Yasuhide Morikawa

Publications (41)65.26 Total impact

• Source

  Available from: Go Wakabayashi

  Article: Effect of an omega-3 lipid emulsion in reducing oxidative stress in a rat model of intestinal ischemia-reperfusion injury.

  Atsuhiro Arisue, Naoki Shimojima, Masayuki Tomiya, Takayuki Shimizu, Daisuke Harada, Mitsuo Nakayama, Hirofumi Tomita, Masahiro Shinoda, Minoru Tanabe, Ikuro Maruyama, Masaru Mizuno, Tatsuo Kuroda, Go Wakabayashi, Yasuhide Morikawa
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  ABSTRACT: The usefulness of omega-3 lipid emulsions has been extensively studied. The objectives of the present study were to examine the effect of an omega-3 lipid emulsion in reducing oxidative stress in a rat model of intestinal ischemia-reperfusion injury and the underlying mechanism. A total of 66 rats were divided into three dietary groups (lipid-free, soybean oil, and fish oil groups). Each animal was administered total parenteral nutrition for 3 days, followed by induction of intestinal ischemia for 100 min. Animals subjected to sham surgery served as the controls. Intestinal tissue and blood were harvested 6 and 12 h after the surgery, then, assessment of the histological damage score, plasma-related parameters, and statistical evaluation were performed. The histological damage score in the intestinal tissues was significantly lower in the fish oil group than in the soybean oil group (P = 0.0121). The late-phase urinary level of 8-hydroxy-2-deoxyguanosine was also significantly lower in the fish oil group as compared with that in the other groups (P = 0.0267). Furthermore, the plasma level of high-mobility group box 1 protein was also significantly lower in the fish oil group as compared with that in the lipid-free group (P = 0.0398). It appeared that intravenous administration of an omega-3 lipid emulsion prior to ischemia-reperfusion injury reduced the oxidative stress and severity of tissue damage. Modification of membrane fatty acids may serve as the mechanism underlying this reduction of tissue damage.
  Pediatric Surgery International 08/2012; 28(9):913-8. · 1.25 Impact Factor
• Article: Hepatoblastoma Metastasis Confined to the Pulmonary Artery: Report of a Case.

  Yotaro Izumi, Ken Hoshino, Naoki Shimojima, Yasushi Fuchimoto, Yuichiro Hayashi, Yasuhide Morikawa, Hiroaki Nomori
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  ABSTRACT: Here, we report a case of hepatoblastoma metastasis to the left pulmonary artery which was resected by left lingular segmentectomy plus left lower lobectomy in 5-year-old girl. She had previously undertaken right upper lobectomy and multiple lung partial resections on bilateral lungs as hepatoblastoma metastatectomies. Prediction of postoperative pulmonary function based on perfusion scan merged with CT image and the measurement by CT volumetry, showed that left lingular segmentectomy plus left lower lobectomy could preserve 78% of the preoperative functional values and resection was done. Three weeks after the operation, her condition recovered to the preoperative level. Pathological examination showed that the metastasis was tumor embolism of hepatoblastoma which extended into the pulmonary arterial wall, which to our knowledge, has not been previously reported.
  Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia. 08/2012;
• Article: Cyclosporine A-based immunotherapy in adult living donor liver transplantation: accurate and improved therapeutic drug monitoring by 4-hr intravenous infusion.

