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Komatsuzaki N, Hashizume N, Sakamoto S, Nakahara H, Tsuruhisa S, Masui D, Koga Y, Higashidate N, Saikusa N, Ishii S, Fukahori S, Yamashita Y, Tanaka Y, Yagi M, Kaji T. The Evaluation of Gastric Emptying Using the 13 C-Acetate Breath Test in Neurologically Impaired Patients - A Focus on the Stomach Function and Morphology. Kurume Med J 2024:MS6934017. [PMID: 38369338 DOI: 10.2739/kurumemedj.ms6934017] [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] [Indexed: 02/20/2024]
Abstract
PURPOSE We explored factors affecting gastric emptying in neurologically impaired (NI) patients using the 13C-acetate breath test. METHODS Twenty-four NI patients were classified by the presence of gastroesophageal reflux disease (GERD), which was treated by fundoplication plus gastrostomy, or the absence of GERD, which was treated by gastrostomy alone, along with gastric malposition involving cascade stomach and organoaxial gastric volvulus (OGV). Gastric emptying parameters (GEPs), which were the emptying half time (T 1/2 , minute), the lag phase time (T lag , minute), and the gastric emptying coefficient (GEC), were measured before and after surgery. We evaluated the relationship between GEPs and GERD, gastric malposition, and surgical intervention. All data were expressed as the median (interquartile range). RESULTS The T1/2 and GEC of patients with OGV were significantly worse than in those without OGV before surgery (T1/2 with OGV: 241.3 [154.9, 314.3] vs. T1/2 without OGV: 113.7 [105.2, 151.4], p = 0.01, GEC with OGV: 3.19 [2.46, 3.28] vs. GEC without OGV: 3.65 [3.24, 3.90], p = 0.02). GERD and cascade stomach were not associ ated with GEPs. The GEPs of all NI patients showed no significant difference between before and after surgery. The surgical change in T1/2 (ΔT 1/2 ) in the patients with OGV was significantly lower than in those without OGV (ΔT1/2 with OGV: -47.1 [-142.7, -22.1] vs. ΔT1/2 without OGV: -3.78 [-26.6, 12.0], p = 0.03). CONCLUSION Stomach malposition, such as OGV, seems to affect gastric emptying and may be improved by surgi cal intervention.
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Affiliation(s)
- Naoko Komatsuzaki
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine
- Division of Pediatric Surgery, Department of Surgical Specialties, National Center for Child Health and Development
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine
| | | | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine
- Division of Medical Safety Management, Kurume University School of Medicine
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine
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Higashidate N, Sakamoto S, Saikusa N, Koga Y, Masui D, Nakahara H, Nakamura M, Saikusa M, Kinoshita M, Kaji T. Tubular intestinal duplication extending from the stomach to the ileum associated with multiple intestinal atresia and situs inversus: a case report. Surg Case Rep 2023; 9:141. [PMID: 37556040 PMCID: PMC10412515 DOI: 10.1186/s40792-023-01728-2] [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: 07/03/2023] [Accepted: 08/06/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Duplication of the alimentary tract can occur in any of its parts. For duodenal duplication, complete resection is particularly difficult when the ampulla of Vater is on the duplicated lumen and a deliberate management is necessary. CASE PRESENTATION A 0-day female baby was referred to our department due to abdominal distention. The X-ray examination showed dextrocardia and opacity of the liver on the left side and abdominal ultrasonogram revealed remarkable intestinal dilatation. Therefore, urgent laparotomy was performed on the day of birth. Complete situs inversus of the abdominal organs was revealed, and the origin of the jejunum was on the left side and was accompanied by tubular intestinal duplication. The origin of the duplicated intestine was at the pancreatic head's dorsal area. There were two points of type Шa atresia on the ileum. Therefore, we spared the duplicated intestine with a length of 3 cm to secure the passage of the biliary and pancreatic juices by a functional-side-to-side anastomosis with a 45-mm Endo-GIA™ camel load (Medtronic, Minneapolis, MN, USA). The ileum was transected at the distal side of the atresia point, and end-to-end jejunoileostomy was performed. Postoperative gastrointestinal series revealed remnants of the duplicated alimentary tract on the dorsal area of the stomach. CONCLUSIONS Identifying the position of the ampulla of Vater is crucial in the surgery of alimentary tract duplication with duodenal involvement. However, in the present case, it was difficult to identify whether the ampulla of Vater was on the true or duplicated lumen, and we had to spare the duplicated duodenum. Stapler anastomosis could be performed safely even in neonatal cases.
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Affiliation(s)
- Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Misa Nakamura
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Mamoru Saikusa
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masahiro Kinoshita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tatsuru Kaji
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Iinuma Y, Yokoyama N, Saikusa N, Hashidate H, Naito SI, Hirayama Y, Nakaya K, Nitta K. A long-term survivor after radical surgery in early childhood for biliary tract cancer associated with congenital biliary dilatation despite a positive margin for epithelial carcinoma. Journal of Pediatric Surgery Case Reports 2022. [DOI: 10.1016/j.epsc.2022.102211] [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: 02/07/2023] Open
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Masui D, Fukahori S, Hashizume N, Ishii S, Higashidate N, Koga Y, Sakamoto S, Tsuruhisa S, Nakahara H, Saikusa N, Tanaka Y. Influence of laparoscopy-aided gastrostomy on gastroesophageal reflux in neurologically impaired patients using multichannel intraluminal impedance pH measurements. Esophagus 2022; 19:360-366. [PMID: 34655356 DOI: 10.1007/s10388-021-00888-0] [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: 06/26/2021] [Accepted: 10/09/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Development of gastroesophageal reflux disease (GERD) after gastrostomy remains debatable. Therefore, this study aimed to evaluate whether laparoscopy-aided gastrostomy (LAG) influence on the occurrence of GERD in neurologically impaired (NI) patients. Furthermore, we investigated whether preoperatively excluding NI patients with GERD can reduce the number of patients requiring subsequent anti-reflux surgery (ARS) after LAG. METHODS This retrospective study included 35 NI patients (median age: 11.0; interquartile range 5.0-23.5 years) who underwent LAG according to our criterion from October 2012 to June 2020 and MII-pH before and after LAG. MII-pH parameters were compared in all patients and among three age groups between before and after LAG. RESULTS There were no significant differences in MII-pH parameters before and 1 year after LAG in all patients, and no patient underwent subsequent ARS. Only one paediatric patient with 64 number of reflux episodes before LAG required subsequent ARS 3 years after LAG. CONCLUSIONS Generally, LAG did not influence the postoperative GERD at 1 year after LAG, and our criteria could reduce the number of patients requiring subsequent ARS. However, paediatric NI patients with higher number of reflux episodes in preoperative MII-pH study may need careful long-term follow-up after LAG.
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Affiliation(s)
- Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Fukuoka, Japan
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Nakahara H, Hashizume N, Yoshida M, Fukahori S, Ishii S, Saikusa N, Koga Y, Higashidate N, Sakamoto S, Tsuruhisa S, Tanaka Y, Yamashita Y, Yagi M. Creatinine-to-cystatin C ratio estimates muscle mass correlating the markers of the patients with severe motor and intellectual disabilities. Brain Dev 2022; 44:196-202. [PMID: 34782198 DOI: 10.1016/j.braindev.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/05/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022]
Abstract
AIM The creatinine-to-cystatin C ratio (CCR) has been acknowledged as a potential marker of muscle mass. The purpose of the present study was to evaluate the relationship between CCR and nutritional status in a bioelectrical impedance analysis (BIA) of patients with severe motor and intellectual disabilities (SMID). METHODS This study included 39 patients with SMID (17 males, 22 females) over 16 years of age were included retrospectively. CCR was calculated as serum creatinine (mg/dL)/cystatin C (mg/L) × 10. The BIA parameters such as the phase angle (PhA), fat free mass (FFM), appendicular skeletal muscle mass (ASM) and appendicular skeletal muscle mass index (ASMI) values were measured using BIA. Correlation analyses between CCR and the BIA parameters were conducted. RESULTS The mean CCR is 4.47 ± 1.34. Significant positive relationships between CCR and FFM, PhA, ASM, ASMI were identified (r = 0.3373, p = 0.0357. r = 0.4273, p = 0.0093. r = 0.5008, p = 0.0012. r = 0.4706, p = 0.0025 and r = 0.4751, p = 0.0022, respectively). CONCLUSIONS The study indicated that CCR in the patients with SMID is a useful parameter that allows for the muscle mass to be estimated easily and accurately. This means that evaluating CCR could be used as a simple and important screening tool for PhA, FFM and muscle mass.
