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Biomedical subjects

K Kuwata

Publications and source records attributed to K Kuwata.

At least 109 records · Page 6Linked to original sources

[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↗

Histologic and embryologic studies on the innervation of the pelvic viscera in patients with Hirschsprung's disease.

On the specimens taken at autopsy from three newborns with Hirschsprung's disease and three newborns in the control group, the innervation of the pelvic organs was histologically studied. The authors found that all the pelvic organs, except for the rectum in patients with Hirschsprung's disease, preserved a completely normal innervation not only of pelvic autonomic nerve plexuses, but also of sensory nerves of spinal origin. Even in the wall of the aganglionic rectum, the extrinsic sympathetic as well as parasympathetic nerve fibers were preserved, which showed a marked proliferative change due to the absence of target nerve cells upon which they otherwise terminated. An additional embryologic study was performed upon 20 human embryos. The results revealed that the pelvic nerve plexuses were formed during the six to ten gestational week period by neural cells migrating along the pelvic visceral branches of sacral nerves, while none of these neural cells was found to enter the rectum. The enteric plexuses of the rectum were formed later by neural cells that migrated down along the alimentary tract in a craniocaudal manner. The two separate origins, the sacral for the pelvic nerve plexuses and the vagal for the enteric plexuses of the rectum, seem to be the reason why innervation of the genitourinary organs, which are located in front of the aganglionic rectum, is normal in those patients with Hirschsprung's disease.

Autonomic Nervous System↗

[The effects of sphincteroplasty on manometric profile of common bile duct and the duodenum (author's transl)].

A simultaneous manometric monitoring of the common bile duct (CBD) and the duodenum were performed 2 weeks after choledocholithotomy on 15 patients whose common bile ducts were explored without sphincteroplasty and 30 patients with sphincteroplasty. These manometric studies were carried out by open-tip catheters intubated into the CBD and duodenum through the T-tube at the operation. In patients without sphincteroplasty, no effects of the duodenal pressure on a CBD pressure profile were recognized, while a synchronized pressure profile of the CBD and the duodenum was obtained in patients with sphincteroplasty. By stimulation with morphine (Morphine sulfate; 0.17 mg/Kg iv bolus), waxing and waning of the pressured in the CBD without sphincteroplasty were observed with 20 cmH2O in maximum at about 13 minutes after injection. However, in the CBD with sphincteroplasty, scale-over increase of the pressure curve was seen immediately after duodenal contraction caused by morphine stimulation. A direct infusion of 5 ml of 0.1 N hydrochloride to the duodenum causes hyperperistalsis of the duodenum, which made a synchronized pressure profile in the CBD with sphincteroplasty but made no remarkable change in a pressure profile of the CBD without sphincteroplasty. These findings conclude that the sphincter of Oddi plays an important role as a "pressure barrier" between the CBD and the duodenum, and that with the destruction of this sphincter by sphincteroplasty, a pressure profile of the CBD becomes close to that of the duodenum. This simultaneous manometric study of the CBD and the duodenum might be one of most valuable methods for evaluation of completeness of the sphincteroplasty.

Ampulla of Vater↗

Hemangioma of the liver. Diagnosis with combined use of laparoscopy and hepatic arteriography.

A case of hepatic hemangioma is reported in which preoperative diagnosis, with the combined aid of serial selective hepatic arteriography and laparoscopy, was necessary. The patient underwent right hepatic lobectomy after extensive extrahepatic individual ligations with no severe postoperative complications. The combined use of selective hepatic arteriography and laparoscopy is emphasized as essential for the correct diagnosis of hepatic hemangioma.

Adolescent↗