Submucosal tumors of the terminal ileum managed by endoscopic polypectomy.
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Aged↗
Biomedical subjects
M Fujishima
Publications and source records attributed to M Fujishima.
Endoscopic findings in Yersinia enterocolitica enterocolitis.
The endoscopic findings in the colon and terminal ileum in eight cases of Yersinia enterocolitica enterocolitis infection were studied. The diagnosis was based on the isolation of Y. enterocolitica in the feces and/or elevated serum antibody titers to the organism. Total colonoscopy was performed between 7 and 38 days (mean, 24 days) after the onset of symptoms. In all patients, the terminal ileum was affected, followed by frequent involvement of the ileocecal valve and the cecum, and less frequently, the ascending colon. In the terminal ileum, round or oval elevations with or without ulcers were detected. Small ulcers were detected on the ileocecal valve and in the cecum. These findings were observed even 4 to 5 weeks after the onset of symptoms, suggesting a relatively long course for this disease.
Adolescent↗
Endoscopic features of gastric carcinoids.
Endoscopic findings were studied in eight patients with gastric carcinoid tumors. Five patients had a single tumor and the remainder had multiple tumors. Endoscopic examinations revealed smooth, submucosal masses rounded in shape in all patients. In six patients, the lesion was accompanied by an irregularly shaped erythematous depression or ulceration, which was considered to be a characteristic endoscopic finding of gastric carcinoid. An accurate preoperative diagnosis was made in six patients by endoscopy in combination with biopsy.
Adult↗
Endoscopic ultrasonography in rectal carcinoid tumors: contribution to selection of therapy.
To assess the clinical value of endoscopic ultrasonography (EUS) in carcinoid tumors of the rectum, we studied endoscopic and EUS findings in five patients whose tumors were relatively small in size. Endoscopy revealed sessile or semi-pedunculated smooth elevations, with mucosa of normal appearance. The elevations ranged from 5 to 15 mm in diameter, and were yellowish to white in color. EUS failed to demonstrate a small tumor in two patients whereas in the remaining three patients, a homogeneously hypoechoic mass, which was restricted to the submucosal layer, was detected. All patients were treated by endoscopic excision or local resection of the tumor, which resulted in complete removal of the tumor. We believe that even though EUS is not efficacious in cases of very small carcinoid tumors of the rectum, it can provide clinically important information in choosing therapy.
Aged↗
Intraoperative endoscopy for small intestinal damage in radiation enteritis.
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Constriction, Pathologic↗
Minute non-polypoid adenoma of the colon detected by colonoscopy: correlation between endoscopic and histologic findings.
To characterize the endoscopic features of minute non-polypoid neoplastic lesions of the colon, we investigated the endoscopic, macroscopic, and histologic findings in 34 lesions detected by colonoscopy, which were smaller than 5 mm and were endoscopically recognized as flat or depressed lesions. The lesions were divided into two groups according to their endoscopic features; 8 lesions were completely flat and the remaining 26 lesions were flat-topped elevations with a central depression. Macroscopic examinations revealed that the center of the endoscopically flat lesion was slightly elevated, whereas the center of the flat-topped elevation was characterized by a central depression. All of the lesions were histologically diagnosed as tubular adenomas. The flat lesions were composed of flatly elevated adenomatous glands, while the flat-topped elevations with a depression were characterized by surrounding hyperplasia arising from normal glands. The whole thickness of the mucosa was replaced by adenomatous glands in the lesions with an obvious central depression, while the adenomas tended to spread superficially in the lesions with a shallow depression. These findings suggest that pre-cancerous lesions other than small polyps do exist in the colon and that colonoscopic examination provides some clue toward a prediction of the histologic architecture of the lesions.
Adenoma↗
Endoscopic ultrasonography in primary gastric lymphoma: correlation with endoscopic and histologic findings.
To evaluate the potential value of endoscopic ultrasonography in primary gastric lymphoma, we compared endoscopic ultrasonography findings with endoscopic and histologic findings in 15 patients in whom the diagnosis had been established by radiography and endoscopy, including forceps biopsy. The patients were divided into four groups according to the endoscopic ultrasonography findings. The groups included the following: superficially spreading type (six patients), diffusely infiltrating type (three patients), mass-forming type (four patients), and mixed type (two patients). The endoscopic ultrasonography findings correlated well with the endoscopic, macroscopic, and histologic findings. The histologic findings in nine patients with the endoscopic ultrasonography superficially spreading type or diffusely infiltrating type revealed B-cell lymphoma arising from mucosa-associated lymphoid tissue, which shows slowly infiltrative growth. In four patients with the endoscopic ultrasonography mass-forming type, on the other hand, the tumor histologic finding consisted of diffuse large-cell or diffuse mixed-cell type. Our results indicate that endoscopic ultrasonography may provide information helpful for the management of primary gastric lymphoma.
