Biomedical subjects

S Suita

Publications and source records attributed to S Suita.

At least 109 records · Page 6Linked to original sources

PubMed1997

The distribution and co-localization of nitric oxide synthase and vasoactive intestinal polypeptide in nerves of the colons with Hirschsprung's disease.

The distribution and co-localization of nitric oxide synthase (NOS) and vasoactive intestinal polypeptide (VIP) were examined by means of immunohistochemistry and NADPH diaphorase (NADPH-d) histochemistry in the gut of patients with Hirschsprung's disease. In the normoganglionic segment, many nitrergic nerve cells were localized in Auerbach's plexus and nerve fibres were observed preferentially in the circular muscle. The submucosal nitrergic nerve cells were mainly situated in Schabadasch's plexus with occasional cells demonstrable in Meissner's plexus. NOS and VIP were co-localized in most ganglion cells of Auerbach's plexus. In the oligoganglionic segment, a marked reduction of NOS- and VIP- positive nerve cells and fibres was noticed in both the myenteric and submucosal plexuses, and nitrergic fibres had disappeared in the inner layer of the circular muscle. In the aganglionic segment, NOS and VIP were revealed only in extrinsic nerve fasciculi and rami and co-localized in a few fibres. From these observations, the inner layer of the circular muscle of the oligoganglionic segment and the whole of the muscularis propria of the aganglionic segment were considered to be totally lacking in nitrergic innervation. Nitrergic nerves of the human colon comprise both intrinsic and extrinsic elements and the majority of intrinsic nitrergic nerve cells contain VIP. Very low numbers of extrinsic nitrergic fibres contain VIP.

Child↗

PubMed1997

Abnormalities in visceral evoked potentials from the anal canal in children with chronic constipation.

The integrity of the sensory nervous system in the anal canals of chronically constipated children was investigated using evoked potential techniques examining cerebral and spinal evoked potentials from the lower extremities and anal canal. Stimulation of the posterior tibial nerve produced no significant difference in the parameters of spinal and cerebral evoked potentials between 18 controls and 12 chronically constipated children. However, stimulation of the anal canal resulted in evoked potentials related to the age and/or consciousness level of the control children. Reproducible cerebral responses were obtained only from nine of these control children, all aged over 4 years, who were examined while awake without sedatives. A typical response was characterized by a polyphasic wave occurring with an onset latency of 79.4 +/- 27.7 ms (mean +/- SD). In the 12 chronically constipated children, the 5 sedated patients examined while asleep did not show any reproducible potential, as in the controls. However, in the remaining 7 children examined while awake, the occurrence of the anal canal evoked potential was significantly reduced, and only two exhibited a cerebral response. These findings suggest that rectal mucosal perception of the intraluminal stimuli might be disturbed in some children with chronic constipation.

Adolescent↗

PubMed1997

Acute suppurative perithyroiditis: MR findings.

We report the MR findings in two cases of acute suppurative perithyroiditis. MR has the advantages over other imaging modalities of being able to distinguish areas of inflammation from adjacent normal tissue and of allowing imaging in planes which more accurately demonstrate the extent of the lesion. MR imaging is one of the most useful methods to evaluate this entity.

Acute Disease↗

PubMed1997

Functional innervation of the aganglionic segment in Hirschsprung's disease--a comparison of the short- and long-segment type.

