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Biomedical subjects

T Miyano

Publications and source records attributed to T Miyano.

At least 217 records · Page 12Linked to original sources
PubMed1983

An abnormal pancreatico-choledocho-ductal junction in cases of biliary tract carcinoma.

A histopathologic study on how the common bile duct and main pancreatic duct open into the duodenum was performed on 72 autopsied cases of biliary tract carcinoma. Type IIIb which was considered to be an abnormal pancreatico-choledocho-ductal junction was identified in 8 of 34 cases in common bile duct carcinoma and in 4 of 24 cases in gallbladder carcinoma, while none of the control cases belonging to Type IIIb. In cases of Type IIIb, reflux of pancreatic juice may occur into the bile duct and produce the repeated inflammation on the biliary tract. Therefore, the abnormal pancreatico-choledocho-ductal junction was suggested to be one of the pathogenic factors which cause biliary tract carcinoma.

Aged↗
PubMed1983

Antibiotic excretion into the bile after hepatic-portojejunostomy in biliary atresia.

Antibiotic excretion into the bile was studied using LMOX and CMZ in 16 postoperative cases of biliary atresia patients who had had hepatic portoenterostomy with Suruga II type enterostomy with the following results: Group I: Excellent excretion which was almost the same as that seen with adult patients; Group IIa: Good or poor excretion, depending on the amount of bile flow and liver function; Group IIb: Very poor excretion; Group III: Good excretion but depending on the amount of bile flow and liver function. As the total bile acid level in bile showed a higher level, the biliary excretion of antibiotics was greater. Our study indicates that antibiotic excretion into the bile in infants is closely related to the condition of the liver function and the biliary passages.

Bile↗
PubMed1983

A new antitumor antibiotic, awamycin.

A new antibiotic, awamycin, was isolated from the culture broth of Streptomyces sp. No. 80-217. It appeared to belong to the quinone indicator group from results of physicochemical studies and has the empirical formula C38H49NO12S. This antibiotic possessed antibacterial and antitumor activities against Gram-positive bacteria and experimental murine tumors. The antibiotic also showed direct cytotoxic activity against HeLa cells in vitro.

Animals↗
PubMed1983

[Cefotiam excretion into the bile after radical operation of congenital biliary atresia].

Twelve infants having undergone extrahepatic cholangiojejunostomy (SURUGA'S procedure II) after portal hepaticojejunostomy as a radical operation for congenital biliary atresia received prophylactic cefotiam (CTM) against biliary tract infection, 50 mg/kg by intravenous drip in 1 hour, followed by serial determinations of bile and serum CTM levels. The patients were evaluated as to degree of CTM excretion into the bile, by classification into 4 groups according to success or failure in establishing the anastomosis, bile outflow and persistence of jaundice. Patients with an established anastomosis, satisfactory bile flow and no longer jaundice showed high biliary antibiotic concentrations whereas lower biliary antibiotic levels were seen in those with failure in anastomosis, poor bile flow and persistent jaundice. In both cases, nevertheless, the antibiotic concentration in bile sufficiently exceeded the MIC80 values of CTM against principal bacterial pathogens causative of biliary tract infections, thus demonstrating clinical significance of the use of CTM for this purpose. The antibiotic excretion into the bile improved with normalization of liver function in an infant displaying satisfactory bile outflow from an early postoperative stage. The bile and serum CTM assay data obtained by the agar well method showed a high degree of correlation with those by high performance liquid chromatography.

Bacterial Infections↗
PubMed1983

[Cefmetazole excretion into the bile after hepatic portojejunostomy in congenital bile duct atresia].

Antibiotics excretion into the bile was studied using CMZ which was administered by drip infusion in 12 postoperative cases of congenital bile duct atresia patients who had hepatic portojejunostomy with SURUGA II type enterostomy with the following results. Group I (correctable type children, with good bile flow, no jaundice): Excellent excretion was almost the same as that seen in adult patients. Group IIa (uncorrectable type children, with good bile flow, no jaundice): Excretion was poor but good depending on the amount of bile flow and liver function. Group IIb (uncorrectable type children, with poor bile flow, jaundice): Excretion was very poor. Group III (uncorrectable type infants, with good flow, no jaundice): Excretion was good depending on the amount of bile flow and liver function. Our study indicates that antibiotics excretion into the bile in children is closely related to the condition of the hepatic function and biliary passage.

