Biomedical subjects

T Muto

Publications and source records attributed to T Muto.

At least 397 records · Page 22Linked to original sources

PubMed1993

Percutaneous transhepatic cholecystostomy for acute acalculous cholecystitis.

The effectiveness and long-term results of percutaneous cholecystostomy for acute acalculous cholecystitis are evaluated. Fifteen patients with acute acalculous cholecystitis were treated prospectively by this procedure, using a pigtail catheter successfully placed under ultrasonographic and fluoroscopic guidance. Prompt relief of the signs and symptoms of cholecystitis was achieved in 14 patients. One required emergency cholecystectomy for uncontrolled bleeding after drainage. Another patient underwent prophylactic cholecystectomy before further chemotherapy for leukaemia. The remaining 13 patients required no further surgery. Morbidity and mortality rates were 13 per cent and nil respectively. Long-term follow-up showed no recurrence of cholecystitis after removal of the catheter. Percutaneous cholecystostomy is a safe, effective and usually definitive procedure for the treatment of acute acalculous cholecystitis.

Acute Disease↗

PubMed1993

A giant tumor of the mesocolon found to be metastasis from an alpha-fetoprotein-producing gastric carcinoma: report of a case.

We present herein an extremely rare case of metastasis from a gastric carcinoma to the mesocolon. A 71-year-old woman underwent a laparotomy for gastric cancer with an intra-abdominal mass. Her serum alpha-fetoprotein level was very high at 3,560 ng/ml. The abdominal mass was subsequently revealed to be a metastatic tumor of the transverse mesocolon derived from an alpha-fetoprotein-producing gastric carcinoma, but no other metastatic focus was found. An immunohistochemical study revealed alpha-fetoprotein-positive cells in both lesions. The serum alpha-fetoprotein level became normal after the operation which was followed by a course of chemotherapy, and no recurrence has been observed thus far in 6 months of follow up.

Adenocarcinoma↗

PubMed1993

A pharmacological analysis of prostaglandin E1 on portal blood flow after partial hepatectomy in rats.

Portal venous flow (PVF) and portal venous pressure (PVP) were examined after the jugular or portal injection of Prostaglandin E1 (PGE) in rats partially hepatectomized by either 40% or 66%. In the 66% hepatectomized animals, the jugular injection of PGE at 5.0 micrograms/kg/min produced an increase in PVF concomitant with a fall in systemic arterial pressure (SAP), while PVP remained unchanged. The portal injection of PGE at 0.5 micrograms/kg/min increased PVF to a level equivalent to that evoked by the jugular injection of 5.0 micrograms/kg/min PGE, without any change in SAP. PVP was reduced synchronistically with an increase in PVF. The PVF response to a portal injection of PGE at 0.5 micrograms/kg/min was not reproduced in liver intact rats. These results suggest that PGE is potent in increasing PVF in the partially resected condition of the liver and that the portal vascular bed is involved in this response.

Alprostadil↗

PubMed1993

A case of bilateral obturator hernias: image diagnosis and description of a retropubic operative approach.

A case of bilateral obturator hernias which was diagnosed by ultrasonography (US) and computed tomography (CT), and repaired by a retropubic extraperitoneal operative approach under spinal anesthesia is reported herein. A 91-year-old woman presented with lower abdominal and left groin pain consistent with a Howship-Romberg sign. US demonstrated an image of the bowel projecting from the small pelvic space to the left thigh with a to-and-fro movement of the bowel contents. The definitive diagnosis of an incarcerated left obturator hernia was made by CT which also revealed a mass in the right obturator foramen. Surgery was performed through a retropubic extraperitoneal approach under spinal anesthesia. No necrosis was observed in the incarcerated bowel and resection was not necessary. A simple hernial sac was found in the right obturator canal. The operation using the retropubic extraperitoneal approach was successful and we believe it to be the most effective procedure for obturator hernias which have been diagnosed early.

Aged↗

PubMed1993

Primary small cell carcinoma of the esophagus with ectopic gastrin production. Report of a case and review of the literature.

A case of primary small cell carcinoma of the esophagus in which extensive hormonal studies could be performed is reported. The tumor was considered as a neuroendocrine tumor because the tumor cells showed intracytoplasmic argyrophilia, neurosecretory granules, and positive stain for neuron-specific enolase with Grimelius stain, electron microscopy, and immunohistochemistry, respectively. Furthermore, the tumor was regarded as a gastrin-producing tumor because of positive stain for gastrin in the tumor cells. The present case is the first case of primary small cell carcinoma of the esophagus with ectopic gastric production.

Carcinoma, Small Cell↗

PubMed1993

Malignant potential in flat elevations.

