Journal of Computer Aided Surgery Vol.7 No.2


重症心不全に対する治療戦略 〜再生医療を中心に〜
A strategy of myocardial regenaration therapy for the impared myocardium

澤 芳樹a
a 大阪大学大学院 医学系研究科心臓血管外科

Yoshiki Sawa a
a Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine

Abstract: Regards to the therapy for end-stage failing heart, the heart transplantation is the only effective treatment but is still limited by donor shortage. Therefore, a novel strategy for myocardial regeneration are desired. Cell transplantation as a new approach to restore impaired heart still has several problems. Recently, we have developed cell sheet implantation to impaired heart. Therefore, we hypothesized that a tissue engineered contractile cardiomyocyte sheets may promise myocardial regeneration in the impaired myocardial injury. Two weeks after Left anterior descending (LAD) ligation, two different treatments were conducted; 30 rats were divided into three groups; cardiomyocytes sheets implantation (T group, n =10), 2) fibroblast sheets implantation (F group, n =10) and the control group with no treatment(C group, n =10). Cardiomyocyte sheets attached on the infarct myocardium in alignment and seemed to be homogeneous tissue in the myocardium. And immunohistochemical stain demonstrated neoangiogenesis and randomly oriented Connexin43 in implanted cardiomyocyte sheets. We constructed autologous myoblast sheets by the same method as cardiomyocyte sheets and implanted to the infarct myocardium. Myoblast sheets showed attachment to myocardium with angiogenesis. Systolic function was significantly higher in the myoblast sheet group. Histology revealed greater cellularity without scar formation and reduction of LV dilatation due to significant thickened wall. In conclusion, cardiomyocyte sheets integrated the impaired myocardium and improved cardiac performance. Thus, the contractile cardiomyocyte sheets may potentially regenerate the impaired myocardium.

Keywords: Myocardial regenearation cell transplantation, myoblast, bone marrow, heart failure.


細胞シート工学の誕生について
Inside Story of Development of Cell Sheet Engineering

大和雅之a
a 東京女子医科大学 先端生命医科学研究所

Masayuki Yamato a
a Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medial University

Abstract: In order to realize true regenerative medicine, diverse research fields should be integrated for the establishment of a collective research group with various disciplines. For example, less invasive cell sheet transplantation in clinical settings should be achieved by the utilization of computer-aided robotic surgery. Here, I summarize my personal view and inside stories on early development of cell sheet engineering and its clinical applications in regenerative medicine from my research experiences as well as philosophy inspired by scientific fiction movies.

Keywords: Temperature-responsive culture dishes, cornea, stem cells.


人工酸素運搬体の開発と実用化
Development and Practical Application for Artificial Oxygen Carrier

緒方嘉貴a
a テルモ株式会社 研究開発センター

Yoshitaka Ogata a
a TERUMO corporation R&D center

Abstract: The development of artificial blood had been proceeded through the development research of the artificial oxygen carrier : TRM-645 to substitute for the blood transfusion. We have developed the liposome encapsulated hemoglobin that have superior function for oxygen transport which was close to red blood cell as the biomimetics-technology of red blood cell. The function of oxygen transport was designed which the P50 value was controlled to 40-50torr to use the inositol-hexaphosphate as an allosteric effector. The oxygen transporting efficiency of TRM-645 under respiration with 30-50 % oxygen was superior to that of human red blood cells (hRBC). The development of the artificial oxygen carrier will be able to evolve to aim at the treatment for the stroke and the myocardial infarction as oxygen infusion liquid from the blood substitution in future. So, development of the function design will change from the blood substitution to the therapeutic purposes.

Keywords: Artificial blood, Artificial oxygen carrier, Blood substitute, Liposome, Oxygen infusion.


ポストゲノム時代における生細胞解析の重要性
Live Cell Analysis in Post Genome Science

唐木幸子a
a オリンパス株式会社 研究開発センター研究開発本部基礎技術部

Sachiko Karaki a
a Advanced Core Technology Department, Research and Development Division, Corporate R&D Center, OLYMPUS CORPORATION

Abstract: Though the Human Genome Project was completed, analyses of gene information will continue for many years especially in live cell analysis. To take observation for these research, various systems for examining living cells and DNA have developed. With these solutions, research in post genome science trends toward new approaches to research on new drugs, clinical analysis and diagnosis.

Keywords: Live cell, Genome analysis, Imaging cytometer, In vivo imaging, Laser scanning microscope.


