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Biomedical subjects

Y Tsuchida

Publications and source records attributed to Y Tsuchida.

At least 91 records · Page 5Linked to original sources
PubMed1997

[Perinatal surgery and perinatal treatment].

Recent results of neonatal surgery in Japan are presented. Nowadays, babies born with esophageal atresia, diaphragmatic and abdominal wall defects (gastroschisis and amphalocele) require special intensive surgical care after delivery, while those with imperforate anus, hirschoprung's disease and intestinal atresia will follow a relatively smooth postoperative course. Prenatal surgery or treatment may be necessary for some fetuses with congenital diaphragmatic hernia and congenital cystic adenomatoid malformation of the lung. Experiences at the authors institutions were reported, and recent results at institutions in the united states are introduced.

Congenital Abnormalities↗
PubMed1996

Sensitive method for the determination of pulmonary surfactant phospholipid/sphingomyelin ratio in human amniotic fluids for the diagnosis of respiratory distress syndrome by thin-layer chromatography-immunostaining.

By TLC-immunostaining with the monoclonal antibody VJ-41, which preferentially reacted with sphingomyelin (Sm) and disaturated fatty acid-containing phosphatidyl choline (DSPC), Sm and surfactant phospholipid dipalmitoyl PC were only detected in the lipid extracts from human amniotic fluid. The method was useful in the selective and simultaneous determination of surfactant phospholipid and Sm concentrations in the amniotic fluids to determine the level of maturity of the lungs of the fetus. By measuring the density of spots visualized by TLC-immunostaining, we detected Sm at a sensitivity two times higher than that for dipalmitoyl PC using the antibody. More than 50 ng of dipalmitoyl PC and Sm was detected on the same TLC plate and the standard curves were linear up to 1 microgram of phospholipids. The method was applied to determine the surfactant phospholipid/Sm ratio in 20 microliter of the amniotic fluids obtained at delivery, and the amniotic fluids from the women who delivered a baby suffering from respiratory distress syndrome (RDS) were easily discriminated from the normal amniotic fluids. In an analysis of 200 microliter of amniotic fluids from 4 RDS cases and 16 normal baby cases, the mean DSPC/Sm ratios were 0.97 +/- 0.53 and 5.75 +/- 1.29, respectively.

Amniocentesis↗
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

Arthrodesis of knee joint by vascularized fibular graft.

Knee arthrodesis has been performed in 17 patients using vascularized fibular graft (VFG); 15 of them could be followed more than 1 year. Twelve were bone defect following tumor resection, two were traumatic bone defect, and one was intractable traumatic non-union. Three types of graft were performed; single VGF as supplement (Type I) in 5 cases, double VFG for femoral defect (Type II) in 8 cases, and double VFG for tibial defect (Type III) in 4 cases. Bone union was achieved in all cases except one. The average time to primary bone union was 4.7 months. Hypertrophy of the graft was observed significantly in some of Type II and in all of Type III. VGF is a useful method for knee fusion in patients with a large bone defect or with an intractable non-union.

Adolescent↗
PubMed1996

Latissimus dorsi musculocutaneous free flap transplantation to salvage below-elbow amputation in an emergency operation: a case report.

We used a free latissimus dorsi musculocutaneous flap (LD m-c flap) to cover a large skin defect at the stump of a forearm in an emergency operation. The patient we discuss is a 52-year-old man. Amputation at the distal one third of the left forearm occurred after catching his hand and wrist in a machine. The amputated left hand was severely damaged and there were wide skin defects. The function of the elbow joint was well preserved. Both the radius and ulna were cut 7 cm distal from the elbow joint. A 20 x 8 cm square of LD m-c flap was transplanted, to the stump of the forearm. The flap survived without incident. The range of motion of the elbow joint was from 20 degrees to 85 degrees. The prosthesis was well fitted to the stump, and the patient returned to his workshop 9 months after injury.

Amputation Stumps↗
PubMed1996

Developmental changes of neutral glycosphingolipids as receptors for pulmonary surfactant protein SP-A in the alveolar epithelium of murine lung.

