Publications by authors named "Tatsuo Kuroda"
Purpose: This study aimed to investigate the current practices in the diagnosis and surgical management of anorectal malformations (ARMs) in female patients in Japan, specifically focusing on anovestibular fistula (AVF), rectovaginal fistula (RVF), and persistent cloaca (PC).
Methods: An anonymous online survey was conducted with 61 institutional members of the Japanese Study Group for Anorectal Anomalies.
Results: Sixty-one institutions (100%) completed the survey.
Article Synopsis
- A population pharmacokinetic analysis was performed on data from 215 Japanese subjects taking oral sirolimus, identifying factors that affect the drug's pharmacokinetics across different age groups, including neonates, infants, and adults.
- The study found that sirolimus levels increased with higher hemoglobin and that the granule form had significantly higher exposure than the tablet form, while certain drugs decreased its levels significantly.
- The PopPK model developed can help customize sirolimus dosing for individuals based on their age and body weight to ensure effective treatment within the proper concentration range.
Article Synopsis
- This study examines the diagnosis and treatment practices for rectourethral fistulas (RUF) in male patients with anorectal malformations (ARMs) in Japan, using a comprehensive questionnaire survey among medical institutions.
- Results show that laparoscopic-assisted anorectoplasty (LAARP) is favored for high-type ARMs, while posterior sagittal anorectoplasty (PSARP) is preferred for intermediate-type ARMs, highlighting differences in surgical techniques and tools used.
- The findings indicate distinct management strategies for RUF in PSARP and LAARP procedures, suggesting the need for more research on postoperative outcomes related to these varied approaches.
Article Synopsis
- This clinical trial aimed to assess the safety and effectiveness of a time-intensified treatment strategy for high-risk neuroblastoma, involving delayed local surgery following aggressive chemotherapy.
- Seventy-five patients were enrolled, with a 3-year progression-free survival rate of 44.4% and an overall survival rate of 80.7%, indicating a significant response to therapy without any deaths during treatment.
- However, there were high rates of adverse effects, with 48% experiencing severe complications and 25% facing major surgical issues, suggesting more research is needed to confirm findings and improve safety.
Article Synopsis
- Intractable lymphatic anomalies (LAs) include conditions like cystic lymphatic malformations and Gorham-Stout disease, which can cause severe symptoms, necessitating studies on potential treatments.
- A clinical trial conducted in Japan assessed the effectiveness of sirolimus, where 11 patients received daily doses and were monitored for changes in their conditions over 52 weeks.
- Results showed that 54.5% of patients experienced a partial response to treatment, with sirolimus proving to be safe and potentially improving symptoms and quality of life, although no complete responses were achieved.
Article Synopsis
- There is currently no standard diagnostic method or treatment for congenital isolated hypoganglionosis (CIHG), prompting a study to evaluate patient outcomes and surgical interventions over nearly three decades.
- Data from 19 patients were analyzed, focusing on surgical procedures like enterostomy types and the intestinal ratio (IR), with all patients requiring a diverting enterostomy.
- Results indicated that patients with Santulli-type and Bishop-Koop-type stomas had better growth outcomes and lower dependency on parenteral nutrition compared to those with end-stomas or tube-stomas, highlighting the need for tailored surgical approaches and possible intestinal transplantation for achieving enteral autonomy.
Aim: To evaluate the use of donor-derived cell-free DNA (dd-cfDNA) in diagnosing graft injuries in Japanese liver transplantation (LTx), including family-related living donors.
Methods: A total of 321 samples from 10 newly operated LTx recipients were collected to monitor the early dynamics of dd-cfDNA levels after LTx. Fifty-five samples from 55 recipients were collected during protocol biopsies (PB), whereas 36 samples from 27 recipients were collected during event biopsies, consisting of 11 biopsy-proven acute rejection (AR), 20 acute dysfunctions without rejection (ADWR), and 5 chronic rejections.
Article Synopsis
- The study aims to use the iBALF score, a marker of liver fibrosis from blood tests, to identify patients with biliary atresia (BA) who are likely to have poor outcomes after bile drainage surgery.
- An analysis of 380 BA patients showed that those with an iBALF score above 5.27 had significantly lower chances of surviving with their native liver after one year, with only 4.7% of these patients achieving native liver survival.
- The findings suggest that patients with a preoperative iBALF score over 5.27 may not benefit from bile drainage surgery and should be considered for primary liver transplantation instead.
Background: Patients with intestinal failure (IF) often present with abnormal body composition characterized by high fat mass. However, the distribution of fat and its association with the development of IF-associated liver disease (IFALD) remain unclear. This study aims to investigate the body composition and its relationship with IFALD in older children and adolescents with IF.
View Article and Find Full Text PDFArticle Synopsis
- * Researchers reviewed data from 89 patients and found that the in-hospital mortality rate after LT was 5.6%, with higher risks noted in patients aged 17 years and older and those who had two or more previous abdominal surgeries.
- * The findings highlight that age and the number of prior surgeries are significant risk factors for mortality following LT, suggesting these should be considered when planning future surgeries.
Potential benefit of rapid genetic testing for Pallister-Hall syndrome.
Clin Pediatr Endocrinol
February 2023
Pallister-Hall syndrome (PHS) is defined as a group of characteristic manifestations caused by a monoallelic pathogenic variant. A two-month-old infant was referred to our institution because of undetermined sex. The infant had atypical genitalia with postaxial polysyndactyly, a hypothalamic mass, and an imperforate anus.
