鶴田 雅士 (ツルタ マサシ)

Tsuruta, Masashi

写真a

所属(所属キャンパス)

医学部 外科学教室(一般・消化器) (信濃町)

職名

専任講師(有期)

メールアドレス

メールアドレス

経歴 【 表示 / 非表示

  • 2000年05月
    -
    2002年04月

    慶應義塾大学病院, 外科学教室, 研修医

  • 2001年05月
    -
    2002年04月

    多摩丘陵病院, 外科, 医員(出向)

  • 2002年05月
    -
    2003年04月

    埼玉社会保険病院, 外科, 医員(出向)

  • 2002年05月
    -
    2006年04月

    慶應義塾大学医学部, 外科学教室, 専修医

  • 2006年05月
    -
    2010年03月

    多摩丘陵病院, 外科, 医師

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学歴 【 表示 / 非表示

  • 1994年04月
    -
    2000年03月

    慶應義塾, 医学部, 医学科

学位 【 表示 / 非表示

  • 医学博士, 慶應義塾, 論文, 2009年04月

    Heat shock protein 27, a novel regulator of 5-fluorouracil resistance in colon cancer

免許・資格 【 表示 / 非表示

  • 日本外科学会 認定医, 2004年12月

  • 日本外科学会 専門医, 2006年12月

  • 日本がん治療認定医, 2009年04月

  • 日本消化器外科学会 専門医, 2010年01月

  • 日本内視鏡外科学会 技術認定医, 2010年01月

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研究分野 【 表示 / 非表示

  • 消化器外科学

  • 外科学一般

研究キーワード 【 表示 / 非表示

  • 大腸癌

  • 慢性炎症性腸疾患

研究テーマ 【 表示 / 非表示

  • Surfactant protein dと炎症性腸疾患, 

    2013年04月
    -
    継続中

  • 腸内細菌と大腸癌, 

    2013年04月
    -
    継続中

  • 大腸癌肺転移のメカニズムについて, 

    2013年04月
    -
    継続中

  • 大腸癌に対する5-Fluorouracil 薬剤耐性におけるHeat shock protein 27の役割について, 

    2006年
    -
    継続中

 

著書 【 表示 / 非表示

  • ジェネラリストのための外来診療・処置ガイドライン

    鶴田 雅士, 医学書院, 2016年02月

    担当範囲: 第9章腹部領域 Sister Mary Joseph's nodule

     概要を見る

    Sister Mary Joseph's nodule(SMJN)は、内臓悪性腫瘍の臍転移の総称である。その頻度は1%未満と低いものの、臍腫瘤の38%は悪性で、かつその80%以上は転移性との報告もある。日常臨床において比較的遭遇することの多い臍炎などを診た際にも、SMJNを念頭に置き、CTや内視鏡などの画像診断も必要に応じて行う。原疾患によっては切除治療も予後を改善するとの報告もあるが、多くは終末像の1つであり、QOLなども含めた包括的な対応を要することが多い。

  • 慶應義塾大学病院の医師100人と学ぶ病気の予習帳

    鶴田 雅士, 講談社, 2015年12月

    担当範囲: 6-6 痔

     概要を見る

    痔疾患には内外痔核、痔瘻、裂肛がある。痔核および裂肛は疼痛や出血などを認め、その治療は基本的に対症療法が中心となる。坐剤などの薬物療法および便通のコントロールによりその多くは対処可能であるが、効果不十分な場合は手術治療が必要になる。最近ではジオン注による硬化療法も普及しているが、有資格の医師のみ可能と限定されている。痔瘻は将来的に癌を合併する危険もあり、根治手術が勧められる。

  • 最新アッペ・ヘモ・ヘルニア・下肢バリックスの手術-第3版-

    鶴田 雅士, 金原出版, 2015年03月

    担当範囲: (第1章)アッペ 虫垂炎の外科治療に必要な局所解剖(解説/特集)

