka Metropolitan University School of Medicine, Osaka, Japan
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11
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Kano M, Furugane R, Hogetsu K, Yamada Y, Maniwa J, Kobayashi T, Hashizume N, Mori T, Watanabe E, Takahashi M, Fujino A, Kanamori Y, Terashima K, Matsumoto K, Yoneda A. Vaginal yolk sac tumor resected by a novel laparo/endoscope-assisted posterior sagittal approach: a case report. Surg Case Rep 2022; 8:162. [PMID: 36036317 PMCID: PMC9424445 DOI: 10.1186/s40792-022-01520-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Yolk sac tumor (YST) is a germ cell tumor that is generally associated with good prognosis in children. It has been recently reported that vaginal YSTs can be cured using chemotherapy alone. Thus, minimal invasiveness and function preservation are pre-requisites for surgical approaches. Herein, we report a case of vaginal YST that was resected in a function-preserving manner using a unique combination of surgical approaches. Case presentation In a 9-month-old Asian female infant, a vaginal tumor was detected while investigating for vaginal bleeding. The patient was referred to our hospital, and the tumor was diagnosed as a YST after incisional biopsy. Six courses of carboplatin-based chemotherapy were administered. Contrary to the findings in previous reports, the tumor was chemo-resistant and surgical resection was required for the residual tumor. During surgery, we utilized laparoscopic and endoscopic procedures to ensure tumor-free surgical margins at the cervix, rectum, and lateral wall of the vagina. Additionally, the posterior sagittal approach was used to easily resect the tumor, and the vagina was reconstructed leaving only inconspicuous scars in the intergluteal cleft. No complications occurred postoperatively. Pathological examination of the surgical specimen revealed tumor-free surgical margins. The patient received four cycles of intensified chemotherapy before and after the surgery. The patient has been disease-free for 6 months now. Conclusions Our combination of laparo/endoscopic and posterior sagittal approach ensured a tumor-free macroscopic surgical margin with easier, cosmetically pleasing vaginal reconstruction, while preserving the anorectal and urinary functions. We believe that this approach could be utilized not only for vaginal YST, but also for any vaginal tumor, especially those arising from the posterior or lateral wall.
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12
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Shirai R, Osumi T, Sato-Otsubo A, Nakabayashi K, Ishiwata K, Yamada Y, Yoshida M, Yoshida K, Shioda Y, Kiyotani C, Terashima K, Tomizawa D, Takasugi N, Takita J, Miyazaki O, Kiyokawa N, Yoneda A, Kanamori Y, Hishiki T, Matsumoto K, Hata K, Yoshioka T, Kato M. Quantitative assessment of copy number alterations by liquid biopsy for neuroblastoma. Genes Chromosomes Cancer 2022; 61:662-669. [PMID: 35655408 DOI: 10.1002/gcc.23073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/27/2022] [Accepted: 05/10/2022] [Indexed: 11/08/2022] Open
Abstract
Liquid biopsy, a method of detecting genomic alterations using blood specimens, has recently attracted attention as a non-invasive alternative to surgical tissue biopsy. We attempted quantitative analysis to detect amplification of MYCN (MYCNamp) and loss of heterozygosity at 11q (11qLOH), which are clinical requisites as prognostic factors of neuroblastoma. In this study, cell-free DNA (cfDNA) was extracted from plasma samples from 24 neuroblastoma patients at diagnosis. Copy numbers of MYCN and NAGK genes were quantitatively analyzed by droplet digital PCR (ddPCR). 11qLOH was also assessed by detecting allelic imbalances of heterozygous single nucleotide polymorphisms in the 11q region. The results obtained were compared to those of specimens from tumor tissues. The correlation coefficient of MYCN copy number of cfDNA and tumor DNA was 0.88 (P < 0.00001). 11qLOH was also accurately detected from cfDNA, except for one case with localized NB. Given the high accuracy of liquid biopsy, to investigate components of cfDNA, the proportion of tumor-derived DNA was estimated by examining the variant allele frequency of tumor-specific mutations in cfDNA. The proportion of tumor-derived DNA in cfDNA was 42.5% (range, 16.9%-55.9%), suggesting sufficient sensitivity of liquid biopsy for neuroblastoma. In conclusion, MYCN copy number and 11qLOH could be quantitatively analyzed in plasma cfDNA by ddPCR assay. These results suggest that plasma cfDNA can be substituted for tumor DNA and can also be applied for comprehensive genomic profiling analysis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ryota Shirai
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Tomoo Osumi
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Aiko Sato-Otsubo
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, University of Tokyo, Tokyo, Japan
| | - Kazuhiko Nakabayashi
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Keisuke Ishiwata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yuji Yamada
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Masanori Yoshida
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
| | - Kaoru Yoshida
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Nao Takasugi
- Department of Pediatrics, University of Tokyo, Tokyo, Japan
| | - Junko Takita
- Department of Pediatrics, University of Tokyo, Tokyo, Japan.,Department of Pediatrics, Graduate School of Medicine Kyoto University, Kyoto City, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Nobutaka Kiyokawa
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Akihiro Yoneda
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoro Hishiki
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kato
- Department of Pediatric Hematology and Oncology Research, National Research Institute for Child Health and Development, Tokyo, Japan.,Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, University of Tokyo, Tokyo, Japan
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13
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Furugane R, Kobayashi T, Hashizume N, Mori T, Watanabe E, Kano M, Takahashi M, Murakoshi M, Sato M, Kamei K, Fujino A, Yoneda A, Kanamori Y. Recurrent outflow obstruction of a choked catheter for peritoneal dialysis caused by a fallopian tube fimbria in a five-month-old female. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2021.102131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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14
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Hashizume N, Yoneda A, Kano M, Yoshii S, Uehara Y, Fujino A, Kanamori Y. A case of enormous congenital cervicofacial immature teratoma. Pediatr Int 2022; 64:e15394. [PMID: 36271713 DOI: 10.1111/ped.15394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 01/24/2023]
Affiliation(s)
- Naoki Hashizume
- Division of Pediatric Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Yoneda
- Division of Pediatric Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.,Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Motohiro Kano
- Division of Pediatric Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Saori Yoshii
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | - Yohji Uehara
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Fujino
- Division of Pediatric Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Pediatric Surgery, Department of Pediatric Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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15
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Kobayashi T, Kanamori Y, Furugane R, Mori T, Kano M, Takahashi M, Fujino A. Congenital dermal sinus in the lateral buttock. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.102087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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16
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Takahashi M, Kanamori Y, Kobayashi T, Kobayashi M, Tsukamoto K, Yamagishi S, Furugane R, Kutsukake M, Mori T, Kano M, Yoneda A, Ito Y, Fujino A. “Triple duodenal obstruction” complicated with intestinal malrotation and several cardiovascular malformations. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.102078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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17
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Aoki H, Miyazaki O, Irahara S, Okamoto R, Tsutsumi Y, Miyasaka M, Sago H, Kanamori Y, Suzuki Y, Morimoto N, Nosaka S. Value of parametric indexes to identify tracheal atresia with or without fistula on fetal magnetic resonance imaging. Pediatr Radiol 2021; 51:2027-2037. [PMID: 33988754 DOI: 10.1007/s00247-021-05092-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/18/2021] [Accepted: 04/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Tracheal atresia causes some secondary changes (dilated trachea, flattened/inverted diaphragm, hyperintense and hyperinflated lungs). They can be reduced if a high airway fistula is present. OBJECTIVE This study evaluated fetal MR images of tracheal atresia and the secondary changes, focusing on the presence of a fistula. MATERIALS AND METHODS We assessed fetal MR images of tracheal atresia without fistula (n=4, median 26 weeks), tracheal atresia with fistula (n=4, median 33 weeks) and controls (n=30, median 32 weeks). We evaluated airway obstruction using true-positive rate in tracheal atresia and false-positive rate in controls indicating they are likely normal variants. Tracheal diameter, craniocaudal-anteroposterior ratio of the right hemidiaphragm, lung-to-liver signal intensity ratio, and cardiothoracic ratio were compared among the three groups using the Kruskal-Wallis test followed by pairwise comparison using the Mann-Whitney U test. RESULTS True-positive rate was 100% in tracheal atresia, while false-positive rate was 20% in controls. The Kruskal-Wallis test showed differences among groups in craniocaudal-anteroposterior ratio and cardiothoracic ratio (P<0.001) but not in tracheal diameter (P=0.256) or lung-to-liver signal intensity ratio (P=0.082). The pairwise comparison in craniocaudal-anteroposterior ratio and cardiothoracic ratio showed differences between controls and tracheal atresia without fistula (P<0.01) and with fistula (P<0.05). CONCLUSION Fetal MRI is useful for the diagnosis of tracheal atresia, and detection of airway obstruction is essential. Lower craniocaudal-anteroposterior ratio and cardiothoracic ratio might be reliable measures even if a fistula is present.
