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T Muto

Publications and source records attributed to T Muto.

At least 325 records · Page 18Linked to original sources
PubMed1995

Growth hormone and insulinlike growth factor I enhance host defense in a murine sepsis model.

OBJECTIVE: To investigate the effects of exogenous growth hormone (GH) and insulinlike growth factor I (IGF-I) on host defense and survival in a murine model of Escherichia coli sepsis. DESIGN: Prospective randomized experimental trials. SETTING: Laboratory. MATERIALS: Nine-week-old female BALB/c mice. INTERVENTIONS: Mice were injected subcutaneously with 4.8 or 0.48 mg/kg of body weight per day of GH, 24 or 2.4 mg/kg of body weight per day of IGF-I or, as a control, normal saline solution, for 6 days. Mice were then challenged intraperitoneally with 1 x 10(8) colony-forming units per body of E coli. MAIN OUTCOME MEASURES: Fifty mice were observed for survival. In the next experiments, samples from the high-dose GH, high-dose IGF-I, and saline control groups were harvested before or at 4 or 6 hours after challenge. Numbers of peritoneal exudative cells and tissue-viable bacterial counts were determined. Peritoneal exudative cells were cultured with lipopolysaccharide (10 micrograms/mL) for 24 hours. Levels of tumor necrosis factor, interleukin-1, and interleukin-6 in the peritoneal lavage fluid, plasma and supernatants of peritoneal exudative cell culture were measured. RESULTS: Both high and low doses of GH and high-dose IGF-I significantly prolonged survival. Growth hormone and IGF-I significantly increased peritoneal exudative cell numbers and reduced viable bacterial counts in the peritoneal lavage fluid and the liver. These hormones significantly suppressed excessive systemic cytokine production, while enhancing in vitro cytokine production and preserving local cytokine responses. CONCLUSION: The immunomodulation produced by administration of GH or IGF-I leads to improved host defense in this murine model of E coli sepsis.

Analysis of Variance↗
PubMed1995

Blunt pancreatic trauma with main pancreatic duct disruption managed successfully with total parenteral nutrition: report of a case.

Although surgery is the usual treatment of choice for pancreatic trauma with disruption of the main pancreatic duct, we report herein the case of a patient in whom blunt pancreatic trauma with disruption of the proximal main pancreatic duct was successfully managed by conservative treatment. An 18-year-old women presented with abdominal pain 22 days after being involved in a car accident in which her upper abdomen was thrust against the steering wheel. Computed tomography revealed a pancreatic pseudocyst and a prevertebral pancreatic fracture, and endoscopic retrograde pancreatography showed complete disruption of the main pancreatic duct at the neck. Considering that the patient had been clinically stable since the accident, we elected to continue with conservative management and placed her on total parenteral nutrition. Rapid recovery followed and 6 years later, the patient remains well without any exocrine or endocrine insufficiency despite atrophy of the distal pancreas. This experience indicates that selected cases of main pancreatic duct disruption following blunt trauma may be amenable to conservative management.

Adolescent↗
PubMed1995

Malignant insulinoma causing liver metastasis 8 years after the initial surgery: report of a case.

We report herein a rare case of malignant insulinoma which recurred as multiple liver metastasis 8 years after the initial resection. The patient was a 51-year-old Japanese man who originally presented in 1985 at the age of 43 years suffering from general malaise and syncope. The initial surgery in 1985 involved complete enucleation of a 15 x 13 mm insulinoma located in the uncus of the pancreas. Histopathologically, the tumor was diagnosed as a benign adenoma (insulinoma) which was immunohistochemically stained with only the anti-insulin monoclonal antibody. Macroscopically, there were no signs of either invasion or metastasis. During the subsequent 7 years, he did not show any symptoms or significant abnormality in laboratory data. However, in 1993, the patient again experienced syncope with hypoglycemia and hyperinsulinemia. Ultrasonography revealed multiple echogenic lesions in the liver and a second laparotomy confirmed multiple hepatic metastases from insulinoma, the histopathological findings of which were similar to those of the primary tumor from 8 years before. The patient is currently being treated with streptozotocin and 5-fluorouracil via a catheter in the hepatic artery.