The authors examined the neuro-effector transmission in the aganglionic segment from 13 patients with Hirschsprung's disease, 10 patients had short-segment type and three patients had long-segment type. Circular muscle strips were prepared and the responses to transmural electrical field stimulation were examined using the isometric tension recording technique. In the ganglionic preparations from the short- and long-segment cases, the stimulation evoked a biphasic response consisting of a relaxation and an atropine-sensitive contraction. The relaxation was partly inhibited by N-omega-nitro-L-arginine (NNLA, a nitric oxide [NO] synthase inhibitor), and the effect of NNLA was abolished completely in the presence of L-arginine, which suggested the presence of NO-mediated inhibitory innervation. In the aganglionic preparations from the short-segment-type cases, stimulation evoked only an atropine-sensitive contraction, while in the aganglionic preparations from the long-segment-type cases, a weak inhibitory response persisted after the contractile response was abolished by atropine. This NO-mediated inhibitory response was frequently detected as the examined region approached the ganglionic segment. These results suggest that the aganglionic segment in the long-segment-type cases might therefore receive NO-mediated inhibitory input from the proximal ganglionic segment.

Colon, Sigmoid↗

PubMed1997

Prenatal phthalate causes cryptorchidism postnatally by inducing transabdominal ascent of the testis in fetal rats.

Phathalate esters, which are commonly used as plasticizers for polyvinyl chloride, are also well known to disturb Sertoli cells. This study aims to show the effect of prenatally administered phthalate on testicular descent in pre- and postnatal rats. Pregnant rats were exposed to mono-n-butyl phthalate (MBP) by gavage from the 15th to the 18th gestational days. Rats administered with solvent only were used as controls. In 20-day-old fetuses (n = 15), the degree of transabdominal testicular ascent in relation to the bladder neck was thus found to be significantly higher in MBP-treated rats than that of the controls (n = 19). In addition, in MBP-treated male offspring (n = 26), 22 rats showed either bilateral or unilateral cryptorchidism at the age of 30 to 40 days old, and the occurrence of cryptorchidism was 84.6%. By contrast, the occurrence of cryptorchidism was 0% in the control rats (n = 15, P < .001). It is therefore suggested that prenatal exposure to MBP may disturb the Sertoli cells and elevate the fetal testes relative to the bladder neck while also inducing cryptorchidism postnatally. Sertoli cells may thus play an important role in the transabdominal descent of the testis by secreting Müllerian-inhibiting substance (MIS), which is known to act as a putative mediator of the transabdominal phase.

Abdomen↗

PubMed1997

External anal sphincter dysfunction and postoperative bowel habits of patients with Hirschsprung's disease.

An electromyogram (EMG) of the external and sphincter (EAS) was obtained both before and after surgery in five patients with Hirschsprung's disease and eight normal control patients. The EMG, evoked by the transrectal stimulation of the pudendal nerve, was recorded at both the sacral and anal regions to investigate the deep and superficial EAS, respectively. In eight control patients, the EMG at the sacral region consisted of a polyphasic wave with apparently two or three major peaks, and the simple monophasic wave with one or two peaks was found at the anal region. Its peak corresponded to the early peaks in the sacral region. The mean onset latency of the EMG in the sacral region was 2.8 ms. Four patients with Hirschsprung's disease also exhibited responses that were similar to the controls, and their postoperative bowel habits were satisfactory. However, the remaining one patient, who still required a daily enema after surgery, exhibited an apparently different response, which was monophasic at both the sacral and anal regions with a long onset latency of 5.0 ms before and after surgery. It is postulated that some cases with Hirschsprung's disease might be associated with an EAS dysfunction before surgery, which possibly led to the development of postoperative bowel dysmotility.

Anal Canal↗

PubMed1997

Surgical strategy for the treatment of pyriform sinus fistula.

Pyriform sinus fistula recurs when a complete excision of the fistula has not been made. As a supportive technique for this radical operation, the authors performed an intraoperative endoscopic examination of the pyriform sinus for the cannulation or dye injection of the tract in four cases. In three cases, the sinuses were relatively long and ran outside the thyroid cartilage. The cannulation of the tract with a guide wire, in these cases, was useful for identifying the thin membranous tract. In one of these three cases sinus fistula recurred, but a complete excision of the tract was then performed by introducing a 10F Nelaton catheter over a guide wire, which allowed for easy handling of the remnant tract. In the remaining case, cannulation proved not to be useful because the tract was short and ran inside the thyroid cartilage. A short tract embedded within the inferior constrictor muscle could only be found through careful observation after repeated dye injections. The proper selection of the optimum supportive techniques as described above, are considered to be essential for performing a complete excision.

