論文 - 伊東 大
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Postoperative Monitoring by Near-Infrared Spectroscopy in Transferred Free Tissue 査読あり
Fujita Tamaki, Ito Hiroshi, Ito Noriko, Nakai Michikazu
International Journal of Surgical Wound Care 6 ( 4 ) 112 - 120 2025年12月
担当区分：責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本創傷外科学会
Background: Near-infrared spectroscopy is being increasingly frequently used for postoperative monitoring of free flaps, offering real-time data on regional oxygen saturation and total hemoglobin index. However, comprehensive reports on Hb values and ssfree flaps using near-infrared spectroscopy analyzed the findings.<br>Methods: Eight types of free flaps were evaluated. The regional oxygen saturation and total hemoglobin index were measured in flap and normal control sites immediately after surgery and on postoperative days 1, 2, 3, 5, and 7. Measurements were taken by the surgeon or assistant. Flap viability was assessed clinically and with near-infrared spectroscopy; reoperation or other interventions were performed as necessary. Data were analyzed using a generalized linear mixed model.<br/>Results: Among 110 monitored flaps, 10 failed; of these, 4 were salvaged, 4 were partially necrotic, and 2 were completely necrotic. Causes included venous thrombus (four), arteriovenous thrombus (two), hematoma (one), and other causes (three). All failures were detected between postoperative days 1 and 4. Successful flaps showed lower regional oxygen saturation and higher total hemoglobin index values than normal controls. The difference in regional oxygen saturation was greater after the first postoperative day than immediately after surgery, while the total hemoglobin index difference remained constant. Radial forearm flaps had higher initial regional oxygen saturation and total hemoglobin index; deep inferior epigastric artery perforator flaps showed lower values throughout.<br>Conclusions: Near-infrared spectroscopy parameters vary by flap type and should be considered in postoperative monitoring. Differences between the flap and control sites, especially in total hemoglobin index, may serve as useful criteria for flap assessments.<br/>
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伊東 憲子, 伊東 大, 藤田 環
創傷 16 ( 3 ) 98 - 102 2025年
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Ito Hiroshi, Hori Keijiro, Niimi Yosuke, Watanabe Tatsushi
Journal of Plastic and Reconstructive Surgery 1 ( 1 ) 20 - 25 2022年1月
担当区分：筆頭著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：一般社団法人 日本形成外科学会
In some cases of free flap transfer, two comitant veins must be anastomosed to a single suitable recipient vein to avoid congestion due to the lack of network between the two comitant veins. In this situation, both veins are mostly anastomosed to the recipient vein in an end-to-side fashion. However, the distal end of the recipient vein sometimes has to be cut to reach the comitant veins that are short in length. In such cases, we anastomose both of the comitant veins to a single recipient vein in an end-to-end fashion with a twin tower shape. The twin tower-shaped anastomosis technique involves two comitant veins in parallel anastomosed to a single recipient vein in an end-to-end fashion, and the gap of the two comitant veins is closed directly via an interrupted suture method. With this technique, two comitant veins and the recipient vein can be successfully anastomosed in an end-to-end fashion.
