[Treatment of a case of paraganglioma arising in the retroperitoneum].
Explore the source record for details and available documents.
Humans↗
Biomedical subjects
T Muto
Publications and source records attributed to T Muto.
Carcinoma of the ampulla of Vater: histopathologic analysis of tumor spread in Whipple pancreatoduodenectomy specimens.
Controversies exist regarding the application of the pylorus-preserving pancreatoduodenectomy (PPPD) to malignancies. This study was intended to disclose the pattern of spread of ampullary cancer and to substantiate that tumor spread at resectable stages does not involve the tissues preserved by PPPD. We examined 40 consecutive Whipple pancreatoduodenectomy specimens: mucosal cancer, 4 cases; cancer invading (but not penetrating) the sphincter of Oddi, 1; cancer invading the submucosa of the duodenum, 12; cancer invading the proper muscle of the duodenum, 5; cancer invading the subserosal layer of the duodenum, 7; and cancer invading pancreatic parenchyma, 11. Five cases of mucosal cancer or cancer invading (but not penetrating) the sphincter spread locally without nodal involvement and showed a 5-year survival of 80% without recurrence, being better (p < 0.05) than the 40% survival for patients with more advanced cancers. Sixty-three percent of the remaining 35 cases had metastasis to regional lymph nodes. The 5-year survival of 28% among those with cancer penetrating the proper muscle was worse (p < 0.05) than the 59% survival for those with less advanced cancers. No cases had involved the anatomic structures that would have been preserved by a PPPD. In three cases (7.5%), gastric cancer coexisted. In conclusion, ampullary cancer not penetrating the sphincter spreads locally. Once penetrating the sphincter, it often spreads regionally and causes recurrence. Cancer penetrating the proper muscle of the duodenum bears a worse prognosis. PPPD is an attractive alternative to the Whipple operation for ampullary cancer because no involvement was found in the tissue preserved by the PPPD. However, surgeons should be aware of a concomitant gastric cancer when doing a PPPD.
Adult↗
Treatment of carcinoma in adenomas.
Invasive carcinomas in polyps removed during endoscopy are described. Most of them can be treated adequately by polypectomy alone, but some need additional surgical treatment. Incomplete excision, poorly-differentiated carcinoma, and lymphatic invasion are associated with increased risk of residual carcinoma and lymph node metastases, making colorectal resection more attractive; however, in elderly patients and poor-risk patients, the risks of surgery should be balanced against the possible advantage of curative surgery. Rectal polyps may be large but sphincter preservation can usually be achieved by different types of local excision. Recently described flat adenomas may contain carcinoma, but may also be treated by polypectomy using snare or hot biopsy.
Adenocarcinoma↗
Tumor spread in superficial esophageal cancer: histopathologic basis for rational surgical treatment.
To formulate a rational approach for the surgical treatment of patients with superficial esophageal cancer (SEC), tumor spread was clinicopathologically studied in 89 patients with SEC. There were 31 mucosal and 58 submucosal tumors. Lymph node metastases were not found in any of those with a mucosal tumor, while one or more lymph nodes were positive for cancer in 41.4% of those with a submucosal tumor. Furthermore, cancer metastasized to extramediastinal nodes, including cervical and abdominal nodes, in 14 patients, accounting for 58.3% of those with nodal metastasis. The 5-year survival rate was 100% and there were no recurrences after esophagectomy in those with a mucosal tumor, whereas the survival rate of those with a submucosal tumor was 64.3% at 5 years (p < 0.01). Based on the different biological behavior of mucosal and submucosal esophageal cancer, we conclude that mucosal tumors may be adequately treated by any type of local resection but submucosal tumors require a subtotal esophagectomy with systematic lymphadenectomy involving the cervical, mediastinal, and abdominal nodes for cure.
Adult↗
Gardner's syndrome associated with periampullary carcinoma, duodenal and gastric adenomatosis. Report of a case.
A 48-year-old man with Gardner's syndrome, who had abdominoperineal resection for rectal carcinoma in 1962, was found to have an ulcerating growth of the duodenum, and pancreaticoduodenectomy was performed in 1979. Histologic examination by complete step-serial sectioning disclosed a well-differentiated adenocarcinoma with adenomatous remnants, a large adenoma with focal carcinoma, 256 adenomas of the duodenum, and 91 adenomas of the gastric antrum. The world medical literature was reviewed, and 29 cases of periampullary carcinoma and 12 cases of gastric carcinoma complicating familial polyposis coli or Gardner's syndrome were analyzed.