Adult↗
Endoscopic features in amyloidosis of the small intestine: clinical and morphologic differences between chemical types of amyloid protein.
Thirty patients with amyloidosis of the small intestine were studied to determine the correlations between the chemical types of amyloid protein and endoscopic, histologic, or clinical features. Endoscopic examinations of the jejunum revealed various findings such as a fine granular appearance, erosions and mucosal friability, thickening of the valvulae conniventes, and multiple polypoid protrusions in 23 cases. Immunohistochemical study of the biopsy specimens identified the following chemical types of amyloid protein: amyloid A protein (AA) in 20 cases, light chain protein (AL) in 8, beta 2-microglobulin (AH) in 1, and prealbumin (AF) in 1. The fine granular appearance was found significantly more often in the AA cases (p < 0.001), whereas multiple polypoid protrusions and thickening of the valvular conniventes were observed only in the AL cases (p < 0.001). Histologically, wide granular amyloid deposits in the propria mucosae were seen significantly more often in the AA cases (p < 0.01), whereas massive amyloid deposits in the muscularis mucosae, submucosa, and muscularis propria were the more dominant findings in the AL cases (p < 0.001). Clinically, a more frequent occurrence of diarrhea, malabsorption, and occult blood in stools was present in the AA cases, whereas mechanical obstruction and chronic intestinal pseudo-obstruction were evident only in the AL and the AH cases. These results suggest that clinicopathologic differences between the amyloid proteins exist in small intestinal amyloidosis and that endoscopic appearance relates to the specific accumulation pattern of each type of amyloid protein.
Adult↗
Culture of colonoscopically obtained biopsy specimens in acute infectious colitis.
To investigate the value of colonoscopy in the diagnosis of acute infectious colitis, we prospectively cultured both feces and biopsy specimens obtained during colonoscopy of patients who, because of clinical features such as the acute onset of abdominal pain and diarrhea, were suspected of having the disease. Of the 20 patients who participated in the study, some causative micro-organism was identified in 13 (Campylobacter in 6 patients, Salmonella in 5 patients, and Yersinia in 2 patients), but not in the remaining 7. In addition, biopsy specimens were more sensitive for culture (positive for Campylobacter in 4 patients, Salmonella in 5 patients, and Yersinia in 1 patient) than were feces samples (positive for Campylobacter in 2 patients and for Yersinia and Salmonella in 1 patient each) (50% versus 20%, p = 0.048). These findings suggest that cultures of biopsy specimens obtained during colonoscopy may be diagnostic in sporadic cases of acute enterocolitis caused by bacteria.
Acute Disease↗
Rapidly and infiltratively growing Crohn's carcinoma of the small bowel: serial radiologic findings and a review of the literature.
We carried out a retrospective evaluation of serial changes in the small bowel radiographs of a patient with small bowel cancer accompanied by long-standing Crohn's disease. During the 8 months before diagnosis, marked morphological changes were noted. A solitary and irregular protrusion, and rapidly growing stricture under careful medical management of the underlying disease may indicate the development of cancer.
Adenocarcinoma↗
Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in a rural area of Japan. The Funagata diabetes study.
PURPOSE: To determine the prevalence of type 2 diabetes and impaired sucrose tolerance (IGT) among people aged 40 and over in a rural area, Funagata, Japan, by using a 75-g oral glucose tolerance test (OGTT), and to compare the prevalence to that obtained from a more urban area, Hisayama, Japan. METHODS AND RESULTS: Total eligible subjects for the Funagata study were 3526. Among them, 140 were confirmed to have diabetes judged by the 1985 WHO criteria. A 75-g OGTT was conducted, excluding the 140 known cases of diabetes. The 1985 WHO criteria were used to classify the current diabetes status of participants. The overall participation rate was 74.4%. The prevalence of diabetes (known and newly diagnosed cases combined) was 9.1% for men and 10.8% for women. The prevalence of IGT was 12. 0% for men and 16.5% for women. Age-adjusted prevalence (using 1990 Japanese census) of diabetes and IGT in men in Hisayama is two times higher than in Funagata (12.8% vs. 6.8% for diabetes, 19.5% vs. 10. 3% for IGT). Age-adjusted prevalence of IGT in women in Hisayama is significantly higher than in Funagata. CONCLUSIONS: The prevalence of type 2 diabetes among people aged 40 and over is approximately 10% even in a rural area of Japan. Prevalence of diabetes and IGT is much higher in an urban area than in a rural area in Japan.
