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Biomedical subjects

S Kamata

Publications and source records attributed to S Kamata.

At least 19 recordsLinked to original sources
PubMed1992

Massive small bowel resection in neonates--is weaning from parenteral nutrition the final goal?

Eight surviving cases from an original 15 pediatric patients who underwent massive small bowel resection during their neonatal period were reviewed for a period of 2-19 years to assess long-term prognosis. the primary diseases were congenital intestinal atresia in 6 cases and midgut volvulus in 2. The length of the residual small intestine ranged from 27-75 cm and the ileocaecal valve had been resected in 3 cases. All cases were able to be weaned from parenteral nutrition and at present, 6 of the children can tolerate normal meals but 2 are still receiving enteral nutrition, in the form of a low residue diet at home. Near normal somatic growth was achieved in the most recent 5 cases who received intensive nutritional treatment in the immediate postoperative period, whereas 3 who did not receive nutritional management exhibited growth retardation. The D-Xylose absorption test revealed gradual improvement and finally normal absorption in all except one case with the shortest remaining intestine (27 cm). However, the fat absorption test revealed abnormal absorption in cases with a residual intestine of less than 45 cm. Late metabolic complications such as renal calculi, cholelithiasis and pathologic fractures were encountered in 3 cases.

Child↗
PubMed1992

Anterior sagittal anorectoplasty for rectovestibular and anovestibular fistula.

Rectovestibular (or anovestibular) fistula is the most common form of anorectal anomaly in female infants. In the surgical repair of these malformations, anal transplantation has been in widespread conventional use. Based on the idea of posterior sagittal anorectoplasty, we devised a new approach, anterior sagittal anorectoplasty, in which, in the lithotomy position, the anterior portion of sphincter muscles are cut through a median perineal skin incision and then the rectum is pulled through the center of these muscles to make its opening at the normal position. The operation has been performed in 12 patients with satisfactory results.

Anal Canal↗
PubMed1992

Injection of bleomycin as a primary therapy of cystic lymphangioma.

Forty-five patients (19 boys and 26 girls) with lymphangioma have been treated at Osaka University Hospital during the 10-year period from January 1978 to December 1987. Twenty-nine underwent initial bleomycin (BLM) therapy. These patients' lesions consisted of large cystic masses that were demonstrated by echography or computed tomography scans. BLM was administered as a solution of 1 mg/mL in saline, after aspiration of the cyst contents using a puncture needle. The total dose ranged from 3 mg to 32 mg (average, 10 mg) and was administered between 1 and 16 times. Of the 29 cases treated with BLM, 25 cases (86%) showed significant reduction of the mass and 16 (55%) showed complete disappearance. Recurrence occurred in 3 patients. One responded to further injection of BLM, and the other 2 required surgical resection. Thirteen patients required surgical resection; however, in those cases, the previous injection of BLM was found to minimize the extent of surgical resection required. There were no serious side effects with BLM injection. Injection of BLM as an initial treatment of cystic lymphangioma was found to be very useful. It can reduce the size of the mass and even result in complete disappearance; consequently, it can minimize the frequency and extent of surgical intervention.

Bleomycin↗
PubMed1992

Intrapancreatic duodenal duplication associated with pancreatic pseudocysts.

A rare case of intrapancreatic duodenal duplication causing pancreatitis is reported. At 2 years of age, the patient presented with a recurrent pancreatic pseudocyst. Intraoperative pancreatogram showed the presence of cystic duodenal duplication in the aberrant lobe of the pancreas communication with the pancreatic duct. Since the resection of the duplication, she has been free from recurrence of pancreatitis. In this case, intraoperative pancreatography was of great value.

Duodenum↗
PubMed1992

A novel class of platelet activating factor (PAF) antagonists. I. Synthesis and structure-activity studies on PAF-sulfonamide isosteres.

New platelet activating factor (PAF) antagonists, 3 were synthesized by replacing the charged phosphate and trimethylammonium moieties with sulfonamide and heterocyclic quaternary ammonium functionalities, respectively (PAF-sulfonamide isosteres). Darmstoff phosphatidic acid analogues of this class (Darmstoff-sulfonamide isosteres), 6 were also synthesized. The activity of these compounds as PAF antagonists was evaluated from their in vitro inhibitory effect on PAF-induced platelet aggregation in rabbit platelet-rich plasma. Among the compounds tested, some of the 2-methoxypropane derivatives with an octadecylcarbamoyloxy or octadecylcarbamoylthio side chain at the 1-position and a propylsulfonamide function bearing a terminal polar substituent such as a quaternary quinolinium or substituted quinolinium group at the 3-position were found to be the most potent (IC50 = 0.3-0.6 microM).

Animals↗
PubMed1992

A novel class of platelet activating factor (PAF) antagonists. II. Modification of the 2-position of the glycerol backbone of PAF-sulfonamide isosteres.

In a continuing effort to obtain more potent platelet activating factor (PAF) antagonists, we tried to synthesize a series of PAF-sulfonamide isosteres in which the substituent at the 2-position was modified to an acetoxy equivalent other than the methoxy group. These modifications produced highly active PAF antagonists. Compound 3-[2-(5-methyl-2H-tetrazol-2-yl)-3-(octadecylcarbamoyloxy) propylaminosulfonyl]propylquinolinium iodide (52) showed the most potent activity in the in vitro inhibitory effect on PAF-induced platelet aggregation in rabbit platelet-rich plasma (IC50 = 125 nM) and also in the in vivo protective effect on PAF-induced lethality in mice, with prolonged duration of action. Optically active enantiomers of this compound were synthesized and the (S)-(-)-isomer (IC50 = 87 nM) was found to be three times more potent that the (R)-(+)-isomer (IC50 = 289 nM), clearly exemplifying the enantioselectivity in the PAF-antagonist action of this novel compound.