Adenocarcinoma↗
Comparative histologic study of adenomas of the large intestine in Japan and England, with special reference to malignant potential.
The malignant potential of large-intestinal adenomas varies with size, histologic type, and grade of epithelial atypia in the same way in England and in Japan. Adenomas in England have greater malignant potential than those in Japan because they grow larger and more often show a villous growth pattern. Although the adenoma--carcinoma sequence operates in the same way in the two countries it is suggested that the higher incidence of colorectal cancer in England is due to the greater prevalence as well as the greater size of English adenomas. More studies of the epidemiology and geographic pathology of large-intestinal adenomas are needed to clarify their importance as a predisposing cause of colorectal cancer in low-risk as well as high-risk areas.
Adenoma↗
Spread of gallbladder carcinoma: CT evaluation with pathologic correlation.
BACKGROUND: To assess the accuracy of computed tomographic (CT) imaging in the detection of spread and staging of gallbladder carcinoma. METHODS: CT findings of spread of gallbladder carcinoma in 59 Japanese patients who underwent radical surgery were correlated retrospectively with pathologic findings. RESULTS: The incidence of histologically proven nodal involvement was 54% (32 patients) and the most common spread of gallbladder carcinoma. The sensitivities in CT detection of N1 and N2 nodal involvement were 36% and 47%, respectively; positive predictive values were 94% and 92%, respectively. Direct extension to the liver, extrahepatic bile duct, and gastrointestinal tract or pancreas were histologically confirmed in 24, 18, and five patients. The sensitivities in the CT detection of direct spread to the liver of less than 2 cm, more than 2 cm, the extrahepatic bile duct, and the gastrointestinal tract or pancreas were 65%, 100%, 50%, and 57%, respectively; positive predictive values were 77%, 100%, 90%, and 100%, respectively. The incidence of liver metastases and involvement of interaortocaval nodes were 7% and 16%, respectively. The sensitivities in CT detection of liver metastases and involvement of interaortocaval nodes were 75% and 21%, respectively; positive predictive values were 100% and 86%, respectively. CT could not detect direct spread to omentum and peritoneal seedings. CONCLUSION: For detecting the spread of gallbladder carcinoma, CT imaging has low to moderate sensitivity; however, CT imaging can help in determining resectability and in planning the treatment, especially in advanced-stage gallbladder carcinoma, because of a high positive predictive value.
Adult↗
p21Waf1/Cip1 expression is a prognostic marker in curatively resected esophageal squamous cell carcinoma, but not p27Kip1, p53, or Rb.
BACKGROUND: p21Waf1/Cip1 (p21), p27Kip1 (p27), p53, and Rb play critical roles in cell cycle regulation and may influence the clinical behavior of tumors. We examined whether their expression is useful to predict survival of patients with esophageal squamous cell carcinoma (ESC). METHODS: Expression of p21, p27, p53, and Rb was studied by the immunohistochemical method in specimens from 62 patients with curatively resected ESC tumors and scored by a computerized image analysis system. RESULTS: The median expression scores of p21, p27, p53, and Rb (14, 12, 27, and 50, respectively) were used as cut-off points to define low and high expression groups for each protein. The 5-year survival rate for the high p21 expression group was 68%; that for the low expression group was 31% (P = .0062). p27, p53, and Rb were not correlated with overall survival. When patients were categorized into four groups based on p21 expression level and lymph node involvement (pN), the survival curves were significantly different (P = .0017). Thus, patients without lymph node involvement but with low p21 expression had survival similar to that of patients with lymph node involvement and high p21 expression. Multivariate analysis showed that age (P = .0102), lymph node involvement (P = .0076), and p21 (P = .0276) were independent prognostic factors. CONCLUSIONS: Expression of p21 is an independent prognostic factor in curatively resected ESC. Definition of new subgroups of patients based on p21 expression may help to enhance the stratification of stage.
Adult↗
Functional down-regulation of beta1 and beta2 integrins of lamina propria lymphocytes (LPL) and tumor-infiltrating lymphocytes (TIL) in colorectal cancer patients.