Adult↗
Post-treatment retinopathy in a case of diabetes mellitus with A3243G mutation of mitochondrial DNA.
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Adenine↗
Effect of nicardipine versus enalapril on plasma endothelin-1 in hypertensive patients with type 2 diabetes mellitus.
We compared the effects of dihydropyridine type Ca channel blocker slow-release nicardipine and angiotensin converting enzyme inhibitor enalapril on plasma endothelin-1 (ET-1) levels in hypertensive type 2 diabetic patients (n=20). Nicardipine or enalapril was administered for 6 months by a crossover design. Nicardipine and enalapril comparably lowered blood pressure. Enalapril significantly reduced urinary albumin excretion in microalbuminuric patients, whereas nicardipine did not. Urinary beta2-microglobulin excretion was significantly increased during nicardipine treatment. However, both drugs significantly reduced plasma ET-1 as compared with pretreatment levels, close to that in healthy control (2.9 +/- 0.3 pg/ml in control, 4.8 +/- 0.3 pg/ml before treatment, 3.2 +/- 0.3 pg/ml during nicardipine vs before treatment p<0.05, 2.9 +/- 0.4 pg/ml during enalapril vs before treatment p<0.01). The decrease in plasma ET-1 was significantly correlated with the increase in natriuresis in normoalbuminuric patients treated with enalapril ( r= -0.82, p<0.01) but not in those treated with nicardipine. Although nicardipine and enalapril had different renal effects, both drugs equally suppressed plasma ET-1 levels in hypertensive patients with type 2 diabetes.
Albuminuria↗
Haemodynamic and humoral consequences of chronic infusion of vasopressin in conscious rats.
1. To determine the long-term haemodynamic and humoral effects of arginine vasopressin (AVP), a chronic intravenous infusion of AVP was performed in conscious Wistar normotensive rats. 2. AVP (1, 10, 50 or 100 ng/h) or saline as a vehicle control was infused continuously into the right jugular vein at a rate of 1 microL/h using an osmotic minipump for 7 days. 3. As a result, significant elevations of systolic blood pressure were observed in association with increases in plasma AVP concentration. Significant decreases in heart rate were observed during infusion of 100 ng/h of AVP. Mean arterial pressures measured directly on the sixth day of infusion were significantly higher in the rats given 50 ng/h (125 +/- 3 mmHg) or 100 ng/h (125 +/- 2 mmHg) compared with control rats (117 +/- 2 mmHg). Intravenous injection of the V1 antagonist, d(CH2)5Tyr(Me)AVP, significantly reduced the elevated mean arterial pressure induced by 50 or 100 ng/h of AVP (-7 +/- 4 and -11 +/- 2 mmHg, respectively). Plasma renin and norepinephrine concentrations were not affected by AVP infusion, while plasma epinephrine concentration was lower in the rats given 100 ng/h of AVP. Intravenous infusion of AVP did not alter bodyweight, serum electrolytes or osmolality. 4. These results suggest that AVP has a long-term pressor effect which is attributable to its vasoconstrictor action in conscious rats.
Animals↗
Clinical features in young adult patients with ischaemic colitis.
The clinical, radiographic and endoscopic findings in 16 patients with ischaemic colitis, all of whom were < 45 years of age, were analysed. The clinical features were characterized by an acute onset of abdominal pain and rectal bleeding, and persistent constipation prior to the onset of symptoms. Twelve of the 16 patients did not have any known predisposing factors. Barium enema examination and colonoscopy revealed longitudinal ulcers and oedema of the left side of the colon of these patients. These features were then compared with those found in patients with ischaemic colitis, who were > 70 years of age. Although the clinical symptoms, the site of involvement and the initial radiographic or endoscopic findings were similar between the two groups, the transient form of ischaemic colitis and constipation prior to the onset of symptoms were more frequently present in the young patients than in the old patients. These findings suggest that ischaemic colitis, which is not a rare condition even in young adults, is less severe in young patients than in old patients, and that constipation may be related to the pathogenesis of this disease in young adults.