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指間形成に対する局所皮弁の工夫 査読あり
伊東 大、仲沢弘明、森岡康祐
形成外科 45 ( 10 ) 951 - 959 2002年
担当区分：筆頭著者 記述言語：日本語 掲載種別：研究論文（学術雑誌）
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増刊号 エキスパートの知恵と経験211Pearls-若手にシェアしたい私のこだわり- 四肢の手術 2.爪床損傷の程度を見極める:抜爪して評価を! 査読あり
伊東 大
形成外科 68 ( 13 ) S93 - S93 2025年6月
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増刊号 エキスパートの知恵と経験211Pearls-若手にシェアしたい私のこだわり- マインド 7.知っておいて損はない専攻医心得 査読あり
伊東 大
形成外科 68 ( 13 ) S211 - S211 2025年6月
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広範囲重症熱傷に対する凍結同種皮膚移植術のための安定したAllograftの供給に関する研究
池田 弘人, 青木 大, 伊東 大, 織田 順, 片平 次郎, 久志本 成樹, 島田 賢一, 鳴海 篤志, 福島 英賢, 松村 一, 田中 秀治, 副島 一孝, 佐々木 淳一
熱傷 50 ( 3 ) 145 - 149 2024年9月
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 日本熱傷学会
【目的】広範囲重症熱傷に対する凍結同種皮膚移植術は患者の救命治療に有用である. 一般社団法人日本スキンバンクネットワークは凍結同種皮膚を保存・供給する本邦で唯一の組織バンクであり, 全国80の熱傷治療施設のネットワークを構築している. 本研究では, 全国のいかなる施設においても凍結同種皮膚を一定の超低温で搬送し, 移植にいたるまで安全かつviabilityの高い皮膚を供給できるか, 搬送用タンク (以下ドライシッパー) 内の温度をモニタリングし, 距離・搬送時間・季節等の影響について検討した.<br> 【方法】液体窒素を充填したドライシッパーに温度記録センサーを取り付け, サンプルを搬送し, タンクが返送されるまでの温度変化を記録した. 搬送地域は沖縄・九州・四国・東海・関東・東北・北海道の7ヵ所とし, 期間① (2019年12月～2020年3月) と期間② (2020年9月～11月) の2回のテスト搬送を実施した.<br> 【結果】庫外温度の変動幅は, 地域的, 季節性により最大14.2℃ (夏季：沖縄県), 25.0℃ (冬季：北海道) となっており, 搬送中の外気温や施設内気温などの差によるものと考えられるが, 庫内温度は, それらの地域的, 季節性の影響なく, 平均－194.8～－196.1℃に保持されていた.<br> 【結論】調査したどの地域においても季節地域差などの影響はほとんどなく, 質を保ったままの搬送が確認できた. 現状の搬送方法で問題なく凍結保存皮膚を届けられると判断できる.
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連載 随想 儚き夢 招待あり 査読あり
伊東 大
形成外科 67 ( 3 ) 229 - 229 2024年3月
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Microvascular reconstruction for oral cancer in older adult patients: the impact of age on surgical outcomes. 査読あり
Kouketsu A, Kaneuji T, Yamaguma Y, Yamauchi K, Sugiura T, Takahashi T, Ito H, Yamashita Y
Oral surgery, oral medicine, oral pathology and oral radiology 137 ( 1 ) 6 - 11 2024年1月
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眉毛下切開で治療した小児眼窩上壁骨折の1例 査読あり
南里 健太, 伊東 大, 伊東 憲子
創傷 15 ( 3 ) 81 - 85 2024年
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切断指 Zone別対応マニュアル！どう対応する!? ZoneⅢ. 招待あり 査読あり
伊東 大、南里健太、伊東憲子
PAPERS 2023年10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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著明な乳房増大をきたした若年発症の乳腺過誤腫の治療経験 査読あり
渡邊 龍志, 伊東 大
創傷 14 ( 1 ) 23 - 29 2023年
担当区分：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） 出版者・発行元：一般社団法人 日本創傷外科学会
DOI： 10.11310/jsswc.14.23
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遊離組織移植後の近赤外線組織オキシメータによる補助的モニタリングの可能性. 査読あり
松山周世、伊東 大
創傷 13 ( 3 ) 109 - 117 2022年
担当区分：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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膝蓋骨露出を伴う熱傷後難治性潰瘍に対する遊離皮弁による治療経験 －下行膝動脈穿通枝の有用性－. 査読あり
松山周世、伊東 大
日本マイクロサージャリー学会会誌 34 ( 3 ) 156 - 161 2021年
担当区分：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：日本マイクロサージャリー学会
We report a case of reconstruction with a free flap for a post deep burn ulcer with an exposed patella. Bone or tendon is located directly below the skin in the lower extremity, especially around the knee, and blood flow around the knee is unstable. Therefore, intractable ulcers are not uncommon. There are many methods for reconstructing defects of the lower extremities such as direct closure, skin grafting, local flaps, and free flaps. When considering free flap transfer for knee defects, recipient vessel selection is the main challenge. We selected the descending genicular artery as the recipient vessel and applied a latissimus dorsi free flap to cover the defect. The flap survived without notable complications. One year after the operation, the patient was able to walk without difficulties in daily life. The descending genicular artery is useful as the recipient vessel in reconstruction with free flaps in patients with lower limb trauma.