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Affiliation(s)
- Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Masui D, Fukahori S, Nakahara H, Tsuruhisa S, Sakamoto S, Higashidate N, Hashizume N, Koga Y, Saikusa N, Ishii S, Tanaka Y. Negative-Pressure Pulmonary Edema After Difficult Endotracheal Intubation in a Patient with Juvenile Rheumatoid Arthritis Undergoing Spigelian Hernia Surgery: A Case Report. Am J Case Rep 2022; 23:e934678. [PMID: 35338108 PMCID: PMC8965629 DOI: 10.12659/ajcr.934678] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 35-year-old
Final Diagnosis: Negative-pressure pulmonary edema
Symptoms: Difficult airway management
Medication:—
Clinical Procedure: —
Specialty: Anesthesiology • Critical Care Medicine
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Affiliation(s)
- Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | | | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Imagawa K, Fukahori S, Hashizume N, Saikusa N, Higashidate N, Ishii S, Masui D, Sakamoto S, Tsuruhisa S, Nakahara H, Tanaka Y, Yagi M, Yamashita Y. Quality of life of caregivers supporting neurologically impaired patients who underwent surgery. Pediatr Int 2022; 64:e15138. [PMID: 35972060 DOI: 10.1111/ped.15138] [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: 04/19/2021] [Revised: 12/03/2021] [Accepted: 01/17/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND A questionnaire survey was conducted to clarify whether surgical treatments performed by a pediatric surgeon improve the quality of life (QOL) of caregivers (medical doctors, nurses, physical therapists, and nursery teachers) supporting neurologically impaired (NI) patients who work at specialized institutions. METHODS The questionnaire survey was conducted with caregivers who cared for NI patients who underwent an operation at the Department of Pediatric Surgery, Kurume University Hospital. Quality-of-life related responses concerning the change of care after surgical procedures in NI patients were collected in addition to the background data related to caregivers and the surgical procedures performed for them. Degrees of difficulty in caring for NI patients and of the caregivers' own QOL postoperatively were also compared. RESULTS There were 192 valid responses. The majority of responses were from females and nurses aged in their 40s and 50s. The surgical procedure performed most often in the NI patients was gastrostomy. Of the respondents, 77% answered that the postoperative care became easier. The degrees of difficulty in caring for NI patients and the caregivers' own QOL were significantly higher and lower, respectively, among physical therapists compared with caregivers in other occupations. Moreover, the QOL in respondents with factors related to a longstanding relationship with NI patients was significantly higher compared with the respondents without them. CONCLUSION This survey indicated that surgical procedures for NI patients might contribute to improved QOL for the caregiver by reducing the difficulty of caring for NI patients.
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Affiliation(s)
- Kentaro Imagawa
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Suguru Fukahori
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Naoki Hashizume
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Nobuyuki Saikusa
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Naruki Higashidate
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shinji Ishii
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Daisuke Masui
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Saki Sakamoto
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shiori Tsuruhisa
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirotomo Nakahara
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshiaki Tanaka
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan.,Department of Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Japan
| | - Minoru Yagi
- Departments of Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
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Sakamoto S, Hashizume N, Fukahori S, Ishii S, Saikusa N, Higashidate N, Aramaki S, Matsuo Y, Takeshita E, Tanaka Y, Yamashita Y, Yagi M. Complications in patients with neurological impairment after gastrostomy. Pediatr Int 2021; 63:1357-1362. [PMID: 33560541 DOI: 10.1111/ped.14645] [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: 11/20/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Neurological impairment (NI) is responsible for most conditions that require a permanent gastrostomy tube. The present study assessed the occurrence of short- and long-term complications after video-assisted gastrostomy (VAG) in patients with NI. METHODS The incidence of short- (<6 months) and long-term (over 2 years) complications of VAG were analyzed in a retrospective study. The differences between the incidence of the complications of VAG according to the age at surgery (≤15 years vs. ≥16 years) were also evaluated. The short- and long-term complications observed were granulation tissue formation, infection requiring antibiotic treatment, skin problems, perigastrostomy leakage, vomiting, accidental tube dislodgement, dumping syndrome, ileus, and peritonitis. RESULTS Eighty-two patients were evaluated for short- and long-term complications. The long-term complication rate was significantly lower than the short-term complication rate (P = 0.0026). Onodera's prognostic nutritional index before VAG in patients with long-term complications was significantly lower than in patients without such complications (P = 0.046). The incidence of long-term granulation tissue formation, infection, and vomiting were significantly lower than those of similar short-term complications. Long-term skin problems were associated with short-term skin problems (odds ratio: 18.95; 95% confidence interval: 4.53-92.98; P < 0.001). The number of patients ≥16 years old with short- and long-term skin problems was significantly higher than in patients ≤15 years old (P = 0.0014 and P = 0.0073, respectively). CONCLUSIONS The incidence rate of granulation tissue formation and infection after VAG were lower in the long term than in the short term. However, patients ≥16 years old presented with persistent complications.
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Affiliation(s)
- Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shuichi Aramaki
- Department of Pediatric, National Hospital Organization Higashisaga Hospital, Higashiomi, Japan
| | - Yusaku Matsuo
- Social Welfare Corporation, Yukari-Iryo-Ryoiku Center, Tosu, Japan
| | - Eiko Takeshita
- Yanagawa Institute for Developmental Disabilities, Yanagawa, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Fukuoka, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
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Hashizume N, Shin R, Akiba J, Sotogaku N, Asagiri K, Hikida S, Fukahori S, Ishii S, Saikusa N, Koga Y, Egami H, Tanaka Y, Nishi A, Yagi M. The herbal medicines Inchinkoto and Saireito improved hepatic fibrosis via aquaporin 9 in the liver of a rat bile duct ligation model. Pediatr Surg Int 2021; 37:1079-1088. [PMID: 33710364 DOI: 10.1007/s00383-021-04882-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine if the administration of the Japanese herbal medicines Inchinkoto (ICKT) and Saireito (SRT) ameliorate hepatic fibrosis and derangement of hepatocyte aquaporins (AQPs) following bile duct ligation (BDL) in a rat model of obstructive cholestasis. MATERIALS AND METHODS Five groups of Wistar rats were used, and the groups included sham surgery (Sham group), BDL with no treatment (NT group), BDL plus ICKT (ICKT group), BDL plus SRT (SRT group), and BDL plus ICKT and SRT (SRT/ICKT group). Each herbal medicine was administered at 1 g/kg/day on the first postoperative day. The serum levels and various clinical markers were measured with real-time polymerase chain reaction. Staining was used to evaluate the degree of fibrosis and the inflammatory responses. RESULTS Serum aspartate aminotransferase and alanine aminotransferase in the ICKT and SRT/ICKT groups were significantly lower than those in the NT group. NF-κB mRNA expression was significantly decreased in the ICKT group and the SRT/ICKT group compared with the NT group. AQP9 mRNA expression was significantly increased in the ICKT group and the SRT/ICKT group compared with the NT group. The degree of Masson's trichrome staining in the SRT/ICKT group was significantly lower than that in the NT group. The degree of NF-κB staining in the SRT/ICKT group was significantly lower than that in the NT, ICKT, or SRT group. CONCLUSIONS The postoperative administration of ICKT and SRT induced synergistic beneficial effects, resulting in the reduction of hepatic fibrosis via mechanisms involving the inhibition of NF-κB expression and the improvement of AQP9 downregulation.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Ryusuke Shin
- Department of Pharmacology, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Naoki Sotogaku
- Department of Pharmacology, Kurume University School of Medicine, Kurume, Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shigeki Hikida
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hideaki Egami
- Department of Innovative Kampo Medicine, Kurume University Medical Center, Kurume, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Japan
| | - Akinori Nishi
- Department of Pharmacology, Kurume University School of Medicine, Kurume, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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10
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Fukahori S, Sakamoto S, Hashizume N, Masui D, Higasidate N, Tsuruhisa S, Nakahara H, Koga Y, Saikusa N, Ishii S, Tanaka Y, Yagi M. Laparoscopic identification of combined pediatric femoral hernia and ruptured abdominal cyst of the canal of Nuck: A report of an extremely rare case. Asian J Endosc Surg 2021; 14:557-560. [PMID: 32924249 DOI: 10.1111/ases.12866] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/06/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
A 7-year-old girl was referred to our hospital with a suspected right-sided indirect inguinal hernia. An egg-sized elastic, non-painful mass was palpated in the right inguinal region. Preoperative CT demonstrated a 30-mm simple cystic mass in the right internal inguinal canal, which we diagnosed as an abdominal cyst of the canal of Nuck. Laparoscopy revealed that the abdominal cystic component was ruptured, so we performed Pott's procedure. However, the patient's right groin swelled on postoperative day 3, necessitating re-operation. The patient's symptoms recurred again after 3 months, despite having had two surgical repairs. In the third operation, a right-sided femoral hernia was confirmed and repaired via external and laparoscopic approaches. To the best of our knowledge, there have been no reports on the combination of femoral hernia and cyst of the canal of Nuck in children. A laparoscopic approach was useful for obtaining a definitive diagnosis and conducting a safe and secure surgical repair.
