Biomedical subjects

M Iida

Publications and source records attributed to M Iida.

At least 325 records · Page 18Linked to original sources

PubMed1994

Role of nonpolypoid neoplastic lesions in the pathogenesis of colorectal cancer.

PURPOSE: The aim of this study was to investigate the role of nonpolypoid neoplastic lesions of the colorectum in the pathogenesis of colorectal cancer. METHODS: We retrospectively compared the incidence of cancer between polypoid and nonpolypoid lesions detected by colonoscopy during the period of 1991 to 1992. RESULTS: Of the 686 lesions in 336 patients included in the investigation, 644 lesions were regarded as polypoid, either sessile, semipedunculated, or pedunculated, while 42 lesions were recognized as small nonpolypoid lesions characterized by minimal elevation with depression on colonoscopy. The incidence of cancer in adenoma or pure cancer was significantly higher in the nonpolypoid lesions (19.0 percent) than in the polypoid lesions (6.8 percent, P < 0.01), especially in the lesions found in the rectum or in the sigmoid colon. In addition, all 8 nonpolypoid cancers were pure cancers, whereas 26 of the 44 polypoid cancers contained adenoma. The nonpolypoid cancers were smaller and they invaded the submucosa more frequently than did the polypoid cancers. CONCLUSIONS: Nonpolypoid lesions are more likely to be a precursor of advanced cancer in the colorectum than usual polyps. Colonoscopists should strive hard to detect these lesions with a view to cancer surveillance, even though they are generally found less frequently than polyps.

Adenoma↗

PubMed1994

Preventive effect of immunosuppressive agents against indomethacin-induced small intestinal ulcers in rats.

The mechanism of nonsteroidal antiinflammatory drug-induced intestinal ulcers is not clearly understood. To evaluate whether immunosuppressants have a preventive effect against indomethacin-induced gastrointestinal damage, we investigated the effects of prednisolone, cyclosporin, and the newly developed immunosuppressant FK-506 in intracolonically indomethacin-treated rats: 24 mg/kg of indomethacin, administered intracolonically for two days, caused gastric ulcers and two types of small intestinal ulcers (longitudinal ulcers and scattered small ulcers). Pretreatment with intraperitoneal immunosuppressants reduced the size of gastric ulcers. Both cyclosporin (10 mg/kg) and FK-506 (1 mg/kg, 2 mg/kg) treatments significantly reduced the incidence and the length of the longitudinal ulcers of the small intestine when compared to the vehicle-treated controls, whereas prednisolone (20 mg/kg) did not show any preventive effect. Furthermore, the number of small scattered ulcers of the small intestine was significantly reduced by the high dose of FK-506 (2 mg/kg), but not by cyclosporin or prednisolone. These findings indicate that immunosuppressants have protective and antiinflammatory effects in indomethacin-induced gastroenteropathy, suggesting that cytokines may be important mediators in the pathogenesis of enteropathy induced by nonsteroidal antiinflammatory drugs.

Animals↗

PubMed1994

Clinical course and long-term prognosis of Crohn's disease in Japan.

The long-term outcome of Crohn's disease was reviewed in 74 patients who had a history of more than 10 years (range 10.8-27.3) since disease onset. The observation period was between 4.3 and 18.5 years, the mean and SD being 10.6 +/- 3.1 years. The means and SD of age at onset and final observation were 21 +/- 7 and 37 +/- 8 years, respectively. Fifty-eight of the 74 patients had not undergone bowel resection at the time of diagnosis; of these 58, 31 (53.4%) had an operation for the disease during the follow-up period. Thus, of the 74 patients, 47 (63.5%) (these 31, plus the 16 who had undergone bowel resection at the time of diagnosis) had an operation at least once during a follow-up period of 10 years or more. The cumulative operation rates 5, 10, and 15 years after onset in the 74 and 58 patients above were 18.9%, 6.9%, and 40.8%, and 34.8%, 49.1%, and 46.0%, respectively. The corresponding figures 5 and 10 years after diagnosis in all 74 patients and the 58 patients were 32.3% and 28.6% and 47.3% and 46.3%, respectively. There were no significant differences in the incidence of operation rate in relation to anatomical involvement. Cumulative reoperation rates 1, 3, 5, and 10 years after the first operation in the 31 patients who were operated on during the follow-up period were 3.4%, 6.9%, 25.5%, and 51.7%, respectively. Three patients died, the causes of death in one being directly related to Crohn's disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

Intestinal and extraintestinal complications of Crohn's disease: predictors and cumulative probability of complications.