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Affiliation(s)
- Hidekazu Aoki
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan. .,Department of Diagnostic Radiology, Tohoku University Hospital, Miyagi, Japan.
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Saho Irahara
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Reiko Okamoto
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yoshiyuki Tsutsumi
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Mikiko Miyasaka
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
| | - Haruhiko Sago
- Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yasuyuki Suzuki
- Department of Critical Care and Anesthesia, National Center for Child Health and Development, Tokyo, Japan
| | - Noriko Morimoto
- Division of Otolaryngology, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Shunsuke Nosaka
- Department of Radiology, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan
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18
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Kanamori Y, Tahara K, Kutsukake M, Yamada Y, Mori T, Kudo Y, Miyake K, Fujita T, Fujino A, Abiko Y, Fukui K, Wada Y, Ito Y. Giant omphalocele treated by staged operation and successive conservative therapy using artificial dermis (Terudermis®) for effective epithelization. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Mori T, Fujino A, Takahashi M, Furugane R, Kobayashi T, Kano M, Yoneda A, Kanamori Y, Suzuki R, Nishi K, Kamei K, Kitamura M. Successful endoscopic surgical treatment of pleuroperitoneal communication in two infant cases. Surg Case Rep 2021; 7:181. [PMID: 34383172 PMCID: PMC8360259 DOI: 10.1186/s40792-021-01266-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background Pleuroperitoneal communication (PPC) is an uncommon, but potentially life-threatening complication of peritoneal dialysis (PD). If a fistula does not close with conservative treatment, surgical repair is required. However, approximately half of these patients are forced to shift from PD to hemodialysis. Although it is important to confirm the site of the fistula to achieve a successful surgical treatment, this identification is more difficult in pediatric patients than in adults. Case presentation We report two infantile cases of severe PPC associated with PD. In both cases, the age at onset was less than 2 years, and right-sided pleural effusion with dyspnea was observed. PPC was diagnosed by the change in color of the pleural fluid after the injection of a dye into the peritoneal cavity. Peritoneal scintigraphy and single-photon emission computed tomography and computed tomography (SPECT/CT) were performed, and these were effective in locating the fistula site. Endoscopic surgery (video-assisted thoracic surgery (VATS) and laparoscopic surgery) was performed. Indocyanine green (ICG), which was injected into the abdominal cavity, showed the exact site of the fistula. The fistula was successfully closed by attaching an absorbable sheet to it from the thoracic side and an autograft (the falciform ligament) to it from the abdominal side in one patient. In the other patient, the fistula site was resected and sutured, and reinforced with an absorbable sheet. In both cases, PD was resumed without any complication. Conclusion We successfully treated two infants of PPC by endoscopic surgery. To identify the fistula site, the ICG navigation method was useful. Even in small infants, PPC can be treated successfully by endoscopic surgical repair if the site of the fistula is identified.
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Affiliation(s)
- Teizaburo Mori
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan.
| | - Akihiro Fujino
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Masataka Takahashi
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Ryoya Furugane
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Tamotsu Kobayashi
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Motohiro Kano
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Akihiro Yoneda
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Yutaka Kanamori
- Division of Pediatric Surgery, National Center for Child Health and Development, 2-10-1 Okura Setagaya-ku, Tokyo, 157-8535, Japan
| | - Ryutaro Suzuki
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Kentaro Nishi
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Koichi Kamei
- Division of Nephrology and Rheumatology, National Center for Child Health and Development, Tokyo, Japan
| | - Masayuki Kitamura
- Division of Radiology, National Center for Child Health and Development, Tokyo, Japan
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20
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Watanabe T, Ohno M, Tahara K, Tomonaga K, Ogawa K, Takezoe T, Fuchimoto Y, Fujino A, Kanamori Y. Efficacy and safety of sclerotherapy with polidocanol in children with internal hemorrhoids. Pediatr Int 2021; 63:813-817. [PMID: 33045763 DOI: 10.1111/ped.14506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/23/2020] [Accepted: 10/07/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hemorrhoids are an extremely rare condition in children, and data on its incidence and treatment in the pediatric population remains scarce. We retrospectively reviewed children who underwent sclerotherapy for internal hemorrhoids, and analyzed patients' characteristics and outcomes. METHODS A total of 14 pediatric patients who underwent sclerotherapy were included. Patients' ages and the required amount of polidocanol, depending on the grade of hemorrhoids, and the correlation between age and volume of sclerosant, were statistically analyzed. RESULTS Patients had a male predominance with a ratio of 2.5:1 (grade 2:6 patients, grade 3:8 patients). Four children had underlying conditions including portal hypertension and Klippel-Trenaunay syndrome. Of the 14 patients, 43% had constipation requiring medication or enema. Only one minor complication, a perianal ulceration, was found to be associated with sclerotherapy. Patients with grade 3 hemorrhoids required a significantly larger amount of polidocanol than those with grade 2 hemorrhoids. Two patients with grade 3 hemorrhoids required a second session of treatment for recurrence. The success rate of sclerotherapy with polidocanol was 86%. CONCLUSIONS Sclerotherapy with polidocanol is a safe, effective, and less invasive treatment option for internal hemorrhoids in children. Further studies are needed to investigate this treatment approach.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan.,Department of Pediatric Surgery, Tokai University School of Medicine, Kanagawa, Japan
| | - Michinobu Ohno
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kazunori Tahara
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Kotaro Tomonaga
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Katsuhiro Ogawa
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Toshiko Takezoe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yasushi Fuchimoto
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Fujino
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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21
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Fuyuki M, Usui N, Taguchi T, Hayakawa M, Masumoto K, Kanamori Y, Amari S, Yamoto M, Urushihara N, Inamura N, Yokoi A, Okawada M, Okazaki T, Toyoshima K, Furukawa T, Terui K, Ohfuji S, Tazuke Y, Uchida K, Okuyama H. Prognosis of conventional vs. high-frequency ventilation for congenital diaphragmatic hernia: a retrospective cohort study. J Perinatol 2021; 41:814-823. [PMID: 33177680 DOI: 10.1038/s41372-020-00833-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/19/2020] [Accepted: 09/18/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To determine the appropriate initial ventilatory mode for neonatal congenital diaphragmatic hernia (CDH) by comparing patient prognosis following conventional mechanical ventilation (CMV) versus high-frequency oscillatory ventilation (HFO). STUDY DESIGN This multicenter retrospective cohort study was performed at 15 participating hospitals in Japan between 2011 and 2016. The 328 eligible CDH infants were classified into CMV (n = 78) and HFO groups (n = 250) to compare mortality and incidence of bronchopulmonary dysplasia (BPD). Propensity score matching was applied to reduce confounding by indication. RESULT While crude mortality was significantly higher in the HFO than the CMV group, adjusted odds ratio (OR) did not show significant difference in mortality between groups (OR of HFO group: 0.98, 95% confidence interval (CI): 0.57-1.67). Adjusted OR of BPD incidence showed no significant difference between groups (OR of HFO group: 1.66, 95%CI: 0.50-5.49). CONCLUSION Initial ventilatory mode in CDH patients, whether CMV or HFO, does not affect prognosis.
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Affiliation(s)
- Makiko Fuyuki
- Department of Pediatrics, Osaka City University Graduate School of Medicine, Osaka, Japan. .,Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan.