Catheterization↗

PubMed1997

Total colonic aganglionosis with or without small bowel involvement: a changing profile.

BACKGROUND/PURPOSE: To identify recent trends in the diagnosis and treatment of total colonic aganglionosis with or without small bowel involvement (TCSA), the authors analyzed the findings in 107 patients who had TCSA seen between 1988 and 1992 at 147 medical institutions throughout Japan and compared the results with those of a previous survey conducted between 1978 and 1982. RESULTS: The estimated incidence of total colonic aganglionosis was 1 in 58,084 live births, the male to female ratio was 1.5:1, and the incidence of associated anomalies was 15%. These findings were all very similar to those of the previous survey. Ten years ago, 83.6% of all patients underwent Martin's procedure. In the recent survey, this rate had fallen to 52.1%, and a right colon patch method has also been developed as a new procedure. A marked decrease in the overall mortality rate from 40.9% to 21.5% was observed. However, a high mortality rate persists in those cases with small bowel involvement (33.3%); most such cases are complicated with enterocolitis. CONCLUSIONS: Although the general features of TCSA were similar to those in the previous survey, a substantial improvement in the treatment results for TCSA has occurred. However, further efforts are still required both to prevent and more effectively to treat enterocolitis, especially in cases involving any aganglionosis extending into small bowel.

Enterocolitis↗

PubMed1997

Energy metabolism during cold ischemia and reperfusion in rat small intestinal transplantation: comparison of jejunal and ileal grafts.

BACKGROUND/PURPOSE: In segmental small intestinal transplantation, the question as to whether the jejunum or ileum is the better graft remains unclear. The authors investigated this question regarding nutrition, blood chemistry, and adaptation. METHODS: The authors compared the jejunum and ileum as the proper portion of segmental graft in rat small intestinal transplantation, regarding energy metabolism both during cold preservation and after reperfusion using high-performance liquid chromatography, as well as histological examination. RESULTS: In a cold preservation study, the concentrations of adenosine triphosphate (ATP) in the jejunum versus ileum at 0, 6, 12, 24, and 48 hours of cold preservation were 1.98 +/- 0.93 versus 1.83 +/- 0.84, 0.79 +/- 0.51 versus 0.55 +/- 0.41, 0.60 +/- 0.41 versus 0.58 +/- 0.45, 0.38 +/- 0.28 versus 0.47 +/- 0.39, and 0.44 +/- 0.26 versus 0.55 +/- 0.29 (micromol/g dry weight), respectively. There were no significant differences between the jejunum and ileum at any times of preservation. Adenosine monophosphate (AMP), adenosine diphosphate (ADP), total adenine nucleotides (TAN), and energy charge (EC) also showed no significant differences between the jejunum and ileum at any times of preservation. In the reperfusion study, the concentrations of ATP in jejunum versus ileum 30 minutes after reperfusion after 6, 12, and 24 hours of cold preservation were 0.68 +/- 0.19 versus 0.50 +/- 0.17, 0.71 +/- 0.51 versus 0.42 +/- 0.14, and 0.93 +/- 0.29 versus 0.75 +/- 0.47 (micromol/g dry weight), respectively. Each value was slightly higher in the jejunum than that in the ileum; however, there were no statistically significant differences. TAN showed the same changes as ATP. No significant differences were found between the jejunum and ileum in either AMP, ADP, or EC. The histological findings both just before and 30 minutes after reperfusion were also compared. However, no evident differences were found between the jejunum and ileum. CONCLUSION: These results thus suggest that no significant differences exist between the jejunum and ileum regarding energy metabolism either during cold preservation or after reperfusion in small intestinal transplantation.