Age Factors↗
PubMed1982

Reoperation in the treatment of biliary atresia.

Rehepatic-portoenterostomy and curettage were performed as reoperative procedures for treatment of biliary atresia. In cases of rehepatic-portoenterostomy, microsurgical technique is an important factor in order to obtain satisfactory operative results. The indication for rehepatic-portoenterostomy, the age of the patient, the size of the intrahepatic bile ducts at the porta hepatis area, the degree of liver fibrosis and liver cell change are closely related to the prognosis of rehepatic-portoenterostomy cases. Since 1977, all seven cases who underwent rehepatic-portoenterostomy showed bile excretion and at present, 3 out of 7 have no jaundice. Curettage is an effective treatment for cessation of bile flow in cases which underwent hepatic portoenterostomy and showed bile excretion for a certain period postoperatively. The timing of curettage is closely related to the results of the curettage. In 9 out of 17 cases which received curettage, we were able to obtain fairly good bile flow and at present, 4 out of 9 show no jaundice.

Bile↗
PubMed1981

Treatment of biliary atresia: a study of our operative results.

The operative results in 87 biliary atresia cases were investigated from the aspect of the histologic findings in the liver and the remnant of the extrahepatic bile ducts, and the details of the operative procedures. The degree of liver fibrosis, the liver cell changes, and the type of extrahepatic bile ducts are closely related to our operative results. Our operative results have been improving since 1977 due to the advancement of microsurgical techniques and a new type of operative procedure for prevention of ascending cholangitis. Twenty-five of 29 cases (86.2%) surgically corrected are alive, showing bile excretion, and are in a satisfactory general condition.

Bile Ducts↗
PubMed1981

"The choledocho-pancreatic long common channel disorders" in relation to the etiology of congenital biliary dilatation and other biliary tract disease.

The amylase level of bile and various cholangiograms was studied in 36 cases of congenital biliary dilatation. (C.B.D.) The amylase level above 10000 U/L was considered to suggest the existence of choledocho-pancreatic long common channel formation. Radiologically, the dilatation of intrahepatic bile duct was seen in 9 out of 19 (47%) Type I cases and in all (100%) Type II cases. The cystic dilatation of intrahepatic bile duct was seen in all Type I cases which have cystic choledochal dilatation. On the other hand, fusiform dilatation was seen in all Type II cases with fusiform choledochal dilatation. End to side Choledocho-pancreatic anastomosis was performed to produce an experimental model of human choledocho-pancreatic long common channel disorders, thus leading to the dilatation of the common bile duct as well as the reflux of pancreatic juice into the bile duct. The reflux of Pancreatic juice and congenital stricture due to the choledocho-pancreatic long common channel formation were considered to be the important causative factors in the etiology of C.B.D.. Furthermore, pathology of the choledocho-pancreatic long common channel disorders was found to be important in relation to the etiology of both C.B.D. and other lesions of the biliary tract and pancreas.

Adolescent↗
PubMed1980

A clinicopathologic study of choledochal cyst.

Choledochal cyst is quite common in Japan. The etiology of this lesion is not clear, and there remain problems in its treatment as well. Radiologic investigation of the distal common bile and pancreatic ducts was performed by operative cholangiography and endoscopic retrograde cholangiopancreatography. Anomalies at the junction of these ducts were found in all of the patients. Localilzed cystic dilatation of the extra-hepatic bile ducts without intrahepatic bile duct dilatation was produced experimentally by ligation of the distal choledochus in infant rats. Concerning the etiology, we agree with Babbitt's hypothesis that weakness of the choledochal wall is produced by reflux of pancreatic juice via an anomalous choledochopancreatic junction. We think that the stenosis associated with this anomaly is the critical factor. From our follow-up study of 30 cases, we find excision of the cyst to be the most important part of treatment. Choledochal cysts presenting under 6 months of age had clinical symptoms and pathology similar to biliary atresia.

Age Factors↗
PubMed1980

A histopathologic study of the region of the ampulla of Vater in congenital biliary atresia.