View Article and Find Full Text PDFBiliary stricture is a serious postoperative complication of liver transplantation. We report the case of a 2-year-old boy with severe biliary anastomotic stricture after left lobe living donor liver transplantation. As cannulation from the occluded B3 into the jejunum was impossible using the conventional technique, a gunsight approach was utilized.
View Article and Find Full Text PDFBiliary complications after hepatectomy in living donors have yet to be eradicated. We hypothesized that a standardized upfront Glissonean approach and liver hanging maneuver (GH) would prevent mechanical and thermal injuries to the hilar plate of the remnant liver by determining the point of bile duct division and the final destination of hepatectomy preceding liver parenchymal transection (safety) and facilitate liver transection deep within the parenchyma and allow maximum length of hilar structures (rationality). GH was implemented in 2016 and its incidence of bile leakage was retrospectively compared against the conventional technique.
View Article and Find Full Text PDFPurpose: The application of slide tracheoplasty (STP) in the treatment of congenital tracheal stenosis (CTS) has improved patient outcomes over the past few decades. We reviewed our experiences with the procedure, elucidated risk factors, and discussed important aspects of perioperative management to improve outcomes.
Method: Patients with CTS undergoing STP between July 1998 and December 2020 were enrolled.
Background: 5-Aminolevulinic acid (ALA)-based photodynamic therapy (PDT) is widely used in cancer therapy because of the tumor-specific accumulation of photosensitizing protoporphyrin IX (PpIX). We aimed to assess the susceptibility of human neuroblastoma cell lines to ALA-PDT and determine the mechanism of PDT.
Methods: We used four human neuroblastoma cell lines (GOTO, NB9, IMR32, and NB1) and a gastric cancer cell line (MKN45) as a positive control.
Article Synopsis
- Erythropoietic protoporphyria (EPP) is a rare genetic disorder that can lead to liver failure, often requiring liver and bone marrow transplants due to protoporphyrin build-up.
- A 20-year-old man with EPP underwent a split liver transplant but faced complications from EPP relapse and serious bile leakage, leading to his death.
- The case emphasizes the need for early recognition of liver deterioration in EPP patients and careful post-transplant management to prevent severe complications.
Article Synopsis
- A retrospective study in Japan analyzed the effectiveness of allogeneic hematopoietic stem cell transplantation for recurrent neuroblastomas, focusing on patients who progressed after initial remission between 2003 and 2010.
- Data from 61 patients revealed that those who underwent allogeneic transplantation had significantly better progression-free survival (28.3%) and overall survival (24.3%) compared to those who didn’t (6.0% and 12.0%, respectively).
- Factors like the duration of initial remission and receiving allogeneic transplantation were important predictors of better progression-free survival outcomes.
BACKGROUND Infectious complications after solid organ transplantation can be fatal, and early diagnosis and intervention are important. To the best of our knowledge, no study has examined the diagnostic utility of presepsin, a known accurate biomarker, for infectious complications after liver transplantation. This study aimed to evaluate the utility of presepsin for detecting infection and perioperative kinetics of presepsin after liver transplantation.
View Article and Find Full Text PDFConsidering that some biliary atresia (BA) survivors with native liver have reached reproductive age and face long-lasting complications, specific attention needs to be paid to pregnant cases. This study aimed to investigate the relationship between liver function, perinatal outcomes, and prognosis. A database review was conducted to identify pregnant BA cases with native liver and perinatal data, and clinical information on BA-related complications was analyzed.
View Article and Find Full Text PDFBackground: Minimally invasive surgery (MIS) is appropriate for the treatment of some neuroblastomas (NBs); however, the indications and technical issues are unclear. This study aimed to clarify the current status of MIS for mediastinal NB in Japan.
Methods: Preliminary questionnaires requesting the numbers of neuroblastoma cases in which MIS was performed from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery.
Background: Evidence has been published on the successful applications of the anti-tumor necrosis factor alpha antibody infliximab, such as induction therapy, salvage treatment for acute cellular rejection, and treatment for chronic ulcerative inflammation, in intestinal transplant recipients. However, the optimal protocol for the effective use of infliximab remains largely undetermined due to scarcity of available clinical data. We report a continuative application of infliximab as maintenance therapy for recurrent chronic ulcerative ileitis in a recipient of isolated intestinal transplantation (ITx).
View Article and Find Full Text PDFBackground: Some neuroblastoma (NB) cases are suitable for minimally invasive surgery (MIS), but indication and technical issue are unclear. We assessed the current status of MIS for abdominal NB after mass screening period in Japan.
Methods: Preliminary questionnaires requesting the numbers of NB cases that underwent MIS from 2004 to 2016 were sent to 159 Japanese institutes of pediatric surgery.
Article Synopsis
- The study investigates the effectiveness of oral sodium phenylbutyrate (SPB) for treating hyperammonemia in infants with congenital portosystemic shunt (CPSS).
- A case of a 9-month-old patient shows that after starting SPB treatment, ammonia levels significantly decreased from dangerously high levels to acceptable ones over several days.
- By 12 months of age, the patient exhibited normal psychomotor development, suggesting that oral SPB could be a viable treatment option for managing hyperammonemia in this condition.
The occurrence of fetuses suspected of having ambiguous genitalia will likely increase in the future. Currently, the impact of prenatal genetic counseling on parents' understanding and psychological preparedness has not been addressed. We provided prenatal genetic counseling to parents of two fetuses suspected of ambiguous genitalia.
View Article and Find Full Text PDFIntroduction: Decellularized tissue exhibits cell matrix-like properties, along with reduced antigenicity. We explored the potential of decellularized allogeneic trachea to restore the upper respiratory tract, focusing on pediatric application. This study specifically aimed at long-term observation of tissue regeneration using a micro-miniature pig model.
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