論文 - 伊東 大
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A successfully resected case of left trisectionectomy with arterio-portal combined resection for advanced cholangiocarcinoma 査読あり
Atsushi Nanashima, Naoya Imamura, Masahide Hiyoshi, Koichi Yano,Takeomi Hamada, Teru Chiyotanda, Hiroshi Ito.
International Journal of Surgery Case Reports 2018年10月
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エレベーターにて生じた小型犬用リードによる手指不全切断の１例 査読あり
藤井香綸、松峯元、伊東 大 、櫻井裕之
日本形成外科学会会誌 38 ( 8 ) 428 - 432 2018年8月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Matsumine H., Mogami M., Fujiwara O., Hasegawa M., Ito H., Sakurai H.
Microsurgery 38 ( 5 ) 498 - 503 2018年7月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Microsurgery
© 2017 Wiley Periodicals, Inc. Purpose: Intraparenchymatous venous pressure (IVP) monitoring in flap can measure venous pressure with catheter placement. Among patients with IVP monitoring, this study reviewed postoperative microvascular complications for investigating the transplanted-tissue salvage-rate. Patients and Methods: Two hundred and seventy-one patients (male, 132; female, 139; mean age, 52.3 years; age range, 9–82 years) underwent free flap transfer and postoperative continuous IVP monitoring, which performed as follows; a venous catheter was connected to a transducer, and venous pressure in the flap was recorded for three consecutive days postoperatively. The threshold of alarm for elevated venous pressure was set at 50 mm Hg. When abnormal measurements or fluctuation were observed, the vascular anastomotic site was exposed immediately. The flap salvage-rate of non-IVP monitoring group (n = 393; male, 305; female, 81; mean age, 61.3 years; age range, 23–83 years), which were confirmed by a portable ultrasonographic device, was compared with that of IVP-monitoring group. Results: Twenty-one patients developed postoperative microvascular complications at the vascular anastomosis sites. Sensitivity rate of IVP monitoring was 86%; specificity rate, 96%; positive predictive value rates, 64%; negative predictive value rate, 99%; false positive rate, 4%. The flap salvage-rate was 83% in venous thrombosis cases and only 33% in arterial thrombosis cases. In non-IVP monitoring group, flap salvage-rate was 20% with arterial thrombosis and 36% with venous thrombosis, resulting in an increasing the salvage-rate (P =.021). Conclusions: IVP monitoring could visualize and quantify venous pressure waves in flap and detect early microvascular complications, resulting in a marked improvement in the graft-tissue salvage-rate.
DOI： 10.1002/micr.30293
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手指切断に対する再接着術 招待あり 査読あり
伊東 大
PEPARS 134 ( 2 ) 23 - 32 2018年2月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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A resected case of hepato-pancreaticoduodenectomy for widely extended cholangiocarcinoma undergoing previous intra-abdominal poly-surgery 査読あり
Nanashima A., Imamura N., Hiyoshi M., Yano K., Hamada T., Chiyotanda T., Nagatomo K., Hamada R., Ito H.
International Journal of Surgery Case Reports 2018年1月
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非結核性抗酸菌による化膿性脊椎炎に対し血管柄付き腓骨移植術で再建をした1例 査読あり
池田 果林, 伊東 大, 中尾 崇, 最上 真理子, 長 渚, 井砂 司
創傷 9 ( 4 ) 158 - 161 2018年
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Digital Artery Massage for Improving Ischemia after Distal Digital Replantation Surgery. 査読あり
Yousuke Niimi, Hiroshi Ito, Karin Ikeda, Miho Kirita, Junji Hishiyama, Hiroyuki Sakurai
Journal of Reconstructive Microsurgery Open 3 25 - 27 2018年
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌）
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Ito H., Malgerud E., Asmussen S., Lopez E., Salzman A., Enkhbaatar P.
