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Biomedical subjects

A Munakata

Publications and source records attributed to A Munakata.

At least 73 records · Page 4Linked to original sources
PubMed1997

Cold snare excision is a safe method for diminutive colorectal polyps.

Cold snare excision (CSE) has proved to be an effective method for the destruction of diminutive polyps of the colon and rectum. We investigated the correlation between polyp size and bleeding time at the resected end after CSE, and also an appropriate measuring method using CSE. Eighty patients with single polyps were examined. Each polyp was identified as being 5 mm in diameter or smaller using the open-biopsy forceps technique (OBFT). The size of the polyp was calculated using our measuring system (SMS). Of the polyps identified as being 5 mm in diameter or less using OBFT, 15% were 6 mm or more using the SMS. CSE was performed for each polyp, and the time taken for the hemostasis (bleeding time of the CSE; BTCSE) was determined. In seventy-seven polyps that were 6 mm or smaller in SMS, a correlation was noted between SMS and BTCSE. In three polyps that were 7 mm or more by SMS, hemostasis took 10 min or more after CSE, and required electrocoagulation. These results suggest that CSE is a safe method for the removal of polyps determined to be 6 mm in diameter or smaller using the SMS.

Aging↗
PubMed1997

High prevalence of the CagA-positive Helicobacter pylori strains in Japanese asymptomatic patients and gastric cancer patients.

BACKGROUND: Several studies have shown that infection of Helicobacter pylori strains possessing cagA is associated with atrophic gastritis and gastric cancers. METHOD: In 58 pairs of early gastric cancer patients and sex- and age-matched controls, isolated H. pylori strains were tested for possession of cagA. The presence of atrophic gastritis was also examined. RESULTS: Proportions of cagA-positive strains were 100% in cancer patients and 92.3% in controls. Atrophic gastritis was seen in 96.7% and 95.8% of cancer and control patients in whom cagA-positive strains (NS) were detected. However, it was seen in only 20% of H. pylori-negative control patients (P < 0.01). CONCLUSIONS: The present results do not suggest any specific association between cagA-positive strains and gastric cancer. However, frequent prevalence of cagA-positive strains might be associated with the high incidence of atrophic gastritis in Japanese populations.

Adult↗
PubMed1997

[The clinical study of radical cystectomy for lymph node positive bladder cancer].

BACKGROUND: The impact of pelvic lymph node dissection on the survival of patients with lymph node positive bladder cancer is controversial. We analyzed the records of the bladder cancer patients treated with radical cystectomy. METHODS: Between 1976 and 1993, 84 patients with transitional cell carcinoma of the bladder were treated with radical cystectomy at Tokyo Metropolitan Komagome General Hospital. Sixteen patients (19.0%) had pathologically proved nodal metastases. These patients' records were reviewed with regard to pathological status, and the outcome compared with negative lymph node patients. The two patients with pN3, which we could not completely undergo lymph node dissection of, were excluded from the analyses for recurrence and survival. RESULTS: There were 10 males and 6 females, aged between 47 and 83 with a mean of 68.3 years. There were significant differences between the patients with positive lymph node and negative in the rate of grade 3 and the rate of infiltration of cancer to the vein and lymphatics of the bladder walls. The frequency of the patients of positive lymph node was 5.3% in pT1, 10.0% in pT2, 28.6% in pT3a, 32.0% in pT3b, 50.0% in pT4, and none in pTis, pTa and pT4is. The five-year survival rates estimated by the Kaplan-Meier method were 68.6% over all 82 patients, 75.7% for the patients with negative lymph node and 30.7% for positive. Of the patients with positive lymph node, two-year survival was 80.0% for pT2-3a, versus 0% for pT3b-4. This difference was highly significant (p < 0.01). But survival analysis for pT2-3a showed no significant difference between the lymph node negative patients and positive. The recurrence rate was 57.1% (8 of 14) in patients with positive lymph node and seven patients suffered from distant metastases. All the patients which had recurrent tumors died by bladder cancer. CONCLUSION: Radical cystectomy with lymph node dissection can provide favorable outcome in lymph node positive patients with low stage (pT2-3a). But the patients with high stage (> or = pT3b) were poor prognosis. Most of the patients died by distant metastases.