腹腔鏡下手術支援のための仮想腹腔鏡像作成に関する検討
A study on a Method for Generating Virtual Laparoscopic Images for the Aids of Laparoscopic Surgery

林 雄一郎a, 森 健策b, 末永康仁b, 鳥脇純一郎c, 橋爪 誠d
a 名古屋大学大学院 工学研究科
b 名古屋大学大学院 情報科学研究科
c 中京大学 生命システム工学部
d 九州大学大学院 医学研究院

Yuichiro Hayashi a, Kensaku Mori b, Yasuhito Suenaga b, Junichiro Toriwaki c, Makoto Hashizume d
a Graduate School of Engineering, Nagoya University
b Graduate School of Information Science, Nagoya University
c School of Life System Science and Technology, Chukyo University
d Graduate School of Medical Sciences, Kyushu University

Abstract: In this paper, we propose a method for generating virtual laparoscopic images for the aid of laparoscopic surgery. Since the field of view of a laparoscope is very limited, the load of a surgeon who performs laparoscopic surgery is quite large. It would be very useful to generate virtual laparoscopic images from pre-operative CT or MRI images. Since the abdominal wall is lifted during laparoscopic surgery, it is required to deform an original CT image for generating a virtual laparoscopic image. We extract the abdominal wall semi-automatically and model the extracted abdominal wall by using a node and spring model. The method lifts the abdominal wall by elastic deformation. A virtual laparoscopic image is obtained by reconstructing the CT image from the result of elastic deformation. We applied the proposed method to four abdominal X-ray CT images. Experimental results showed that the proposed method could generate virtual laparoscopic images and were very useful for pre-operative surgical planning and intra-operative surgical navigation.

Keywords: Virtual laparoscopy, Virtual endoscopy, Laparoscopic surgery, Surgical simulation, Deformation.


ロボット手術プランニングのための脳の力学的モデリング
Physical Brain Model for the Planning of the Robotic Surgery

吉澤愛子a, 岡本 淳a, 藤江正克a
a 早稲田大学大学院 理工学研究科

Aiko Yoshizawa a, Jun Okamoto a, Masakatsu Fujie a
a Graduate School of Science and Engineering, Waseda University

Abstract: This paper proposes the planning and navigation of a surgical robot to perform safe and effective operations using finite element analysis results based on physical models of the brain. The physical brain models were determined based on the results of physical property tests. Finite element analyses of virtual tension tests were carried out under the same conditions as the actual tension tests, and the results of the analysis coincided with those of the test. The finite element analyses of robotic brain surgery were carried out using a two-dimensional structure, which consisted of the proposed physical models. Assuming two types of robot models are used (the brain spatula and capsule type robot respectively), stress distribution in the brain, caused by each robot model, was simulated in the analyses. The preoperative planning was considered based on the analysis results, and the safe velocity of the robot’s movement was estimated as well. The results of this research showed that organ modeling was necessary for preoperative planning in order to implement safe surgery.

Keywords: Physical brain model, Surgical robot, Surgical planning, Finite element method.


立体内視鏡下手術操作時の疲労に対する両眼立体視の影響
Evaluation of Fatigue Attributed to Binocular Stereopsis on Surgical Tasks with a Stereoscopic Endoscope

山内康司a,篠原一彦b
a 産業技術総合研究所 人間福祉医工学研究部門
b 東京工科大学 バイオニクス学部

Yasushi Yamauchi a, Kazuhiko Shinohara b
a Institute for Human Science & Biomedical Engineering, National Institute of Advanced Industrial Science and Technology (AIST)
b School of Bionics, Tokyo University of Technology

Abstract: For medical stereoscopic imaging, the usefulness of the presentation of depth information and the issues of picture quality and fatigue have been discussed. The aim of this study is to investigate the influence of binocular stereopsis on surgeon's fatigue by subjective and psychophysiological scores. 14 subjests were asked to perform three kinds of tasks - a pegboard, incision, and suturing - under the 2D and 3D conditions conducted for one hour in total. We evaluated the degree of fatigue by a questionnaire (Subjective Symptom Test of Fatigue) and by the critical flicker fusion frequency (CFF) test. In the flicker test, eyestrain due to the tasks was not observed under either 2D or 3D display conditions. Although subjective fatigues of muscles and eyes were significant, no difference was found depending on the display conditions. CFF did not show any evidence of fatigue caused by the binocular stereopsis.

Keywords: Stereoscopic endoscope, Binocular stereopsis, Critical Flicker Fusion Frequency, Fatigue.