Journal of Translational Medicine 15 ( 1 ) 2017年12月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Journal of Translational Medicine
© 2017 The Author(s). Background: Septic shock is a major cause of death in intensive care units around the world. The aim of the study was to investigate whether the novel drug R-100 (a superoxide degradation catalyst and nitric oxide donor) improves pulmonary function in a sheep model of septic shock caused by Pseudomonas aeruginosa and smoke inhalation. Methods: Eleven female sheep were prepared surgically and randomly assigned to a treatment group (n = 5) or a control group (n = 6) after inhalation of cooled cotton smoke and airway instillation of live P. aeruginosa (2.5 × 1011CFU) by bronchoscope under deep anesthesia and analgesia. The treatment group received an intravenous infusion of a total of 80 mg/kg of R-100 diluted in 500 mL of 5% dextrose. The control group was given 500 mL of 5% dextrose. All animals received intravenous lactated Ringer's solution to maintain a hematocrit level at baseline ± 3%. Blood gas and hemodynamics were measured at baseline and then analyzed every 3 h during the 24-h study period. Results are expressed as mean ± SEM. Results: The treated animals showed significant improvement in their pulmonary gas exchange (PaO2/FiO2ratio at 24 h: 246 ± 29 vs. 90 ± 40 mmHg control, P < 0.05). Pulmonary arterial pressures were reduced in the treated group (24 h: 26 ± 1 vs. 30 ± 2 cm mmHg control, P < 0.05). The treated animals also had an improved total fluid balance after 24 h (190 ± 45/24 h mL vs. 595 ± 234/24 h mL control, P < 0.05). Conclusions: Treatment with R-100 improves pulmonary gas exchange and blood oxygenation, and prevents a fluid imbalance in sheep subjected to smoke inhalation and P. aeruginosa.
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The flap revisited-the venous flap 招待あり 査読あり
Ito H., Higashimori T., Nakazawa H., Sakurai H.
Japanese Journal of Plastic Surgery 59 ( 7 ) 695 - 703 2016年7月
担当区分：筆頭著者, 責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Japanese Journal of Plastic Surgery
The venous flap is a unique flap that was first reported by Nakayama in an experimental rat model in 1981. In a conventional flap, gaseous exchange and metabolism depend on the blood flowing in from the artery, through the capillary system, and then flowing out through the vein. The venous flap depends on the venous system for blood flow into and out of the flap. There have been reports on "true venous flaps" that use venous blood for inflow, but arterialized venous flaps are more common because of better viability of the flap. The venous flap does not require an inflow artery, and can be harvested by direct visualization of the venous plexus under the skin, allowing for 1) less time in flap elevation, 2) less donor site morbidity, and 3) a thinner flap. In the 1990's, venous flaps were used in our institution, mainly for reconstruction of the extremities, but the major drawback was the instability of blood flow due to unphysiological circulation, leading to partial necrosis of the flap. Blood circulation from the vein to the capillaries required overcoming the valves, which caused a decrease in blood flow to the skin surface. Additionally, arterial blood flowing into the venous system resulted in an increase in venous pressure, further reducing perfusion to the skin surface. Venous flaps are less frequently utilized because of their unstable survival, and the increased use of perforator flaps and other thin flaps also contribute to the decline of their application. However, the advantages listed above are useful for small to medium-sized deficiencies in hand trauma, especially as an emergency flap, and therefore venous flaps should be included as a treatment option.
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Intraosseous hemangioma of the zygomatic bone 査読あり
Hishiyama J., Isago T., Ito H.
JPRAS Open 6 5 - 10 2015年12月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：JPRAS Open
© 2015 The Authors. Intraosseous hemangiomas are rare, and although they have been described in the calvaria and vertebrae, those occurring in the zygomatic bone are extremely rare. We report the case of a 52-year-old man who presented with a painless hard swelling in the left zygomatic process. The computed tomography and magnetic resonance imaging findings showed an intraosseous mass located in the left zygomatic bone just inferolateral to the orbit. A pathologic analysis of the surgical specimen revealed a cavernous hemangioma. The surgical defect was reconstructed with an autogenous rib bone that was fixated with titanium miniplates. The literature is reviewed and computed tomography, magnetic resonance imaging, and angiographic findings are discussed with particular reference to a surgical resection and reconstruction.
