詳細

冨田　興一 （トミタ　コウイチ）

  • 医学科　教授/主任
Last Updated :2024/04/25

コミュニケーション情報 byコメンテータガイド

  • コメント

    近畿大学病院形成外科では、これから乳がん手術を受けられる方はもちろん、すでに手術を終えられた方に対してもあらゆる乳房再建の選択肢を提供することができます。まずはお気軽に受診ください。

研究者情報

学位

  • 医学博士（大阪大学）

ホームページURL

科研費研究者番号

  • 90423178

J-Global ID

研究キーワード

  • 同種移植   シュワン細胞   マクロファージ   p21   p75NTR   皮弁知覚   nerve predegeneration   神経再生   遊走能   ミエリン化   坐骨神経   p75   再生医学   乳房再建   脂肪組織由来間葉系幹細胞   顔面神経再建   末梢神経再生   Facial nerve reconstruction   Peripheral nerve regeneration   

現在の研究分野（キーワード）

    近畿大学病院形成外科では、これから乳がん手術を受けられる方はもちろん、すでに手術を終えられた方に対してもあらゆる乳房再建の選択肢を提供することができます。まずはお気軽に受診ください。

研究分野

  • ライフサイエンス / 形成外科学 / 乳房再建
  • ライフサイエンス / 医療薬学
  • ライフサイエンス / 生理学
  • ライフサイエンス / 神経科学一般

経歴

  • 2023年04月 - 現在  近畿大学医学部 形成外科学講座教授
  • 2019年05月 - 2023年03月  大阪大学大学院医学系研究科器官制御外科学講座 形成外科准教授
  • 2014年 - 2019年04月  大阪大学大学院医学系研究科器官制御外科学講座 形成外科医学部内講師
  • 2011年09月  大阪大学大学院医学系研究科 器官制御外科学講座 形成外科助教
  • 2009年09月 - 2011年08月  マンチェスター大学 ブロンドマッキンドー研究所リサーチフェロー
  • 2007年10月 - 2009年08月  大阪大学大学院医学系研究科 器官制御外科学講座 形成外科助教
  • 2004年04月 - 2007年09月  大阪大学大学院医学系研究科 器官制御外科学講座 形成外科大学院博士課程
  • 2003年04月 - 2004年03月  大阪大学医学部附属病院 形成外科Hospital医員
  • 2001年04月 - 2003年03月  関西労災病院 形成外科医員
  • 2000年06月 - 2001年03月  大阪大学医学部附属病院Hospital研修医
  • 2000年03月  大阪大学医学部医学科 卒業Medical School, Faculty of Medicine

学歴

  • 2004年04月 - 2007年09月   大阪大学   大学院医学系研究科   器官制御外科学講座形成外科学
  •         - 2007年   大阪大学   Graduate School, Division of Medical Sciences   Plastic and reconstructive surgery

所属学協会

  • 日本ペインクリニック学会   アメリカ形成外科学会   日本手術手技学会   日本頭蓋顎顔面外科学会   日本創傷外科学会   日本乳癌学会   日本乳房オンコプラスティックサージャリー学会   再生医療学会   日本マイクロサージャリー学会   日本形成外科学会   

研究活動情報

論文

  • Three Case Reports of Adult-Onset Still’s Disease Associated with Breast Implantation
    Kosuke Maitani; Miki Kadowaki; Yuko Yamagiwa; Yumiko Yasuhara; Shino Kozuki; yohei Otsuka; Tateki Kubo; Koichi Tomita
    Plastic and Reconstructive Surgery Global Open in press 2024年07月 [査読有り]
  • 冨田 興一
    近畿大学医学雑誌 48 3-4 41 - 48 近畿大学医学会 2023年12月 [査読有り][招待有り]
     
    世界的に乳がん患者数は増加傾向にあるが，その一方で生存率も改善しており，治療後の生活の質が重要視されるようになってきた．乳房再建手術は，患者の乳房喪失による心理的苦痛を解消し，心理的回復を促す効果があるとされ，その重要性が増している．本邦では自家組織を用いた乳房再建が2006年に，人工乳房を用いた再建が2014年に保険収載され，乳がん手術後における乳房再建率は近年増加傾向にある．本稿では年々進化，多様化する乳房再建の現状について概説する．
  • Takehiko Sakai; Goro Kutomi; Tadahiko Shien; Sota Asaga; Tomoyuki Aruga; Makoto Ishitobi; Sayaka Kuba; Masataka Sawaki; Kaori Terata; Koichi Tomita; Chikako Yamauchi; Yutaka Yamamoto; Hiroji Iwata; Shigehira Saji
    Breast Cancer 31 1 1 - 7 2023年10月 [査読有り][招待有り]
  • Hydrogen-generating Si-based agent improves fat graft survival in rats
    Naoya Otani; Koichi Tomita; Yuki Kobayashi; Kazuya Kuroda; Hikaru Kobayashi; Tateki Kubo
    Plastic and Reconstructive Surgery in press 2023年10月 [査読有り]
  • Kazuya Kuroda; Koichiro Kiya; Shinsuke Matsuzaki; Hironori Takamura; Naoya Otani; Koichi Tomita; Kenichiro Kawai; Toshihiro Fujiwara; Kunihiro Nakai; Ayako Onishi; Taiichi Katayama; Tateki Kubo
    Experimental dermatology 32 11 2012 - 2022 2023年09月 
    The formation of hypertrophic scars and keloids is strongly associated with mechanical stimulation, and myofibroblasts are known to play a major role in abnormal scar formation. Wounds in patients with neurofibromatosis type 1 (NF1) become inconspicuous and lack the tendency to form abnormal scars. We hypothesized that there would be a unique response to mechanical stimulation and subsequent scar formation in NF1. To test this hypothesis, we investigated the molecular mechanisms of differentiation into myofibroblasts in NF1-derived fibroblasts and neurofibromin-depleted fibroblasts and examined actin dynamics, which is involved in fibroblast differentiation, with a focus on the pathway linking LIMK2/cofilin to actin dynamics. In normal fibroblasts, expression of α-smooth muscle actin (α-SMA), a marker of myofibroblasts, significantly increased after mechanical stimulation, whereas in NF1-derived and neurofibromin-depleted fibroblasts, α-SMA expression did not change. Phosphorylation of cofilin and subsequent actin polymerization did not increase in NF1-derived and neurofibromin-depleted fibroblasts after mechanical stimulation. Finally, in normal fibroblasts treated with Jasplakinolide, an actin stabilizer, α-SMA expression did not change after mechanical stimulation. Therefore, when neurofibromin was dysfunctional or depleted, subsequent actin polymerization did not occur in response to mechanical stimulation, which may have led to the unchanged expression of α-SMA. We believe this molecular pathway can be a potential therapeutic target for the treatment of abnormal scars.
  • Reconstruction of a spinal accessory nerve defect using vascularized vastus lateralis motor nerve graft: A Case report
    Shiori Yanagishita; Naoya Otani; Shien Seike; Koichi Tomita; Tateki Kubo
    Plastic and Reconstructive Surgery-Global Open in press 2023年09月 [査読有り]
  • Koichi Tomita; Mifue Taminato; Tateki Kubo
    Journal of Plastic, Reconstructive & Aesthetic Surgery 83 250 - 257 2023年08月 [査読有り]
  • 形成外科学界 未来予想図 Ⅲ神経₋1 知覚再建手術の未来
    冨田興一
    形成外科 66 増刊号 S42 - S45 2023年06月 [査読有り][招待有り]
  • 細川 亙; 冨田 興一
    形成外科 66 5 527 - 527 克誠堂出版(株) 2023年05月
  • 冨田 興一; 久保 盾貴
    形成外科 66 5 571 - 575 克誠堂出版(株) 2023年05月 [査読有り][招待有り]
  • 乳房温存オンコプラスティックサージャリー ステップアップガイド ―Volume replacement：ステップ2― 広背筋皮弁（latissimus dorsi musculocutaneous flap）による補填術
    冨田 興一; 矢野 健二; 田港 見布江; 久保 盾貴
    Oncoplastic Breast Surgery 8 1 51 - 59 2023年04月 [査読有り][招待有り]
  • Yusuke Shikano; Koichi Tomita; Naoya Otani; Kazuya Kuroda; Tateki Kubo
    Plastic and reconstructive surgery. Global open 11 3 e4835  2023年03月 [査読有り]
     
    Refractory axillary lymphorrhea is a postoperative complication of breast cancer with no established standard treatment. Recently, lymphaticovenular anastomosis (LVA) was used to treat not only lymphedema but also lymphorrhea and lymphocele in the inguinal and pelvic regions. However, only a few reports have been published on the treatment of axillary lymphatic leakage with LVA. This report presents a case of successful treatment of refractory axillary lymphorrhea after breast cancer surgery with LVA. A 68-year-old woman underwent nipple-sparing mastectomy for right breast cancer, axillary lymph node dissection, and immediate subpectoral tissue expander placement. Postoperatively, the patient developed refractory lymphorrhea and subsequent seroma around the tissue expander, and underwent postmastectomy radiation therapy and frequent percutaneous aspiration of the seroma. However, lymphatic leakage persisted, and surgical treatment was planned. Preoperative lymphoscintigraphy showed lymphatic outflow from the right axilla to the space around the tissue expander. There was no dermal backflow in the upper extremities. To reduce lymphatic flow into the axilla, LVA was performed at two sites in the right upper arm. The lymphatic vessels used for anastomosis were 0.35 mm and 0.50 mm in diameter, and each was anastomosed to the vein in an end-to-end fashion. The axillary lymphatic leakage stopped shortly after the operation, and there were no postoperative complications. LVA may be a safe and simple option for the treatment of axillary lymphorrhea.
  • Koichi Tomita; Tateki Kubo
    International Journal of Clinical Oncology 2023年02月 [査読有り][招待有り]
     
    Abstract Although the number of patients with breast cancer continues to rise worldwide, survival rates for these patients have significantly improved. As a result, breast cancer survivors are living longer, and quality of life after treatment is of increasing importance. Breast reconstruction is an important component that affects quality of life after breast cancer surgery. With the development of silicone gel implants in the 1960s, autologous tissue transfer in the 1970s, and tissue expanders in the 1980s, breast reconstruction has advanced over the decades. Furthermore, the advent of perforator flaps and introduction of fat grafting have rendered breast reconstruction a less invasive and more versatile procedure. This review provides an overview of recent advances in breast reconstruction techniques.
  • Yutaka Matsumura; Rei Watanabe; Hanako Koguchi-Yoshioka; Miki Kume; Shuichi Nakai; Junichi Furuta; Hiroaki Azukizawa; Yosuke Ishitsuka; Atsushi Tanemura; Mifue Taminato; Hiroki Tashima; Naoya Otani; Koichi Tomita; Tateki Kubo; Manabu Fujimoto
    Journal of Investigative Dermatology 143 6 1097 - 1100 2022年12月 [査読有り]
  • 私の乳房再建選択アルゴリズム : 当科における自家組織乳房再建術式
    冨田興一; 田港見布江; 久保盾貴
    形成外科 65 9 1017 - 1023 2022年09月 [査読有り][招待有り]
  • Ryota Nakamura; Koichi Tomita; Nanaho Omura; Eriko Nishimura; Kyuto Higashimoto; Tateki Kubo; Hisashi Hikasa
    Plastic and Reconstructive Surgery - Global Open 10 8 e4484 - e4484 2022年08月 [査読有り]
  • Naoya Otani; Koichi Tomita; Kazuya Kuroda; Mifue Taminato; Tateki Kubo
    Aesthetic Plastic Surgery 46 4 1942 - 1949 2022年08月 [査読有り]
  • Megumi Ishii; Hiroki Tashima; Koichi Tomita; Tomoyuki Kurita; Tateki Kubo
    Plastic and Reconstructive Surgery - Global Open 10 5 e4296 - e4296 2022年05月 [査読有り]
  • Naoya Otani; Koichi Tomita; Yuki Kobayashi; Kazuya Kuroda; Yoshihisa Koyama; Hikaru Kobayashi; Tateki Kubo
    Scientific Reports 12 1 6168 - 6168 2022年04月 [査読有り]
     
    Abstract Hydrogen is effective against ischemia–reperfusion (I/R) injury in skin flaps. However, the difficulty of continuously administering a sufficient amount of hydrogen using conventional methods has been an issue in the clinical application of hydrogen-based therapy. An Si-based agent administered orally was previously shown to continuously generate a large amount of hydrogen in the intestinal environment. In this study, we assessed the effect of the Si-based agent on the inhibition of I/R injury in skin flaps using a rat model. In the I/R groups, the vascular pedicle of the abdominal skin flap was occluded for three hours followed by reperfusion. In the I/R + Si group, the Si-based agent was administered perioperatively. After reperfusion, flap survival rate, blood flow, oxidative stress markers, inflammatory markers/findings, and degree of apoptosis were evaluated. Flap survival rate was significantly higher, and histological inflammation, apoptotic cells, oxidative stress markers, and levels of inflammatory cytokine mRNA and protein expression were significantly lower, in the I/R + Si group compared to the I/R group. The Si-based agent suppressed oxidative stress, apoptosis, and inflammatory reactions resulting from I/R injury, thereby contributing to improvements in skin flap survival.
  • Naoya Otani; Koichi Tomita; Mifue Taminato; Kazuya Kuroda; Kenji Yano; Tateki Kubo
    Annals of Plastic Surgery 88 4 e1 - e8 2022年04月 [査読有り]
     
    BACKGROUND: In breast reconstruction, both aesthetic outcomes and sensory function are important for postoperative quality of life. Innervated flaps are useful in reconstruction after conventional mastectomy (CM), which leaves a large portion of the skin paddle exposed on the body surface. However, whether they are also useful in skin-sparing mastectomy (SSM) and nipple-sparing mastectomy (NSM) remains unclear. This study aimed to examine the usefulness of innervated flaps in restoring sensation after SSM and NSM using a rat model. METHODS: Dorsal cutaneous nerves of rats were entirely eliminated except for the medial branch of the dorsal cutaneous nerve of thoracic segment 13, resulting in an innervated field surrounded by a denervated field. The innervated field was elevated as an innervated island flap and then subcutaneously embedded, with the skin paddle deepithelialized entirely (NSM group, n = 5) or except at the center (SSM group, n = 6). In the control model (CM group, n = 5), the flap was sutured back into its original position. Postoperative changes in the mechanonociceptive field were evaluated using the cutaneous trunci muscle reflex test. Immunohistochemical evaluation of regenerated nerves in the new mechanonociceptive field was performed at postoperative week 12. RESULTS: In the SSM and CM groups, the mechanonociceptive field expanded around the skin paddle. In the NSM group, a new mechanonociceptive field appeared at postoperative week 4 and expanded thereafter. Areas of the mechanonociceptive field at postoperative week 12 did not differ significantly between the SSM and NSM groups, but were significantly smaller compared with the CM group and comparable to original flap areas. Histologically, S100- and PGP9.5-positive nerve fibers were observed in the dermis of the new mechanonociceptive field and subcutaneous flap tissue. CONCLUSIONS: Subcutaneously embedded innervated island flaps induced nerve regeneration and sensory reinnervation of the denervated skin, suggesting that innervated flaps may also be useful in reconstruction post-SSM/NSM.
  • 冨田 興一; 田港 見布江; 矢野 健二; 久保 盾貴
    Pepars 183 146 - 153 2022年03月 [査読有り][招待有り]
  • 座波 久光; 淺野 裕子; 小川 朋子; 喜島 祐子; 佐武 利彦; 津川 浩一郎; 冨田 興一; 藤本 浩司
    Oncoplastic Breast Surgery 6 4 91 - 102 一般社団法人 日本乳房オンコプラスティックサージャリー学会 2021年12月 [査読有り]
     
    本邦に適したoncoplastic breast-conserving surgery (OPBCS) に関する手技習得のためのステップアップガイドの草案を提案したい。 OPBCSステップアップガイド : ①Basic OPBCS ; OPBCSに臨むにあたっての基本的心構え。OPBCSでは, 背景乳腺濃度や立位での形態の評価および写真撮影による評価も重要である。 ②Volume displacement ; ステップ1 ; 通常の温存術における乳腺内組織の剥離と移動に加え, 皮膚切開の工夫や乳頭乳輪の位置を調整することで, 乳頭の偏位・変形を予防することができる。 ステップ2 ; 乳房縮小術を基盤としたOPBCSを特徴づける手術群。 ③Volume replacement ; ステップ1 ; 乳房外の周辺組織をtransposition flapやadvancement flapのような局所弁として欠損部に充填する方法で, 小範囲の欠損部に使用される。 ステップ2 ; 広背筋皮弁, 穿通枝皮弁等を充填する方法で, 多くの組織量が得られ, 充填できる領域の自由度もステップ 1より高い。
  • 座波 久光; 淺野 裕子; 小川 朋子; 喜島 祐子; 佐武 利彦; 津川 浩一郎; 冨田 興一; 藤本 浩司
    Oncoplastic Breast Surgery 6 4 82 - 90 一般社団法人 日本乳房オンコプラスティックサージャリー学会 2021年12月 [査読有り]
  • Effectiveness of skin graft in the chest for post-burn cervical contractures
    Kosuke Maitani; Koichi Tomita; Mifue Taminato; Tateki Kubo
    Plastic and Reconstructive Surgery Global Open in press 2021年12月 [査読有り]
  • DIEP flapによる一次一期乳房再建後に生じた広範な乳房皮膚壊死に対し、対側乳房からの全層植皮を行った1例
    野守 美千子; 冨田 興一; 田港 見布江; 久保 盾貴
    日本形成外科学会会誌 41 11 685 - 685 (一社)日本形成外科学会 2021年11月
  • 脂肪注入を付加した側頭筋膜弁による外耳道癌切除後の再建
    鹿野 雄介; 田島 宏樹; 田港 見布江; 前田 大介; 清家 志円; 冨田 興一; 久保 盾貴
    日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 39回 120 - 120 (一社)日本頭蓋顎顔面外科学会 2021年11月
  • Kosuke Maitani; Koichi Tomita; Mifue Taminato; Tateki Kubo
    Plastic and Reconstructive Surgery - Global Open 9 10 e3887 - e3887 2021年10月 [査読有り]
  • 外骨腫が原因と考えられた右足背動脈損傷の症例
    田中 弘之; 清家 志円; 冨田 興一; 田島 宏樹; 前田 大介; 田港 見布江; 野守 美千子; 大郷 真理子; 高瀬 一葉; 久保 盾貴
    日本形成外科学会会誌 41 9 550 - 550 (一社)日本形成外科学会 2021年09月
  • Mifue Taminato; Koichi Tomita; Kenji Yano; Naoya Otani; Kazuya Kuroda; Tateki Kubo
    Journal of Plastic, Reconstructive & Aesthetic Surgery 74 9 2379 - 2386 2021年09月 [査読有り]
     