  Taizo Hibi, Minoru Tanabe, Ken Hoshino, Yasushi Fuchimoto, Shigeyuki Kawachi, Osamu Itano, Hideaki Obara, Masahiro Shinoda, Naoki Shimojima, Kentaro Matsubara, Yasuhide Morikawa, Yuko Kitagawa
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  ABSTRACT: A paucity of data exists for evaluating therapeutic drug monitoring in association with clinical outcomes of cyclosporine A (CYA) treatment in living donor liver transplantation (LDLT). A retrospective cohort analysis was conducted on 50 consecutive adult patients who underwent LDLT between 2001 and 2009 to investigate the feasibility and efficacy of 4-hr continuous intravenous infusion of CYA-based immunotherapy (4-hr CYA-IV, n=27) and compare the pharmacokinetic profile and short-term prognoses with an oral microemulsion formulation of CYA (CYA-ME, n=23). All patients in the 4-hr CYA-IV group reached target CYA peak by day 3 compared with only 22% in the CYA-ME group (P<0.001). Adjustability to achieve the target range was easier in the 4-hr CYA-IV group compared with the CYA-ME group (P=0.017). Acute cellular rejection rate was lower in the 4-hr CYA-IV group (0%) compared with the CYA-ME group (17%, P=0.038). A subset analysis of the CYA-ME group revealed that CYA exposure was affected by external bile output (P=0.006). Patients in the CYA-ME group showed increased risk of switch to tacrolimus (35%) compared with the 4-hr CYA-IV group (7%, P=0.030). Toxicities and mortality rates were equivalent. The optimal initial dose of oral CYA at conversion from the 4-hr CYA-IV was considered to be 3-fold greater than that of the intravenous dose. In LDLT, our 4-hr CYA-IV immunosuppression protocol was superior to CYA-ME oral dosing and allowed accurate therapeutic drug monitoring with excellent patient compliance.
  Transplantation 07/2011; 92(1):100-5. · 4.00 Impact Factor
• Article: Skill qualifications in pediatric minimally invasive surgery.

  Tadashi Iwanaka, Yasuhide Morikawa, Atsuyuki Yamataka, Masaki Nio, Osamu Segawa, Hiroshi Kawashima, Masahito Sato, Hirotsugu Terakura, Hiroshi Take, Ryuichiro Hirose, Makoto Yagi
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  ABSTRACT: In 2006, The Japanese Society of Pediatric Endoscopic Surgeons devised a plan to develop a pediatric endoscopic surgical skill qualification (ESSQ) system. This system is controlled by The Japan Society for Endoscopic Surgery. The standard requirement for skills qualification is the ability of each applicant to complete common types of laparoscopic surgery. The main goal of the system is to decrease complications of laparoscopic surgery by evaluating the surgical skills of each applicant and subsequently certify surgeons with adequate skills to perform laparoscopic operations safely. A committee of pediatric ESSQ created a checklist to assess the applicant's laparoscopic surgical skills. Skills are assessed in a double-blinded fashion by evaluating an unedited video recording of a fundoplication for pediatric gastroesophageal reflux disease. The initial pediatric ESSQ system was started in 2008. In 2008 and 2009, respectively, 9 out of 17 (53%) and 6 out of 12 (50%) applicants were certified as expert pediatric laparoscopic surgeons. Our ultimate goal is to provide safe and appropriate pediatric minimally invasive procedures and to avoid severe complications. To prove the predictive validity of this system, a survey of the outcomes of operations performed by certified pediatric surgeons is required.
  Pediatric Surgery International 03/2011; 27(7):727-31. · 1.25 Impact Factor
• Article: Survival of a congenital ileal atresia infant weighing 359 g at birth after laparotomy.

  Yasushi Fuchimoto, Hirofumi Tomita, Fumika Takasato, Yuki Yamamoto, Masaharu Mori, Naoki Shimojima, Ken Hoshino, Isamu Hokuto, Kazushige Ikeda, Yasuhide Morikawa
  Pediatrics International 02/2011; 53(1):127-8. · 0.63 Impact Factor
• Article: Final diagnosis in patients with congenital cystic lung disease detected by fetal ultrasonography.

  Gen Kuratsuji, Isamu Hokuto, Masataka Higuchi, Goro Koinuma, Yasuhide Morikawa, Ken Hoshino, Mamoru Tanaka, Kei Miyakoshi, Kazushige Ikeda
  Pediatrics International 02/2011; 53(1):131-2. · 0.63 Impact Factor
• Article: A long-term survival case of tracheal agenesis: management for tracheoesophageal fistula and esophageal reconstruction.