Humans↗
PubMed1995

Prevention of local recurrence by extended lymphadenectomy for rectal cancer.

This study was undertaken to determine if the degree of lymphadenectomy correlates with the prevention of local recurrence. The authors retrospectively reviewed the clinical data of 269 patients who underwent curative surgery for rectal cancer. The study was divided into three periods based on the method of lymphadenectomy as follows: period I (1963-1979) when extended lymphadenectomy was not performed; period II (1980-1985) when this was partially done with no attempt to dissect the obturator and proximal middle rectal lymph nodes; and period III (1986-1990) when this was completely performed for patients with appropriate indications. The local recurrence rates were 21%, 10%, and 8% for Periods I, II, and III, respectively (P < 0.05). The incidence of local recurrence tended to be greater in period I versus periods II and III according to type of operation, location, and stage of the primary tumors. The local recurrence rates arising from lateral node metastases were 11%, 4%, and 2% for periods I, II, and III, respectively (P < 0.05), while the incidence related to an insufficient surgical margin was approximately 5% throughout the three periods. We thus conclude that the degree of lymphadenectomy is a major determinant of local recurrence following a curative operation for rectal cancer.

Adult↗
PubMed1995

The influence of surgical insults on restenosis after transluminal balloon angioplasty.

The influences of atherogenic response on restenosis after transluminal balloon angioplasty and the anastomosis of arterial reconstruction were investigated. Iliac transluminal balloon angioplasty was performed on 81 consecutive patients at 86 sites, between January, 1987 and December, 1992. A balloon angioplasty alone was performed in 58 patients at 60 sites, while distal revascularization was performed in 23 patients on 26 limbs, in association with the angioplasty. An improvement in the inflow of the distal grafts was achieved in 22 of these 23 patients in 26 limbs. The combined distal revascularization included 21 femoropopliteal bypasses, 3 femorofemoral bypasses, and 2 thromboendarterectomies at the profunda femoris arteries. A reduction in the luminal diameter after the balloon angioplasty was determined by means of follow-up arteriograms which showed no obvious progression of the restenosis at the angioplasty sites even when neointimal hyperplasia had developed at the anastomosis of the arterial reconstruction. The accumulative graft patency rate of the combined distal revascularization did not differ significantly from that of femoropopliteal reconstructions alone during the same study period. This study demonstrated that concomitant surgical insults do not have a detrimental effect on restenoses at angioplasty sites.

Aged↗
PubMed1995

A peroperative comparison of Western and Oriental colonic anatomy and mesenteric attachments.

It has been suggested that the Oriental colon is easier to colonoscope than its Western counterpart. The aim of this study was to investigate possible differences in colonic anatomy between Western and Oriental patients that might explain this observation. Measurements of colonic length and mesenteric attachments were taken according to a set protocol from 115 Western (Caucasian) and 114 Oriental patients at laparotomy. Sigmoid adhesions were found more frequently in Western (17%) compared to Oriental (8%) patients, P = 0.047. A descending mesocolon of > or = 10 cm occurred in 10 (8%) Western patients but only 1 (0.9%) Oriental patient, P = 0.01. The splenic flexure was more frequently mobile in Western patients (20%) compared to Oriental (9%) patients, P = 0.016. In 29% - of Western patients the mid-transverse colon reached the symphysis pubis, or lower when pulled downwards in contrast to 10% of Oriental patients, P < 0.001. There was no significant difference in total colonic length comparing Western (median = 114 cm, range 68-159 cm) to Oriental (median = 111 cm, range 78-161 cm) patients. Western patients have a higher incidence of sigmoid colon adhesions and increased colonic mobility when compared to Orientals. These findings support the observation that colonoscopy is a more difficult procedure in Western patients.

Adult↗
PubMed1995

Electrogastrography prior to and following total gastrectomy, subtotal gastrectomy, and gastric tube formation.

