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Biomedical subjects

H Kai

Publications and source records attributed to H Kai.

At least 163 records · Page 9Linked to original sources
PubMed1984

Induction of enterokinase in the rat small intestine following hypersecretion of trypsinogen by chronic trypsin inhibitor feeding.

The interrelationship between trypsin/trypsinogen and enterokinase (EK) was studied in rats following induction of trypsinogen hypersecretion by various agents. Both soybean trypsin inhibitor and para-aminobenzamidine increased intraluminal tryptic activities to a level about twice that found in the control rats. This resulted in an increase in the mucosal and the intraluminal contents of EK in the rat small intestine. On the other hand, in cholecystokinin-treated rats, although there was an increase of intraluminal trypsin, the increase was about 80% less than in the inhibitor-fed rats. Under this condition, there was no effect on the mucosal or the intraluminal EK. These results suggested that substantial increase in intraluminal trypsin/trypsinogen levels (two-fold over control) will increase the mucosal and the intraluminal concentrations of EK in the rat small intestine. Our observation extends previous reports that a decreased level of trypsin/trypsinogen, such as in pancreatic insufficiency, leads to a decrease in mucosal EK. These observations, when taken together, strongly support the modulating role of intraluminal trypsin/trypsinogen levels in controlling the EK concentrations in the small intestine.

4-Aminobenzoic Acid↗
PubMed1984

Breath hydrogen test in infants and children with blind loop syndrome.

Breath hydrogen production after oral lactose loading was examined in infants and children with stagnant loop syndrome, blind loop syndrome, or both. All six infants under 3 years of age had bacteriological evidence of small intestinal colonization. The characteristics of the breath hydrogen test in this syndrome are: (a) extremely high basal excretion of breath hydrogen (after overnight fasting); (b) an earlier and greater breath hydrogen value (0.293 +/- 0.201 ml/min/m2: mean +/- SD) after oral lactose administration than formed in lactose malabsorption alone (0.050 +/- 0.041 ml/min/m2); and (c) the observation of a sustained hydrogen rise over several hours. This investigation demonstrated that the breath hydrogen test is a promising and noninvasive tool for diagnosing blind (or stagnant) loop syndrome.

Blind Loop Syndrome↗
PubMed1984

Total parenteral nutrition with a new amino acid solution for infants.

The currently available, commercially prepared amino acid mixtures for intravenous usage do not result in completely normal plasma amino acid patterns. Taking into consideration the known imbalances that occur with the commercial preparations, we designed a new amino acid solution (AF). This solution was prepared to contain a low concentration of those amino acids usually found in increased concentrations in plasma during the course of total parenteral nutrition (TPN) with a commercially prepared product (CF) and a high concentration of branched-chain amino acids and arginine. Plasma amino acid concentrations were determined for nine infants receiving CF (Group A) and eight infants receiving AF (Group B) as the protein source while on TPN for 5 days. These data were compared to 2-h postprandial values obtained from breast-fed, growing infants serving as controls. In comparison with controls, the plasma concentrations of threonine, glycine, methionine, phenylalanine, tryptophan, and lysine were higher in infants in group A, while those of taurine, alanine, valine, cystine, isoleucine, and proline were lower. In group B, the levels of valine and leucine were slightly higher, while those of alanine, cystine, tyrosine, histidine, and proline were lower. Mean nitrogen balances in groups A and B were + 112 and + 170 mg/kg/day, respectively. Therefore, our new amino acid solution may be better for infants receiving TPN.

Amino Acids↗
PubMed1983

Hyperthermo-chemo-radiotherapy for carcinoma of the esophagus.

Hyperthermo-chemo-radiotherapy was prescribed preoperatively for eight patients with carcinoma of the esophagus. Histological study of the resected specimens showed marked effect in two, moderate effect in four and slight effect in two. In those with marked effect, there were no viable neoplastic cells, and severe necrosis and complete destruction were evident on the mucosal surface. These two patients have had no recurrence, now at 27th and 31st postoperative months. Those findings suggest that hyperthermo-chemo-radiotherapy is effective for selected patients with carcinoma of the esophagus.

Aged↗
PubMed1983

Delayed anastomosis of the cervical portion of the esophagus in bypass operations for unresectable carcinoma of the esophagus.

To prevent the high incidence of anastomotic leakage in a bypass operation for unresectable carcinoma of the esophagus, we devised a two stage bypass procedure, in which the anastomosis of the cervical portion of the esophagus to the gastric tube is delayed for about two weeks after the first operation. With this approach, the short segment of the cervical part of the esophagus adequately adheres to the surrounding tissue by the time of the second operation, and the anastomotic site no longer responds to the strong force accompanying deglutition. One-half of the anastomotic leaks which occurred on the one stage procedure was reduced to nil when the two stage approach was done.

Esophageal Neoplasms↗
PubMed1983

Endotract antenna for application of hyperthermia to malignant lesions.

As hyperthermia treatment for deeply located malignant lesions is most difficult, two types of endotract antenna were devised, one constructed for radio frequency and the other for administration of microwave to tumors of the esophagus and colorectum. Well-controlled temperatures can be applied to the narrowed pyloric canal of dogs with these two instruments, which appear to have great promise for clinical application.

Animals↗
PubMed1983

Patterns of recurrence after curative resection for carcinoma of the thoracic part of the esophagus.

Two hundred patients with a previously untreated carcinoma of the thoracic portion of the esophagus and who underwent curative or noncurative resection were retrospectively evaluated. The patterns of recurrence were compared with the pathologic findings at operation. In 30 of 90 (33.3 per cent) patients in the curative resection group and 68 of 110 (61.8 per cent) of those in the noncurative resection group, there was a recurrence. Hematogenic recurrence was most frequent in instances of blood vessel invasion of the carcinoma detected at the time of the operation, and death occurred during the early postoperative period. Lymph node recurrence was most frequent in instances of lymphatic invasion or blood vessel invasion, or both, and the postoperative survival time in such patients was double that seen in those with a hematogenic-related recurrence.