A dramatic change in the glycosphingolipid composition in murine lung occurred between 1 day and 1 week after birth. GlcCer and LacCer were the predominant neutral glycosphingolipids prenatally and 1 day after birth, and the concentrations of globo- and ganglio-series glycosphingolipids increased abruptly from 1 week after birth, reaching maxima at 2-3 weeks. To explore the functional significance of the change, we examined the role of neutral glycosphingolipids as receptors for the murine pulmonary surfactant protein, SP-A, and found that SP-A bound to LacCer, Gg3Cer, and Gg1Cer, but not to Gb3Cer, Gb4Cer, IV3GalNAc alpha-Gb4Cer, sulfatide, or several gangliosides. On TLC-blotting with 125I-labeled SP-A, the binding of SP-A to Gg3Cer and Gg4Cer was 5 times higher than that to LacCer, and on immunohistochemical staining Gg4Cer and Gg3Cer was mainly observed in the alveolar epithelium. Thus, the capacity to retain SP-A of glycolipid receptors per gram dry weight of lung at 1 week after birth was 1.6 times higher than that at 1 day after birth, and reached a maximum 3 weeks after birth. These findings suggest that the enhanced synthesis of the ganglio-series neutral glycosphingolipids 1 week after birth results in an increase in the binding capacity for SP-A on the epithelial cell surface of alveoli.

Animals↗
PubMed1996

Genetic clinical markers of human neuroblastoma with special reference to N-myc oncogene: amplified or not amplified?--An overview.

Neuroblastoma is the most common extracranial tumor in children, and cytogenetically, chromosome 1p deletions, extrachromosomal double minutes, and homogeneously staining regions (HSRs) are commonly observed in cell lines and in tumors in advanced stages. It is found that an HSR represents genomic amplification of N-myc, which plays a key role in determining the aggressiveness of neuroblastoma. However, stage IV neuroblastomas or cell lines which lack N-myc amplification are also progressive, and some of them show evidence of N-myc expression in terms of mRNA and/or N-Myc oncoprotein. It was recently shown that a small proximal locus mapped between 1p35-36.1 and 1p36.23 may function as a suppressor gene of N-myc amplification. In neuroblastoma, a pattern of diploidy is associated with rapid tumor growth and poor survival. Expression of bcl-2 proto-oncogene is strongly associated with unfavorable histology, while expressions of Ha-ras and trk-A proto-oncogenes indicate a favorable prognosis. trk-A proto-oncogene encodes a receptor for nerve growth factor. Genetic characteristics of neuroblastomas found by urinary catecholamine mass screening are also discussed.

Biomarkers, Tumor↗
PubMed1996

Competitive polymerase chain reaction for the quantification of N-myc gene copy number in neuroblastoma.

An absolute quantification method for the N-myc gene copy number of neuroblastoma specimens was established by applying the competitive polymerase chain reaction (cPCR). The competitor plasmid (pZH2) lacking an MluI site in the exon 2 was constructed to distinguish two product species amplified from genomic DNA and the competitor plasmid. By using this cPCR system, we could obtain qualitative results within 1 day, i.e. amplified or unamplified, and quantitative results by using radiolabelled nucleotides within 4 days. The copy numbers of N-myc in 47 neuroblastoma specimens by cPCR correlated well with those by Southern hybridization (r = 0.85). We conclude that cPCR is a simple and rapid method, requires only a small amount (200 ng) of sample DNA, and is expected to be used for prognostic evaluation in neuroblastomas.

Base Sequence↗
PubMed1996

[Development of intrahepatic cholelithiasis long after primary excision of choledochal cysts].

