Misc - 水口　徹

緊急手術を要した稀な急性胆嚢疾患の2切除例

井上 大成, 木村 康利, 信岡 隆幸, 藤兼 智子, 水口 徹, 桂巻 正, 平田 公一

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  66 ( 増刊 ) 688 - 688  2005年10月

膵管胆道合流異常症・膵癒合不全に総肝管隔壁形成を伴った一例

秋月 恵美, 木村 康利, 信岡 隆幸, 井上 大成, 藤兼 智子, 水口 徹, 桂巻 正, 平田 公一

日本膵管胆道合流異常研究会プロシーディングス ( 日本膵・胆管合流異常研究会 )  28回   62 - 63  2005年10月

膵管胆道合流異常症・膵癒合不全に総肝管隔壁形成を伴った一例

藤兼 智子, 木村 康利, 信岡 隆幸, 井上 大成, 水口 徹, 桂巻 正, 宮西 浩嗣, 林 毅, 石渡 裕俊, 平田 公一

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  66 ( 9 ) 2347 - 2347  2005年09月

十二指腸乳頭部癌とカルチノイドを合併したCholedochoceleの1例

井上 大成, 木村 康利, 信岡 隆幸, 藤兼 智子, 水口 徹, 桂巻 正, 遠藤 高夫, 阿部 環, 岡 俊州, 平田 公一

日本臨床外科学会雑誌 ( 日本臨床外科学会 )  66 ( 9 ) 2348 - 2348  2005年09月

Hand-assisted laparoscopic pylorus-preserving pancreaticoduodenectomy for pancreas head disease

Y Kimura, K Hirata, M Mukaiya, T Mizuguchi, K Koito, T Katsuramaki

AMERICAN JOURNAL OF SURGERY ( EXCERPTA MEDICA INC )  189 ( 6 ) 734 - 737  2005年06月

　概要を見る

Laparoscopic procedures for pancreatic surgery have been significantly improved recently; however, the number of successful laparoscopic or laparoscopy-assisted pancreaticoduodenectomies (PDs) has been limited. The limitations could be attributed to the complexity of the reconstruction procedures under laparoscopic observations and the high incidence of critical morbidity with PDs. To overcome the shortcomings, we developed the first hand-assisted laparoscopic pylorus-preserving PD and, in this report, present the case of a patient with a low-grade malignant tumor on the pancreas head. (c) 2005 Excerpta Medica Inc. All rights reserved.

DOI

Biliary injury after laparoscopic cholecystectomy: end-to-end anastomosis covered with umbilical vein

Y Kimura, K Hirata, M Mukaiya, T Mizuguchi, T Nobuoka, T Furuhata, T Katsuramaki

JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY ( SPRINGER TOKYO )  12 ( 3 ) 269 - 271  2005年

　概要を見る

The management of biliary injuries after laparoscopic surgery presents a surgical challenge. We describe a promising method of biliary reconstruction with umbilical vein covering followed by end-to-end anastomosis. In the patient reported here, the umbilical vein was identified in the pedicled ligamentum teres, transected as if it were a sheet, and sutured, then covered ventrally to the anastomosed bile duct. This procedure may be a promising reinforcement of the reconstructed site which maintains the biliary integrity; however, it can be applied, only in selected situations.

DOI PubMed CiNii

Growth of hepatic angiomyolipoma indicating malignant potential

T Mizuguchi, T Katsuramaki, T Nobuoka, A Nishikage, H Oshima, H Kawasaki, S Kimura, M Satoh, K Hirata

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY ( BLACKWELL PUBLISHING ASIA )  19 ( 11 ) 1328 - 1330  2004年11月

速報，短報，研究ノート等（学術雑誌）  

DOI

Endo-bowel clamp (PL540S) for safe rectal irrigation in laparoscopy-assisted rectal resection

T Furuhata, F Hata, T Tsuruma, H Nishimori, K Yamaguchi, T Mizuguchi, Y Kimura, T Katsuramaki, M Mukaiya, K Sasaki, K Hirata