Aged↗
PubMed1997

Improved localizing method of radiopill in measurement of entire gastrointestinal pH profiles: colonic luminal pH in normal subjects and patients with Crohn's disease.

OBJECTIVE: To measure gastrointestinal (GI) pH profiles in patients with Crohn's disease with an improved pH radiotelemetry method. METHODS: A computer-assisted method was developed to exactly localize a pH sensitive radiotelemetry capsule (radiopill) in the GI tract from the stomach to the cecum by detecting distinct changes in transmitted pH signals sampled at 1-sec intervals. The combined usage of a radiodirectional probe facilitated localization of the radiopill in the colon. With this improved method, GI pH profiles in four patients (male/female, 3/1; age range, 21-34 yr) with Crohn's disease that involved the left colon (active disease: 3; disease at quiescent state, 1) were measured and compared with those in four gender- and age-matched control subjects (controls). RESULTS: Gastric and small intestinal luminal pH profiles in Crohn's disease were similar to those in the controls. In contrast, colonic luminal pH profiles in both right (uninvolved) and left (involved) colon in active or quiescent Crohn's disease showed more coarse fluctuations with a significantly low value than those seen in the controls. The minimum colonic pH registered in the four patients was 0.6, 1.2, 3.2, and 5.3 pH unit, respectively. The overall mean luminal pH (+/-SD) in the right colon was 5.3 +/- 0.3 for the patients versus 6.8 +/- 0.2 for the controls (p < 0.01) and that in the left colon was 5.3 +/- 0.7 versus 7.2 +/- 0.3 (p < 0.01), respectively. CONCLUSION: This study first demonstrates that an extremely acidic colonic environment occurs in either active or inactive Crohn's disease.

Adult↗
PubMed1997

[Current medical therapies for Crohn's disease in Japan].

Current available therapies for Crohn's disease in Japan are reviewed in this report. Elemental diet is most effective for both inducing and maintaining remission in Japan. There appears to be no difference between elemental diet, oligopeptide diet and intact nutrients in effectiveness for active Crohn's disease. Although corticosteroid is also useful for treating active Crohn's disease, low dose of it is not effective for maintaining remission. Steroid has important role in combined therapy with elemental diet. New steroid, budesonide appears to be fascinate because of less adverse effects. Recently, instead of salazosulfapyridine, 5-aminosalicylic acid (5-ASA) proved to be more effective not only for active disease but also for maintenance of remission including small intestinal type of Crohn's disease with reduced adverse effects. Azathioprine, 6-mercaptopurine (6-MP), methotrexate and metronidazole are second choice treatment in patients whose disease relapse frequently. Although methotrexate appears to be effective for active Crohn's disease, the role of it has to be defined. Evidences support the use of 5-ASA and methotrexate for prophylaxis after surgery. It is important to chose and combine the therapies, thinking of the situation of each patient.

Aminosalicylic Acids↗
PubMed1997

[Two cases of advanced gastric cancer effectively treated with chemotherapy of 5-fluorouracil, cisplatin and cytarabine].