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Affiliation(s)
- Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Naruki Higasidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
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11
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Higashidate N, Fukahori S, Ishii S, Saikusa N, Hashizume N, Koga Y, Masui D, Sakamoto S, Tsuruhisa S, Nakahara H, Tanaka Y, Fukahori M, Miwa K, Naito Y, Yagi M. De novo gastric cancer developing after liver transplantation from deceased donor for biliary atresia: a case report. Surg Case Rep 2021; 7:123. [PMID: 34003401 PMCID: PMC8131442 DOI: 10.1186/s40792-021-01210-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/14/2021] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Apart from Kasai's procedure, liver transplantation (LTx) has dramatically improved the outcome of children with biliary atresia (BA). However, de novo malignancy has been reported to be one of the major causes of late mortality after LTx among adults. We report a rare case of de novo gastric cancer developing after LTx for BA received during childhood. CASE PRESENTATION A 21-year-old male patient who had undergone LTx for BA at age 2 years occasionally visited our outpatient clinic due to symptoms of epigastric pain and dysphagia. Endoscopic examination and computed tomography revealed advanced gastric cancer at the gastroesophageal junction with multiple liver metastases. Despite systemic chemotherapy, the disease progressed, resulting in patient's death 2 years after the diagnosis. CONCLUSIONS De novo malignancy in the absence of post-transplant lymphoproliferative disease is rare in pediatric patients who received LTx. To the best of our knowledge, no report has been available on the development of gastric cancer after LTx for BA during childhood. Primary physicians should therefore establish a follow-up plan for patients receiving LTx for BA considering the potential for the development of de novo malignancy, including gastric cancer, despite its rarity.
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Affiliation(s)
- Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshiaki Tanaka
- Division of Medical Safety Management, Kurume University Hospital, Kurume, Japan
| | - Masaru Fukahori
- Multidisciplinary Cancer Treatment Center, Kurume University Hospital, Kurume, Japan
| | - Keisuke Miwa
- Multidisciplinary Cancer Treatment Center, Kurume University Hospital, Kurume, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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12
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Masui D, Fukahori S, Hashizume N, Ishii S, Higashidate N, Sakamoto S, Tsuruhisa S, Nakahara H, Saikusa N, Tanaka Y, Yagi M. Simultaneous Evaluation of Laryngopharyngeal Reflux and Swallowing Function Using Hypopharyngeal Multichannel Intraluminal Impedance Measurements in Neurologically Impaired Patients. J Neurogastroenterol Motil 2021; 27:198-204. [PMID: 33795541 PMCID: PMC8026379 DOI: 10.5056/jnm20125] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/02/2021] [Indexed: 01/28/2023] Open
Abstract
Background/Aims This study aims to evaluate the presence of laryngopharyngeal reflux (LPR) and to investigate the use of hypopharyngeal baseline impedance (BI) for assessing swallowing dysfunction and gastroesophageal reflux disease (GERD) using hypopharyngeal multichannel intraluminal impedance and pH (HMII-pH) monitoring in neurologically impaired patients (NIPs). Methods The study population in this retrospective study comprised 20 NIPs (mean age, 36.1 ± 15.0 years; age range, 13-64 years) who underwent multichannel intraluminal impedance and pH (MII-pH), HMII-pH, and laryngoscopy using the Hyodo scoring method from December 2016 to April 2019. The MII-pH and HMM-pH parameters were compared in the NIPs, whereas hypopharyngeal BI values were compared between NIPs with ≥ 5 and < 5 in Hyodo scores. Correlations between the hypopharyngeal BI values and the Hyodo score were analyzed using Spearman’s correlation coefficient. A receiver operator characteristic curve was created to determine the optimum cut-off of hypopharyngeal BI value to discriminate SD. Results Three NIPs were diagnosed with pathological LPR and GERD by the HMII-pH monitoring. No significant differences in parameters were observed between MII-pH and HMII-pH monitoring. The correlation analysis demonstrated a significant negative correlation between the hypopharyngeal BI values and Hyodo scores. The optimal cutoff value for hypopharyngeal BI was 1552 Ω. Conclusions This study demonstrated the usefulness of HMII-pH monitoring in identifying NIP with pathological LPR. Considering the difficulties in performing examinations in NIPs, HMII-pH monitoring may be a potentially useful technique for the simultaneous evaluation of swallowing dysfunction, LPR, and GERD in NIP.
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Affiliation(s)
- Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
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13
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Kurahachi T, Higashidate N, Hashizume N, Fukahori S, Ishii S, Saikusa N, Koga Y, Masui D, Sakamoto S, Taki S, Tanaka Y, Yagi M. Left-sided Amyand's hernia in an infant with bilateral inguinal hernia. Journal of Pediatric Surgery Case Reports 2021. [DOI: 10.1016/j.epsc.2021.101832] [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: 10/22/2022] Open
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14
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Hashizume N, Sakamoto S, Fukahori S, Ishii S, Saikusa N, Koga Y, Higashidate N, Tsuruhisa S, Nakahara H, Tanaka Y, Yagi M. Gastrointestinal stromal tumor in perforated Meckel's diverticulum: a case report and literature review. Surg Case Rep 2020; 6:265. [PMID: 33026577 PMCID: PMC7541806 DOI: 10.1186/s40792-020-01038-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/08/2020] [Accepted: 09/28/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Gastrointestinal stromal tumor (GIST) is rare neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. GIST has been found largely in the stomach, small bowel, colon and rectum, and esophagus, but about 5% are found in other locations. We herein report a 56-year-old woman with a GIST in perforated Meckel's diverticulum. After encountering this patient, a review of the literature found reports of 18 similar patients. Case presentation A 56-year-old woman diagnosed with galactosialidosis (β-galactosidase-neuraminidase deficiency) presented with vomiting. On contrast-enhanced computed tomography, peritonitis due to perforation of the intestine was diagnosed based on the free air and dilated loop of the small bowel. Laparotomy revealed perforation of Meckel’s diverticulitis located 50 cm from the ileocecal valve. Partial resection of the ileum, including the diverticulum, and end-to-end anastomosis of the small intestine were performed. Regarding the pathological findings, the edge of the diverticulum wall consisted of a solid mass measuring 1.0 cm in size, and the tumor cells were spindle-shaped with 1 mitosis present per 50 high-power fields. The diagnosis was established as GIST of the Meckel's diverticulum. The postoperative period was uneventful. Follow-up at two years revealed no evidence of recurrence. Conclusion GIST in perforated Meckel's diverticulum is very rare. The potential for the coexistence of GIST or other tumor should be considered in the treatment of perforated Meckel's diverticulum.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan.,Division of Medical Safety Management, Kurume University Hospital, 67 Asahimachi, Kurume, 830-0011, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka, 830-0011, Japan
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15
