Hiroki Kai

Fukuoka University, Hukuoka, Fukuoka, Japan

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Publications (9)8.22 Total impact

  • No preview · Article · Jan 2014 · The Journal of the Japanese Associtation for Chest Surgery
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    ABSTRACT: Wound dehiscence caused by surgical site infection (SSI) presents a complicated problem. Negative pressure wound therapy (NPWT) was developed to treat wound dehiscence. Nutritional treatment using arginine has also been recently shown to be effective for the treatment of pressure ulcers. Therefore, wound complications due to SSI were treated using NPWT combined with nutritional therapy with an arginine-rich supplement (ARS). Six pediatric patients with wound dehiscence due to SSI received this combined therapy. The average age of the patients was 12.2 mo. The operations that these patients underwent included laryngotracheal separation, radical operation for spinal bifida, gastrostomy, colostomy, anorectoplasty, and tumor extirpation. A local wound infection induced wound dehiscence in all patients. Therefore, NPWT was introduced with an enteral administration of ARS. All wounds completely healed within 1 mo after the introduction of this combined therapy without any other complications from the NPWT or ARS. A follow-up study at 6 mo after this therapy was completed showed no complications associated with the wounds. This combination therapy using NPWT and ARS administration was effective in inducing early healing of infected wound complications after surgery.
    No preview · Article · May 2011 · Nutrition
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    ABSTRACT: This report presents the case of a 6-day-old male with cystic biliary atresia (CBA), and the cyst was detected antenatally. Antenatal ultrasonography suggested the possibility of CBA or a choledochal cyst at 16 weeks' gestation. However, the cyst disappeared during the later gestational period. The cyst was detected again by preoperative imaging. Surgical cholangiography at 30 days of age confirmed CBA, but the common hepatic duct (CHD) was extremely narrow. The histopathological findings revealed the partial obstruction of CHD. These findings suggest that correctable CBA (I cyst) may change into uncorrectable CBA (IIId).
    No preview · Article · Jan 2011 · Pediatric Surgery International
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    ABSTRACT: Recently, minimally invasive thoracoscopic surgery has offered several options for both the diagnosis and surgical treatment in the field of pediatric surgery. This report reviews the surgical experience in order to assess the problems including the complications, encountered during thoracoscopic surgery in children under 15 years of age in the Kyushu area, Japan. From 1993 to 2005, 153 boys and 103 girls underwent thoracoscopic surgery for chest disease. Pertinent information included number of operations for each year, sex, age, indication, treatment procedure, follow-up duration, cause of conversion to thoracotomy, method of treatment, and complication. There has gradually been an increase in the number of operations every year. These included procedures for funnel chest, n= 121; pneumothorax, n= 25; mediastinal tumor, n= 25; palmar hyperhydrosis, n= 23; neuroblastoma, n= 11; and cystic lung disease, n= 10. A large portion of the surgery was for patients under 1 year of age excluding neonates. Approximately half of the procedures were for the excision of a neuroblastoma. Approximately half of the patients older than 5 years of age underwent Nuss procedure for funnel chest. Almost all of the pneumothorax and palmar hyperhydrosis surgery was for patients 14 or 15 years old. Three patients required a conversion to a standard thoracotomy. Six complications occurred. There was no mortality associated with the thoracoscopic surgical procedures. Thoracoscopy is a useful diagnostic and therapeutic tool for both infants and children. Various thoracoscopic complex procedures have been performed both safely and effectively.
    No preview · Article · May 2009 · Pediatrics International
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    ABSTRACT: This report describes the case of an ileal perforation secondary to clamping of the exomphalos minor in 3-day-old girl. Eighteen accidental clamping or cutting cases were found in the published work. It is thought that this defect resulted from either the clamping, ligation or cutting of the bowel in a small unrecognized omphalocele. These complications are extremely rare, but should be held in mind when performing an umbilical ligation.
    No preview · Article · Aug 2008 · Journal of Obstetrics and Gynaecology Research
  • Y. Oka · K. Asabe · H. Kai · T. Shirakusa