    BACKGROUND: No effective methods currently exist for breast neurotization in implant-based breast reconstruction. Here, we focused on direct neurotization (DN), in which axons regenerating from nerve stumps are directed to the mastectomy flap and aimed to assess whether DN can generate a new mechano-nociceptive field using a rat model of back skin sensory denervation. METHODS: Dorsal cutaneous nerves (DCNs) of rats were exposed and transected, leaving only the left medial branch of the DCN of thoracic segment 13 (mDCN-T13) intact. This procedure resulted in an isolated innervated field surrounded by a denervated field. The mDCN-T13 was transected, and the proximal nerve stump was sutured to the subdermis (DN subdermal group, n = 6) or dermis (DN dermal group, n = 5) of a different region of the denervated field. In the Crush group (n = 5), the intact mDCN-T13 was only crushed. We evaluated the generation of a new mechano-nociceptive field over time using the cutaneous trunci muscle (CTM) reflex test and histomorphometrically evaluated regenerating nerves in the reinnervated region. RESULTS: In the DN groups, the CTM reflex appeared in the DN area after postoperative week 4. The new mechano-nociceptive field gradually expanded afterwards, and by postoperative week 12, the area was substantially larger than the original region innervated by the mDCN-T13 in the DN dermal group, although not as large as that in the Crush group. In histomorphometric evaluations, many S100-positive myelinated fibers were observed in the dermis of the reinnervated area for all groups. CONCLUSION: In targeted sensory reinnervation, DN of the skin is revolutionary in that it allows a new innervated area to be generated at a desired location regardless of whether a distal nerve stump is available. DN may present an effective approach for breast neurotization in breast reconstruction after mastectomy, particularly for procedures that cannot use sensate flaps such as implant-based breast reconstruction.
  • T. Okada; M. Koseki; H. Kato; K. Tomita; K. Tanaka; J. Chang; H. Inui; K. Kanno; A. Saga; T. Ohama; T. Kujiraoka; H. Hattori; M. Nishida; S. Yamashita; Y. Sakata
    Atherosclerosis 331 e137 - e137 2021年08月 [査読有り]
  • 遊離深大腿動脈穿通枝(PAP)皮弁による乳房部分切除後再建
    冨田 興一; 田港 見布江; 田島 宏樹; 久保 盾貴
    日本乳癌学会総会プログラム抄録集 29回 12 - 12 (一社)日本乳癌学会 2021年07月
  • 脂肪注入併用広背筋皮弁による全乳房再建に対するPatientreported outcome
    田港 見布江; 冨田 興一; 久保 盾貴; 矢野 健二
    日本乳癌学会総会プログラム抄録集 29回 12 - 12 (一社)日本乳癌学会 2021年07月
  • 冨田 興一
    形成外科 64 13 S19 - S19 克誠堂出版(株) 2021年06月
  • Mifue Taminato; Koichi Tomita; Michiko Nomori; Daisuke Maeda; Shien Seike; Hiroki Tashima; Kenji Yano; Tateki Kubo
    Journal of Plastic, Reconstructive & Aesthetic Surgery 74 6 1213 - 1222 2021年06月 [査読有り]
     
    Immediate fat grafting to the latissimus dorsi myocutaneous (LD) flaps is a breakthrough that addresses the issue of insufficient volume of LD. However, the use of this procedure in Asian patients has not yet been reported. Retrospective chart reviews were conducted on 54 Japanese cases of total breast reconstruction using fat-augmented LD flaps at our hospital from September 2017 to June 2019. There were 24 immediate reconstruction cases, 18 immediate two-stage reconstruction cases, nine delayed reconstruction cases, and three delayed two-stage reconstruction cases. Median age was 46 years (range, 29-69 years), and median body mass index was 21.5 (17-33.8). Median mastectomy specimen and flap weight was 225 g (123-993) and 225 g (130-796), respectively. The median volume of fat graft was 114 ml (46-305) for the LD flap and 58 ml (15-200) for the pectoralis major muscle. Of the 53 completed reconstruction cases, 38 (71.7%) achieved sufficient volume with the initial operation and six (11.3%) required additional fat grafting. The proportion of cases in the immediate reconstruction group, which achieved sufficient volume in the initial operation was significantly higher than those of the other three reconstruction groups (p = 0.007). Total breast reconstruction with fat-augmented LD flaps is a viable procedure for thin patients who have insufficient abdominal tissue, for those who wish to avoid abdominal scars, and for those in whom abdominal flaps have already been used. The procedure allows for large volume transplantation even with small skin paddles, which allows for smaller skin paddles to be designed without the need for extensive subcutaneous dissection.
  • 進行癌における複数茎遊離空腸と深下腹壁動脈穿通枝皮弁の同時移植 複数茎遊離空腸のbridge flapとしての可能性
    榊 由華子; 田島 宏樹; 冨田 興一; 田港 見布江; 清家 志円; 野守 美千子; 久保 盾貴; 栗田 智之
    日本形成外科学会会誌 41 4 232 - 232 (一社)日本形成外科学会 2021年04月
  • 黒田 諒子; 清家 志円; 田原 紳一郎; 前田 大介; 田島 宏樹; 冨田 興一; 久保 盾貴
    創傷 12 2 74 - 77 (一社)日本創傷外科学会 2021年04月 
    症例は77歳男性で、左母指背側腫瘤を主訴とした。腫瘤は10年来認め、1ヵ月前より増大傾向で自壊し出血した。MRI所見で左母指背側皮下に42.4mm×27.3mm×18.3mm大の皮下腫瘤を認め、T1強調像で腫瘤辺縁が高～等信号、腫瘤主体が低信号、T2強調像で辺縁・主体とも高信号であった。皮膚自壊部分辺縁の生検の病理結果はpyogenic granulomaもしくはgranulation所見であった。局所麻酔下に腫瘤側壁の皮膚を温存して腫瘤を摘出した。病理所見は真皮と連続して線維性被膜に覆われた血腫であり、器質化血腫の像を呈し悪性所見は認めず、臨床経過と併せて標記の診断とした。術後5ヵ月で再発は認めていない。
  • 誘因なく手部に生じたChronic expanding hematomaの1例
    黒田 諒子; 清家 志円; 田原 紳一郎; 前田 大介; 田島 宏樹; 冨田 興一; 久保 盾貴
    創傷 12 2 74 - 77 (一社)日本創傷外科学会 2021年04月 [査読有り]
  • 冨田興一; 田港見布江; 矢野健二; 久保盾貴
    Pepars 172 58 - 62 全日本病院出版会 2021年04月 [査読有り][招待有り]
  • Kosuke Maitani; Makoto Yamasaki; Naoya Otani; Shien Seike; Koichi Tomita; Kotaro Yamashita; Koji Tanaka; Tomoki Makino; Yuichiro Doki; Tateki Kubo
    Esophagus 18 2 416 - 419 2021年04月 [査読有り]
     
    BACKGROUND: Malignant invasion of the respiratory tract is a common complication in advanced cases of esophageal carcinoma. Resection and reconstruction can be extremely challenging, particularly when the invasion is intrathoracic. A circumferential tracheal resection with direct tracheal closure or mediastinal tracheostomy is often performed, but the outcome is not always favorable, with high morbidity rates, loss of vocal function, and reduced quality of life. METHODS: We present our experience in performing an intrathoracic tracheal reconstruction in which a conchal cartilage graft was used in combination with a pectoralis major muscle transposition. RESULTS: This was successfully done following the noncircumferential resection of the intrathoracic trachea due to mural invasion by a metastatic lymph node of esophageal carcinoma. CONCLUSIONS: We believe this report will contribute to the growing body of clinical expertise on procedures for intrathoracic tracheal reconstruction.
  • Miki Kume; Eiji Kiyohara; Yutaka Matsumura; Hanako Koguchi-Yoshioka; Atsushi Tanemura; Yuma Hanaoka; Mifue Taminato; Hiroki Tashima; Koichi Tomita; Tateki Kubo; Rei Watanabe; Manabu Fujimoto
    Frontiers in Immunology 12 651048 - 651048 2021年03月 [査読有り]
     
    In cutaneous T-cell lymphoma (CTCL), which arises from skin-tropic memory T cells, malignant T cells and benign T cells are confined in the same skin lesions. It is thus difficult to evaluate the phenotypic characteristics and functional activities of benign T cells in CTCL. Disialoganglioside with three glycosyl groups (GD3) is increasingly expressed on the surface of solid malignant tumor cells and takes part in tumor progression and suppression of tumor immunity. However, the role of GD3 in CTCL is not well-understood. In this study, the malignant and benign T cells in CTCL skin lesions were distinguished by flow cytometry and their phenotypic characteristics were compared with those of T cells from control skin specimens. In CTCL skin lesions, the benign T cells included limited resident memory T cells (TRM), which are sessile in skin and known to exert strong antitumor function. The benign T cells showed diminished Th17 property, and the expression of GD3 was high in the malignant T cells. The expression of GD3 in the malignant T cells inversely correlated with IL-17A production from the benign CD4 T cells. GD3 from the malignant T cells was implied to be involved in suppressing the Th17 activity of the benign T cells independent of the regulation of TRM differentiation in CTCL. Revealing the role of GD3 in inhibiting the production of IL-17A in CTCL would aid the understanding of the suppressive mechanism of the antitumor activity by malignant tumor cells.
  • Hiroki Tashima; Koichi Tomita; Tomoyuki Kurita; Tateki Kubo
    Annals of Plastic Surgery 86 3 265 - 267 2021年03月 [査読有り]
  • Miho Saiga; Yuko Hosoya; Hiroki Utsunomiya; Yukiko Kuramoto; Satoko Watanabe; Koichi Tomita; Yukiko Aihara; Mayu Muto; Makoto Hikosaka; Takashi Kawaguchi; Tempei Miyaji; Takuhiro Yamaguchi; Sadamoto Zenda; Aya Goto; Minoru Sakuraba; Taro Kusano; Kenta Miyabe; Tomoaki Kuroki; Tomoyuki Yano; Mifue Taminato; Mitsuru Sekido; Yui Tsunoda; Toshihiko Satake; Hiroyoshi Doihara; Yoshihiro Kimata
    BMJ Open 11 2 e042099 - e042099 2021年02月 [査読有り]
     
    IntroductionThe aim of breast reconstruction (BR) is to improve patients’ health-related quality of life (HRQOL). Therefore, measuring patient-reported outcomes (PROs) would clarify the value and impact of BR on a patient’s life and thus would provide evidence-based information to help decision-making. The Satisfaction and Quality of Life After Immediate Breast Reconstruction study aimed to investigate satisfaction and HRQOL in Japanese patients with breast cancer who undergo immediate breast reconstruction (IBR). Methods and analysisThis ongoing prospective, observational multicentre study will assess 406 patients who had unilateral breast cancer and underwent mastectomy and IBR, and were recruited from April 2018 to July 2019. All participants were recruited from seven hospitals: Okayama University Hospital, Iwate Medical University Hospital, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Showa University Hospital, University of Tsukuba Hospital, Osaka University Hospital and Yokohama City University Medical Center. The patients will be followed up for 36 months postoperatively. The primary endpoint of this study will be the time-dependent changes in BREAST-Q satisfaction with breast subscale scores for 12 months after reconstructive surgery, which will be collected via an electronic PRO system. Ethics and disseminationThis study will be performed in accordance with the Ethical Guidelines for Medical and Health Research Involving Human Subjects published by Japan’s Ministry of Education, Science and Technology and the Ministry of Health, Labour and Welfare, the modified Act on the Protection of Personal Information and the Declaration of Helsinki. This study protocol was approved by the institutional ethics committee at the Okayama University Graduate School of Medicine, Dentistry, on 2 February 2018 (1801-039) and all other participating sites. The findings of this trial will be submitted to an international peer-reviewed journal. Trial registration numberUMIN000032177.
  • 冨田 興一; 久保 盾貴
    形成外科 64 1 22 - 25 克誠堂出版(株) 2021年01月 [査読有り][招待有り]
  • Yoshihiro Sowa; Tsunao Kishida; Koichi Tomita; Tetsuya Adachi; Toshiaki Numajiri; Osam Mazda
    Plastic and reconstructive surgery 146 6 826e-827e  2020年12月
  • Kosuke Maitani; Koichi Tomita; Hiroki Tashima; Michiko Nomori; Mifue Taminato; Tateki Kubo
    Plastic and Reconstructive Surgery - Global Open 8 12 e3299 - e3299 2020年12月 [査読有り]
     
    While the use of free flaps has become routine and is associated with a low complication rate, pedicled flaps remain a solid reconstructive option in various clinical situations. Pedicled flaps provide a reliable vascular supply and involve a simple surgical procedure. Although the procedure is advantageous from the standpoint of a low rate of flap ischemia, thrombosis, and total flap loss, these complications are still occasionally observed due to intraoperative pedicle injury, postoperative torsion, or compression. Here we report on a case of severe venous thrombosis in a pedicled latissimus dorsi (LD) flap used for breast reconstruction. The patient was a 52-year-old woman who underwent mastectomy and immediate breast reconstruction with a LD flap for left breast cancer. Postoperatively, the color of the skin paddle became dark blue over time. Emergent surgical exploration revealed kinking and narrowing of the thoracodorsal vessels and extensive venous thrombi. The kinked pedicles were repaired and selective thrombolytic therapy was performed. A thrombolytic agent was administered through the serratus anterior branch of the thoracodorsal artery in retrograde fashion while the thoracodorsal vessels were clamped just cephalad to the bifurcation. This allowed for draining of the thrombolytic agent and thrombi through the serratus anterior branch of the thoracodorsal vein without flowing into the systemic circulation. To the best of our knowledge, this is the first report of selective thrombolysis using a pedicle branch to treat venous thrombosis in a pedicled flap. If major vascular branches are available in a pedicled flap, selective thrombolytic therapy may be possible without disconnecting the pedicle, as in the present case.
  • 広背筋皮弁と腰動脈穿通枝皮弁のキメラ皮弁による乳房再建
    大谷 直矢; 田島 宏樹; 冨田 興一; 栗田 智之; 久保 盾貴
    日本マイクロサージャリー学会学術集会プログラム・抄録集 47回 165 - 165 (一社)日本マイクロサージャリー学会 2020年11月
  • 乳房再建術後の有茎広背筋皮弁に生じた静脈血栓に対し、ウロキナーゼの選択的動注により皮弁を救済した症例
    米谷 公佑; 田島 宏樹; 野守 美千子; 田港 見布江; 冨田 興一; 久保 盾貴
    日本マイクロサージャリー学会学術集会プログラム・抄録集 47回 166 - 166 (一社)日本マイクロサージャリー学会 2020年11月
  • 口唇の静脈奇形に対して行った15手術の検討
    清家 志円; 鹿野 雄介; 岡田 翠; 前田 大介; 田港 見布江; 田島 宏樹; 冨田 興一; 久保 盾貴
    日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 38回 113 - 113 (一社)日本頭蓋顎顔面外科学会 2020年11月
  • 側頭頭頂筋膜を用いた外耳道癌切除後の再建
    鹿野 雄介; 清家 志円; 岡田 翠; 田港 見布江; 前田 大介; 田島 宏樹; 冨田 興一; 久保 盾貴
    日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 38回 116 - 116 (一社)日本頭蓋顎顔面外科学会 2020年11月
  • Naoya Otani; Hiroki Tashima; Koichi Tomita; Tomoyuki Kurita; Tateki Kubo
    Plastic and Reconstructive Surgery - Global Open 8 11 e3222 - e3222 2020年11月 [査読有り]
     
    Latissimus dorsi (LD) flaps are widely used in breast reconstruction for their ease of use and minimal sacrifice of the donor site. Various strategies to increase flap volume have been suggested, but tissue volume is often insufficient for patients with little subcutaneous fat. While lumbar artery perforator (LAP) flaps are advantageous for thin patients because they allow for the addition of a large amount of fat, the vascular pedicle is short and vascular grafts are often required. To address these shortcomings, we propose here a LD-LAP chimeric flap. Specifically, the LD flap and LAP flap are elevated as one piece, and the 6th or 7th intercostal artery perforators and lumbar artery perforators, which are harvested together with the flap, are connected via intra-flap crossover anastomosis. Anastomosis for both intercostal artery perforators and lumbar artery perforators was performed about 1 cm away from the flap. Indocyanine green angiography performed after anastomosis showed improved blood flow to the LAP flap portion of the chimeric flap. The chimeric flap was used in 4 patients, with a mean flap volume of 460 ml (range, 300-690 ml) and mean duration of 439 minutes (393-484 minutes) for reconstruction surgery. During the mean follow-up period of 29.5 months (range, 16-40 months), sufficient tissue volume was obtained and none of the patients developed flap necrosis. Although our method requires vascular anastomosis and may extend operative time, it substantially increases LD flap volume and thus is likely to be an effective auxiliary component to breast reconstruction using LD flaps.
  • 当院における両側乳癌再建症例の検討 同時性両側乳癌と異時性両側乳癌における傾向
    野守 美千子; 冨田 興一; 田港 見布江; 矢野 健二; 久保 盾貴
    日本乳癌学会総会プログラム抄録集 28回 56 - 56 (一社)日本乳癌学会 2020年10月
  • シリコン乳房インプラント合併症により自家組織への転換を行った症例の検討
    田港 見布江; 冨田 興一; 野守 美千子; 矢野 健二; 久保 盾貴
    日本乳癌学会総会プログラム抄録集 28回 87 - 87 (一社)日本乳癌学会 2020年10月
  • ノットレス縫合デバイスを用いた対側乳房下溝形成
    冨田 興一; 田港 見布江; 野守 美千子; 久保 盾貴; 矢野 健二
    日本形成外科学会会誌 40 8 438 - 438 (一社)日本形成外科学会 2020年08月
  • Michiko Nomori; Koichi Tomita; Mifue Taminato; Kenji Yano; Tateki Kubo
    Plastic and Reconstructive Surgery - Global Open 8 7 e3022 - e3022 2020年07月 [査読有り]
  • Koichi Tomita; Mifue Taminato; Michiko Nomori; Daisuke Maeda; Shien Seike; Hiroki Tashima; Kenji Yano; Tateki Kubo
    Plastic and Reconstructive Surgery - Global Open 8 6 e2930 - e2930 2020年06月 [査読有り]
     
    BACKGROUND: In the typical procedure for secondary correction of the inframammary fold (IMF) following breast reconstruction, a large incision is often required, and this increases surgical invasiveness. The "drawstring method" is a simple procedure for recreating a smooth IMF. We modified the drawstring method and developed an essentially scarless method for IMF correction from small stab incisions. METHODS: Patients at our hospital who presented with IMF ptosis or loss of definition after breast reconstruction and required IMF correction, as well as those who requested IMF recreation for the contralateral breast, during the period spanning May 2016 to June 2019 were considered for this study. We collected and analyzed demographic data, as well as complications and postoperative outcomes. RESULTS: The new method was performed on 20 patients, with the following breakdown: IMF recreation after breast reconstruction with a deep inferior epigastric artery perforator flap (11 patients), IMF recreation after breast reconstruction with a breast implant (2 patients), IMF recreation after breast reconstruction with fat graft (5 patients), and IMF recreation for the contralateral breast (2 patients). Overcorrection of the IMF stabilized by 2-3 months postoperatively, resulting in a smooth and well-defined IMF. For non-breast implant cases, the implant volume increased at the lower pole. Slack in the suture was observed in only 2 patients of the deep inferior epigastric artery perforator group and in 1 patient of the breast implant group after 6 months postoperatively. CONCLUSIONS: Our new method allows for the recreation of an essentially scarless, smooth, and well-defined IMF. IMF definition can be adjusted by altering the depth of the barbed suture. Since this method can be performed under local anesthesia, it offers the benefits of reducing medical costs and physical burden on patients.
  • Daisuke Maeda; Koichi Tomita; Mifue Taminato; Kenji Yano; Tateki Kubo
    International Journal of Surgical Wound Care 1 3 130 - 132 2020年 [査読有り]
  • 冨田 興一; 田港 見布江; 野守 美千子; 矢野 健二; 久保 盾貴
    形成外科 63 1 45 - 52 克誠堂出版(株) 2020年01月 [査読有り][招待有り]
  • Sowa Y; Kishida T; Tomita K; Adachi T; Numajiri T; Mazda O
    Plastic and reconstructive surgery 144 6 1025e - 1036e 2019年12月 [査読有り]
     
