Search PubMed⌕ Search

Biomedical subjects

S Maetani

Publications and source records attributed to S Maetani.

At least 55 records · Page 3Linked to original sources
PubMed1990

[A re-evaluation of pupillary sensitivity to autonomics in diabetic patients].

It is well known that pupils of diabetic patients are supersensitive to topical administration of autonomics, and whether the penetration of instilled drugs into the anterior chamber is high or not is an important problem from a causal point of view. Fluorescein penetration into the anterior chamber after topical instillation was examined by fluorophotometry in 39 diabetic patients aged 30-70 and 26 age-matched healthy subjects. Penetration increased in correlation with aging in both groups. Though there was no significant difference between the distribution of fluorescein penetration in patients with DR-Scott 0, I, II and those in healthy subjects, patients with DR-Scott III.V showed higher penetration than the former in each age-group. A study of the relation between the pupillary sensitivity to diluted solution of pilocarpine and fluorescein penetration in diabetic patients revealed significant correlation (r = 0.48, p less than 0.05) in cases aged less than 50. As a result, penetration of drug into the anterior chamber was considered to be a significant parameter of pupillary sensitivity.

Administration, Topical↗
PubMed1989

The reappraisal of prognostic classifications for colorectal cancer.

The prognostic usefulness of four variables and four staging systems were evaluated by the Akaike Information Criterion (AIC) and conventional statistical tests for survival time analysis (log rank test, generalized Kruskal-Wallis test, and linear trend test), based on the data of 394 colorectal cancer patients who had been followed for more than 5 years after surgery. The four variables were the histopathologic findings of cancer penetration through the bowel wall (w), lymphnode metastasis (n), intraoperative observations of liver metastasis (H), and peritoneal dissemination (P). They were graded according to the general rules proposed by the Japanese Society for Cancer of the Colon and Rectum (JRSCCR). The staging systems were Turnbull's modification of Dukes' classification, UICC's TNM system, the Japanese classification proposed by JRSCCR, and the authors' modification of the latter. AIC calculated changing the cutoff points of survival time, as well as by reclassifying predictor variables into two categories by different levels. The results of the standard tests differed from those of AIC in the evaluation of the four variables. The former statistics showed that the intraoperative observations were of more prognostic importance than the histopathologic findings, whereas AIC revealed that the histopathologic variables have more prognostic information except for prediction of early outcome. Further analysis of the w-factor showed that survival is more drastically changed by serosal involvement or extensive extramuscular invasion than by penetration of the muscularis propria. Analysis of the n-factor indicated that a major change in survival time occurs twice, i.e., when lymphnode metastasis occurs and when it extends beyond the paracolic level. Compared with single variables, the staging system using multiple factors gives more information on both early and long-term outcomes. The authors conclude that AIC analysis provides prognostic information that cannot be obtained with conventional tests.

Colorectal Neoplasms↗
PubMed1989

[Effect of blood transfusion on prognosis of colorectal cancer patients].

To evaluate the effect of blood transfusion on prognosis of colorectal cancer, data of 592 patients having been operated on in our department were analyzed using Cox method, logistic regression and Mantel-Haenszel test. The predictor variables were age, tumor location, Turnbull's modification of Dukes stage, preoperative hemoglobin (HB), anesthetic time (AT), perioperative blood transfusion (BT), and intraoperative blood loss (BL). Cox analysis showed that the most significant prognostic factors were Stage and BT (p less than 0.001), followed by location and BL. Logistic analysis also revealed that Stage and BT were significant predictors of 1-year and 5-year survivals. Similar results were obtained by Mantel-Haenszel test in which the patients were stratified by Stage, and grouped by HB, BT and BL. BT was a significant factor whereas BL and HB did not achieve statistical significance. We conclude that BT is an important prognostic factor unrelated to other variables and its adverse effect on survival is of higher significance than BL and HB. Some measures including clinical decision analysis were proposed to avoid unnecessary blood transfusion in surgery.

Colorectal Neoplasms↗
PubMed1988

[Statistical analysis of pathological factors influencing prognosis of colorectal carcinoma].

