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Biomedical subjects

T Miyano

Publications and source records attributed to T Miyano.

At least 163 records · Page 9Linked to original sources
PubMed1991

Narrow duct segment distal to choledochal cyst.

"Narrow segments" (or stenotic portions) of the common bile duct (CBD) distal to cysts in two patients (a 50-yr-old woman and a 25-yr-old man) with choledochal cyst (CholCyst) were studied macroscopically and histologically. The narrow segments of the ducts were patent and connected with the main pancreatic duct extraduodenally, whereas the CBD in controls were neither dilated nor stenotic, and joined the main pancreatic duct within the duodenal wall. These narrow segments were 1 cm long. In case 1, a minute orifice was found in the narrow segment of the duct macroscopically and was identified microscopically as a small duct from a pancreatic lobule. In case 2, a small pancreatic duct also joined the narrow segment of the duct. These small pancreatic ducts were derived from the ventral pancreas, based on distribution of PP-islets. Therefore, the narrow duct distal to the cyst in patients with CholCyst (or congenital biliary dilatation) was considered to be a branch of the ventral pancreatic duct.

Adult↗
PubMed1990

Problems of mass screening for neuroblastoma: analysis of false-negative cases.

The Japanese mass screening (MS) system for neuroblastoma at 6 months of age has resulted in the earlier diagnosis of the tumor with excellent therapeutic results. However, some problems are involved in the present MS system. We present six false-negative cases, ages ranging from 1 year 11 months to 3 years 11 months. Neuroblastoma cell taken from four of these patients were studied biologically. These patients had advanced disease (one was stage III; five were stage IV). Three of the patients have died and one is terminally ill despite undergoing surgery combined with intensive chemotherapy. Cytogenetic analysis performed in three cases showed that all the cases had diploid chromosome mode associated with 1P-, double minutes (DMs), or marker chromosomes. N-myc oncogene analysis, performed in four cases, showed amplification in two; one patient had diploid chromosomes, but the other was not examined cytogenetically. These findings were strikingly different biologically from those of cases found by MS. The majority of neuroblastomas detected by MS were found to be triploid tumors without N-myc amplification. These findings suggest that the main reason for the false-negative results in the patients we examined is that they were tumor-free or the tumors were so small in size that they were unable to produce urinary vanillylmandelic acid and or homovanillic acid levels high enough to be detected at the time of MS. Therefore, we conclude that MS at 6 months of age is too early to detect neuroblastoma with a diploid chromosome mode and/or amplified N-myc oncogene. We propose that MS at the age of 1 year 6 months would be more effective to pick up these cases, because treatment strategies depend on the different biological characteristics of tumor cells.

Adrenal Gland Neoplasms↗
PubMed1990

Ovarian development in Meishan pigs.

Ovaries collected from a total of 35 Meishan gilts of various ages were morphologically and histologically examined. Vesicular follicles were first observed in ovarian sections at 45 d of age. Simultaneously, protruding follicles appeared on the surface of the ovaries, and then ovarian weight increased rapidly with an increasing number of protruding follicles. About half of the gilts between 75 and 90 d of age had ovaries with corpora lutea, indicating that some of them had started estrous cycles before reaching 75 d of age. In Meishan gilts treated with exogenous gonadotropins, ovaries were stimulated as early as 45 d of age. These results suggest that the precocity of Meishan gilts may include the development of vesicular follicles in the ovaries at an early age.

Journal Article↗
PubMed1990

A study on more than 20 years of postoperative follow-up in pediatric surgical cases.

There have been very few postoperative follow-up studies from the aspect of philosophical anthropology in the field of pediatric surgery. Fifty patients who underwent surgery either during the neonatal period or infancy and have been receiving medical treatment or consultation for more than 20 years in Juntendo University Hospital and Katsunan Hospital, were investigated from the aspect of philosophical anthropology. During adolescence or young adulthood, 52% of the patients were suffering from their medical problems. Forty percent of patients were bullied by their peers during their elementary school age due to various medical problems. As patients became adolescents or young adults, 20% of them started to feel that others were prejudiced against them or they were discriminated against when going to school or looking for a job. About 30% of patients who were of elementary school age and of adolescent or adult age, were introverted and short-tempered. Eighteen percent of the patients who were of elementary school age and adolescent or young adult age, were not satisfied with their family, particularly their parents, because of their medical problems. When patients became adults, 40% were not satisfied with their own society, particularly with others in their working place. More than 80% of patients who were of preschool age were shielded from their medical problems by their parents. As they became older, their parents were not always able to cover up their medical problems, but understanding school teachers and their elders were able to shield some of patients from social ridicule. By learning the results of this study, it is important for pediatric surgeons to minimize postoperative medical problems, giving proper surgery and postoperative care. Pediatric surgeons should become very supportive medical doctors to patients who suffer from postoperative medical problems.

Adaptation, Psychological↗
PubMed1990

Indication for portoenterostomy based on 103 patients with Suruga II modification.