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Hashizume N, Aiko T, Fukahori S, Ishii S, Saikusa N, Koga Y, Higashidate N, Sakamoto S, Tsuruhisa S, Nakahara H, Muta H, Miyoshi H, Naito Y, Yamamoto H, Oda Y, Tanaka Y, Yagi M. Benign mesenteric lipomatous tumor in a child: a case report and literature review. Surg Case Rep 2020; 6:243. [PMID: 32997268 PMCID: PMC7527397 DOI: 10.1186/s40792-020-01020-7] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/21/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Lipomatous tumors are the most common type of soft-tissue tumors. Benign lipomatous tumors are lipomas and lipoblastoma. We herein report a case of benign mesenteric lipomatous tumor and the largest collection of known benign mesenteric lipomatous tumors in children in the literature. CASE PRESENTATION A 3-year-old girl presented with repeated dull abdominal pain and left abdominal mass swelling. On a physical examination, the child had a soft, moderately distended left abdomen that was not tender when palpated. Computed tomography and magnetic resonance imaging demonstrated a large fatty mass within the mesentery, measuring approximately 8 × 6 cm. The mass extended from the right upper quadrant to the lower pole of the kidneys. Laparotomy with resection of the mesenteric tumor was performed under general anesthesia. A well-capsuled tumor was a soft, yellow mass and found loosely attached to the mesenterium of the ileum. A histopathological examination demonstrated the lobular proliferation of mature adipocytes. Atypical lipoblasts were not seen. These features are compatible with benign lipomatous tumor, such as lipoma or lipoblastoma with maturation. CONCLUSION In conclusion, benign mesenteric lipomatous tumors tend to be large in size over 10 cm in longitudinal length. However, resection is well tolerated in the vast majority of cases with benign post-operative courses.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Takato Aiko
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Hiroko Muta
- Department of Diagnostic Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Hiroaki Miyoshi
- Department of Diagnostic Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Yoshiki Naito
- Department of Diagnostic Pathology, Kurume University School of Medicine, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Higashku umade 3-1-1, Fukuoka, 812-8582, Fukuoka, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Higashku umade 3-1-1, Fukuoka, 812-8582, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.,Division of Medical Safety Management, Kurume University Hospital, Asahimachi 67, Kurume, 830-0011, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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16
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Hashizume N, Tanaka Y, Asagiri K, Fukahori S, Ishii S, Saikusa N, Yoshida M, Tanikawa K, Asakawa T, Yagi M. Perioperative reactive oxygen species in infants with biliary atresia: A retrospective observational study. Medicine (Baltimore) 2020; 99:e21332. [PMID: 32756118 PMCID: PMC7402746 DOI: 10.1097/md.0000000000021332] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Biliary atresia (BA) is a devastating cholestatic disorder of infants that presents during the first several months after birth due to an idiopathic obstruction to the bile flow. Without prompt diagnosis, Kasai portoenterostomy, and deliberate follow-ups, the resulting cholestasis leads to progressive hepatic failure. Oxidative stress is an abnormal phenomenon inside cells or tissues caused by a disturbance in the reactive oxygen species (ROS). We aimed to measure perioperative ROS in BA patients.Data are presented as median (25th, 75th percentiles). We evaluated 15 BA patients (age 55 [48, 69] days) and measured ROS; serum superoxide dismutase (SOD), urinary 8-iso prostaglandin F2α (8-iso-PGF2α) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) preoperatively and 30 days later to compare values with serum liver function tests and histologic grades of liver cholestasis. For compared BA patients, 4 normal subjects as control group (age 55 [27, 75] days) measured ROS and serum liver function tests.In BA patients, the preoperative serum SOD was 6.1 IU/mL (4.7, 7.2), urinary 8-iso-PGF2α was 1969 pg/mg Cre (1697, 2374), and urinary 8-OHdG was 37.1 ng/mg Cre (33.1, 53.7). At the postoperative day 30, the serum SOD was 5.2 IU/mL (4.2, 6.7), urinary 8-iso-PGF2α was 1761 pg/mg Cre (1256, 3036), and urinary 8-OHdG was 42.1 ng/mg Cre (29.65, 72.64). In ROS, there were no significant differences between the 2 periods. In control group, urinary 8-iso-PGF2α was significantly lower than that in preoperative BA patient group. However, other ROS were not significant differences between control group and BA patient group. The concentration of urinary 8-iso-PGF2α was positively correlated with total bilirubin and direct bilirubin levels (preoperatively: r = 0.6921, P = .0042 and r = 0.6639, P = .007, postoperatively: r = 0.6036, P = .0172 and r = 0.6464, P = .0092, respectively). The preoperative ROS were not correlated with histologic grades of liver cholestasis. Various factors such as liver inflammation, lipid malabsorption, and tissue disorders due to jaundice might affect the antioxidant activity and elevated urinary 8-iso-PGF2α. However, at least until 30 days later, urinary 8-OHdG as oxidative DNA damage might persist after the operation whether the cholestasis improved or not.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine
- Division of Medical Safety Management, Kurume University Hospital
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine
- Department of Pediatric Surgery, St Mary's Hospital
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Ken Tanikawa
- Departments of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takahiro Asakawa
- Department of Pediatric Surgery, Kurume University School of Medicine
- Department of Pediatric Surgery, St Mary's Hospital
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine
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17
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Higashidate N, Fukahori S, Hashizume N, Ishii S, Saikusa N, Sakamoto S, Kurahachi T, Tanaka Y, Ohtaki M, Yagi M. Does clinical score accurately support fecoflowmetry as a means to assess anorectal motor activity in pediatric patients after anorectal surgery? Asian J Surg 2020; 43:1154-1159. [PMID: 32169517 DOI: 10.1016/j.asjsur.2020.02.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE We investigated the relationship between Krickenbeck score (KS) and fecoflowmetry (FFM) parameters and assessed the characteristics of this new questionnaire test by comparing Kelly's clinical score (KCS) in pediatric patients with anorectal surgery for anorectal malformation (ARM) and Hirschsprung's disease (HD). METHODS We enrolled pediatric patients who underwent anorectal surgery for ARM or HD. Bowel function was assessed with KS and KCS thereafter, FFM and anorectal manometry (AM) were conducted. Patients were divided into subgroups according to each parameter of the scoring system and each FFM parameter was compared among the KCS or KS subgroups, respectively. Moreover, correlation analyses were conducted between FFM and AM parameters. RESULTS The comparison of FFM parameters among the subgroups of KCS showed that Fmax in the KCS staining 2 group was significantly higher than that in KCS staining 1 group and the Fmax in KCS sphincter squeeze 1 group was significantly higher than that in KCS sphincter squeeze 0 group. Moreover, Fmax in the KCS "good" group was significantly higher than that in the KCS "fair" group. The comparison of FFM parameters among the subgroups of KS parameters showed that TR in the no soiling group was significantly higher than that in the KS grade 2 soiling group. FFM and AM parameters showed a significant positive correlation between Fmax and voluntary squeezing anal pressure. CONCLUSION FFM clarified the different characteristics of two scoring systems, namely, KCS reflects the anal sphincter performance, whereas the KS soiling score might reflect the tolerance and evacuation ability.