    No preview · Article · Jan 2008 · Nihon Kikan Shokudoka Gakkai Kaiho
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    ABSTRACT: The present study was carried out using electron microscopy to evaluate the expression of lamellar bodies in type II pneumocytes of fetal rabbit lungs with hypoplasia induced by oligohydramnios. Using an amniotic shunting rabbit model, the lungs obtained from 32 fetuses, including 16 experimental fetuses (shunting group) and 16 control fetuses (control group), were used for electron microscopic studies. At least 250 type II pneumocytes per fetus were photographed. The number of lamellar bodies per type II pneumocyte was counted. The number of lamellar bodies per type II pneumocyte of the shunting group was consistently and significantly less than that of the control group (5.49 +/- 2.07 vs 7.58 +/- 2.08; P < 0.01). These results suggest that the occurrence of hypoplastic lungs induced by oligohydramnios is associated with an immaturity of the surfactant system, especially the expression of the lamellar bodies of type II pneumocytes.
    No preview · Article · Dec 2007 · Journal of Obstetrics and Gynaecology Research
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    ABSTRACT: A previous study documented the effects of maternal corticosteroid treatment on structural growth and functional development in fetal lungs associated with pathogenic conditions such as oligohydramnios using immunohistochemical and morphometric analyses. The purpose of the present study was to examine the effect of maternal dexamethasone treatment the expression of lamellar body in type II pneumocytes of the fetal rabbit lungs with hypoplasia induced by oligohydramnios using electron microscopy. Using an amniotic shunting rabbit model, pregnant rabbits were injected intravenously with either 0.1 ml of saline or 0.25 mg/kg/day of dexamethasone in 0.1 ml of saline 48 and 24 h before the delivery of fetuses, at day 30 of gestation. The number of lamellar bodies per type II pneumocyte was counted in each group using electron micrographs. The number of lamellar bodies per type II pneumocyte in the lungs of the shunted group that received saline was consistently and significantly less than that of the other three groups (5.49 +/- 2.07 vs. 7.34 +/- 2.27: shunted group that received dexamethasone, 7.58 +/- 2.08: non-shunted group that received saline, 7.79 +/- 1.90: non-shunted group that received dexamethasone; P < 0.01). These results suggest that maternal dexamethasone treatment accelerates the maturation of the surfactant system, especially the expression of lamellar bodies in type II pneumocytes, even in hypoplastic lungs induced by oligohydramnios.
    No preview · Article · Oct 2007 · Pediatric Surgery International
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    ABSTRACT: Infants, especially extremely low birth weight infants (ELBWIs, birth weight <1,000 g) continue to have a high mortality after gastrointestinal (GI) perforation. In Japan, the overall mortality rate for neonates under 30 days having GI perforation was 31.6% in 2003. From 1974 to 2003, 34 cases of GI perforation in neonates were treated surgically in Fukuoka University Hospital. The overall mortality rate was 50% (17 of 34). Etiologies included necrotizing enterocolitis (NEC) (35.3%), meconium peritonitis (25%), idiopathic (25%), and gastric perforation (11.8%). The present series was divided into four groups: survival and non-survival neonates of the early (1974 to 1997) and recent (1998 to 2004) periods. Several prognostic factors of neonatal GI perforation were compared between several groups. The gestational week (GW) at birth, birth weight (BW) and weight at operation were significantly lower for non-surviving neonates in the recent period compared with the other three groups. Although a real improvement in surgical outcome was noted with improved neonatal intensive care management, the mortality rate was still high, especially in extremely premature cases under both 1,000 g and 29 GWs. The vast majority of these extremely premature babies thus comprised the NEC patients. It is therefore necessary to substantially improve the medical treatment level for such premature babies.
    Preview · Article · Jan 2003 · The Turkish journal of pediatrics