    BACKGROUND: Platelet-rich plasma contains high concentrations of growth factors that stimulate proliferation and migration of various cell types. Earlier experiments demonstrated that local platelet-rich plasma administration activates Schwann cells to improve axonal regeneration at a transected peripheral nerve lesion. However, the optimal concentration of human platelet-rich plasma for activation of human Schwann cells has not been determined, and mechanisms by which platelet-rich plasma activates Schwann cells remain to be clarified. METHODS: Human Schwann cells were cultured with various concentrations of platelet-rich plasma in 5% fetal bovine serum/Dulbecco's Modified Eagle Medium. Cell viability, microchemotaxis, flow cytometry, and quantitative real-time polymerase chain reaction assays were performed to assess proliferation, migration, cell cycle, and neurotrophic factor expression of the human Schwann cells, respectively. Human Schwann cells were co-cultured with neuronal cells to assess their capacity to induce neurite extension. Neutralizing antibodies for platelet-derived growth factor-BB (PDGF-BB) and insulin-like growth factor-1 (IGF-1) were added to the culture to estimate contribution of these cytokines to human Schwann cell stimulation by platelet-rich plasma. RESULTS: An addition of platelet-rich plasma at 5% strongly elevated proliferation, migration, and neurotrophic factor production of human Schwann cells. Both PDGF-BB and IGF-1 may be involved in mitogenic effect of platelet-rich plasma on human Schwann cells, and PDGF-BB may also play an important role in the migration-inducing effect of platelet-rich plasma. Neutralization of both PDGF-BB and IGF-1 cancelled the promoting effect of platelet-rich plasma on neurite-inducing activity of human Schwann cells. CONCLUSION: This study may suggest the optimal concentration of platelet-rich plasma for human Schwann cell stimulation and potential mechanisms underlying the activation of human Schwann cells by platelet-rich plasma, which may be quite useful for platelet-rich plasma therapy for peripheral nerve regeneration. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.
  • Tanaka Y; Seike S; Tomita K; Ikeda JI; Morii E; Isomura ET; Kubo T
    Journal of surgical case reports 2019 12 rjz375  2019年12月 [査読有り]
     
    AbstractAngiosarcoma is a rare malignant tumour, which accounts for 1–2% of all malignant soft-tissue tumours. Most cases of angiosarcoma arise spontaneously, and malignant transformation of vascular malformation to angiosarcoma is extremely rare. We describe the case of a 70-year-old woman with a massive arteriovenous malformation in her shoulder, which gradually enlarged, despite repeated surgeries and radiation therapy over 53 years. She also presented with rapidly growing haemorrhagic masses in her oral cavity. Excision biopsy was performed, and the pathohistological diagnosis was angiosarcoma. Positron emission tomography–computed tomography revealed high fluorodeoxyglucose accumulation in the oral cavity and right shoulder, the latter of which was consistent with the location of the arteriovenous malformation. The masses in the oral cavity were diagnosed as metastatic angiosarcoma from the right shoulder, where the massive arteriovenous malformation was suspected to have malignantly transformed. This report describes a possible case of malignant transformation of arteriovenous malformation to angiosarcoma.
  • 経験 経括約筋的アプローチによる直腸膣瘻・直腸膀胱瘻の治療経験
    竹村 文吾; 木矢 孝一郎; 大郷 真理子; 冨田 興一; 久保 盾貴; 石井 愛; 藤山 浩; 細川 亙
    形成外科 62 9 1017 - 1022 2019年09月 [査読有り][招待有り]
  • エキスパンダー感染からのリカバリー (特集 人工物による乳房再建のリカバリー)
    田港 見布江; 冨田 興一; 矢野 健二; 久保 盾貴
    形成外科 62 8 837 - 846 2019年08月 [査読有り][招待有り]
  • 脂肪注入術の生着率を向上させる方法(3)皮弁移植との併用 (特集 脂肪注入術の現況)
    會沢 勇亮; 冨田 興一; 田港 見布江; 矢野 健二; 細川 亙
    形成外科 62 5 497 - 503 2019年05月 [査読有り][招待有り]
  • 田港 見布江; 冨田 興一; 矢野 健二; 細川 亙
    Oncoplastic Breast Surgery 3 1-2 12 - 18 (一社)日本乳房オンコプラスティックサージャリー学会 2018年09月 [査読有り][招待有り]
     
    人工物を用いた乳房再建では、一度感染を生じると再手術や抜去につながる可能性も高く、さらには最終的な整容面にも影響を及ぼす可能性がある。人工物再建後感染における危険因子として、喫煙、肥満、糖尿病、大きな乳房サイズ、放射線療法、化学療法、乳房切除皮膚の壊死、再建時期などが挙げられる。感染の危険度が高い患者に対しては、自家組織再建を含めた適切な術式の選択、十分なインフォームドコンセントおよび術前計画が重要であると考えられた。
  • Tateki Kubo; Shien Seike; Koichiro Kiya; Koichi Tomita; Ko Hosokawa
    Plastic and reconstructive surgery. Global open 6 8 e1889  2018年08月 [査読有り]
     
    Background: Although there have been many reports on the success of free jejunal flap transfer for pharyngoesophageal reconstruction, reports on salvage procedures for failed transfers remain sparse. In this report, we retrospectively reviewed our salvage procedures for failed jejunal transfers and previous articles describing salvage treatment in failed jejunal flap cases. Methods: This report includes 6 cases of failed jejunal flap transfer, leading to necessary salvage surgery. We reviewed all cases to examine salvage procedures and early postoperative complications such as fistula formation. We also assessed postoperative late complications and swallowing function during long-term follow-up. A review of the literature was performed via PubMed. Results: Rejejunal transfer was performed successfully in 3 of 6 cases. Gastric pull-up reconstruction was adopted in 2 cases. In 1 case, an external stoma was created because of the patient's poor medical condition. All 3 cases of rejejunal transfer and 1 gastric pull-up case recovered to resuming a normal diet. However, 1 gastric pull-up case required supplemental feeding with a jejunostomy tube. We reviewed 6 articles describing salvage treatment in failed jejunal flap cases. Conclusion: When free jejunal transfer fails, rejejunal transfer is optimal. However, in cases that lack suitable recipient vessels or have infection, a second jejunal transfer should not be considered. In such cases, gastric pull-up or colon interposition may be an alternative because they do not require vascular anastomosis. Pedicled pectoralis major flap is also an alternative, although the risk of salivary fistulas is very high.
  • Akimitsu Nishibayashi; Koichi Tomita; Mifue Taminato; Kenji Yano; Ko Hosokawa
    Plastic and reconstructive surgery. Global open 6 8 e1890  2018年08月 [査読有り]
     
    Background: We previously reported that good surgical outcomes can be obtained with breast mold made by 3-dimensional printing. However, detailed breast shape is often difficult to create. Accordingly, we aimed to determine whether transplanting a flap and bioabsorbable mold in vivo would yield better results by retaining the flap shape inside the mold during the scar formation period. Methods: Vascularized adipose flaps were elevated in the bilateral inguinal region of male Sprague-Dawley rats (n = 7). A cone-shaped, bioabsorbable mold (LactoSorb mesh) was created using a template. On the experimental side, the flap was inserted into the mold and fixed. On the control side, a conical flap was created using absorbable sutures, based on a template. Results: The flaps were harvested 3 months postoperatively, and flap volume, base area, and projection were measured with 3-dimensional imaging. Volume and base area on the mold side tended to be smaller than those on the control side (P = 0.18 and 0.13, respectively) and close to the values of the template. In addition, the ratio of projection and base area value was significantly greater on the mold side than on the control side (P = 0.04). Histology revealed little inflammatory cell invasion, and scar tissue thickness around the flap showed no significant difference between the 2 groups (P = 0.76). Conclusions: This study demonstrated that soft-tissue morphology can be controlled to some extent with a bioabsorbable mold. Its clinical application in breast reconstruction requires further investigation.
  • 心血管疾患における再生医療・細胞治療 重症家族性高コレステロール血症に対する再生医療の臨床応用
    冠野 昂太郎; 小関 正博; 嵯峨 礼美; 岡田 健志; 朝治 真澄; 冨田 興一; 大須賀 慶悟; 江副 幸子; 西田 誠; 坂田 泰史; 山下 静也
    日本動脈硬化学会総会プログラム・抄録集 50回 153 - 153 (一社)日本動脈硬化学会 2018年06月
  • 【わかりやすい感覚器疾患】 感覚器と感覚器疾患のトピックス 再生医療 触覚
    冨田 興一; 細川 亙
    日本医師会雑誌 147 特別1 S319 - S319 日本医師会 2018年06月 [招待有り]
  • Naoya Otani; Koichi Tomita; Mifue Taminato; Kenji Yano; Ko Hosokawa
    Plastic and reconstructive surgery. Global open 6 4 e1702  2018年04月 [査読有り]
     
    Supplemental Digital Content is available in the text.
  • 木矢 孝一郎; 久保 盾貴; 冨田 興一; 清家 志円; 細川 亙
    形成外科 61 2 145 - 155 克誠堂出版 2018年02月 [査読有り][招待有り]
  • 下垂乳房症例における自家組織による2期乳房再建3Dイメージングを用いた治療戦略
    野守 美千子; 冨田 興一; 細川 亙; 矢野 健二
    日本形成外科学会会誌 37 11 666 - 666 (一社)日本形成外科学会 2017年11月
  • Shoko Yasuda; Koichi Tomita; Koichiro Kiya; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 5 11 e1572  2017年11月 [査読有り]
  • 冨田 興一; 矢野 健二; 細川 亙
    形成外科 60 10 1134 - 1142 克誠堂出版 2017年10月 [招待有り]
  • 家族性高コレステロール血症に対する再生医療・細胞治療の臨床応用
    小関 正博; 嵯峨 礼美; 岡田 健志; 冠野 昂太郎; 冨田 興一; 大須賀 慶吾; 江副 幸子; 西田 誠; 坂田 泰史; 山下 静也
    日本動脈硬化学会総会プログラム・抄録集 49回 291 - 291 (一社)日本動脈硬化学会 2017年06月
  • 冨田 興一; 矢野 健二; 細川 亙
    Pepars 125 57 - 63 全日本病院出版会 2017年05月 [査読有り][招待有り]
     
    乳房温存術では大部分の乳腺組織が温存されるため、乳房の質感や知覚に優れる。一方で、切除部位・量や乳房形態によっては術後に大きな変形をきたすことがある。術後の乳房変形を最小限とするため、これまで様々なoncoplastic surgeryが報告されている。体格的に日本人は組織充填法の適応となり易く、中でも広背筋皮弁はその手技の簡便さと豊富な血流から、乳房温存術後における有力な再建法と言える。本稿では広背筋皮弁を用いた組織充填法について、その適応、手術法、および2次再建例や組織不足例における工夫について述べる。(著者抄録)
  • Yoshihiro Sowa; Tsunao Kishida; Koichi Tomita; Kenta Yamamoto; Toshiaki Numajiri; Osam Mazda
    STEM CELLS TRANSLATIONAL MEDICINE 6 4 1207 - 1216 2017年04月 [査読有り]
     
    Schwann cells (SCs) play pivotal roles in the maintenance and regeneration of the peripheral nervous system. Although transplantation of SCs enhances repair of experimentally damaged peripheral and central nerve tissues, it is difficult to prepare a sufficient number of functional SCs for transplantation therapy without causing adverse events for the donor. Here, we generated functional SCs by somatic cell reprogramming procedures and demonstrated their capability to promote peripheral nerve regeneration. Normal human fibroblasts were phenotypically converted into SCs by transducing SOX10 and Krox20 genes followed by culturing for 10 days resulting in approximately 43% directly converted Schwann cells (dSCs). The dSCs expressed SC-specific proteins, secreted neurotrophic factors, and induced neuronal cells to extend neurites. The dSCs also displayed myelin-forming capability both in vitro and in vivo. Moreover, transplantation of the dSCs into the transected sciatic nerve in mice resulted in significantly accelerated regeneration of the nerve and in improved motor function at a level comparable to that with transplantation of the SCs obtained from a peripheral nerve. The dSCs induced by our procedure may be applicable for novel regeneration therapy for not only peripheral nerve injury but also for central nerve damage and for neurodegenerative disorders related to SC dysfunction.
  • Toshihiro Saito; Koichi Tomita; Daisuke Maeda; Ko Hosokawa; Kenji Yano
    Archives of Plastic Surgery 44 2 173 - 174 2017年03月 [査読有り]
  • Koichi Tomita; Kenji Yano; Mifue Taminato; Michiko Nomori; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 5 10 e1511  2017年 [査読有り]
     
    Background: Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. In the present study, these technologies were applied to the reconstruction of breasts with ptosis. Methods: Eight breast cancer patients with ptotic breasts underwent two-stage unilateral DIEP flap breast reconstruction. In the initial surgery, tissue expander (TE) placement and contralateral mastopexy are performed simultaneously. Four to six months later, 3D bilateral breast imaging is performed after confirming that the shape of the contralateral breast (post-mastopexy) is somewhat stabilized, and a 3D-printed breast mold is created based on the mirror image of the shape of the contralateral breast acquired using analytical software. Then, DIEP flap surgery is performed, where the breast mold is used to determine the required flap volume and to shape the breast mound. Results: All flaps were engrafted without any major perioperative complications during both the initial and DIEP flap surgeries. Objective assessment of cosmetic outcome revealed that good breast symmetry was achieved in all cases. Conclusions: The method described here may allow even inexperienced surgeons to achieve reconstruction of symmetrical, non-ptotic breasts with ease and in a short time. While the requirement of two surgeries is a potential disadvantage, our method will be particularly useful in cases involving TEs, i.e., delayed reconstruction or immediate reconstruction involving significant skin resection.
  • Mifue Taminato; Koichi Tomita; Kenji Yano; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 5 10 e1535  2017年 [査読有り]
     
    Infectious complications represent one of the most prominent factors contributing to tissue expander (TE) loss in breast reconstruction procedures. Several patient characteristics that increase the risk for surgical-site infection or TE infection have been reported, but no study has focused on the relationship between atopic dermatitis (AD) and TE infection or surgical-site infection. Recently, we investigated 203 cases of breast reconstruction surgeries performed using TEs and noted that all 3 patients who had AD developed infectious complications that ultimately led to TE removal. Considering its pathophysiology, it is likely that patients with AD relatively easily develop infectious complications due to barrier dysfunction, abnormalities in innate immune responses, or colony formation by Staphylococcus aureus. Particular caution should be exercised for breast reconstruction using man-made materials in cases complicated by AD.
  • 西林 章光; 冨田 興一; 杉尾 勇太; 細川 亙; 矢野 健二
    Oncoplastic Breast Surgery 1 2 59 - 63 (一社)日本乳房オンコプラスティックサージャリー学会 2016年12月 [査読有り]
     
    ティッシュ・エキスンパンダー(TE)を用いて2期的乳房再建を行った150例(160乳房)を対象として、感染例の検討、感染に影響する因子の解析を行った。対象は1次再建87例(93乳房)、2次再建62例(67乳房)、左右異時再建1例(2乳房)で、鼻咽腔MRSA保菌者は8例(9乳房)であった。全150例(160乳房)において術後にTE感染を認めたのは8例(9乳房)で、うち1次再建例は5例(6乳房)、2次再建例は3例(3乳房)であった。感染8例(9乳房)中、入れ替えを要したのは5例(6乳房)で、うち2例(2乳房)が最終的にTE抜去となった。危険因子解析では、肥満、腋窩郭清および鼻咽腔MRSA保菌が有意に術後TE感染を増加させる因子であることが示唆された。一方、年齢、乳癌術式、再建時期、術前・術後放射線照射、TE挿入位置、術中TE拡張量は術後TE感染に有意な影響を及ぼす因子ではなかった。
  • Sugio Y; Tomita K; Hosokawa K
    Plastic and reconstructive surgery. Global open 4 11 e1128  2016年11月 [査読有り]
  • 冨田 興一; 矢野 健二; 波多 祐紀; 西林 章光; 細川 亙
    形成外科 59 10 1093 - 1099 克誠堂出版 2016年10月 [査読有り][招待有り]
  • Akimitsu Nishibayashi; Koichi Tomita; Koichiro Kiya; Kenji Yano; Ko Hosokawa
    NEUROREPORT 27 15 1134 - 1139 2016年10月 [査読有り]
     
    The loss of nociceptive function in the skin because of trauma or surgery can impair the quality of life. The recovery of nociceptor function is mediated by two different axonal responses: nerve growth factor (NGF)-dependent collateral sprouting of undamaged nerves and NGF-independent regeneration of damaged nerves. We reported previously that adipose-derived stem cells (ASCs) can transdifferentiate into Schwann cell (SC)-like cells (dASCs) and that transplantation of dASCs increases axonal density in skin flaps. In the present study, we used an animal model that allowed for the individual assessment of collateral sprouting and regeneration. In-vitro differentiation of ASCs to dASCs significantly increased the production of NGF and brain-derived neurotrophic factor (BDNF) to levels comparable with SCs. In-vivo experiments showed that dASC and SC transplantation significantly increased the area of the mechano-nociceptive field in both collateral sprouting and regeneration models, whereas ASC transplantation exerted no significant effect. Antibody blocking experiment showed that these effects of dASC transplantation in the regeneration model were partly mediated by BDNF. Interestingly, the final areas of nociceptive fields between the two experimental models did not differ significantly for any treatment condition. These results indicate that dASC transplantation differentially facilitates collateral sprouting and axonal regeneration by delivering NGF and other neurotrophic factors (e.g. BDNF), respectively. Although there is a limit to nociceptive field enlargement irrespective of axonal response, dASC transplantation could present a new approach for improving nociceptive function in denervated skin.
  • Nishibayashi A; Tomita K; Sugio Y; Hosokawa K; Yano K
    Plastic and reconstructive surgery. Global open 4 10 e1076  2016年10月 [査読有り]
  • Koichi Tomita; Kenji Yano; Akimitsu Nishibayashi; Shien Seike; Ko Hosokawa
    SPRINGERPLUS 5 1 1656  2016年09月 [査読有り]
     