SURGERY TODAY ( SPRINGER )  34 ( 10 ) 882 - 884  2004年10月

　概要を見る

We describe a technique of rectal irrigation using an endo-bowel clamp (PL540S) in laparoscopy-assisted rectal resection. One of the major concerns associated with current techniques of laparoscopy-assisted rectal resection is accidental tumor spillage because it is difficult to perform the necessary procedures without grasping and manipulating the bowel and mesorectum near the tumor. Therefore, sufficient intraoperative rectal irrigation is essential for preventing intraluminal implantation of rectal cancer. However, this can be difficult, especially if the tumor is located in the rectum. By placing a PL540S before transection, it is possible to occlude the rectum completely and irrigate it effectively. We think that the PL540S is a valuable device in laparoscopic surgery for rectal cancer.

DOI

Serum hyaluronate level for predicting subclinical liver dysfunction after hepatectomy

T Mizuguchi, T Katsuramaki, T Nobuoka, M Kawamoto, H Oshima, H Kawasaki, H Kikuchi, C Shibata, K Hirata

WORLD JOURNAL OF SURGERY ( SPRINGER )  28 ( 10 ) 971 - 976  2004年10月

　概要を見る

The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 15 minutes (ICGR(15)), lectin-cholesterol (LCAT), hepatocyte growth factor (HGF); liver uptake ratio of technetium-99m galactosyl human serum albumin (Tc-99m-GSA) at 15 minutes (HH15), prealbumin, and hepatic uptake ratio of Tc-99m-GSA at 15 minutes (LHL15). In addition, the model for end-stage liver disease (MELD) score at 7 days after operation was well correlated with serum HA, ICGR(15), HH15, and LHL15. In patients who showed serum an HA level of = 100 ng/ml before hepatectomy, the MELD score had significantly deteriorated by 7 days after hepatectomy. Of the 20 patients who showed a serum HA level < 100 ng/ml before hepatectomy, 11 had high serum HA after hepatectomy. The bilirubin level 7 days after operation in this group was much higher than that for patients who maintained a serum HA level < 100 ng/ml after hepatectomy. In addition, the serum HGF level before hepatectomy in this group was significantly lower. We concluded that the serum HA level is a reliable indicator when evaluating liver function and predicting liver dysfunction after hepatectomy. Furthermore, patients with a significantly low HGF level who have a normal HA level are susceptible to liver dysfunction after hepatectomy.

DOI

Significance of combined spiral 3-D computed tomography angiogram and pneumocolon for primary mesenteric stromal tumor

T Mizuguchi, T Katsuramaki, T Nobuoka, T Hirano, T Ichimura, H Maeda, H Kawasaki, K Koito, K Hirata

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY ( BLACKWELL PUBLISHING ASIA )  19 ( 8 ) 946 - 948  2004年08月

速報，短報，研究ノート等（学術雑誌）  

DOI

Successful management of severe acute pancreatitis with multiple organ failure

T Mizuguchi, M Mukaiya, H Imaizumi, Y Kimura, Y Masuda, T Katsuramaki, Y Asai, K Hirata

