Development of pressure valve puncture type shunt tube kit for fetal urinary tract obstruction and fetal pleural effusion
Project/Area Number |
17K11523
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Research Category |
Grant-in-Aid for Scientific Research (C)
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Allocation Type | Multi-year Fund |
Section | 一般 |
Research Field |
Pediatric surgery
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Research Institution | St. Marianna University School of Medicine |
Principal Investigator |
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Co-Investigator(Kenkyū-buntansha) |
關 保二 聖マリアンナ医科大学, 医学部, 教授 (20309462)
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Project Period (FY) |
2017-04-01 – 2020-03-31
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Project Status |
Completed (Fiscal Year 2019)
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Budget Amount *help |
¥4,290,000 (Direct Cost: ¥3,300,000、Indirect Cost: ¥990,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
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Keywords | 胎児手術 / 尿路閉塞 / 後部尿道弁 / 胎児胸水 / 膀胱羊水腔シャント / 胸腔羊水腔シャント / 膀胱機能 / 胎児水腫 / 胎児治療 / 胎児期尿路閉塞 / 多嚢胞性異形性腎 / 排尿障害 / 多嚢胞性異形成腎 / 胎児手術学 / 多嚢腎 |
Outline of Final Research Achievements |
We developed a percutaneously-inserted valved shunt for obstructive uropathy (OU). Methods: In fetal lambs, creating bladder outlet obstruction at 60 days gestation, shunting the bladder at 80 days, delivering them at term (140-145 days). Initially, the step between the trocar and the insertion sheath was too large. We reduced it. The 2nd modification strengthened the tip of the shunt, changing the bladder end to a triple-fin Malecot. The 3rd modification was creating a barbed pantograph on the fins of the Malecot catheter and improving the retention fins on the amniotic end. Results: In the 1st group of 10 lambs with OU, only 1 was in place at term. In the 2nd group of 3 lambs, only 1 catheter was successfully placed. In the 3rd group of 10 lambs, we attempted shunt placement in 8 lambs, with 5 successfully placed in the bladder. All were in place at term. Conclusion: Addition of a barbed pantograph on the fins of the bladder end of the shunt improves its retention.
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Academic Significance and Societal Importance of the Research Achievements |
胎児期に診断された閉塞性尿路疾患に対して行われる胎児期の膀胱羊水腔シャント術はそのタイミングを逸すると腎機能や膀胱機能の廃絶で胎児死亡につながる。また、膀胱に一定の圧がかかるバルブ付きシャントチューブの挿入で膀胱機能が温存出来る事を報告した。今回、子宮壁から穿刺可能な圧調整バルブ付き膀胱羊水腔シャントチューブを開発し、羊を用いて胎児実験をおこなった。 初期は樹脂製ポートであったが金属製穿刺針に変更した。また穿刺針とポートの隙間を無くした。圧調整部分はスリット状に作成し、先端の形態は留置固定率が高かった三叉マレコット型は留置率が高かった。穿刺可能な圧調整穿刺キットのプロトタイプが完成した。
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Report
(4 results)
Research Products
(30 results)
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[Journal Article] 羊胎仔の各胎生の腎における尿管芽の役割についての検討2018
Author(s)
川口皓平, 川口拓哉, 大林樹真, 小池淳樹, 眞鍋周太郎, 長江秀樹, 高木正之, 関保二, Jane Zuccollo, Kevin C Pringle, 北川博昭
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Journal Title
発達腎研究会
Volume: 26
Pages: 20-23
Related Report
Int'l Joint Research
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[Journal Article] The role of the ureteric bud in the development of the ovine fetal kidney.2018
Author(s)
Kawaguchi Kohei, Obayashi Juma, Kawaguchi Takuya, Koike Junki, Seki Yasuji, Tanaka Kunihide, Ohyama Kei, Nagae Hideki, Furuta Shigeyuki, Takagi Masayuki, Pringle KC, Kitagawa Hiroaki.