| | - Noriaki Usui
- Department of Pediatric Surgery, Osaka Women's and Children's Hospital, Izumi, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masahiro Hayakawa
- Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
| | - Kouji Masumoto
- Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Shoichiro Amari
- Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Masaya Yamoto
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Naoto Urushihara
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Noboru Inamura
- Department of Pediatrics, Kinki University, Faculty of Medicine, Osaka-Sayama, Japan
| | - Akiko Yokoi
- Department of Pediatric Surgery, Kobe Children's Hospital, Kobe, Japan
| | - Manabu Okawada
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Tadaharu Okazaki
- Department of Pediatric General and Urogenital Surgery, Juntendo University School of Medicine, Tokyo, Japan.,Department of Pediatric Surgery, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Katsuaki Toyoshima
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Taizou Furukawa
- Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Keita Terui
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoko Ohfuji
- Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yuko Tazuke
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Keiichi Uchida
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroomi Okuyama
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
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22
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Mori T, Miyake K, Kudo Y, Fujita T, Kutsukake M, Yamada Y, Tahara K, Fujino A, Kondo R, Kaneko Y, Saito Y, Terashima K, Matsumoto K, Yoshioka T, Kanamori Y. Intrapericardial immature teratoma with pericardial effusion in a 4-month-old boy. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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23
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Okada K, Mizuno M, Moriuchi H, Kusuda S, Morioka I, Mori M, Okamoto K, Okada K, Yoshihara S, Yamagishi H, Yokoyama U, Kubota T, Kudo K, Takagi M, Ito S, Kanamori Y, Sasahara Y. The Working Group for Revision of "Guidelines for the Use of Palivizumab in Japan": A Committee Report. Pediatr Int 2020; 62:1223-1229. [PMID: 33078556 DOI: 10.1111/ped.14410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/16/2020] [Indexed: 12/31/2022]
Affiliation(s)
| | | | | | - Satoshi Kusuda
- Japan Society for Neonatal Health and Development, Osaka, Japan
| | - Ichiro Morioka
- Japan Society for Neonatal Health and Development, Osaka, Japan
| | - Masaaki Mori
- Japanese Society for Pediatric Infectious Diseases, Tokyo, Japan.,Pediatric Rheumatology Association of Japan, Tokyo, Japan
| | - Keisuke Okamoto
- Japanese Society for Pediatric Infectious Diseases, Tokyo, Japan
| | | | | | - Hiroyuki Yamagishi
- Japanese Society of Pediatric Cardiology and Cardiac Surgery, Tokyo, Japan
| | - Utako Yokoyama
- Japanese Society of Pediatric Cardiology and Cardiac Surgery, Tokyo, Japan
| | | | - Kazuko Kudo
- The Japanese Society of Pediatric Hematology/Oncology, Tokyo, Japan
| | - Masatoshi Takagi
- The Japanese Society of Pediatric Hematology/Oncology, Tokyo, Japan
| | - Shuichi Ito
- Japanese Society for Pediatric Nephrology, Tokyo, Japan
| | | | - Yoji Sasahara
- Japanese Society for Immunodeficiency and Autoinflammatory Diseases, Tokyo, Japan
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24
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Watanabe T, Mori M, Shimizu T, Yamamoto Y, Tei E, Hirakawa H, Ohno M, Tahara K, Tomonaga K, Ogawa K, Takezoe T, Fuchimoto Y, Fujino A, Kanamori Y. Intraluminal manipulator-assisted laparoscopic surgery for Hirschsprung disease. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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25
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Wada S, Ozawa K, Sugibayashi R, Suyama F, Amari S, Ito Y, Kanamori Y, Okuyama H, Usui N, Sasahara J, Kotani T, Hayakawa M, Kato K, Taguchi T, Endo M, Sago H. Feasibility and outcomes of fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: A Japanese experience. J Obstet Gynaecol Res 2020; 46:2598-2604. [PMID: 32989906 PMCID: PMC7756773 DOI: 10.1111/jog.14504] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/03/2020] [Accepted: 09/15/2020] [Indexed: 11/29/2022]
Abstract
AIM To present the feasibility, safety and outcomes of fetoscopic endoluminal tracheal occlusion (FETO) for the treatment of severe congenital diaphragmatic hernia (CDH). METHODS This was a single-arm clinical trial of FETO for isolated left-sided CDH with liver herniation and Kitano Grade 3 stomach position (>50% stomach herniation into the right chest). FETO was performed at 27-29 weeks of gestation for cases with observed/expected lung to head ratio (o/e LHR) <25% and at 30-31 weeks for cases with o/e LHR ≥25%. RESULTS Eleven cases were enrolled between March 2014 and March 2016, and balloon insertion was successful in all cases. The median o/e LHR at entry was 27% (range, 20-33%). The median gestational age at FETO was 30.9 (range, 27.1-31.7) weeks. There were no severe maternal adverse events. One fetus died unexpectedly at 33 weeks of gestation due to cord strangulation by the detached amniotic membrane. There were 3 cases (27%) of preterm premature rupture of membranes. In all 10 cases, balloon removal at 34-35 weeks of gestation was successful. The median gestational age at delivery was 36.5 (range, 34.2-38.3) weeks. The median duration of occlusion and the median interval between balloon insertion and delivery were 26 days (range: 17-49 days) and 43 days (range, 21-66 days), respectively. Both the survival rate at 90 days of age and the rate of survival to discharge were 45% (5/11). CONCLUSION The FETO is feasible without maternal morbidity in Japan and could be offered to women whose fetuses show severe isolated left-sided CDH to accelerate fetal lung growth.
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Affiliation(s)
- Seiji Wada
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Katsusuke Ozawa
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Rika Sugibayashi
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Fumio Suyama
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Shoichiro Amari
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Yushi Ito
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical SpecialtiesNational Center for Child Health and DevelopmentTokyoJapan
| | - Hiroomi Okuyama
- Department of Pediatric SurgeryOsaka University Graduate School of MedicineSuitaJapan
| | - Noriaki Usui
- Department of Pediatric SurgeryOsaka Women's and Children's HospitalIzumiJapan
| | - Jun Sasahara
- Department of Maternal Fetal MedicineOsaka Women's and Children's HospitalIzumiJapan
| | - Tomomi Kotani
- Department of Obstetrics and GynecologyNagoya University Graduate School of MedicineNagoyaJapan
| | - Masahiro Hayakawa
- Division of Neonatology, Center for Maternal‐Neonatal CareNagoya University HospitalNagoyaJapan
| | - Kiyoko Kato
- Department of Obstetrics and GynecologyKyushu University School of MedicineFukuokaJapan
| | - Tomoaki Taguchi
- Department of Pediatric SurgeryKyushu University School of MedicineFukuokaJapan
| | - Masayuki Endo
- Department of Obstetrics and GynecologyOsaka University Graduate School of MedicineSuitaJapan
| | - Haruhiko Sago
- Center for Maternal‐Fetal, Neonatal and Reproductive MedicineNational Center for Child Health and DevelopmentTokyoJapan
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26
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Tahara K, Kanamori Y, Miyake K, Kudo Y, Fujita T, Kutsukake M, Mori T, Yamada Y, Fujino A, Shimizu H, Arai K, Tsutsumi Y, Miyazaki O. Groove pancreatitis treated by duodenal and biliary bypass. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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27
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Hishiki T, Fujino A, Watanabe T, Tahara K, Ohno M, Yamada Y, Tomonaga K, Kutsukake M, Fujita T, Kawakubo N, Matsumoto K, Kiyotani C, Shioda Y, Miyazaki O, Fuji H, Yoshioka T, Kanamori Y. Definitive Tumor Resection after Myeloablative High Dose Chemotherapy Is a Feasible and Effective Option in the Multimodal Treatment of High-Risk Neuroblastoma: A Single Institution Experience. J Pediatr Surg 2020; 55:1655-1659. [PMID: 31575417 DOI: 10.1016/j.jpedsurg.2019.08.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/23/2019] [Accepted: 08/29/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND/PURPOSE The delayed local treatment approach (DL) in high-risk neuroblastoma (HR-NB) refers to the process in which tumor resection is performed after the completion of all the courses of chemotherapy, including myeloablative high-dose chemotherapy (HDC). Alternatively, in the conventional local treatment approach (CL), tumor resection is performed during induction chemotherapy. In this study, we compared the surgical outcomes in HR-NB patients treated by CL and DL. METHOD Forty-seven patients with abdominal HR-NB underwent primary tumor resection from 2002 to 2018. The timing of surgery was generally determined by following the trials and guidelines available at the time. The outcomes and surgical complications between the two strategies were compared. RESULT Operation time, blood loss, and postoperative WBC counts were lower in the DL group (n = 25) when compared to the CL group (n = 22), statistical significance notwithstanding. Major vascular structures were less frequently encased in the DL group tumors, while immediate surgical complications were significantly more frequent in the CL group (P < 0.05). Furthermore, the 3-year EFSs were 50.0% and 53.9% in the DL and CL groups, respectively. CONCLUSION DL appears to be a feasible and effective treatment option for HR-NB. Nonetheless, further verifications using larger cohorts are warranted. LEVEL OF EVIDENCE Treatment study, Level III.