Adult↗
PubMed1982

Cough dynamics in oesophageal cancer: prevention of postoperative pulmonary complications.

The value of the cough reflex and its pressure and flow in the immediate postoperative period was measured in patients who underwent subtotal oesophagectomy and reconstruction for oesophageal cancer and other thoracic surgery. Twenty-two patients with subtotal oesophagectomy and reconstruction were found to have an extensive reduction in cough reflex and force, compared with those who had undergone pulmonary lobectomy. Damage to the vagal nerve caused by dissection of the paratracheal lymph nodes, and injury to the diaphragm during operation for oesophageal cancer appeared to be responsible for the inability to cough. It was of interest that the patients who showed a high value of cough reflex and force in the immediate postoperative period had few pulmonary complications. The postoperative measurement of cough ability may be a useful indicator for safe extubation of the intratracheal tube, as a means of preventing pulmonary complications after thoracic surgery. Continuous mechanical ventilation and frequent suction to remove retained secretions are strongly recommended for the patients who are unable to cough properly.

Aneurysm↗
PubMed1982

Postoperative long-term immunochemotherapy for esophageal carcinoma. 5 year survival.

Two groups of patients with esophageal carcinoma were studied retrospectively: Group I as controls, included 50 patients who underwent esophageal resection mainly combined with preoperative radiation therapy during the period from 1965 to 1971; and Group 2 included 83 patients who were given the same treatment plus post-operative radiation and adjuvant postoperative long-term cancer immunochemotherapy during the period from 1972-1979. The one, two and five-year survival rates were 32.0, 14.0 and 12.0 per cent in Group 1, and 55.4, 35.8 and 21.5 per cent in Group 2 respectively. There were significant differences in one-year (p less than 0.02) and two-year (p less than 0.05) survival rates between the two groups. We also found that adjuvant therapy was effective in patients with no lymph node metastasis, while it was less effective in those with lymph node metastases.

Adjuvants, Immunologic↗
PubMed1982

Clinical efficacy of the stapled anastomosis in esophageal reconstruction.

We have clinically evaluated Russian and American stapling devices used for esophageal reconstruction and compared the results following stapled anastomosis with those following hand-sutured procedures, both performed by the same surgeon. With the Russian stapler, anastomoses performed in 17 patients with carcinoma of the thoracic esophagus resulted in only one (5.9%) anastomotic leak; in 12 hand-sutured anastomoses and in 11 anastomoses done with an American stapler, no anastomotic complication occurred. Thus, a long gastric tube with good blood supply is of paramount importance, and if the technical details of surgical stapling can be overcome, a stapled anastomosis appears to be as safe as a manual suturing for patients undergoing esophageal reconstruction.

Esophageal Neoplasms↗
PubMed1982

Failure of p-aminobenzoic acid screening test to diagnose pancreatic insufficiency in Shwachman's syndrome.

The 6-h urine recovery of p-aminobenzoic acid (PABA) following the administration of a standard dose of N-benzoyl-L-tyrosyl-p-aminobenzoic acid (BTPABA) was performed in 13 control subjects and two siblings with Shwachman's syndrome. The control subjects showed a recovery of 67 +/- 12.1% (mean +/- 1 SD) of the administered dose, consistent with previously reported values. Unexpectedly, the recovery of PABA in two siblings with Shwachman's syndrome was found to be 67 and 63%, respectively. The values are well within the normal range. In these siblings, fecal chymotrypsin activities were very low when measured with N-acetyl-L-tyrosyl-ethyl ester (ATEE) as substrate, but were normal when BTPABA was the substrate. The duodenal juice of the younger affected child following pancreozymin-secretin stimulation showed very low chymotrypsin activity against ATEE, BTPABA, and N-benzoyl-L-tyrosyl-ethyl ester. These findings suggest that there may be BTPABA-splitting activity in the lower bowel of these siblings with Shwachman's syndrome. This activity might be that of enteric bacteria or of the intestinal mucosa.

4-Aminobenzoic Acid↗
PubMed1982

Problems in esophageal bypass for unresectable carcinoma of the thoracic esophagus.

The clinical evaluation of esophageal reconstruction in both resectable and unresectable carcinoma of the thoracic esophagus is described. Our operative technique for obtaining a long gastric tube and creating and end-to-side anastomosis has been highly successful, and the anastomotic failure rate was remarkably lowered in patients with resectable carcinoma of the esophagus. However, anastomotic leakage remains a serious problem for those undergoing esophageal bypass for unresectable carcinoma of the esophagus. The most likely cause of anastomotic failure after bypass seems to be the tug on the anastomosis with each swallow.

Esophageal Neoplasms↗
PubMed1980

Watery diarrhoea with a vasoactive intestinal peptide-producing ganglioneuroblastoma.

An 8-month-old boy with persistent watery diarrhoea and failure to thrive developed abdominal distension, hypokalaemia, and flushing of the face and trunk. A high concentration of vasoactive intestinal peptide-like immunoreactivity was found in the serum. Soon after resection of a suprarenal mass, the serum level of vasoactive intestinal peptide became normal and the diarrhoea stopped. Histologically the tumour was a ganglioneuroblastoma: the cells showed fluorescence by the indirect immunofluorescence technique with anti-vasoactive intestinal peptide serum. Electron microscopical examination showed abundant secretory granules in the tumour cells. Reports of chronic watery diarrhoea in children due to neural crest tumours are reviewed, with particular respect to the clinical features of the syndrome.

Abdominal Neoplasms↗