Biliary sricture with dilatation is a putative cause of intrahepatic bile duct stones. However, this hypothesis has never been proven. Fifty-six patients had operative cholangiography, underwent standard excision of a choledochal cyst, and were reviewed at follow-up clinics at a mean follow-up time of 14 years and 6 months. The incidence of complications such as intrahepatic cholelithiasis was analyzed according to the morphologic types of the intrahepatic bile ducts as observed at the initial operation. Group I patients (29 cases) did not show any dilatation of the intrahepatic bile ducts. Only one (3%) developed intrahepatic cholelithiasis. In Group II (24 cases), the intrahepatic bile ducts were dilated but not associated with any down-stream stenosis, one patient (4%) suffered from intrahepatic chalelithasis. Group III patients (3 cases) had dilatation of the intrahepatic bile ducts associated with a down-stream stenosis, and none of them was free from the development of intrahepatic biliary stones (3 cases). Group III patients are most likely to develop intrahepatic cholelithiasis afterwards, and their stenosis should be relieved by whatever means are feasible at initial operation.

Adolescent↗
PubMed1996

[How to improve the results of treatment of biliary atresia].

In the present article, strategies on how to improve the clinical results of patients with biliary atresia are discussed. Our policies include 1) meticulous and accurate dissection and enteric anastomosis at the porta hepatic with the use of hepatic mobilization, 2) use of a complete external biliary fistula (Sawaguchi method), 3) use of an intussusception-type anti-reflux valve in the Roux-en-Y limb, 4) prompt reoperation if necessary, 5) prolonged use of antibiotics and choleretics, 6) in-patient care for as long as 3 months after hepatic portoenterostomy, etc. 19 of 21 patients, treated at National Children's Hospital and University of Tokyo, became jaundice-free, and we conclude that these policies mentioned above are necessary to keep the jaundice-free ratio at 90%, not at 70% which is the average ratio at all Japanese institutions.

Anti-Bacterial Agents↗
PubMed1996

Development of intrahepatic cholelithiasis long after primary excision of choledochal cysts.

BACKGROUND: Biliary stricture with dilatation is a putative cause of intrahepatic bile duct stones. However, this hypothesis has never been proved. STUDY DESIGN: Fifty-six patients had operative cholangiography, underwent standard excision of a choledochal cyst, and were reviewed at follow-up clinics at a mean follow-up time of 13 years and 6 months. The incidence of complications such as intrahepatic cholelithiasis was analyzed according to the morphologic types of the intrahepatic bile ducts as observed at the initial operation. RESULTS: Group 1 patients (29 cases) did not show any dilatation of the intrahepatic bile ducts. Intrahepatic cholelithiasis developed in only one case (3 percent). In group 2 (24 cases), the intrahepatic bile ducts were dilated but not associated with any downstream stenosis. One patient (4 percent) suffered from intrahepatic cholelithiasis. Group 3 patients (3 cases) had dilatation of the intrahepatic bile ducts associated with downstream stenosis, and none of them was free from the development of intrahepatic biliary stones (3 cases). CONCLUSIONS: Patients with biliary dilatation with stricture of the intrahepatic bile ducts are most likely to develop intrahepatic cholelithiasis after surgical excision of a choledochal cyst, and their stenosis should be relieved by whatever means feasible at initial operation.

Bile Ducts, Intrahepatic↗
PubMed1995

Aneurysm of the transverse cervical artery occurring in association with a cavernous hemangioma as a complication of Klippel-Trénaunay syndrome: report of a case.

We report herein the case of a 14-year-old girl with Klippel-Trénaunay syndrome who developed an aneurysm of the transverse cervical artery. Because it was continuing to increase in size, with an associated risk of rupture, an aneurysmectomy was performed. Pathological examination of the resected specimen revealed a cavernous hemangioma located near the aneurysm. To our knowledge no other case of an aneurysm occurring in association with a cavernous hemangioma as a complication of Klippel-Trénaunay syndrome has ever been reported.

Adolescent↗
PubMed1995

Hirschsprung's disease associated with Ondine's curse: a special subgroup?

The authors report a case of the rare occurrence of congenital central hypoventilation syndrome (Ondine's curse) and long segmental colonic aganglionosis (Hirschsprung's disease). A review of 24 reported cases showed that the proportion of females having this concurrence is higher than for ordinary Hirschsprung's disease. It also appears that the aganglionic segment is much longer in these cases than in ordinary Hirschsprung's disease.

