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S Kamata

Publications and source records attributed to S Kamata.

At least 55 records · Page 3Linked to original sources
PubMed1999

New classification of stage IV squamous cell carcinoma of the oropharynx.

OBJECTIVE: The recent progress in reconstructive surgery for the treatment of head and neck carcinomas has made it possible to radically resect cancers. However. the choice of treatment for oropharyngeal carcinoma is rather difficult. Radical treatment sometimes results in severe complications, suggesting that some modes of treatment might reduce the quality of life. The 5-year survival rate of patients with stage IV oropharyngeal carcinoma is still very poor. It is necessary to re-classify stage IV squamous cell carcinoma of the oropharynx in relation to the prognosis. Foote et al. (Base of tongue carcinoma: patterns of failure and predictors of recurrence after surgery alone. Head Neck 1993:15:300-307) demonstrated the two subgroups of stage IV oropharyngeal squamous cell carcinoma, as favorable stage IV and unfavorable stage IV. In this study, we have re-examined the validity of these subsets and we have demonstrated the new subsets of stage IV squamous cell carcinoma of the oropharynx. METHODS: We have examined 221 cases of oropharyngeal squamous cell carcinoma at the Cancer Institute Hospital in Tokyo between 1971 and 1994. A total of 107 cases of stage IV were included. We analyzed these cases retrospectively. RESULTS: Based on the subsets demonstrated by Foote et al., there were no significant differences between the two groups in our cases, suggesting that these subsets were not useful for the choice of the treatment. In order to make a new classification in view of better choice of treatment, either radical treatment or palliative therapy, these cases were divided into two new groups of stage IV. one group with relatively good results (T1-3 N2 M0 and T4 NO-1 M0; new favorable stage IV), and the other with very poor results (any-T any-N M1 and any-T N3 M0 and T4 N2 M0; new unfavorable stage IV). Patients with the new favorable stage IV have a 5-year survival rate of 30.4%, and those with the new unfavorable stage IV had a survival rate of 0%. CONCLUSION: These new subsets of stage IV can be directly related to the prognosis, and are therefore useful in the choice of treatment.

Carcinoma, Squamous Cell↗
PubMed1999

Functional ileus in neonates: Hirschsprung's disease-allied disorders versus meconium-related ileus.

Sixty-eight neonates with functional ileus were reviewed. Twelve required laparotomy; in seven, histological studies revealed decreased ganglia and ganglion cells of the myenteric plexus (MP) (Group A), and in five, MP was normal (Group B). In the remaining 56 cases, obstructive symptoms were relieved following conservative therapy (Group C). All Group A cases except one had normal birth weight, while Group B and C cases showed significantly lower birth weights. A marked caliber change of the small intestine and/or small-caliber distal intestine with meconium stagnation in the proximal intestine was commonly demonstrated at operation in Group A and B, or on contrast enema in Group C. Four Group A cases died of enteritis, and three survivors suffered from prolonged obstructive symptoms. The grade of histological abnormality of MP correlated with the clinical outcome. In Group B, three died of sepsis shortly after surgery, but two survivors have been free from symptoms. Group A can be categorized as Hirschsprung's disease-allied disorders (HAD). Group B and C can be categorized as meconium-related ileus (MRI). The similarity of the macroscopic findings of HAD and MRI, and the occurrence of MRI exclusively in low birth weight neonates, strongly suggest that functional immaturity of MP plays a role in the etiology of MRI.

Ganglia↗
PubMed1999

Nasal nocardiosis in a calf.

Nasal nocardiosis was found in a female Japanese Black calf, 11 months of age. Macroscopically, the posterior half of the left nasal passage was completely obstructed by yellowish brown caseous substance and the mucosa was irregularly thickened. In the brain, a few soft brown foci were present in the olfactory bulb and frontal lobe. Microscopically, there were closely packed granulomas in the nasal cavity and brain. The lesions were characterized by a center of cellular debris surrounded by epithelioid macrophages, neutrophils, lymphocytes and multinucleated giant cells of the Langhans type. Special stains revealed the presence of a large number of filamentous branching gram-positive, partially acid-fast organisms in these epithelioid cells and giant cells, and in cellular debris.