A histopathologic investigation of the duodenal wall and adjacent tissues in the vicinity of the papilla of Vater was performed in 37 autopsied cases of congenital biliary atresia which were treated in the Department of Pediatric Surgery of the Juntendo University Hospital during the past 11 years. A high incidence of the association of a congentially abnormal junction of the common bile duct and pancreatic duct, that is, a long common channel and a poorly developed sphincter musculature, were found in congenital biliary atresia. This suggests the possibility that reflux of pancreatic juice into the biliary system, followed by nonsuppurative chronic inflammation of bile ducts, may ultimately lead to the obstructive cholangiopathy seen in biliary atresia.

Ampulla of Vater↗
PubMed1980

The choledocho-pancreatico-ductal junction in infantile obstructive jaundice diseases.

A histopathological study on how the common bile duct and main pancreatic duct open into the duodenum was performed on autopsied cases of infantile obstructive jaundice diseases, and control cases. The so-called "common channel" formation type (Type III) was divided into two types; the junction of the common bile duct and the pancreatic duct was situated in the mucosal or submucosal layer of the duodenum in type IIIa and the junction below the propria muscularis of the duodenum in type IIIb. Type IIIb was identified in 17 out of 28 cases in congenital biliary atresia and in 2 cases of congenital choledochal cyst, while the control cases all belonged to type IIIa. In cases of type IIIb the well-developed sphincter muscle was located in the submucosal layer and it surrounded the common channel after joining of both ducts suggesting the possibility of free communication of both ducts. As the intraductal pressure of pancreatic duct is normally higher than that of the bile duct, reflux of pancreatic juice may occur into the bile duct. Abnormal choledocho-pancreaticoductal junction was suggested to be a pathogenic factor which causes infantile obstructive jaundice diseases. ACTA PATHOL. JPN. 30: 187 approximately 194, 1980.

Bile Duct Diseases↗
PubMed1979

Z shaped primary colorectal anastomosis using the GIA autosuture for Hirschsprung's disease.

The Duhamel operation for Hirschsprung's disease has won wide acceptance throughout the world. However, this procedure is not without difficulties, and the usual technique of employing various crushing clamps for division of the colo-rectal septum is inelegant, inconvenient and uncertain. This paper presents an operative technique with particular reference to the use of the GIA autosuture surgical stapling instrument in the Z shaped primary colorectal side-to-side anastomosis for Hirschsprung's disease advocated by Ikeda. This is a single and primary procedure, and makes the postoperative care easier and more comfortable for the patients. Experiences with twenty-five patients are reported.

Child↗
PubMed1979

Abnormal choledocho-pancreatico ductal junction related to the etiology of infantile obstructive jaundice diseases.

According to our current radiologic, histopathologic, and experimental studies, the congenital stenosis associated with anomalous choledocho-pancreatico ductal junction is considered to be the most important etiologic factor in congenital biliary dilatation. Furthermore, the possibility of pancreatic juice reflux into the biliary tract due to the abnormal choledocho-pancreatico ductal junction, which could lead to obstructive cholangiopathy, was suggested in relation to the pathogenesis of congenital biliary atresia.

Animals↗
PubMed1977

A histopathological study of the remnant of extrahepatic bile duct in so-called uncorrectable biliary atresia.

Histopathological study of the remnant of extrahepatic bile ducts in 40 cases of so-called uncorrectable biliary atresia, upon which we operated the last three years, has been performed. The histological findings of the remnant were classified into three types. Only two cases were found to have type 1a ducts in the porta hepatis area, from which we can expect better prognosis postoperatively. We also found that as the patients become older, the size of the duct in the remnant becomes smaller and the hepatic fibrosis becomes more remarkable. Therefore the operation should be performed in the infant with this lesion as young as possible. As for the evaluation of operative results of hepatic portoenterostomy for this lesion, a proper evaluation can be made only in those cases in which a microscopic examination of the remnant of extrahepatic bile duct at the porta hepatis area has been adequately performed. Concerning the pathogenesis of biliary atresia, we presume that congenital abnormalities of bile ducts are a basic factor, and additional nonspecific inflammation and bile stasis complete its pathological condition.

Age Factors↗
PubMed1976

Treatment of biliary atresia: microsurgery for hepatic portoenterostomy.

Microsurgery was used for hepatic portoenterostomy as the treatment of biliary atresia in 46 patients whom we treated since 1972. The microscope had a higher power (eight or ten times) magnification. As for the results of the operative procedure with the microscope, of 46 patients, 32 (70 percent) showed satisfactory bile flow postoperatively.

Common Bile Duct↗