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Biomedical subjects

K Sakoda

Publications and source records attributed to K Sakoda.

At least 73 records · Page 4Linked to original sources
PubMed1982

Surgical aspect ot cystic dilatation of the bile duct. An anomalous junction of the pancreaticobiliary tract in adults.

Twenty-two cholangiograms of adults with congenital dilatation of the common bile duct were studied and analyzed. Diagnosis of this disease was established by endoscopic retrograde cholangiopancreaticography in nine patients, by percutaneous transhepatic cholangiography in two patients, and by operative cholangiography in 11 patients. All patients, except one with Caroli's disease, were classified as type I according to Alonso-Lej. An anomalous junction of the pancreaticobiliary ductal system (AJPBDS) was observed in 15 cases. In nine patients the common bile duct joined the main pancreatic duct, and in the remaining six patients, the pancreatic duct was noted to join the common bile duct. These anomalies are considered to be an important etiologic factor in the development of choledochal dilatation. Total cyst excision and hepaticojejunostomy in a Roux-en-Y fashion is recommended as the procedure of choice in those cases with AJPBDS. This is based on the high incidence of cholangitis and the high propensity to induce malignancy of cystic wall following simple drainage.

Adult↗
PubMed1982

[A case of aspergillotic meningoencephalitis associated with trigeminal neuralgia].

A case of aspergillotic meningoencephalitis associated with trigeminal neuralgia was reported. The patient, a 41-year-old female, was admitted to our hospital on Nov. 20, 1977 with the chief complaint of right trigeminal neuralgia. On admission right facial paresthesia and right abducens palsy were found. The skull x-ray and tomogram showed enlargement of the right superior orbital fissure. Ct scan revealed an irregular high density around the right superior orbital fissure. The examination of spinal fluid showed 75 mg/dl protein, 72 mg/dl sugar and 11 cells. A biopsy of the mass and trigeminal rhizotomy were performed on Dec. 21, 1977. Microscopically, the specimen was composed of nonspecific granulomatous inflammatory tissue. Thereafter, loss of visual acuity, total ophthalmoplegia and facial paresis gradually appeared on the right side with high fever elevation. Immunologically, peripheral blood lymphocytes responded normally to PHA and PWM, but numbers of lymphocytes showed a tendancy of decrease with deterioration. On the other hand, serum IgG and IgM levels were rather increased. CT scan showed that an irregular high density mass extended to the right orbital apex and the pterygoid fossa. Spinal fluid revealed 260 mmH2O pressure with 76 mg/dl protein, 55 mg/dl sugar and 293 cells, but no organisms were demonstrated. Four months after the operation, swelling of the right subtemporal region became remarkable, in which region a puncture revealed much pus retention, and Aspergillus fumigatus was cultured from the aspirated pus. The patient became comatose and died on May 20, 1978. Autopsy showed thick, yellowish green pseudomembranes covering from the right temporal tip to the basal cistern. The both of cerebral hemispheres were swollen and revealed multiple small softenings all over the brain. Small hemorrhage occupying the right temporal subcortex and microabscess located in the left thalamus were also seen. Microscopical examination disclosed that the pseudomembrane was composed of the necrotizing suppurative inflammation with branched septate hypha of Aspergillus. There have been a few reports of aspergillotic meningoencephalitis associated with trigeminal neuralgia and enlargement of the superior orbital fissure like this case. Some discussion was made on the importance for the diagnosis of aspergillosis to perform fungal culture and histological examination of materials obtained from the inflammatory site, and immunological data of this case was also presented.

Adult↗
PubMed1981

CT scan of pituitary adenomas.