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Affiliation(s)
- Tomoro Hishiki
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development; Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development; Department of Pediatric Surgical Oncology, National Cancer Center Hospital.
| | - Akihiro Fujino
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Kazunori Tahara
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Michinobu Ohno
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Yohei Yamada
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Kotaro Tomonaga
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Mai Kutsukake
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Takuro Fujita
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Naonori Kawakubo
- Division of Surgical Oncology, Children's Cancer Center, National Center for Child Health and Development; Department of Pediatric Surgical Oncology, National Cancer Center Hospital
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development
| | - Chikako Kiyotani
- Children's Cancer Center, National Center for Child Health and Development
| | - Yoko Shioda
- Children's Cancer Center, National Center for Child Health and Development
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development
| | - Hiroshi Fuji
- Department of Radiology, National Center for Child Health and Development
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development
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28
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Sekiguchi M, Seki M, Kawai T, Yoshida K, Yoshida M, Isobe T, Hoshino N, Shirai R, Tanaka M, Souzaki R, Watanabe K, Arakawa Y, Nannya Y, Suzuki H, Fujii Y, Kataoka K, Shiraishi Y, Chiba K, Tanaka H, Shimamura T, Sato Y, Sato-Otsubo A, Kimura S, Kubota Y, Hiwatari M, Koh K, Hayashi Y, Kanamori Y, Kasahara M, Kohashi K, Kato M, Yoshioka T, Matsumoto K, Oka A, Taguchi T, Sanada M, Tanaka Y, Miyano S, Hata K, Ogawa S, Takita J. Integrated multiomics analysis of hepatoblastoma unravels its heterogeneity and provides novel druggable targets. NPJ Precis Oncol 2020; 4:20. [PMID: 32656360 PMCID: PMC7341754 DOI: 10.1038/s41698-020-0125-y] [Citation(s) in RCA: 160] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023] Open
Abstract
Although hepatoblastoma is the most common pediatric liver cancer, its genetic heterogeneity and therapeutic targets are not well elucidated. Therefore, we conducted a multiomics analysis, including mutatome, DNA methylome, and transcriptome analyses, of 59 hepatoblastoma samples. Based on DNA methylation patterns, hepatoblastoma was classified into three clusters exhibiting remarkable correlation with clinical, histological, and genetic features. Cluster F was largely composed of cases with fetal histology and good outcomes, whereas clusters E1 and E2 corresponded primarily to embryonal/combined histology and poor outcomes. E1 and E2, albeit distinguishable by different patient age distributions, were genetically characterized by hypermethylation of the HNF4A/CEBPA-binding regions, fetal liver-like expression patterns, upregulation of the cell cycle pathway, and overexpression of NQO1 and ODC1. Inhibition of NQO1 and ODC1 in hepatoblastoma cells induced chemosensitization and growth suppression, respectively. Our results provide a comprehensive description of the molecular basis of hepatoblastoma and rational therapeutic strategies for high-risk cases.
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Affiliation(s)
- Masahiro Sekiguchi
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masafumi Seki
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoko Kawai
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kenichi Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Misa Yoshida
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoya Isobe
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Noriko Hoshino
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryota Shirai
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Mio Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Ryota Souzaki
- Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kentaro Watanabe
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuki Arakawa
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiromichi Suzuki
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yoichi Fujii
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Keisuke Kataoka
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
| | - Yuichi Shiraishi
- Center for Cancer Genomics and Advanced Therapeutics, National Cancer Center Research Institute, Tokyo, Japan
| | - Kenichi Chiba
- Center for Cancer Genomics and Advanced Therapeutics, National Cancer Center Research Institute, Tokyo, Japan
| | - Hiroko Tanaka
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Teppei Shimamura
- Department of Systems Biology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yusuke Sato
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aiko Sato-Otsubo
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shunsuke Kimura
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Pediatrics, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yasuo Kubota
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mitsuteru Hiwatari
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsuyoshi Koh
- Department of Hematology/Oncology, Saitama Children's Medical Center, Saitama, Japan
| | | | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Mureo Kasahara
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Kenichi Kohashi
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Akira Oka
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masashi Sanada
- Department of Advanced Diagnosis, Clinical Research Center, Nagoya Medical Center, Nagoya, Japan
| | - Yukichi Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Satoru Miyano
- Center for Cancer Genomics and Advanced Therapeutics, National Cancer Center Research Institute, Tokyo, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Institute for the Advanced Study of Human Biology (WPI-ASHBi), Kyoto, Japan.,Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institute, Stockholm, Sweden
| | - Junko Takita
- Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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29
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Mori T, Kudo Y, Kanamori Y, Tahara K, Yamada Y, Kutsukake M, Fujita T, Miyake K, Fujino A, Takahashi N, Morimoto N, Kosugi Y, Uehara Y, Ito Y, Miyazaki O, Sugibayashi R, Ozawa K, Wada S, Sago H. Prenatal diagnosis of congenital thyroid teratoma. Journal of Pediatric Surgery Case Reports 2020. [DOI: 10.1016/j.epsc.2020.101459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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30
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Yamada Y, Kitayama K, Oyachi M, Higuchi S, Kawakita R, Kanamori Y, Yorifuji T. Nationwide survey of endogenous hyperinsulinemic hypoglycemia in Japan (2017-2018): Congenital hyperinsulinism, insulinoma, non-insulinoma pancreatogenous hypoglycemia syndrome and insulin autoimmune syndrome (Hirata's disease). J Diabetes Investig 2020; 11:554-563. [PMID: 31742894 PMCID: PMC7232294 DOI: 10.1111/jdi.13180] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/02/2019] [Accepted: 11/14/2019] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION We aimed to investigate the nationwide incidence, treatment details and outcomes of patients with endogenous hyperinsulinemic hypoglycemia (EHH), including those with transient/persistent congenital hyperinsulinism (CHI), insulinoma, non-insulinoma pancreatogenous hypoglycemia syndrome and insulin autoimmune syndrome (Hirata's disease) in Japan. MATERIALS AND METHODS A nationwide, questionnaire-based survey was carried out to determine the number of patients with EHH who were treated for hypoglycemia or hypoglycemia-related complications in 2017-2018. The questionnaires were sent to all hospitals in Japan with >300 beds, and with pediatric and/or adult clinics likely managing EHH patients. The secondary questionnaires were sent to obtain the patients' date of birth, sex, age at onset, treatment details and post-treatment outcomes. RESULTS A total of 447 patients with CHI (197 transient CHI, 225 persistent CHI and 25, unknown histology), 205 with insulinoma (118 benign, 18 malignant and 69 unknown subtype), 111 with non-insulinoma pancreatogenous hypoglycemia syndrome (33 post-gastric surgery HH, 57 postprandial HH, 10 nesidioblastosis and 11 unknown subtype) and 22 with insulin autoimmune syndrome were identified. Novel findings included: (i) marked improvement in the prognosis of persistent CHI over the past 10 years; (ii) male dominance in the incidence of transient CHI; (iii) non-insulinoma pancreatogenous hypoglycemia syndrome emerging as the second most common form of EHH in adults; (iv) frequent association of diabetes mellitus with insulin autoimmune syndrome; and (v) frequent post-treatment residual hypoglycemia and impaired quality of life. CONCLUSIONS The first nationwide, all age group survey of EHH showed the current status of each type of EHH disorder and the unmet needs of the patients.
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Affiliation(s)
- Yuki Yamada
- Division of Pediatric Endocrinology and MetabolismChildren’s Medical CenterOsaka City General HospitalOsakaJapan
| | - Kana Kitayama
- Division of Pediatric Endocrinology and MetabolismChildren’s Medical CenterOsaka City General HospitalOsakaJapan
| | - Maki Oyachi
- Division of Pediatric Endocrinology and MetabolismChildren’s Medical CenterOsaka City General HospitalOsakaJapan
| | - Shinji Higuchi
- Division of Pediatric Endocrinology and MetabolismChildren’s Medical CenterOsaka City General HospitalOsakaJapan
| | - Rie Kawakita
- Division of Pediatric Endocrinology and MetabolismChildren’s Medical CenterOsaka City General HospitalOsakaJapan
| | - Yutaka Kanamori
- Division of SurgeryNational Center for Child Health and DevelopmentTokyoJapan
| | - Tohru Yorifuji
- Division of Pediatric Endocrinology and MetabolismChildren’s Medical CenterOsaka City General HospitalOsakaJapan
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31
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Kanamori Y, Tahara K, Ohno M, Tomonaga K, Yamada Y, Hishiki T, Fujino A, Miyazaki O, Nosaka S, Morimoto N, Sugibayashi R, Ozawa K, Wada S, Sago H, Tsukamoto K, Isayama T, Ito Y. Congenital high airway obstruction syndrome complicated with foregut malformation and high airway fistula to the alimentary tract – a case series with four distinct types. Case Reports in Perinatal Medicine 2020. [DOI: 10.1515/crpm-2019-0064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Congenital high airway obstruction syndrome (CHAOS) is a rare disease and recently has been noticed to show typical prenatal images, such as hyperinflated lungs and flattened or inverted diaphragms. However, in some cases correct diagnosis may be difficult and in such cases the mortality rate increases.
Case presentation
We report four cases of CHAOS complicated with a high airway fistula to the alimentary tract and foregut malformation. The patients did not show the typical features of CHAOS in the fetus. This may be attributed to the high airway fistula acting as a decompression route for the accumulated lung fluids to the alimentary tract.
