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Biomedical subjects

N Katada

Publications and source records attributed to N Katada.

At least 73 records · Page 4Linked to original sources
PubMed1983

Postprandial pancreatic secretion and plasma hormones in dogs with pancreatic fistula.

The responses of exocrine pancreas, plasma secretin, and gastrin to a test meal were studied in six dogs prepared with gastric and duodenal fistulas. The experiment was doubly repeated in each dog. Pancreatic juice was diverted to the exterior by direct cannulation into the major pancreatic duct. Volume, bicarbonate, and protein secretion of pancreatic juice were rapidly increased and then gradually reduced after the ingestion of the meal. Plasma secretin concentration reached a peak at 25 min after the ingestion of the meal and remained higher than the basal level for about 3 h. Plasma gastrin concentration rapidly reached a higher plateau which lasted for 40 min after the load of the test meal. A close correlation was observed between bicarbonate secretion and the increment in plasma secretin concentration and between protein secretion and the increment in plasma gastrin concentration. When pancreatic juice is diverted to the exterior, endogenously released secretin and gastrin appear to play an important role in postprandial pancreatic secretion.

Animals↗
PubMed1982

Case report of a pancreatic pseudocyst ruptured into the splenic vein causing extrahepatic portal hypertension.

In a 42 year old female, a fistula developed between the splenic vein and the pancreatic duct through the cavity of a pseudocyst in the tail of the pancreas and resulted in an extrahepatic portal hypertension. The fistula was visualized by endoscopic retrograde cholangiopancreatography and percutaneous transhepatic portography, then was successfully resected by surgery. The possible etiology of extended obstruction of both splenic and portal veins in chronic pancreatitis with pseudocyst was discussed.

Adult↗
PubMed1979

Huge lipomatous pseudohypertrophy of the pancreas.

A rare case of lipomatous pseudohypertrophy of the pancreas associated with multiple cysts in an adult is presented. Endoscopic retrograde pancreatography showed a long, willow-like main pancreatic duct. Resected body and tail of the pancreas weighed 1,200 gm.

Adult↗
PubMedDate not supplied

Laparoscopic Toupet fundoplication for gastroesophageal reflux disease with poor esophageal body motility.

Impaired esophageal body motility is a complication of chronic gastroesophageal reflux disease (GERD). In patients with this disease, a 360-degree fundoplication may result in severe postoperative dysphagia. Forty-six patients with GERD who had a weak lower esophageal sphincter pressure and a positive acid reflux score associated with impaired esophageal body peristalsis in the distal esophagus (amplitude <30 mm Hg and >10% simultaneous or interrupted waves) were selected to undergo laparoscopic Toupet fundoplication. They were compared with 16 similar patients with poor esophageal body function who underwent Nissen fundoplication. The patients who underwent Toupet fundoplication had less dysphagia than those who had the Nissen procedure (9% vs.44%; P=0.0041). Twenty-four-hour ambulatory pH monitoring and esophageal manometry were repeated in 31 Toupet patients 6 months after surgery. Percentage of time of esophageal exposure to pH <4.0, DeMeester reflux score, lower esophageal pressure, intra-abdominal length, vector volume, and distal esophageal amplitude all improved significantly after surgery. Ninety-one percent of patients were free of reflux symptoms. The laparoscopic Toupet fundoplication provides an effective antireflux barrier according to manometric, pH, and symptom criteria. It avoids potential postoperative dysphagia in patients with weak esophageal peristalsis and results in improved esophageal body function 6 months after surgery.

Deglutition Disorders↗
PubMedDate not supplied

Marginal ulcer on the jejunum after proximal gastrectomy by jejunal interposition.

Marginal ulcer after proximal gastrectomy has never been previously reported, despite that this procedure preserves the fundic gland area of the stomach, which secretes gastric acid. In this report, we describe a patient who developed a marginal ulcer on the oral side of the gastrojejunal anastomosis after proximal gastrectomy by jejunal interposition. This case serves as a reminder that gastric acid secretion of the remnant stomach must be carefully monitored after proximal gastrectomy in gastric cancer surgery.

Anastomosis, Surgical↗
PubMedDate not supplied

Surgical outcome of node-positive early gastric cancer with particular reference to nodal status.