  Yasushi Fuchimoto, Masaharu Mori, Fumika Takasato, Hirofumi Tomita, Yuki Yamamoto, Naoki Shimojima, Ken Hoshino, Goro Koinuma, Yasuhide Morikawa
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  ABSTRACT: Tracheal agenesis is a very rare disorder which leads to severe respiratory disorders immediately after birth. Reports are very limited on long-term survival cases. We report here a long-term survival case with Floyd's type I tracheal agenesis. During the neonatal stage, the patient underwent abdominal esophageal banding to substitute esophagus for trachea and transection at the cervical esophagus with esophagostomy. Subsequently, airway management was difficult due to a fragile tracheoesophageal fistula, but the fistula was conservatively treated and stabilized with the patient's growth. This patient is a very rare case in whom oral feeding was achieved after esophageal reconstruction using a gastric tube. For this case, we describe mainly (1) the management method of the tracheoesophageal fistula and (2) esophageal reconstruction without thoracotomy.
  Pediatric Surgery International 01/2011; 27(1):103-6. · 1.25 Impact Factor
• Source

  Available from: Masashi Yoshida

  Article: The developments and achievements of endoscopic surgery, robotic surgery and function-preserving surgery.

  Masashi Yoshida, Toshiharu Furukawa, Yasuhide Morikawa, Yuko Kitagawa, Masaki Kitajima
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  ABSTRACT: The breakthrough in laparoscopic surgery has been the development of a charge-coupled device camera system and Mouret performing cholecystectomy in 1987. The short-term benefits of laparoscopic surgery are widely accepted and the long-term benefit of less incidence of bowel obstruction can be expected. The important developments have been the articulating instrumentation via new laparoscopic access ports. Since 2007, single-incision laparoscopic surgery has spread all over the world. Not only single-scar but also no-scar operation is a current topic. In 2004, Kalloo reported the flexible transgastric peritoneoscopy as a novel approach to therapeutic interventions. In 2007, Marescaux reported transvaginal cholecystectomy in a patient. The breakthrough in robotic surgery was the development of the da Vinci Surgical System. It was introduced to Keio University Hospital in March 2000. Precision in the surgery will reach a higher level with the use of robotics. In collaboration with the faculty of technology and science, Keio University, the combined master-slave manipulator has been developed. The haptic forceps, which measure the elasticity of organs, have also been developed. The first possible sites of lymphatic metastasis are known as sentinel nodes. Otani reported vagus-sparing segmental gastrectomy under sentinel node navigation. This kind of function-preserving surgery will be performed frequently if the results of the multicenter prospective trial of the dual tracer method are favorable. Indocyanine green fluorescence-guided method using the HyperEye charge-coupled device camera system can be a highly sensitive method without using the radioactive colloid. 'Minimally invasive, function-preserving and precise surgery under sentinel node navigation in community hospital' may be a goal for us.
  Japanese Journal of Clinical Oncology 09/2010; 40(9):863-9. · 1.78 Impact Factor
• Article: Idiopathic hypereosinophilic syndrome in a case with ABO-incompatible liver transplantation for biliary atresia complicated by portal vein thrombosis.

  Yohei Yamada, Ken Hoshino, Naoki Shimojima, Masahiro Shinoda, Hideaki Obara, Shigeyuki Kawachi, Yasushi Fuchimoto, Minoru Tanabe, Yuko Kitagawa, Yasuhide Morikawa
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  ABSTRACT: Idiopathic HES is characterlized by prolonged eosinophilia without an identifiable underlying cause and multiple-organ dysfunction. We report a case of a LDLT for a 12-yr-old Japanese girl with BA accompanied by HES. Histological examination of the resected liver showed biliary cirrhosis with dense eosinophilic infiltration of portal tracts and the lobules of the liver. She developed portal vein thrombosis on post-operative day 10 and the histopathological findings of the thrombus revealed dense eosinophilic deposition, suggesting that HES might have influenced the formation of this thrombus. Liver graft biopsies also demonstrated the presence of activated eosinophilils with biliary damage. Blood chemistry findings suggested liver dysfunction as a result of the eosinophilic infiltrations. Prednisolone treatment improved the liver dysfunction. Four years after LDLT, she remains clinically well on prednisolone at 0.3 mg/kg/day, with an eosinophil count ranging from 10 to 15%. A literature review has not shown any previous reports of HES with BA. This case demonstrates the possibility of an association between eosinophilic infiltration and liver dysfunction during follow-up for BA and after LDLT.
  Pediatric Transplantation 08/2010; 14(5):e49-53. · 1.48 Impact Factor
• Article: Newly developed haptic forceps enables sensitive, real-time measurements of organ elasticity.