Conclusion
The combination of CHAOS, foregut malformation and a high airway fistula is very rare and classified into four distinct types: (1) CHAOS with a high airway fistula but not with a foregut malformation; (2) CHAOS with esophageal atresia and tracheoesophageal fistula; (3) CHAOS with a high airway fistula and duodenal atresia; and (4) CHAOS with esophageal atresia, tracheoesophageal fistula and duodenal atresia. It may be useful for treating physicians to be aware of these four distinct types and the typical characteristics of each type.
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Affiliation(s)
- Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , 2-10-1 Okura Setagaya-ku , Tokyo 157-8535 , Japan , Tel.: +81-3-3416-0181, Fax: +81-3-3416-2222
| | - Kazunori Tahara
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , Okura Setagaya-ku , Tokyo , Japan
| | - Michinobu Ohno
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , Okura Setagaya-ku , Tokyo , Japan
| | - Kotaro Tomonaga
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , Okura Setagaya-ku , Tokyo , Japan
| | - Yohei Yamada
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , Okura Setagaya-ku , Tokyo , Japan
| | - Tomoro Hishiki
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , Okura Setagaya-ku , Tokyo , Japan
| | - Akihiro Fujino
- Division of Surgery, Department of Surgical Specialties , National Center for Child Health and Development , Okura Setagaya-ku , Tokyo , Japan
| | - Osamu Miyazaki
- Department of Radiology , National Center for Child Health and Development , Tokyo , Japan
| | - Shunsuke Nosaka
- Department of Radiology , National Center for Child Health and Development , Tokyo , Japan
| | - Noriko Morimoto
- Division of Otolaryngology, Department of Surgical Specialties , National Center for Child Health and Development , Tokyo , Japan
| | - Rika Sugibayashi
- Division of Fetal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Katsusuke Ozawa
- Division of Fetal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Seiji Wada
- Division of Fetal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Haruhiko Sago
- Division of Fetal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Keiko Tsukamoto
- Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Tetsuya Isayama
- Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
| | - Yushi Ito
- Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine , National Center for Child Health and Development , Tokyo , Japan
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Moriyama S, Sakai R, Tagaito S, Kanamori Y, Mizohashi T, Tamada S, Nomoto M, Kokuhata K, Mizuguchi Y, Takahashi A. P44 Impact of the distal radial artery approach in nursing service. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The distal transradial approach (dTRA) is a newly developed technique expected to reduce bleeding and other complications, such as occlusions, arising from the nature of the puncture site during transradial access. However, there is a paucity of data with regard to the nursing workload during or after achieving hemostasis. The present study aimed to evaluate the workload of the nursing service associated with dTRA in patients undergoing diagnostic coronary angiography (CAG).
Methods
Two-hundred patients who underwent CAG using a 4-Fr sheath system in our hospital between October 2017 and September 2018 were enrolled in the study. Of the total, 100 patients underwent dTRA for CAG (dTRA group), and the other 100 patients underwent the conventional transradial approach (TRA) for CAG (TRA group). After CAG, continuous compression was performed for 3 hours in the TRA group using a TR Band™, which is a hemostasis device for TRA, to remove 2 ccs and 3 ccs of air at 30 and 120 minutes, respectively. If bleeding occurred, 1 to 2 ccs were replaced using the band, followed by a wait time of 15 minutes. Similarly, continuous compression was performed in the dTRA group usingSTEPTY™, a compression tape with a 6-mm-thick pad at the central portion, and the patient’s arm was wrapped in an elastic bandage for 2 hours after CAG. We compared the dTRA and TRA groups in terms of nursing workload associated with the achievement of hemostasis and the complications related to the puncture site.
Results
The nursing-service workload associated with the management of hemostasis, including the nursing hours, the time taken to measure vitals, and the recording times were found to be significantly shorter for the dTRA group compared to that of the TRA group (2.1 ± 0.5 vs 4.1 ± 0.7 times, p < 0.001; 2.1 ± 0.4 vs 4.1 ± 0.7 times, p < 0.001; 2.1 ± 0.4 vs 4.1 ± 0.6 times, p < 0.001, respectively). Further, the number of cases requiring treatment for bleeding was fewer in the dTRA group than in the TRA group (3 vs 12 cases, p < 0.05).
Conclusions
The workload of the nursing service associated with achieving hemostasis in the dTRA group was significantly lower compared to that in the TRA group. The introduction of dTRA for routine coronary catheterization possibly help in reducing the complications and the nursing workload in daily nursing practices.
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Affiliation(s)
- S Moriyama
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - R Sakai
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - S Tagaito
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - Y Kanamori
- Sakurakai Takahashi Hospital, Kobe, Japan
| | | | - S Tamada
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - M Nomoto
- Sakurakai Takahashi Hospital, Kobe, Japan
| | - K Kokuhata
- Sakurakai Takahashi Hospital, Kobe, Japan
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Yamada Y, Ohno M, Fujino A, Kanamori Y, Irie R, Yoshioka T, Miyazaki O, Uchida H, Fukuda A, Sakamoto S, Kasahara M, Matsumoto K, Fuchimoto Y, Hoshino K, Kuroda T, Hishiki T. Fluorescence-Guided Surgery for Hepatoblastoma with Indocyanine Green. Cancers (Basel) 2019; 11:cancers11081215. [PMID: 31434361 PMCID: PMC6721588 DOI: 10.3390/cancers11081215] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 01/06/2023] Open
Abstract
Fluorescence-guided surgery with indocyanine green (ICG) for malignant hepatic tumors has been gaining more attention with technical advancements. Since hepatoblastomas (HBs) possess similar features to hepatocellular carcinoma, fluorescence-guided surgery can be used for HBs, as aggressive surgical resection, even for distant metastases of HBs, often contributes positively to R0 (complete) resection and subsequent patient survival. Despite a few caveats, fluorescence-guided surgery allows for the more sensitive identification of lesions that may go undetected by conventional imaging or be invisible macroscopically. This leads to precise resection of distant metastatic tumors as well as primary liver tumors.
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Affiliation(s)
- Yohei Yamada
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan.
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
| | - Michinobu Ohno
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Yutaka Kanamori
- Department of Pediatric Surgery, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Rie Irie
- Department of Pathology, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Osamu Miyazaki
- Department of Radiology, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Hajime Uchida
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Akinari Fukuda
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Seisuke Sakamoto
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Mureo Kasahara
- Center for Organ Transplantation, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Kimikazu Matsumoto
- Children Cancer Center, National Center for Child Health and Development, Tokyo 157-0074, Japan
| | - Yasushi Fuchimoto
- Department of Pediatric Surgery, International University of Health and Welfare, Chiba 286-0048, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Tomoro Hishiki
- Division of Surgical Oncology, National Center for Child Health and Development, Tokyo 157-0074, Japan
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34
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Watanabe T, Ohno M, Tahara K, Tomonaga K, Fuchimoto Y, Fujino A, Hishiki T, Tsukamoto K, Ito Y, Sugibayashi R, Wada S, Sago H, Higuchi M, Kawasaki K, Yoshioka T, Kanamori Y. An investigation on clinical differences between congenital pulmonary airway malformation and bronchial atresia. J Pediatr Surg 2018; 53:2390-2393. [PMID: 30227995 DOI: 10.1016/j.jpedsurg.2018.08.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 08/25/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND/PURPOSE Differences in clinical features between congenital pulmonary airway malformation (CPAM) and bronchial atresia (BA) have not yet been clearly described. METHODS We retrospectively reviewed 112 patients with a pathological diagnosis of CPAM or BA. The clinical parameters were statistically analyzed between these diseases. RESULTS Seventy-one patients received prenatal diagnosis and 41 received postnatal diagnosis. The percentage of prenatal diagnosis was significantly higher in CPAM patients (84% vs 50%, p < 0.001). Among patients with prenatal diagnosis, the backgrounds were not different between the two diseases except for the number of Caesarean sections (81% vs 9%, p < 0.0001). The numbers of patients that underwent fetal interventions and emergent neonatal surgery were higher in CPAM (51% vs 15%, p < 0.01 and 76% vs 12%, p < 0.0001), although there was no statistical difference in survival rate (86% vs 97%, p = 0.2). In patients receiving postnatal diagnosis, pneumonia was the primary symptom in most BA patients, whereas respiratory distress was the major symptom in patients with CPAM. Age at presentation of the primary symptom was significantly older in BA patients (4.2 years vs 1.2 years, p < 0.005). CONCLUSION CPAM and BA have distinct clinical features in terms of therapeutic and natural history. Careful imaging evaluation and pathological analysis can lead to an accurate diagnosis of BA. TYPE OF STUDY Prognostic study. LEVEL OF EVIDENCE Level II. This study is categorized as a "Prognostic Study" with LEVEL III of Evidence.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan; Department of Pediatric Surgery, Tokai University School of Medicine, Kanagawa, Japan.
