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Biomedical subjects

S Suita

Publications and source records attributed to S Suita.

At least 181 records · Page 10Linked to original sources
PubMed1991

Significance of prenatal diagnosis in a patient with a huge neck tumor.

Due to the great advancements in fetal ultrasonography, the number of prenatal diagnoses are increasing, greatly contributing to improved neonatal surgery. It is now relatively easy to detect huge fetal cystic masses, and we have experienced three cases with a huge neck tumor detected in utero, one case with teratoma and two cases with cystic hygroma. Each case was complicated by neonatal asphyxia, and the neonate needed resuscitation by means of endotracheal intubation. The infant with teratoma unfortunately died of respiratory distress due to compression of the trachea before a perinatal team could be organized. Although the remaining cases with cystic hygroma were treated by a perinatal team, one died 19 hours after birth and the other has survived with the aid of endotracheal intubation in the hospital for three years. In addition, all four cases of cystic hygroma detected antenatally in our institute, which were not delivered, also had fetal hydrops which suggested a general lymphatic derangement. Cystic hygroma detected in utero is considered to be different from that detected after birth, since the former is associated with genetic lymphatic derangement. Prenatal diagnosis enables such patients to survive the perinatal period, but may not improve the prognosis of fetal cystic hygroma so much.

Adult↗
PubMed1990

Effect of verapamil on conversion of xanthine dehydrogenase to oxidase in ischemic rat liver.

The effect of organ flushing with the calcium entry blocker verapamil on the conversion of innocent enzyme xanthine dehydrogenase (XDH) to superoxide generating enzyme xanthine oxidase (XOD) in ischemic rat livers was studied. This enzyme conversion progressed over time in warm or cold ischemia. In non-flushed livers, the activities of XOD as percentages of XDH plus XOD after 6 h at 37 degrees C and 6 days at 4 degrees C were 80.3 +/- 5.2 and 31.6 +/- 2.1, respectively. In the livers flushed with Euro-Collins solution, the conversion was inhibited to 37.0 +/- 3.9% (P less than 0.001) after 6 h of warm ischemia, while this inhibitory effect was not found in cold ischemia. Verapamil given through the portal vein on flushing further suppressed the conversion in both warm and cold ischemia (with 5.0 microM of verapamil, 21.2 +/- 5.8% (P less than 0.001) after 6 h of warm ischemia and 25.2 +/- 3.3% (P less than 0.01) after 6 days of cold ischemia). A similar effect was also obtained with the addition of 10 or 30 mM of EGTA instead of verapamil. In contrast, no inhibitory effect on conversion was obtained in livers flushed and homogenized with 10.0 microM of verapamil followed by incubation for 6 h at 37 degrees C. In the livers that were flushed and stored at a warm temperature for 6 h, verapamil reduced the increase of tissue lipid peroxidation product (P less than 0.02) after 15 min of reperfusion. Although the precise mechanisms of these inhibitory effects of verapamil on the enzyme conversion are still uncertain, it is thought that organ flushing with verapamil might reduce the XOD-mediated postischemic reperfusion injury in livers subjected to prolonged ischemia.

Animals↗
PubMed1990

Distribution of neuropeptide Y-like immunoreactivity in the normoganglionic and aganglionic segments of human colon.

The localisation and distribution of neuropeptide Y (NPY)-like immunoreactivity were studied by use of immunohistochemical methods in gut tissues from 19 patients with Hirschsprung's disease, including 4 cases of long segment aganglionosis. In the normoganglionic segment, immunoreactive cell bodies and nonvaricose processes were seen within both myenteric and submucous plexuses. A scarce supply of varicose fibres was found in the lamina propria mucosae, muscularis mucosae and longitudinal muscle layer. NPY fibres were more frequently encountered in the circular muscle layer, although with a weakly immunostaining intensity. In addition, blood vessels in the submucosal connective tissue were surrounded by a typical plexus of varicose, NPY-positive fibres. Immunoreactive endocrine cells could be detected in the colonic epithelium. In the aganglionic segment, numerous nerve fasciculi comprising a small to moderate number of NPY fibres with varicosities were observed throughout the entire layer of the colonic wall. A few varicose, NPY-positive fibres were also contained in the relatively large, hypertrophic nerve fasciculi located in the intermuscular zone and submucosal connective tissue. NPY-immunoreactive fasciculi were more densely distributed in the distal aganglionic segment than in the proximal aganglionic one. On the other hand, the distribution of NPY-positive fibres in long segment aganglionosis was quite different from that in short segment type; in cases of long segment type, no immunoreactive nerve fibres were detected within the circular muscle layer of the proximal aganglionic segment near the oligoganglionic segment and only a few fibres were observed within the hypertrophic nerve bundle of the intermuscular zone.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1990

Xanthogranulomatous cholecystitis in an infant with obstructive jaundice.