    Background: When the inframammary fold (IMF) is excised in mastectomy procedures for oncologic reasons, it must be recreated to restore a natural breast shape. Despite refinements in surgical techniques, postoperative loss of a well-defined IMF can occur. This study aimed to assess the outcomes of IMF recreation after two-stage, implant-based breast reconstruction. Methods: We retrospectively reviewed 75 consecutive patients who underwent unilateral, two-stage, implant-based breast reconstruction between 2013 and 2015 at the authors' institution. Among them, IMF recreation was performed in 37 patients through a modified Nava's internal method. Aesthetic outcomes of the recreated IMFs were evaluated by observer assessment of two criteria, and critical factors affecting IMF outcomes were also analyzed. Results: We found that contralateral breast ptosis (p < 0.05) and lack of postmastectomy radiotherapy (PMRT, p < 0.01) were significant predictors of better IMF outcomes. Nipple-sparing mastectomy and skin-sparing mastectomy resulted in better IMF outcomes, as compared with non-skin-sparing mastectomy (p < 0.05 for each), while no significant difference was observed between them in patients who did not undergo PMRT (p = 0.19). Similarly, larger implant volume, but not projection of implant, was a predictor of better IMF outcomes when limited to patients who did not undergo PMRT (p < 0.05). Age, body mass index, timing of reconstruction, and extent of overexpansion had no significant effect on IMF outcomes. Conclusions: Based on these critical factors, the shape of the reconstructed breast and the need for reshaping the contralateral breast can be predicted. Special attention should be paid to patients with non-skin-sparing mastectomy and PMRT. When these patients desire a medium-to large-sized ptotic breast, conversion to autologous reconstruction can achieve symmetrical breast reconstruction.
  • 杉尾 勇太; 細川 亙; 冨田 興一
    形成外科 59 1 5 - 11 克誠堂出版 2016年01月 [招待有り]
  • 冨田 興一; 矢野 健二
    医学のあゆみ 255 4 271 - 275 医歯薬出版 2015年10月 [査読有り][招待有り]
     
    マイクロサージャリー技術の進歩により、筋肉を犠牲にせず、ドナー部位への侵襲が非常に小さい穿通枝皮弁が普及してきた。乳房再建においても、下腹部の皮下脂肪を深下腹壁動脈穿通枝皮弁(DIEP flap)として欠損部へ移植する方法が標準術式のひとつとなっている。また、乳癌手術後に一定の期間を経て施行される二次乳房再建では、乳房皮膚の不足を他部位の皮膚で補うのではなく、ティッシュ・エキスパンダー(TE)を用いて残存皮膚を拡張することで、色調・質感に優れた乳房を再建することができる。本稿では、DIEP flapとTEを用いた二次乳房再建法について、著者らの最近の工夫を交えて述べる。(著者抄録)
  • 冨田 興一; 高田 章好; 矢野 健二
    形成外科 58 増刊 S102 - S111 克誠堂出版(株) 2015年09月 [査読有り][招待有り]
  • Koichi Tomita; Akimitsu Nishibayashi; Kenji Yano; Ko Hosokawa
    MICROSURGERY 35 6 474 - 480 2015年09月 [査読有り]
     
    Background: One of the major problems with nerve grafts is that the survival of a graft segment, including endoneurial Schwann cells (SCs), is uncertain. We investigated whether the survival of nerve grafts is improved when adipose-derived stem cells (ASCs) are incorporated into the grafts. Methods: To examine the cell-protective effects of ASCs on SCs in vitro, we used an indirect coculture system. In vivo effects of the incorporation of ASCs into grafts were examined using a graft model in the rat common peroneal nerve. Grafts were entubulated to isolate them from the surrounding tissues, mimicking the clinical conditions of a poorly vascularized recipient bed. Thirty-six Lewis rats were divided into three groups, i.e., nerve graft only, entubulated nerve graft, and entubulated nerve graft+ASC transplantation. In each group, four rats and eight rats were used for short-term (10 days) and long-term (12 weeks) follow-up study, respectively. Results: After 24 hours of serum deprivation, the numbers of 7-aminoactinomycin D, and TUNEL-positive SCs significantly decreased when indirectly cocultured with ASCs (P<0.01). When ASCs were transplanted to the epineurial layer of the grafts, the number of endoneurial TUNEL-positive cells decreased significantly, as compared with grafts without ASCs, at 10 days postoperatively (P<0.05). Postoperative walking track analysis showed that the ASC-transplanted grafts showed significantly faster function recovery, as compared with grafts without ASCs (P<0.05). Conclusion: These results suggest that nerve autografts+ASC therapy could offer a new approach to obtaining optimal outcomes after peripheral nerve injury. (C) 2015 Wiley Periodicals, Inc.
  • Ken Matsuda; Tateki Kubo; Megumi Fukai; Mamoru Kikuchi; Hisashi Hikasa; Yoriko Nakajima; Koichi Tomita; Minoru Shibata; Ko Hosokawa
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 68 7 973 - 978 2015年07月 [査読有り]
     
    Local flaps and composite grafting are the procedures of choice for reconstructing relatively small soft tissue defects. However, despite their limited conveyable volume, local flaps sometimes require a wide dissection area and long new incisions. Composite grafts also have serious limitations and require a well-vascularized recipient bed. To overcome these limitations, we used a free vascularized perivascular tissue flap based on the descending branch of the lateral femoral circumflex artery. Using this method, we performed reconstructions for seven patients (four cases in head and neck region and three cases in lower limb) with various soft tissue defects (ranged from 4.0 cm(3) to 40.0 cm(3)). This flap was easily elevated, without the need for precise preoperative flap design, and the flap volume was adjustable regardless of whether deep fascia and muscle were included. The flap has a rich vascular supply, which allows bone and cartilage tissue to be combined with the transfer of soft tissue, and satisfactorily treats chronic wounds with poor blood supply. (C) 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • 冨田 興一; 矢野 健二
    形成外科 58 6 609 - 616 克誠堂出版 2015年06月 [査読有り][招待有り]
  • 冨田 興一
    上原記念生命科学財団研究報告集 29 1 - 6 上原記念生命科学財団 2015年 [招待有り]
  • Nishibayashi A; Hata Y; Hori Y; Tomita K; Matsuda K; Yano K; Hosokawa K
    Eplasty 15 ic34  2015年 [査読有り]
  • Ken Matsuda; Koichi Tomita; Megumi Fukai; Tateki Kubo; Akiteru Hayashi; Minoru Shibata; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 3 6 e407  2015年 [査読有り]
     
    The free groin flap results in less donor-site morbidity than other skin flaps and is suitable for use in children and adolescents. However, the vascular pedicle is relatively short and vessel diameter is small, which makes vascular anastomosis technically difficult. To overcome this limitation, we harvested vein and arterial grafts from the flap elevation area without placing additional skin incisions. Use of short (2–3 cm) vein/arterial grafts greatly simplified flap insetting and vascular anastomosis. This procedure may expand the indications for free groin flap transfer.
  • Koichi Tomita; Kenji Yano; Akimitsu Nishibayashi; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 3 6 e432  2015年 [査読有り]
     
    In autologous breast reconstruction, skin envelope reconstruction is especially important given the flexibility of new breast parenchyma. Our experience suggests a better control of breast shape with subcutaneous tissue expander (TE) placement compared with submuscular TE placement. We speculate that capsule formation might be different in subcutaneous TE placement compared with submuscular TE placement. To elucidate this hypothesis, we collected capsules formed around the TE in two-stage breast reconstruction patients and evaluated differences in histology and capsule wall thickness between subcutaneous (n = 7) and submuscular (n = 8) TE placement. Our findings show that subcutaneous TE placement results in thinner capsule formation with low vascularity when compared with submuscular TE placement (354 ± 96 μm and 589 ± 92 μm, respectively P < 0.001). Because thin connective tissue can reduce postoperative shrinkage of the skin envelope, it would be beneficial to predict and control the shape of reconstructed breast. Although further study is needed, differences in vascularity between subcutaneous tissue and muscle might affect the thickness of capsules.
  • Koichi Tomita; Megumi Yokoi-Fukai; Takayoshi Ishihara; Kosuke Morita; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 3 6 e433  2015年 [査読有り]
  • Koichi Tomita; Akimitsu Nishibayashi; Kenji Yano; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 3 10 e544  2015年 [査読有り]
     
    Radical parotidectomy often results in complex facial nerve defects involving the main nerve trunk and multiple distal nerve branches. Although cable nerve grafting often leads to good nerve regeneration, severe synkinesis due to aberrant axonal regrowth is inevitable. In such situations, the use of 2 motor sources to differentially reanimate the upper and lower face could minimize synkinesis. Here we describe a method of total facial nerve reconstruction in which the upper and lower face are differentially reconstructed with the hypoglossal nerve and facial nerve, respectively, using 2 interpositional nerve grafts. Reconstruction of the lower face with the facial nerve restored voluntary and coordinated animation, and reconstruction of the upper face with the hypoglossal nerve restored frontalis muscle tone and eye closure. These results suggest that our method could serve as an alternative to conventional techniques that use only the facial or hypoglossal nerve.
  • Koichi Tomita; Kenji Yano; Yuki Hata; Akimitsu Nishibayashi; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 3 3 e316  2015年 [査読有り]
     
    Recent advances in 3-dimensional (3D) surface imaging technologies allow for digital quantification of complex breast tissue. We performed 11 unilateral breast reconstructions with deep inferior epigastric artery perforator (DIEP) flaps (5 immediate, 6 delayed) using 3D surface imaging for easier surgery planning and 3D-printed molds for shaping the breast neoparenchyma. A single- or double-pedicle flap was preoperatively planned according to the estimated tissue volume required and estimated total flap volume. The DIEP flap was then intraoperatively shaped with a 3D-printed mold that was based on a horizontally inverted shape of the contralateral breast. Cosmetic outcomes were assessed as satisfactory, as confirmed by the postoperative 3D measurements of bilateral breasts. We believe that DIEP flap reconstruction assisted with 3D surface imaging and a 3D-printed mold is a simple and quick method for rebuilding a symmetric breast.
  • Hata Y; Osuga K; Uehara S; Yano K; Kikuchi M; Tomita K; Matsuda K; Kubo T; Fujiwara T; Hosokawa K
    Plastic and reconstructive surgery. Global open 2 9 e207  2014年09月 [査読有り]
  • Hata Y; Osuga K; Kubo T; Matsuda K; Tomita K; Kikuchi M; Fujiwara T; Yano K; Hosokawa K
    Plastic and reconstructive surgery. Global open 2 8 e205  2014年08月 [査読有り]
  • Ryoko Ichibori; Takashi Fujiwara; Tomoko Tanigawa; Shigeyuki Kanazawa; Kenta Shingaki; Kosuke Torii; Koichi Tomita; Kenji Yano; Yasuo Sakai; Ko Hosokawa
    JOURNAL OF COSMETIC DERMATOLOGY 13 2 158 - 163 2014年06月 [査読有り]
     
    Twin studies, especially those involving monozygotic (MZ) twins, facilitate the analysis of factors affecting skin aging while controlling for age, gender, and genetic susceptibility. The purpose of this study was to objectively assess various features of facial skin and analyze the effects of environmental factors on these features in MZ twins. At the Osaka Twin Research Center, 67 pairs of MZ twins underwent medical interviews and photographic assessments, using the VISIA (R) Complexion Analysis System. First, the average scores of the right and left cheek skin spots, wrinkles, pores, texture, and erythema were calculated; the differences between the scores were then compared in each pair of twins. Next, using the results of medical interviews and VISIA data, we investigated the effects of environmental factors on skin aging. The data were analyzed using Pearson's correlation coefficient test and the Wilcoxon signed-rank test. The intrapair differences in facial texture scores significantly increased as the age of the twins increased (P=0.03). Among the twin pairs who provided answers to the questions regarding history differences in medical interviews, the twins who smoked or did not use skin protection showed significantly higher facial texture or wrinkle scores compared with the twins not exposed to cigarettes or protectants (P=0.04 and 0.03, respectively). The study demonstrated that skin aging among Japanese MZ twins, especially in terms of facial texture, was significantly influenced by environmental factors. In addition, smoking and skin protectant use were important environmental factors influencing skin aging.
  • 藤原 貴史; 矢野 健二; 丹治 芳郎; 金澤 成行; 冨田 興一; 細川 亙
    創傷 5 2 70 - 76 (一社)日本創傷外科学会 2014年04月 [査読有り]
     
    皮下乳腺全摘後の乳房再建を広背筋皮弁で行う場合,再建乳房のボリューム不足を経験することがあるが,これは,再建ボリュームの過不足の判断が術者の裁量に委ねられてきたことによる。そこでわれわれは,乳癌切除量と広背筋皮弁採取量を術前に予測し,両者を照合することによって客観的に再建ボリュームの過不足を判断している。それぞれの予測式として,乳癌切除体積(ml)=0.229×[切除範囲面積(cm2)×患側乳房projection(cm)]+51.351,広背筋皮弁重量(g)=13.50×body mass index(kg/m2)+1.67×皮島面積(cm2)-163.26という回帰式が得られた。広背筋皮弁重量/乳癌切除体積の値が1.8〜2.0であれば,乳房の再建ボリュームは最適であろうと考えられた。以上により,皮下乳腺全摘後の広背筋皮弁再建における再建ボリュームの過不足を客観的に予測判断することができる。(著者抄録)
  • Tomoko Tanigawa; Shigeyuki Kanazawa; Ryoko Ichibori; Takashi Fujiwara; Takuya Magome; Kenta Shingaki; Shingo Miyata; Yuki Hata; Koichi Tomita; Ken Matsuda; Tateki Kubo; Masaya Tohyama; Kenji Yano; Ko Hosokawa
    BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 14 133  2014年04月 [査読有り]
     
    Background: Oxidative stress has been suggested as a mechanism underlying skin aging, as it triggers apoptosis in various cell types, including fibroblasts, which play important roles in the preservation of healthy, youthful skin. Catechins, which are antioxidants contained in green tea, exert various actions such as anti-inflammatory, anti-bacterial, and anti-cancer actions. In this study, we investigated the effect of (+)-catechin on apoptosis induced by oxidative stress in fibroblasts. Methods: Fibroblasts (NIH3T3) under oxidative stress induced by hydrogen peroxide (0.1 mM) were treated with either vehicle or (+)-catechin (0-100 mu M). The effect of (+)-catechin on cell viability, apoptosis, phosphorylation of c-Jun terminal kinases (JNK) and p38, and activation of caspase-3 in fibroblasts under oxidative stress were evaluated. Results: Hydrogen peroxide induced apoptotic cell death in fibroblasts, accompanied by induction of phosphorylation of JNK and p38 and activation of caspase-3. Pretreatment of the fibroblasts with (+)-catechin inhibited hydrogen peroxide-induced apoptosis and reduced phosphorylation of JNK and p38 and activation of caspase-3. Conclusion: (+)-Catechin protects against oxidative stress-induced cell death in fibroblasts, possibly by inhibiting phosphorylation of p38 and JNK. These results suggest that (+)-catechin has potential as a therapeutic agent for the prevention of skin aging.
  • Y. Imagawa; K. Tomita; K. Kitahara; K. Yano; K. Hosokawa
    Hernia 18 4 587 - 590 2014年 [査読有り]
     
    Purpose: Surgical repair of symptomatic perineal hernia is challenging, especially via a perineal approach with limited exposure of the hernia sac. Furthermore, insecure fixation of autologous or synthetic materials to bony structures often results in recurrence. Here, we describe the application of a titanium mesh for perineal hernia repair. Methods: We performed hernia repair with a thin titanium mesh via a perineal approach in three patients who developed secondary perineal hernia following abdominoperineal resection. After the hernia sac was isolated and dissected, the titanium mesh was molded and placed over the ischium and coccyx to support the pelvic floor. Results: No major complications occurred, and all three patients were free of recurrence at follow-up after 73, 109, and 6 months, respectively. The patients experienced slight pain in the perineal region when sitting, which resolved within 6 months. Conclusion: Our successful preliminary results indicate that a titanium mesh is useful for perineal hernia repair by the perineal approach, as it can provide rigid support for the pelvic floor by its entire surface while ensuring stability without any fixation. © 2013 Springer-Verlag.
  • Hiroki Tashima; Masakazu Fujikawa; Ken Izumi; Ken Matsuda; Koichi Tomita; Ko Hosokawa
    Eplasty 14 e9  2014年 [査読有り]
  • Koichi Tomita; Kenji Yano; Yuta Sugio; Takayoshi Ishihara; Akimitsu Nishibayashi; Ken Matsuda; Ko Hosokawa
    Plastic and Reconstructive Surgery - Global Open 2 10 e231  2014年 [査読有り]
     
    Corrective surgery following breast-conserving surgery is generally challenging due to severe fibrosis induced by postoperative radiotherapy. Although use of the latissimus dorsi myocutaneous flap offers a safe and reliable option, exposure of the skin paddle to the skin surface is often inevitable to achieve correction of nipple-areola complex malposition, leaving conspicuous, patchwork-like scars on the breast. In this report, we describe a 2-stage procedure using a subcutaneous tissue expander and the latissimus dorsi myocutaneous flap for the correction of both nipple-areola complex malposition and breast volume without skin paddle exposure. Although careful observation is necessary during skin expansion, this technique could offer an alternative option for patients undergoing corrective surgery following breast-conserving surgery.
  • Ken Izumi; Masakazu Fujikawa; Hiroki Tashima; Takuya Saito; Yohei Sotsuka; Koichi Tomita; Ko Hosokawa
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 66 11 1528 - 1533 2013年11月 [査読有り]
     
    Recent advances in perforator flap surgical techniques have allowed for safe and reliable autologous tissue transfer with minimal donor-site morbidity. Between April 2012 and January 2013, we performed immediate breast reconstruction using free medial circumflex femoral artery perforator (MCFAP) flaps in 15 patients after breast-conserving surgery. The flaps were harvested from patients in the lithotomy position, while a second surgical team simultaneously conducted tumour resection. Of the 15 procedures performed, three flaps were dissected as true perforator flaps, while 12 flaps were dissected as muscle-sparing perforator flaps. The mean flap weight was 138.5 g (range, 77-230 g) and the mean pedicle length was 5.7 cm (range, 3.0-9.0 cm). Recipient vessels for anastomosis were serratus branches in 10 patients, internal mammary vessels in three patients and thoracodorsal vessels in two patients. The mean duration of surgery was 6.74 h (range, 5.65-9.45 h). There were no major complications requiring surgical intervention. Researchers observed partial flap necrosis, which manifested as small firm lesions in two patients, as well as local wound infection and dehiscence in one patient, which resolved spontaneously. There were no instances of donor-site seroma formation or lymphoedema in any of the patients. An objective assessment of postoperative photographs showed that cosmetic results were mostly satisfactory. Donor-site scars along the medial groin crease were inconspicuous and readily concealed by clothing. Given its reliable vascularity and minimal donor-site morbidity, the free MCFAP flap can be a good alternative for partial breast reconstruction after breast-conserving surgery. (c) 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Koichi Tomita; Akimitsu Nishibayashi; Kenji Yano; Ko Hosokawa
    Plastic and Reconstructive Surgery 1 3 e22  2013年06月 [査読有り]
     