Integrins play an important role in various lymphocyte functions. In this study, we isolated lamina propria lymphocytes (LPL) and tumor-infiltrating lymphocytes (TIL) from normal and malignant tissues in patients with colorectal cancer, and examined the expression of beta1 and beta2 integrins on these lymphocytes quantitatively with two-color flow cytometry. Both LPL and TIL expressed a lower level of common beta1 chain (CD29) in CD4 and CD8 subpopulations than did peripheral blood lymphocytes (PBL). Among the associated alpha chains, the expression levels of alpha1 (CD49a) and alpha2 (CD49b) were slightly higher, whereas those of alpha4 (CD49d) and alpha6 (CD49f) were markedly reduced in LPL and TIL. No significant differences were observed in expressions of any alpha1 integrin chains between these two lymphocytes populations. Similarly, both alphaL (CD11a) and beta2 (CD18) were down-regulated in TIL and LPL with CD8+ cytotoxic phenotype, but not in those with CD4+ phenotype. CD8+ TIL expressed a slightly but significantly higher level of alphaLbeta2 than did CD8+ LPL. CD8+ LPL and CD8+ TIL consistently showed significantly decreased binding to purified ICAM-1, VCAM-1 and HT29 colon cancer cells as compared with CD8+ PBL. Although CD8+ TIL showed a slightly higher level of adhesion to these substrates than did CD8+ LPL, the level was much lower than that in PBL. The expression pattern and functional down-regulation of these integrins may be one of the reasons why TIL cannot eradicate the cancer cells in colorectal cancer.
Adenocarcinoma↗
Effects of fibroblast growth factors and platelet-derived growth factor on food intake in rats.
In the present study, the relations between acidic and basic fibroblast growth factors (aFGF and bFGF, respectively), platelet-derived growth factor (PDGF), and food intake were studied. When aFGF-, bFGF-, and PDGF-like activity in cerebrospinal fluid (CSF) was examined by bioassay, the activity of those factors significantly increased in postfeeding CSF, compared to prefeeding CSF. Injections of aFGF, bFGF, aFGF (synthetic amino-terminal peptide of aFGF), and PDGF into the third cerebral ventricle decreased food intake, and injections of anti-aFGF, anti-bFGF, and anti-aFGF antibodies into the lateral hypothalamus (LHA) increased food intake. The activity of LHA glucose-sensitive neurons was inhibited by electrophoretic application of aFGF. These results suggest that aFGF, bFGF and PDGF have in vivo physiological roles in the central nervous system, distinct from those as mitogens.
Animals↗
In vitro function of porcine hepatocyte spheroids in 100% human plasma.
To assess their functional stability, porcine hepatocyte spheroids, which have great potential in bioartificial liver systems and/or xenogeneic liver transplantation, were cultured in vitro in 100% human plasma, and their ammonium detoxification capacity was measured. In a short-term functional study, collagen-gel entrapped and rotationally cultured porcine hepatocyte spheroids showed almost the same functional expression, which was approximately twice that of monolayers. No significant functional deterioration was observed up to day 10 as compared with those in a synthesized medium without collagen gel entrapment. In a longer term study (4 wk) using rotational culture, morphological and functional deterioration presumably due to immunorejection involving complement proteins and natural antibodies progressed gradually with culture time. On the termination of the culture, the detoxification ability for the residual cells was approximately two-thirds that on day 2.
Animals↗
Transient intraocular pressure elevation after trabeculotomy and its occurrence with phacoemulsification and intraocular lens implantation.
PURPOSE: To elucidate the characterization of intraocular pressure (IOP) spike after trabeculotomy, and after the combined procedure of phacoemulsification and aspiration (PEA) and intraocular lens (IOL) implantation. METHODS: Included in this study were 39 patients (53 eyes) with primary open-angle glaucoma with IOPs uncontrolled even with anti-glaucoma medication. We conducted a retrospective study for the following two groups: Patients who underwent trabeculotomy alone (25 eyes) and patients undergoing trabeculotomy combined with PEA and implantation of an IOL (28 eyes). RESULTS: In 7 (28%) of the 25 eyes after trabeculotomy alone and 7 (25%) of the 28 eyes after the combined procedure, transient IOP elevation was found postoperatively. The incidence of hyphema-related IOP spike was significantly higher in eyes after trabeculotomy alone (16%) than after the combined procedure (0%). After removal of the blood present in the anterior chamber in eyes with hyphema-related IOP spikes, the IOP levels were well controlled. CONCLUSIONS: Hyphema-related IOP spike is one of the common complications in eyes after trabeculotomy alone, and the combined procedure decreases the incidence of this complication. It is thought that removal of prolonged massive hyphema is effective as treatment for hyphema-related IOP spike.
Adult↗
Epidermoid cyst in the temporomandibular joint after a dermal graft.