Animals↗
PubMed1999

[Aggressive angiomyxoma in the scrotum: a case report].

A case of aggressive angiomyxoma occurring in the scrotum is reported. A 57-year-old Japanese man presented with a 2-year history of non-tender soft mass in the scrotum. Computed tomography and magnetic resonance imaging revealed a well-defined mass 8 cm in diameter extending from the medial aspect of the left ischium. Angiography revealed faint vascularity fed by the left internal pudendal artery. Excision was performed by a scrotal approach, and histological examination confirmed an aggressive angiomyxoma. The patient showed no recurrence at 3 months follow-up.

Female↗
PubMed1999

The importance of the plasma amino acid molar ratio in patients with biliary atresia.

BACKGROUND: Plasma amino acid patterns and the therapeutic benefits of amino acid supplements are not examined well in postoperative patients with biliary atresia (BA). This study aimed to investigate profiles of the amino acid molar ratio, the Fischer molar ratio (FR, valine + leucine + isoleucine/phenylalanine + tyrosine), and relationships with other nutritional parameters and to assess the efficacy of enteral nutrient preparations for hepatic failure in patients with BA. METHODS: In study 1 profiles of FR were analyzed in 24 patients with BA (aged 3 to 12 years) in the postoperative period and compared with liver function tests and anthropometric measures. In study 2 10 patients with BA with a FR < 2.0 were begun on a dietary regimen consisting of an ordinary diet supplemented with a branched-chain amino acid-enriched elemental diet. RESULTS: Study 1: In jaundiced patients with total bilirubin levels > 2.0 mg/dL the FR remained below 2.0 throughout the period of observation, in contrast with nonjaundiced patients. The FR was closely related to the levels of serum albumin and plasma rapid turnover proteins and anthropometric measures as well as biochemical data reflecting intrinsic liver function. Study 2: A significant increase in rapid turnover proteins and improvement of general status were noted concurrently with an increase of the FR. CONCLUSIONS: The FR indicates a combination of nutritional status and intrinsic liver function in post-operative BA patients. The FR is a useful parameter in conducting nutritive therapy with a branched-chain amino acid-enriched elemental diet in those patients.

Adolescent↗
PubMed1999

[Emergency and subemergency coronary artery bypass graft: active use of arterial grafts].

Fifty-nine patients underwent emergency or subemergency coronary artery bypass grafting (CABG) from June 1996 to February 1999. The patients were divided into two groups, namely an emergency group (13 patients) and subemergency group. The patients in the emergency group were operated on within 24 hours of diagnosis and those in the subemergency group were operated immediately after 24 hours of diagnosis. In the emergency group, two patients required cardiac resuscitation before operation because of a cardiogenic shock. Eleven patients of the emergency group required intra-aortic balloon pumping (IABP) before operation. Eleven patients operated for mediansternotomy with a cardiopulmonary bypass and remaining two patients for minimally invasive direct coronary artery bypass grafting (MIDCAB). The ratio of arterial grafts was 52% in the emergency group (8 LITA, 7 Radial artery, 1 RGEA). Four of the 13 patients used only SVG. There was one each of the operative and hospital death. On the post operative angiography of the grafts, arterial graft were all patent. In the subemergency group, 38 of 46 patients underwent conventional CABG with median sternotomy using a cardiopulmonary bypass. MIDCAB was indicated in eight patients. Thirty-one patients had a bypass formed with only arterial grafts, 84.7% of whom used arterial grafts. On the postoperative angiography, LITA, RGEA, and IEA were all patent and the radial artery was occluded in one anastmosis (96%). Only one patients died of mediastinitis 25 days after operation. In both groups CABG using arterial grafts can be done even with IABP inserted if the preoperative condition is stable. This will help improve late prognosis.