Animals↗

PubMed1997

Intrapulmonary Mycobacterium avium infection as the first manifestation of chronic granulomatous disease.

A 10-month-old Japanese male infant, with no history of being prone to infections, contracted an intrapulmonary mycobacterial infection. After 2 months of intermittent fever, radiological examinations revealed mass lesions in the lung and mediastinum. Biopsy specimens showed granulomas with caseous necrosis, from which Mycobacterium avium was isolated. There was no history of mycobacteriosis or immunodeficiency diseases among his relatives. Analyses of the O2- release and expression of NADPH oxidase components verified that he suffered from gp91-phox- chronic granulomatous disease (CGD), and that his mother was a carrier of the disease. This is a rare clinical presentation for the onset of CGD, suggesting that the invasive mycobacteriosis might result from defective intracellular killing of CGD-phagocytes.

Granulomatous Disease, Chronic↗

PubMed1997

Evoked potential abnormalities in postoperative patients with biliary atresia.

The somatosensory evoked potentials from the lower extremities were measured postoperatively in 15 patients with biliary atresia to investigate whether they were free of neurologic dysfunction. Because long-standing cholestasis causes progressive neuropathy due to malabsorption of vitamin E, the serum vitamin E, D, and A levels were also examined to evaluate the fat-soluble vitamin status. The cerebral evoked potentials to posterior tibial nerve stimulation were recorded in all 15 patients as well as in 45 controls, but spinal evoked potentials examined at the level of the cauda equina could not be recorded in five patients more than 8 years of age with long-standing icterus. The remaining 10 patients exhibited spinal evoked potentials as observed in the controls, but the mean neural conduction velocity at the cauda equina was significantly lower than that of the 45 controls (42.0 +/- 5.1 m/s vs 52.3 +/- 6.8 m/s, P = .0002). The serum vitamin E, D, and A levels were within the normal range in 13, 9, and 1 of 15 patients, respectively. These results suggest that the patients with long-term follow-up are still at risk of developing neural disturbances even with normal serum vitamin E status.

Adolescent↗

PubMed1997

Motility studies of the esophagus in a case of esophageal atresia before primary anastomosis and in experimental models.

Esophageal motility was assessed in a case of long-gap esophageal atresia (EA) without tracheoesophageal fistula before primary anastomosis, in addition esophageal manometrical studies were also experimentally performed in mongrel dogs to investigate the pathogenesis of the motility disorders in successfully repaired EA. Coordinated peristaltic contractions were observed between the proximal and distal esophageal pouch when swallowing before primary anastomosis in EA. In addition, these contractions induced a reflex relaxation of the lower esophageal sphincter (LES) as seen in the normal esophagus at the age of 8 months. At the age of 28 days, however, the LES showed an unstable pressure profile and the absence of a reflex relaxation in response to the contractions of the proximal esophageal pouch. On the other hand, experimental studies were carried out on six mongrel dogs weighing 12-15 kg. In group 1 (n = 3), the esophagus was divided at the level of the tracheal carina and both the proximal and distal pouches were closed separately. In group II (n = 3), the esophageal branches of the vagal nerves were divided between the level of the aortic arch and the esophageal diaphragmatic hiatus. Postoperatively, coordinated peristaltic contractions were shown between the proximal and distal esophageal pouches in group I, although the vagotomized esophagus showed abnormal simultaneous contractions in group II. These results suggested that even if the esophageal continuity is disrupted, the coordinated peristaltic contractions are propagated between the proximal and distal esophagus before primary anastomosis in EA, and thus postoperative esophageal motility disorders may result from the surgical damage to the vagus during operative procedures.

Anastomosis, Surgical↗

PubMed1997

Bilateral adrenal neuroblastoma.