A very rare case of epidermoid cyst of the left temporomandibular join (TMJ) after a dermal graft inserted as the interposing material in the surgical correction of TMJ ankylosis is presented. Two years after the surgery, a cystic lesion the size of a walnut was observed in the TMJ region. The cyst contained an odorless, straw-coloured mucoid fluid and a wall lined by stratified squamous epithelium containing orthokeratin. It contained no hair follicles or sweat glands.
Ankylosis↗
Different effects of long-chain and medium-chain triglycerides on glucose oxidation during total parenteral nutrition.
This study was undertaken to clarify differences in the effects of lipid emulsions containing either long-chain or medium-chain triglycerides (MCT) on glucose metabolism during total parenteral nutrition (TPN). Glucose kinetics were assessed in beagle dogs using primed, constant infusions of [14C]- and [6-3H]glucose. The rate of appearance of glucose, the percent of VCO2 derived from the oxidation of glucose, the rate of glucose oxidation, and the percent of glucose uptake oxidized were measured at the end of 72 hours of each of the two TPN regimens, ie, TPN in which soybean oil served as long-chain triglyceride comprising 40% of nonprotein calories (L-TPN), and TPN in which tricaprylin emulsion served as MCT (M-TPN). Glucose intake was 5.9 +/- 0.5 mg/kg per minute in L-TPN and 5.8 +/- 0.2 mg/kg per minute in M-TPN. There was no significant difference in the rate of glucose appearance between L-TPN and M-TPN. The rate of glucose oxidation was higher with M-TPN than with L-TPN (p < .05). Not only the percent of VCO2 derived from the oxidation of glucose but also the percent of glucose uptake oxidized tended to be higher during M-TPN than during L-TPN. These findings suggest that the glucose metabolism of dogs receiving L-TPN is different from that of dogs receiving M-TPN.
Animals↗
Effects of growth hormone and insulin-like growth factor 1 (IGF-1) treatments on the nitrogen metabolism and hepatic IGF-1-messenger RNA expression in postoperative parenterally fed rats.
BACKGROUND: Few studies have made direct comparisons of the metabolic effects of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). We have assessed the dose-dependent effects of GH and IGF-1 treatments on nitrogen metabolism, intestinal structure, and hepatic IGF-1-messenger RNA (mRNA) expression in postoperative parenterally fed rats. METHODS: Rats were maintained on total parenteral nutrition (TPN) for 3 days after gastrectomy. GH (0.4 or 0.8 IU/kg/d) or IGF-1 (1,2, or 4 mg/kg/d) was infused throughout the experimental period. Anabolic effects of GH and IGF-1 were assessed by body weight change, nitrogen excretion, and whole-body protein turnover. Organ weights, intestinal structure, plasma IGF-1 levels and hepatic IGF-1-mRNA contents were also determined. RESULTS: Both GH and IGF-1 attenuated body weight loss and nitrogen excretion and increased whole-body protein synthesis and spleen weight. These observations suggest that the anabolic effects of 1 mg/kg/d of IGF-1 were equivalent to those of 0.66 IU/kg/d of GH. IGF-1, but not GH, reduced atrophy of the intestinal mucosa. GH treatment increased hepatic IGF-1-mRNA and the plasma IGF-1 level, whereas IGF-1 treatment increased the plasma IGF-1 level with no change in the hepatic IGF-1-mRNA content. CONCLUSIONS: Administration of GH or IGF-1 attenuates catabolism after surgery. The anabolic effects of 1 mg/kg/d of IGF-1 are equivalent to those of 0.66 IU/kg/d of GH. IGF-1 reduces intestinal mucosal atrophy. GH increases hepatic IGF-1-mRNA and the plasma IGF-1 level.
Animals↗
Alanyl-glutamine-supplemented total parenteral nutrition improves survival and protein metabolism in rat protracted bacterial peritonitis model.