PANCREAS ( LIPPINCOTT WILLIAMS & WILKINS )  28 ( 2 ) 211 - 213  2004年03月

DOI

乳癌肝転移に対する肝切除８例について

桂巻 正, 水口 徹, 大村 東生, 中村 幸雄, 木村 康利, 本間 敏男, 古畑 智久, 向谷 充宏, 佐々木 一晃, 平田 公一

日本臨床外科学会雑誌 ( Japan Surgical Association )  65 ( 9 ) 2304 - 2308  2004年

　概要を見る

過去7年間で当科で経験した乳癌肝転移8例に対して肝切除術を施行し,肝切除の意義について検討した.乳癌肝転移8例の平均年齢は48.5歳で,腫瘍個数は単発例3例,多発例(3個以上) 5例,平均最大腫瘍径は3.6cmであった.術式は部分切除が4例,左葉切除が2例,右葉部分切除を伴った左葉切除,拡大S5亜区域切除がそれぞれ1例で,全例が重篤な術後合併症なく約2週間で退院した.肝切除後の1年生存率は87.5%, 3年生存率は33.3%で,腫瘍個数別の3年生存率は単発例が66.7%,多発例が0%で,単発例の生存率は有意に良好であった.残肝再発を3例に,他臓器再発を5例に認め,残肝再発症例の予後は不良であった.乳癌肝転移例においては単発例であれば長期生存例が期待できるので,切除可能であれば肝切除を施行すべきであるが,多発例では肝切除のみでは肝転移は制御できないと考えられた.

DOI CiNii

劇症肝炎に対するアフェレシス治療の適応と限界.

日本アフェレシス学会雑誌   22   213 - 218  2003年

A Case of Intrahepatic Cholangiocarcinoma with Atypical Multinodular Image Findings <Case Report>

Nishikawa Noriko, Katsuramaki Tadashi, Mizuguchi Toru, Kimura Sachiko, Sasaki Aya, Nobuoka Takayuki, Nui Akihiro, Kimura Yasutoshi, Furuhata Tomohisa, Yamaguchi Koji, Hirata Koichi

Tumor research : experimental and clinical ( 札幌医科大学 )  38   13 - 16  2003年

　概要を見る

We report the imaging findings of an atypical case of cholangiocarcinoma. The patient was a 59-year-old man, in whom a multicystic liver mass was found on the left lobe of the liver by US. However, the images obtained from contrast CT showed small nodules had gathered and a low density mass in the early phase and peripheral enhancement in the late phase. It seemed to be liver echinococcosis because a group of small nodules appeared on the CT image. An extended left lobectomy of the liver was carried out. The pathological finding was cholangiocarcinoma.

DOI CiNii

Clinical application and limitation of apheresis for fulminant hepatic failure.

Japanese J. Apheresis   22   213 - 218  2003年

組織再生と ES 細胞 : 上皮細胞移植の将来

水口 徹, 平田 公一, 原田 敬介, 宮本 茂樹

日本腹部救急医学会雑誌 = Journal of abdominal emergency medicine   22 ( 7 ) 1015 - 1021  2002年11月

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長期生存したstage4大腸癌症例の検討

水口徹, 佐々木一晃, 古畑智久, 泰史壮, 桂巻正, 高坂一, 平田公一

日本消化器外科学会雑誌   35 ( 7 )  2002年

J-GLOBAL

Enhanced proliferation and differentiation of rat hepatocytes cultured with bone marrow stromal cells

T Mizuguchi, T Hui, K Palm, N Sugiyama, T Mitaka, AA Demetriou, J Rozga

JOURNAL OF CELLULAR PHYSIOLOGY ( WILEY-LISS )  189 ( 1 ) 106 - 119  2001年10月

　概要を見る

Liver transplantation is the only clinically effective method of treating acute liver failure. However, wider application of this therapeutic modality is restricted primarily by shortage of donor organs. in the search for alternative methods of liver replacement therapy, investigators have focused on transplantation of normal allogeneic hepatocytes and on the development of liver support systems utilizing isolated hepatocytes. Since all human livers suitable for cell harvest are being used for transplantation, hepatocyte therapy using human tissue would require growing of cells in vitro. Unfortunately, although hepatocytes have tremendous capacity to proliferate in vivo, their ability to grow in culture is severely limited. Stromal cells from bone marrow and other blood-forming organs have been found to support hematopoiesis. In this paper, we show that bone marrow-derived stromal cells (BMSCs) enhance proliferation and support differentiation of rat hepatocytes in culture. Further, we demonstrate that in hepatocyte/BMSC co-cultures, clonal expansion of small hepatocytes (SH) is increased. Using semipermeable membrane cultures, we established that direct cell-cell contact is necessary for stimulation of cell proliferation. We also show that BMSCs which are in direct contact with hepatocytes and SH colonies express Jagged1. This suggests a potential role for Notch signaling in the observed effects. Finally, we present evidence that the expression and activity of liver specific transcirption factors, CCAAT/enhancer binding proteins and liver specific key enzymes Such as tryptophan 2,3-dioxygenase, are improved in hepatocyte/BMSC co-cultures. In conclusion, results of this study indicate that BMSCs could facilitate proliferation and differentiation of primary rat hepatocytes and their progenitors (SH) in vitro. J. Cell. Physiol. 189: 106-119, 2001. (C) 2001 Wiley-Liss, Inc.