  Koji Atsuta, Soji Ozawa, Naoki Shimojima, Tomoyuki Shimono, Shigeru Susa, Takayoshi Takei, Kouhei Ohnishi, Yasuhide Morikawa
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  ABSTRACT: Currently available master-slave manipulators cannot recognize the elasticity of organs or tissues. The aim of this study was to examine whether a newly developed haptic forceps using a linear motor could measure the elasticity of living organs using an animal model. We measured the elasticity values and the disruption limit values of rat organs using the new haptic forceps. The elasticity of the materials was calculated using the formula "power / position", with N/m as the unit. We successfully and reproducibly measured the changes in the elasticity values of various materials in real time. We were also able to perceive tactile changes transmitted through the forceps. The changes in gastrointestinal contraction were synchronized with the visually observed changes, and these changes were monitored and measured as elasticity values in real time using the forceps. The damage limits were also successfully measured. In conclusion, the new haptic forceps enabled highly sensitive, real-time measurements of elasticity in living rat organs. The use of this forceps enables the disruption limit values of organs to be measured, and the device could be useful for setting safety limits when grasping organs during endoscopic surgery.
  Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 02/2010; 19(3):177-83. · 1.33 Impact Factor
• Article: Prenatal diagnosis of retroperitoneal teratoma: a case report and review of the literature.

  Satoshi Asai, Hitoshi Ishimoto, Seon Hye Kim, Takayuki Higuchi, Kazuhiro Minegishi, Mamoru Tanaka, Ken Hoshino, Yasuhide Morikawa, Yasunori Yoshimura
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  ABSTRACT: We report a case of retroperitoneal teratoma diagnosed prenatally by serial sonographic examinations in the third trimester. A 29-year-old woman was referred for sonographic evaluation at 33 weeks' gestation because of a fetal intra-abdominal mass. Our initial sonographic image suggested a neuroblastoma. Repeat ultrasound images demonstrated an increase in size of the tumor, while the content of the tumor became predominantly solid with areas of calcification. Teratoma should be considered on detection of any cystic or mixed semisolid mass, especially when calcification is present. The fetus was prenatally diagnosed with retroperitoneal teratoma. After birth at 39 weeks, the tumor was removed and histological analysis revealed an immature retroperitoneal teratoma. Intensive monitoring of the changes in ultrasound images of the tumor should provide ground for a precise antenatal diagnosis.
  Fetal Diagnosis and Therapy 03/2009; 25(1):76-8. · 1.05 Impact Factor
• Source

  Available from: Go Wakabayashi

  Article: Liver regeneration in donors and adult recipients after living donor liver transplantation.

  Junko Haga, Motohide Shimazu, Go Wakabayashi, Minoru Tanabe, Shigeyuki Kawachi, Yasushi Fuchimoto, Ken Hoshino, Yasuhide Morikawa, Masaki Kitajima, Yuko Kitagawa
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  ABSTRACT: In living donor liver transplantation, the safety of the donor operation is the highest priority. The introduction of the right lobe graft was late because of concerns about donor safety. We investigated donor liver regeneration by the types of resected segments as well as recipients to assess that appropriate regeneration was occurring. Eighty-seven donors were classified into 3 groups: left lateral section donors, left lobe donors, and right lobe donors. Forty-seven adult recipients were classified as either left or right lobe grafted recipients. Volumetry was retrospectively performed at 1 week, 1, 2, 3, and 6 months, and 1 year after the operation. In the right lobe donor group, the remnant liver volume was 45.4%, and it rapidly increased to 68.9% at 1 month and 89.8% at 6 months. At 6 months, the regeneration ratios were almost the same in all donor groups. The recipient liver volume increased rapidly until 2 months, exceeding the standard liver volume, and then gradually decreased to 90% of the standard liver volume. Livers of the right lobe donor group regenerated fastest in the donor groups, and the recipient liver regenerated faster than the donor liver. Analyzing liver regeneration many times with a large number of donors enabled us to understand the normal liver regeneration pattern. Although the donor livers did not reach their initial volume, the donors showed normal liver function at 1 year. The donors have returned to their normal daily activities. Donor hepatectomy, even right hepatectomy, can be safely performed with accurate preoperative volumetry and careful decision-making concerning graft-type selection.
  Liver Transplantation 12/2008; 14(12):1718-24. · 3.39 Impact Factor
• Article: Mesothelial cyst of the liver in a neonate.