BACKGROUND: The risk of recurrence according to nodal status in patients with node-positive early gastric cancer (EGC) remains unclear and no appropriate treatment approaches have yet been established for such patients. MATERIALS AND METHODS: The surgical outcome of gastrectomy in combination with lymphadenectomy was examined in a total of 100 patients (54 males and 46 females, ranging in age from 25 to 84 years; average 56.6 years) with EGC and metastasis to lymph nodes. The outcome was assessed with particular reference to the extent of lymph node metastasis. RESULTS: The 5 and 10-year overall survival rates were 93.5 and 89.8%, respectively. Significant differences in survival were detected when anatomical distribution of lymph node metastasis (p < 0.0001), number of positive nodes (p = 0.0004) and tumor size (p = 0.0085) were examined. In particular, in 73 patients for whom the metastasis was limited to a perigastric node, prognosis was excellent and no recurrence was observed during the follow-up period. On the other hand, 27 patients with metastasis to a lymph node beyond the perigastric region were defined as comprising a high risk group for recurrence among node-positive EGC patients due to their poor prognosis (10-year survival rate, 58.5%). CONCLUSION: The results of the present study have suggested that radical gastrectomy combined with lymphadenectomy is essential to achieve complete remission in patients with lymph node metastasis restricted to perigastric nodes. For patients with a high risk of recurrence in EGC, whose condition is complicated by lymph node metastasis beyond the perigastric region, care should be taken to prevent recurrence by conducting long-term follow-up even after radical surgery. In order to improve survival, an appropriate protocol for post-operative adjuvant therapy may be needed for patients such as those with advanced gastric cancer.

Adult↗
PubMedDate not supplied

Limited effectiveness of extended lymph-node dissection for node-negative patients with proximal gastric cancer.

BACKGROUND: The optimal surgical treatment with respect to the extent of lymph-node dissection for node-negative patients with gastric cancer remains to be established. MATERIALS AND METHODS: A total of 101 node-negative patients with proximal gastric cancer (62 males and 39 females; age range 33 to 79 years; mean 58.0 years), who had undergone curative total gastrectomy, were retrospectively evaluated to determine whether any correlation existed between survival and the extent of lymph-node dissection (D1, limited; D2, extended lymph-node dissection). RESULTS: The 10-year survival rates of patients with T1 (n = 59), T2 (n = 31) or T3 tumors (n = 11) were 100%, 90.0% and 46.7%, respectively. Significant differences in survival were found between patients with T1 and T2 tumors (p = 0.018), T2 and T3 tumors (p = 0.003), and T1 and T3 tumors (p < 0.0001). Despite the fact that only 9 patients with a T1 tumor underwent a D2 lymph-node dissection, all other patients had an excellent prognosis. On the other hand, the 10-year survival rates of patients with T2 or T3 tumors who underwent a D1 or D2 lymph-node dissection were 83.3% and 76.8%, respectively, representing no significant difference between the two procedures for advanced stage cases (p = 0.590). Multivariate analysis showed that depth of invasion was the only statistically significant prognostic factor (p < 0.0001; relative risk, 19.018). CONCLUSIONS: Conventional radical prophylactic D2 lymph-node dissection does not improve the survival of node-negative patients with proximal gastric cancer when compared to limited D1 dissection.

Adult↗
PubMedDate not supplied

Factors associated with pN3 stage tumors according to the TNM classification in advanced gastric cancer.

BACKGROUND/AIMS: The aim of the present study was to analyze factors associated with pN3-stage tumors, as classified according to the TNM Classification of Malignant Tumors, in patients who undergo curative resection for advanced gastric cancer. METHODOLOGY: A total of 391 patients with advanced gastric cancer (247 males and 144 females; average age, 59.2 years) were enrolled in the present study. The numbers of dissected regional lymph nodes and positive nodes were assessed, and node stage was determined according to TNM. Patient survival and factors associated with pN3-stage tumors were then analyzed. RESULTS: The 5-year survival rate was 82.9% for the 132 N0 patients, 66.4% for the 154 N1 patients, 41.1% for the 64 N2 patients and 21.1% for the 41 N3 patients. A significant difference was found between some of the curves (N0 and N1, p = 0.0012; N1 and N2, p = 0.0007; N2 and N3, p = 0.0055). In logistic regression analysis, independent factors associated with advanced gastric cancers with a pN3-stage tumor were tumor diameter (> 6 cm vs. < or = 6 cm, p = 0.0037), number of dissected nodes (> 30 vs. < or = 30, p = 0.0143), depth of invasion (T3 or T4 vs. T2, p = 0.0028) and microscopic type (undifferentiated vs. differentiated, p = 0.0147). CONCLUSIONS: The results of the present study suggest that tumor diameter (> 6 cm), depth of invasion (T3 or T4) and microscopic type (undifferentiated type) are the most reliable indicators of pN3-stage tumors in patients who undergo curative resection for advanced gastric cancer.

Adult↗