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Biomedical subjects

A Toyosaka

Publications and source records attributed to A Toyosaka.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Pathophysiology of defecatory disturbance in the patient with Hirschsprung's disease and chronically constipated patients with simple megarectum].

The disturbance of defecation in the patient with Hirschsprung's disease and the pathophysiology of constipation in the constipated patient with simple megarectum were investigated. In Hirschsprung's disease, an existence of aganglionosis and the sphincter achalasia are two main factors which cause clinical symptoms such as chronic constipation and megacolon. As a surgical treatment, we have routinely performed our modified Duhamel's operation. Postoperative followup study indicated that the most cases in our series have gained a satisfactory defecatory function 1 to 3 years after operation. In chronically constipated patient with simple megarectum, on the other hand, it was found manometrically that the most of them had significantly high anal canal pressure and incomplete anal relaxation after rectal stimulation. These findings indicate that those patients have hypertonic and achalasic sphincter. Therefore, the authors propose "high anal pressure syndrome (HAPS)" for such constipated patient with simple megarectum. As to the surgical treatment, 6 patients with simple megarectum had a complete posterior internal sphincterotomy and the postoperative results were excellent or good in our series.

Adolescent↗
PubMed1984

Endoscopic extraction of foreign bodies from the duodenum: four cases in infancy.

Four cases of foreign bodies in the duodenum were treated using a flexible fibre-optic panendoscope. All the patients were boys and eight months to four years of age. The ingested foreign materials were an injection needle, a marking pin, a hairpin and a curtain hook. Endoscopic extraction was attempted, because the ingested objects might cause perforation or obstruction of the gastrointestinal tract. Until recently, they had to be carefully watched or prophylactic operation suggested. Under general anaesthesia, duodenal endoscopy was easily performed and extraction of foreign bodies was not found to be difficult during infancy. This is considered to be a safer and less hazardous way than careful watching or prophylactic operation.

Child, Preschool↗
PubMed1984

Malignant pheochromocytoma with ACTH production.

An autopsy case of a 54-year-old woman with malignant pheochromocytoma and ectopic ACTH production was reported. Noradrenaline was increased in 24 hour urine and in the blood sample from the left adrenal vein. Hormone assay studies of the tumor tissue and plasma revealed abnormally high levels of ACTH. Formaldehyde fume induced fluorescence method demonstrated biogenic amine in the tumor cytoplasm. Electron microscopic examinations also disclosed numerous neurosecretory granules in the tumor cytoplasm. These findings confirmed that this pleomorphic carcinoma of the left adrenal gland was one of the APUDoma originating from the adrenal medulla, so-called pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1983

Increase in muscarinic acetylcholine receptors in mouse intestine by hexamethonium treatment.

The effects of hexamethonium (C6) administration on muscarinic acetylcholine receptors (mACh-R) in the intestine and brain of mice were investigated. Mice were treated with C6 with an osmotic mini-pump (330 mg/kg/day) for one week and then the binding of 3H-quinuclidinylbenzilate (3H-QNB) in the intestine and brain were assayed. This treatment increased the maximum specific binding (Bmax) of 3H-QNB from 160 to 320 fmoles/mg protein in the ileum and from 190 to 340 fmoles/mg protein in the rectum, without affecting the KD values in these regions. On the contrary, C6 treatment did not change the Bmax or KD value in brain tissues. This C6 treatment increased the sensitivity of the contractile response of the intestine to muscarinic agonists, possibly by increasing mACh-R.

Animals↗
PubMed1983

Simultaneous radical surgical treatment for membranous obstruction of the inferior vena cava and the coincident hepatocellular carcinoma--the first successful case.

To our knowledge, this is the first report of a patient for whom a successful radical treatment for both membranous obstruction of the inferior vena cava (MOVC) and coincident hepatocellular carcinoma (HCC) were simultaneously carried out. A 36 year old Japanese man with Budd-Chiari syndrome due to MOVC was found to have HCC in the right hepatic lobe during a shunt operation between the inferior vena cava (IVC) and the right atrium (RA), using a vascular prosthetic graft. He was referred to us from another institute for further operative procedures. Both the mediastinum and the abdomen were entered through a long midline incision with longitudinal splitting of the sternum. The graft that had been occluded by thrombus was removed. Transcardiac membranotomy was achieved by manual manipulation and then by Tubb's dilator. The hepatic tumor with an abundant surgical margin of the liver was resected. The tumor of 2.5 X 2.5 X 2.0 cm was a well differentiated clear cell type HCC associated with congestive liver cirrhosis. Postoperative contrast and pressure studies through IVC showed satisfactory results. Serum alfa-fetoprotein levels decreased from 503 to 12 ng/ml. The patient is well at least for 44 months after the surgery without any recurrence at the time of completion of this writing.

