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Biomedical subjects

K Ohama

Publications and source records attributed to K Ohama.

At least 91 records · Page 5Linked to original sources
PubMed1990

The internal anal sphincter in anorectal malformation.

Recently it has been morphologically clarified that a layer of thick smooth muscle, mimicking the internal anal sphincter, exists at the rectal and even in high and intermediate anorectal malformations. This paper will describe two studies focussed on the internal anal sphincter in anorectal malformation. I. Experimental study: Utilisation of the rectal end for reconstructive surgery would necessitate the mobilisation of the rectum. We performed a chronic animal experiment in order to investigate the influence of rectal mobilisation on anal function and the role of the internal anal sphincter in anal continence. Fifteen dogs were operated on; rectal separation was performed in 5 dogs, resection of the internal anal sphincter in 5 dogs and both procedures in 5 dogs. Anorectal manometric studies for 24 weeks revealed that rectal separation caused only a transient mild disturbance in anal functions with the exception of long-standing high rectal compliance, while resection of the internal anal sphincter caused a persistent severe disturbance. II. Clinical study: The function of the smooth muscle thickening at the rectal end was investigated and operations to preserve the rectal end were evaluated in cases of high and intermediate anorectal malformations. In 5 infants with anorectal malformations (high type 2, intermediate type 3), for whom colostomies had been performed as newborn, a preoperative manometric study at the rectal end was performed with a probe introduced from the distal colostomy. Thereafter, they all underwent a rectal end preserving operation. They were followed up manometrically and clinically after the operation. A preoperative manometric study of the rectal end showed the presence of rhythmic activity in all and positive reflexive pressure fall by rectal distension in 4. The rectal end preserving operation maintained rhythmic activity in all of them, rectoanal reflex in 3 and good results are expected clinically. These two studies suggest that the functional internal anal sphincter, which exists at the rectal end also in high and intermediate anorectal malformations, should be utilised for reconstruction because of the essential role it plays in anal continence.

Anal Canal↗
PubMed1989

[Clinico-pathological study of elderly women with malignant ovarian tumors].

Twenty-five elderly women (those 70 years or older) with borderline and malignant ovarian tumors during the past 20 years were reviewed clinico-pathologically in comparison with 160 younger women (those 69 years or younger). The following results were obtained: 1) The incidence rate of elderly women for all patients of borderline and malignant ovarian tumors was 13.5%, and did not tend to increase in the past several years. 2) The rate that the elderly woman visited first at the other department excepting the department of obstetrics and gynecology was 36%, and which was statistically higher than that of the younger woman (p less than 0.01). 3) Fifty-two % of elderly patients had some complications and the incidence was significantly higher than that (23.1%) of younger patients (p less than 0.005). 4) Histopathologically in elderly patients, 9 patients (36%) were of serous cystadenocarcinoma and 17 patients (68%) were of malignant epithelial tumor (primary ovarian cancer and malignant Brenner tumor). 5) Of elderly patients, 8 (47.1%) were in Stage III and IV, and it was higher incidence than that (33.3%) of younger patients. In advanced cases, the histological grades became more poorly. 6) The survival rate of elderly patients in Stage III and IV was significantly lower than that in Stage I and II. The various treatment for Stage III and IV patients did not demonstrate the correlation in prognosis. In contrast, the survival rate for the group treated surgically in Stage I and II was significantly higher than that of non-surgical group (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

[Etiological consideration of neonatal gastric rupture: assumption of possible association with gastric volvulus and gastroesophageal reflux].

Spontaneous gastric rupture of the newborn infant can be lethal. While the etiology of this problem is unknown, pneumatic rupture of the stomach seems the most logical explanation. The rupture mostly occurs in the anterior wall of the fundus near or on the greater curvature with in the first seven days of life. Three such patients have been managed during the past 5 years. These patients are presented in detail. X-ray films of those 3 patients, of a case of gastroesophageal reflux, and of some reported cases of impending gastric rupture are also presented in an effort to better understand the pathogenesis of this gastric catastrophe. (1) Clinical findings of a double air fluid level in the upper stomach at the upright position found in one case and of the direction of advancement of the nasogastric tube enable us to consider the gastric organoaxial volvulus as an etiological factor. (2) Plain x-ray and barium study films of the case of gastroesophageal reflux and of the reported cases of impending gastric rupture also suggest some degree of gastric volvulus as the cause of corresponding diseases. (3) Fluid accumulation in the fundus is facilitated by gastric organoaxial rotation and the fluid-filled fundus acts as a barrier to prevent eructation. Retention of feeds occurs as a result of air accumulating at the pyloric end. In such situation of a fluid trap syndrome, tremendous intragastric pressures enough to cause rupture may result when vomiting occurs.