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Affiliation(s)
- Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Shinij Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Tomohiro Kurahachi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Yoshiaki Tanaka
- Division of Medical Safety Management, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
| | - Masahiro Ohtaki
- Department of Pediatric Surgery, Tsuruoka Municipal Shonai Hospital, 4-20 Izumi-cho, Tsuruoka, Yamagata, 997-8515, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan
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Hashizume N, Tanaka Y, Fukahori S, Ishii S, Saikusa N, Koga Y, Higashidate N, Masui D, Sakamoto S, Yagi M. Adherences to oral nutritional supplementation among hospital outpatients: An online cross-sectional survey in Japan. PLoS One 2019; 14:e0222972. [PMID: 31557201 PMCID: PMC6762170 DOI: 10.1371/journal.pone.0222972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/11/2019] [Indexed: 12/02/2022] Open
Abstract
Oral nutritional supplements (ONS) are multi-nutrient products used to increase the energy and nutrient intakes of patients. The aim of this study was to examine whether or not the adherence of patients varies according to their receiving prescription or over-the-counter ONS. Data were obtained from an online cross-sectional survey conducted with patients in Japan. A total of 107 patients who matched the inclusion criteria for the prescription ONS group and 148 who matched the criteria for the over-the-counter ONS group were further analyzed. In the prescription and over-the-counter ONS groups, the main medical reason for ONS consumption were “malnutrition” (48 patients [44.9%] vs. 63 patients [42.6%] p = 0.798], “frailty” (29 patients [27.1%] vs. 36 patients [24.3%] p = 0.663) and “aging” (25 patients [23.4%] vs. 30 patients [20.3%] p = 0.644). The proportion of “No particular disease” for prescription ONS consumption was significantly lower than that for over-the-counter ONS (6 patients [5.6%] vs. 24 patients [16.2%] p = 0.001). The body mass index of the prescription ONS group was significantly higher than that of the over-the-counter ONS group (21.1±4.38 kg/m2 vs. 19.9±3.75 kg/m2, p = 0.0161). In the prescription ONS group, all patients were given medical advice by doctors or registered dietitians. In contrast, in the over-the-counter ONS group, only 46 patients (31.1%) were given advice by doctors or registered dietitians (p<0.001). In the prescription ONS group, ONS was taken significantly more times and for a longer duration than in the over-the-counter ONS group (p<0.0001). However, among patients given advice by doctors or registered dietitians, there were no significant differences between the groups. Greater support by the medical team is still needed in order to maximize adherence to supplementation, especially concerning the calories, timing and period, so that benefits can be achieved and sustained.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
- * E-mail:
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
- Division of Medical Safety Management, Kurume University Hospital, Kurume, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka Japan
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Masui D, Fukahori S, Mizuochi T, Watanabe Y, Fukui K, Ishii S, Saikusa N, Hashizume N, Higashidate N, Sakamoto S, Takato A, Yoshiura KI, Tanaka Y, Yagi M. Cystic biliary atresia with paucity of bile ducts and gene mutation in KDM6A: a case report. Surg Case Rep 2019; 5:132. [PMID: 31414320 PMCID: PMC6694366 DOI: 10.1186/s40792-019-0688-4] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 08/02/2019] [Indexed: 12/28/2022] Open
Abstract
Background Biliary atresia (BA) cases are generally not associated with congenital abnormalities. However, accurate diagnosis of BA is often challenging because the histopathological features of BA overlap with those of other pediatric liver diseases and rarely overlap with those of other genetic disorders. We experienced a rare case of BA with the histopathological finding of bile duct paucity, a gene mutation in KDM6A, and KS-like phenotypes. Case presentation A male baby was diagnosed with biliary atresia by intraoperative cholangiography at 4 days of age, and histological examination following a liver biopsy revealed a paucity of bile ducts and several typical clinical findings of Alagille syndrome. However, Alagille syndrome was ruled out after neither JAG1 nor NOTCH2 gene mutations were identified. Whole-exome sequencing on DNA from his parents was additionally performed to examine other possible syndromic disorders, and a mutation was identified in KDM6A. However, Kabuki syndrome was not diagnosed as a result. The histological finding of interlobular bile duct paucity and the genetic mutation in KDM6A, as well as several clinical findings consistent with Alagille syndrome or Kabuki syndrome, made it difficult to confirm the diagnosis of BA. Conclusions Based on the interesting findings of the present case, we hypothesized that KDM6A is associated with hepatic malformations via a connection with the Notch signaling pathway.
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Affiliation(s)
- Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Tatsuki Mizuochi
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Yoriko Watanabe
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.,Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Kurume, Japan
| | - Kaori Fukui
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Aiko Takato
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, 830-0011, Japan
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Hashizume N, Tanaka Y, Yoshida M, Fukahori S, Ishii S, Saikusa N, Masui D, Higashidate N, Sakamoto S, Tsuruhisa S, Yuge K, Ohya T, Yagi M, Yamashita Y. Resting energy expenditure prediction using bioelectrical impedance analysis in patients with severe motor and intellectual disabilities. Brain Dev 2019; 41:352-358. [PMID: 30501961 DOI: 10.1016/j.braindev.2018.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 08/23/2018] [Revised: 11/05/2018] [Accepted: 11/05/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Resting energy expenditure (REE) is expected to be lower in with severe motor and intellectual disabilities (SMID) patients than in healthy subjects because of their relatively low fat-free mass (FFM). Therefore, an REE predictive equation for SMID patients may be required. The aim of this study was to validate existing REE predictive weight-based equations (Harris-Benedict, WHO, Mifflin, Owen, Schofield) and FFM-based REE equations (Mifflin, Owen and Cunningham) and to develop a new SMID patient-specific FFM-based REE equation. METHODS Twenty-eight (22 males, 6 females) SMID patients over 18 years of age were included. The REE was measured using indirect calorimetry. FFM were measured using bioelectrical impedance analysis. A multiple linear regression analysis was used to develop a new FFM-based REE predictive equation. The accurate predictions compared the measured REE and root mean square error. RESULTS The median measured REE was 950 (25th,75th percentile:712.75, 1102.75) kcal/day. The new FFM-based equation was as follows: REE (kcal/day) = 550.62 + 16.62 FFM (kg). The new FFM-based REE resulted in the highest percentage of accurate predictions within 10% of measured REE (42.9%). The root mean square errors were the smallest for the new FFM-based REE and largest for Harris-Benedict (91.00 and 185.22 kcal/day). CONCLUSION For SMID patients, the REE cannot accurately be predicted using the existing weight-based REE equations. Furthermore, the existing FFM-based REE equations are less accurate with regard to the measured REE than the new FFM-based REE equation. The new FFM-based equation is advised for use in SMID patients.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Yoshiaki Tanaka
- Division of Medical Safety Management, Kurume University Hospital, Kurume, Fukuoka, Japan
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kotaro Yuge
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takashi Ohya
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Higashidate N, Fukahori S, Ishii S, Saikusa N, Hashizume N, Koga Y, Masui D, Tsuruhisa S, Aikoh T, Taki S, Tanaka Y, Yagi M. Non-traumatic testicular dislocation mimicking incarcerated inguinal hernia in a one-year-old boy. Journal of Pediatric Surgery Case Reports 2018. [DOI: 10.1016/j.epsc.2018.08.009] [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: 10/28/2022] Open
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22
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Sakamoto S, Hashizume N, Fukahori S, Ishii S, Saikusa N, Yoshida M, Masui D, Higashidate N, Tsuruhisa S, Ozono S, Tanigawa M, Naito Y, Tanaka Y, Yagi M. A large retroperitoneal lipoblastoma: A case report and literature review. Medicine (Baltimore) 2018; 97:e12711. [PMID: 30290672 PMCID: PMC6200453 DOI: 10.1097/md.0000000000012711] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Lipoblastoma is a rare benign soft tissue tumor that occurs most commonly in infants and children. However, retroperitoneal lipoblastomas are rare, occurring in <5% of cases. We report a case of large retroperitoneal lipoblastoma and the largest collection of known retroperitoneal lipoblastomas in children in the literature. CASE PRESENTATION A 3-year-old girl presented with left abdominal mass. Magnetic resonance imaging (MRI) revealed a soft tissue mass measuring 12 × 8 × 6 cm in the retroperitoneal region. The mass had a clearly defined margin and a reticular pattern with an interposing fat component. Based on these findings, the mass was suspected to be a soft-tissue tumor, most likely lipoblastoma.Laparotomy with resection of the retroperitoneal mass was performed. The tumor was easily dissected from the retroperitoneal space without injury to surrounding structure.A histopathological examination demonstrated the mature proliferation of adipocytes and spindle-shaped cells separated by fibrovascular septa accompanied by myxoid changes. The cells were separated into lobules by septa, and areas of immature adipocytes showing a signet-ring or multivacuolar appearance were present at the periphery. Histopathological diagnosis was lipoblastoma. Follow-up at 6 months revealed no evidence of recurrence. CONCLUSION Retroperitoneal lipoblastoma is rare and tends to be large in size when diagnosed at presentation. Complete resection should not be delayed, as impingement on the surrounding structures is imminent.