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陰圧閉鎖療法の理論と実践、創面に対する陰圧の効果（理論）と至適陰圧 招待あり 査読あり
伊東 大、井砂 司
PAPERS 97 2015年1月
担当区分：筆頭著者, 最終著者, 責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Asmussen S., Ito H., Traber D., Lee J., Cox R., Hawkins H., McAuley D., McKenna D., Traber L., Zhuo H., Wilson J., Herndon D., Prough D., Liu K., Matthay M., Enkhbaatar P.
Thorax 69 ( 9 ) 819 - 825 2014年9月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Thorax
Background Human bone marrow-derived mesenchymal stem (stromal) cells (hMSCs) improve survival in mouse models of acute respiratory distress syndrome (ARDS) and reduce pulmonary oedema in a perfused human lung preparation injured with Escherichia coli bacteria. We hypothesised that clinical grade hMSCs would reduce the severity of acute lung injury (ALI) and would be safe in a sheep model of ARDS. Methods Adult sheep (30-40 kg) were surgically prepared. After 5 days of recovery, ALI was induced with cotton smoke insufflation, followed by instillation of live Pseudomonas aeruginosa (2.51011 CFU) into both lungs under isoflurane anaesthesia. Following the injury, sheep were ventilated, resuscitated with lactated Ringer's solution and studied for 24 h. The sheep were randomly allocated to receive one of the following treatments intravenously over 1 h in one of the following groups: (1) control, PlasmaLyte A, n=8; (2) lower dose hMSCs, 5106 hMSCs/kg, n=7; and (3) higher-dose hMSCs, 10106 hMSCs/kg, n=4. Results By 24 h, the PaO2/FiO2 ratio was significantly improved in both hMSC treatment groups compared with the control group (control group: PaO2/FiO2 of 9715 mm Hg; lower dose: 28855 mm Hg (p=0.003); higher dose: 3272 mm Hg ( p=0.003)). The median lung water content was lower in the higher-dose hMSCtreated group compared with the control group (higher dose: 5.0 g wet/g dry [IQR 4.9-5.8] vs control: 6.7 g wet/g dry [IQR 6.4-7.5] ( p=0.01)). The hMSCs had no adverse effects. Conclusions Human MSCs were well tolerated and improved oxygenation and decreased pulmonary oedema in a sheep model of severe ARDS.9999.
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Healing efficacy of sea buckthorn (Hippophae rhamnoides L.) seed oil in an ovine burn wound model 査読あり
Ito H., Asmussen S., Traber D., Cox R., Hawkins H., Connelly R., Traber L., Walker T., Malgerud E., Sakurai H., Enkhbaatar P.
Burns 40 ( 3 ) 511 - 519 2014年5月
担当区分：筆頭著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Burns
To investigate the efficacy of sea buckthorn (SBT) seed oil - a rich source of substances known to have anti-atherogenic and cardioprotective activity, and to promote skin and mucosa epithelization - on burn wound healing, five adult sheep were subjected to 3rd degree flame burns. Two burn sites were made on the dorsum of the sheep and the eschar was excised down to the fascia. Split-thickness skin grafts were harvested, meshed, and fitted to the wounds. The autograft was placed on the fascia and SBT seed oil was topically applied to one recipient and one donor site, respectively, with the remaining sites treated with vehicle. The wound blood flow (LASER Doppler), and epithelization (ultrasound) were determined at 6, 14, and 21 days after injury. 14 days after grafting, the percentage of epithelization in the treated sites was greater (95 ± 2.2% vs. 83 ± 2.9%, p < 0.05) than in the untreated sites. Complete epithelization time was shorter in both treated recipient and donor sites (14.20 ± 0.48 vs. 19.60 ± 0.40 days, p < 0.05 and 13.40 ± 1.02 vs. 19.60 ± 0.50 days, p < 0.05, respectively) than in the untreated sites, confirmed by ultrasound. In conclusion, SBT seed oil has significant wound healing activity in full-thickness burns and split-thickness harvested wounds. © 2013 Elsevier Ltd and ISBI.