Adult↗
PubMed1983

Serum and erythrocyte acetylcholine esterase in Hirschsprung's disease.

Determination of acetylcholine esterase in serum (S-AChE) and erythrocytes (E-AChE) was carried out in nine patients with Hirschsprung's disease and 16 normal controls. S-AChE was significantly elevated in patients with Hirschsprung's disease, while no significant difference was observed in E-AChE in these two groups. In 17 patients with Hirschsprung's disease, S-AChE and E-AChE were determined after definitive operation. Twelve of these patients underwent a Duhamel type procedure in which a small part of the aganglionic bowel segment remained unresected. Five patients were treated by Swenson's procedure performing complete resection of the aganglionic bowel segment. S-AChE in patients treated by the Duhamel type procedure remained elevated, while it was as low as that in normal controls in patients who underwent Swenson's procedure. There was no significance in E-AChE in both groups. This study suggests a close relation of the level of S-AChE to the extent of the aganglionic bowel segment in Hirschsprung's disease.

Acetylcholinesterase↗
PubMed1983

[Second-look operation for childhood solid malignancy].

Forty-four cases with childhood solid malignancy during the period from 1973 to 1982, were analysed. 11 cases underwent second-look operation, including 4 neuroblastomas, 4 hepatoblastomas, 1 malignant teratoma, 1 nephroblastoma, and 1 rhabdomyosarcoma. Two cases of hepatoblastoma in second-look operation are surviving over two years with no evidence of disease, and one case survived 5 years 8 months. For one patient of initially unresectable neuroblastoma, second-look operation was successfully performed by complete resection followed by paraortic-lymphonode dissection. In two cases of Wilms' tumor and malignant teratoma, second-look operations were performed for the purpose of treatment decision after radical operation. In the unresectable tumors or recurrent tumors or metastatic lesions, complete cure can be expected by aggressive surgical approach and combination chemotherapy followed by second-or third-look operation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

[Pathohistological evaluation of hepatic artery ligation (HAL) or transcatheter arterial embolization (TAE) on primary carcinoma of the liver].

Ischemic effect of interruption of hepatic artery upon the expansively growing primary carcinoma of the liver was studied on six resected specimens obtained by hepatectomy having been carried out 10 to 35 days after HAL or TAE. Both HAL and TAE were found to bring about an extensive coagulative necrosis in the main tumor. No substantial difference was observed between the two in the degree or the mode of necrosis produced. Complete necrosis of the tumor was observed in a case of a nodular type hepatoma in the visceral aspect of the right posterior segment. An incomplete necrosis was obtained in the main tumor of remaining 5 cases. The necrotized region was clearly demarcated from the viable portion in the tumor by the septal formation which was probably used to be the part of the capsule around the tumor. This suggested that the compartment in the tumor separated by these septa is supplied by the different artery independently. Therefore, if the interruption therapy is chosen as the sole procedure, it is stressed that complete hepatic dearterialization is mandatory for the treatment of liver cancer.

Carcinoma, Hepatocellular↗
PubMed1983

[The significance of hepatic lobectomy as the surgical treatment for primary hepatocellular carcinoma].

Since most patients with primary hepatocellular carcinoma (HCC) in Japan have cirrhosis, indication of hepatectomy is now tending to be limited to a single segment or subsegment for small HCC. However, pathologic examinations on the resected specimens have revealed that intrahepatic metastases were associated in more than 50% of HCC smaller than 5 cm, indicating that hepatic resection is required in these patients to be as extensive as possible within the limit of hepatic reserve. Our multiple regression equation provided for the preoperative prediction of an early prognosis of hepatectomized patient has successfully reduced the incidence of postoperative fatal liver failure from 17% before 1980 to 6% after 1981. The sequential volumetric CT measurements of the remaining liver after hepatectomy in humans has revealed an ability of the cirrhotic liver to regenerate nearly as normal liver in patient who has well tolerated hepatic resection. Ligation or embolization of the portal vein of an affected side in patients with unresectable HCC has rapidly induced a compensatory hypertrophy in the contralateral lobe to be remained, indicating the potential usefulness of this procedure to relatively reduce the loss of functioning liver mass by the proposed lobectomy.

Carcinoma, Hepatocellular↗