  Koji Komori, Ken Hoshino, Junichi Shirai, Yasuhide Morikawa
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  ABSTRACT: Mesothelial cysts are very rare congenital cystic lesions that are derived from coelomic remnants. We report a neonate with a mesothelial cyst of hepatic origin. On routine antenatal ultrasound study, an intra-abdominal mass was seen. After birth, the cystic lesion's size increased to 8 cm and became symptomatic. Surgical resection was performed. Preoperative diagnostic imaging studies, including CT and MRI, did not identify the etiology, but the cyst appeared to be of hepatic origin. Intra-operatively, the cystic lesion was confirmed to have originated from the liver. Based on immunohistological analysis, the final diagnosis was mesothelial cyst of the liver.
  Pediatric Surgery International 05/2008; 24(4):463-5. · 1.25 Impact Factor
• Article: Development of a new flat needle and a reduced surface coating thread for endoscopic suturing.

  Soji Ozawa, Yasuhide Morikawa, Junya Oguma, Yuko Kitagawa, Hironori Asada, Masaki Kitajima
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  ABSTRACT: Intracorporeal suturing during endoscopic surgery is a difficult procedure. The curved needle is the most difficult to position properly within the jaws of the needle driver. The low friction suture materials exhibit good knot run-down, but at the expense of increased tendency for slipping. It is therefore necessary to invent a new needle and a new thread to facilitate intracorporeal suturing. We made a new flat needle (F-needle) to facilitate grasping and a new reduced silicone-coated thread to prevent the knots from loosening. The time required to grasp the F-needle and the round needle (R-needle) by 10 surgeons was measured. The angle between the needle and the needle driver was measured. The minimum number of intertwining knots required for the knot to hold was counted, and the minimum number of superimposed knots that prevented the knots from coming undone when the testing machine attempted to release them was counted. The F-needle was grasped in less time than the R-needle. The error in yaw angle with the F-needle was smaller than in the R-needle. The minimum number of knots needed to hold against the untying force with the reduced silicone-coated thread was less than with the conventional silicone-coated thread. The new flat needle was grasped more accurately and quickly than the round needles, and the thread with reduced surface coating was less likely to loosen. Therefore, the combination of the new flat needle and thread with reduced surface coating is useful for endoscopic suturing.
  Journal of Surgical Research 05/2008; 145(2):266-71. · 2.25 Impact Factor
• Article: The role of graft and host accommodation in a hamster-to-rat cardiac transplantation model.

  Koji Komori, Yasushi Fuchimoto, Yasuhide Morikawa, Hideaki Obara, Shigeyuki Kawachi, Minoru Tanabe, Ken Hoshino, Motohide Shimazu, Yumi Matsuzaki, Masaki Kitajima
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  ABSTRACT: We evaluated the importance and mechanism of graft and host accommodation in hamster-to-rat cardiac xenotransplantation models. To evaluate graft accommodation, accommodated hamster grafts (Group 2) were transplanted to naïve host rats treated with FK506, and compared with naïve hamster grafts (Group 1). To evaluate host accommodation, three groups were evaluated: naive hamster hearts were transplanted to naïve hosts treated with FK506 (Group 3: 0.5 mg/kg, Group 4: 1.0 mg/kg) and splenectomy, and compared with accommodating hosts (Group 5) with FK506 0.5 mg/kg and splenectomy. We examined graft survival, histopathology, antihamster antibodies and B-1 cells in blood. Graft survival in Group 2 (3.4+/-0.9 days) was not significantly different from that in Group 1 (2.8+/-0.4 days). Graft survival in Groups 4 and 5 (>30 days) was significantly prolonged compared with that in Group 3 (6.0+/-0.7 days). Histopathology of Groups 1-3 showed humoral rejection, whereas Groups 4 and 5 showed normal histology and expression of protective genes. In Groups 1-3, antihamster immunoglobulin (Ig) M and B-1 cells increased significantly compared to Groups 4 and 5, where IgM and B-1 cells remained low or were reduced. Host accommodation was more important than graft accommodation. Accommodating grafts expressing protective genes were rejected with an elevation of both IgM and B-1 cells. In accommodated hosts, both IgM and B-1 cells decreased, suggesting that B-1 cells may be responsible for the production of antihamster antibodies. These results suggest that sufficient suppression of B-1 cells, resulting in decreased titers of antihamster antibodies, may play an important role in host accommodation.
  Transplantation 01/2008; 85(1):112-7. · 4.00 Impact Factor
• Source