Although the prognosis of biliary atresia has greatly advanced, only two thirds of patients are able to survive for a long time. This study was designed to investigate the correlation between liver fibrosis, size of ductuli at porta hepatis, and prognosis in order to determine the indications for the Kasai operation. The results of this study showed that the more severe fibrosis of the liver becomes, the worse will be the postoperative clinical features, and the larger the size of ductuli at porta hepatis, the better the prognosis. Based on these results, we have concluded that it is often possible to predict the prognosis at radical surgery by evaluating frozen sections. Patients can be divided into three groups according to these histological findings: group 1 (correctable, or RI in F1); group 2 (RII in F1, RI or RII in F2); group 3 (RIII, RI, or RII in F3). Although the Kasai operation is definitely indicated for patients in groups 1 and 2, making a stoma should be avoided in group 2, because the possibility of liver transplantation may arise in the future. Meanwhile, there is no indication for the Kasai operation for the patients in Group 3, liver transplantation is recommended.

Age Factors↗
PubMed1990

Tubular anal duplication--experiences with two cases.

Anal duplication is a very rare abnormality, especially in infants. Two cases of tubular anal duplication of the infant and neonate are reported in this paper. In all cases, removal of the duplicated anus through the perineal approach was accomplished without difficulty. The histology revealed a squamous epithelium with smooth muscle component around the cavity, combined with collumnar or transitional epithelium. There was no evidence of inflammation. The postoperative courses were uneventful with satisfactory anal function. The definite aetiology of this condition is still unknown, although several hypotheses have been proposed.

Anal Canal↗
PubMed1990

Prostaglandin and fatty acid metabolism in patients with extrahepatic biliary atresia.

The relationship between essential fatty acid (EFA) deficiency and disturbance of prostaglandin (PG) biosynthesis was studied in children after radical operation for extrahepatic biliary atresia (EBA). In addition, to investigate the method for treatment of postoperative EFA deficiency and disturbance of PG biosynthesis, the serum fatty acid and plasma PG levels were determined before and after supplementation of an EFA-rich powder (38 g of linoleic acid per 100 g of powder) through Suruga II enterostomy. Before administration of the EFA-rich powder, linoleic acid, arachidonic acid, PGE1, and PGF2 alpha levels were significantly lower in both good bile excretion and poor bile excretion groups than in the control group. After administration, linoleic acid and PGE1 levels significantly increased in the good bile excretion group as compared with the preadministration values. These results suggest that the supplementation of EFA-rich powder is an effective treatment for linoleic acid deficiency and disturbance of PGE1 biosynthesis in postoperative EBA patients.

Alprostadil↗
PubMed1990

Histiocytosis X: successful treatment with recombinant interferon-alpha A.

Two patients with disseminated histiocytosis X were treated with intramuscular injections of recombinant interferon alpha A. The bone, skin and visceral lesions of these patients diminished rapidly. Significant sclerosis and recalcification of bone were observed. From our limited but positive experience, it would be justified to consider the use of interferon in patients with disseminated histiocytosis X.

Histiocytosis, Langerhans-Cell↗
PubMed1990

[Preclinical and clinical studies on aztreonam in pediatric surgery].

Aztreonam (AZT) was administered to immature infants, neonates and infants for preclinical and clinical studies. 1. Sufficient serum concentrations were obtained upon 1-hour intravenous drip infusion of AZT 40 mg/kg to infants with biliary atresia. The average T1/2 was about 1 hour and urinary recovery rates were in a range between 35.2 and 61.3%. Biliary recovery rates were 0.03-0.4%. 2. AZT was given to 5 cases for prophylaxis and the results showed its prophylactic effect in 3 cases. 3. AZT is effective against Gram-negative bacteria and its efficacies in the treatment of 4 infection-cases were "excellent" in 2 cases and "effective" and "somewhat effective" in 1 case each. 4. Neither side effects nor abnormal laboratory test values were observed in any of the 9 cases given AZT.

Aztreonam↗
PubMed1989

Ursodeoxycholic acid therapy in the treatment of biliary atresia.

The prognosis of operated biliary atresia in the cases with bile excretion chiefly depends upon the prevention of ascending cholangitis. An antibiotic is therefore intravenously administered during the early postoperative phase, but cannot be used over a long period. In the cases showing satisfactory bile excretion after operation, ascending cholangitis is rare because of rapid disappearance of jaundice. Regarding this, the authors prescribed ursodeoxycholic acid (UDCA) at 10-15 mg/kg/day to 6 infants with biliary atresia for several weeks after operation, and then determined the effects of UDCA in improving jaundice and bile excretion. As a result, serum bilirubin and serum total bile acid (STBA) levels were decreased in 4 of the 6 infants. In the remaining 2 infants, their STBA levels showed no decrease, but were rather increased; these infants subsequently died of hepatic failure. These results suggested that UDCA is useful in the treatment of cholestasis associated with biliary atresia in the cases attaining postoperative bile excretion. It was also suggested that the treatment with UDCA should be stopped when the STBA levels increased after the beginning of the treatment. Therefore, it was thought that STBA levels measured during UDCA therapy could serve as a good indicator of the choleretic effect of UDCA.