    Background: Sensory recovery of skin flaps is generally poor unless they are elevated as an innervated flap. The aim of this study was to elucidate if Schwann cell (SC)-like cells differentiated from adipose-derived stem cells (ASCs) could improve the cutaneous nerve regeneration in skin flaps. Methods: Microvascular island groin flaps were elevated bilaterally in 32 Lewis rats. On the right flap, the epigastric nerve was resected and ligated (noninnervated flap), and on the left flap, the nerve was crushed (innervated flap). ASCs, SC-like cells differentiated from ASCs (dASCs), SCs, or vehicle were simultaneously injected to the dermal and hypodermal layers of flap. After 20 weeks, the reinnervation pattern of flap was assessed im-munohistochemically using a neuronal marker, PGP9.5. Results: dASC cultures produced significantly higher amount of nerve growth factor and brain-derived neurotrophic factor compared with ASC cultures (P < 0.01), and the level was comparable to that of SC cultures. Although a long-term survival of the transplanted cells was not found, dASCs and SCs significantly increased reinnervation density in the periphery of both types of flaps (P < 0.05), and this effect was more pronounced in noninnervated flaps. On the other hand, ASC transplantation showed no statistically significant effect on the peripheral reinnervation (P > 0.05). In the center of flap, there was no statistically significant increase in reinnervation density in all groups irrespective of flap innervation (P > 0.05). Conclusions: dASCs could improve flap reinnervation by 2 mechanisms: First, neurotrophic factors produced by dASCs facilitated regrowth of cutaneous axons from the surroundings of flap. Second, nerve growth factor released by dASCs induced the collateral sprouting of undamaged axons in adjacent tissues. In addition to the use of innervated flaps, dASC transplantation therapy could be a new approach to improve the sensory recovery of skin flaps.
  • 横見 明典; 種村 篤; 田中 文; 谷 守; 片山 一朗; 金澤 成行; 波多 祐紀; 菊池 守; 冨田 興一; 細川 亙
    Skin Cancer 28 1 63 - 67 (一社)日本皮膚悪性腫瘍学会 2013年06月 [査読有り]
     
    大阪大学にて2000年から2011年に乳房外Paget病と診断された69例を対象とした疫学的検討を行った。経過観察期間は1〜72ヵ月(平均観察期間35ヵ月)、初診時年齢は49〜97歳、平均年齢は72.4歳、男女比は2.5:1であった。発生部位は外陰部63例、肛門周囲4例、腋窩2例であった。病期分類は皮膚悪性腫瘍取扱いガイドラインに準じて行った。病期IAは38例、病期IBは17例、病期IIは3例、病期IIIは3例、病期IVは8例であった。治療は手術が60例、化学療法が9例、放射線療法が5例であった(重複あり)。5年生存率は病期I、II、IIIが100%、病期IVが0%であった。(著者抄録)
  • K. Tomita; T. Madura; Y. Sakai; K. Yano; G. Terenghi; K. Hosokawa
    NEUROSCIENCE 236 55 - 65 2013年04月 [査読有り]
     
    Increasing evidence has shown that adipose-derived stem cells (ASCs) could transdifferentiate into Schwann cell (SC)-like cells to enhance nerve regeneration, suggesting potential new cell-based transplantation therapy for peripheral nerve injuries and neurodegenerative disorders. For the implementation of these results to the clinical setting, it is of great importance to establish the differentiation of human ASCs (hASCs) into a Sc phenotype. In this study, we studied hASCs obtained from subcutaneous fat tissue of healthy donors. By a mixture of glial growth factors we differentiated them into Schwann cell-like cells (dhASCs). We then assessed their ability to act as Schwann cells in vitro and in vivo and also compared them with primary human Schwann cells (hSCs). Enzyme-linked immunosorbent assay showed that dhASCs secreted brain-derived neurotrophic factor (BDNF)/nerve growth factor (NGF) at a comparable level, and glial cell-derived neurotrophic factor (GDNF) at a level even higher than hSCs, whereas undifferentiated hASCs (uhASCs) secreted low levels of these neurotrophic factors. In co-culture with NG108-15 neuronal cells we found that both dhASCs and hSCs significantly increased the percentage of cells with neurites, the neurite length, and the number of neurites per neuron, whereas uhASCs increased only the percentage of cells with neurites. Finally, we transplanted green fluorescent protein (GFP)-labeled hASCs into the crushed tibial nerve of athymic nude rats. The transplanted hASCs showed a close association with PGP9.5-positive axons and myelin basic protein (MBP)-positive myelin at 8 weeks after transplantation. Quantitative analysis revealed that dhASCs transplantation resulted in significantly improved survival and myelin formation rates (a 7-fold and a 10-fold increase, respectively) as compared with uhASCs transplantation. These findings suggest that hASCs took part in supporting and myelinating regenerating axons, and thus have achieved full glial differentiation in vivo. In conclusion, hASCs can differentiate into SC-like cells that possess a potent capacity to secrete neurotrophic factors as well as to form myelin in vivo. These findings make hASCs an interesting prospect for cell-based transplantation therapy for various peripheral nerve disorders. (C) 2013 IBRO. Published by Elsevier Ltd. All rights reserved.
  • Akimitsu Nishibayashi; Koichi Tomita; Kenji Yano; Ko Hosokawa
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 66 2 E53 - E55 2013年02月 [査読有り]
  • Tomita K; Yano K; Nishibayashi A; Fukai M; Miyasaka M; Hosokawa K
    Eplasty 13 e28  2013年 [査読有り]
  • Koichi Tomita; Tomas Madura; Cristina Mantovani; Giorgio Terenghi
    JOURNAL OF NEUROSCIENCE RESEARCH 90 7 1392 - 1402 2012年07月 [査読有り]
     
    Transplantation of autologous Schwann cells (SCs) is a promising approach for treating various peripheral nerve disorders, including chronic denervation. However, given their drawbacks, such as invasive biopsy and lengthy culture in vitro, alternative cell sources would be needed. Adipose-derived stem cells (ASCs) are a candidate, and in this study rat ASCs transdifferentiated into a SC phenotype (dASC) cocultured with dorsal root ganglion neurons were shown to associate with neurites and to express myelin basic protein (MBP)-positive myelin protein. Furthermore, dASCs transplanted into a chronically denervated rat common peroneal nerve survived for at least for 10 weeks, maintaining their differentiated state. Immunohistochemical analysis revealed that transplanted dASCs associated with regenerating axons, forming MBP-/protein zero-positive myelin sheaths. The cell survival and myelin expression assessed by double labelling with S100 and glial fibrillary acidic protein were similar between the dASC- and SC-transplanted nerves. Importantly, transplantation of dASCs resulted in dramatically improved motor functional recovery and nerve regeneration, with a level comparable to, or even superior to, transplantation of SCs. In conclusion, dASCs are capable of myelinating axons in vivo and enhancing functional outcome after chronic denervation. (c) 2012 Wiley Periodicals, Inc.
  • Tomas Madura; Koichi Tomita; Giorgio Terenghi
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 64 12 1641 - 1646 2011年12月 [査読有り]
     
    Background: Activation of the Small GTP-binding protein Rho following the nerve injury contributes to the lack of regeneration in the peripheral nervous system. By elucidating the mechanisms leading to Rho activation, a nonsteroidal anti-inflammatory drug ibuprofen has been identified as a potent inhibitor of Rho activity. In this study we tested the hypothesis, that inhibiting Rho activity by ibuprofen will enhance posttraumatic regeneration after peripheral nerve injury. Methods: In adult female Wistar rats we introduced an experimental injury by excising a 5 mm piece of the tibial nerve and returning it to the injury site as an interpositional graft. The animals then received ibuprofen or phosphate buffered saline through an osmotic pump for a period of 3 weeks. Following the injury we recorded tibial functional index (TFI) on a weekly basis. After 3 months we measured nerve conduction velocity and peak amplitude of action potential (PAAP). Also, the histomorphometric analysis was carried out in the zone distal to the injury site. Results: We found that the animals receiving ibuprofen recovered the tibial nerve function more rapidly, with the TFI being significantly different 8, 9, 11 and 12 weeks after the injury. We also detected the values of the PAAP, the area of axons and the area of myelin to be significantly greater in the experimental group. Conclusions: Our results show that ibuprofen significantly enhanced regeneration after tibial nerve axotomy and repair in rats. This study is expected to set a stage for testing the ibuprofen in the human patients. (C) 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Koichi Tomita; Giorgio Terenghi; Tomas Madura
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 64 11 1546 - 1548 2011年11月 [査読有り]
  • Koichi Tomita; Kenji Yano; Ko Hosokawa
    ANNALS OF PLASTIC SURGERY 66 4 334 - 338 2011年04月 [査読有り]
     
    In breast reconstruction, sensation in the reconstructed breasts affects the patients' quality of life along with its aesthetic outcome. Fortunately, less invasive procedures such as breast-conservative surgery (BCS) and skin-sparing mastectomy (SSM) have greatly contributed to the improved aesthetic outcome in immediate breast reconstruction. However, there are few reports on the recovery of breast sensation after BCS and SSM. We retrospectively reviewed 104 consecutive patients who underwent immediate breast reconstruction with the latissimus dorsi myocutaneous flap between 2001 and 2006 at our institution. The sensations of pain, temperature, touch, and vibration were examined at the nipple and skin envelope during the follow-up period (range: 12-61 months, mean: 31 months), and a stratified analysis was performed to determine the critical factors affecting the sensation recovery after BCS and SSM. We found that large breast size significantly impaired the recovery of sensation in the nipple and skin envelope after BCS as well as SSM. Older age and high body mass index value were the factors which negatively affected the sensation in the skin envelope after SSM. While all our BCS patients underwent postoperative radiation therapy, it did not negatively affect the recovery of sensation in SSM patients. On the basis of these findings, we could further improve the sensation of the reconstructed breasts after BCS and SSM. Especially after SSM, the use of innervated flaps is recommended in the patients with large breast, increased age, or obesity when the nipple-areola complex is resected.
  • Nishioka M; Tanemura A; Yamanaka T; Umegaki N; Tani M; Katayama I; Takemasa I; Sekimoto M; Tomita K; Tamai N
    Journal of skin cancer 2011 213406  2011年 [査読有り]
  • 冨田 興一; 久保 盾貴; 松田 健; 藤原 敏宏; 波多 祐紀; 矢野 健二; 細川 亙
    日本マイクロサージャリー学会会誌 23 3 303 - 310 (一社)日本マイクロサージャリー学会 2010年09月 [査読有り]
     
    神経端側縫合を応用した自家神経バイパスグラフト(BG)の有用性を検討するため、ラット神経腫モデルを用いて実験を行った。実験群は総腓骨神経を単純切除後即時縫合した群(対照群)、神経腫モデル作成と同時にBG施行した群(即時BG群)、モデル作成後3週間目にBG施行した群(二期的BG群)、モデル作成のみBGなし群(非BG群)とした。足跡分析によるperoneal functional index(PFI)は、全群で術後低下を認めたが、対照群および即時BG群は徐々に増加して5週目以降に、二期的BG群は8週目以降に非BG群と比較して有意に高値となった。10週目においては対照群、即時BG群、二期的BG群の間でPFIに有意差はなく、運動神経伝達速度、脛骨筋重量の回復にも有意差はなかった。神経短軸方向切片のトルイジンブルー染色による形態学的評価では、BG内にミエリン化した再生軸索を認め、全軸索数は二期的BG群で、軸索密度は即時BG群および二期的BG群で他群に比較して有意に高値であった。
  • Koichi Tomita; Ko Hosokawa; Kenji Yano
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 63 6 E535 - E539 2010年06月 [査読有り]
     
    In treating reversible facial paralysis, cross-facial nerve grafting offers voluntary and emotional reanimation. In contrast, rapid re-innervation and strong neural stimulation can be obtained with hypoglossal-facial nerve crossover. In this article, we describe the method of a combination of these techniques as a one-stage procedure. A 39-year-old man presented with facial paralysis due to nerve avulsion within the stylomastoid foramen. The sural nerve was harvested and two branches were created at its distal end by intraneural dissection. One branch was anastomosed to the contralateral facial nerve, and the other branch was used for hypoglossal-facial nerve crossover, followed by connecting the proximal stump of the graft to the trunk of the paralysed facial nerve in an end-to-end fashion. At 9 months postoperatively, almost complete facial symmetry and co-ordinated movements of the mimetic muscles were obtained with no obvious tongue atrophy. Since our method can efficiently gather neural inputs from the contralateral facial nerve and the ipsilateral hypoglossal nerve, it may become a good alternative for reanimation of reversible facial paralysis when the ipsilateral facial nerve is not available. (C) 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Koichi Tomita; Ko Hosokawa; Kenji Yano; Akiyoshi Takada; Tateki Kubo; Mamoru Kikuchi
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 62 12 1609 - 1615 2009年12月 [査読有り]
     
    Auricular composite grafts represent a well-established technique in facial reconstruction surgery, with several advantages including high survival rate as well as less contraction and good colour match. Although the revascularisation of composite grafts reportedly occurs by inosculation and angiogenesis through both the dermal-dermal connections and the wound bed, we hypothesised that the auricular dermis might have a distinct vascular profile as compared with other regions, that might contribute to the high survival rate of auricular composite grafts. To elucidate this hypothesis, we investigated the dermal vascular profiles of several regions in fresh cadavers using a von-Willebrand factor antibody-binding technique. We assessed the vascular profiles by calculating the blood vessel density and the endothelial surface. Furthermore, we present herein some clinical cases using novel composite grafts in which graft revascularisation was likely based on the dermal-dermal connections. There was a positive correlation between the blood vessel density and the endothelial surface. We found that the postauricular dermis had a significantly richer vascularity than other skin graft donor sites such as the peri-clavicle, groin, back, buttocks and thigh, whereas the scalp and sole demonstrated an abundant vascularity as the postauricle. Unexpectedly, the cheek dermis, which is just adjacent to the auricular region, had a poor vascular profile. Because of its rapid and reliable revascularisation through dermal-dermal connections, the auricular composite graft should be more widely used in reconstructive surgery. It offers an especially good alternative in treating intractable ulcers and in tracheal reconstruction. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Toshihiro Fujiwara; Ken Matsuda; Tateki Kubo; Koichi Tomita; Kenji Yano; Ko Hosokawa
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 62 12 E565 - E569 2009年12月 [査読有り]
     
    Objective: The superior orbital fissure syndrome results from damage to the nerves passing through the superior orbital fissure. In the present case, the superior orbital fissure syndrome developed after repair of facial bone fractures, although the symptoms were not observed before surgery and no obvious cause was found. To investigate the aetiology of this syndrome, we examined the superior orbital fissure anatomically. Methods: We measured the width of superior orbital fissure on the horizontal plane including the optic canal using the computed tomography (CT) scans of other patients and cadavers. Results: The results indicated that the width was 3.73 +/- 1.64 mm in the CT scans of patients and 3.21 +/- 1.09 mm in the cadavers. There was no significant difference between the width in the CT scans and cadavers. The width in the present patient on the affected side was 1.6 mm, that is relatively narrow. Conclusion: After operation, narrow superior orbital fissure may reduce the tolerance to compression of the nerves by oedema. We consider the narrow superior orbital fissure as a risk factor for superior orbital fissure syndrome. When the superior orbital fissure is congenitally narrow, the surgeons should try to avoid excessive pulling of the bone fragment and compression of the orbital tissue during repair of the facial bone fractures. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Koichi Tomita; Yuki Hata; Tateki Kubo; Toshihiro Fujiwara; Kenji Yano; Ko Hosokawa
    NEUROSCIENCE LETTERS 461 1 36 - 40 2009年09月 [査読有り]
     
    In peripheral nerve transection injury, continuity of axons as well as that of the basal lamina is disconnected. In such case, migrating Schwann cells (SCs) would be the only axonal guidance at an early stage of regeneration. However, it takes a few days for the dedifferentiated SCs to start migration, while axonal growth begins a few hours after injury. Consequently, the axons without guidance extensively branch out and wander off at the lesion, resulting in aberrant reinnervation. Therefore, enhancing SCs migration could be an attractive therapeutic strategy. In this study, we investigated the effects of the in vivo nerve predegeneration on SC migration and the time course of these changes. In our analysis, we established a novel animal model by nerve transplantation from S100-GFP mice (in which SCs constitutively express green fluorescent protein driven by the S100B promoter), by which SC migration could be exclusively visualized. Our results showed that SCs acquire the maximal migration ability with 14-day predegeneration, but subsequently it gradually decreased. There was a correlation between the time course of the changes in SC migration and the number of activated macrophages. These findings suggest that using predegenerated nerve grafts in repairing the transected nerves could facilitate SC migration into the recipient nerve stump. This technique could be beneficial for early establishment of axonal guidance and possible functional improvement after transection injury. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
  • Tateki Kubo; Koichi Tomita; Akiyoshi Takada; Kenji Yano; Ko Hosokawa
    SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 43 1 54 - 57 2009年 [査読有り]
     
    We used a thin titanium mesh combined with a prelaminated free radial forearm flap to construct a framework to reconstruct a traumatic defect in an adult ear. The prelaminated forearm flap covered both the anterior and posterior aspects of the titanium framework. A raised ear could therefore be created.
  • Toshihiro Fujiwara; Tateki Kubo; Yoshihisa Koyama; Koichi Tomita; Kenji Yano; Masaya Tohyama; Ko Hosokawa
    JOURNAL OF CHEMICAL NEUROANATOMY 36 3-4 170 - 176 2008年12月 [査読有り]
     
    Slit family of proteins is one of the repulsive axonal guidance cues, and it also plays an important role in neuronal migration and branching through the interaction with roundabout receptors. The function and role of Slit family proteins during peripheral nerve regeneration are still unknown. We examined the expressions of Slits 1-3 mRNAs in the facial nerve nuclei after facial nerve transection by in situ hybridization, using Sprague-Dawley rats. Slit 1 mRNA was weakly expressed in the facial motoneurons, and its expression increased from clay 5 to day 28 after transection, with the peak on day 14 after axotomy. Slits 2 and 3 mRNAs were expressed in the motoneurons of the facial nerve before injury, but the expression of Slit 2 mRNA was down-regulated from day 1 to day 7 after axotomy, with the peak on the first day after injury. Slit 3 mRNA expression in the axotomized side remained unchanged throughout the examination period. Slits 1 and 2 mRNA expression returned to the normal level on day 56 postoperatively. The difference in expression pattern of Slit family mRNA in the neurons during peripheral nerve regeneration suggests that it plays a different role in axonal regeneration after axotomy of peripheral nerves. (C) 2008 Elsevier B.V. All rights reserved.
  • Yoshihisa Koyama; Toshihiro Fujiwara; Tateki Kubo; Koichi Tomita; Kenji Yano; Ko Hosokawa; Masaya Tohyama
    JOURNAL OF CHEMICAL NEUROANATOMY 36 3-4 209 - 215 2008年12月 [査読有り]
     
    Oligodendrocyte myelin glycoprotein (OMgp) has been thought to be expressed in the oligodendrocytes and inhibit the regeneration of the nerves by binding to the Nogo receptor expressed in neurons in the central nervous system (CNS). However, OMgp is expressed in the CNS in the neurons as well as oligodendrocytes. In order to help understanding the physiological role of neuronal OMgp, we examined the change of OMgp expression in the facial nucleus after the facial nerve transection. Real-time RT-pCR and Western blot analysis showed a clown-regulation of OMgp expression in the facial nucleus 5-7 (mRNA) or 5-14 (protein) days after transection. Thereafter, expression of OMgp returned to the control level at 28 clays after axotomy. Subsequent analysis using in silo hybridization histochemistry and immunohistochemistry established that the decrease of OMgp expression was attributable to the expression in facial motoneurons, but not in oligodendrocytes. These findings suggest a possibility that the change of neuronal OMgp expression might be involved in reconnection of neural circuit between axotomized facial neuron and upper motor neuron after transection. (C) 2008 Elsevier B.V. All rights reserved.
  • Ken Matsuda; Masao Kakibuchi; Tateki Kubo; Koichi Tomita; Toshihiro Fujiwara; Ryo Hattori; Kenji Yano; Ko Hosokawa
    JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY 61 11 1357 - 1367 2008年11月 [査読有り]
     