We describe a female infant with obstructive jaundice due to inflammatory stenosis of the choledochus. It was surrounded and narrowed by a xanthogranulomatous lesion, extending from xanthogranulomatous cholecystitis (XGC). The obstructive jaundice was released by a cholecystectomy, resection of the choledochus, and hepaticojejunostomy. This is the first reported case of infantile XGC associated with obstructive jaundice.

Cholecystitis↗
PubMed1990

The fate of swallowed button batteries in children.

The method of treatment and fate of 41 button batteries ingested by 34 children were analysed; 31 batteries were in the stomach and 10 beyond the pylorus. In 31 batteries situated in the stomach, removal by magnet tube technique was attempted in 30 batteries, 25 being successfully taken out, while 5 failed passing through the pylorus at the duodenum. One was removed endoscopically, since a magnet tube was not available. The remaining 10 batteries in 10 children were found at different levels from the duodenum to the rectum. In addition, 5 batteries were pushed down from the stomach during magnet tube removal. These 15 batteries, located in the intestine were excreted during 35 hours. In contrast to other asymptomatic foreign bodies that are allowed to pass through the GI tract spontaneously, we feel that button batteries should be removed by magnet tube technique to avoid complications such as GI tract perforation with associated bleeding, possible mercury poisoning and burns. Magnet tube removal is a simple and safety method requiring neither anaesthesia nor admission.

Child↗
PubMed1990

Therapeutic dilemmas associated with antenatally detected ovarian cysts.

Fifteen instances of ovarian cysts detected antenatally are reported. Seven cysts more than 5 centimeters in diameter were treated surgically because of clinical signs, such as palpable abdominal mass, vomiting and abdominal distension. Seven cysts less than 5 centimeters in diameter, and one cyst more than 5 centimeters in diameter began to regress spontaneously within six months after birth. Because the pathophysiologic nature of neonatal ovarian cysts has not been elucidated and because the borderline between physiologic and pathologic factors is still unclear, we propose a more conservative approach in the management of neonatal ovarian cysts to avoid unnecessary operations.

Clinical Protocols↗
PubMed1989

Heterogenous expression of endothelial cell markers in infantile hemangioendothelioma. Immunohistochemical study of two solitary cases and one multiple one.

Three cases of infantile hemangioendothelioma were immunohistochemically studied with the use of antibodies against von Willebrand factor (vWF), Ulex europaeus I lectin (UEA I), vimentin, thrombomodulin (TM), and actin, as endothelial cell (EC) markers. Because of a broad variety of histologic features, the growth pattern of the tumor cells was subclassified into the following four subtypes: capillary, sinusoidal, cavernous, and myxomatous parts. The solitary tumor from patients 1 and 2 was composed of these four components, but the multiple tumor in the patient 3 consisted of capillary and sinusoidal parts. Immunohistochemically, vWF and vimentin were dominantly expressed in the ECs of the cavernous and myxomatous parts. UEA I had strongly positive results in all histologic types, except the myxomatous part. Expression of vWF and vimentin in neoplastic EC suggests that functional differentiation of the tumor tissue occurs in the myxomatous and cavernous parts and may be related to the spontaneous regression of the infantile hemangioendothelioma.

Actins↗
PubMed1989

Management of pediatric patients who have swallowed foreign objects.

The clinical management of children who have swallowed foreign bodies presents a great challenge for both pediatricians and pediatric surgeons. Our 7-year experience of treating 141 patients with a history of foreign body ingestion is reported. In 114 patients, there were 122 foreign bodies present in areas from the esophagus to the rectum, as located by plain chest and abdominal x-ray examination. In two patients, a plastic toy and the plastic cap of a razor were passed with stool a few days later. In the remaining 25 patients, nothing was found. In babies under one year of age, button batteries were the most commonly swallowed foreign bodies, while coins were the most frequently swallowed objects in children over the age of three years. Seventeen foreign bodies in the esophagus were removed: seven by balloon catheter, four endoscopically, and one by a magnet tube. Four were dislodged into the stomach. Twenty nine of the 78 items present in the stomach were button batteries and 23 of the items were removed using a magnet tube. One was removed endoscopically and 5 batteries that had moved beyond the pylorus were excreted within 48 hours. Twenty four coins in the stomach were managed conservatively. Surgical intervention was required in two patients; one patient had a previous history of pyloromyotomy, and a magnet tag measuring 1.5 cm in diameter did not pass through the pylorus for 7 weeks. The other patient had swallowed a sewing needle that moved into the descending colon and abdominal pain ensued.

