KAWATE, Norihiko

写真a

Affiliation

Faculty of Human Sciences, School of Human Sciences

Job title

Professor

Concurrent Post 【 display / non-display

  • Faculty of Human Sciences   Graduate School of Human Sciences

Degree 【 display / non-display

  • Tokyo Medical University   Docotor of Medicine

Professional Memberships 【 display / non-display

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    Japan Surgical Society

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    The Japan Lung Cancer Society

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    The Japan Society for Respiratory Endoscopy

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    The Japanese Society of Clinical Cytology

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    The Japanese Association for Chest Surgery

 

Research Interests 【 display / non-display

  • Cancer, Lifestyle-related diseases, General Medicine, Rehabilitation Medicine, Health Surveillance Medicine, Emergency Medicine

Papers 【 display / non-display

  • Maximizing Use of Robot-Arm No. 3 in Da Vinci-Assisted Thoracic Surgery

    Naohiro Kajiwara, Junichi Maeda, Koichi Yoshida, Yasufumi Kato, Masaru Hagiwara, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    INTERNATIONAL SURGERY   100 ( 5 ) 930 - 933  2015.05  [Refereed]

     View Summary

    We have previously reported on the importance of appropriate robot-arm settings and replacement of instrument ports in robot-assisted thoracic surgery, because the thoracic cavity requires a large space to access all lesions in various areas of the thoracic cavity from the apex to the diaphragm and mediastinum and the chest wall.(1-3) Moreover, it can be difficult to manipulate the da Vinci Surgical System using only arms No. 1 and No. 2 depending on the tumor location. However, arm No. 3 is usually positioned on the same side as arm No. 2, and sometimes it is only used as an assisting-arm to avoid conflict with other arms (Fig. 1). In this report, we show how robot-arm No. 3 can be used with maximum effectiveness in da Vinci-assisted thoracic surgery.

    DOI

  • Cost-benefit performance of robotic surgery compared with video-assisted thoracoscopic surgery under the Japanese national health insurance system

    Naohiro Kajiwara, James Patrick Barron, Yasufumi Kato, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Annals of Thoracic and Cardiovascular Surgery   21 ( 2 ) 95 - 101  2015

     View Summary

    Background: Medical economics have significant impact on the entire country. The explosion in surgical techniques has been accompanied by questions regarding actual improvements in outcome and cost-effectiveness, such as the da Vinci&lt
    sup&gt
    ®&lt
    /sup&gt
    Surgical System (dVS) compared with conventional video-assisted thoracic surgery (VATS). Objective: To establish a medical fee system for robot-assisted thoracic surgery (RATS), which is a system not yet firmly established in Japan. Methods: This study examines the cost benefit performance (CBP) based on medical fees compared with VATS and RATS under the Japanese National Health Insurance System (JNHIS) introduced in 2012. Results: The projected (but as yet undecided) price in the JNHIS would be insufficient if institutions have less than even 200 dVS cases per year. Only institutions which perform more than 300 dVS operations per year would obtain a positive CBP with the projected JNHIS reimbursement. Conclusion: Thus, under the present conditions, it is necessary to perform at least 300 dVS operations per year in each institution with a dVS system to avoid financial deficit with current robotic surgical management. This may hopefully encourage a downward price revision of the dVS equipment by the manufacture which would result in a decrease in the cost per procedure.

    DOI PubMed

  • High-speed 3-dimensional imaging in robot-assisted thoracic surgical procedures

    Naohiro Kajiwara, Soichi Akata, Masaru Hagiwara, Koichi Yoshida, Yasufumi Kato, Masatoshi Kakihana, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Annals of Thoracic Surgery   97 ( 6 ) 2182 - 2184  2014

     View Summary

    We used a high-speed 3-dimensional (3D) image analysis system (SYNAPSE VINCENT, Fujifilm Corp, Tokyo, Japan) to determine the best positioning of robotic arms and instruments preoperatively. The da Vinci S (Intuitive Surgical Inc, Sunnyvale, CA) was easily set up accurately and rapidly for this operation. Preoperative simulation and intraoperative navigation using the SYNAPSE VINCENT for robot-assisted thoracic operations enabled efficient planning of the operation settings. The SYNAPSE VINCENT can detect the tumor location and depict surrounding tissues quickly, accurately, and safely. This system is also excellent for navigational and educational use. © 2014 by The Society of Thoracic Surgeons Published by Elsevier Inc.