| | - Michinobu Ohno
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Kazunori Tahara
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Kotaro Tomonaga
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Yasushi Fuchimoto
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiro Fujino
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Tomoro Hishiki
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Keiko Tsukamoto
- Division of Neonatology, National Center for Child Health and Development
| | - Yushi Ito
- Division of Neonatology, National Center for Child Health and Development
| | - Rika Sugibayashi
- Division of Fetal Medicine, National Center for Child Health and Development
| | - Seiji Wada
- Division of Fetal Medicine, National Center for Child Health and Development
| | - Haruhiko Sago
- Division of Fetal Medicine, National Center for Child Health and Development
| | - Masataka Higuchi
- Division of Pulmonology, National Center for Child Health and Development
| | - Kazuteru Kawasaki
- Division of Pulmonology, National Center for Child Health and Development
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development
| | - Yutaka Kanamori
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
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35
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Ogawa K, Kanamori Y, Watanabe T, Tomonaga K, Kutsukake M, Goto M, Ohno M, Tahara K, Hishiki T, Fujino A. Acute pancreatitis caused by a duodenal duplication cyst covering the ampulla of Vater. Journal of Pediatric Surgery Case Reports 2018. [DOI: 10.1016/j.epsc.2018.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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36
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Muto M, Matsufuji H, Taguchi T, Tomomasa T, Nio M, Tamai H, Tamura M, Sago H, Toki A, Nosaka S, Kuroda T, Yoshida M, Nakajima A, Kobayashi H, Sou H, Masumoto K, Watanabe Y, Kanamori Y, Hamada Y, Yamataka A, Shimojima N, Kubota A, Ushijima K, Haruma K, Fukudo S, Araki Y, Kudo T, Obata S, Sumita W, Watanabe T, Fukahori S, Fujii Y, Yamada Y, Jimbo K, Kawai F, Fukuoka T, Onuma S, Morizane T, Ieiri S, Esumi G, Jimbo T, Yamasaki T. Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease, 2017. Pediatr Int 2018; 60:400-410. [PMID: 29878629 DOI: 10.1111/ped.13559] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/27/2018] [Accepted: 03/07/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite the presence of ganglion cells in the rectum, some patients have symptoms similar to those of Hirschsprung's disease. A consensus has yet to be established regarding the terminology for these diseases. We defined this group of diseases as "allied disorders of Hirschsprung's disease" and compiled these guidelines to facilitate accurate clinician diagnosis and provide appropriate treatment strategies for each disease. METHODS These guidelines were developed using the methodologies in the Medical Information Network Distribution System (MINDS). Of seven allied disorders, isolated hypoganglionosis; megacystis-microcolon-intestinal hypoperistalsis syndrome; and chronic idiopathic intestinal pseudo-obstruction were selected as targets of clinical questions (CQ). In a comprehensive search of the Japanese- and English-language articles in PubMed and Ichu-Shi Web, 836 pieces of evidence related to the CQ were extracted from 288 articles; these pieces of evidence were summarized in an evidence table. RESULTS We herein outline the newly established Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease. Given that the target diseases are rare and intractable, most evidence was drawn from case reports and case series. In the CQ, the diagnosis, medication, nutritional support, surgical therapy, and prognosis for each disease are given. We emphasize the importance of full-thickness intestinal biopsy specimens for the histopathological evaluation of enteric ganglia. Considering the practicality of the guidelines, the recommendations for each CQ were created with protracted discussions among specialists. CONCLUSIONS Clinical practice recommendations for allied disorders of Hirschprung's disease are given for each CQ, along with an assessment of the current evidence. We hope that the information will be helpful in daily practice and future studies.
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Affiliation(s)
- Mitsuru Muto
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hiroshi Matsufuji
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tomoaki Taguchi
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Takeshi Tomomasa
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Masaki Nio
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hiroshi Tamai
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Masanori Tamura
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Haruhiko Sago
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Akira Toki
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Shunsuke Nosaka
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tatsuo Kuroda
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Masahiro Yoshida
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Atsushi Nakajima
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hiroyuki Kobayashi
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Hideki Sou
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Kouji Masumoto
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshio Watanabe
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yutaka Kanamori
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshinori Hamada
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Atsuyuki Yamataka
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Naoki Shimojima
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Akio Kubota
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Kosuke Ushijima
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Ken Haruma
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Shin Fukudo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yuko Araki
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Takahiro Kudo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Satoshi Obata
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Wataru Sumita
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Toshihiko Watanabe
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Suguru Fukahori
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshimitsu Fujii
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Yoshiyuki Yamada
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Keisuke Jimbo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Fujimi Kawai
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tomoya Fukuoka
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Shinsuke Onuma
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Toshio Morizane
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Satoshi Ieiri
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Genshiro Esumi
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Takahiro Jimbo
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
| | - Tomoko Yamasaki
- The guideline establishment group for allied disorders of Hirschsprung's disease, Science Research, Ministry of Health Labour and Welfare, Fukuoka, Japan
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Komura M, Komura H, Kanamori Y, Tanaka Y, Ohatani Y, Ishimaru T, Sugiyama M, Hoshi K, Iwanaka T. Study of Mechanical Properties of Engineered Cartilage in an in Vivo Culture for Design of a Biodegradable Scaffold. Int J Artif Organs 2018. [DOI: 10.1177/039139881003301102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction An engineered trachea with an absorbable scaffold should be used to augment the repair of a stenotic tracheal section in infants and children because this type of engineered airway structure can grow as the child grows. Our strategy for relief of tracheal stenosis is tracheoplasty by engineered cartilage implantation in accordance with the concept of costal cartilage grafting to enlarge the lumen. This study investigated the mechanical properties of regenerative cartilage with a biodegradable scaffold, Neoveil®, to aid in design of a composite scaffold that maintained semi-rigid properties until cartilage could be generated. Materials and methods New Zealand White rabbit (n=3) chondrocytes were isolated from auricular cartilage with collagenase type 2 digestion. Then 10×106/cm3 chondrocytes in atelocollagen solution were seeded onto polyglycolic acid (PGA) mesh. A total of 36 constructs, 12 from each rabbit, were implanted into athymic mice (3 constructs/mouse). Constructs were retrieved after 8 weeks and evaluated by measurements of mechanical and biochemical properties as well as histological examination. Thirty-six PGA mesh sheets of the same size but without cells were implanted in control mice. Results After 6 weeks of implantation, staining of sections with Safranin O revealed cartilage accumulation. Glycosaminoglycan was gradually produced from chondrocytes in the engineered constructs, correlating with the duration of implantation. Mechanical parameters had the same values as those for rabbit tracheal cartilage 8 weeks after implantation. Conclusions Biodegradable Neoveil® had good biocompatibility and was able to support extracellular matrix formation in engineered cartilage in an animal model.
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Affiliation(s)
- Makoto Komura
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Hiroko Komura
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Yutaka Kanamori
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Yujirou Tanaka
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Yoshiyuki Ohatani
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Tetuya Ishimaru
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Masahiko Sugiyama
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Kazuto Hoshi
- Department of Tissue Engineering (Fujisoft ABC), Graduate School of Medicine, University of Tokyo, Tokyo - Japan
| | - Tadashi Iwanaka
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo - Japan
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Kanamori Y, Takezoe T, Tahara K, Watanabe T, Ohno M, Tomonaga K, Ogawa K, Hishiki T, Fujino A, Ozawa Y, Amari S, Fujinaga H, Ito Y, Miyazaki O, Morimoto N, Sugibayashi R, Ozawa K, Wada S, Sago H. Congenital high airway obstruction syndrome (CHAOS) combined with esophageal atresia, tracheoesophageal fistula and duodenal atresia. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.08.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Yorifuji T, Horikawa R, Hasegawa T, Adachi M, Soneda S, Minagawa M, Ida S, Yonekura T, Kinoshita Y, Kanamori Y, Kitagawa H, Shinkai M, Sasaki H, Nio M. Clinical practice guidelines for congenital hyperinsulinism. Clin Pediatr Endocrinol 2017; 26:127-152. [PMID: 28804205 PMCID: PMC5537210 DOI: 10.1297/cpe.26.127] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/08/2017] [Indexed: 12/11/2022] Open
Abstract
Congenital hyperinsulinism is a rare condition, and following recent advances in
diagnosis and treatment, it was considered necessary to formulate evidence-based clinical
practice guidelines reflecting the most recent progress, to guide the practice of
neonatologists, pediatric endocrinologists, general pediatricians, and pediatric surgeons.
These guidelines cover a range of aspects, including general features of congenital
hyperinsulinism, diagnostic criteria and tools for diagnosis, first- and second-line
medical treatment, criteria for and details of surgical treatment, and future
perspectives. These guidelines were generated as a collaborative effort between The
Japanese Society for Pediatric Endocrinology and The Japanese Society of Pediatric
Surgeons, and followed the official procedures of guideline generation to identify
important clinical questions, perform a systematic literature review (April 2016), assess
the evidence level of each paper, formulate the guidelines, and obtain public
comments.