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Affiliation(s)
- Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine
| | | | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine
| | - Shuich Ozono
- Department of Pediatrics and Child Health, Kurume University School of Medicine
| | | | - Yoshiki Naito
- Departments of Pathology, Kurume University School of Medicine
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine
- Division of Medical Safety Management, Kurume University Hospital, Kurume, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine
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23
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Fukahori S, Yagi M, Ishii S, Asagiri K, Saikusa N, Hashizume N, Yoshida M, Masui D, Higashidate N, Sakamoto S, Nakahara H, Tanaka Y. Analyses of the relationship between a 'number of reflux episodes' exceeding 70 and the pH index in neurologically impaired children by evaluating esophageal combined pH-multichannel intraluminal impedance measurements. Scand J Gastroenterol 2018; 53:519-526. [PMID: 29069993 DOI: 10.1080/00365521.2017.1393558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND The present study aimed to evaluate the characteristics associated with a number of reflux episodes (NoRE) of 70 by comparing the clinical and multichannel intraluminal impedance pH measurements (pH/MII) and pH index (pHI) in neurologically impaired (NI) children. PATIENTS AND METHODS NI children (1-16 years of age) in whom pH/MII had been measured for GERD study were enrolled in this study. All children were divided into NoRE >70 or ≤70 and pHI >4.0 or ≤4.0, >5.0 or ≤5.0 or >7.0 or ≤7.0. In addition, the NI children with pHI >4.0, >5.0 and >7.0 were subdivided into NoRE >70 and ≤70 groups. The clinical and pH/MII measurements were compared between each of the two groups. The cutoff values of pHI and baseline impedance (BI) (Z6) were calculated to discriminate NoRE >70 and ≤70. RESULTS A total of 61 NI children were enrolled in this study. There was a significant difference in the acid-related parameters, the NoRE (nonacid) and BI between NoRE >70 and ≤70, acid-related parameters and BI between pHI >4.0 and ≤4.0, >5.0 and ≤5.0 and >7.0 and ≤7.0 groups. Furthermore, a significant difference was still observed in the BI between NoRE >70 and ≤70 groups among patients with pHI >4.0, >5.0 or >7.0. The cutoff values of pHI and BI (Z6) for discriminating NoRE >70 and ≤70 were 9.2 and 1049Ω, respectively. CONCLUSION The present study indicates that NoRE 70 corresponds to GERD in which patients suffer severe acid exposure with pH of around 9% and esophageal mucosal damage with low BI value in NI children.
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Affiliation(s)
- Suguru Fukahori
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Minoru Yagi
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Shinji Ishii
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Kimio Asagiri
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Nobuyuki Saikusa
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Naoki Hashizume
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Motomu Yoshida
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Daisuke Masui
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Naruki Higashidate
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Saki Sakamoto
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Hirotomo Nakahara
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan
| | - Yoshiaki Tanaka
- a Departments of Pediatric Surgery , Kurume University School of Medicine , Fukuoka , Japan.,b Division of Medical Safety Management , Kurume University School of Medicine , Fukuoka , Japan
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Hashizume N, Asagiri K, Fukahori S, Ishii S, Saikusa N, Higashidate N, Yoshida M, Masui D, Sakamoto S, Tsuruhisa S, Tanaka Y, Yagi M. Functional assessment of the patients with perineal and vestibular fistula treated by anterior sagittal anorectoplasty. Afr J Paediatr Surg 2018; 15:36-41. [PMID: 30829307 PMCID: PMC6419547 DOI: 10.4103/ajps.ajps_91_17] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Anterior sagittal anorectoplasty (ASARP) has been a standardised operative treatment for anorectal malformation (ARM). This retrospective study was undertaken to evaluate patients with perineal fistula (PF) and vestibular fistula (VF) treated by ASARP in our institution. PATIENTS AND METHODS Twenty patients (PF, n = 14; male, n = 8 and female, n = 6 and VF, n = 6) were evaluated. Eighteen patients underwent primary ASARP without protective colostomy. Two patients underwent colostomy because of intestinal atresia and suspected of other type ARM. The age range of operation was from 4 months to 5.0 years. Sixteen patients (PF, n = 13; male, n = 7 and female n = 6 and VF, n = 3) over 3 years of age were evaluated according to the Krickenbeck classification. RESULTS Operative complications occurred in one patient. Minor wound dehiscence occurred in six patients. Mucosal prolapse occurred in two patients. According to the Krickenbeck classification, amongst male patients with PF, all patients had voluntary bowel movements (VBMs) and two patients had Grade 1 soiling, while four patients had Grade 2 constipation. Amongst female patients with PF, all patients had VBM and no soiling, one patient had Grade 1 and two patients had Grade 2 constipation. In patients with VF, one patient was continent with Grade 1 soiling. One patient had Grade 2 and two patients had Grade 3 constipation. CONCLUSIONS ASARP without colostomy carried a risk of wound dehiscence. The ASARP technique provided normal or moderate outcomes for VBM and soiling. However, in about half of patients, defecation management with laxative therapy was required to achieve a normal condition.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery; Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
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Ishii S, Fukahori S, Asagiri K, Tanaka Y, Saikusa N, Hashizume N, Yoshida M, Masui D, Komatsuzaki N, Higashidate N, Sakamoto S, Kurahachi T, Tsuruhisa S, Nakahara H, Yagi M. Severe Delayed Gastric Emptying Induces Non-acid Reflux up to Proximal Esophagus in Neurologically Impaired Patients. J Neurogastroenterol Motil 2017; 23:533-540. [PMID: 28750491 PMCID: PMC5628985 DOI: 10.5056/jnm16211] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 12/13/2016] [Revised: 03/04/2017] [Accepted: 04/02/2017] [Indexed: 11/20/2022] Open
Abstract
Background/Aims The aim of this study is to investigate the degree of delayed gastric emptying (DGE) and evaluate how the severity of DGE affects gastroesophageal reflux disease (GERD) in neurologically impaired (NI) patients utilizing 24-hour multichannel intraluminal impedance pH measurements (pH/MII) and 13C-acetate breath test (13C-ABT) analyses. Methods 13C-ABT and pH/MII were conducted in 26 NI patients who were referred to our institution due to suspected GERD. At first, correlation analyses were performed to investigate the correlation between the 13C-ABT parameters and the clinical or pH/MII parameters. Thereafter, all patients were divided into 2 groups (DGE and severe DGE [SDGE] group) according to each cut off half emptying time (t1/2, 90-170 minutes). Each pH/MII parameter was compared between the 2 groups in each set-up cutoff t1/2. Results The mean t1/2 of all patients was 215.5 ± 237.2 minutes and the t1/2 of 24 (92.3%) patients were > 100 minutes. Significant moderate positive correlations were observed between both t1/2 and lag phase time and the non-acid reflux related parameters. Furthermore, the patients in the SDGE group demonstrated higher non-acid reflux related parameters than those of the DGE groups when the cutoff was t1/2 ≥ 140 minutes. Conclusion The present study demonstrated that GE with t1/2 ≥ 140 minutes was related to an increase of non-acid exposure reaching up to the proximal esophagus in NI patients, and indicating that NI patients with SDGE might have a high risk of non-acid GERD.