     概要を見る

    虫垂炎の外科治療に必要な居所解剖を、基本を中心に一部最近の知見を交えつつまとめた。急性虫垂炎は外科医の基本であるが、経験豊富な指導医であっても難渋することもある。また昨今は腹腔鏡手術の施行率も増える一方で、高度炎症や膿瘍を伴う虫垂炎では合併症の報告も多い。切除すべきもの、温存すべきものを確実に認識することが手術においての基本であり、この観点から虫垂切除に必要な解剖をわかりやく解説した。

論文 【 表示 / 非表示

  • Comparison of olanexidine versus povidone-iodine for preventing surgical site infection in gastrointestinal surgery: Study protocol for a multicentre, single-blind, randomised controlled clinical trial

    Takeuchi M., Obara H., Kawakubo H., Shinoda M., Okabayashi K., Mayanagi S., Irino T., Fukuda K., Nakamura R., Wada N., Kitago M., Yagi H., Abe Y., Oshima G., Hori S., Tsuruta M., Ishida T., Yokose T., Hirukawa K., Isobe Y., Sekimoto Y., Harada H., Maeda Y., Shito M., Kondo T., Sato Y., Kitagawa Y.

    BMJ Open (BMJ Open)  9 ( 5 )  2019年05月

     概要を見る

    © 2019 Author(s). Introduction: The prevalence of surgical site infection (SSI) remains higher in gastrointestinal surgery than in other surgeries. Although several guidelines have indicated the efficacy of chlorhexidine and povidone-iodine in reducing the SSI rate, the optimal recommendation has still not been established. Therefore, it is necessary to determine the more effective antiseptic for surgical site preparation. Olanexidine (1.5% olanedine, Otsuka Pharmaceutical Factory, Tokushima, Japan), which is a new antiseptic in Japan, has antimicrobial activity against a wide range of bacteria, including Gram-positive and Gram-negative bacteria. Our study will contribute to determining a new antiseptic for use in gastrointestinal and other surgeries. Methods and analysis: We propose a multicentre, randomised controlled clinical trial for comparing two treatments, that is, 1.5% olanexidine or 10% povidone-iodine, for surgical skin preparation to prevent SSI in clean-contaminated gastrointestinal surgeries with surgical wounds. Patients aged ≥20 years at the time of consent will be included. The primary outcome measure is the 30-day postoperative SSI rate. For the primary analysis, which is aimed at comparing the treatment effects, the adjusted risk ratio and its 95% CI will be estimated using the Mantel-Haenszel method. Ethics and dissemination: The protocol was first approved by the Institutional Review Board of Keio University School of Medicine, followed by the institutional review board of each participating site. Participant recruitment began in June 2018. The final results will be published in international peer-reviewed medical journals.

  • The impact of the mesorectal apparent diffusion coefficient value on surgical difficulty in laparoscopic anterior resection for rectal cancer

    Suzumura H., Tsuruta M., Hasegawa H., Okabayashi K., Ishida T., Asada Y., Makino A., Okuda S., Kitagawa Y.

    Surgery Today (Surgery Today)  49 ( 3 ) 239 - 244 2019年03月

    ISSN  09411291

     概要を見る

    © 2018, Springer Nature Singapore Pte Ltd. Purpose: We aimed to clarify the impact of the apparent diffusion coefficient (ADC) value of the mesorectum from preoperative magnetic resonance imaging (MRI) on surgical difficulty in laparoscopic anterior resection (Lap-AR) for rectal cancer. Methods: In total, 67 patients who had undergone curative Lap-AR for rectal cancer in our hospital from January 2008 to March 2015 and had preoperative MRI findings available were included. We randomly calculated the average ADC in three regions of the mesorectum at the level of the upper edge of the superior border of the femur. Univariate and multivariate analyses were performed to evaluate the correlation between the patients’ clinicopathological characteristics, including the ADC value and short-term surgical outcomes. Results: The univariate analysis revealed that a lower ADC value was associated with a significantly increased operative blood loss (p = 0.008) and prolonged operative time (p < 0.001). The multivariate analysis adjusted for the body mass index, anal verge, tumor location, covering stoma, clinical T factor and conversion revealed that the ADC value was an independent risk factor for a prolonged operative time (R 2 = 0.6003, p < 0.001). Furthermore, the multivariate analysis adjusted for the body mass index, anal verge, covering stoma, clinical T factor and conversion revealed that the ADC value was an independent risk factor for an increased blood loss (R 2 = 0.4345, p = 0.008). Conclusion: A lower ADC value of the mesorectum might be a predictor of surgical difficulty in Lap-AR for rectal cancer.