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Affiliation(s)
- Tohru Yorifuji
- Division of Pediatric Endocrinology and Metabolism, Children's Medical Center, Osaka City General Hospital, Osaka, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | | | - Masanori Adachi
- Department of Endocrinology and Metabolism, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Shun Soneda
- Department of Pediatrics, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Shinobu Ida
- Department of Pediatric Gastroenterology, Nutrition and Endocrinology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Takeo Yonekura
- Department of Pediatric Surgery, Nara Hospital, Kindai University Faculty of Medicine, Nara, Japan
| | - Yoshiaki Kinoshita
- Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yutaka Kanamori
- Department of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Hiroaki Kitagawa
- Division of Pediatric Surgery, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Masato Shinkai
- Department of Surgery, Kanagawa Children's Medical Center, Kanagawa, Japan
| | - Hideyuki Sasaki
- Department of Pediatric Surgery, Tohoku University, Miyagi, Japan
| | - Masaki Nio
- Department of Pediatric Surgery, Tohoku University, Miyagi, Japan
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40
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Maeda K, Watanabe T, Sato K, Takezoe T, Migita M, Takahashi M, Ohno M, Tahara K, Fuchimoto Y, Uchikawa S, Takayama S, Kanamori Y. Two cases of asymptomatic rib exostosis treated by prophylactic surgical excision. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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41
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Watanabe T, Amari S, Tsukamoto K, Ito Y, Tomizawa D, Yoshioka T, Kanamori Y. Resolution of liver disease in transient abnormal myelopoiesis with fish oil emulsion. Pediatr Int 2017; 59:515-518. [PMID: 28401746 DOI: 10.1111/ped.13250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/23/2016] [Accepted: 01/25/2017] [Indexed: 11/30/2022]
Abstract
Neonates with Down syndrome are at risk of developing transient abnormal myelopoiesis (TAM), which is characterized by transient clonal myeloproliferation of the blast cells. TAM can resolve spontaneously, but some patients die at an early age due to organ failure. Liver fibrosis in TAM is a life-threatening condition, but treatment options have not yet been established. Here, we report on the case of an infant with TAM complicated by liver disease, whose hyperbilirubinemia was successfully ameliorated with omega-3 fatty acid (ω3FA) lipid emulsion. Timely ω3FA lipid emulsion may be a feasible treatment for liver disease in TAM before serious liver damage develops.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Shoichiro Amari
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | - Keiko Tsukamoto
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | - Yushi Ito
- Division of Neonatology, National Center for Child Health and Development, Tokyo, Japan
| | - Daisuke Tomizawa
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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42
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Ohno M, Takezoe T, Watanabe T, Tahara K, Hishiki T, Fujino A, Matsuo M, Higuchi M, Kawasaki K, Shioda Y, Kato M, Kiyotani C, Matsumoto K, Takakuwa E, Irie R, Yoshioka T, Kimura S, Seki M, Takita J, Kanamori Y. A female case of pleuropulmonary blastoma type 1 whose pulmonary cystic lesion was followed since neonate. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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43
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Komura M, Kanamori Y, Tanaka Y, Kodaka T, Sugiyama M, Terawaki K, Suzuki K, Iwanaka T. Mosapride for gastroesophageal reflux disease in neurologically impaired patients. Pediatr Int 2017; 59:347-351. [PMID: 27561215 DOI: 10.1111/ped.13144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 08/16/2016] [Accepted: 08/24/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The prokinetic agent cisapride is effective for the treatment of gastroesophageal reflux disease (GERD) in infants and children, but is no longer used for this purpose because of safety concerns. Therefore, other pharmacological agents need to be investigated for efficacy in GERD treatment. In this study, we examined the effectiveness and safety of mosapride for the treatment of neurologically impaired children and adolescents with GERD. METHODS Mosapride (0.3 mg/kg/day) was administered to 11 neurologically impaired patients with GERD (five male; median age, 12.3 years). Esophageal acid exposure was measured using esophageal pH monitoring before and at >5 days after the start of mosapride treatment. The pressure and length of the lower esophageal sphincter were compared before and after mosapride treatment. RESULTS In the 11 patients, median reflux index (percentage of the total monitoring period during which recorded pH was <4.0) was 17.5% (range, 4.4-59%) before and 8.2% (range, 2.8-20.7%) after mosapride treatment (P = 0.02). Median esophageal clearance was 1.0 min/reflux (range, 0.5-2.1 min/reflux) before and 0.7 min/reflux (range, 0.4-1.2 min/reflux) after treatment with mosapride (P = 0.02). The median number of reflux episodes before (219) and after (122) drug treatment did not differ significantly. CONCLUSION The decreased reflux index in neurologically impaired patients with GERD is due to mosapride, therefore mosapride may be a candidate for GERD treatment.
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Affiliation(s)
- Makoto Komura
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yutaka Kanamori
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Yujiro Tanaka
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tetsuro Kodaka
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Masahiko Sugiyama
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kan Terawaki
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Kan Suzuki
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tadashi Iwanaka
- Department of Pediatric Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
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44
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Takezoe T, Nomura M, Ogawa K, Tomonaga K, Ohno M, Tahara K, Watanabe T, Hishiki T, Fujino A, Miyasaka M, Miyazaki O, Fujinaga H, Fujimoto T, Ito Y, Sugibayashi R, Ozawa K, Wada S, Sago H, Irie R, Yoshioka T, Kanamori Y. Prenatally diagnosed, right-sided congenital diaphragmatic hernia complicated by hepatic pulmonary fusion and intrathoracic kidney. ACTA ACUST UNITED AC 2017. [DOI: 10.15761/bdj.1000104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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45
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Abd Eldaim M, Hashimoto O, Ohtsuki H, Yamada T, Murakami M, Onda K, Sato R, Kanamori Y, Qiao Y, Tomonaga S, Matsui T, Funaba M. Expression of uncoupling protein 1 in bovine muscle cells1. J Anim Sci 2016; 94:5097-5104. [DOI: 10.2527/jas.2016-0726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- M.A. Abd Eldaim
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
- Department of Biochemistry and Chemistry of Nutrition, Faculty of Veterinary Medicine, University of Sadat City, 32897, Egypt
| | - O. Hashimoto
- Laboratory of Experimental Animal Science, Kitasato University, School of Veterinary Medicine, Towada 034-8628, Japan
| | - H. Ohtsuki
- Laboratory of Experimental Animal Science, Kitasato University, School of Veterinary Medicine, Towada 034-8628, Japan
| | - T. Yamada
- National Institute of Livestock and Grassland Science, Nasushiobara 329-2793, Japan
| | - M. Murakami
- Laboratory of Molecular Biology, Azabu University School of Veterinary Medicine, Sagamihara 252-5201, Japan
| | - K. Onda
- Laboratory of Internal Medicine III, Azabu University School of Veterinary Medicine, Sagamihara 252-5201, Japan
| | - R. Sato
- Laboratory of Internal Medicine III, Azabu University School of Veterinary Medicine, Sagamihara 252-5201, Japan
| | - Y. Kanamori
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
| | - Y. Qiao
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
| | - S. Tomonaga
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
| | - T. Matsui
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
| | - M. Funaba
- Division of Applied Biosciences, Graduate School of Agriculture, Kyoto University, 606-8502, Japan
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46
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Yamoto M, Inamura N, Terui K, Nagata K, Kanamori Y, Hayakawa M, Tazuke Y, Yokoi A, Takayasu H, Okuyama H, Fukumoto K, Urushihara N, Taguchi T, Usui N. Echocardiographic predictors of poor prognosis in congenital diaphragmatic hernia. J Pediatr Surg 2016; 51:1926-1930. [PMID: 27663123 DOI: 10.1016/j.jpedsurg.2016.09.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND/PURPOSE The purpose of this study was to investigate echocardiographic parameters in relation to the outcomes of isolated left-sided congenital diaphragmatic hernia (CDH). METHODS This multicenter, retrospective, observational study was conducted among patients with CDH born between 2006 and 2010. Patients in this study did not have severe cardiac malformations or chromosomal aberrations. Patients with incomplete echocardiographic examinations were excluded. In total, 84 patients with left-sided isolated CDH were included in this study. The prognostic parameters were obtained from postnatal echocardiographic images within 24h after birth. RESULTS Eight patients died before 90days of birth. Univariate analysis showed that the presence of continuous right to left shunt at the ductus, left pulmonary artery diameter of <2.7mm, right pulmonary artery diameter of <3.3mm, and left ventricular diastolic diameter of <10.8mm, were the predictors of poor prognosis. Multivariate logistic regression analysis showed that right pulmonary artery diameter of <3.3mm (adjusted OR 10.28, 95% C.I.: 1.15-249.19) and left ventricular diastolic diameter of <10.8mm (adjusted OR 7.86, 95% C.I.: 1.01-82.82) were predictors of poor prognosis. CONCLUSIONS This study revealed that the predictors of poor prognosis associated with CDH include smaller right pulmonary artery and left ventricular diastolic diameters. Retrospective Study-Level II.