Ninety-nine colonoscopically removed flat elevations were examined. They were divided into two groups: Group 1--flat elevations 1 to 5 mm in diameter (55 cases)--and Group 2--flat elevations 6 to 10 mm in diameter (44 cases). Group 2 had a higher percentage of adenomas (86.4 percent) than Group 1 (67.3 percent). In adenoma cases (flat adenomas), Group 2 tended to show a higher degree of dysplasia. The rates of mild and moderate dysplasia were 83.8 percent and 16.2 percent in Group 1 vs. 1.70 percent and 13.2 percent in Group 2, respectively. Group 2 contained six cases (15.8 percent) of intramucosal carcinoma (severe dysplasia), while there were no cancer cases in Group 1. Both malignancy rate and degree of dysplasia were size dependent; the larger the lesion the more severe the dysplasia. Our study also revealed that small flat elevations tend to contain higher numbers of nonneoplastic lesions than do larger lesions. Increased detection of nonneoplastic lesions seems to have contributed to an overall decline in the malignancy rate of flat elevations in recent reports.

Adenoma↗

PubMed1993

A case report of celiac axis compression and implications in regional chemotherapy for liver metastasis.

Regional chemotherapy through a catheter placed in the hepatic artery is routinely used for treatment of unresectable liver metastasis from colon carcinoma. With some frequency, anatomical variations of the hepatic artery, including compression of the celiac axis, are found, and must be recognized preoperatively for appropriate management and placement of the catheter. We report a case of a colon cancer patient with multiple liver metastases and compression of the celiac axis, who received decompression of the celiac axis and catheterization of the hepatic artery.

Adenocarcinoma↗

PubMed1993

Enhanced liver regeneration in rats treated with 15-deoxyspergualin alone and in combination with FK 506.

The effects of 15-deoxyspergualin (DSG) alone and in combination with FK 506 (FK) on liver regeneration after 2/3 hepatectomy was studied. The administration of 5 mg/kg DSG increased the liver weight as a percentage of the body weight (RLW) in the 5 days following the hepatectomy. This enhanced regeneration was not affected if interleukin(IL)-2 was also given. The combination of 1 mg/kg DSG and 0.05 mg/kg FK induced the highest values for RLW. The amounts of food and water intake increased in the DSG and FK combined group. Blood chemistry indicated that the combined administration of DSG and FK could reduce side-effects more effectively than separate administration. These observation led us to conclude that DSG has a stimulating potency in liver regeneration by means of direct suppression of T cell activation, and there is a synergistic effect on regeneration by DSG and FK.

Animals↗

PubMed1993

Ileal obstruction due to metastatic liposarcoma: a case report.

Liposarcoma in the mesentery or small intestine is rare. Intestinal obstruction due to liposarcoma is particularly rare. We report here the case of a 33-year-old man with intestinal obstruction due to metastasis of a liposarcoma to the ileum. Although he died due to multiple metastases, it should be emphasized that he recovered from intestinal obstruction by resecting the tumor in the ileum. The pertinent literature is also briefly reviewed.

Adult↗

PubMed1993

Treatment of choledocholithiasis in patients with liver cirrhosis. Surgical treatment or endoscopic sphincterotomy?

OBJECTIVE: The clinical features of choledocholithiasis were analyzed in cirrhotic patients. The outcomes of surgical treatment and endoscopic sphincterotomy (EST) in this situation were compared and the risk factors predictive of an increased mortality rate were identified. SUMMARY BACKGROUND DATA: In cirrhotic patients, high risk for gallbladder stones in cholecystectomy has been established. Common bile duct stones can often exacerbate liver dysfunction and might be more difficult to treat. METHODS: Among 16 cirrhotic patients with choledocholithiasis, 9 underwent choledocholithotomy and T-tube placement (surgery group) and 7 underwent EST (EST group). Pretreatment clinical data were comparable between groups. RESULTS: Among 16 patients, 15 had biliary tract symptoms and 7 had cholangitis. The surgery group had excessive intraoperative hemorrhage (1576 mL) and a high morbidity rate (66.7%). The mortality rate was 44.4%: 0% in Child A or B classification patients and 80% in Child C patients. The common causes of death were liver failure, postoperative hemorrhage, and sepsis. The EST group had no complications related to procedures, but there was one death (14.3%) due to preexisting liver failure. Hepatic dysfunction, coagulopathy, and cholangitis were factors predictive of an increased mortality rate. CONCLUSIONS: Choledocholithiasis in cirrhotic patients should be treated by EST after liver function and general condition are improved by medical management, except in emergency cases.

Adult↗

PubMed1993

Effect of experimental hypochlorhydria on the histological differentiation of adenocarcinomas in the canine stomach.