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Journal Title
Journal of Pediatric Surgery
Volume: 53
Issue: 12
Pages: 2502-2506
DOI
Related Report
Peer Reviewed / Open Access / Int'l Joint Research
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[Journal Article] 羊胎仔腎を用いた糸球体構築の免疫組織学的検討2017
Author(s)
大林樹真, 川口皓平, 田中邦英, 関保二, 長江秀樹, 眞鍋周太郎, 大山慧, Kevin C Pringle, 小池淳樹, 高木正之, 北川博昭
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Journal Title
発達腎研究会誌
Volume: 25
Pages: 17-20
Related Report
Int'l Joint Research
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[Presentation] Multicystic dysplastic kidneys and the β-catenin signaling mechanism in 2 obstructive uropathy models in the fetal lamb.2019
Author(s)
Kohei Kawaguchi, Takuya Kawaguchi, Juma Obayashi, Junki Koike, Yasuji Seki, Kunihide Tanaka, Kei Ohyama, Hideki Nagae, Masayuki Takagi, Kevin C Pringle, Hiroaki Kitagawa
Organizer
The 52st Annual Meeting of the Pacific Association of Pediatric Surgeons2019
Related Report
Int'l Joint Research
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[Presentation] Identifying of diagnostic biomarkers by peptidomics using amniotic fluid of fetal lamb diaphragmatic hernia model2019
Author(s)
Takuya Kawaguchi, Mitsumi Arito, Tsutiya Atsuhiro, Naoya Suematsu, Toshiyuki Sato, Kazuki Omoteyama, Masaaki Sato, Manami Kurokawa, Tomohiro Kato, Kohei Kawaguchi, Kevin C Pringle, Hiroaki Kitagawa
Organizer
32nd International Synposium on Pediatric Surgery Research2019
Related Report
Int'l Joint Research
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[Presentation] The role of ureteric buds in the kidneys of each embryo of the sheep fetus.2018
Author(s)
Kawaguchi Kohei, Kawaguchi Takuya, Obayashi Juma, Koike Junki, Seki Yasuji, Tanaka Kunihide, Ohyama Kei, Nagae Hideki, Furuta Shigeyuki, Takagi Masayuki, Pringle KC, Kitagawa Hiroaki
Organizer
The 51st Annual Meeting of the Pacific Association of Pediatric Surgeons.
Related Report
Int'l Joint Research
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[Presentation] 長期中心静脈栄養管理中に認めた腎障害症例の検討2018
Author(s)
川口皓平, 川口拓哉, 大林樹真, 大山慧, 長江秀樹, 古田繁行, 脇坂宗親, 斉藤陽, 小板橋賢一郎, 小池淳樹, 北川博昭
Organizer
第55回日本小児外科学会学術集会
Related Report
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[Presentation] 横隔膜ヘルニア羊モデルにおける肺低形成の過程、病態の検討2017
Author(s)
川口皓平, 大林樹真, 小池淳樹, 田中邦英, 関保二, 長江秀樹, 眞鍋周太郎, 大山慧, Jane Zuccollo, 高木正之, Kevin C Pringle, 北川博昭
Organizer
第54回日本小児外科学会学術集会
Related Report
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[Presentation] Muscle imbalance as a cause of scoliosis.2017
Author(s)
Kawaguchi Kohei, Obayashi Juma, Koike Junki, Tanaka Kunihide, Seki Yasuji, Nagae Hideki, Manabe Shutaro, Oyama Kei, Jane Zuccollo, Takagi Masayuki, Kevin C Pringle, Kitagawa Hiroaki
Organizer
PAPS 50th Annual Scientific Meeting
Related Report
Int'l Joint Research
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[Presentation] Evalution of alveolar epithelial cells in the sheep model of congenital diaphragmatic hernia: Type 1 alveolar epithelial cells and histopathological image analysis2017
Author(s)
Obayashi Juma, Kawaguchi Kokei, Koike Junki, Tanaka Kunihide, Seki Yasuji, Nagae Hideki, Manabe Shutaro, Oyama Kei, Takagi Masayuki, Kevin C Pringle, Kitagawa Hiroaki
Organizer
PAPS 50th Annual Scientific Meeting
Related Report
Int'l Joint Research
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