We reported two cases of advanced gastric cancer effectively treated with chemotherapy of 5-fluorouracil (5-FU), cisplatin (CDDP) and cytarabine (Ara-C), 5-FU (300-350 mg/body) was given by continuous intravenous infusion. Ara-C (20-40 mg/body) by continuous infusion and CDDP (15-20 mg/body) were added intravenously for 3-6 days. For case 1, epirubicin (30 mg/body) was also given on the first day of each therapy course. Case 1 was a 62-year-old female who had gastric cancer with liver metastasis, ovarian metastasis and peritonitis carcinomatosa. After 3 courses of the chemotherapy, reduction of ovarian metastasis greater than 75% was observed. The value of CA125 decreased from 6,800 U/ml to 527 U/ml and ascites disappeared. Case 2 was a 54-year-old male who had type 3 advanced gastric cancer with multiple liver metastases. He received 6 courses of the therapy. Both primary and metastatic tumors showed over 50% reduction in tumor size. These suggested that this combination therapy was effective for inoperable advanced gastric cancers.

Adenocarcinoma↗
PubMed1997

[Hematological characteristics of hypoplastic MDS patients with chromosomal abnormalities, who had been followed for aplastic anemia with normal karyotypes].

During 1990 to 1993, five patients who had been treated in our hospital for aplastic anemia (AA) with a normal karyotype, were found to have hypoplastic myelodysplastic syndromes (hMDS); three patients with RA, one RAEB, and one RAEB-T, and all of them have chromosomal abnormalities. The mean age of the hMDS patients (4 men, 1 woman) was 51.0 years (range 31-61). We retrospectively studied the hematological features of the 5 cases in the early stage without chromosomal abnormalities. They showed, 1) appearance of erythroblasts (3/5), 2) more reticulocyte counts than typical AA (mean 7.8 x 10(4)/microliter), 3) macrocytic anemia (mean MCV 106fl) in peripheral blood, 4) relative erythroid hyperplasia (M/E ratio 0.2-1.5), and 5) low lymphocyte counts (mean percentage of lymphocytes 32, 8%) in bone marrow. Considering about the differences or transformation between AA and hMDS, it is interesting that all five patients have initially had a normal karyotype and subsequently developed chromosomal abnormalities.

Adult↗
PubMed1996

Annual changes in colorectal carcinoma incidence in Japan. Analysis of survey data on incidence in Aomori Prefecture.

BACKGROUND: In recent years, the mortality rate for colorectal carcinoma in Japan has rapidly been increasing, and there are indications that it may surpass that of gastric carcinoma, with colorectal carcinoma fast becoming one of the main targets of cancer treatment in Japan. METHODS: Eight thousand three hundred and eighty-six case records of colorectal carcinoma (4479 males and 3907 females; 4691 colon carcinoma cases and 3695 rectal carcinoma cases), diagnosed over 18 years from 1974 to 1991 in Aomori Prefecture, were analyzed. RESULTS: Age-adjusted incidence for colorectal carcinoma per 100,000 population were 12.6 and 8.7 for males and females, respectively, in 1974. The corresponding rates were 20 and 13.6, respectively, in 1980, and 42.5 and 25.6, respectively, in 1991. Among patients with colon carcinoma, a higher proportion have sigmoid colon carcinoma. The degree of increase in the incidence of sigmoid colon carcinoma was almost the same as that of right-sided colon carcinoma. By birth cohort analysis, among those born in 1934 or earlier, the incidence at the same age was higher in the younger population. CONCLUSION: It is possible that the age-adjusted incidence of colorectal carcinoma in Japan will soon resemble that of the white population in the United States, in a manner similar to that of Japanese-Americans.

Adult↗
PubMed1996

Characterization of mucin in whole-gut lavage fluid obtained from patients with inflammatory bowel disease.

Whole-gut lavage fluid, collected by administering an electrolyte lavage solution orally, was found to be an excellent and easily collectable source of abundant mucin. Furthermore, the biochemical features of the mucin from patients with ulcerative colitis and Crohn's disease were investigated. The mucin was separated into four fractions by Sepharose CL-4B, Sepharose CL-2B, and DEAE Sephacel chromatography. Compared with healthy subjects, the total yields of mucin from ulcerative colitis patients were low due to a deficiency of neutral mucin, whereas those from Crohn's disease patients were high, which was attributable mainly to high-molecular-weight mucin. The fucose and sulfate contents were low in ulcerative colitis, but only the former was low in Crohn's disease. The different biochemical features of the mucin obtained from whole gut lavage fluid appear to reflect mucosal pathological changes associated with inflammatory bowel disease.