Neuroblastoma has been recognized as the most common solid tumor of infancy and childhood. The occurrence of bilateral adrenal neuroblastoma, however, is extremely rare and only a small number of cases have been previously reported. The authors herein report the clinical, histopathological and molecular biological features of two bilateral adrenal cases out of 125 neuroblastoma patients treated at Kyushu University Hospital over a 35-year period. The clinical and histopathological data of the two cases of bilateral adrenal neuroblastoma were reviewed. In Case 1, which had multiple liver metastases, a post-mortem examination revealed bilateral adrenal involvement. In Case 2, which had been detected by mass screening, CT showed masses in both adrenal glands. No big differences in size were recognized between the tumors in either of the cases. A histopathological examination revealed rosette fibrillary type neuroblastomas in both cases. The DNA of these tumor samples stored at -80 degrees C was extracted and the number of copies of the N-myc gene was determined by a Southern blot analysis. Fourteen copies of the gene were detected in Case 1, whereas neither of the tumors in Case 2 showed any amplification. The clinical outcome, histopathological findings and N-myc gene analysis of two cases might support the variety of biological features of this rare group of neuroblastoma.

Adrenal Gland Neoplasms↗

PubMed1997

High-dose chemotherapy and autologous blood stem cell transplantation in children with metastatic neuroblastoma.

High-dose chemotherapy (HDC) followed by autologous blood stem cell transplantation (ABSCT) was performed to improve the prognosis of children with metastatic neuroblastoma over 1 year of age at diagnosis. Seven stage IV neuroblastoma patients with a median age of 3.9 years (range 1.6-11.4 years) received conventional chemotherapy before leukapheresis for ABSCT. The median duration of chemotherapy before harvest was 8 months (range 3-23 months). Peripheral blood stem cells (PBSC) were harvested from them after the use of cytotoxic drugs plus granulocyte colony-stimulating factor. The median number of granulocyte-macrophage colony forming units collected after harvest was 23.2 x 10(4)/kg (range 10.1-45.3 x 10(4)/kg). The patients were administered HDC consisting of carboplatin, etoposide, and melphalan followed by ABSCT. Hematopoietic reconstitution after ABSCT was favorable; recovery of granulocytes count > 0.5 x 10(9)/L occurred within 2 weeks and stable platelet engraftment occurred at a median duration of 23 days (range 7-33 days). The toxicity of ABSCT was well tolerable. Two of the four patients who received ABSCT at their first complete remission remained in remission 67 and 68 months after ABSCT. One with partial remission also showed a good response for 8 months. The other two at first relapse showed a transient regression of the tumor. The prognosis of seven patients who received ABSCT was significantly better than that of 13 patients who received conventional therapy alone. These findings suggest that HDC followed by ABSCT is safe and useful as consolidation therapy for the treatment of patients with metastatic neuroblastoma.

Adrenal Gland Neoplasms↗

PubMed1997

[Current status of antenatal diagnosis & perinatal medical network].

Antenatal diagnosis has undergone an explosion of growth in the last decade. This has revolutionized the practice of fetal medicine. Ideally, the antenatal diagnosis of congenital anomalies should improve antenatal counseling, it may also affect the timing, site, and method of delivery and potentially allow for intrauterine surgical correction. Paradoxically worse outcomes, however, have been observed in cases of some anomalies such as diaphragmatic hernia and omphalocele. Most of them combined premature birth and/or low birth weight with associated lethal anomalies: the combination almost inevitably led to mortality. In order to reduce the mortality, new approaches will be required for such anomalies in the future. Perinatal medical network will also be important to promote a closer association between perinatal medicine and perinatal surgery.

Community Networks↗

PubMed1996

Neuronal and muscular functions as parameters of graft viability in small bowel transplantation.