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Affiliation(s)
- Masaya Yamoto
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
| | - Noboru Inamura
- Department of Pediatric Cardiology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Keita Terui
- Department of Pediatric Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kouji Nagata
- Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan
| | - Yutaka Kanamori
- Division of Surgery, National Center for Child Health and Development, Tokyo, Japan
| | - Masahiro Hayakawa
- Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan
| | - Yuko Tazuke
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akiko Yokoi
- Department of Pediatric Surgery, Hyogo Children's Hospital, Kobe, Japan
| | - Hajime Takayasu
- Department of Pediatric Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroomi Okuyama
- Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koji Fukumoto
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Naoto Urushihara
- Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Tomoaki Taguchi
- Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan
| | - Noriaki Usui
- Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
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Moritake Y, Kanamori Y, Hane K. Emission wavelength tuning of fluorescence by fine structural control of optical metamaterials with Fano resonance. Sci Rep 2016; 6:33208. [PMID: 27622503 PMCID: PMC5020684 DOI: 10.1038/srep33208] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 08/04/2016] [Indexed: 12/04/2022] Open
Abstract
We demonstrated fine emission wavelength tuning of quantum dot (QD) fluorescence by fine structural control of optical metamaterials with Fano resonance. An asymmetric-double-bar (ADB), which was composed of only two bars with slightly different bar lengths, was used to obtain Fano resonance in the optical region. By changing the short bar length of ADB structures with high dimensional accuracy in the order of 10 nm, resonant wavelengths of Fano resonance were controlled from 1296 to 1416 nm. Fluorescence of QDs embedded in a polymer layer on ADB metamaterials were modified due to coupling to Fano resonance and fine tuning from 1350 to 1376 nm was observed. Wavelength tuning of modified fluorescence was reproduced by analysis using absorption peaks of Fano resonance. Tuning range of modified fluorescence became narrow, which was interpreted by a simple Gaussian model and resulted from comparable FWHM in QD fluorescence and Fano resonant peaks. The results will help the design and fabrication of metamaterial devices with fluorophores such as light sources and biomarkers.
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Affiliation(s)
- Y Moritake
- Department of Nanomechanics, Tohoku University, Japan
| | - Y Kanamori
- Department of Nanomechanics, Tohoku University, Japan
| | - K Hane
- Department of Nanomechanics, Tohoku University, Japan
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48
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Watanabe T, Horikawa R, Masaki H, Yoshioka T, Matsumoto K, Kanamori Y. Anal Canal Carcinoma in a Child With Disorders of Sex Development. Pediatr Blood Cancer 2016; 63:1293-5. [PMID: 27037640 DOI: 10.1002/pbc.25988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 03/03/2016] [Indexed: 11/11/2022]
Abstract
Squamous cell carcinoma of the anal canal in children is rare. To date, the etiology and outcome of this condition have been not fully understood. Here, we report an 11-year-old child with anal canal cancer who had concomitant disorders of sex development. Radiotherapy followed by salvage surgery achieved disease-free survival of 3 years. Since overexpression of cell cycle regulatory protein p16 was immunohistochemically evident in tumor tissue, human papillomavirus infection was considered as a causative factor in the carcinogenesis.
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Affiliation(s)
- Toshihiko Watanabe
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Hidekazu Masaki
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development, Tokyo, Japan
| | - Kimikazu Matsumoto
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
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49
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Nishigaki K, Kanamori Y, Ikeda M, Sugiyama M, Minowa H, Kamibeppu K. Changes in Mothers' Psychosocial Perceptions of Technology-dependent Children and Adolescents at Home in Japan: Acknowledgement of Children's Autonomy. Asian Nurs Res (Korean Soc Nurs Sci) 2016; 10:100-5. [PMID: 27349666 DOI: 10.1016/j.anr.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 10/23/2015] [Accepted: 01/07/2016] [Indexed: 11/16/2022] Open
Abstract
PURPOSE This research was conducted to reveal Japanese mothers' changing perceptions towards their technology-dependent children in the home care setting. METHODS Fourteen Japanese mothers participated in semi-structured interviews, which were analyzed using a grounded theory approach. RESULTS "Degree of preoccupation with the child" emerged as the category representing the mothers' perceptions towards their child. Three categories emerged that represented the progression of maternal perceptions over time: "accepting the child's conditions", "mastering the management of care in various conditions", and "considering social participation for the child". CONCLUSIONS First, mothers gradually accepted the conditions of their child after his/her disease and disability were known. Second, others managed technology-required care and concurrently considered the social participation of their child through daily care at home. Third, the level of preoccupation with the child was affected by the mothers' management of care and their attitude towards the social participation of their child in home care. In this study, as is widely alleged in historical recognition of Japan, mothers provided daily care almost without help from other family members. Additionally, they thought it natural and good for their children. Above all, especially in Japan, professional support for mothers are necessary so that they can take breaks from care.
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Affiliation(s)
- Kaori Nishigaki
- Division of Nursing, Faculty of Healthcare, Tokyo Healthcare University, Tokyo, Japan; Division of Health Sciences and Nursing, Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Yutaka Kanamori
- Division of Surgery, Department of Surgical Specialties, National Center for Child Health and Development, Tokyo, Japan
| | - Mari Ikeda
- Department of Nursing, Administration and Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masahiko Sugiyama
- Department of Pediatric Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Hideko Minowa
- Former the University of Tokyo Hospital, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Division of Health Sciences and Nursing, Department of Family Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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50
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Tomita H, Fuchimoto Y, Fujino A, Hoshino K, Yamada Y, Masugi Y, Sakamoto M, Kasahara M, Kanamori Y, Nakazawa A, Yoshida F, Akatsuka S, Nakano M, Kuroda T. Development and Validation of a Novel Fibrosis Marker in Biliary Atresia during Infancy. Clin Transl Gastroenterol 2015; 6:e127. [PMID: 26583502 PMCID: PMC4816091 DOI: 10.1038/ctg.2015.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 10/12/2015] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Most biliary atresia (BA) patients suffer from liver fibrosis and often require liver transplantation. The aim of this study was to develop and validate a novel fibrosis marker for BA patients aged <1 year-the infant BA liver fibrosis (iBALF) score-subsequent to the previously reported fibrosis marker for BA patients aged ≥1 year. METHODS From three institutions for pediatric surgery, BA patients and their native liver histology examinations performed at the age of <1 year were retrospectively identified and assigned to a development cohort (58 patients and 73 examinations) or validation cohort (92 patients and 117 examinations) according to their institutions. Histological fibrosis stages (F0-F4), blood test results, and clinical information at the time of liver histology examination were reviewed. The iBALF score was determined using multivariate ordered logistic regression analysis and was assessed for its associations with histological fibrosis stages. RESULTS The iBALF score equation was composed of natural logarithms, including serum total bilirubin level, blood platelet counts, and days of age. The score revealed a strong correlation with fibrosis stage (r=0.80 and 0.73 in the development and validation cohorts, respectively; P<0.001). The areas under the receiver-operating characteristic curves for diagnosing each fibrosis stage were 0.86-0.94 in the development cohort and 0.86-0.90 in the validation cohort (P<0.001), indicating good diagnostic power. In addition, no patient with an iBALF score >6 (equivalent to F4) at the initial surgery survived with their native liver at 1 year of age (n=9). CONCLUSIONS The iBALF score that was developed was a good noninvasive marker of native liver fibrosis for BA patients aged <1 year.
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Affiliation(s)
- Hirofumi Tomita
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan.,Department of Pediatric Surgery, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Yasushi Fuchimoto
- Department of Surgery, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Akihiro Fujino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Ken Hoshino
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Yamada
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Masugi
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Michiie Sakamoto
- Department of Pathology, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Mureo Kasahara
- Department of Transplant Surgery, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Yutaka Kanamori
- Department of Surgery, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Atsuko Nakazawa
- Department of Pathology, National Center for Child Health and Development, Okura Setagaya-ku Tokyo, Japan
| | - Fumiko Yoshida
- Department of Pediatric Surgery, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Seiya Akatsuka
- Department of Pathology, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Miwako Nakano
- Department of Pediatric Surgery, Saitama City Hospital, Midori-ku, Saitama-shi, Japan
| | - Tatsuo Kuroda
- Department of Pediatric Surgery, Keio University School of Medicine, Tokyo, Japan
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