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Biomedical subjects

M Muto

Publications and source records attributed to M Muto.

209 records · Page 12Linked to original sources
PubMedDate not supplied

[Defecography and treatment of essential anal pain].

INTRODUCTION: Proctalgia is a chronic anal pain in the absence of any organic conditions of the anorectum and excluding such morphofunctional disorders as rectal prolapse, intussusception and solitary rectal ulcer, which are easily shown with defecography but not with other imaging techniques. Proctalgia patients undergo a long workup and many instrumental and radiologic examinations and are finally referred to the proctologist with a condition which is difficult to diagnose and treat. We investigated the defecographic findings and anorectal abnormalities of essential proctalgia, as well as the correlation between radiologic findings, clinical symptoms and efficacy of biofeedback treatment. MATERIALS AND METHODS: We retrospectively examined 31 patients (21 women and 10 men; age range: 25-67 years, mean: 46) with defecography, clinico-proctologic investigations integrated with anoscopy and sigmoidoscopy, anorectal manometry and psychological tests. The women were submitted to gynecologic examination: 8 patients had a history of anorectal and pelvic surgery. We did not perform anal electromyography because it may cause painful sphincterial spasms. All patients underwent 30-minute weekly sessions of biofeedback till regression of symptoms. RESULTS: Anal pain was described as anorectal in 18 cases, anoperineal in 7, anosphincterial in 5 and rectovaginal in 1 case. It radiated to the sacrum in 42% of cases, thighs in 23%, gluteus muscles in 19%, and was related to evacuation in 39% of cases. Pain lasted some hours (58%) to a few minutes (42%). Manometric data showed sphincterial hypertonia in 14 patients. Eleven patients suffered from anxiety and were on drug treatment. Defecography demonstrated rectocele in 15 cases, puborectalis muscle syndrome in 14, external sphincter spasm in 12, perineal descent in 8, rectal muscosal prolapse in 4, intussusception in 3 and fecal incontinence in 2 cases. After 10 weeks of biofeedback training, all patients reported improvement of symptoms, which was confirmed at manometry as reduced sphincterial pressure. CONCLUSIONS: The etiology of essential proctalgia is unknown, but functional disorders of the pelvic floor and sphincterial muscles, as well as altered perineal stasis and pudendal conditions, all play an important role. These data are confirmed in our study where puborectalis syndrome, external sphincterial spasm and perineal descent are involved in over 70% of cases. Defecography is a useful tool because it permits to diagnose abnormal anorectal morphology and to diagnose sphincterial and puborectalis muscle dysfunctions which are missed with other instrumental and imaging techniques.

Adult↗
PubMedDate not supplied

Primary squamous cell carcinoma of the stomach: a case report with a review of Japanese and Western literature.

A case of a 75 year-old male with primary squamous cell carcinoma of the stomach is reported. It is extremely rare to see squamous cell carcinoma developing in the stomach, without being accompanied by a component of adenocarcinoma. Up to the present, 18 Japanese and 62 Western cases of this type of carcinoma have been reported in the literature. The origin of this malignancy has not been well elucidated yet and thus, several plausible hypotheses have been proposed. In this presented case, the tumor consisted of only squamous cell carcinoma and the focus of squamous metaplasia was not found histologically in the adjacent mucosa. Therefore, it may be considered that the carcinoma arises from misplaced squamous cell nests of the stomach.

Aged↗
PubMedDate not supplied

[Gunshot wounds of the cranium studied with computerized tomography. Personal experience in 23 cases].

INTRODUCTION: Gunshot wounds to the head are usually mortal injuries. Their frequency has been increasing in the last years because of increasing crime rates. Gunshot wounds to the head require close clinical and diagnostic cooperation of the neurosurgeon and radiologist, detailed assessment of skull and brain damage, and finally prompt treatment. Emergency Computed Tomography (CT) makes a useful tool for depicting bullet course and brain damage, and thus helps plan treatment. We investigated the CT signs of subdural hematoma, lacerocontusive focus, subarachnoid hemorrhage, hemoencephalus, skull bone fracture and thecal hollow and report them as an aid to the neurosurgeon and the radiologist, for best treatment planning, and in an attempt to establish useful prognostic criteria. MATERIAL AND METHODS: We retrospectively reviewed 23 cases of gunshot injuries to the head studied with CT at the Emergency Unit of Loreto Mare Hospital in Naples, Italy. Twenty patients were men and 3 women; their mean age was 31 years (range: 18-49). Three women and 2 men had been injured accidentally by wandering bullets, and one case was an attempted suicide; all the other cases resulted from shootings. CT slices were 10 mm thick, with 8 mm gap (5 mm in complex injuries and when posterior cranial fossa was involved); all scans were unenhanced. RESULTS: We found 22 penetrating gunshot wounds: 13 of them with thecal entry hole and intracranial bullet retention and 9 with an entry and an exit hole. One case was a superficial wound. Crash skull fractures were seen in 22 cases and they were fragmented in 12, with overlapping thecal fragments in 4, and with deep fragments in 2 cases. There were scattered bone splinters in 3 cases and the bullet was retained in the mastoid bone in one case. Lacerocontusive foci were assessed in 22 cases, brain swelling in 20, subarachnoid hemorrhage in 19, brain hematoma in 15, blood in the ventricular system in 9, pneumoencephalus in 7, air bubbles along the bullet course in 7, impression on ventricula and linear structures in 7, interhemispheric blood in 5, and finally blood effusion in Sylvian scissure in 4 cases. DISCUSSION AND CONCLUSIONS: Gunshot wounds to the head are complex and severe traumas with high mortality rates because of both early and late effects and complications. CT provides the neurosurgeon with abundant findings for diagnosis and surgical planning, which may result in improved survival rates. In these patients emergency CT plays a fundamental diagnostic role in depicting brain damage and thus remains the method of choice for thorough, rapid and accurate brain and skull studies, as well as to detect possible injury to the chest and abdomen.

Adolescent↗
PubMedDate not supplied

Involvement of p53 gene in the allelic deletion of chromosome 17p in human ovarian tumors.

Previous reports have shown that one copy of the chromosome 17 was frequently lost in human ovarian cancers (1). The position of the allelic deletion has not been mapped and involvement of p53 gene has not been determined. In this study, we have shown that in human ovarian carcinoma, the commonest region of allelic loss in chromosome 17p is 17p 13.3 (65%) and 17p13.1 (63.7%; 6 out of 9 informative cases). Allelic loss was also observed at region 17p12 - 11.1 but at a lower frequency (38.6% to 37.5%). The pattern of allelic loss of p53 gene was consistent in both primary and secondary metastatic tumors of the same patient. No gross rearrangement of p53 was however observed at the remaining allele using Southern blot analysis. Allelic loss of p53 gene was closely associated with 17p 13.3, the terminal portion of chromosome 17p. The high frequency of allelic loss of p53 gene in ovarian carcinomas conformed with recent findings in cancers of colon, breast, lung and brain suggesting inactivation of p53 gene play a rate limiting step in pathogenesis of human malignancies.

Alleles↗