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Affiliation(s)
- Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naoko Komatsuzaki
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Tomohiro Kurahachi
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
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Masui D, Fukahori S, Asagiri K, Ishii S, Saikusa N, Hashizume N, Yoshida M, Higasidate N, Sakamoto S, Tsuruhisa S, Tanaka Y, Yagi M. Wandering spleen associated with omphalocele in a neonate: An unusual case with non-operative management. Journal of Pediatric Surgery Case Reports 2017. [DOI: 10.1016/j.epsc.2017.06.003] [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: 11/30/2022] Open
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27
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Hashizume N, Fukahori S, Asagiri K, Ishii S, Saikusa N, Higashidate N, Yoshida M, Masui D, Sakamoto S, Tanaka Y, Yagi M, Yamashita Y. The characteristics of salivary pepsin in patients with severe motor and intellectual disabilities. Brain Dev 2017; 39:703-709. [PMID: 28495303 DOI: 10.1016/j.braindev.2017.04.008] [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: 01/31/2017] [Revised: 04/08/2017] [Accepted: 04/11/2017] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of the present study was to determine the utility of measuring the salivary pepsin level (SPL) as an objective assessment of gastroesophageal reflux disease (GERD) in severe motor and intellectual disabilities (SMID) patients. SUBJECTS AND METHODS This prospective study included 26 SMID patients who underwent simultaneous 24-h multichannel intraluminal impedance pH measurement (pH/MII) and SPL evaluation. The enrolled patients were divided into GERD (+) or GERD (-) groups according to the pH/MII findings. The age, gender and pH/MII parameters were compared between the two groups. A correlation analysis was also conducted for the SPL following early-morning fasting and post-enteral feeding and the age, gender, presence of gastrostomy and tracheostomy and pH/MII parameters. The SPL was compared between the two sampling groups. RESULTS Fifteen patients were classified as GERD (+), and 11 patients were classified as GERD (-). The mean SPL following early-morning fasting and post-enteral feeding among all patients were 104.3 (median: 38, 25th and 75th percentile: 12, 361) ng/ml and 222.2 (median: 152:0, 500) ng/ml, respectively. Regarding positivity, 76.9% and 73.1% of SPL values in early-morning fasting and post-enteral feeding SMID patients, respectively, were positive (≧16ng/ml). The SPL following early-morning fasting demonstrated a weak but significant positive correlation with age. In contrast, we noted no correlation between the pH/MII parameters and the SPL for either the early-morning fasting or post-enteral feeding patients, and no significant difference in the SPL was observed between the GERD (+) and (-) patients. CONCLUSIONS The present study showed that a high proportion of SMID patients had a relatively high SPL, regardless of the presence of GERD. The SPL in SMID patients might be affected by several distinctive factors in addition to gastroesophageal reflux.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Yoshida M, Asagiri K, Fukahori S, Tanaka Y, Hashizume N, Ishii S, Saikusa N, Higashidate N, Masui D, Komatsuzaki N, Nakahara H, Yagi M, Yamashita Y. The utility of a phase angle analysis in patients with severe motor and intellectual disabilities. Brain Dev 2017; 39:557-563. [PMID: 28365067 DOI: 10.1016/j.braindev.2017.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 09/05/2016] [Revised: 03/03/2017] [Accepted: 03/03/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE The purpose of the present study was to evaluate whether evaluating the phase angle (PhA), in a bioelectrical impedance analysis (BIA) is useful for estimating the nutritional status of severe motor and intellectual disabilities (SMID) patients. SUBJECTS AND METHODS This retrospective study included 31 SMID patients (mean age: 33.9±13.5years, median age: 29years (range: 18-58years), male/female: 23/8). First, each of the parameters from the total study population and the male and female SMID patients were compared with those of healthy Asian subjects. Second, correlation analyses were conducted to investigate the correlation between the PhA and the other BIA parameters (appendicular skeletal muscle mass index (ASMI), appendicular muscle mass (AMM), extracellular water (ECW)/total body water (TBW)) as well as subjective global assessment and serum nutritional markers. Finally, all patients were divided into 2 groups according to their albumin (Alb) (<3.5 or ≥3.5) values and PhA of the 2 groups were compared. RESULTS The mean PhA and ASMI were a considerably low, whereas ECW/TBW was considerably high in comparison to the healthy Asian subjects. Significant negative correlations were observed between the PhA and ECW/TBW, whereas there were significant positive correlations between PhA and AMM, ASMI, total protein and albumin levels. Furthermore, PhA of Alb ≥3.5 group was significantly higher than that of Alb <3.5 group. CONCLUSIONS The present study indicated that SMID patients demonstrate the low PhA, which were similar to sarcopenia and a certain proportion of them also potentially have nutritional disturbances.
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Affiliation(s)
- Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan; Division of Medical Safety Management, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Naoko Komatsuzaki
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
| | - Yushiro Yamashita
- Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan
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Fukahori S, Yagi M, Ishii S, Asagiri K, Saikusa N, Hashizume N, Yoshida M, Masui D, Komatsuzaki N, Higashidate N, Nakahara H, Tanaka Y. A baseline impedance analysis in neurologically impaired children: A potent parameter for estimating the condition of the esophageal mucosa. Neurogastroenterol Motil 2017; 29. [PMID: 28086260 DOI: 10.1111/nmo.13012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 03/27/2016] [Accepted: 11/23/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of the present study was to investigate whether the baseline impedance (BI) value is a useful parameter to evaluate the condition of the esophageal mucosa in neurologically impaired (NI) children undergoing multichannel intraluminal impedance pH measurements (pH/MII). METHODS The retrospective study included 55 NI patients ≤15 years. The patients were divided into acid gastroesophageal reflux disease (GERD), non-acid GERD and GERD (-) groups. Furthermore, the patients in the acid GERD group were subdivided into erosive reflux disease (ERD) and non-erosive reflux disease (NERD) groups. pH/MII parameters and BI values (Z1-6) were compared among three groups or between two groups, respectively. A Spearman's correlation analysis was used for the correlation analysis of pH/MII parameters and BI values. A receiver operator characteristic curve analysis was used to evaluate the optimum cut-off values of BI to discriminate ERD patients. KEY RESULTS The BI values of the proximal and the distal channels in ERD group were significantly lower than those in NERD group. The BI values of the distal channels demonstrated significant negative correlations with acid exposure related pH/MII parameters. The optimal cut off value of BI in the most distal channel was determined to be 1500 Ω. CONCLUSIONS & INFERENCES The present study suggested that NI children with reflux esophagitis were likely to suffer mucosal damage up to the proximal esophagus and cut-off BI values may help estimate the presence of reflux esophagitis. Baseline impedance is a potent parameter, reflecting the esophageal mucosal damage in NI children who have difficulty in undergoing endoscopic examinations.
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Affiliation(s)
- S Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - M Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - S Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - K Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - N Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - N Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - M Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - D Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - N Komatsuzaki
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - N Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - H Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Y Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Hashizume N, Yagi M, Egami H, Asagiri K, Fukahori S, Ishii S, Saikusa N, Yoshida M, Masui D, Tanaka Y. Clinical Efficacy of Herbal Medicine for Pediatric Lymphatic Malformations: A Pilot Study. Pediatr Dermatol 2016; 33:191-5. [PMID: 26777254 PMCID: PMC5066663 DOI: 10.1111/pde.12777] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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] [Indexed: 12/28/2022]
Abstract
BACKGROUND Lymphatic malformations (LMs) are congenital malformations of the lymphatic system that commonly affect the head and neck region and cause marked cosmetic and functional complications. In this pilot study, we present eight children with LMs treated using an herbal medicine for this indication. METHODS Between January 2009 and May 2014, eight children (four boys, four girls) with LMs were treated using oral administration of an herbal medicine, Eppikajyutsuto (TJ-28; Tsumura, Tokyo, Japan), as monotherapy. RESULTS Four of the cases were macrocystic and four were mixed micro- and macrocystic. The mean treatment duration was 7.2 ± 2.9 months (range 5-12 mos). The mean LM volume shrinkage on magnetic resonance imaging was 54.5 ± 38.3% (macrocystic 73.6 ± 27.0%; mixed micro- and macrocystic 35.4 ± 41.5%). One of four macrocystic lesions had a marked reduction, two had a moderate reduction, and one had no response. A marked reduction was observed in three of the four mixed micro- and macrocystic cases; the other mixed cystic case had no response. The treatment was well tolerated, without severe adverse events. CONCLUSIONS This preliminary study demonstrates the beneficial effects of TJ-28. Further evaluations of this therapeutic modality are warranted.
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Affiliation(s)
- Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Department of Innovative Kampo Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hideaki Egami
- Department of Innovative Kampo Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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31
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Higashidate N, Asagiri K, Fukahori S, Ishii S, Saikusa N, Koga Y, Hashizume N, Yoshida M, Sakamoto S, Tanaka Y, Tanigawa K, Yagi M. An infant with pleuropulmonary blastoma type II detected during the prenatal period. Journal of Pediatric Surgery Case Reports 2014. [DOI: 10.1016/j.epsc.2014.05.001] [Citation(s) in RCA: 3] [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: 11/29/2022] Open
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Yagi M, Egami H, Ishii S, Yoshida M, Koga Y, Saikusa N, Fukahori S, Asagiri K, Tanaka Y. [Kampo medicine in the pediatric surgical field]. Nihon Geka Gakkai Zasshi 2013; 114:246-250. [PMID: 24167977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Kampo medicine has been used for over 4,000 years. Recently, some Kampo formulas have been prescribed for postoperative pediatric patients with gastrointestinal anomalies and disease. However, it has been only 30 years since Kampo medicine has been widely used in the pediatric surgical field. Some of the principal Kampo formulas used for daily treatment in the pediatric surgical field are: Rikkunshito and Bukuryouin-Gou-Hangekoubokuto for patients after upper gastrointestinal surgery; Daikenchuto for patients after colorectal surgery; Inchinkoto for postoperative patients with biliary atresia; and Hainosankyuto for periproctal abscess. Kampo formulas according to the postoperative condition are reviewed from the viewpoint of evidence-based medicine, our experience, and experiments. The results of the Kampo treatments listed above were superior to the results when a Kampo formula was not administered in pediatric patients postoperatively.