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Jacob S., Zhu Y., Asmussen S., Ito H., Herndon D., Enkhbaatar P., Hawkins H., Cox R.
Toxicology Mechanisms and Methods 24 ( 4 ) 250 - 258 2014年5月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Toxicology Mechanisms and Methods
The effects of tiotropium bromide on ERK 1/2, SMAD 2/3 and NFκB signaling in bronchial submucosal gland (SMG) cells of sheep after smoke inhalation and burn injury (S + B) were studied. We hypothesized that tiotropium would modify intracellular signaling processes within SMG cells after injury. Bronchial tissues were obtained from uninjured (sham, n = 6), S + B injured sheep 48 h after injury (n = 6), and injured sheep nebulized with tiotropium (n = 6). The percentage (mean ± SD) of cells showing nuclear localization of phosphorylated ERK 1/2, pSMAD 2/3, and NFκB (p65) was determined by immunohistochemistry. Nuclear pERK 1/2 staining was increased in injured animals as compared to sham, (66 ± 20 versus 14 ± 9), p = 0.0022, as was nuclear pSMAD, 84 ± 10 versus 20 ± 10, p = 0.0022. There was a significant decrease in pERK 1/2 labeling in the tiotropium group compared to the injured group (31 ± 20 versus 66 ± 20, p = 0.013), and also a decrease in pSMAD labeling, 62 ± 17 versus 84 ± 10, p = 0.04. A significant increase for NFκB (p65) was noted in injured animals as compared to sham (73 ± 16 versus 7 ± 6, p = 0.0022). Tiotropium-treated animals showed decreased p65 labeling as compared to injured (35 ± 17 versus 74 ± 16, p = 0.02). The decrease in nuclear expression of pERK, pSMAD and NFκB molecules in SMG cells with tiotropium treatment is suggestive that their activation after injury is mediated in part through muscarinic receptors. © 2014 Informa Healthcare USA, Inc. All rights reserved: reproduction in whole or part not permitted.
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OP-026-1 羊熱傷モデルにおけるSea buckthorn seed oilの創傷治癒効果(OP-026 基礎 再生医療・その他,一般演題,第114回日本外科学会定期学術集会) 査読あり
伊東 大, 井砂 司, 櫻井 裕之, Perenlei Enkhbaatar
日本外科学会雑誌 115 ( 2 ) 2014年3月
担当区分：筆頭著者, 責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人日本外科学会
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20 年前の腹部皮弁を turn-over flap として利用し治癒した肘頭難治性熱傷瘢痕潰瘍 査読あり
菱山 潤二, 井砂 司, 伊東 大, 田邉 裕美, 末澤 絵美, 本田 隆司
創傷 5 ( 4 ) 200 - 203 2014年
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久保 和之, 中野 貴光, 沖田 英久, 伊東 大, 櫻井 裕之
日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery 33 ( 3 ) 166 - 170 2013年3月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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耳介変形の分類と治療の実際 招待あり 査読あり
伊東 大
外来小児科 2013年
担当区分：筆頭著者, 責任著者 記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Yamamoto Y., Enkhbaatar P., Sakurai H., Rehberg S., Asmussen S., Ito H., Sousse L., Cox R., Deyo D., Traber L., Traber M., Herndon D., Traber D.
