[Application and limitation of endoscopic polypectomy in stomach polyps].
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Biomedical subjects
Publications and source records attributed to H Yanai.
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Monocytic leukemia (MoL) cells were obtained from the peripheral blood of a patient in whom the leukemic cells infiltrating various lymphoreticular organs exhibited features intermediate between interdigitating reticulum cells (IDC) and ordinary phagocytic macrophages, whereas the leukemic cells in the peripheral blood were essentially monocytic and lacked such features. Peripheral blood CD4+ T-cells were established as an interleukin-2-dependent T-cell line. When the MoL cells were exposed for a few days to conditioned medium from the T-cell line, they extended several dendritic cytoplasmic projections and became intensely positive for HLA-DR antigen, cytoplasmic S-100 beta protein, and CD1 antigen. Functionally, the conditioned medium significantly down-regulated Fc-mediated and Fc-independent phagocytic activities, and the levels of lysosomal enzymes such as lysozyme and nonspecific esterase in the MoL cells. Moreover, the conditioned medium significantly up-regulated the accessory cell function of the MoL cells as measured by the primary allogenic mixed leukocyte reaction (MLR). Furthermore, the conditioned medium significantly down-regulated the expression of CD14 antigen. Biochemical analysis indicated that the factor responsible for these changes is a protein which is distinct from known human cytokines and whose molecular weight is approximately 31 kDa. These findings suggest that IDC are closely related the monocytic lineage and that helper T-cells play an important role in constructing the microenvironment of T-lymphoid tissues which is necessary for the differentiation and maturation of IDC.
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The development of a new strip biopsy technique for endoscopic mucosectomy utilizing endoscopic saline injection and a double-channel endoscope permits the safe and simple resection of superficial type early gastric cancer which has been difficult to perform with conventional polypectomy techniques. Preresection assessment of the depth of invasion and postresection assessment of efficacy are important with regard to treatment of early gastric cancer, but conventional endoscopic ultrasonography employed for this purpose requires special equipment and involves intricate procedures. An ultrasonic probe which can be used endoscopically has recently been developed and is currently in the trial stage. The authors have conducted studies with respect to a 7.5 MHz radial scanning type Miniature Ultrasonic Probe as well as a 20 MHz manual linear scanning type Sonoprobe System. Experimental studies indicated that the former type is capable of delineating postresection ulcers, while the latter permitted delineation of tumors as hypoechoic images in 9 of 11 cases of early gastric cancer.
The strategy for peptic ulcer therapy has been changing with the clinical application of the gastric proton pump inhibitor (PPI). In Japan, Miyoshi et al and Takemoto et al reported an earlier reepithelialization of peptic ulcer with omeprazole (OME) or lansoprazole (LAN) than famotidine (FAM). Miyoshi et al also reported that there was no significant difference between OME and FAM in ulcer relapse rate during a one year follow-up period. Therefore, there were two problems. One is application of PPI for prevention of ulcer relapse, and the other is the more accurate diagnosis of ulcer healing. Application of PPI for maintenance therapy is not yet realized in Japan, but, Lauritsen et al had already reported on the efficacy and safety of OME, 20 mg, three days a week and 10 mg, daily in prevention of duodenal ulcer relapse. Reepithelialization (red scar) is already established as a starting point of maintenance therapy, and from Miyake's report, a white scar is believed a favorable (non relapsing) end point.
The purpose of this study was to clarify the significance of immunohistological staining for PCNA/cyclin in human colorectal lesions. Our results: The PCNA-positive cells existed at the bottom of colonic tubuli in the normal and hyperplastic conditions. In the neoplastic lesions, however, the positive cells were existed at the relatively surface of the mucosa (chi 2: P less than 0.01) and distributed irregularly from the bottom to the top of carcinoma tissue. These results suggested that immunohistological staining for PCNA would specifically detect the cell proliferation and be beneficial for practical use and clinical application of the diagnosis of the colorectal lesions.
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We have designed a screening system to diagnose unruptured aneurysms, including the use of digital subtraction angiography (DSA). We surveyed 115 patients who had undergone clipping procedures after subarachnoid hemorrhage (SAH) and questioned them with regard to the subjective symptoms. Sixty-eight of 92 patients who returned the questionnaire reported, prior to rupture, headache, eye pain, and neck pain most frequently, and also impairment of extraocular movements, ptosis, visual field defects, and motor and sensory disturbances. Nineteen (47.5%) of 40 patients who had complete pain relief after surgery complained of headache from 1 week to 1 month before SAH. In addition, nine patients (22.5%) complained of headache for several years, and were also pain-free after surgery. For the indication of DSA, we employed an expert system based on fuzzy set theory. Seven groups of parameters are: Group 1, a basic questionnaire concerning age, sex, and past and family histories; Group 2, 15 warning signs selected on the basis of retrospective study; and Groups 3-7, detailed questions concerning each sign. Scoring weights assigned to each condition based on the results of the retrospective study, and threshold values were determined by several neurosurgeons. The certainty factors for intermediate hypotheses were calculated from these weights and threshold values and summed up, from which the conclusion was obtained. Twelve new cases of unruptured cerebral aneurysm were diagnosed using this screening system. This system may improve the ability to diagnose cerebral aneurysms before rupture.
In order to analyze the pattern in the geographical distribution of cancer death in 24 countries of the world, correlation coefficients were calculated between pairs of mortality rates of different cancer sites, using the data for 13 sites in males and 14 sites in females over 18 years from 1950 to 1967. Then factor analysis by means of varimax method was performed on 13 x 13 correlation matrix for males, 14 x 14 correlation matrix for females and 27 x 27 correlation matrix for males and females combined. As a result of factor analysis, three factors are extracted, which are commonly recognized in both males and females. The first factor has high positive factor loadings on pancreas, prostate (for males), skin, and intestine cancers, and negative loadings on stomach and liver cancers. The second factor has high positive factor loading on rectum, intestine, and lung cancers, and the third factor on larynx, oral, and esophagus cancers. Factor analysis based on 27 x 27 correlation matrix revealed that the third factor of both sexes are heterogeneous with regards to the distributions of the factor score. In order that we may find some clues to develop an etiological hypothesis for each site of cancer, we obtained the correlation coefficient between the scores of the extracted factors and the variables on food and environmental agent, and performed stepwise regression methods as well. One of the most striking results we obtained was that excessive drinking of alcohol and the lack of appropriate intake of fruit are suspected as etiological promoters in the pathogenesis of oral, esophagus, and larynx cancers in males.
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Structures of Cornell Medical Index and Medical Data Index were examined by factor analysis. Both of the translated questionnaires were self-administered by six hundred male employees. Questions of low response rate less than 5 and 6% were excluded, and 117 and 70 questions were analysed finally by the method of varimax rotation for CMI and MDI respectively. Ten factors were extracted. Cummulated contribution ratio of them amounted to 72.0 and 84.1% for CMI and MDI respectively. The first two factors were common for the both questionaires and had pronounced contribution ratio amounting to 36.7 and 29.3% for CMI and MDI respectively. The first factors was composed of questions related to autonomic inbalance, gastrointesinal symptom and fatigue, so it was named a tendency of many physical complaints. This factor was considered to be characteristic and representative one in such general health questionnaires, which was closely related to response set of the respondent. The second factor of the questionnaires was named mental instability. The two major factors would correspond to the first and the second component of the Subjective Fatigue Complaint Test (1970) by Japan Association of Industrial Health. Not also CMI but MDI were found to have a poor scalability except for the two major factors.