Female↗
PubMed1995

Esophageal duplication cyst associated with pulmonary cystic malformations.

Two cases of esophageal duplication cyst associated with pulmonary cystic malformations (cystic bronchiectasis with pneumonia in one, intrapulmonary bronchogenic cysts with bronchial atresia in the other) are reported. The coexistence of these complex anomalies supports the recognition that esophageal duplication cyst also is an entity of a broad spectrum of developmental abnormalities caused by abnormal budding of the primitive foregut. Nine cases of similar complex anomalies in the lung and esophagus have been reported. Although rare, this malformation complex should be borne in mind in the treatment of pediatric mediastinal and pulmonary malformations.

Abnormalities, Multiple↗
PubMed1995

Familial multiple mesothelial cysts of the spleen.

A 5-month-old boy who was diagnosed as having hydrops fetalis at 25 weeks' gestation had severe ascites of unknown origin. At the age 12 months, ultrasonography and computed tomography showed multiple cysts in the spleen that were increasing in size rapidly. Splenectomy resulted in complete disappearance of the ascites. These cysts were diagnosed as mesothelial cysts because the cell lining of the splenic cysts stained positively with alcian blue and cytokeratin. The boy's mother had undergone splenectomy for splenic and retroperitoneal lymphangiomas at 4 years of age. Histological reevaluation showed that the lining of her splenic cysts had the same mesothelial components as her son's. Their chromosomal assay showed normal karyotypes. Mesothelial cyst of the spleen appears similar to splenic lymphangioma morphologically; however, bleomycin and OK-432 were not effective. Familial splenic mesothelial (epidermoid) cysts have been reported in three sets of siblings, but this is the first report of their occurrence in mother and son.

Adult↗
PubMed1995

Modified Marcy repair of large indirect inguinal hernia in infants and children.

Based on a review of operative notes of recurrent inguinal hernia cases from the authors' primary series, a surgical technique modified from the Marcy repair is described. With this technique, emphasis is placed on preservation of the intact internal spermatic fascia and reduction in the size of the internal inguinal ring. Through the inguinal approach, the sleeve-like extension of the internal spermatic fascia is incised longitudinally along the cord and up to the internal ring. The cord structures are dissected off the sac, and as much of the fascial tissue as possible is preserved intact. Both edges of the fascial defect are approximated with an unabsorbable suture; great care is taken to not penetrate the wall of the sac. The same suture is then used for high ligation, via a stay suture placed on the transversalis fascia on the other side of the neck, to reduce the size of the internal ring. The technique can be used in premature babies who have a flimsy, easily torn sac, and in some cases of giant hernia with a widely dilated internal inguinal ring, if the direct wall integrity remains adequate.

Adolescent↗
PubMed1995

Antenatal diagnosis of biliary atresia (type I cyst) at 19 weeks' gestation: differential diagnosis and etiologic implications.

At 19 weeks' gestation, two cystic structures were first identified in the abdomen of a fetus. A repeat ultrasonography at 34 weeks confirmed a definite cyst communicating with the liver. The baby was born at 39 weeks, and serum direct bilirubin started to rise to 4.1 mg/dL. An operative cholangiogram at 23 days of life showed a cystically dilated choledochus with distal atresia and a relatively smooth yet hypoplastic intrahepatic biliary tree. Complete obliteration of the cystic duct was also noted. After excision of the cystic common bile duct, hepatico-jejunal anastomosis was performed, and the patient did well for 8 months postoperatively. Liver biopsy showed proliferation of the bile ductules, but no interlobular bile ducts were observed in any portal triad. A diagnosis of biliary atresia was established. Including the present case, five cases of antenatally diagnosed biliary atresia have been reported. All of them had type I cyst, and antenatal diagnosis was made at 19 to 32 weeks' gestation. Differential diagnosis between biliary atresia of type I cyst and choledochal cyst with complete distal obstruction has been a matter of discussion, and recognition of the entity of antenatally diagnosed biliary atresia is of significant importance from an etiological point of view.

Adult↗