On electrogastrography (EGG) spectral analysis, an activity of 3 cycles per minute (cpm) is supposed to be specific for the stomach. After total or subtotal gastrectomy, the original site of the stomach is occupied mainly by the intestine. We attempted to determine if intestinal activity could be recorded in this region with EGG. Epigastric recordings were performed in patients prior and following gastrointestinal or control surgeries. Spectral analysis, using the maximal entropy method and ensemble means was applied to data analysis from these recordings. Preoperatively, the majority of the power peaks were found around 3, 6, and 11 cpm. The postprandial-to-fasting power ratio of all of these power peaks increased significantly postprandially (P < 0.05-0.01). Following total gastrectomy, the power peak around 3 cpm disappeared or was significantly diminished in amplitude (P < 0.05). The postoperative-to-preoperative power ratio ranged from 0.03 to 0.10 (P < 0.001-0.01). However, the power peak around 11 cpm did not significantly change prior to or following total gastrectomy, and the 11 cpm peak appeared relatively dominant. Simultaneous manometric studies in the Roux limb demonstrated a correlation between the power spectral frequency of EGG and manometry at 11 cpm. Therefore, the 11 cpm peak appeared to reflect jejunal or Roux limb electrical activity. The postoperative to preoperative power ratio for the 3 cpm also was significantly reduced following subtotal gastrectomy and gastric tube formation in patients in the postprandial state (P < 0.05-0.001).

Adult↗
PubMed1995

Laparoscopic-assisted colectomy and lymphadenectomy without peritoneal insufflation for sigmoid colon cancer patients.

PURPOSE: A new method for laparoscopic-assisted sigmoid colectomy and lymphadenectomy is presented. The purpose of this method is to avoid complications and restrictions associated with pneumoperitoneum. METHODS: Abdominal wall is lifted up with Kirschner wires, which are placed in the middle and left lower abdomen; then a minilaparotomy, which can be created because air-tightness is not necessary, is extended at the beginning of the operation to later remove the resected specimen. Two laparoscopic instruments are inserted through the right lower abdomen. Through the minilaparotomy, the surgeon can operate with conventional instruments. RESULTS: Operative time can be shortened, and surgical manipulations such as ligations and sutures are far easier than and cosmetic results are similar to those of laparoscopic surgery under pneumoperitoneum. CONCLUSION: We believe that this technique is a safe, time-saving, and cost-beneficial technique for sigmoid colectomy, and by changing the location of the minilaparotomy, this method can also be applied to other types of gastrointestinal surgery.

Abdominal Muscles↗
PubMed1995

Analysis of small cystic lesions of the pancreas.

UNLABELLED: There have been few reports on (1) the nature and pathogenesis of small cystic lesions of the pancreas, (2) their incidence, age distribution, and location, and (3) their significance as potential precursors of intraductal papillary tumors, mucinous cystic tumors, and duct cell carcinomas. MATERIALS: Epithelial growth of small cystic lesions in 300 consecutive autopsy cases and in seven cases of small duct cell carcinoma from among 2300 elderly autopsy cases, was evaluated by histopathological analysis. One hundred eighty-six cystic lesions were found in 73 of 300 autopsy cases (24.3%). The incidence of cystic lesions increased with age. Cystic lesions were equally distributed throughout the pancreas. Epithelial atypia was histologically classified into five groups: normal epithelium; papillary hyperplasia without atypia; atypical hyperplasia; carcinoma in situ; and invasive carcinoma. The incidence of each group was 47.5, 32.8, 16.4, 3.4, and 0%, respectively. Epithelia of atypical hyperplasia or carcinoma in situ were more prevalent in small cystic lesions (less than 4 mm in diameter) than in larger lesions (chi-square test, p < 0.05). Epithelia of dilated ductular branches adjacent to cystic lesions showed a similar degree of atypia as the epithelia of the cystic lesions themselves (p < 0.01). Epithelial atypia of the main pancreatic duct was mild in all of the cases but two, and was not related to that of the cystic lesion. Among the seven cases of small duct cell carcinoma, two cases had small cancerous cystic lesions, 4.1 and 5.3 mm in diameter, within the tumor. Small cystic lesions appear to have the potential to progress to malignancy but definitive evidence has not been demonstrated. Additional studies, including molecular biological examinations, are necessary to fully understand the biology of these lesions.

Aged↗
PubMed1995

Familial adenomatous polyposis: should patients undergo surveillance of the upper gastrointestinal tract?