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Affiliation(s)
- Minoru Yagi
- Departments of Pediatric Surgery, Kurume University School of Medicine, Fukuoka, Japan
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33
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Kojima SI, Yagi M, Asagiri K, Fukahori S, Tanaka Y, Ishii S, Saikusa N, Koga Y, Yoshida M, Masui D, Komatsuzaki N, Nakagawa SI, Ozono S, Tanikawa K. Infantile neuroblastoma of the urinary bladder detected by hematuria. Pediatr Surg Int 2013; 29:753-7. [PMID: 23543098 DOI: 10.1007/s00383-013-3305-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/20/2013] [Indexed: 12/21/2022]
Abstract
Malignant tumors of the urinary bladder in infants are extremely rare. Rhabdomyosarcoma is the most likely tumor in this site, whereas neuroblastoma of the urinary bladder is exceedingly uncommon and is not listed as a differential diagnosis for tumors of this site. We present a case of neuroblastoma arising from the dome of the bladder wall, detected by hematuria. Only six cases of neuroblastoma originating from the bladder, including the present case have been reported. Of the cases, five arose from the dome of the bladder wall. In this report, the differential diagnosis of bladder tumors in children is discussed. A diagnosis of neuroblastoma should be taken into consideration, especially in the case of tumors arising from the dome of the bladder wall despite an uncommon location.
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Affiliation(s)
- Shin-ichiro Kojima
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan.
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Fukahori S, Asagiri K, Ishii S, Tanaka Y, Kojima SI, Saikusa N, Koga Y, Yoshida M, Masui D, Komatsuzaki N, Seki Y, Yagi M. Pre and post-operative evaluation of gastroesophageal reflux and esophageal motility in neurologically impaired children using combined pH–multichannel intraluminal impedance measurements. Pediatr Surg Int 2013; 29:545-51. [PMID: 23519548 PMCID: PMC3657348 DOI: 10.1007/s00383-013-3295-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [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] [Accepted: 02/28/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) in patients with neurological impairment (NI) has not been fully studied before and after fundoplication procedure because their characteristics such as generalized gastrointestinal dysmotility, non-acid reflux, and the proximal reflux due to feeding of enteral nutrition via a nasogastric tube prevent their GERD from being detected by 24 h pH monitoring. The aim of this study was to elucidate whether multichannel impedance-pH measurement (pH/MII) is able to detect the subtypes of GERD and the differences in the reflux episodes of the severity of GERD, the ingestion pathway, and before and after fundoplication. The second aim was to determine whether a trial evaluation of dry swallows was able to be used to assess the esophageal motility of NI patients as an alternative examination. PATIENTS AND METHODS The 24 h pH/MII was conducted on 20 NI children [15 were the patients before Nissen's fundoplication (BN), of whom, six were fed orally (FO) and nine were fed via nasogastric tube (NGT), and five were the patients after Nissen's fundoplication (AN)]. All reflux episodes were evaluated and compared between patients with pathological GERD (PG) and non-pathological GERD (NG) and between patients who had FO and NGT and patients between BN and AN. Dry swallows were conducted to evaluate the esophageal motility. The average bolus presence time (BPT) and total bolus transit time (TBTT) were compared between the PG and NG, FO and NGT, and the BN and AN subgroups. RESULTS A total of 1,064 reflux episodes were detected by pH/MII. Of those, 303 (28.5 %) were non-acid-related and 477 episodes reached the proximal esophagus. Of the 12 patients (57.1 %) showing pathological GERD, two cases (16.7 %) demonstrated predominantly weakly acidic PG. More than half of the reflux episodes of PG patients reached to the proximal esophagus. The numbers of total reflux and proximal reflux episodes in the PG were significantly higher than those in NG patients. The number of proximal reflux episodes in the FO group was significantly higher than that in the NGT groups, whereas NGT patients showed more non-acidic reflux episodes than FO patients. A trial evaluation of dry swallows demonstrated no significant differences in this study. CONCLUSION The pH/MII was useful to detect the subtype of GERD in NI patients which could not be detected by 24 h pH monitoring. It can, therefore, be considered to have first priority for testing NI patients who are suspected to be suffering from GERD.
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Affiliation(s)
- Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Kimio Asagiri
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Shin-ichiro Kojima
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Daisuke Masui
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Naoko Komatsuzaki
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Yoshitaka Seki
- Department of Pediatrics, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011 Japan
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Tanaka Y, Asakawa T, Saikusa N, Kojima S, Koga Y, Hashizume N, Iida H, Yagi M. [Perioperative nutritional support from the viewpoint of risk management]. Nihon Geka Gakkai Zasshi 2010; 111:149-155. [PMID: 20540326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The nutritional condition of perioperative patients affects the results of surgical treatment. For a better prognosis, surgeons must always consider patients' nutritional status preoperatively. After first assessing the nutritional status, a regimen to improve and/or maintain proper nutrition should be selected taking symptoms and treatment procedure into consideration. Peripheral parenteral nutrition provides limited energy. If patients' nutritional status requires improvement and they must fast for a long-term, total parenteral nutrition should be administered. Parenteral nutrition is nonphysiologic therapy and may have severe complications. During the administration of enteral nutrition via a gastrointestinal fistula or nasogastric tube, vomiting and incorrect infusion due to the improper positioning of the feeding tube may occur. When administering nutrition therapy via a gastrostomy or intestinal fistula, care must be taken to determine the appropriate dose and infusion rate. To provide suitable nutritional therapy, our knowledge of the various options available must be expanded.
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Affiliation(s)
- Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Japan
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Saikusa N, Naito S, Iinuma Y, Ohtani T, Yokoyama N, Nitta K. Invasive cholangiocarcinoma identified in congenital biliary dilatation in a 3-year-old boy. J Pediatr Surg 2009; 44:2202-5. [PMID: 19944233 DOI: 10.1016/j.jpedsurg.2009.06.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [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: 03/12/2009] [Revised: 06/12/2009] [Accepted: 06/13/2009] [Indexed: 02/07/2023]
Abstract
We herein report a 3-year-old male demonstrating invasive cholangiocarcinoma (CC) associated with congenital biliary dilatation (CBD). A 3-year-old Japanese boy was admitted to our hospital with abdominal pain and vomiting. Computed tomography and magnetic resonance imaging demonstrated a dilated extrahepatic bile duct. A diagnosis of Todani's type 1a CBD was made. Intraoperative cholangiography demonstrated the presence of pancreaticobiliary maljunction but could not reveal any tumor lesion in the bile duct. The excision of extrahepatic bile duct and gallbladder and Roux-en-Y hepaticojejunostomy were performed. On gross inspection, we could not find any tumor lesion in the resected specimen. However, the postoperative histopathologic examinations confirmed the presence of well-differentiated tubular adenocarcinoma with lymphovascular invasion. Most of the carcinoma remained within the mucosal layer, and the carcinoma was identified at both the distal and proximal surgical margins of the bile duct. We scheduled additional surgery to eradicate the residual carcinoma, but informed consent for the extra surgery could not be obtained. A close follow-up with abdominal computed tomography has been going on without either additional surgery or adjuvant chemotherapy about for 1 year. The patient has so far been clinically doing well without any obvious symptoms of recurrent disease. To our knowledge, this report is the youngest case of CC associated with CBD.
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Affiliation(s)
- Nobuyuki Saikusa
- Department of Pediatric Surgery, Niigata City General Hospital, Niigata City, Niigata 950-1197, Japan.
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Sato T, Nitta K, Iinuma Y, Komori T, Naito S, Saikusa N, Haniu H, Yamazaki H, Hoshina S, Ooishi M, Nagayama Y. Massive pulmonary gas embolism in a neonate with ileal atresia and meconium peritonitis. J Pediatr Surg 2009; 44:e21-3. [PMID: 19231516 DOI: 10.1016/j.jpedsurg.2008.11.028] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2008] [Accepted: 11/03/2008] [Indexed: 10/21/2022]
Abstract
We presented the case of a neonate with portal venous gas and pulmonary gas embolism. The patient presented with severe respiratory distress and abdominal distension 12 hours after birth. An ultrasound revealed intravascular microbubbles moving into a pulmonary artery that were traveling from the portal venous system through a ductus venosus. Additional clinical observations were hypotension and a sudden decrease in end-tidal carbon dioxide with a markedly discrepant high Pco(2), indicating a massive pulmonary gas embolism. Operative findings revealed congenital ileal atresia and meconium peritonitis with abscess. Gas-forming Escherichia coli was recovered from the abscess contents. The patient had respiratory distress, shock, disseminated intravascular coagulation, and intractable diarrhea but eventually recovered and was discharged on the 131st postoperative day.
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Affiliation(s)
- Takashi Sato
- Division of Neonatology, Perinatal Medical Center, Niigata-City General Hospital, Niigata, Japan.
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