The physiological properties of neurons and smooth muscles were studied after cold preservation of a rat small intestinal graft, in order to evaluate the graft viability before reperfusion. A 25-cm jejunal graft was harvested from a Lewis rat and stored in University of Wisconsin solution for 0, 12, 24, 48, and 72 hr at 4 degrees C (n = 8, each group). The intestinal samples were physiologically studied at the end of cold preservation. The positive rates of the specimens showing both biphasic nervous activities and spontaneous rhythmic activities were 100, 100, 88, 25, and 0% in 0-, 12-, 48-, and 72-hr preservation groups, respectively. The maximal contractions produced by acethylcholine chloride were 1.12 +/- 0.32, 0.63 +/- 0.22, 0.43 +/- 0.15, 0.52 +/- 0.32, and 0.27 +/- 0.13g for the 0-, 12-, 24-, 48-, and 72-hr preservation groups, respectively. The graft survivals after syngeneic transplantation (n = 6, each group) were 6 out of 6 (100%), 5 out of 6 (83%), 5 out of 6 (83%), 1 out of 6 (17%), and 0 out of 6 (0%) for the 0-, 12-, 24-, 48-, and 72-hr preservation groups, respectively. The graft survival correlated closely with the positive sample rates of the specimens, showing both biphasic nervous activities and spontaneous rhythmic activities. It only took about 1 hr and 20 min to complete the physiological examination of the graft, and thus, such an examination of the graft is considered to be both a simple and a reliable method for predicting graft viability before transplantation.

Animals↗

PubMed1996

Evaluation of patients with advanced neuroblastoma surviving more than 5 years after initiation of an intensive Japanese protocol: a report from the Study Group of Japan for Treatment of Advanced Neuroblastoma.

In January 1985, a single protocol consisting of cyclophosphamide, vincristine, tetrahydropyranyl adriamycin, and cis-platinum for the treatment of advanced neuroblastoma was begun nationwide in Japan and was found to improve clinical results significantly in terms of 2- or 3-year survival rate. Between January 1985 and December 1988, 113 eligible patients (7 infants younger than 12 months of age with stage IVA disease and 106 patients aged 12 months or older with stage III or IV disease) were enrolled and followed up for 5 years or more after initiation of treatment, as of March 1994. In this study, the usefulness of the protocol for the treatment of advanced neuroblastoma was evaluated with survival rates in relation to age, tumor site, stage, and N-myc amplification for patients surviving more than 5 years after initiation of the protocol. Fifty of the 113 patients were alive 5 years or more after initiation of the treatment, 39 without any episodes of disease recurrence. Fourteen (70%) of 20 patients with stage III, 6 (50%) of 12 with stage IVB, and 24 (30%) of 81 with stage IVA disease were alive and disease-free 5 years after initiation of the protocol. Twenty (56%) of 36 patients without N-myc amplification were alive at 5 years after initiation of the protocol. Only one patient who was alive without evidence of the disease at 5 years had recurrence afterward.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1996

Energy metabolism and tissue blood flow as parameters for the assessment of graft viability in rat small bowel transplantation.

The assessment of small bowel graft viability by means of energy metabolism and tissue blood flow was investigated and compared with pathological findings. Syngeneic heterotopic small bowel transplantations were performed using male Lewis rats, which were divided into four groups according to the duration of cold preservation in University of Wisconsin (UW) solution; 6-, 12-, 24-, and 48-hour groups. The adenine nucleotide metabolism, the tissue blood flow, and the pathological profiles of the grafts were all compared among the groups. The adenosine triphosphate (ATP) levels at the end of cold storage and at 30 minutes after reperfusion, as well as the total adenine nucleotide (TAN) levels at the end of cold storage, before reperfusion, and at 30 minutes after reperfusion were significantly lower in the 48-hour group than those in the other groups, and the blood flow level at reperfusion was significantly lower in the 48-hour group than that in the others. Histological damage after reperfusion extended deep into the crypt layer in the 48-hour group but was confined to within villi in the other groups. These results suggest that the tissue ATP, TAN, and the blood flow levels are considered useful parameters for the assessment of small bowel graft viability.

Adenine Nucleotides↗