Aged↗
PubMed1999

[Late phase II clinical study of RP56976 (docetaxel) in patients with advanced/recurrent head and neck cancer].

A late phase II clinical study of RP56976 (docetaxel), a new anticancer agent for advanced/recurrent head and neck cancer, was conducted in 29 institutions all over Japan as a multi-institutional cooperative study. Docetaxel was administered by 1 to 2-hour intravenous infusion at a dose of 60 mg/m2 every 3 to 4 weeks. Of 63 patients eligible in this study, 59 were judged as complete cases. Complete response (CR) was observed in 1 patient, partial response (PR) in 13, no change (NC) in 25, and progressive disease (PD) in 20, for an overall response rate of 22.2% (14/63, 95% CI: 12.7-34.5%) in eligible cases, and 23.7% (14/59, 95% CI: 13.6-36.6%) in complete cases. Previously treated patients showed a 17.9% (10/56) response rate, whereas treatment--naive patients showed a 57.1% (4/7) response rate. Among 46 patients who received prior chemotherapy, one CR and 7 PR were observed with a 17.4% response rate. Major hematological toxicities were leucopenia in 95.1% (> or = grade 3, 59.7%) and neutropenia in 90.3% (> or = grade 3, 79.0%). Other severe toxicities (> or = grade 3) included anorexia in 9.7% (6 cases), diarrhea in 3.2% (2 cases), dyspnea in 3.2% (2 cases), and fatigue in 3.2% (2 cases). One patient had a grade 3 interstitial pneumonia; however, symptoms were resolved by the administration of corticosteroids. During this study, one patient died due to multiple organ failure (MOF) caused by disseminated intravascular coagulation (DIC), and this case was reported as a therapy-related death. Based on these results, docetaxel is an active agent for treatment of head and neck cancer.

Adenocarcinoma↗
PubMed1998

Prolonged preoperative stabilization using high-frequency oscillatory ventilation does not improve the outcome in neonates with congenital diaphragmatic hernia.

Although delayed repair with preoperative stabilization using high-frequency oscillatory ventilation (HFOV) has been advocated in neonates with congenital diaphragmatic hernia (CDH), improved survival has not been reported. We compared survival between neonates undergoing delayed repair after prolonged stabilization for more than 48 h using HFOV and those undergoing immediate repair following short stabilization using HFOV in subjects with high-risk CDH. Patient selection was made by two criteria: fetuses with the lung/thorax transverse area ratio (L/T) below 0.26 and neonates who presented with respiratory distress significant enough to require intubation within 6 h after delivery. Selection of the strategies differed by era and medical center. Stabilization failed in 11 of 18 patients with delayed repair and only 7 patients (38.9%) in this group survived, but 18 of 23 patients (78.3%) in the immediate-repair group survived (P < 0.05). Although lower values of Apgar scores, best postductal PO2 (BPtDPO2), gestational weeks, and L/T and more frequent patch repair were observed in the delayed than in the immediate repair group, significant differences in survival among the subpopulations were also observed in the prenatally diagnosed group, including the group with L/T < 0.15 and the group that required ECMO, the group with the best preductal PO2 (BPrDPO2) >/= 100 torr, and the group with BPtDPO2 < 100 torr. These results indicate that prolonged stabilization for more than 48 h using HFOV does not improve survival in patients with high-risk CDH.

Combined Modality Therapy↗
PubMed1998

Successful laparoscopic cholecystectomy in a child with upper transverse scarring: report of a case.

Laparoscopic cholecystectomy (LC) was safely performed for cholelithiasis in a 4-year-old boy who had a long transverse operative scar in the upper abdomen as a result of intestinal surgery performed during the neonatal period. The adhesions beneath the scar were sharply divided and sometimes coagulated, and additional working ports were subsequently placed as the adhesiolysis proceeded. LC was performed in the usual fashion using 5-mm titanium clips, and his postoperative course was uneventful. This case report serves to demonstrate that laparoscopic surgery is feasible even for pediatric patients who have undergone previous major intraabdominal surgery.