Hypochlorhydria is considered to be a risk factor for gastric cancer, both clinically and experimentally. In humans, the hypo-acidic condition appears to be closely associated with the development of differentiated-type gastric carcinomas. We investigated relationships between antral pH and histological types of gastric cancer using an animal model. A total of 7.65 g of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) was orally administered to male beagle dogs. Subsequently, the dogs were divided into four groups and underwent four surgical interventions designed to create various conditions in the antrum. Antral pH was recorded at the time of killing after an observation period ranging from 16 to 33 months. The number of gastrin-secreting cells (G-cells) was counted after immunohistochemical staining. Carcinomas were found in the antrum of 12 of the 21 dogs that had survived. Although limited doses of ENNG, such as those used in this study, have been reported to produce only undifferentiated adenocarcinomas, differentiated adenocarcinomas were found in seven of these 12 dogs. Antral pH and the number of G-cells were significantly higher in these seven dogs than in the other five dogs, which had developed only undifferentiated adenocarcinomas. Bile inflow showed no significant effect on the development of differentiated adenocarcinomas. Neither atrophic gastritis nor intestinal metaplasia was seen in any of the dogs. These results suggest that the hypo-acidic condition itself may play a role in the development of differentiated adenocarcinomas.

Achlorhydria↗

PubMed1993

Morphometric analysis of colonic adenomatous polyps.

Morphometric evaluation of adenomas of the colon to determine their degree of dysplasia is still controversial, since subjective factors influence the decision concerning benignancy or malignancy. Some indices have been proposed to assist in categorizing intermediate lesions into benign or malignant. However, these indices show a wide range of distribution. To evaluate the reliability of one such index, the index of structural atypism (ISA, area of glands/area of stroma), we studied polyps as a whole, and found great variability of index values within a single polyp.

Colonic Polyps↗

PubMed1993

[Effect of the passage and storage of strains, and inoculum size on the change of zone pattern types and sizes produced by protease of methicillin resistant Staphylococcus aureus].

Protease produced by Staphylococcus aureus precipitates digests of casein in standard methods caseinate agar (SMCA) plate, and the various sizes of A to E precipitation types were produced depending on strains of inoculated Staphylococcus aureus, as previously reported. To evaluate these phenomena for epidemiological use, we investigated the effects of bacterial passage, storage and dosage on zonal pattern and the size of precipitation rings. Methicillin resistant Staphylococcus aureus (MRSA) was found to produce variable types and sizes of precipitation rings depending upon the inoculated strains. After 5, 30 and 50 passages in heart infusion broth (HIB), each of the strains randomly selected from MRSA strains showed that the precipitation pattern of A to E produced the same types and sizes of precipitation rings. The storage effects were assessed by comparing those strains in different storage time. The strain stored for 1 and 3 years at room temperature in HIB contained 0.8% agar produced the same pattern of precipitation rings at that of the freshly isolated one. Finally, the dosage of inoculated bacteria was examined. Overnight broth (HIB) cultures of MRSA were directly inoculated in SMCA plates, and were found to produce almost the same size of precipitation rings (reproducible within 3 mm). These findings indicated that protease digestion on SMCA plate provides a rapid, sensitive, and specific assay that can supplement the currently available modalities for typing of MRSA strains.

Agar↗

PubMed1993

Carcinoma of the gallbladder: CT evaluation of lymphatic spread.

PURPOSE: To clarify the computed tomographic (CT) characteristics of positive nodes and to assess the ability of CT to demonstrate lymphatic spread. MATERIALS AND METHODS: CT findings of lymph nodes in 51 patients with histologically proved gallbladder carcinoma were correlated with pathologic findings retrospectively. RESULTS: Thirty-one of 51 patients (61%) had a total of 157 positive nodes, 60 (38%) of which were depicted at CT. A positive node was defined at CT as a soft-tissue mass with an anteroposterior dimension of at least 10 mm that showed ringlike or heterogeneous enhancement. These criteria had a positive predictive value of 75% for cystic nodes, 90% for pericholedochal nodes, 100% for posterosuperior pancreatoduodenal nodes, 100% for retroportal nodes, 88% for right celiac nodes, 100% for hepatic nodes, 100% for superior mesenteric nodes, and 83% for interaortocaval nodes. CONCLUSION: CT does not reliably demonstrate all regional nodes of gallbladder carcinoma, but the criteria of size and pattern of enhancement reliably indicate lymphatic spread, which has an important bearing on disease staging and treatment planning.

Carcinoma↗

PubMed1993

Hepatic branch vagotomy can suppress liver regeneration in partially hepatectomized rats.