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脊髄髄膜瘤瘤被膜の病理組織学的検討 査読あり
伊東 大
創傷 12 ( 3 ) 127 - 132 2021年
担当区分：筆頭著者 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 日本創傷外科学会
脊髄髄膜瘤の治療において，脳神経外科による脊髄形成術・髄膜瘤還納術後，皮膚軟部組織欠損部の被覆を形成外科に依頼されることが多い。欠損範囲が小さい場合は一次的縫縮が可能であることが多いが，欠損が広範な場合は植皮・筋皮弁・局所皮弁を用いた再建が必要となり，これまでにさまざまな再建方法が報告されている。今回，われわれ通常破棄されていると思われる脊髄髄膜瘤上の脆弱な膜様組織（以下瘤被膜）の病理組織学的検査を行い，植皮片として利用が可能であるかを検討した。瘤被膜の病理組織学的検査では，全症例において正常な皮膚構造を有していたが，一方で通常存在しない神経様組織が含まれていた。この結果より，瘤被膜を植皮片として利用した場合は，術後厳重な経過観察が必要であり，一時的な創閉鎖目的に瘤被膜を使用する利用価値はあると考えられた。
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特集 壊死性軟部組織感染症-私はこうして治療した- 腎移植後に発症した壊死性軟部組織感染症の2例 招待あり 査読あり
長谷川 祐基, 櫻井 裕之, 伊東 大
形成外科 63 ( 8 ) 983 - 993 2020年8月
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細井 聡士, 池ノ上 実, 落合 昂一郎, 久保 環, 武野 慎祐, 伊東 大
創傷 11 ( 4 ) 184 - 190 2020年
担当区分：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 日本創傷外科学会
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DIEP flapにおける深下腹壁動脈恥骨枝の有用性 査読あり
溝 渕 貴 俊，伊 東 大，櫻 井 裕 之
Oncoplastic Breast Surgery 4 ( 3 ) 74 - 78 2019年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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右肝動脈及び門脈合併切除再建を伴う肝左三区域・尾状葉・肝管切除術を行った肝門部領域胆管癌の1例 査読あり
今村直哉、七島篤志、濱田剛臣、矢野公一、旭吉雅秀、伊東大
宮崎県医師会医学会誌 43 ( 2 ) 149 - 156 2019年
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Negative-pressure wound therapy for fixing full-thickness skin graft on the thumb 査読あり
Yousuke Niimi, Hiroshi Ito, Hiroyuki Sakurai
J Plast Reconstr Aesthet Surg Open 2018年12月
記述言語：英語 掲載種別：研究論文（学術雑誌）
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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.
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長田 篤祥, 伊東 大, 久保 和之, 佐々木 健司
日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery 31 ( 1 ) 26 - 33 2011年1月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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断端形成術後に行った切断指再接着術の経験:―インフォームドコンセントの重要性について― 査読あり
伊東 大, 長田 篤祥, 久保 和之, 櫻井 裕之
日本マイクロサージャリー学会会誌 24 ( 1 ) 37 - 41 2011年
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） 出版者・発行元：日本マイクロサージャリー学会
We describe a case of finger replantation after stump-plasty. The replantation was successfully carried out, but the case highlighted the importance of proper informed consent from the patient. The patient, a 39-year-old woman who incurred a sharp left middle finger amputation by a meat slicer, received initial treatment at a neighboring general hospital where she underwent stump-plasty. Records from this hospital revealed that treatment options were explained to the patient (replantation vs. stump-plasty) but that the patient had not opted for replantation. Nevertheless, the patient stated that as she had been in a state of distress, she had not fully understood what had been explained and had left the treatment decision to her treating physician. The same day, the patient visited our hospital with the amputated finger and requested a replantation. More than 7 hours had elapsed since the injury, but since the finger was iced and in good condition, we carried out the replantation, which required venous grafting. The postoperative course was without complications and the finger survived completely.<br> In the treatment of finger amputation, the gold standard is to carry out replantation, unless the patient requests otherwise. At the time of injury, patients are often in distress and lack decision-making capacity, leaving treatment decision solely to the physician. In our facility, we devote ample time to a full informed consent process, explaining treatment options, risks and benefits. This case may have been the result of an inadequate informed consent process at the first facility with the patient not fully understanding the risks and benefits; it also highlights the importance of properly conducted informed consent before surgical treatment.