Aging↗
PubMed1989

Treatment of laryngotracheoesophageal cleft.

Four patients with laryngotracheoesophageal cleft were treated in our institution. Two of the patients survived and two died. Cleft levels ranged from partial 15 mm laryngotracheoesophageal to total with extended right bronchoesophageal cleft.

Bronchi↗
PubMed1989

Adenoma and stone formation of the biliary tract in puppies that had choledochopancreatic anastomosis.

A canine model of anomalous choledochopancreatic ductal junction (APCDJ) was produced by choledochopancreatic end to side ductal anastomosis performed in 77 mongrel puppies weighing between 1.5 and 5 kg. Histopathological studies of the biliary tract showed that as the post-operative period became lengthened metaplasia and hyperplasia increased. In nine dogs that lived for over 5 years after the operation, papillomatous adenoma occurred in four (44%), and biliary stones in seven (78%). The histological changes seen in the biliary epithelium of our experimental canine model suggest that bile duct carcinoma may be due to the persistent return of pancreatic juice into the bile duct in patients with APCDJ.

Anastomosis, Surgical↗
PubMed1989

A report of a case with pure red cell aplasia induced by sodium valproate.

A 5-year-old girl developed pure red cell aplasia (PRCA) during sodium valproate (VPA) administration. Only four cases of VPA induced PRCA have been reported in the literature. Furthermore no precise report concerning the underlying mechanisms is available. Using a system for the clonal growth of autologous bone marrow committed erythroid stem cells (CFU-E, BFU-E) VPA itself was not inhibitory for colony formation at a physiological concentration. Patient's serum and peripheral mononuclear cells collected at admission showed no inhibitory effects on erythroid progenitor cell growth. Rapid recovery from PRCA was observed after discontinuation of VPA, without immunosuppressive therapy. Our observation suggests that VPA may induce PRCA through the inhibitory effect beyond the differentiation stage of BFU-E and CFU-E in some cases.

Child, Preschool↗
PubMed1989

Study of the structure-activity relationships of new dihydropyridine derivatives.

The effects of structure around the 3- and 5-alkoxycarbonyl groups and the 2-carbamate groups of 4-(2,3-dichlorophenyl)-2-carbamoyloxymethyl dihydropyridine derivatives were investigated, concerning their vasodilating action, plasma level, hypotensive action and acute toxicity. High negative linear correlation was found between the plasma levels and the number of C atoms in esterifying alkyl groups in 3- and 5-positions of the dihydropyridine ring. High plasma levels and effective hypotensive action were found in compounds having lower alkyls as esterifying groups of 3- and 5-carboxyl groups, among 2-unsubstituted derivatives.

Animals↗
PubMed1989

[Current state of the treatment of congenital biliary atresia].

Current state of the treatment of biliary atresia was studied concerning following factors based on our experience of 240 patients during 1966 to 1988, particularly 103 patients who received Kasai operation with Suruga II modification. 1. Operative results: Overall and Suruga II. 2. Predictable factors of the prognosis at the first radical operation, especially, among the age, the hepatic fibrosis and the size of ductuli at porta hepatis. 3. Technical refinement of Kasai operation, especially concerning the exposure of portal area and the anastomosis. 4. Our recent device of modified Kasai operation, that is, hepatic portoduodenostomy with interposition of ileocecoappendix. 5. Rehepatic portoenterostomy in case of poor postoperative bile flow. From our experiences, Kasai operation is indicated to the patients who have mild or moderate liver fibrosis and good sized ductuli at porta hepatis, but not to the patients who have advanced liver fibrosis and extremely poor ductuli. In such circumstance, liver transplantation should be considered. Rehepatic portoenterostomy is only indicated to the patients who have a good bile flow after the initial Kasai operation but not to the patients who have no bile flow.

Biliary Atresia↗
PubMed1989

[Study of reinduction chemotherapy in bone marrow relapse of childhood acute lymphoblastic leukemia].

Twenty children with acute lymphoblastic leukemia (ALL) in relapse were treated with various combinations of anti-leukemic agents in approach to the induction of remission. Among them, the four-drug reinduction regimen consisting of prednisolone, vincristine, daunomycin and L-asparaginase (PVDA regimen) was found to be highly effective. The incidence of remission was 100% (2/2) for first reinduction. The regimen also proved to be effective in the management of multiple subsequent relapses. The rate of remission induction for second and third to fifth reinduction attempts were 60% (3/5) and 50% (4/8), respectively. The over all remission rate was 60%. The median duration of subsequent remission for the entire patients treated by PVDA regimen was short, only 11 weeks (range: 3 to 26 weeks). PVDA regimen was effective in reinduction of remission in childhood ALL with relapse, but was not effective in remission maintenance. Optimal maintenance therapy for subsequent remissions has to be determined.

Adolescent↗