    Background: The effectiveness of end-to-side nerve graft for multiple branch reconstruction was confirmed using a new rat four-branch facial nerve reconstruction model with end-to-side cross-face nerve graft. Methods: Forty Lewis rats were randomly divided into four groups with different reconstruction methods for four branches (bilateral buccal. and marginal branches) of the bilateral facial nerves as follows: group I In = 12), single sciatic nerve graft with end-to-side neurorrhaphy; group 11 (n = 12), four cable grafts using two sciatic and two ulnar nerves with end-to-end neurorrhaphy; group III (n = 8), no repair; and group IV (n = 8), sham operation. The four groups were compared with double retrograde tracing of the facial nucleus, electrophysiological and histomorphometrical assessment of the reconstructed facial nerve. Results: Although there were no significant differences between groups I and 11 in the electro-physiological. tests, group I showed more uniform and better reinnervation in the histomorphometrical assessment. Retrograde tracing of facial nucleus revealed significantly higher number of double-labeled neurons in group I although the total number of labeled neurons was not different between the two groups. Conclusions: End-to-side nerve graft shows a good functional recovery, requires less graft, and is easy to perform. With the availability of the side of the nerve graft itself as a nerve coaptation site, it can be an effective alternative in facial nerve reconstruction and be of great value in various kinds of peripheral nerve surgery. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
  • Sumiko Yoshitatsu; Ken Matsuda; Kenji Yano; Ko Hosokawa; Koichi Tomita
    JOURNAL OF RECONSTRUCTIVE MICROSURGERY 24 7 479 - 487 2008年10月 [査読有り]
     
    The purpose of this study was to determine whether sensory reinnervation with end-to-side neurorrhaphy preserves muscle mass in pedicled muscle flaps. A new muscle flap model innervated by the common peroneal nerve (CPN) was tested in rats. Animals were divided into group 1 (CPN transected without repair), group 2 (CPN transected and immediately repaired by end-to-end neurorrhaphy), and groups 3A and 3B (CPN transected and repaired with the sural nerve, by end-to-end and end-to-side neurorrhaphy, respectively). We evaluated the muscle-preserving effect by measuring muscle weight and performed histological and morphometric analyses 3 months after the procedure. Sensory reinnervation significantly preserved the muscle mass, although less than motor reinnervation. There was no significant difference between the end-to-end and end-to-side procedures. Results of morphometric analysis in each group paralleled those of mean muscle weight. Sensory reinnervation with end-to-side neurorrhaphy appears to be useful in the preservation of muscle flap mass.
  • 【神経端側縫合】 神経端側縫合の基礎研究 端側縫合を用いた神経移植とaxonal supercharging techniqueへの応用
    久保 盾貴; 松田 健; 藤原 敏宏; 冨田 興一; 矢野 健二; 細川 亙
    日本マイクロサージャリー学会会誌 21 3 249 - 255 (一社)日本マイクロサージャリー学会 2008年09月 [査読有り][招待有り]
     
    ラット坐骨神経欠損モデルを用い、移植した正中神経の側面に腓骨神経の断端を縫合した端側縫合群と、正中神経および尺骨神経に脛骨神経、腓骨神経を端々縫合した群で再建効果を比較した。両群間で経時的機能回復評価に有意差はなく、再生軸索の連続性を評価する逆行性トレーサーを用いた検討でも有意差はなかった。前頸骨筋および腓骨神経の組織像にも有意差はなく、端側縫合は端々縫合と同等の効果が得られた。次に、神経の損傷部位より末梢側の側面に他の神経の近位端を端側縫合付加する方法(axonal supercharging tecnique)について検討した。縫合付加群は術後30日以降で付加なしの対照群と比較して有意に優れた知覚回復を認め、支配筋重量も有意に回復していた。また逆行性トレーサーを用いた検討では再生軸索の進入が確認され、組織像でも神経再生促進が示唆された。神経端側縫合付加は神経損傷後の機能回復促進に有効と考えられた。
  • Koichi Tomita; Kenji Yano; Ken Matsuda; Akiyoshi Takada; Ko Hosokawa
    ANNALS OF PLASTIC SURGERY 61 1 19 - 23 2008年07月 [査読有り]
     
    With the recent advances in oncologic breast surgery breast reconstruction with the latissimus dorsi myocutaneous (LDM) flap without an implant has become a good option among other autologous tissue reconstructions available. However, only a few large-scale studies have so far evaluated the critical factors affecting its esthetic outcomes. We retrospectively reviewed 97 consecutive patients who underwent breast reconstruction with the LDM flap between 2001 and 2005 at our institution. The esthetic outcome in comparison with the normal breast was evaluated by means of observer assessment consisting of 7 criteria. A stratified analysis was performed to determine the factors affecting the esthetic outcomes after the breast-conservative surgery and skin-sparing mastectomy. We found that reconstruction of the lower half of the breast and exposure of the skin paddle resulted in poor esthetic outcomes after breast-conservative surgery. Large preoperative brassiere cup size, radiation history, axillary node dissection, and exposure of the skin paddle were the factors which negatively affected the overall outcomes after skin-sparing mastectomy. Age, body mass index, presence of nipple areola-complex defect, or design of skin paddle did not affect the esthetic outcomes. On the basis of these critical factors, we could determine the indications and limitations of breast reconstruction with LDM flap. In some cases, further technical modifications are still warranted, and we believe that these modifications will optimize the use of this flap in breast reconstruction.
  • 冨田 興一; 久保 盾貴; 細川 亙
    日本形成外科学会会誌 28 5 307 - 314 (一社)日本形成外科学会 2008年05月 
    目的:われわれは、顔面神経等の混合神経損傷後における機能回復がいまだ満足のいくものではない原因の一つとして、末梢神経軸索再生時に生じる過剰な軸索分枝が重要であると考えている。今回、正常ミエリンに存在し、軸索再生阻害因子として知られるMyelin-Associated Glycoprotein(以下、MAG)が、軸索分枝および機能回復に与える影響について検討した。方法:数%の軸索に蛍光蛋白質を発現するマウスにおいて、MAGを徐放投与し、軸索再生形態を検討した。さらに、ラット坐骨神経損傷モデルに対して同様にMAGを投与し、機能回復および神経再生の質的評価を行った。結果:MAG投与により末梢神経損傷後軸索分枝の程度は有意に抑制された。ラット坐骨神経損傷モデルにおいて機能回復が促進され、神経回復の質的向上を認めた。考察:MAG投与は、過剰な軸索分枝を抑制し、質的神経再生を向上させ、機能回復を促進することが明らかとなった。混合神経損傷後における新たな治療アプローチとなりうると考えられた。(著者抄録)
  • Koichi Tomita; Tateki Kubo; Ken Matsuda; Kenji Yano; Masaya Tohyama; Ko Hosokawa
    GLIA 55 14 1498 - 1507 2007年11月 [査読有り]
     
    The mature peripheral nervous system (PNS) generally shows better regeneration of injured axons as opposed to the central nervous system (CNS). However, complete functional recovery is rarely achieved even in the PNS although morphologically good axonal regeneration often occurs. This mainly results from aberrant reinnervation due to extensive branching of cut axons with consequent failure of synchronized movements of the muscles. Myelin-associated glycoprotein (MAG), a well-characterized molecule existing both in the CNS and PNS myelin, is considered to be a potent inhibitor of axonal regeneration especially in the CNS. In the present study, we investigated whether MAG has any effects not only on axonal elongation, but also on axonal branching. We show herein that MAG minimized branching of the peripheral axons both in vitro and in vivo via activation of RhoA. Furthermore, after sciatic nerve transection in rats, focal and temporary application of MAG to the lesion dramatically enhanced the functional recovery. Using double retrograde labeling and preoperative/postoperative labeling of spinal neurons, reduced hyperinnervation and improved accuracy of target reinnervation was confirmed, respectively. In conclusion, as MAG significantly improves the quality of axonal regeneration, it can be used as a new therapeutic approach for peripheral nerve repair with possible focal and temporary application. (C) 2007 Wiley-Liss, Inc.
  • Toshihiro Fujiwara; Ken Matsuda; Tateki Kubo; Koichi Tomita; Ryo Hattori; Takeshi Masuoka; Kenji Yano; Ko Hosmawa
    JOURNAL OF NEUROSURGERY 107 4 821 - 829 2007年10月 [査読有り]
     
    Object. In an attempt to improve peripheral nerve repair, the influence of the addition of reverse end-to-side neurorrhaphy for an injured peripheral nerve was investigated in the rat sciatic nerve transection model. Methods. Twelve Sprague-Dawley rats were divided into two groups (six rats in each group). In Group 1, the right sciatic nerve was cut at a point distal to the gluteal notch and repaired using end-to-end neurorrhaphy with four 10-0 nylon epineurial sutures. In Group It, after performing the same procedure as in Group I, the left sciatic nerve was cut distally and passed through a subcutaneous tunnel to the right side. The proximal stump of the left sciatic nerve was co-apted to the epineurial window of the right sciatic nerve distal to the injured point in an end-to-side fashion using 10-0 nylon epineurial sutures. The effects were evaluated using analgesimeter recordings for the hind paw, electrophysiological tests, measurement of the muscle contraction force, a double-labeling technique, weight measurement and histological examination of the gastrocnemius muscle, histological examination of the bilateral sciatic nerves, and immunofluorescent staining. Results. Results from the many tests used to evaluate the reverse end-to-side neurorrhaphy technique indicated that functional recovery of the denervated target organs was promoted by axonal augmentation. Conclusions. The reverse end-to-side neurorrhaphy technique could be useful in peripheral nerve repair.
  • Koichi Tomita; Tateki Kubo; Ken Matsuda; Toshihiro Fujiwara; Kenji Yano; Jonathan M. Winograd; Masaya Tohyama; Ko Hosokawa
    GLIA 55 11 1199 - 1208 2007年08月 [査読有り]
     
    The function of the p75(NTR) neurotrophin receptor (p75(NTR)) in nervous system regeneration is still controversial. Part of that controversy may be due to the fact that p75(NTR) is expressed by both neuronal and glial cell types and may have very distinct and even contradictory roles in each population. In this study, to elucidate the in vivo function of p75(NTR) in Schwann cells during remyelination after peripheral nerve injury, we established a new animal model for p75(NTR)-deficient Schwann cell transplantation in nude mice. We performed quantitative assessments of the functional, histological, and electro physiological recovery after sciatic nerve injury, and compared them with those of the P75(NTR)(+1+) Schwann cell transplanted animals. At 710 weeks after injury, the motor recovery in the p75(NTR)(-/-) Schwann cell transplanted animals was significantly impaired compared with that in the p75(NTR)(+/+) Schwann cell transplanted animals. The lower number of the retrogradely labeled motoneurons and the hypomyelination in the p75(NTR)(-/-) Schwann cell transplanted animals were evident at 6 and 10 weeks after injury. At 10 weeks after injury, the radial growth in the axon caliber was also impaired in NTR the P75(NTR)(-/-) Schwann. cell transplanted animals. Measurement of the amount of myelin proteins and the nerve conduction velocity at 10 weeks after injury reflected these results. In summary, the p75(NTR) expression in Schwann cells is important for remyelination process, and the motor recovery after injury is impaired due to impaired axonal growth, remyelination, and radial growth in the axon calibers. (C) 2007 Wiley-Liss, Inc.
  • Koichi Tomita; Kenji Yano; Takeshi Masuoka; Ken Matsuda; Akiyoshi Takada; Ko Hosokawa
    ANNALS OF PLASTIC SURGERY 59 2 149 - 151 2007年08月 [査読有り]
     
    The latissimus dorsi flap has been widely used in breast reconstruction surgery. Despite its potential advantages such as low donor morbidity and vascular reliability, the complication of donor-site seroma fort-nation frequently occurs. Consecutive 174 patients who underwent breast reconstruction with the latissimus dorsi flap from 2001 to 2006 were retrospectively reviewed. The age, body mass index (BMI), smoking history, timing of reconstruction, type of breast surgery and nodal dissection, and several other intraoperative data were analyzed. The overall incidence of postoperative seroma was 21%. Increased age (>50 years) and obesity (BMI >23 kg/m(2)) were significant risk factors for seroma formation (P = 0.02 and 0.004, respectively). The patients who underwent skin-sparing mastectomy or modified radical mastectomy had higher incidence of seroma formation (28% and 33%, respectively) as compared with those who had breast-conservative surgery (11%). A significant correlation was found between the type of breast surgery and the incidence of seroma (P = 0.04). The type of nodal dissection did not affect the incidence of postoperative seroma (P = 0.66). We concluded that increased age, obesity, and invasive breast surgery are risk factors for donor-site seroma formation after breast reconstruction with the latissimus dorsi flap. Close attention should be paid to prevent development of postoperative seroma when operating on such high-risk patients.
  • Tomita K; Kubo T; Yano K; Hosokawa K
    Plastic and reconstructive surgery 119 5 1619; author reply 1619 - 20 2007年04月 [査読有り]
  • Koichi Tomita; Tateki Kubo; Ken Matsuda; Toshihiro Fujiwara; Ken-ichiro Kawai; Takeshi Masuoka; Kenji Yano; Ko Hosokawa
    JOURNAL OF RECONSTRUCTIVE MICROSURGERY 23 3 163 - 171 2007年04月 [査読有り]
     
    The treatment of neuroma-in-continuity is controversial. To bypass neuroma-in-continuity with a nerve graft using end-to-side neurorrhaphy is considered to be theoretically a good option. To test this therapeutic modality, we performed a nerve bypass graft in a neuroma-in-continuity rat model. An obstructive neuroma-in-continuity was created in a transected peroneal nerve by interposition using the aponeurosis of the spinal muscles. In the experimental animals, (1) immediate, (2) 3-week delayed, or (3) no ulnar nerve bypass graft was performed. The peroneal functional index (PFI), conduction velocity, tibialis anterior muscle weight, and histomorphometric analyses were performed and compared with control (simply cut and repair) animals. On postoperative day 70, the recoveries of the PFI values, conduction velocity, and tibialis anterior muscle weight in the bypassed animals showed no significant differences as compared with the control animals, and the extent of these recoveries in the bypassed animals were significantly superior to those in the no-graft animals. In the histomorphometric analysis, the mean percent nerve in the bypassed animals was significantly larger than that in the no-graft animals. In conclusion, this technique may be a good alternative to the current therapeutic techniques for neuroma-in-continuity when there is a significant retained function.
  • Tomas Madura; Tateki Kubo; Marvin Tanag; Ken Matsuda; Koichi Tomita; Kenji Yano; Ko Hosokawa
    PLASTIC AND RECONSTRUCTIVE SURGERY 119 2 526 - 535 2007年02月 [査読有り]
     
    Background: The Rho family of small GTPases is responsible for various processes involving actin cytoskeleton in eukaryotic cells, including neurite outgrowth. Several substances found at the peripheral nerve injury site were shown to activate one member of this family, Rho. The activation of Rho leads to neurite outgrowth inhibition and the development of posttraumatic neuropathic pain. The authors used the clinically tested Rho-associated kinase inhibitor fasudil hydrochloride to enhance the functional recovery of the peripheral nerve in the rat. Methods: In the peroneal nerve interpositional graft model, the authors administered fasudil (experimental groups) or saline (control groups) (1) intraperitoneally and (2) directly into the graft by microinjection (n = 6 animals per experimental condition). Neural recovery was assessed during postoperative follow-up lasting 80 days by peroneal functional index, electrophysiologic, and histomorphometric analyses. Results: The peroneal functional index returned to values not significantly different from preoperative values on days 55 (fasudil injected into the graft) and 60 (fasudil injected intraperitoneally) in the experimental groups. In the control groups, this took 70 (saline injected intraperitoneally) and 75 days (saline injected into the graft). These results are supported by electrophysiologic and histomorphologic assessments. Conclusions: The authors determined that fasudil hydrochloride was capable of accelerating the functional regeneration after peripheral nerve axotomy, which is consistent with the results of reports about Rho cascade disruption in the central nervous system. Because fasudil hydrochloride is a clinically tested drug, it could be used to enhance neural regeneration in human patients as well.
  • Koichi Tomita; Tateki Kubo; Ken Matsuda; Ryo Hattori; Toshihiro Fujiwara; Kenji Yano; Ko Hosokawa
    MICROSURGERY 27 5 500 - 509 2007年 [査読有り]
     
    After peripheral nerve injury, minimizing axonal misdirection has been a matter of importance to obtain good functional outcomes. In general, it becomes more challenging as the nerve defect length is longer. As previous works suggested that a conduit repair leaving a short gap could induce some target-specific reinnervation, we expected that a distally placed conduit combined with nerve graft would enhance the specificity of reinnervation, especially in dealing with a long gap. To test this, a 14-mm-long gap was created in the rat sciatic nerves and repaired with either 1) whole nerve graft (WG), 2) interfascicular nerve grafts (FG), or 3) whole nerve graft combined with distally placed silicone tube leaving a 5-mm gap (TUBG). At the end of follow up, the extent of target specific reinnervation (measurement of the compound muscle action potentials evoked by stimulation of the sciatic nerve and its tibial and common peroneal fascicles) and the accuracy of motoneuronal projection (sequential retrograde labeling of the common peroneal motor pool) were assessed. Both assessments revealed that groups FG and TUBG had a similar selectivity, which was significantly higher than in group WG. Consistent with these results, the functional recovery as assessed by walking track analysis showed no significant difference between groups FG and TUBG, whereas those were significantly superior to group WG. In contrast, histomorphometric assessment of the regenerating axons and wet muscle weight showed no significant difference among the three groups. In conclusion, conduit repair would have some effects on reducing motor axonal misdirection, and it might be more effective when used in the management of a large defect in combination with nerve graft. (C) 2007 Wiley-Liss, Inc.
  • K Kashibuchi; K Tomita; JA Schalken; H Kume; T Yamaguchi; S Muto; S Horie; T Kitamura
    EUROPEAN UROLOGY 49 5 839 - 845 2006年05月 
    Objectives: To determine the value of loss of the expression of E-cadherin and cadherin-associated molecules as useful markers for both prognosis and bladder recurrence in patients with upper urinary tract cancer. Materials and methods: In 61 paraffin-embedded nephroureterectomy specimens, the expression of E-cadherin and alpha-, beta-, and gamma-catenin was examined by immunohistochemical staining. To evaluate the prognostic significance, Kaplan-Meier survival curves were calculated and compared by the log-rank test. A multivariate test was performed to detect prognostic markers. Results: Normal expression was found in 32 cases (52.5%) for E-cadherin, 41 cases (67.2%) for alpha-catenin, 42 cases (68.9%) for beta-catenin, and 31 cases (50.8%) for gamma-catenin. The expression patterns of E-cadherin and alpha-, beta- and gamma-catenin were significantly correlated with each other. Survival analysis showed a significant difference between normal and aberrant expression in each staining. Multivariate analysis revealed that tumor stage and the expression of E-cadherin were independent prognostic factors for cause-specific survival. in contrast, there was no significant correlation between the expression of E-cadherin and alpha-, beta-, and gamma-catenin and bladder recurrence. Conclusion: Our data suggest E-cadherin may be a good prognostic marker for patients with upper urinary tract cancer. (c) 2005 Elsevier B.V. All rights reserved.
  • K Tomita; T Kubo; K Matsuda; T Madura; K Yano; T Fujiwara; H Tanaka; M Tohyama; K Hosokawa
    BRAIN RESEARCH 1081 1 44 - 52 2006年04月 [査読有り]
     
    Recent studies have provided evidence that p21(Cip1/WAF1) has not only cell cycle-associated activities but also other biological activities like neurite elongation. To investigate the role of p21(Cip1/WAF1) in the in vivo axonal regeneration in the peripheral nervous system, we developed a p21(Cip1/WAF1) knockout (KO) mice sciatic nerve injury model. We performed quantitative assessments of the functional, histological, and electrophysiological recoveries after sciatic nerve injury in p21(Cip1/WAF1) KO mice and compared the results with those of the wild-type mice. p21(Cip1/WAF1) KO mice showed a significant delay of the motor functional recovery between 21 and 42 days after sciatic nerve injury. The values of motor conduction velocity in p21(CiP1/WAF1) KO mice were significantly lower than those in the wild-type mice on postoperative day 28. The mean percent neural tissue and the mean nerve axon width of p21(Cip1/WAF1) KO mice were significantly less than those of the wild-type mice, which was caused by hyperphosphorylation of neurofilaments. Therefore, p21(Cip1/WAF1) was considered to be involved in radial axon growth and to be essential for the motor functional recovery following peripheral nervous system injury. (c) 2006 Elsevier B.V. All rights reserved.