DOI： 10.11270/jjsrm.24.37
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Granular cell tumor of the suprasternal space 査読あり
Ihara K., Ito H., Nakajima Y., Fukaya E., Nakazawa H., Nozaki M.
Journal of Dermatology 37 ( 10 ) 900 - 903 2010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：Journal of Dermatology
A case of granular cell tumor (GCT) was reported. We encountered a 33-year-old woman with a painless, elastic, hard mass in the soft tissue of the suprasternal space. The tumor was excised with several millimeters margin of normal tissue above the deep cervical fascia and the wound was closed primarily. Histological examination on hematoxylin-eosin stain showed a tumor growth in the mid- to deep dermis and eosinophilic small granules that were consistent with granular cell tumors. Immunohistochemical studies showed positive staining for S-100 protein. We experienced a case of a granular cell tumor occurring in the suprasternal space and report the importance of including it in the differential diagnosis of subcutaneous soft tissue tumors. © 2010 Japanese Dermatological Association.
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Fingertip amputation salvage on arterial anastomosis alone: An investigation of its limitations
Ito H., Sasaki K., Morioka K., Nozaki M.
Annals of Plastic Surgery 65 ( 3 ) 302 - 305 2010年9月
担当区分：筆頭著者, 最終著者, 責任著者 記述言語：英語 掲載種別：研究論文（学術雑誌） 出版者・発行元：Annals of Plastic Surgery
Background: We have previously reported the importance of adequate and precise arterial anastomosis and the hypothesis that, up to subzone III, fingertip amputation salvage can be achieved on arterial anastomosis alone. These findings were reported during the meeting of the Japanese Society of Reconstructive Microsurgery. This is our follow-up report with insight and opinion on the limitations of complete fingertip amputation salvage on arterial anastomosis alone. Methods: We examined 67 fingers (59 patients) with fingertip amputations presenting to our hospital between January 2005 and December 2008. Amputation levels and whether these injuries received only arterial or both arterial and venous anastomoses were noted. Fisher exact test was used to examine statistical differences between the groups. Results: Amputation levels were 11 in subzone I, 20 in subzone II, 17 in subzone III, and 19 in subzone IV. Successful replantation was achieved in 87% (58 of 67) of fingers. There was no statistically significant difference between fingers receiving arterial alone versus both anastomoses in amputations of subzones I, II, and III. Conclusions: We found that with proper postoperative congestion care, no statistically significant difference in replantation success of fingers receiving arterial anastomosis alone versus both arterial and venous were noted up to subzone III. However, in subzone IV, regardless of the postoperative congestion, compete necrosis rates are high; thus, it is speculated that a venous anastomosis is necessary for successful replantation. It is preferable to perform as many anastomoses as possible, but we believe that it is also desirable for the procedure to be fast and less invasive. In cases that have no adequate vein, fingertip replantation can be achieved on arterial anastomosis alone up to subzone III. © 2010 by Lippincott Williams & Wilkins.
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伊東 大, 佐々木 健司, 中森 大記, 長田 篤祥, 野崎 幹弘
日本マイクロサージャリー学会会誌 = Journal of Japanese Society of Reconstructive Microsurgery 22 ( 3 ) 251 - 257 2009年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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血管柄付き遊離腸骨鼠径皮弁により再建した先天性母指形成不全症の治療経験 : 長期経過観察と仮骨延長法による骨延長
中森 大記, 佐々木 健司, 伊東 大, 森岡 康祐, 野崎 幹弘
日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery 28 ( 12 ) 771 - 776 2008年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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指尖部切断再接着症例の検討 査読あり
伊東 大, 佐々木 健司, 越智 正和, 此枝 央人, 野崎 幹弘
日本マイクロサージャリー学会会誌 = Journal of Japanese Society of Reconstructive Microsurgery 20 ( 2 ) 108 - 114 2007年6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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伊東 大, 森岡 康裕, 片平 次郎, 仲沢 弘明, 野崎 幹弘
日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery 27 ( 4 ) 316 - 320 2007年4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）
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Two cases of fibrolipoma in nucha 査読あり
Konoeda H., Ito H., Ochi M., Sasaki K.