Child, Preschool↗
PubMed1998

Mutational analysis of the endothelin-B receptor gene in Japanese Hirschsprung's disease.

BACKGROUND/PURPOSE: Hirschsprung's disease (HD, HSCR) is one of the most common diseases in the field of pediatric surgery. It is well known that the aganglionic bowel is primarily a causative factor of dismotility of distal narrow segment. Recent studies have shown that mutations in endothelin-B receptor (EDNRB), endothelin-3, RET, glial cell line-derived neurotrophic factor (GDNF) genes are responsible for the occurrence of congenital aganglionosis. Here, the authors describe two new mutations of the EDNRB gene in Japanese patients with HD. RESULTS: One patient had a heterozygous point mutation at the splice donor site of intron 3, leading to premature termination of translation of EDNRB mRNA. Another patient has a heterozygous missense mutation (N1041) in exon 1, but the same mutation was found in two of 50 normal individuals, so the mutation may be a noncausative polymorphism of the EDNRB gene. CONCLUSION: These results provide further evidence that a spectrum of different mutations within the EDNRB gene are responsible for HD.

Base Sequence↗
PubMed1998

Thirty-eight years experience of malignant hepatic tumors in infants and childhood.

A description is given of therapeutic experiences with 39 cases of malignant liver tumors in infancy and childhood during the past 38 years. Of these patients, 9 not undergoing hepatic resection all died, while 18 (60%) of 30 patients treated by hepatic resection survived. When only patients with hepatoblastoma are considered, 14 of 24 patients are alive, although 3 of them had local recurrence and had lung metastasis. Among patients with other types of liver tumor, those with hepatocellular carcinomas (2 cases) and vascular neoplasms all died in a short period of time, whereas 2 with yolk sac tumor and one with metabolic pancreatic tumor are alive despite of tumor recurrence. In summary, the results of surgical treatment of malignant liver tumors in infancy and childhood, which formerly were poor, have been improved remarkably, which we owe mainly to: 1) advances in diagnostic imaging techniques (e.g., angiography, ultrasonography, CT and MRI) permitting early diagnosis, localization of tumor, visualization of the coursing of major vessels (particularly, hepatic artery & vein) and more accurate definition of resectability, 2) technical improvement of hepatic resection and 3) progress of chemotherapy mainly with cisplatin and adriamycin.

Adolescent↗
PubMed1998

[A study of minimally invasive direct coronary artery bypass (MIDCAB): comparison of low risk group and high risk group].

We started to perform MIDCAB for the cases of markedly low cardiac function from June, 1996 and obtained satisfactory results. So we expanded the indications to include only left anterior descending artery (LAD) lesion from June, 1997 and have since performed this operation on 14 cases. The 14 cases of MIDCAB were divided into two groups, Group L consisting of 6 low risk cases: 1 lesion alone without any complications involving other organ before operation and Group H made up of 8 high risk cases: multi branch lesion but rated as high risk because of the extracorporeal circulation being used. Both Group L and Group H were free of operation death and hospital death. In Group L, all the cases underwent operation without blood transfusion, the period of postoperative stay in ICU was not longer than 1 day, on catecholamine was required after operation and complications were not found either. The patency of the graft was 100 percent. The patients were discharged 13.7 days after operation. In Group H, 2 cases required blood transfusion and 3 cases required catecholamine after operation. Complication arising from operative wound were noted in 3 cases. One GEA graft to the right coronary artery and one LITA to the LAD buried in the muscle were occluded. After operation, hospital stay for 23.9 days was required. In Group L, the postoperative course was excellent, so MIDCAB was considered indicated well for this group. In Group H too, the selection of MIDCAB was considered adequate that the risk of conventional CABG is considered much higher.