書籍

講演・口頭発表等

  • 脂肪注入の生着率を向上させる内服治療法の開発-体内水素発生能を有するシリコン製剤の効果検証-
    大谷直矢; 冨田興一; 冨田興一; 小林悠輝; 黒田一也; 小林光; 久保盾貴
    日本形成外科学会基礎学術集会プログラム・抄録集 2023年
  • 頭皮部の動静脈奇形に対する切除範囲についての考察
    清家 志円; 若杉 侑加; 鹿野 雄介; 田港 見布江; 冨田 興一; 久保 盾貴
    日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 2022年11月 (一社)日本頭蓋顎顔面外科学会
  • 喉頭温存頸部食道切除術に対して複数茎遊離空腸再建術を行う際の当科の工夫
    大垣 智慧; 田島 宏樹; 鹿野 雄介; 清家 志円; 田港 見布江; 冨田 興一; 久保 盾貴
    日本形成外科学会会誌 2022年09月 (一社)日本形成外科学会
  • 中年期に特発性乳房巨大リンパ嚢胞を呈したリンパ管奇形の一例
    柳下 詩織; 清家 志円; 鹿野 雄介; 前田 大介; 田島 宏樹; 田港 見布江; 冨田 興一; 久保 盾貴
    日本形成外科学会会誌 2022年05月 (一社)日本形成外科学会
  • 体内水素発生能を有するシリコン製剤の有用性:皮弁虚血再灌流障害の抑制効果
    大谷直矢; 冨田興一; 小林悠輝; 黒田一也; 小林光; 久保盾貴
    日本形成外科学会基礎学術集会プログラム・抄録集 2022年
  • 脂肪注入を付加した側頭筋膜弁による外耳道癌切除後の再建
    鹿野 雄介; 田島 宏樹; 田港 見布江; 前田 大介; 清家 志円; 冨田 興一; 久保 盾貴
    日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 2021年11月 (一社)日本頭蓋顎顔面外科学会
  • DIEP flapによる一次一期乳房再建後に生じた広範な乳房皮膚壊死に対し、対側乳房からの全層植皮を行った1例
    野守 美千子; 冨田 興一; 田港 見布江; 久保 盾貴
    日本形成外科学会会誌 2021年11月 (一社)日本形成外科学会
  • 巨大血小板性血小板減少症と両側肘部黄色腫を契機に診断されたシトステロール血症の1例
    岡田 健志; 小関 正博; 加藤 恒; 冨田 興一; 松井 崇浩; 田中 克尚; 乾 洋勉; 冠野 昂太郎; 大濱 透; 西田 誠; 石原 光昭; 鯨岡 健; 服部 浩明; 山下 静也; 坂田 泰史
    日本動脈硬化学会総会プログラム・抄録集 2021年10月 (一社)日本動脈硬化学会
  • 手術療法の新たな展望 「乳房温存オンコプラスティックサージャリーワーキンググループ」の活動と提案
    座波 久光; 淺野 裕子; 小川 朋子; 喜島 祐子; 佐武 利彦; 津川 浩一郎; 冨田 興一; 藤本 浩司
    日本乳癌学会総会プログラム抄録集 2021年07月 (一社)日本乳癌学会
  • PROとClinRO 乳房再建術後の満足度とQOLを調査する多施設前向きコホート研究・SAQLA study術後12ヵ月のアウトカム
    雑賀 美帆; 細谷 優子; 黒木 知明; 倉元 有木子; 冨田 興一; 相原 有希子; 武藤 真由; 佐武 利彦; 宮路 天平; 川口 崇; 渡部 聡子; 木股 敬裕
    日本乳癌学会総会プログラム抄録集 2021年07月 (一社)日本乳癌学会
  • 当院におけるDirect-to-implant(DTI)による一次一期乳房再建の導入と安全性の検討
    有竹 賀子; 相原 智彦; 沖代 格次; 清水 宏; 冨田 興一
    日本乳癌学会総会プログラム抄録集 2021年07月 (一社)日本乳癌学会
  • 脂肪注入併用広背筋皮弁による全乳房再建に対するPatientreported outcome
    田港 見布江; 冨田 興一; 久保 盾貴; 矢野 健二
    日本乳癌学会総会プログラム抄録集 2021年07月 (一社)日本乳癌学会
  • 遊離深大腿動脈穿通枝(PAP)皮弁による乳房部分切除後再建
    冨田 興一; 田港 見布江; 田島 宏樹; 久保 盾貴
    日本乳癌学会総会プログラム抄録集 2021年07月 (一社)日本乳癌学会
  • 進行癌における複数茎遊離空腸と深下腹壁動脈穿通枝皮弁の同時移植 複数茎遊離空腸のbridge flapとしての可能性
    榊 由華子; 田島 宏樹; 冨田 興一; 田港 見布江; 清家 志円; 野守 美千子; 久保 盾貴; 栗田 智之
    日本形成外科学会会誌 2021年04月 (一社)日本形成外科学会
  • 埋め込み型知覚皮弁による皮膚再知覚化の検討
    大谷直矢; 冨田興一; 田港見布江; 黒田一也; 矢野健二; 久保盾貴
    日本形成外科学会基礎学術集会プログラム・抄録集 2021年
  • AMED乳房再建の術後満足度とQOLを評価する多施設共同研究・SAQLA study-術後12ヶ月のアウトカム-
    雑賀美帆; 細谷優子; 宇都宮裕己; 倉元有木子; 冨田興一; 相原有希子; 武藤真由; 佐武利彦; 彦坂信; 宮路天平; 川口崇; 山口拓洋; 渡部聡子; 木股敬裕
    日本形成外科学会総会・学術集会プログラム・抄録集 2021年
  • 広背筋皮弁と腰動脈穿通枝皮弁のキメラ皮弁による乳房再建
    大谷 直矢; 田島 宏樹; 冨田 興一; 栗田 智之; 久保 盾貴
    日本マイクロサージャリー学会学術集会プログラム・抄録集 2020年11月 (一社)日本マイクロサージャリー学会
  • 乳房再建術後の有茎広背筋皮弁に生じた静脈血栓に対し、ウロキナーゼの選択的動注により皮弁を救済した症例
    米谷 公佑; 田島 宏樹; 野守 美千子; 田港 見布江; 冨田 興一; 久保 盾貴
    日本マイクロサージャリー学会学術集会プログラム・抄録集 2020年11月 (一社)日本マイクロサージャリー学会
  • 当院における両側乳癌再建症例の検討 同時性両側乳癌と異時性両側乳癌における傾向
    野守 美千子; 冨田 興一; 田港 見布江; 矢野 健二; 久保 盾貴
    日本乳癌学会総会プログラム抄録集 2020年10月 (一社)日本乳癌学会
  • シリコン乳房インプラント合併症により自家組織への転換を行った症例の検討
    田港 見布江; 冨田 興一; 野守 美千子; 矢野 健二; 久保 盾貴
    日本乳癌学会総会プログラム抄録集 2020年10月 (一社)日本乳癌学会
  • 側頭頭頂筋膜を用いた外耳道癌切除後の再建
    鹿野雄介; 清家志円; 岡田翠; 田港見布江; 前田大介; 田島宏樹; 冨田興一; 久保盾貴
    日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 2020年
  • SAQLA study(乳房再建術後のHRQOL・満足度を調査する多施設共同研究)進捗報告:登録患者の背景について
    雑賀美帆; 細谷優子; 冨田興一; 倉元有木子; 宇都宮裕己; 相原有望子; 武藤真由; 彦坂信; 宮路天平; 川口崇; 山口拓洋; 渡部聡子; 木股敬裕
    日本形成外科学会総会・学術集会プログラム・抄録集 2020年
  • Oncoplastic surgery Oncoplastic surgeryを前提とした乳房部分切除術と乳房切除術の選択基準について
    冨田 興一
    日本外科系連合学会誌 2019年05月 日本外科系連合学会
  • 小関正博; 嵯峨礼美; 冠野昂太郎; 岡田健志; 朝治真澄; 冨田興一; 大須賀慶悟; 江副幸子; 西田誠; 西田誠; 坂田泰史; 山下静也; 山下静也
    日本再生医療学会総会(Web) 2019年
  • 上肢巨大動静脈奇形に対して瘤縮小術を行った一例  [通常講演]
    大谷 直矢; 清家 志円; 野守 美千子; 大矢 孝一郎; 田港 見布江; 冨田 興一; 久保 盾貴; 細川 亙; 日笠 壽
    日本形成外科学会会誌 2018年08月
  • 冠野昂太郎; 小関正博; 嵯峨礼美; 岡田健志; 朝治真澄; 冨田興一; 大須賀慶悟; 江副幸子; 西田誠; 西田誠; 坂田泰史; 山下静也; 山下静也; 山下静也
    日本動脈硬化学会総会・学術集会プログラム・抄録集(Web) 2018年06月
  • 自家組織乳房再建における乳房下溝形成 ノットフリー縫合デバイス(STRATAFIX)の有用性  [通常講演]
    大谷 直矢; 冨田 興一; 田港 見布江; 細川 亙; 矢野 健二
    日本形成外科学会会誌 2018年06月
  • 心血管疾患における再生医療・細胞治療 重症家族性高コレステロール血症に対する再生医療の臨床応用  [通常講演]
    冠野 昂太郎; 小関 正博; 嵯峨 礼美; 岡田 健志; 朝治 真澄; 冨田 興一; 大須賀 慶悟; 江副 幸子; 西田 誠; 坂田 泰史; 山下 静也
    日本動脈硬化学会総会プログラム・抄録集 2018年06月
  • 家族性高コレステロール血症ホモ接合体に対する同種脂肪組織由来幹細胞移植療法の開発の現状  [通常講演]
    小関 正博; 嵯峨 礼美; 冠野 昂太郎; 岡田 健志; 朝治 真澄; 冨田 興一; 大須賀 慶悟; 江副 幸子; 西田 誠; 坂田 泰史; 山下 静也
    日本動脈硬化学会総会プログラム・抄録集 2018年06月
  • オンコプラスティックサージャリー 多様化する乳房再建術 脂肪注入術によるオンコプラスティックサージャリーのパラダイムシフトを目指して  [通常講演]
    冨田 興一; 田港 見布江; 矢野 健二; 細川 亙
    日本乳癌学会総会プログラム抄録集 2018年05月
  • シリコン乳房インプラントによる2期再建術 当院における中期成績の検討  [通常講演]
    冨田 興一; 田港 見布江; 矢野 健二; 細川 亙
    日本乳癌学会総会プログラム抄録集 2018年05月
  • 感染合併によりTE抜去となったアトピー性皮膚炎患者の3症例  [通常講演]
    田港 見布江; 冨田 興一; 矢野 健二; 細川 亙
    日本乳癌学会総会プログラム抄録集 2018年05月
  • 岡田健志; 小関正博; 嵯峨礼美; 嵯峨礼美; 冠野昂太郎; 冨田興一; 大須賀慶悟; 川本弘一; 江副幸子; 西田誠; 坂田泰史; 山下静也; 山下静也
    日本再生医療学会総会(Web) 2018年 (一社)日本動脈硬化学会
  • 種々の腹部皮弁による乳房再建:術式と適応 DIEP flapを用いた乳房再建 その適応と術式について  [通常講演]
    冨田 興一; 田港 見布江; 矢野 健二; 細川 亙
    日本マイクロサージャリー学会学術集会プログラム・抄録集 2017年12月
  • 自家組織乳房再建におけるノットフリー縫合デバイス(STRATAFIX)を用いた乳房下溝形成の経験  [通常講演]
    大谷 直矢; 冨田 興一; 田港 見布江; 矢野 健二; 細川 亙
    日本マイクロサージャリー学会学術集会プログラム・抄録集 2017年12月
  • 小関正博; 小関正博; 嵯峨礼美; 嵯峨礼美; 岡田健志; 川瀬良太; 小林卓哉; 朝治真澄; 冨田興一; 大須賀慶悟; 川本弘一; 江副幸子; 西田誠; 西田誠; 坂田泰史; 山下静也; 山下静也
    再生医療 2016年02月
  • 小関 正博; 嵯峨 礼美; 江副 幸子; 小林 卓哉; 朝治 真澄; 松田 響; 朱 頴こう; 岡田 健志; 西良 雅己; 中谷 和弘; 川瀬 良太; 増田 大作; 大濱 透; 西田 誠; 冨田 興一; 細川 亙; 大須賀 慶悟; 富山 憲幸; 川本 弘一; 伊藤 壽記; 柳 光司; 市 育代; 森山 博由; 早川 堯夫; 荒井 秀典; 斯波 真理子; 坂田 泰史; 山下 静也
    日本動脈硬化学会総会プログラム・抄録集 2015年06月 (一社)日本動脈硬化学会
  • 早老症から抗加齢医学を考える 皮膚の老化メカニズム解明の糸口となるか
    金澤成行; 久保盾貴; 冨田興一; 金田真理; 片山一郎; 細川亙
    日本抗加齢医学会総会プログラム・抄録集 2014年
  • 遊離腓骨を用いた下顎再建における3Dシミュレーションとpre-bended mini-plateの使用経験  [通常講演]
    服部 亮; 菊池 守; 冨田 興一; 久保 盾貴; 細川 亙; 村瀬 剛
    日本形成外科学会会誌 2010年11月 (一社)日本形成外科学会
  • Reanimation of facial paralysis by one-stage double innervation technique using an intraneural-dissected sural nerve graft  [通常講演]
    6th International Muscle Symposium, Vienna, Austria 2010年
  • Nerve bypass grafting for the treatment of neuroma-in-continuity: an experimental study on the rat  [通常講演]
    5th Congress of the World Society for Reconstructive Microsurgery、Okinawa, Japan 2009年
  • 波多祐紀; 富田興一; 菊池守; 久保盾貴; 細川亙; 大須賀慶悟
    日本形成外科学会総会・学術集会プログラム・抄録集 2008年

MISC

  • 頭皮部の動静脈奇形に対する切除範囲についての考察
    清家 志円; 若杉 侑加; 鹿野 雄介; 田港 見布江; 冨田 興一; 久保 盾貴 日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 40回 123 -123 2022年11月
  • 喉頭温存頸部食道切除術に対して複数茎遊離空腸再建術を行う際の当科の工夫
    大垣 智慧; 田島 宏樹; 鹿野 雄介; 清家 志円; 田港 見布江; 冨田 興一; 久保 盾貴 日本形成外科学会会誌 42 (9) 580 -580 2022年09月
  • 中年期に特発性乳房巨大リンパ嚢胞を呈したリンパ管奇形の一例
    柳下 詩織; 清家 志円; 鹿野 雄介; 前田 大介; 田島 宏樹; 田港 見布江; 冨田 興一; 久保 盾貴 日本形成外科学会会誌 42 (5) 296 -296 2022年05月
  • 脂肪注入を付加した側頭筋膜弁による外耳道癌切除後の再建
    鹿野 雄介; 田島 宏樹; 田港 見布江; 前田 大介; 清家 志円; 冨田 興一; 久保 盾貴 日本頭蓋顎顔面外科学会学術集会プログラム・抄録集 39回 120 -120 2021年11月
  • 小関正博; 嵯峨礼美; 冠野昂太郎; 岡田健志; 朝治真澄; 冨田興一; 大須賀慶悟; 江副幸子; 西田誠; 西田誠; 坂田泰史; 山下静也; 山下静也; 山下静也 日本動脈硬化学会総会・学術集会プログラム・抄録集(Web) 50th 219 (WEB ONLY) -219 2018年06月
  • 遊離腓骨を用いた下顎再建における3Dシミュレーションとpre-bended mini-plateの使用経験
    服部 亮; 菊池 守; 冨田 興一; 久保 盾貴; 細川 亙; 村瀬 剛 日本形成外科学会会誌 30 (11) 643 -643 2010年11月

受賞

  • 2018年03月 財団法人 武田科学振興財団 医学系研究奨励
     
    受賞者: 冨田 興一
  • 2016年11月 第114回関西形成外科学会学術集会 優秀演題賞
     
    受賞者: 野守美千子;冨田興一
  • 2016年07月 American Society of Plastic Surgeons Best Paper Award 2016 in Plastic and Reconstructive Surgery Global Open "Best Case Report-Silver"
     Differential reanimation of the upper and lower face using two interpositional nerve grafts in total facial nerve reconstruction. 
    受賞者: 冨田 興一
  • 2014年07月 大阪大学 大阪大学総長奨励賞
     
    受賞者: 冨田 興一
  • 2013年08月 大阪大学 大阪大学総長奨励賞
     
    受賞者: 冨田 興一
  • 2009年 上原記念生命科学財団 リサーチフェローシップ
  • 2008年04月 日本形成外科学会 平成19年 日本形成外科学会学術奨励賞
     
    受賞者: 冨田 興一

共同研究・競争的資金等の研究課題

  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2022年04月 -2025年03月 
    代表者 : 冨田 興一; 大谷 直矢
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2021年04月 -2024年03月 
    代表者 : 大谷 直矢; 冨田 興一
     