    DOI PubMed

  • Extended indications for robotic surgery for posterior mediastinal tumors

    Naohiro Kajiwara, Masatoshi Kakihana, Jitsuo Usuda, Tatsuo Ohira, Norihiko Kawate, Norihiko Ikeda

    Asian Cardiovascular and Thoracic Annals   20 ( 3 ) 308 - 313  2012.06

     View Summary

    Previously, we evaluated use of the da Vinci Surgical System for anterior and middle mediastinal tumors in clinical cases, focusing on feasibility, safety, and appropriate settings. In this study, we evaluated extending the indications for robotic surgical treatment of posterior mediastinal tumors to include those located adjacent to the upper vertebrae or aorta. Three patients with mediastinal tumors located immediately adjacent to the vertebrae or aorta, underwent resection with the da Vinci Surgical System. All resected tumors were benign histologically. Robotic surgery enabled treatment of tumors located in the posterior mediastinum, which are very difficult to reach, making resection with the conventional video-assisted thoracoscopic surgery technique extremely difficult. All procedures were performed safely, smoothly, and extremely precisely. Crucial to the success of these operations were the appropriate placement and angle of the special da Vinci surgical ports in relation to the target and the patient's position, which varied according to the tumor location. © The Author(s) 2012.

    DOI PubMed

  • Interventional management for benign airway tumors in relation to location, size, character and morphology Journal of Thoracic Disease

    Naohiro Kajiwara, Norihiko Kawate, Norihiko Ikeda

    J. of Thoracic Diseases   3 (4)   221 - 230  2011.12

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Books and Other Publications 【 display / non-display

  • Surgical textbook for nursing

    ( Part: Joint author)

    2017.08

  • 肺癌細胞診断 形態とその臨床 改訂版 第2章 肺癌の確定診断法 8.CTガイド下針生検

    河手典彦

    ベクトル・コア  2013.11

  • ナースの外科学 改訂第6版 各論5 呼吸器疾患

    池田徳彦, 河手典彦

    中外医学社  2013.01

  • ロボット手術の現況と展望

    梶原直央( Part: Joint author)

    金原出版  2012.11

  • 呼吸療法テキスト 10気道管理-3気管支鏡

    学会合同呼吸療法認定士認定委員会( Part: Joint author)

    アトムス  2012.06

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Research Projects 【 display / non-display

  • Then analysis of lung cancer protein using two-dimensional polyacrylamide gel electrophoresis Application for adjuvant chemotherapy

    Project Year :

    1998
    -
    1999
     

     View Summary

    1. Sixteen polypeptides associated with histopathological differentiation were detected using two-dimensional polyacrylamide gel electrophoresis of primary lung carcinoma.
    2. Based on the expression of the polypeptides associated with either histopathological differentiation or cell proliferation, we classified primar lung adenocarcinoma into typical case and atypical case. 65.4% of the typical cases were diagnosed as well differentiated adenocarcinoma histopathologically. Also, 65.4% of the typical cases showed negative in lymph node metastasis. On the other hand, 20.5% and 34.9% of the atypical cases were judged as well differentiated case and cases without lymph node metastasis, respectively. Furthermore, we recognized the statistically significant difference in three year-disease free survival(62.9% in typical cases, 27.1% in atypical cases ; p=0.0011).
    3. We produced monoclonal antibodies against N-terminal of TA02 molecule. The histological distribution of TA02 was clarified immunohistochemically using this antibody and human tissues. Also, we obtained the evidence that TA02 molecule was homologos with NapsinA which was a novel aspartic proteinase published at the end of 1998, because the adenocarcinoma cases with high expression of TA02 showed the expression of napsin A in RNA level. Furthermore, GST fusion protein of Napsin A showed positive reaction with anti-TA02 antibody.
    4. TS02 associated with neuroendocrine cells was homologous with protein gene product 9.5(PGP 9.5). In the TS02 positive cases two-years prognosis become worse compared to TS02 negative cases.
    5. Compred to the 2DE patterns between CDDP-resistant cell line and the parents cell line, the positions of reticulocarbin and glutathione-S-transferase π were identified on 2DE gel. The expession level of reticulocalbin, which was Ca-binding protein at endoplasmic reticulum, became low in the CDDP-resistant cell line. On the other hand, the expression level of GST-πbecame high, remarkably.
    6. The analysis based on lung cancer protein using 2DE is valuable for the evaluation of biological tumor malignancy.