  • Adhesive intestinal obstruction increases the risk of intestinal perforation in peritoneal dialysis patients: A case report

    Fujii K., Washida N., Arai E., Tsuruta M., Wakino S., Itoh H.

    BMC Nephrology (BMC Nephrology)  19 ( 1 )  2018年06月

     概要を見る

    © 2018 The Author(s). Background: Peritonitis secondary to bowel perforation is a rare and potentially fatal complication in peritoneal dialysis (PD) patients. However, the early diagnosis of bowel perforation is difficult in PD patients because the initial symptoms and signs of bowel perforation are similar to those of PD-associated peritonitis. Furthermore, the risk of bowel perforation in PD patients is unclear. Here, we present a case of intestinal perforation located at the site of adhesive intestinal obstruction in a PD patient. Case presentation: A 73-year-old man on PD presented with progressive worsening of abdominal pain and cloudy peritoneal fluid. The peritoneal fluid cell count was increased to 980/ml and peritoneal dialysis-associated peritonitis was diagnosed. Computed tomography showed local adhesions causing agglomeration of the dilated intestine. He initially responded to antibiotic treatment; however, his abdominal pain was rapidly worsened after resumption of oral intake. On hospital day 23, computed tomography showed loss of contents from the dilated intestine and discharge of fecal material from the PD tube was noted. Thus, small bowel perforation was diagnosed, and he underwent ileocecal resection with colostomy creation. As indicators of EPS was not evident, PD catheter was removed. Since then, he has been on maintenance of hemodialysis since then. Conclusion: The findings of the present case suggest that adhesive intestinal obstruction in PD patients can increase the risk of intestinal perforation. Careful monitoring for the early detection of intestinal perforation is required in such cases.

  • Comparison of Preoperative Inflammation-based Prognostic Scores in Patients with Colorectal Cancer

    Suzuki Y., Okabayashi K., Hasegawa H., Tsuruta M., Shigeta K., Kondo T., Kitagawa Y.

    Annals of Surgery (Annals of Surgery)  267 ( 3 ) 527 - 531 2018年03月

    ISSN  00034932

     概要を見る

    © 2016 Wolters Kluwer Health, Inc. All rights reserved. Objective: To evaluate the prognostic impact of the systemic inflammation score (SIS) in colorectal cancer (CRC) patients in comparison with a conventional inflammation-based score, the modified Glasgow Prognostic Score (mGPS). Summary Background Data: The SIS, which is calculated based on the preoperative serum albumin level and lymphocyte-to-monocyte ratio, is a reported prognostic marker in clear-cell renal cell carcinoma. However, the utility of the SIS in CRC remains unclear. Methods: The study involved 727 CRC patients who underwent curative resection between September 2005 and December 2011. The prognostic impact of SIS and mGPS was evaluated using survival analyses. The prognostic impact of each score was compared visually by means of time-dependent receiver operating characteristics analysis. Results: The median age of the patients was 67 (interquartile range: 58-75) years. The TNM stage distribution was stage I, 29.8%; stage II, 33.6%; stage III, 30.3%; and stage IV, 6.3%. The median follow-up period was 5.61 years (interquartile range: 4.24-7.06). Multivariate analysis revealed that an increased SIS and mGPS were independent prognostic factors (SIS: P = 0.018; mGPS: P = 0.005, respectively). The time-dependent receiver operating characteristics curve of the SIS was superior to that of the mGPS throughout the observation period. The estimated area under the curve (AUC) of the SIS was significantly higher than that of the mGPS (7-yr survival: SIS 0.673, mGPS 0.605, P = 0.030). Conclusions: The SIS is a novel prognostic factor in CRC patients. Additionally, the SIS is an alternative inflammation-based biomarker, which may improve the prediction of clinical outcomes.