  Available from: Masaki Kitajima

  Chapter: Basic Study of Appropriate Knot-Tying Force in the Gastrointestinal Tract for Development of Haptic Surgical Robot

  Junya Oguma, Soji Ozawa, Yasuhide Morikawa, Toshiharu Furukawa, Yuko Kitagawa, Masakazu Ueda, Kouhei Ohnishi, Masaki Kitajima
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  ABSTRACT: Assessment of the efficiency of wound healing in terms of the extent of angiogenesis and expression of growth factor at the wound sites in this study revealed that a knot-tying force of 1.5 N may be the most appropriate for optimal wound healing in the gastrointestinal tract of the Beagle model. Wound healing can be evaluated on the basis of physical parameters and histological parameters. The physical parameters include shear stress and tensile strength, and some reports have suggested relationships between these parameters and wound healing (Thijs et al., 1990). Angiogenesis is one of the most important parameters for measuring wound healing, including the healing of wounds in the gastrointestinal tract (Seifert et al., 1997),
  01/2008; , ISBN: 978-3-902613-18-9
• Article: Transileocolic venous balloon dilatation for the management of primary and recurrent portal venous stenosis after living donor liver transplantation in children.

  Ryo Hotta, Ken Hoshino, Seishi Nakatsuka, Shioko Nakao, Jun Okamura, Yohei Yamada, Koji Komori, Yasushi Fuchimoto, Hideaki Obara, Shigeyuki Kawachi, Minoru Tanabe, Yasuhide Morikawa, Subaru Hashimoto, Masaki Kitajima
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  ABSTRACT: Portal venous stenosis is relatively a rare complication after liver transplantation in children and it sometimes leads to life threatening event due to gastrointestinal bleeding or graft failure. Recently, balloon dilatation has been widely accepted as a treatment of choice for the management of portal venous stenosis. The purpose of this study was to evaluate the feasibility of transileocolic venous balloon dilatation for the management of primary and recurrent portal venous stenosis after living donor liver transplantation (LDLT) in children. The records of 57 pediatric liver transplants were retrospectively reviewed. Nine patients (15.8%) with portal venous stenosis were identified. Seven symptomatic children with portal venous stenosis underwent balloon dilatation. Two approaches were employed for balloon dilatation; the transileocolic venous approach and the percutaneous transhepatic approach. In patients with recurrent stenosis, careful follow-up was carried out while they were asymptomatic. Twelve balloon dilatations were performed in seven children with primary or recurrent portal venous stenoses. The initial technical success rate was 91.7% (11/12), while 6 out of 12 (50.0%) procedures resulted in recurrent stenosis. Five out of six recurrent stenoses required repeated balloon dilatation. The clinical success rate of balloon dilatation in our study was 85.7% (6/7). Other than recurrent stenosis, two procedure-related complications occurred. In conclusion, transileocolic venous balloon dilatation was a safe and effective procedure for portal venous stenosis after LDLT in children.
  Pediatric Surgery International 11/2007; 23(10):939-45. · 1.25 Impact Factor
• Article: Knot-tying force during suturing and wound healing in the gastrointestinal tract.