  • Then analysis of lung cancer protein using two-dimensional polyacrylamide gel electrophoresis Application for adjuvant chemotherapy

    Project Year :

    1998
    -
    1999
     

     View Summary

    1. Sixteen polypeptides associated with histopathological differentiation were detected using two-dimensional polyacrylamide gel electrophoresis of primary lung carcinoma.
    2. Based on the expression of the polypeptides associated with either histopathological differentiation or cell proliferation, we classified primar lung adenocarcinoma into typical case and atypical case. 65.4% of the typical cases were diagnosed as well differentiated adenocarcinoma histopathologically. Also, 65.4% of the typical cases showed negative in lymph node metastasis. On the other hand, 20.5% and 34.9% of the atypical cases were judged as well differentiated case and cases without lymph node metastasis, respectively. Furthermore, we recognized the statistically significant difference in three year-disease free survival(62.9% in typical cases, 27.1% in atypical cases ; p=0.0011).
    3. We produced monoclonal antibodies against N-terminal of TA02 molecule. The histological distribution of TA02 was clarified immunohistochemically using this antibody and human tissues. Also, we obtained the evidence that TA02 molecule was homologos with NapsinA which was a novel aspartic proteinase published at the end of 1998, because the adenocarcinoma cases with high expression of TA02 showed the expression of napsin A in RNA level. Furthermore, GST fusion protein of Napsin A showed positive reaction with anti-TA02 antibody.
    4. TS02 associated with neuroendocrine cells was homologous with protein gene product 9.5(PGP 9.5). In the TS02 positive cases two-years prognosis become worse compared to TS02 negative cases.
    5. Compred to the 2DE patterns between CDDP-resistant cell line and the parents cell line, the positions of reticulocarbin and glutathione-S-transferase π were identified on 2DE gel. The expession level of reticulocalbin, which was Ca-binding protein at endoplasmic reticulum, became low in the CDDP-resistant cell line. On the other hand, the expression level of GST-πbecame high, remarkably.
    6. The analysis based on lung cancer protein using 2DE is valuable for the evaluation of biological tumor malignancy.

  • Development of Photodynamic Therapy for Malignant Tumors

     View Summary

    Photodynamic therapy (PDT) is based on incorporation of a photosensitizer that has high affinity for malignant tissue and stimulation of the photosensitizer with a low power laser beam, with tumorcidal effects. Using the same principle fluorescence can also be elicited from the tumor by a laser beam of a different wavelength in order to detect the lesion. Our team has investigated this therapeutic modality in basic and clinical studies for ten years. Our initial studies employed hematoporphyrin derivative (HpD) as the photosensitizer for PDT with an argon dye laser and we have reported the first cases of five-year survival in a case of cancer treated only by PDT.Mono-L-aspartyl chorin e (NPe ) is a photosensitizer newly developed in 1987. This material shows higher affinity to tumor and better light absorption than HpD. It has a strong absorption band at a wavelength longer than 600nm and consequently is not affected by hemoglobin. Further investigations are necessary for clinical application.An excimer dye laser which more powerful than the argon dye laser has been developed for clinical applications. This laser equipment makes it possible to diagnose and treat in the same procedure by a wavelength-change device. Especially for diagnoses, the fiberscopic image, fluorescent light, and fluorescent wave length are shown in the same image.The basic experiment of photodynamic therapy has been performed. HpD and NPe have been shown to have a high affinity for mitochondria. Damage to the mitochondria by photosensitizer was recognized by decrease in mitochondrial movement. This is in agreement with theories that the first step of photodynamic therapy is degeneration of mitochondria.In 1987 the basic investigation, the laser equipment and the newly developed photosensitizer for photodynamic therapy were established. Our proposed project is a clinical trial and comparison with PDT using HpD and argon dye laser, as well as with other modalities

 

Syllabus 【 display / non-display

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