Burns 38 ( 6 ) 908 - 916 2012年9月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Burns
Smoke inhalation injury frequently increases the risk of pneumonia and mortality in burn patients. The pathophysiology of acute lung injury secondary to burn and smoke inhalation is well studied, but long-term pulmonary function, especially the process of lung tissue healing following burn and smoke inhalation, has not been fully investigated. By contrast, early burn excision has become the standard of care in the management of major burn injury. While many clinical studies and small-animal experiments support the concept of early burn wound excision, and show improved survival and infectious outcomes, we have developed a new chronic ovine model of burn and smoke inhalation injury with early excision and skin grafting that can be used to investigate lung pathophysiology over a period of 3 weeks. Materials and methods: Eighteen female sheep were surgically prepared for this study under isoflurane anesthesia. The animals were divided into three groups: an Early Excision group (20% TBSA, third-degree cutaneous burn and 36 breaths of cotton smoke followed by early excision and skin autografting at 24 h after injury, n = 6), a Control group (20% TBSA, third-degree cutaneous burn and 36 breaths of cotton smoke without early excision, n = 6) and a Sham group (no injury, no early excision, n = 6). After induced injury, all sheep were placed on a ventilator and fluid-resuscitated with Lactated Ringers solution (4 mL/% TBS/kg). At 24 h post-injury, early excision was carried out to fascia, and skin grafting with meshed autografts (20/1000 in., 1:4 ratio) was performed under isoflurane anesthesia. At 48 h post-injury, weaning from ventilator was begun if PaO2/FiO2was above 250 and sheep were monitored for 3 weeks. Results: At 96 h post-injury, all animals were weaned from ventilator. There are no significant differences in PaO2/FiO2between Early Excision and Control groups at any points. All animals were survived for 3 weeks without infectious complication in Early Excision and Sham groups, whereas two out of six animals in the Control group had abscess in lung. The percentage of the wound healed surviving area (mean ± SD) was 74.7 ± 7.8% on 17 days post-surgery in the Early Excision group. Lung wet-to-dry weight ratio (mean ± SD) was significantly increased in the Early Excision group vs. Sham group (p < 0.05). The calculated net fluid balance significantly increased in the early excision compared to those seen in the Sham and Control groups. Plasma protein, oncotic pressure, hematocrit of % baseline, hemoglobin of % baseline, white blood cell and neutrophil were significantly decreased in the Early Excision group vs. Control group. Conclusions: The early excision model closely resembles practice in a clinical setting and allows long-term observations of pulmonary function following burn and smoke inhalation injury. Further studies are warranted to assess lung tissue scarring and measuring collagen deposition, lung compliance and diffusion capacity.
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Asmussen S., Bartha E., Olah G., Sbrana E., Rehberg S., Yamamoto Y., Enkhbaatar P., Hawkins H., Ito H., Cox R., Traber L., Traber D., Szabo C.
Shock 36 ( 4 ) 402 - 409 2011年10月
記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Shock
We investigated the effect of the angiotensin-converting enzyme (ACE) inhibitor captopril in a clinically relevant ovine model of smoke and burn injury, with special reference to oxidative stress and activation of poly(ADP-ribose) polymerase, in the lung and in circulating leukocytes. Female, adult sheep (28-40 kg) were divided into three groups. After tracheostomy and under deep anesthesia, both vehicle-control-treated (n = 5) and captopril-treated (20 mg/kg per day, i.v., starting 0.5 h before the injury) (n = 5) groups were subjected to 2 × 20%, third-degree burn injury and were insufflated with 48 breaths of cotton smoke. A sham group not receiving burn/smoke was also studied (n = 5). Animals were mechanically ventilated and fluid resuscitated for 24 h in the awake state. Burn and smoke injury resulted in an upregulation of ACE in the lung, evidenced by immunohistochemical determination and Western blotting. Burn and smoke injury resulted in pulmonary dysfunction, as well as systemic hemodynamic alterations. Captopril treatment of burn and smoke animals improved PaO2/FiO2 ratio and pulmonary shunt fraction and reduced the degree of lung edema. There was a marked increase in PAR levels in circulating leukocytes after burn/smoke injury, which was significantly decreased by captopril. The pulmonary level of ACE and the elevated pulmonary levels of transforming growth factor β in response to burn and smoke injury were significantly decreased by captopril treatment. Our results suggest that the ACE inhibitor captopril exerts beneficial effects on the pulmonary function in burn/smoke injury. The effects of the ACE inhibitor may be related to the prevention of reactive oxygen species-induced poly(ADP-ribose)polymerase overactivation. Angiotensin-converting enzyme inhibition may also exert additional beneficial effects by inhibiting the expression of the profibrotic mediator transforming growth factor β. © 2011 by the Shock Society.