Skin Research 6 ( 2 ) 145 - 149 2007年4月
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：Skin Research
We report two cases of relative rare fibrolipoma of which pre-operative diagnosis suggested malignant tumor as a potential diagnosis. Case1 : 59-year-old male presented with palpable 4 X 4cm tumor on the nuchal region. There was low and fat signal isointensity in the tumor area on MRI findings. The tumor was resected and histopathologic examination revealed fibrolipoma. Post-operative course was uneventful and no recurrence was found at 13-months follow-up point. Case 2 : 59-year-old male presented with slowly progressive mass on the nuchal region. Preoperative MRI showed 53 X 26mm tumor with combined low and fat signal isointensity. Postoperative histopathologic findings of the specimen revealed fibrolipoma. At 14-months follow-up point, no signs of recurrence were seen. The diagnosis of fibrolipoma should be considered in patients who have slow progressive mass on the nuchal region with combined low and fat signal isointensity on MRI imaging.
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越智 正和, 伊東 大, 此枝 央人, 仲沢 弘明, 佐々木 健司, 野崎 幹弘
熱傷 : 日本熱傷学会機関誌 = Japan journal of burn injuries 33 ( 1 ) 52 - 58 2007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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東京スキンバンクネットワークからの凍結保存同種皮膚移植により救命した小児重症熱傷の治療経験
片平 次郎, 仲沢 弘明, 吉田 栄香, 伊東 大, 森岡 康祐, 野崎 幹弘
熱傷 30 ( 3 ) 180 - 185 2004年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Our Treatment of "Coccygeal Pad" 査読あり
Higashimori T., Nakazawa H., Ito H., Katahira J., Morioka K., Kikuchi Y., Nozaki M., Sasaki K.
Japanese Journal of Plastic and Reconstructive Surgery 47 ( 3 ) 261 - 267 2004年3月
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 and Reconstructive Surgery
"Coccygeal pad" is a torose lesion of the sacrococcygeal area. Pathologically, it is hyperkeratosis and proliferation of dermal collagen. But it is rarely reported on in the plastic and reconstructive surgery fields. We experienced 5 cases in the past 6 years, and studied them retrospectively. All of the cases showed hyperkeratosis and proliferation of dermal collagen in their pathology. There was no recurrence over the last 4-years follow -up. We suggested that the etiology of coccygeal pad consists of congenital factors and chronic stimulation to the sacrococcygeal area. More research is necessary to elucidate this disease.
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小児再接着指における指骨の成長について : Phalangeal Index による検討 査読あり
森岡 康祐, 仲沢 弘明, 片平 次郎, 伊東 大, 菊池 雄二, 佐々木 健司, 野崎 幹弘
日本マイクロサージャリー学会会誌 = Journal of Japanese Society of Reconstructive Microsurgery 16 ( 4 ) 360 - 365 2003年12月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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森岡 康祐, 仲沢 弘明, 片桐 順和, 伊東 大, 岡垣 真寿美, 佐々木 健司, 野崎 幹弘
熱傷 28 ( 3 ) 199 - 206 2002年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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The use of temporary diverting colostomy to manage elderly individuals with extensive perineal burns
Nakazawa H., Ito H., Morioka K., Kikuchi Y., Honda T., Isago T.