Adult↗
PubMed1996

Factors that influence bleeding in superficial-type colorectal tumors: study of endoscopic and histologic correlates.

To clarify the mechanisms responsible for superficial-type colorectal tumor (STT) bleeding, 74 STTs were studied to determine whether their size, shape, surface area features, colorectal site, and level of invasion were correlated with bleeding. The bleeding rate, the proportion of specimens from patients with positive fecal occult blood test (FOBT) results relative to the total number of specimens in each morphological group and probability of an STT being an invasive submucosal carcinoma were positively correlated with tumor size, and bleeding was more common in submucosal than in intramucosal lesions. Logistic regression analysis indicated that the level of submucosal invasion had a significant influence on bleeding. It was also found that the length of erosion on the surface of STTs was significantly greater in bleeding tumors, and that the potential for invasion into the submucosa increased with the area of erosion.

Colon↗
PubMed1996

Validity of various diagnostic tests to evaluate cure of Helicobacter pylori infection.

Many diagnostic methods have been developed and used for detecting Helicobacter pylori to evaluate the success of treatment of H. pylori infection. We investigated and compared the suitability of the rapid urease test (RUT), polymerase chain reaction (PCR), 13C-urea breath test (13C-UBT), and serology with culture for evaluating cure of H. pylori infection. Forty-seven H. pylori-positive gastric ulcer patients received dual therapy of lansoprazole (30 mg u.i.d.) and clarithromycin (200 mg b.i.d.). Four weeks after the completion of treatment, RUT, PCR, 13C-UBT, and culture were performed and the negative rates of these tests were compared. Anti-H. pylori IgG antibodies were measured by enzyme-linked immunosorbent assay (ELISA) before and 4 weeks after completion of the treatment to evaluate changes of titers during the treatment. The negative rate of RUT (55%) was significantly greater than that of culture (27%). Significant declines in titers were seen in the patients who had negative culture results, while the decline in the titer was not significant in the patients who had positive results. PCR assay and 13C-UBT were suitable for the evaluation of H. pylori eradication, but RUT was not suitable, because of its sensitivity. By monitoring anti-H. pylori IgG antibody titers, therapeutic failure can be detected early after completion of treatment.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1996

Comparison of resistant starch with cellulose diet on 1,2-dimethylhydrazine-induced colonic carcinogenesis in rats.

BACKGROUND & AIMS: Epidemiological and experimental studies have shown that dietary fiber may prevent colon cancer. Resistant starch, like dietary fiber, is not subject to digestion in the small intestine. However, it is unknown whether resistant starch inhibits colonic carcinogenesis. In vitro studies have shown that butyrate slows the growth of cultured colon cancer cells. The effect of resistant starch diet on 1,2-dimethylhydrazine-induced colonic carcinogenesis in rats was evaluated, and the colonic butyrate concentration was measured. METHODS: Sprague-Dawley rats were randomly divided into five groups that were fed diets containing no fiber, 3% cellulose, 10% cellulose, 3% resistant starch, or 10% resistant starch. Colonic carcinogenesis and butyrate concentration of colonic contents and feces in each diet group were compared. RESULTS: Total cancer volume per rat in the 10% cellulose group was significantly lower than that in the basal group (109 +/- 54 mm3 and 247 +/- 83 mm3; P < 0.05), but the other groups showed no significant differences. The butyrate concentration in colonic content and in feces were higher in the resistant starch groups than in the cellulose groups. CONCLUSIONS: The resistant starch diet increased butyrate concentration but did not inhibit colonic carcinogenesis. It remains doubtful whether butyrate inhibits the proliferation of colon cancer cells.

1,2-Dimethylhydrazine↗