  Junya Oguma, Soji Ozawa, Yasuhide Morikawa, Toshiharu Furukawa, Yuko Kitagawa, Masakazu Ueda, Masaki Kitajima
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  ABSTRACT: Objective data should be obtained to determine the most suitable knot-tying force for appropriate suturing during robotic surgery. The purpose of this study was to estimate the appropriate force by investigating the efficiency of wound healing in the gastrointestinal tract in dog models. We cut and sutured the stomach and jejunum of 12 beagles, using different magnitudes of knot-tying forces. The relationship between the knot-tying force and variations in the density of the microvessels and basic-fibroblast growth factor (bFGF)-positive cells were evaluated. On the 7th postoperative day (POD) in the stomach, and the 7th and 11th POD in the jejunum, the density of the microvessels in the submucosa at the sites of cutting and ligation was higher for the knot-tying force of 1.5 N than for any other forces used. On the 4th and 7th POD in the stomach and 11th POD in the jejunum, the density of bFGF-positive cell in the mucosa was higher for the knot-tying force of 1.5 N than for any of the other forces used. By assessing the efficiency of wound healing, it was determined that the knot-tying force of 1.5 N may be the most appropriate for optimal wound healing in the gastrointestinal tract of the beagles.
  Journal of Surgical Research 07/2007; 140(1):129-34. · 2.25 Impact Factor
• Source

  Available from: Go Wakabayashi

  Article: Increased serum and hepatic tissue levels of interleukin-18 in patients with fulminant hepatic failure.

  Masahiro Shinoda, Go Wakabayashi, Motohide Shimazu, Hidetsugu Saito, Ken Hoshino, Minoru Tanabe, Yasuhide Morikawa, Shigeatsu Endo, Hiromasa Ishii, Masaki Kitajima
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  ABSTRACT: Fulminant hepatic failure is a serious clinical condition associated with a high mortality rate. Interleukin (IL)-18 is a pro-inflammatory cytokine that is associated with several inflammatory diseases. The purpose of the present paper was therefore to investigate whether IL-18 is elevated in patients with fulminant hepatic failure. Serum levels of IL-18 were measured in patients with fulminant hepatic failure before and after liver transplantation. Native liver tissue samples were collected and the tissue levels of IL-18 were determined. Liver tissues were stained immunohistochemically with antihuman IL-18 antibody. The serum levels of IL-1beta, IL-6, IL-8, IL-12, interferon-gamma, and tumor necrosis factor-alpha were also determined in patients with fulminant hepatic failure before and after liver transplantation. Elevated levels of IL-18 in serum and hepatic tissue were observed in patients with fulminant hepatic failure. Native liver tissue samples were immunohistochemically positive for IL-18. Interleukin-18 levels were markedly reduced after liver replacement. No other inflammatory cytokines were substantially elevated in patients with fulminant hepatic failure. The serum levels of IL-18 levels are elevated much more than those of other cytokines in patients with fulminant hepatic failure.
  Journal of Gastroenterology and Hepatology 12/2006; 21(11):1731-6. · 2.87 Impact Factor
• Article: Successful liver transplantation across the ABO incompatibility barrier in 6 cases of biliary atresia.

  Yohei Yamada, Ken Hoshino, Yasuhide Morikawa, Jun Okamura, Ryo Hotta, Koji Komori, Shioko Nakao, Hideaki Obara, Shigeyuki Kawachi, Yasushi Fuchimoto, Minoru Tanabe, Motohide Shimazu, Masaki Kitajima
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  ABSTRACT: The problem of ABO-incompatible liver transplantation still remains unsolved in older children. In this article, we report on our experience of 6 successful ABO-incompatible liver transplantations in patients with biliary atresia. Six patients (ABO incompatibility type A-->O:1 case, B-->O:2 cases, A-->B:3 cases) were enrolled in this study; 3 patients were aged approximately 1 year and the other 3 ranged in age from 9 to 24 years at the time of transplantation. Each patient received perioperative plasma exchange, until the anti-donor blood-type antibody titers became less than 1:16, and also systemic multidrug immunosuppressive therapy (cyclophosphamide, prednisolone, and tacrolimus). We applied the protocol of intraportal infusion therapy (local administration of prostaglandin E(1), steroid, and gabexate mesilate via a portal vein catheter), splenectomy, and rituximab administration for the older group. Both the patient and graft survival rates remain at 100%, with the follow-up period of the patients ranging from 12 and 123 months. Acute cellular rejection occurred in 2 cases, and both were steroid sensitive. There was no incidence of humoral rejection. Although all cases developed viral infection, all recovered uneventfully with the administration of antiviral agents. ABO-incompatible liver transplantation can be performed with a low risk of humoral rejection or late biliary complications using this combined antirejection strategy, even in older children.
  Journal of Pediatric Surgery 12/2006; 41(12):1976-9. · 1.45 Impact Factor