The pathological and follow-up data of 503 patients with colorectal carcinoma have been analysed to assess quantitatively prognostic values of 16 pathological factors and their sub-categories with aid of computer. Besides the routine procedure, Cox's proportional hazards model, Hayashi's quantification theory II, III, Akaike's information criteria, Kendall's rank correlation, relative risk, and linear trend test were used. Regardless of methods used, liver metastasis, peritoneal dissemination, lymph nodes metastasis, depth of penetration, venous and lymphatic invasion emerged as powerful prognostic variables. Most of the analyses indicated that venous invasion contained the largest amount of prognostic information including that of long-term survival. When venous invasion is graded not only by the number of veins involved but also by the depth of invasion, its prognostic capability was comparable with that of staging systems. The values of relative risks calculated for the factors' sub-category were more closely associated with prognosis than five-year survival rates or median survival rates, thus permitting detailed comparison of different categories. We conclude the modern statistical methods are indispensable tool for prognostic factor analysis.

Colonic Neoplasms↗
PubMed1986

Role of blood transfusion in organ system failure following major abdominal surgery.

Using multivariate probit analysis, the data of 565 patients who underwent major abdominal surgery were retrospectively analyzed, and the etiologic role of blood transfusion in organ system failure (OSF), which includes respiratory failure, gastrointestinal stress bleeding, renal failure, nonobstructive, nonhepatitic jaundice, and coagulopathy, was studied. Apart from the amount of blood transfusion, the following factors were included in the analysis as possible contributors to OSF: age, preoperative hematocrit, organ failure risk (diffuse peritonitis, obstructive cholangitis, liver cirrhosis, terminal cancer, and hemorrhagic shock), operative time, blood loss, and postoperative highest hematocrit. The results showed that, except for preoperative hematocrit, all the factors are statistically significant contributors, blood transfusion being the most significant. There was no statistically significant interaction between blood transfusion and organ failure risk. It is concluded that blood transfusion is an important, independent factor contributing to OSF, and its contribution cannot be attributed to the underlying conditions that require blood transfusion.

Abdomen↗
PubMed1984

Neglected role of torsion and constriction in pathogenesis of simple adhesive bowel obstruction.

We critically analysed the mechanism of simple adhesive bowel obstruction in 88 re-laparotomies for this condition, paying special attention to obstructing factors beside angulation. Twenty-six obstructions were caused by bowel-to-bowel adhesion, and 42 by adhesion of bowel to other structures, whereas in the remaining 20 these two types were combined. Although angulation was almost always found at the site of obstruction, torsion (twisting of bowel about its axis) was detected in 25 of the 33 in situ observations, usually accompanied by various degrees of organic constriction. In bowel-to-bowel adhesion, the torsion and constriction were produced by a unique relation of the bowel to the adhesion; the latter connected one side of the mesenteric margin to the opposite side, encircling the bowel wall obliquely. This was never seen on nonobstructing adhesions. We conclude that torsion and constriction are important causes of simple bowel obstruction as well as strangulated obstruction.

Constriction, Pathologic↗
PubMed1984

[A case of alpha-fetoprotein producing rectal cancer].

A case of AFP producing rectal cancer was represented in this paper. The patients, 68 years old man, was admitted because of anal bleeding and preoperative examinations revealed rectal cancer without liver metastasis and hepatocellular carcinoma. Serum AFP measured preoperatively was 2750-3500 ng/ml and CEA was 23-33 ng/ml. The patient underwent amputation of the rectum and there were no abnormal masses in the liver at surgery. After operation serum AFP and CEA levels were normalized. Histology of the rectal tumor showed a tubular adenocarcinoma of moderately differentiated type. In the specimen, AFP producing tumor cells were detected by immunoenzymatic labelling (PAP) methods.

Adenocarcinoma↗
PubMed1984

Differentiation of congenital biliary atresia and neonatal hepatitis by statistical methods.