Upper gastrointestinal (UGI) endoscopy was performed in 35 asymptomatic patients with familial adenomatous polyposis (FAP) to assess the prevalence of gastric and duodenal polyps and to demonstrate efficacy of endoscopic surveillance in patients with FAP. UGI polyps were found in 25 (71%) of 35 polyposis patients. Among these, gastric fundic gland polyps were involved in seven patients, and UGI adenomas in 18 patients; there were nine gastric adenomas and 14 duodenal adenomas, including six cases of duodenal cancer. UGI polyps were found in 13 of 15 patients with extracolonic manifestations (87%), but in only 12 of 20 patients (60%) without. The median follow-up interval was 8.7 years in growing duodenal adenomas, but 3.5 years in adenomas without changes in size and number. It was concluded that surveillance gastroduodenoscopy every 3-5 years might be enough to treat duodenal adenomas by endoscopic mucosal resection.

Adenomatous Polyposis Coli↗
PubMed1995

Multiple channels for occupational health services to small-scale enterprises in Japan.

This study was performed to clarify the characteristics of multiple channels for occupational health services (OHS) to small-scale enterprises (SSEs) in Japan employing less than 50 workers by reviewing relevant research papers. OHS were provided to SSEs by both government organizations and non-government organizations. Government organizations included the Japanese Industrial Safety & Health Association, regional occupational health centres, prefectural occupational health promotion centres, and other health centres. Non-government organizations were parent companies, occupational health organizations, hospitals, medical associations, trade associations and health insurance societies. The quality of OHS in terms of provision of health personnel and the nature of their services differed greatly between the organizations. Health care programmes were more popular than management of the work environment or working practices in OHS to SSEs. Few organizations provided comprehensive OHS to SSEs. At present, parent companies and occupational health organizations appear to provide the best OHS available to SSEs in Japan.

Commerce↗
PubMed1995

Large cholesterol polyps of the gallbladder: diagnosis by means of US and endoscopic US.

PURPOSE: To identify ultrasonographic (US) features of large cholesterol polyps (> 10 mm in diameter) of the gallbladder in the differential diagnosis of polypoid lesions. MATERIALS AND METHODS: Sixty-seven patients underwent US (n = 67) and endoscopic US (n = 33). Fourteen patients had large cholesterol polyps. Findings in these patients were compared with those in patients with small cholesterol polyps (< or = 10 mm in diameter; n = 34) or other polypoid lesions (n = 19). RESULTS: US demonstrated the large cholesterol polyps as pedunculated masses with granular surfaces. In 94% of patients, all small cholesterol polyps were echogenic whereas the large cholesterol polyps tended to have decreased echogenicity. Endoscopic US showed complete or partial aggregation of echogenic spots in all cholesterol polyps-but not in other polypoid lesions, which included carcinomas. CONCLUSION: Aggregation of echogenic spots seems to be a US feature characteristic of both large and small cholesterol polyps. Routine use of endoscopic US is recommended for differential diagnosis of polypoid lesions because of its high resolution.

Adenocarcinoma↗
PubMed1995

Effective prevention of thrombocytopenia in mice using adenovirus-mediated transfer of HST-1 (FGF-4) gene.

HST-1 (FGF-4) gene product is a member of the fibroblast growth factor family with a signal peptide and plays a crucial role in limb development. We showed previously that an intraperitoneal injection of replication-deficient adenovirus containing the HST-1 gene (Adex1HST-1) into normal mice caused a twofold increase in peripheral platelet count. To investigate whether Adex1HST-1 could effectively prevent experimentally induced thrombocytopenia in mice, we injected Adex1HST-1 intraperitoneally into thrombocytopenic mice induced by administration of a chemotherapeutic agent and/or by irradiation. A single Adex1HST-1 injection caused continuously increased levels of serum HST-1 protein for at least 30 d and increased the count of large megakaryocytes in bone marrow, which specifically recovered platelet counts and more efficiently diminished the extent and duration of thrombocytopenia than any other reported cytokine or any combination of cytokines so far. In the other peripheral hematological parameters, no discernible differences were detected. No other apparent side effects were observed. Therefore, this method could be useful for treatment and/or prevention of thrombocytopenia induced by chemotherapy and/or irradiation for cancer treatment.

Adenoviruses, Human↗
PubMed1995

Establishment of a new extrahepatic bile duct carcinoma cell line, TFK-1.