Adult↗
PubMed1998

[Coronary artery bypass grafting with arterial graft alone: radial artery and inferior epigastric artery used in combination].

UNLABELLED: We experienced 8 cases in which Coronary Artery Bypass Grafting (CABG) was performed by the arterial graft alone with radial artery (RA) and inferior epigastric artery (IEA) used in addition to internal thoracic artery (ITA) and right gastroepiploic artery (RGEA). All the patients were male ranging in age from 50 to 66 years (mean 57.5 year). The number of anastomosis was 3 to 5 branches (mean 3.6 branches). IEA was anastomosed with LITA and used as a composite graft in all cases. As for the proximal anastomosis of RA it was anastomosesd with ascending aorta. On postoperative radiography of graft, LITA, RITA, IEA and RA were all patent and RGEA was occluded only in one anastomosis where it was sequentially used (96.6%). All the patients followed a satisfactory postoperative course, and no case developed any major complications. CONCLUSION: The use of IEA and RA made it possible to perform CABG using only the artery with excellent postoperative results and early patency rate of the graft.

Aged↗
PubMed1998

[High dose chemotherapy with peripheral blood stem cell transplantation (PBSCT) For advanced testicular cancer].

Five patients with metastatic testicular cancer of advanced extent according to the Indiana University criteria were enrolled into this study. All tumors were non-pretreated non-seminomas. Initially all patients were treated with standard dose etoposide, ifosfamide and cisplatin (VIP) regimen. The response of two cycles of VIP was evaluated by tumor markers and diagnostic imagings. Two of the five patients showed a good response to VIP and subsequently achieved a pathological complete response (pCR) following surgical resection of residual masses after 3 or 5 courses of VIP. However, they suffered from severe myelosuppression and underwent peripheral blood stem cell transplantation (PBSCT) following the final course of VIP. The remaining three patients unlikely to be cured by VIP underwent chemotherapy consisting of high dose ICE:ifosfamide (6-10 g/m2 over 4days) carboplatin (1,500 mg/m2 over 4 days), etoposide (1,600-2,400 mg/m2 over 4 days) combined with PBSCT. This regimen resulted in one partial response (PR) with marker-negative and two PR with marker-positive. Residual masses were removed in all three patients and viable tumor cells were found in two. Of the five patients enrolled, four patients (80%) remain disease-free with minimal follow-up of 20 months, and the remaining one died of cancer 10 months after PBSCT. No serious side effects or complications were encountered. This study shows that standard dose induction therapy of VIP followed by early salvage chemotherapy of high dose ICE with PBSCT is well tolerated and effective in the treatment of advanced poor-risk testicular cancer.

Adult↗
PubMed1997

Partial laryngectomy in the treatment of radiation-failure of early glottic carcinoma.

BACKGROUND: This study was undertaken to analyze the functional results, complications, local control rates, and survival in patients undergoing conservation surgery for squamous cell carcinoma (SCC) of the larynx as a salvage procedure for recurrent tumors after previous radiotherapy. METHODS: Twenty-one patients underwent frontolateral laryngectomy for radiation failure, T1 and T2 glottic SCC, at the Cancer Institute Hospital, Tokyo, from 1976 to 1991. All patients were men between the ages of 42 and 83 years. The disease-free interval ranged from 1 to 87 months (median, 26 months). The stage at initial treatment was T1 in 17 patients and T2 in four patients. Local recurrence developed in three patients. RESULTS: The rate of local control was influenced by a surgical margin of less than 1 mm (p < 0.05). Overall voice preservation was achieved in 86% of the patients. The 5-year and 10-year survival rates following frontolateral laryngectomy were 86% and 70%, respectively. Maximum phonation time after surgery ranged from 4 to 18 seconds (median, 8.1 seconds). CONCLUSIONS: These results indicate that in carefully selected cases, frontolateral laryngectomy may be used for treating radiation failure stage I or II vocal cord carcinomas with good success. Careful follow-up may be necessary in patients with a close surgical margin.

Adult↗