Congenital biliary atresia (CBA) is a disorder of early infancy that needs early and accurate diagnosis because the curability may be increased if surgical therapy (hepatic porto-enterostomy) is performed early in the disease course of this condition. But immediate differentiation of CBA from neonatal hepatitis (NH) is very difficult, and even special tests for differential diagnosis are of limited value because of some hazards, including the length of time required, technical difficulties, and so on. The data on 14 patients with CBA and 20 with NH admitted to Tenri Hospital were analyzed by two statistical methods (discriminant analysis and probit analysis) and then scores combining several simple variables were calculated. We tried to differentiate these two conditions by the scoring systems mentioned above, and checked the results of these methods against cases in other hospitals (CBA 6 cases and NH 15 cases). Our scoring systems presented here showed higher discriminant power than any single variable test, including the 131I-BSP excretion test, and can be used where there is no time for differential diagnosis.

Bile Ducts↗
PubMed1983

[Mucosal hyperplasia of the ileum after subtotal colectomy in rats].

To evaluate factors contributing to ileal mucosal hyperplasia following extensive colectomy, the following three models were designed in rats: Subtotal colectomy and end-to-end ileoproctostomy; retransection of the terminal ileum with end-to-side proximal-ileoproctostomy (colectomy group), End-to-side ileoproctostomy without colectomy (bypass group), and End-to-side ileocecostomy (control group). In all groups the terminal ileum was left out of the intestinal stream as defunctionalized segments. Specimens were obtained from the terminal ileum during operation and from both the functioning and the defunctionalized segments at various intervals postoperatively. The mucosal hyperplasia was evaluated by measuring eight variables including numbers of villi around the bowel circumference, villous height, crypt depth, total mucosal thickness, epithelial cell counts per villus, DNA contents per unit length of the bowel and radioactivity of incorporated 3H-thymidine as well as DNA specific activity. The results showed that marked mucosal hyperplasia of the functioning segments was noted in all groups, and that mucosal hyperplasia was also observed in defunctionalized segments of colectomized rats, but not in those of both bypass rats and control. These findings were statistically confirmed by analysis of variance. It was concluded that although intraluminal factors played an important role in mucosal hyperplasia of the ileum following extensive colectomy, humoral factors might be also involved in intestinal adaptation.

Animals↗
PubMed1981

Open peritoneal drainage as effective treatment of advanced peritonitis.

In 13 patients with advanced peritonitis (postoperative suture line breakdown in eight and spontaneous intestinal perforation in five) treatment consisted of widely opening the peritoneal cavity and exposing the contaminated viscera. Eight of the patients underwent diverting enterostomy, and the remaining five underwent an additional drainage procedure to evacuate a residual collection. Clinical improvements were observed in all except one who died without favorable response. Some of the clinical manifestations indicative of organ failures subsided in nine of the ten patients. In five patients peritonitis subsided completely, whereas in another seven it was localized, leaving a fistula; in five of them reoperative closure of the abdominal wall and fistula was performed with one operative death. One patient developed a new enteric fistula from the previous anastomotic site that had been exposed after opening the abdominal wall. There was no intestinal obstruction or inreducible bowel pretrusion during the course of treatment. It was concluded that the open peritoneal drainage procedure, combined, if necessary, with diverting enterostomy, should be considered for advanced peritonitis causing grave systemic complications.

Adult↗
PubMed1980

Parametric survival analysis of gastric cancer patients.

A total of 1026 patients with gastric cancer was followed up for five years after surgery and classified into different groups according to surgeons' assessment of nodal involvement, serosal invasion, peritoneal spread, and hepatic metastasis. The survival of each group was studied by parametric analysis, using the log normal model and three parameters estimated: proportion of patients cured (c), mean (m), and SD of log survival times of patients not cured. With these parameters, compared with the conventional five-year survival or the median time, the survival pattern of each group was delineated in detail, and prognostic inferences beyond the follow-up period were made feasible. Groups with more localized lesions were characterized by higher values of c and m. This implied that although patients in these groups have a better chance of cure, they are exposed to a relatively higher risk of late death due to recurrence. This method proved also useful to compare the prognostic values of different classification and to develop better staging systems.

Follow-Up Studies↗