Abdominal Pain↗
Meiosis-reinitiation-inducing factor of Tetrahymena functions upstream of M-phase-promoting factor.
Reinitiation of meiosis (maturation) of amphibian Bufo and Xenopus oocytes can be induced if Tetrahymena extract is injected into them. The activity differed from M-phase-promoting factor, because action of the former factor on the induction of maturation was inhibited by treatment of the oocytes with cycloheximide. Activity of M-phase-promoting factor was not detected in Tetrahymena extract regardless of the presence of cdc2 homologues in the extract. However, cycloheximide-resistant-maturation-inducing activity appeared in the recipients, when the maturation was induced by injection of Tetrahymena extract. Immunoblots using antibodies against cdc2 showed that injection of Tetrahymena extract induced fast mobility of the recipient cdc2 in the presence of the recipient protein synthesis. The same mobility shift of the cdc2 was also induced when M-phase-promoting factor containing Xenopus oocyte extract was injected into immature oocytes or when the immature oocyte extract was treated with alkaline phosphatase. These results indicate that meiosis-reinitiation-inducing factor of Tetrahymena functions upstream of M-phase-promoting factor to induce dephosphorylation of the recipient cdc2. Tetrahymena cdc2 homologues also showed fast mobility when the Tetrahymena extract was treated with alkaline phosphatase. Preliminary experiments showed that the meiosis-reinitiation-inducing factor of Tetrahymena was a soluble protein.
Alkaline Phosphatase↗
Monoclonal antibody to a bacterial endonuclear symbiont Holospora cross reacts with proteins of contractile vacuole radial canals of Paramecium species.
A monoclonal antibody (mAb) IR-2-1 was raised against a 67-kDa protein purified from the macronucleus-specific bacterial symbiont Holospora obtusa of Paramecium caudatum. The mAb was found to react with two bands (31 and 67-kDa) on gels of H. obtusa. Indirect immunofluorescence microscopy showed that these antigens were distributed inside the cells. However, unexpectedly, this mAb also cross reacted with the radial arms of the contractile vacuole in P. caudatum, P. tetraurelia, P. multimicronucleatum, P. jenningsi and P. bursaria as well as with their cytoplasm. Immunoelectron microscopy showed that the antigens were located on the decorated spongiome of the radial arms. In immunoblots, mAb IR-2-1 reacted with a band of 67 kDa in all Paramecium species examined. However, no band appeared in the immunoblot of isolated macronuclei of H. obtusa-free P. caudatum and no label was seen in the nuclear matrix of the macronucleus of air-dried P. caudatum. These results suggest that the 67-kDa antigen found in H. obtusa was not imported from the host macronucleus and the same antigen in the host contractile vacuoles and cytoplasm were not derived from the symbiont. These results also showed that an epitope on the decorated spongiome of the Paramecium species is shared by its bacterial symbiont. In contrast to the decorated tubule-specific mAb, DS-1, the antigens for IR-2-1 appeared to be loosely membrane bound as they were lost in paraformaldehyde fixed and acetone permeabilized Paramecium.
Animals↗
Quantitative changes in periplasmic proteins of the macronucleus-specific bacterium Holospora obtusa in the infection process of the ciliate Paramecium caudatum.
The Gram-negative bacterium Holospora obtusa is a macronucleus-specific symbiont of the ciliate Paramecium caudatum. The infectious form of this bacterium infects the host macronucleus through digestive vacuoles and differentiates into the reproductive form two days after the infection in the nucleus. The monoclonal antibodies IF-3-1 and IF-3-2 reacted with 39 and 15 kDa periplasmic proteins, respectively, that were specific for the infectious form of H. obtusa. Because the antigens were not detected in the reproductive form of the bacterium, it appears that expression of the proteins decreases during or soon after the infection. Using these antibodies, quantitative changes in the antigens in the early infection process were examined by immunoblotting and immunogold electron microscopy. Immunoblotting showed that the amounts of both antigens were reduced within 1 h after the bacteria were engulfed into the digestive vacuoles of the paramecia, but that the amounts of IF-3-2 antigens declined earlier than the IF-3-1 antigen. Immunogold labeling showed that the level of IF-3-2 antigens became very low in the bacteria in the host digestive vacuoles, whereas there was no similar decrease in amount of IF-3-1 antigens. Possible functions of the antigens are discussed. The IF-3-1 antigens decrease in concentration in parallel with the decrease in the periplasmic region.
Animals↗