BACKGROUND: The effects of glutamine-enriched total parenteral nutrition (TPN) solution on survival, and protein turnover in the whole body and in individual organs were investigated in a rat protracted peritonitis model. METHODS: Twenty-three rats underwent venous catheter insertion. Osmotic pumps were implanted in the peritoneal cavity to allow continuous delivery of Escherichia coli (4 x 10(8) CFU/d). The conventional TPN group received a conventional amino acid solution. The Ala-Gln TPN group received an alanyl-glutamine-enriched TPN solution. The two TPN solutions were isocaloric and isonitrogenous. RESULTS: Over the 5 days of TPN treatment, the survival rate of the Ala-Gln group was significantly higher than that of the conventional group. The Ala-Gln group tended to have increased whole-body protein turnover compared with the conventional group. Fractional protein synthetic rates (FSR) in the liver and gastrocnemius muscle of the Ala-Gln group were significantly higher than those of the conventional group. The serum glutamine concentration correlated positively with the FSR of both liver and muscle. The Ala-Gln group showed significantly greater mucosal height and mitoses per crypt, in the small intestine, than did the conventional group. CONCLUSIONS: Our results suggested that, in comparison with standard glutamine-free TPN, Ala-Gln-supplemented TPN increases protein synthesis in the liver and skeletal muscle, protects the morphology of the intestinal mucosa, and improves survival in protracted bacterial peritonitis. Ala-Gln supplementation may be useful in septic patients.
Alanine↗
Insulin-like growth factor 1 has beneficial effects, whereas growth hormone has limited effects on postoperative protein metabolism, gut integrity, and splenic weight in rats with chronic mild liver injury.
BACKGROUND: Both growth hormone (GH) and insulin-like growth factor 1 (IGF-1) improve protein metabolism after surgical insult in subjects without liver disease. However, these effects in chronic liver injury, in which the GH-IGF-1 axis is impaired, have not been investigated. We examined the anabolic effects of GH and IGF-1 after gastrectomy in rats with chronic mild liver injury. METHODS: Rats with chronic mild liver injury induced by thioacetamide were used. After gastrectomy, the rats were randomized into vehicle control, GH, and IGF-1 groups. In the latter two groups, 0.8 IU/kg/d of GH or 4 mg/kg/d of IGF-1 was infused for 72 hours. Anabolic effects were assessed by body weight change, 3-methylhistidine (3-MH) excretion, nitrogen excretion, and whole-body protein turnover. Organ weights, plasma levels of glucose, insulin, and IGF-1, tissue IGF-1 levels, hepatic messenger RNA (mRNA) content, and intestinal structure were also determined. RESULTS: Both GH and IGF-1 decreased nitrogen excretion. IGF-1, but not GH, increased postoperative body weight, whole-body protein turnover, and splenic weight. IGF-1 reduced atrophy of the intestinal mucosa. GH treatment increased hepatic IGF-1-mRNA and the plasma IGF-1 level, whereas IGF-1 treatment increased the plasma IGF-1 level with no change in the hepatic IGF-1-mRNA content. There were no significant differences in plasma glucose or insulin levels among the three groups. Neither GH nor IGF-1 affected the gastrocnemius muscle IGF-1 level. CONCLUSIONS: IGF-1 has beneficial effects, whereas GH has only limited effects on post-operative protein metabolism, gut integrity, and splenic weight in chronic mild liver injury.
Animals↗
Glutamine-enriched enteral diet enhances bacterial clearance in protected bacterial peritonitis, regardless of glutamine form.
BACKGROUND: The effects of glutamine (Gln)-enriched enteral diets on bacterial clearance were investigated in a rat protracted peritonitis model. The effects of the Gln form, peptide-based vs free amino acid-based, were also compared. METHODS: Twenty-three rats underwent gastrostomy. An osmotic pump was implanted in the peritoneal cavity. The rats received a continuous intragastric infusion of one of three diets: Gln-depleted (Gln 0), Gln-enriched with the Gln in free amino acid form (Gln F), or Gln-enriched with the Gln in oligopeptide form (Gln P). The three formulas were isocaloric and isonitrogenous. The pumps delivered a continuous infusion of Escherichia coli, starting at 48 hours after implantation, for 24 hours. Then, the animals were killed. RESULTS: Bacterial numbers in peritoneal lavaged fluid (PLF) and the liver were significantly lower in the Gln P and Gln F groups than in the Gln 0 group. The bacterial number in PLF correlated with that in the liver. Neither the number nor the population of peritoneal exudative cells differed among groups. Plasma levels of proline, alanine and citrulline were significantly higher in the Gln P and Gln F groups than in the Gln 0 group. Both Gln supplemented groups showed significantly greater villous height, crypt depth, and numbers of mitoses per crypt in the small intestine than the Gln 0 group. CONCLUSIONS: Supplemental Gln enhances peritoneal and hepatic bacterial clearance, regardless of Gln form. Gln-enriched may be more beneficial than Gln-depleted enteral diets in peritonitis.
Animals↗