The role of the vagus nerve in liver regeneration after partial hepatectomy was studied by comparing the effects of hepatic branch vagotomy with those of hepatic branch sympathectomy in rats. The liver weight as a percentage of body weight decreased significantly 7 days after vagotomy compared with the controls and this was associated with a reduction in food intake. There was no difference in the liver weights between the control rats and the pair-fed vagotomized rats. Hepatic sympathectomy had no significant effect on the liver weight. The serum scores indicating hepatic function showed no difference between the control and the vagotomized rats except alkaline phosphatase. The concentration of insulin was unchanged. The number of mitotic hepatocytes remained high at 7 days after vagotomy. These observations led us to conclude that the vagus nerve stimulates liver regeneration, and its effect depends on vagal factors directly and specifically.

Alanine Transaminase↗

PubMed1993

High sensitivity to salt in kininogen-deficient brown Norway Katholiek rats.

Brown Norway Katholiek rats, which have very low levels of plasma kininogens, excreted a much smaller amount of kinin in the urine than normal rats of the same strain. The systolic blood pressure of 7-week-old kininogen-deficient rats fed low (0.3%) NaCl diets (131 +/- 4 mm Hg, n = 12) was not different from that in normal rats. Two percent NaCl diets given from 7 weeks of age for 4 weeks caused rapid increases in blood pressure (167 +/- 4 mm Hg, n = 12, 9 weeks old) in deficient rats, although the same diets induced no blood pressure increase in normal rats. Urinary excretion of active kallikrein and prokallikrein remained constant in both rat groups throughout NaCl loading. During this period, the deficient rats secreted less urine (9 weeks old, P < .05) and less urinary sodium (11 weeks old, P < .05). Serum levels of sodium in deficient rats were higher (P < .05) than in normal rats at 9 weeks of age. Intracellular concentrations of sodium in the erythrocytes of deficient rats were higher (P < .05) than in normal rats throughout NaCl loading. Subcutaneous infusion of bovine low molecular weight kininogen with an osmotic pump in NaCl-loaded deficient rats induced a reduction (P < .01) in blood pressure and increases (P < .05) in urine volume and urinary sodium and kinin levels. By contrast, subcutaneous infusion of the bradykinin antagonist Hoe 140 or of aprotinin in NaCl-loaded normal rats induced a hypertensive response. This antagonist treatment reduced urine volume and urinary sodium. These results indicate that the lack of kinin generation observed in the kininogen-deficient rats was related through sodium retention to the hypertensive response to NaCl loading.

Aging↗

PubMed1993

Inferior mesenteric and hypogastric artery reconstruction to prevent colonic ischaemia following abdominal aortic aneurysmectomy.

In 179 patients receiving prosthetic grafts for abdominal aortic aneurysmectomy, an attempt was made to preserve or restore continuity of at least two vessels, including the patent inferior mesenteric artery (IMA) and bilateral hypogastric arteries (HGAs), so as to prevent colorectal ischaemia. Adjunctive reconstruction of the IMA and/or HGAs was performed in 60 patients; a total of 40 HGAs and 31 IMAs were reconstructed. The hospital mortality rates of patients with elective and ruptured aneurysm repair were 3.9 and 22% respectively. There were no deaths related to colorectal ischaemia. The mean(s.d.) IMA stump blood pressure was 66(18) mmHg and the mean(s.d.) IMA stump pressure index (the ratio of mean peak systolic IMA pressure to mean systolic systemic pressure) was 0.58(0.15). The IMA was revascularized in all patients whose stump pressure was < 40 mmHg and whose index was < 0.4. Postoperative angiography revealed a 94% patency rate for the IMA and 92% for the HGAs. Colorectal ischaemia did not develop in any patient in whom aneurysmectomy was performed electively or in any who had colonoscopy because of watery diarrhoea after surgery. These results indicate the significance of adjunctive reconstruction of the IMA and HGA during abdominal aortic aneurysmectomy.

Adult↗

PubMed1993

[Growth type of colorectal cancer invasion of the proper muscle in relation to DNA ploidy and distribution of PCNA].

In order to elucidate the biological characteristics of colorectal cancer invading the proper muscle, we analyzed DNA ploidy and PCNA labeling index. The growth patterns were divided into three types; those accompanied by intramucosal polypoid growth (PG+), those with non-polypoid growth (PG-), and those ranging between PG+ and PG- (PG+/-). The relationship of DNA ploidy to lymphatic vessel permeation and recurrence was also discussed. The results were as follows: 1) Growth types bore no relation to DNA ploidy and distribution of PCNA. 2) In aneuploidy cancer, it showed a high incidence of lymphatic vessel permeation. A trend of lymphatic metastasis was also observed. Aneuploidy cancer showed a poor prognosis compared with diploidy cancer.

Adult↗