Female↗
PubMed1989

Transcatheter arterial embolization in the management of gynecological neoplasms.

Six patients were treated with transcatheter arterial embolization (TAE). Three patients suffered from intractable genital bleeding; the other three patients were preoperative cases of a stage III adenocarcinoma of the uterine cervix and two of these had gestational trophoblastic disease. Bleeding was stopped in all three cases of intractable hemorrhage; one patient rebled after 6 days. In the three preoperative cases, transcatheter arterial embolization was thought to be effective in decreasing intraoperative blood loss. There are no other reports of application of this technique to preoperative cases to decrease intraoperative blood loss in gynecological cases.

Adenocarcinoma↗
PubMed1989

Increased spontaneous and mitomycin C-induced sister chromatid exchanges in patients with cancer of the cervix uteri, with special reference to stage of cancer.

The frequencies of spontaneous and mitomycin C (MMC)-induced sister chromatid exchange (SCE) were examined in 35 patients with cancer of the cervix uteri (stage 0, eight cases; stage I, nine cases; stage II, nine cases, and stage III, nine cases) before they had undergone cancer treatment, as well as in seven patients with uterine myoma and 18 healthy women as controls. The frequency of SCE was analyzed in reference to the stage of cancer in the cancer group and in reference to chromosome group in the cancer and normal groups. The frequencies of spontaneous and MMC-induced SCE in the cancer group were 10.0 +/- 1.8 and 20.7 +/- 2.6, respectively, and both were significantly higher than in the myoma (8.1 +/- 0.8 and 17.6 +/- 1.8) and normal (7.6 +/- 0.8 and 17.6 +/- 2.3) groups. Furthermore, the frequency of SCE in the cancer group increased with cancer stage. All chromosome groups contributed equally to the increase in SCE in the cancer group. These results indicate that an increase in the frequency of SCE in patients with cervical cancer is related to the presence of cancer, but is not related to a predisposition to cancer.

Adult↗
PubMed1989

The simultaneous use of autologous blood transfusion and hypotensive anesthesia to the radical hysterectomy for uterine carcinomas.

A homologous blood transfusion is often required to replace intraoperative blood loss in a radical hysterectomy. Recently, we have tried the simultaneous use of autotransfusion (predonation and transfusion of autologous blood) and hypotensive anesthesia to eliminate the homologous blood transfusion. Radical hysterectomy was done in 27 cases with uterine cancer from June 1986 to March 1987 at the Kure National Hospital. A homologous blood transfusion was required in 1 of 5 cases with only autotransfusion, none of 5 cases with a simultaneous use of autotransfusion and hypotensive anesthesia, and 6 of 17 cases with neither autotransfusion nor hypotensive anesthesia. The simultaneous use of autotransfusion and hypotensive anesthesia seemed to be effective in reducing the need for homologous blood transfusions.

Adult↗
PubMed1989

[Characteristic ultrasonographic findings of the Krukenberg tumor].

Researching into the possibility of ultrasonographic differential diagnosis between the Krukenberg tumor and primary ovarian cancer, we investigated ultrasonograms of 14 Krukenberg tumors, 14 primary ovarian cancers and 5 rare ovarian tumors. Specifically we examined in each the echo pattern of the tumor wall, solid part and cystic part. The results were as follows. 1) Thirteen of the 14 cases of Krukenberg tumor demonstrated a clear tumor margin, irregular hyperechoic solid pattern and moth-eaten cyst formation. These characteristic ultrasonographic features might reflect the specific pathological findings of the Krukenberg tumor. In only one case was there a clear tumor margin, large central cyst formation and diffuse thick solid part around the cysts. 2) The primary ovarian cancers had an indistinct tumor margin, irregular low echoic solid pattern, clear small cyst formation, papillary proliferation and irregular thickness of the septum. Taking the ultrasonographic characteristic findings of the Krukenberg tumors into consideration, eleven of 14 primary ovarian cancers (78.6%) could be distinguished ultrasonographically from the Krukenberg tumor. 3) In rare cases, only a carcinosarcoma was unable to be distinguished ultrasonographically from the Krukenberg tumor. that make it possible to distinguished it ultrasonographically from primary ovarian cancer.