Animals↗
PubMed1992

[A retrospective analysis of surgical operations on malignancies of the ear].

In the past 20 years from 1970 to 1990, 21 patients with malignancies of the ear were treated at Cancer Institute Hospital. The primary sites were the auricle and cartilaginous external auditory canal (group 1: n = 8), the bony external auditory canal (group 2: n = 6) and the middle ear (group 3:n = 7). In group 1, pathological types were squamous cell carcinoma in four patients and basal cell carcinoma in the other four patients. Seven patients were treated by surgery alone, and the remaining patient was treated by interstitial implant radiotherapy. No recurrence have been noted up to today in this group. In group 2, pathological types were squamous cell carcinoma in four patients and adenoid cystic carcinoma in the other two patients. All of the six patients underwent external canal resection or subtotal temporal resection. Two patients received postoperative radiotherapy. A five year survival rate of group 2 was 60%. In group 3, pathological types were squamous cell carcinoma in six patients and undifferentiated carcinoma in the remaining patient. Most of them underwent radical mastoidectomy followed by irradiation. However, all the patients died within two years after treatment. In group 2 and 3, cytodiagnosis was useful for early discovery. In group 2, temporomandibular joint seemed to be a key point in surgical treatment. In group 3, the combination of conservative surgery with radiotherapy was not a radical treatment. This suggested it necessary to perform subtotal temporal resection to treat malignancy of the middle ear.

Adult↗
PubMed1992

The effect of phlebotomy on serum erythropoietin levels in normal healthy subjects.

We evaluated endogenous serum erythropoietin (Epo) levels in 14 normal subjects (eight males and six females) after a single 400-ml phlebotomy. The subjects were followed up for 56 days. The hemoglobin (Hb) values of both males and females decreased to a nadir on days 3 to 7 post-phlebotomy. Hb values gradually increased, but did not completely recover to pre-phlebotomy levels by day 56. Serum Epo levels increased after 6 h post-phlebotomy, to 20.1 +/- 5.4 (mU/ml) in males and 20.7 +/- 7.0 in females, from the pre-phlebotomy levels of 14.6 +/- 4.0 in males and 13.4 +/- 4.1 in females, respectively. Epo levels continued to increase to peak levels of 25.5 +/- 6.3 in males and 28.7 +/- 11.5 in females on days 7 to 14 and thereafter decreased until day 56. Thus, the Epo response to a 400-ml phlebotomy was relatively small in magnitude and was not sufficient to initiate a significant increase in erythropoiesis. This finding suggests that the administration of recombinant human erythropoietin (rHu-Epo) may be effective for the prompt correction of anemia induced by autologous blood donation and for increasing the volume of predonated autologous blood.

Adult↗
PubMed1992

[Pseudocoarctation associated with dissecting aneurysm of the aorta: a case report].

A case of pseudocoarctation with dissecting aneurysm of the ascending aorta and arch is reported. A 49-year-old man was admitted with chest pain and loss of consciousness. Angiogram showed kinking of the aortic isthmus and dissecting aneurysm of the ascending aorta. There was no pressure gradient between arms and legs. Prosthetic graft replacement of the ascending aorta was successfully performed by the use of total cardiopulmonary bypass with moderate hypothermia. Etiology of the development of pseudocoarctation is unknown, however, hypothesis that embryological abnormality of the aortic arch is one of the contributing factors has been widely accepted. This case was accompanied by bicuspid aortic valve. It is suggested that the developmental etiology of this case seems to be similar to that of classical coarctation of the aorta. Development of the dissecting aneurysm is supposed to be due to hypertension of the upper body during exercise, even though there is no pressure gradient at rest.

Aortic Dissection↗
PubMed1992

[A case of emphysematous pyelonephritis with disseminated intravascular coagulation].

A case of emphysematous pyelonephritis with disseminated intravascular coagulation (DIC) is presented. A 54-year-old woman was admitted to our hospital because of unclear consciousness and extremely high blood glucose level. The laboratory data suggested uncontrolled diabetes mellitus (DM) and urinary tract infection with sepsis and DIC. The plain abdominal X-P and abdominal CT revealed the existence of gas in the right renal parenchyma, perinephric tissue and the upper part of the right ureter. Right nephrectomy was performed after the improvement of the patient's condition by the echo-guided drainage of the right kidney and the treatment for infection, DM and DIC. We reviewed 71 cases of emphysematous pyelonephritis in the Japanese literature and the choice of treatment was discussed.

Disseminated Intravascular Coagulation↗
PubMed1992

Roux-en-Y versus interposition biliary reconstruction.

We compared two types of biliary reconstruction for congenital dilatation of the bile duct--Roux-en-Y hepaticojejunostomy and jejunal interposition hepaticoduodenostomy after removal of the dilated bile duct. There were no significant differences in the occurrence of early and late complications except for the repeated attacks of abdominal pain that occurred only in the group that underwent jejunal interposition hepaticoduodenostomy. The results of further examinations for the presence of bile reflux with 99mTc-pyridoxyl methyl tryptophan scintigraphy and gastroscopy in this group revealed a high incidence of chronic gastritis associated with bile reflux. This report is the first to demonstrate the occurrence of bile reflux gastritis in patients who underwent jejunal interposition hepaticoduodenostomy, which is theoretically a more logical approach than the other method of bile reconstruction. Further studies, with respect to possible mechanisms, as well as careful and longer follow-up evaluation, are required.

Adolescent↗