CT scan is an extremely useful, almost harmless means of diagnosing pituitary adenomas. Growth hormone (GH)-secreting adenomas tent to have higher absorption coefficient on plain CT than the nonfunctioning and prolactin (PRL)-secreting adenomas. The absorption coefficient on contrasting enhanced CT does not identify the specific type of adenoma. Ring-like enhancement was observed in five nonfunctioning and four PRL-secreting adenomas with suprasellar extension, while cystic components were observed in four nonfunctioning and four PRL-secreting adenomas. In three of ten cases of PRL-microadenomas, the site corresponding to the adenoma was not enhanced, whereas the normal pituitary was. A correlation exists between the size of PRL-secreting adenoma and the serum PRL level, but not between the size of GH-secreting adenomas and the serum GH level.

Adenoma↗
PubMed1981

Pathophysiological aspect of the liver in acute obstructive suppurative cholangitis.

This study is prompted in order to clarify the pathophysiological aspect of the liver in acute obstructive suppurative cholangitis (AOSC). An experimental model of AOSC, was prepared by intracholedochal infusion of endotoxin in dogs with and without obstructive jaundice. In the patients with AOSC, liver function was aggravated remarkably compared with that in the stage of non suppurative cholangitis. A rapid fall of platelet count occurred. Experimentally, after intracholedochal infusion of endotoxin, liver function revealed significant hepatic cellular damage. A considerable increase in the S-OCT level was accompanied by a marked rise in blood ammonia concentration. Liver damage due to obstructive jaundice was further aggravated by endotoxin infusion. The level of serotonin in the liver tissue increased markedly after endotoxin infusion. This was accompanied by a rapid fall of platelet counts. Serotonin is considered to be a factor which may cause an impairment of hepatic microcirculation and then hepatic cellular damages. It may be concluded that AOSC is induced by cholangio-venous reflux of endotoxin. Liver function is impaired remarkably due to increased bile canalicular pressure, to the direct affect of endotoxin on liver cells during the process of cholangio-venous reflux, and to impairment of hepatic microcirculation in endotoxin shock. Liver dysfunction contributes to develop this clinical entity and play an important role to make its outcome fatal.

Acute Disease↗
PubMed1980

Portopulmonary shunt by splenopneumopexy as a surgical treatment of Budd-Chiari syndrome.

Portopulmonary shunting by splenopneumopexy was devised as a new surgical procedure for treatment of portal hypertension accompanied by Budd-Chiari syndrome. Technique of this procedure is simple and is safely performed. The remarkable portopulmonary shunts were visualized by splenoportography postoperatively. Splenic pulp pressure was reduced to a postoperative mean value of 258.3 mm H2O from a preoperative mean value of 336.8 mm H2O. Hemorrhage from esophageal varices and ascites were well controlled after operation. Postoperative liver function tests were essentially unchanged from the preoperative values. Any respiratory and circulatory complications after this shunting have not been observed so far. It is concluded that portopulmonary shunt by splenopneumopexy is an effective procedure for portal hypertension caused by Budd-Chiari syndrome.

Adult↗
PubMed1979

[Sphenoethmoidal meningoencephalocele associated with agenesis of corpus callosum and median cleft lip and palate--report of two cases (author's transl)].

Two cases of sphenoethmoidal meningoencephalocele are reported. Patients are a 1 year 7 month old boy and a 3 year old boy. Although sphenoethmoidal meningoencephalocele is reasonably classified as a type of basal meningoencephalocele, the authors could not find out any reports on cases designated as such. The reason must be in difficulty to differentiate the sphenoethmoidal type from the transsphenoidal type. Authors could differentiate them using CT scan. Two other cases were found in cases reported as transsphenoidal type. Further, it is assumed that these four cases including our two cases were accompanied with agenesis of corpus callosum and median cleft lip and palate. Despite the fact that the respective anomalies are rare, they are completely the same, which signifies the possibility that 1) sphenoethmoidal meningoencephalocele, 2) agenesis of corpus callosum and 3) median cleft lip and palate are a single unit of congenital anomalies. It probably should be considered that the cause for these malformations were present even before the formation of the lips which takes place earliest, that is, sixth week of gestation.

Abnormalities, Multiple↗