    水素による組織の酸化ストレス軽減効果が報告されて以来、多くの分野で医療応用へ向けた研究が行われている。形成外科分野でも、水素水や水素ガス投与が皮弁の虚血再灌流障害抑制効果を示すことが報告されている。近年、高用量の水素を持続的に体内で発生させる性質を持つ、シリコン製剤が開発された。このシリコン製剤を用いれば、これまでの課題であった水素の効率的な体内への 取り込みが可能となり、水素の臨床応用が広がる可能性がある。 本研究では、皮膚・軟部組織再建外科分野における水素の治療効果を、このシリコン製剤の使用とラットを用いた動物実験を通して検証することを目的とした。 本年度は、血管柄付き遊離皮弁移植における虚血再灌流障害に対するシリコン製剤の有効性を検証する動物実験を行った。具体的には、1%シリコン製剤含有食餌を摂取させたラットと、通常の食餌を摂取させたラットにおいて、浅下腹壁動静脈を血管茎とした腹部皮弁を挙上し、3時間程度血管茎のクランプを行うことで虚血再灌流障害を誘導した。術後、シリコン製剤を摂食させた群のラットでは、通常の食餌を摂食させた群のラットと比較して、皮弁の生着率が有意に改善し、組織の炎症所見、アポトーシスや炎症性サイトカイン・酸化ストレスマーカーの発現量等も有意に抑制されていた。この結果、シリコン製剤より発生する水素が、皮弁組織の虚血再灌流障害抑制効果を有することが判明し、移植組織の生着率向上に寄与し得ることが証明された。
  • 慢性痛の評価モジュールを搭載した疼痛評価システムの開発と事業化
    日本医療研究開発機構(AMED)：医工連携イノベーション推進事業（開発・事業化事業)
    研究期間 : 2021年04月 -2024年03月
  • In vitro血管化3次元脂肪組織を用いた乳房再建の臨床応用技術
    日本医療研究開発機構(AMED)：橋渡しAシーズ
    研究期間 : 2021年04月 -2023年03月
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2019年04月 -2022年03月 
    代表者 : 冨田 興一; 矢野 健二
     
    乳房切除後、乳房皮膚知覚は障害される。再建乳房の知覚向上には、損傷知覚神経による皮膚再支配が必要である。過去に、移植皮弁を知覚皮弁とする試み（皮弁の知覚神経を乳房側の損傷神経と縫合）を行った。一方、近年、皮下乳腺全摘が普及し、皮弁皮膚を体表に露出せず、皮下へ埋め込むことが多くなった結果、知覚皮弁が使用頻度は減少した。しかし、埋め込み型知覚皮弁において、少なくとも皮弁の表面までは再生 神経は到達する。本研究では、埋め込み型皮弁の知覚化が皮膚知覚回復向上に寄与するかを検討する。さらに、末梢神経再生を促進する脂肪組 織由来間葉系幹細胞移植を併用することで、柔らかく知覚も兼ね備えた乳房の再建を目指す。 今年度はまず、細胞移植を伴わないラットモデルの作成を開始した。広範な知覚脱失領域の中に小範囲の知覚領域をした後、その知覚領域組織を皮弁として挙上、皮下へ埋め込むこんだ。実験群として以下の3群を作成中である。すなわち、知覚皮弁の真皮を残して脱上皮する群、知覚皮弁上の真皮も切除し皮筋・脂肪弁とする群、および皮弁の支配神経を切断し、知覚化を行わない群である。現在、経時的に痛覚、温覚、触覚に関して知覚領域（innervated）と非知覚領域（denervated）の境界線の変化を経時的に評価していく予定である。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2018年04月 -2021年03月 
    代表者 : 金澤 成行; 峯岸 芳樹; 冨田 興一; 馬込 卓弥
     
    我が国では、糖尿病や高齢者が大幅に増加し、糖尿病性皮膚潰瘍、高齢者の褥瘡や皮膚剥離などの皮膚障害の発生率が急増しており、慢性炎症の酸化ストレスによる皮膚の細胞死のため治癒が困難となっている。しかしながら、このような紫外線や慢性炎症などによる酸化ストレスに対する皮膚の防御機構は明らかになっていない。本研究はヒト皮膚線維芽細胞を用いて、酸化ストレスを抑制し、炎症を強く抑えることが可能であるクロロゲン酸の皮膚再生能力を明らかにすることで、クロロゲン酸がヒトの皮膚に与える生理作用を解明する。 本年度は、計画のなかの3つ目の項目である「クロロゲン酸が細胞増殖シグナルに与える影響について」の解明を行った。細胞の生死は細胞内の増殖シグナル・生存シグナルによって、運命づけられている。細胞増殖においては、MAPキナーゼ経路のひとつであるERK1/2やPI3-kinase/Akt経路などが代表的なPathwayである。本年度は、これらのシグナルに焦点をあてて解析した。線維芽細胞をクロロゲン酸10μM刺激後、細胞増殖シグナルであるERK1/2やAktの活性化の状態をウエスタンブロッティング法で解析したところ、クロロゲン酸の刺激でAktの活性化を確認することができた。また、LY294002（PI3-kinase阻害剤）を用いるとAktの活性化の減弱を認めた。以上から、クロロゲン酸のシグナルに関与している分子の一つがAktであること同定できた。 また、計画中の4つ目の項目「クロロゲン酸が細胞死シグナルに与える影響について」も、開始することができた。線維芽細胞をクロロゲン酸10μM で30分刺激した後、細胞死シグナルの代表であるJNKやp38-MAPKの蛋白活性化の状態をウエスタンブロッティング法で現在、解析中である。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2018年04月 -2021年03月 
    代表者 : 峯岸 芳樹; 金澤 成行; 中井 國博; 冨田 興一
     
    レチノイン酸（RA）は組織の発生、パターニング、細胞の増殖・分化など多数の事象に関係しており、それは多数の遺伝子発現の促進や抑制を制御する鍵として機能していることをあらわしている。しかしながらRAは催奇形性があることが知られており、胎児期に過剰に暴露されると口蓋裂、短肢症、無脳症などを生じることで生後致死となってしまう。このため成長期にRAが頭蓋顎顔面骨成長に及ぼす影響は検討できなかった。 本研究では増殖軟骨である11型コラーゲン特異的にCyp26b1を欠失したconditional KO(cKO)マウス(Cyp26b1 ⊿chonマウス)を用いることで、RA過剰の影響を増殖軟骨細胞のみにとどめることで致死を回避し、RAが成長期に頭蓋顎顔面領域に対して及ぼす影響を表現型解析により検討する。 Cyp26b1 ⊿chonマウスは野生型マウスと比較して外見的に中顔面の低形成と下顎突出を認めた。表現型の強い個体では哺乳までは可能であったが、離乳後に餌食が上手にできず致死となった。またかろうじて餌食ができても反対咬合のため下門歯が噛み合わずに鼻に突き刺さるほど異常に伸び、次第に餌食ができなくなることで致死にいたる個体もいた。致死にまでいたらない表現型の少しマイルドなマウスの顎顔面領域の形態をＸ線およびμCTを用いて検討を行った。野生型マウスと比較してCyp26b1 ⊿chonマウスでは頭蓋底の短縮を認め、これが中顔面の低形成に寄与している可能性が考えられた。一方で下顎の成長にはそれほど大きな相違はなく、下顎の突出は相対的なものであった。 成長したCyp26b1 ⊿chonマウスはたくさん得られなかったが、上記の表現型はどの個体にも統一して認められた。餌食が可能で成長した生後6週目での解析が妥当と考えられた。 頭蓋骨の免疫組織染色について、よい染色条件が見つからずに難渋している。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2018年04月 -2021年03月 
    代表者 : 矢野 健二; 冨田 興一; 田港 見布江
     
    本年度は、昨年度に作成した3群、すなわち、①神経断端を皮膚真皮内に埋入、縫合固定する群、②神経断端を真皮直下に縫合固定する群、③神経縫合を行わない群の解析を行った。全身麻酔下にて痛覚、温覚（60℃）が皮下に存在するcutaneous trunci muscleの反射収縮により評価可能であった。痛覚、温覚に関して知覚領域 （innervated ）と非知覚領域（denervated）の境界線の変化を経時的に評価した結果、①群と②群の双方において、direct neurotizationの効果を認めた。①群の方が新規知覚領域の出現は早い傾向にあったものの、最終的な知覚領域の面積は①群と②群の間で有意差を認めなかった。3か月のフォローアップの後、組織採取を行い、パラフィン切片を作成し、抗ニューロフィラメント抗体、抗ミエリンタンパク抗体を用いた組織免疫学的評価を含む検討を行った。その結果、知覚領域の真皮内にミエリン化した神経線維を全ての群で認めた。径の大きなものでは直径5umを超えるAβ線維も確認しており、触覚回復の可能性が示唆された。 次年度は、これらのデータの解析を進め、論文発表を行っていく予定である。
  • Direct neurotizationと間葉系幹細胞移植による乳癌術後皮膚知覚再建法の開発
    武田科学振興財団：医学系研究奨励
    研究期間 : 2017年10月 -2020年03月 
    代表者 : 冨田 興一
  • 乳房再建におけるアウトカム指標の確立と科学的根拠に基づいた患者意思決定支援
    日本医療研究開発機構(AMED)：革新的がん医療実用化研究事業
    研究期間 : 2017年10月 -2020年03月 
    代表者 : 木股 敬裕
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2016年04月 -2019年03月 
    代表者 : 冨田 興一; 細川 亙; 西林 章光; 金澤 成行; 峯岸 芳樹
     
    末梢神経切断損傷においては圧挫損傷と異なり、切断神経間を繋ぐ神経ガイダンスが消失する。シュワン細胞により神経ガイダンスは再形成されるが、瘢痕形成により無秩序に形成される。その結果、過誤支配（誤った標 的組織への再生）等の異常な神経再生が起こり、異常共同運動や筋痙攣の原因となる。本研究では抗炎症作用や、瘢痕形成を抑制する脂肪組織由来間葉系幹細胞（以下、ASC）に着目し、ASC の移植 が末梢神経再生の質に及ぼす影響を検証した。その結果、ASC移植による有意な機能回復向上効果は認めなかったものの、関節拘縮による機能の悪化の頻度が減少した。ASC移植が何らかの調整作用を及ぼした可能性が示唆された。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2013年04月 -2017年03月 
    代表者 : 矢野 健二; 金澤 成行; 冨田 興一; 藤原 貴史
     
    本研究ではポリビニルアルコールのインプラントとしての耐久性、細胞毒性、生体親和性を解析した。加速劣化試験では、シリコン群とPVA群では圧縮強度に変化は認めなかったが、PVA群の一部において試験前後での重量の増大を認めた。細胞毒性試験では、シリコン群とPVA群に、明らかな有意差は認めなかった。また、両群で明らかな形態変化、細胞骨格の変化の違いは認めなかった。ラット皮下埋植試験では、PVAに関して形状がやや膨張し、重量が増えた群も一部あり、PVA群はコントロール群のシリコンブロックに比較して、マクロファージや多核巨細胞などの炎症細胞の集積を認めた。
  • 日本学術振興会：科学研究費助成事業 若手研究(B)
    研究期間 : 2014年04月 -2016年03月 
    代表者 : 冨田 興一
     
    自家神経グラフト（ＡＮＧ）の問題点の一つにＡＮＧ内シュワン細胞（ＳＣ）生存率の低下がある。本研究では脂肪組織由来間葉系幹細胞（ＡＳＣ）の細胞保護効果に着目し、ＡＳＣをＡＮＧへ付加することでＡＮＧ内ＳＣの生存率が向上するのではないかという仮説を検証した。無血清培養下におけるＡＳＣのＳＣに対する保護効果を確認した後、ラット末梢神経損傷モデルにおいてＡＳＣを付加したＡＮＧを移植した。その結果、ＡＮＧ内における細胞死数の減少、および運動機能回復速度の向上を認めた。ＡＳＣを付加したＡＮＧは末梢神経再建において有力な方法となりえる可能性が示唆された。
  • 日本学術振興会：科学研究費助成事業 若手研究(B)
    研究期間 : 2014年04月 -2016年03月 
    代表者 : 西林 章光; 冨田 興一
     
    脱神経後における皮膚知覚の回復は、損傷された知覚神経軸索再生によるものの他、周辺の非損傷知覚神経からの側芽形成による代償性神経再支配によることが知られている。脂肪幹細胞から分化誘導させたdASCを脱神経皮膚へと移植することによる、非損傷神経からの軸索側芽形成および神経軸索再生に与える影響を検証した。dASC移植による移植早期からの知覚領域拡大を確認することができた。その機序として、NGFに依存した非損傷神経からの側芽形成と損傷神経の再生のいずれもが関与していると考えられた。拡大領域には限界が確認されたが、dASC移植は知覚領域の早期回復に対する一つの選択肢となりうる可能性が示唆された。
  • 日本学術振興会：科学研究費助成事業 基盤研究(C)
    研究期間 : 2013年04月 -2016年03月 
    代表者 : 細川 亙; 冨田 興一; 西林 章光; 金澤 成行
     
    3㎝以上の末梢神経欠損に対しては自家神経グラフト（ＡＮＧ）移植が唯一の治療法であるが、ドナー神経の犠牲、採取できる神経量の限界、レシピエントとの形状のミスマッチなどの欠点を有する。本研究ではＡＮＧの代替えと成り得るオーダーメード可能なハイブリッド型人工神経の開発を目指した。薬剤処理によって無細胞化した同種ラット末梢神経へ脂肪組織由来間葉系幹細胞から分化誘導して得られた自家シュワン細胞様細胞を付加することでハイブリッド型人工神経を作製した。神経欠損への移植後、付加した細胞の大部分はレシピエント神経由来のシュワン細胞に置き換わるものの、細胞付加により機能回復速度の促進を認めた。
  • LDLアフェレーシス療法施行中の重症家族性高コレステロール血症に対する、同種脂肪組織由来多系統前駆細胞（ADMPC）を用いた細胞移植療法の確立
    日本医療研究開発機構(AMED)：再生医療実用化研究事業
    研究期間 : 2014年04月 -2016年03月 
    代表者 : 山下 静也
  • 幹細胞を融合したオーダーメード型人工神経の開発
    日本学術振興会：基盤研究C
    研究期間 : 2013年07月 -2016年03月 
    代表者 : 細川 亙
  • ポリビニルアルコールを用いた新しい乳房インプラン ト開発
    日本学術振興会：基盤研究C
    研究期間 : 2013年04月 -2016年03月 
    代表者 : 矢野 健二
  • 自家神経グラフトと間葉系幹細胞を融合した強化型神経グラフトの開発
    公益財団法人上原記念生命科学財団：研究奨励金
    研究期間 : 2014年04月 -2015年03月 
    代表者 : 冨田 興一
  • 自家神経グラフトと間葉系幹細胞を融合した強化型神経グラフトの開発
    かなえ医薬振興財団：研究助成金
    研究期間 : 2014年01月 -2015年01月 
    代表者 : 冨田 興一
  • 混合神経損傷後神経再生の質的向上を目指した神経再建法の開発
    日本損害保険協会：交通事故医療に関する一般研究助成
    研究期間 : 2013年11月 -2014年10月 
    代表者 : 冨田 興一
  • 日本学術振興会：科学研究費助成事業 挑戦的萌芽研究
    研究期間 : 2012年04月 -2014年03月 
    代表者 : 冨田 興一
     
    シュワン細胞（SC）の皮弁内移植に着目し、脂肪幹細胞（ASC）より分化誘導したSC様細胞（dASC）の皮弁知覚向上効果を検討した。ラット鼠径皮弁を挙上、GFPラットより得た各細胞を移植、再縫着した。20週後、皮弁遠位・中心部の神経密度を評価した。移植後各細胞は約2週間の生存を認めた。遠位部ではdASCとSC移植による有意な神経密度増加を認め、その程度は非知覚皮弁でより顕著であった。一方、ASC移植は神経密度に有意な影響を与えなかった。中心部では何れの細胞移植も神経密度に影響しなかった。移植後早期、皮弁遠位部に限定されるもののdASC移植が皮弁知覚向上への新規アプローチとなる可能性が示唆された。
  • 移植皮弁における正常知覚獲得を目指して -脂肪組織由来間葉系幹細胞を用いた研究-
    日本学術振興会：挑戦的萌芽研究
    研究期間 : 2012年07月 -2014年03月 
    代表者 : 冨田 興一
  • 自家シュワン細胞、脂肪組織由来間葉系幹細胞を用いた慢性脱神経の治療
    カシオ科学振興財団、中富健康科学財団：研究助成金
    研究期間 : 2009年10月 
    代表者 : 冨田 興一
  • Treatment of chronic denervation using autologous Schwann cell and adipose-derived stem cell
    研究期間 : 2009年
  • 日本学術振興会：科学研究費助成事業 若手研究(B)
    研究期間 : 2006年 -2008年 
    代表者 : 冨田 興一
     
    末梢神経軸索が損傷を受けた際、様々なneuronal regeneration-associated genes (RAG)の誘導がニューロン、シュワン細胞においておこり、軸索再生を制御していることが明らかになってきた。我々は過去にcDNA microarrayにてp21遺伝子(p21)をRAG候補としてピックアップし、その再生神経軸索径拡大への関与を報告した。しかし、今回のp21KOマウスを用いた研究で再ミエリン化に関しては有意な関与を認めなかったため、p21と同様にRho kinaseシグナル系に属するp75遺伝子(p75)に着目した。p75のミエリン化における働きをin vivoにおいて解析する目的で、p75欠損マウスより採取したシュワン細胞を同種移植したモデルを作成した。このモデルの利点として、p75欠落神経細胞からの影響を排除し、シュワン細胞のみにおけるp75の解析ができる事が挙げられる。p75欠損神経移植群における移植神経内平均再生軸索径及びミエリンの厚さの評価では、p75欠損神経において有意に小さい値を示した。また神経伝導速度の評価においてもp75欠損神経移植群においてコントロール群と比してその回復は有意に阻害された。また、足跡分析による坐骨神経機能評価(SFI)においても同様にp75欠損神経移植群においてその回復が有意に阻害された。これらの結果よりシュワン細胞におけるp75は、軸索径やミエリンの厚みの増大、すなわち再生軸索の成熟に関わっている可能性が示唆された。

委員歴

  • 2024年04月 - 現在   日本形成外科手術手技学会   理事
  • 2024年04月 - 現在   日本マイクロサージャリー学会   定款等検討委員会
  • 2023年04月 - 現在   関西形成外科学会   評議員
  • 2023年02月 - 現在   日本乳房オンコプラスティックサージャリー学会   あり方委員会、脂肪移植ワーキンググループ、乳房温存オンコプラスティックサージャリーワーキンググループ 委員
  • 2023年02月 - 現在   日本乳房オンコプラスティックサージャリー学会   総務委員会 委員長
  • 2023年02月 - 現在   日本乳房オンコプラスティックサージャリー学会   用語委員会 委員長
  • 2022年10月 - 現在   日本乳癌学会   総務委員会 委員
  • 2021年04月 - 現在   日本創傷外科学会   学会誌編集委員（創傷、及びInternational Journal of Surgical Wound Care）
  • 2020年11月 - 現在   日本乳房オンコプラスティックサージャリー学会   研究企画委員長
  • 2020年04月 - 現在   日本創傷外科学会   評議員
  • 2018年10月 - 現在   日本乳房オンコプラスティックサージャリー学会   理事・評議員
  • 2018年04月 - 現在   日本形成外科学会   形成外科診療ガイドライン委員（乳房再建）
  • 2017年07月 - 現在   日本形成外科学会   学会誌編集委員（日形会誌、及びJournal of Plastic and Reconstructive Surgery）
  • 2016年04月 - 現在   日本乳房オンコプラスティックサージャリー学会   学会誌編集委員
  • 2015年04月 - 現在   日本形成外科学会   評議員
  • 2014年09月 - 現在   日本マイクロサージャリー学会   評議員
  • 2020年10月 - 2022年09月   日本乳癌学会   乳癌診療ガイドライン作成委員（外科療法小委員会）
  • 2019年10月 - 2022年03月   厚生労働科学研究時補助金（地域医療基盤開発推進研究事業）   美容医療診療指針作成委員会 委員

担当経験のある科目

  • 形成外科学大阪大学医学部医学科

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