Biomedical subjects

Y Muto

Publications and source records attributed to Y Muto.

581 records · Page 33Linked to original sources

PubMedDate not supplied

Assessing the permeability of the gastrointestinal mucosa after oral administration of phenolsulfonphthalein.

BACKGROUND/AIMS: In this study, the oral phenolsufonphthalein (PSP) absorption test as a simple and non-invasive method for the assessment of either the extent of the permeability of or damage to the gastrointestinal mucosa was evaluated. METHODOLOGY: The permeability of the gastrointestinal mucosa of patients with liver cirrhosis and those who underwent gastrointestinal surgery was assessed by the oral administration of 30 mg of PSP and the measurement of its urinary recovery rate. RESULTS: The urinary PSP excretion in patients with liver cirrhosis (n = 8; 28.8 +/- 6.0%) was significantly higher than that of patients who underwent vascular surgery (n = 8; 10.0 +/- 1.7%) (p < 0.01), which thus suggested an increased permeability of the gastrointestinal mucosa in patients with liver cirrhosis. The urinary PSP excretion rate in patients who underwent a total gastrectomy with Roux-en-Y reconstruction (n = 5) was 17.3 +/- 1.7% which was significantly higher than that observed in the control (p < 0.05), while the same rates in patients who underwent a partial gastrectomy (n = 10) or colectomy (n = 10) were 10.2 +/- 1.8% or 10.6 +/- 0.7%, respectively, which suggested that the intestinal mucosa is damaged by a total resection of the stomach. CONCLUSIONS: The oral PSP absorption test, which is non-invasive, simple and inexpensive, is thus considered to be useful for assessing the degree of damage to or the permeability of the gastrointestinal mucosa under various conditions.

Absorption↗

PubMedDate not supplied

Vascular reconstruction for intraoperative major vascular injuries.

BACKGROUND: The purpose of this study was to find an effective and precise surgical procedure to cope with the major vascular injuries that might be encountered during hepato-biliary and pancreatic surgery. MATERIALS AND METHODS: Among the 220 cases of hepato-biliary and pancreatic surgery from 1991 to 1995 in our department, 8 patients who sustained 13 different instances of vascular injury were reviewed retrospectively. RESULTS: Five injuries occurred in the portal vein (PV), 4 in the hepatic artery (HA), and 2 in the inferior vena cava (IVC). The repair procedures consisted of 2 direct closures, 2 resections of the injured sites followed by the end to end anastomosis, 2 autologous venous grafts and 1 artificial vascular graft implantation, and 2 diversions of the arterial bloodflow of the middle colic artery and the gastroepiploic artery to the injured HA. The reconstructed vessels showed postoperative obstructions in 2 cases, in which artificial vascular graft implantation and direct closure were used for the reconstruction. CONCLUSIONS: Based on the above findings, the use of an artificial graft and a direct closure all contributed to the early postoperative obstruction of the reconstructed vessels. However, a diversion of the arterial bloodflow to the injured hepatic arteries was found to maintain a good postoperative patency in these cases.

Adult↗

PubMedDate not supplied

Esophageal cancer in patients with head and neck cancers.

Nine male patients with separate primary cancers of the esophagus and head and neck (pharynx, larynx) presented with a mean age of 56 years (41-69). They included 7 pharyngeal cancer patients and 2 laryngeal ones. Esophageal cancer was discovered synchronously in 6 patients and metachronously in 3 (1, 4, and 11 years later, respectively). The head and neck cancer was stage-I in one patient, stage-II in 4 and stage-IV in 4. The esophageal cancer was cervical in 2, thoracic in 6 and abdominal in 1. It was early cancer (stage-0) in 6 patients and advanced (stage-IV) in 3. The esophageal cancer was more advanced in the metachronous group, while it was early in the synchronous group. Since the head and neck cancer was advanced, all patients underwent a total laryngectomy for their head and neck cancers. As for esophageal surgery, a transhiatal esophagectomy was, in principle, performed for early cancers while a total thoracic esophagectomy was done for advanced cancers. For the reconstruction of the esophagus, a gastric tube was used. Four patients are still alive with a mean survival time of 25 months, whereas five died of cancer recurrence of either type a mean of 19 months after surgery. As compared with the survival rates of the patients with esophageal cancer alone, the 5-year survival rate was 18.2% for patients with double cancers in this series and 27.9% for those with esophageal cancer alone.

Adult↗

PubMedDate not supplied

Multicystic cavernous hemangioma of the liver: report of a case including diagnostic imaging and pathologic correlation.

The case of a multicystic hemangioma in the liver of a 78-year-old woman is reported. The patient complained of upper abdominal pain and had been seen at a local hospital a few months prior to this admission. An endoscopic examination of the stomach revealed an active gastric ulcer, and ultrasonography (US) of the upper abdomen also incidentally detected a liver tumor. After treating the gastric ulcer, she was then referred to Ryukyu University Hospital in January 1997. US revealed a 3.5-cm, oval-shaped, echogenic tumor with multiple cystic areas in the right lobe of the liver. A CT scan demonstrated a hypodense tumor, that was not enhanced on dynamic CT. Angiography showed a hypovascular tumor that appeared to be a multicystic tumor of heterogeneous high intensity on T2-weighted MRI. The tumor measured 3.5 cm x 3.5 cm in size and was multicystic with a fibrous septum and serous fluid. Histologically the tumor was determined to be cavernous hemangioma of the liver. Atypical hemangiomas should be included in the differential diagnosis when hemangiomas show multicystic features.

Aged↗

PubMedDate not supplied

Surgical treatment for proximal bile duct carcinoma.

BACKGROUND: The surgical management of proximal bile duct carcinoma is controversial. There is no consensus among surgeons as to the indications for radical resection. This article described personal experience with the different surgical procedures for patients with proximal bile duct carcinoma. METHODS: The medical records of fifty-two consecutive patients undergoing surgical resection over a 20-year period were retrospectively analysed in terms of pathology, perioperative mortality, clinical course, and overall survival. RESULTS: The 1-, 3- and 5-year survivals for the entire group were 63.3%, 24.5%, and 21.0%, respectively. The results for local resection of the extrahepatic bile duct in 35 cases were unsatisfactory. Radical resection that included the right extended hepatic lobe, caudate lobe, and extrahepatic bile duct was performed in 9 patients and demonstrated an excellent 5 year survival rate of 44.4%. However, hospital mortality was 22.2%. There was no significant difference among the operative procedures for patients with advanced disease. CONCLUSION: Radical resection remains the procedure of choice in proximal bile duct carcinoma. However, results with surgical therapy alone remain unsatisfactory. Multimodality treatment that also includes radiotherapy and/or chemotherapy is recommended.

Aged↗