Burns 28 ( 6 ) 595 - 599 2002年9月
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：Burns
The regimen of burn treatment for five elderly individuals who had sustained burns that had involved the perineum included formation of colostomy to divert fecal passage. The inclusion of diverting colostomy in this group of patients had made the management of burn wound that had included eventual skin grafting technically easy. A total of 168 patients were admitted to the Burn Unit at the Kagoshima City Hospital between 1997 and 2000. There were 36 patients who had perineal involvement. Of these, there were five elderly patients aged 60 years or older. There were two men and three women who were between 60 and 81 years of age. The mean age was 72 years. The total body surface involvement varied between 7 and 55% with an average body surface involvement of 30%. The sigmoid colon was as the colostomy site. Although, two patients died of injury, the morbidities associated with colostomy procedure were nil. © 2002 Elsevier Science Ltd and ISBI. All rights reserved.
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指間形成に対する局所皮弁の工夫 査読あり
伊東 大、仲沢弘明、森岡康祐
形成外科 2002年
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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森岡 康祐, 仲沢 弘明, 片桐 順和, 伊東 大, 岡垣 真寿美, 菊池 雄二, 佐々木 健司, 野崎 幹弘
日本マイクロサージャリー学会会誌 = Journal of Japanese Society of Reconstructive Microsurgery 14 ( 3 ) 179 - 189 2001年9月
記述言語：日本語 掲載種別：研究論文（学術雑誌）
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Medulloblastomaを合併したNevoid Basal Cell Carcinoma Syndromeの1例 査読あり
伊東 大, 仲沢 弘明, 森岡 康祐, 佐々木 健司, 野崎 幹弘
日形会誌 : 日本形成外科学会会誌 = Journal of Japan Society of Plastic and Reconstructive Surgery 21 ( 8 ) 506 - 511 2001年8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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小児の単純性血管腫の治療:-陰圧下レーザー照射による治療成績- 査読あり
権 成基, 野崎 幹弘, 佐々木 健司, 大久保 麗, 岡垣 真寿美, 伊東 大
日本レーザー医学会誌 16 ( 0 ) 311 - 314 1995年
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：日レ医誌
There are some reports from America that treatment of port wine stain in infants would result in more excellent response than adults. In fact, these reports say that 40 to 70% of patients younger than 7 years old would get almost 100% clearance. There appear, however, to be few papers that report such good results in Japan. This may be caused by difference between Caucasians and Japanese. So we should try new trials using Japanese port wine patients.<BR>We performed dye laser treatment using the negative pressure method on 100 cases of port stain. They received two or more treatment sessions and were evaluated by four levels of treatment response (excellent, good, fair, poor). Of the 19 patients who were younger than seven years old, 12 (63%) had excellent responses, and 6 (37%) had good responses (average number of treatment session was 3.2 times). Of the 12 patients who were from 7 to 12 years old, 2 (16,7%) had excellent responses, 6 (50.0%) had good responses (average number of treatment session was 3.9 times). Of the 16 patients who were from 13 to 18 years old, 4 (25.0%) had excellent responses, 10 (62.5%) good responses (average number of treatment session was 3.6 times). Of the 53 patients who were older than 19 years old, 15 (28.3%) had excellent responses, 26 (49.1%) had good responses (average number of treatment session was 3.1 times).<BR>What we are calling the negative pressure method is a procedure in which a laser ray is irradiated at the spot that is conditioned with the negative pressure (250-350 torr under the atmosphere pressure). This negative pressure, was realized by 'the negative pressure adapter,' that we made and attached to the handpiece of the dye laser apparatus. Suction on the small area of the surface of human skin makes its color more reddish than the color surrounding it. The mechanism of this phenomenon is aggregation of erythrocytes. We infer that ectasia of vessels, and congestion or stopping. of blood flow occurs in this area at the same time. This means an increase in the number of erythrocytes as targets of the laser rays in the vessels. Those vessels with smaller diameter, such as capillaries, usually include fewer erythrocytes. If port wine stain included such. small vessels, irradiation under negative pressure would cause more conspicuous agglutination of red blood cells, fibrin, and platelet thrombus in the vessels. In addition, our histological examination of port wine stain in the cheek showed dermis of children is thinner than adults and children's vessels of port wine stain are apt to be smaller in diameter. These might be the reasons why the negative pressure method is so effective in treating port wine stain of children.