DOI PubMed CiNii

Paper is a compatible bed for rat hepatocytes

T Mizuguchi, T Mitaka, F Sato, Y Mochizuki, K Hirata

ARTIFICIAL ORGANS ( BLACKWELL SCIENCE INC )  24 ( 4 ) 271 - 277  2000年04月

　概要を見る

To develop an effective hybrid bioartificial liver (BAL) device, the material of the scaffold is very important to support hepatocytes that have both growth ability and hepatic differentiated functions. In this study we used paper (Kimwipe, Kimberly-Clark Corp., Roswell, GA, U.S.A.) as a scaffold. Primary hepatocytes isolated from a normal adult rat liver could proliferate on the paper. The secretion of albumin into culture medium by the cells on the paper increased with time in culture and, compared to the cells on dishes, the amount of 48 h albumin secretion at Day 10 was two times larger. Perpendicular sections of hepatocytes on the paper revealed that the cells fell into cavities made by intersecting fibers, piled up, and formed three to four layers. The piled-up cells changed their shape from flat to cuboidal and enlarged their cytoplasm, which was rich in organelles such as mitochondria and peroxisomes with a nucleoid. In addition, they formed bile canalicular structures between the cells. Their morphological appearance was similar to in vivo hepatocytes. Paper (Kimwipe) may be a good candidate as a scaffold to make BAL device.

DOI

Alteration of expression of liver-enriched transcription factors in the transition between growth and differentiation of primary cultured rat hepatocytes

T Mizuguchi, T Mitaka, K Hirata, H Oda, Y Mochizuki

JOURNAL OF CELLULAR PHYSIOLOGY ( WILEY-LISS )  174 ( 3 ) 273 - 284  1998年03月

　概要を見る

In the present study, we showed the role of the liver-enriched transcription factors in the transition during which proliferating hepatocytes become quiescent. We used primary rat hepatocytes cultured in modified L-15 medium. The cells proliferated and, after the addition of 2% dimethyl sulfoxide (DMSO) from day 4, they stopped growing and gradually differentiated. During hepatic proliferation, expression of hepatocyte nuclear factors (HNF)1 alpha, HNF4, C/EBP alpha, and C/EBP beta mRNAs was depressed, whereas that of HNF3 alpha and HNF3 beta transcripts was enhanced. After the addition of DMSO, the expression of HNF1 alpha, HNF3 gamma, and HNF4 returned to the level in isolated cells and HNF1 beta mRNA expression gradually increased. However, expression of C/EBP alpha and C/EBP beta mRNAs was partially recovered. The mitoinhibitory agents, IL-1 beta, IL-6, TGF-beta, and activin A, were examined to determine whether they could induce differentiation of proliferating hepatocytes as shown in cells treated with DMSO. Although these factors inhibited cell growth, the cells did not differentiate. The expression pattern of HNF3 gamma mRNA was quite different in the cells cultured with DMSO and those cultured with cytokines. Therefore, hepatic differentiation requires not only inhibition of DNA synthesis but also induction of appropriate transcription factors. Thus; expression of HNF3 gamma, C/EBP alpha, and C/EBP beta may be necessary for hepatocytes to acquire highly differentiated functions in addition to coexpression of certain amounts of transcripts of HNF1 alpha, HNF1 beta, HNF3 alpha, HNF3 beta, and HNF4 as well as suppression of C/EBP delta. (C) 1998 Wiley-Liss, Inc.

DOI PubMed CiNii