  • Heat shock protein 27 knockdown using nucleotide-based therapies enhances sensitivity to 5-FU chemotherapy in SW480 human colon cancer cells

    Shimada T., Tsuruta M., Hasegawa H., Okabayashi K., Shigeta K., Ishida T., Asada Y., Suzumura H., Koishikawa K., Akimoto S., Kitagawa Y.

    Oncology Reports (Oncology Reports)  39 ( 3 ) 1119 - 1124 2018年03月

    ISSN  1021335X

     概要を見る

    Heat shock protein 27 (Hsp27) is a chaperone protein of low molecular weight that is produced in response to various stresses and has a cytoprotective function. In the present study we found that there is a strong correlation between sensitivity to 5-fiuorouracil (5-FU) and the expression of Hsp27 in colorectal cancer. Apatorsen is an antisense oligonucleotide that targets Hsp27 and has various antitumor effects in some types of cancer, such as bladder and prostate. Although several clinical studies are currently studying apatorsen in many malignancies, to date no promising results have been reported for colorectal cancer. In the present study, we examined the impact of Hsp27 downregulation (via apatorsen) on 5-FU sensitivity in colon cancer both in vitro and in vivo. In vitro, apatorsen significantly decreased the levels of Hsp27 in a dose-dependent manner in human colon cancer SW480 cells. A cell proliferation assay revealed that although apatorsen did not inhibit tumor growth, it resulted in greater 5-FU sensitivity in comparison with treatment with OGX-411 (control). In vivo, intraperitoneal injection of apatorsen decreased the levels of Hsp27 in subcutaneous tumors in a xenograft mouse model using SW480 cells and enhanced 5-FU sensitivity, compared to controls. Although further research is warranted, the present study confirmed that concurrent treatment with Hsp27 knockdown using apatorsen and 5-FU could be a promising therapy for colon cancer.

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KOARA(リポジトリ)収録論文等 【 表示 / 非表示

研究発表 【 表示 / 非表示

  • SURFACTANT PROTEIN D AS THE NOVEL ULCERATIVE COLITIS-SUSCEPTIBLE MOLECULE

    鶴田 雅士

    GASTROENTEROLOGY, 2017年04月

  • Apatorsen enhances 5-FU sensitivity in colon cancer cell SW480

    鶴田 雅士

    CANCER RESEARCH, 2015年08月

  • The impact of oral anticancer drugs on recurrence pattern after adjuvant chemotherapy in colorectal cancer patients.

    鶴田 雅士

    JOURNAL OF CLINICAL ONCOLOGY, 2015年01月

  • Muscle volume loss after the induction of first-line chemotherapy as a novel prognostic factor in metastatic colorectal cancer patients

    鶴田 雅士

    JOURNAL OF CLINICAL ONCOLOGY, 2015年01月

  • Impact of liver fibrosis on effects and adverse effects of unresectable colorectal cancer under first line chemotherapy including CPT-11

    鶴田 雅士

    JOURNAL OF CLINICAL ONCOLOGY, 2015年01月

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競争的資金等の研究課題 【 表示 / 非表示

  • 大腸癌肺転移における肺サーファクタント蛋白d

    2019年04月
    -
    2022年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 鶴田 雅士, 基盤研究(C), 補助金,  代表

 

担当授業科目 【 表示 / 非表示

  • 急性期病態学総論

    2019年度

  • 外科学講義

    2019年度