Child↗
PubMed1988

Management of ovarian cyst detected antenatally.

Ovarian cyst was diagnosed in nine fetuses by antenatal ultrasonographic examination. All deliveries were uncomplicated; two were delivered by cesarean section. The clinical condition in all cases was good. Five of the neonates with a large cyst (more than 5 cm in diameter) were managed surgically, while four were merely followed with repeated ultrasonic examinations. In three of the latter four infants, the cysts disappeared without clinical complications during the subsequent 12 months, and one has been followed for only 2 weeks. The treatment of neonatal ovarian cyst is controversial. Since small ovarian cysts are not clinically significant and may involute, conservative treatment after birth is possible. Repeated ultrasonographic examination may be used to follow small cysts in asymptomatic patients. However, surgical excision in the newborn period has been suggested for larger lesions and/or those with solid components inside the cyst before life-threatening complications occur.

Female↗
PubMed1988

Prolonged retention of a swallowed foreign body in the stomach following pyloromyotomy.

An unusual case of prolonged retention of a swallowed, round-shaped, magnet tack in the stomach of a patient is reported. The patient had had a previous pyloromyotomy for pyloric stenosis. Patients with a history of pyloromyotomy for pyloric stenosis may present special problems for the passage of foreign bodies reaching the stomach and may be more likely to require surgical intervention.

Foreign Bodies↗
PubMed1987

Zinc status and its relations to growth retardation in children with biliary atresia.

Zinc status was studied in 36 children with biliary atresia and in ten children with Hirschsprung's disease or anorectal anomalies. Changes in preoperative and postoperative plasma and urinary zinc levels were measured in 16 children with biliary atresia and ten children with Hirschsprung's disease or anorectal anomalies. Hypozincemia was evident in children with biliary atresia preoperatively and became severe with time when adequate zinc supplementation was not given. Follow-up studies were done in 20 children with biliary atresia aged between 9 months to 10 years. The children with poor bile excretion and impaired liver function tended to have hypozincemia and a high excretion of zinc. Growth retardation was also common in these children. Careful monitoring and appropriate supplementation of micronutrients, including zinc is probably important for normal growth in children with biliary atresia.

Biliary Atresia↗
PubMed1987

Carbohydrate metabolism in infants with biliary atresia.

Carbohydrate metabolism in 9 infants with biliary atresia (BA) was investigated preoperatively and during the early postoperative period when these infants were on parenteral nutrition for 7 days. Findings were compared with data on infants without liver dysfunction. Changes of plasma glucose, immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) in the biliary atresia group with moderate liver fibrosis were the same as those in the control group. However, in one patient with marked liver fibrosis, the molar IRI/CPR ratio was significantly low, thereby suggesting an increased hepatic insulin extraction. This change, however, was transient and the molar IRI/CPR ratio gradually returned to the level of other BA patients and the control groups after the 1st postoperative day. This study shows that in infants with BA, the glucose intolerance seen in adults with obstructive jaundice is absent and the parenteral nutrition can be performed without severe changes of carbohydrate metabolism.

Biliary Atresia↗
PubMed1987

Measurement of the fetal urine production rate using real-time ultrasound in fetuses with bilateral hydronephrosis.

The fetal urine production rate (FUPR) in 147 normal fetuses after 27 weeks of gestation and 5 with bilateral hydronephrosis was measured using real-time ultrasound. Later, the correlation between FUPR and renal function was evaluated postnatally. In the normal fetuses, FUPR (mean +/- 2 SD) increased gradually from 1.9 +/- 1.6 at 27-28 weeks of gestation to 7.5 +/- 4.5 ml/10 min at 37-38 weeks of gestation. In the 5 cases with bilateral hydronephrosis, FUPR was within normal ranges and increased with advances in gestation. Intrauterine intervention was not performed in any of the cases, and, at present, renal insufficiency is nil.

Female↗