A new human extrahepatic bile duct carcinoma cell line (TFK-1) was established from a surgically resected tumor specimen, which was histologically diagnosed as partly papillary adenocarcinoma and partly differentiated tubular adenocarcinoma. The tumor cells cultured in RPMI-1640 medium supplemented with 10% FBS grew as monolayers showing epithelial-like morphology with a population doubling time of 37 hr during exponential growth at passage 40. Chromosome number was distributed in the range of 72 to 76, with a modal number of 73. Tumor markers (CEA, CA19-9, ST-439, DUPAN-2) were negative in culture supernatant and plasma of SCID mice grafted with TFK-1 cells. Though no point mutation at 12 codon of K-ras was detected, expression of c-erb B-2 product and MUC1 antigen was positive. TFK-1 is the third cell line established from extrahepatic bile duct carcinomas in the world literature, and should provide useful information on various aspects of this type of neoplasm.

Adenocarcinoma↗
PubMed1995

Diagnosis of acute pancreatitis: value of endoscopic sonography.

OBJECTIVE: The aim of this study is to assess the diagnostic usefulness of endoscopic sonography in acute pancreatitis. SUBJECTS AND METHODS: Twenty-three patients with clinically diagnosed acute pancreatitis (edematous pancreatitis in 16 and necrotizing pancreatitis with heterogeneous enhancement of the pancreas on contrast-enhanced CT scans in seven) prospectively underwent endoscopic sonography. We studied visualization of the pancreas and the extrahepatic bile duct, capability of differentiation between edematous and necrotizing pancreatitis, and detectability of common bile duct stones and compared the results of endoscopic sonography with those of conventional sonography, CT, and ERCP. In 25 normal subjects, we performed endoscopic sonography to determine the size of the pancreas. RESULTS: Endoscopic sonography could be performed at the bedside noninvasively and repeatedly. Normal pancreas size was defined from the results of normal subjects. Endoscopic sonography adequately showed the whole length of the pancreas and the extrahepatic bile duct in all cases. On endoscopic sonography, the pancreas was enlarged in 10 of 16 patients with edematous pancreatitis and in all seven patients with necrotizing pancreatitis. In edematous pancreatitis, the echogenicity of the pancreas was normal (four patients) or diffusely hypoechoic (12 patients). In all seven patients with necrotizing pancreatitis, endoscopic sonography showed a pancreatic focal hypoechoic mass with or without interspersed echogenic spots. Endoscopic sonography could differentiate edematous and necrotizing pancreatitis as well as CT could. Conventional sonography depicted the pancreas in only 61% of patients. Endoscopic sonography was highly sensitive in depicting inflammatory peripancreatic spread compared with CT. Endoscopic sonography was more sensitive (100%) than conventional sonography (43%) and CT (57%) for detecting bile duct stones in biliary pancreatitis. CONCLUSION: This study suggests that endoscopic sonography may be useful for the diagnosis of acute pancreatitis, particularly in cases of biliary pancreatitis.

Acute Disease↗
PubMed1995

[An experiment on drinking using breath alcohol monitor (Alcomed 3010) by an electrochemical method].

A drinking experiment was performed to evaluate the efficiency of a breath alcohol monitor, Alcomed 3010. The ethanol concentrations in blood and breath were determined by gas chromatography, and in particular the breath ethanol concentration was determined with the breath alcohol monitor and by gas chromatography. The results obtained by two methods were compared. Based on the blood and breath ethanol concentrations, the following conclusions were drawn reading the breath alcohol monitor. The monitor has practical merit for determination of the breath ethanol level. It is small, usable anywhere, with little error in determination. In measuring principle, tobacco and acetone did not affected levels with the meter, but methanol, n-propanol and n-butanol affected determinations with the alcohol monitor. The breath (AM)/blood (GC) ethanol ratio was 1:2555. Comparison of the values determined with the alcohol monitor and gas chromatography yielded the equation: y = 0.998 x +/- 0.012 (r = 0.994). When determinations were made on the pure ethanol gas by the meter and gas chromatograph, the equation was: y = 0.974 x +/- 0.021 (r = 0.994). It may be said therefore that the alcohol monitor is both practically and functionally excellent.

Adult↗