Adult↗
PubMed1989

[A comparative study of the treatment of vulvar carcinomas].

The results of treatment in our department of 24 patients with various vulvar carcinomas between 1969 and 1987 are described. There were 8 patients in stage I, 3 patients in stage II, 10 patients in stage III, 2 patients in stage IV and one patient in recurrence. Eighteen patients could be followed for more than 5 years. Particular attention was given to stage and treatments. The 5-year survival rate was 87% for stage I patients, 28% for stage III patients, 0% for stage IV patient and 0% for a recurrent patient. The 5-year survival rate was 80% (4/5) for operation group, 60% (3/5) for radiation group and 20% (1/5) for radiation and chemotherapy group.

Adenocarcinoma↗
PubMed1988

[The application of autologous blood transfusion and hypotensive anesthesia for radical hysterectomy in uterine cancer].

The homologous blood transfusion is often required for the replacement of intraoperative blood loss in the radical hysterectomy. Recently, we have tried elective autologous blood transfusion and hypotensive anesthesia to eliminate the complications caused by homologous blood transfusion. This study reports our experience at Kure National Hospital. Radical hysterectomy has been done in 27 cases with uterine cancer from June, 1985 to March, 1987. Homologous blood transfusion was required to one of 5 cases with autologous blood transfusion, none of 5 cases with autologous blood transfusion and hypotensive anesthesia, and 6 of 17 cases without either procedures. Autologous transfusion and hypotensive anesthesia seemed to be effective in reducing homologous blood transfusion.

Adult↗
PubMed1987

Decreased superoxide dismutase-2 activity in a patient with ring chromosome 6.

Manganese superoxide dismutase (SOD-2) activity was measured in erythrocytes and leukocytes of a patient with ring chromosome 6. Compared to normal control individuals, SOD-2 activity in leukocytes of the patient was lower, whereas cuprozinc SOD (SOD-1) activity was normal. These findings suggest the cause of decreased enzyme activity is the effect of the ring form on production of the enzyme or inherent instability of ring chromosomes.

Body Height↗
PubMed1987

[Sister chromatid exchange (SCE) in lymphocytes of patients with cancer of the cervix uteri].

The frequency of spontaneous and Mitomycin C (MMC)-induced sister chromatid exchange (SCE) was investigated in peripheral lymphocytes of 31 untreated patients with cervical cancer (stage 0:7 cases, stage I:9 cases, stage II:6 cases and stage III:9 cases), as well as of 7 untreated patients with myoma uteri and 16 healthy women. Factors affecting SCE frequency were also investigated. Age, smoking and atomic bomb exposure did not influence SCE frequency. However, a family history of cancer significantly increased MMC-induced SCE frequency in the cancer group. The mean spontaneous SCE frequency in the cancer group (9.83 +/- 1.74) was significantly higher than that in the myoma group (8.13 +/- 0.81) and healthy women (7.59 +/- 0.85). The mitomycin C-induced SCE frequency was also higher in the cancer group. Spontaneous and MMC-induced SCE frequency gradually increased with the progression of cervical cancer. All chromosome groups equally contributed to the increased SCE frequency in the cancer group. These results suggest that deoxyribonucleic acid of all chromosomes is damaged in patients with cervical cancer.

Adult↗
PubMed1987

[Clinico-pathological study of uterine papillary serous carcinoma].

Eight cases of uterine papillary serous carcinoma were studied clinicopathologically. Postoperatively, four were stage I and four were stage III. Operations combined with radiation and chemotherapy were performed on the stage I cases. Three of them died within one year, and the other one died 3 years and 7 months after treatment. The prognosis was extremely poor even in stage. I. UPSC is histologically similar to ovarian serous carcinoma and is characterized by a papillary architecture supported by a fibrovascular stalk and a lining epithelium of single or stratified atypical cuboidal epithelium. Psammoma bodies were found in 3 out of the 8 cases.

Aged↗