Of 238 patients with Crohn's disease seen at our clinics from April 1973 to August 1988, 203 patients were selected for this study, since they fulfilled the following criteria: they had been followed up for more than 6 months as outpatients or had been treated as inpatients for more than 1 month. They were studied to elucidate: (a) the different types and incidence of various complications, (b) the factors related to complications present at the time of diagnosis, (c) predictors of new complications arising after diagnosis, and (d) the cumulative incidence of complications occurring during the course of the disease from the times of onset and diagnosis. Of the intestinal complications, perianal fistula was most common (33%), followed by strictures with dilatations of the proximal bowel (21%), and internal fistula (14%). Of the extraintestinal complications, menstrual disturbance was the most common (18% of the female patients), followed by arthritis (10%), and aphthous stomatitis (10%). As for the factors influencing complications present at the time of diagnosis, the pattern of bowel involvement was significantly correlated with the presence of intestinal stricture, while the erythrocyte sedimentation rate was significantly correlated with the presence of perianal fistula. A significant predictor of new complications arising after diagnosis was the general well-being of patients at the time of diagnosis. Patients who, at diagnosis, already have complications such as stricture, abdominal abscess, internal or external fistula, massive hemorrhage, and free perforation or anal lesions are more likely to develop new complications in addition to those present at diagnosis, compared with patients without any complications at diagnosis (P = 0.055).

Adult↗

PubMed1994

Serum total cholesterol and mortality in a Japanese population.

Although the relation between serum total cholesterol and coronary heart disease is well established, the relation with mortality from non-coronary disease is controversial. Inverse relations of serum cholesterol with hemorrhagic stroke and cancer have stimulated the examination of cholesterol-non-coronary mortality associations. The population surveyed is 12,187 men and women aged 40-69 years living in Yao City, a suburb of Osaka, who undertook baseline examinations between 1975 and 1984 and had no history of stroke and coronary heart disease at baseline. The subjects were followed on average 8.9 years until the end of 1988 using systematic mortality surveillance. During the follow-up, there were 343 deaths, comprising 170 cancer deaths (International Classification of Death 9th edition: ICD-9, 140-239), 21 coronary heart disease deaths (ICD-9, 410-414), 67 other cardiovascular deaths (ICD-9, 390-458 excluding 410-414), and 85 non-cardiovascular, non-cancer deaths. There was a significant inverse association of serum cholesterol with total and cancer mortality for men, and no significant association for women. The cholesterol-disease association, although not significant, was positive for coronary heart disease and other cardiovascular disease deaths, and inverse for non-cardiovascular, non-cancer deaths in both sexes. The inverse association of serum cholesterol with total and cancer mortality for men remained significant after controlling for age, job classification, hypertension category, usual alcohol intake, cigarette smoking, and relative weight index.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

Intestinal lymphangiectasia: value of double-contrast radiographic study.

Intestinal lymphangiectasia is a disorder presenting as enteric protein loss through the dilated lymphatics without mucosal ulceration. To determine the double-contrast radiographic features and to assess the significance of them, five patients with intestinal lymphangiectasia were examined using single- and double-contrast small intestinal studies. The double-contrast examinations demonstrated clearly the main radiographic findings of smooth nodular protrusions, thickening of the mucosal folds, with no evidence of mucosal ulceration. Compared with the single-contrast study, smooth nodular protrusions were seen more often and in more widespread segments, particularly in the duodenum, on double-contrast study. Thickening of the mucosal folds was revealed similarly by both methods. Double-contrast study appears to be worthwhile to demonstrate the characteristic radiographic findings of this disease.

Adolescent↗

PubMed1994

Gastrointestinal manifestations of Cowden's disease. Report of four cases.

Four patients with an established diagnosis of Cowden's disease underwent barium meal study, upper gastrointestinal endoscopy, barium enema examination, and colonoscopy. In three, the esophagus was affected by small protrusions, which were diagnosed as glycogenic acanthosis. Numerous hyperplastic polyps were found in the stomach in three patients, and in one an inflammatory fibroid polyp was also detected. Either lymphangiectasia or lymphoid polyps were found in the duodenum in two patients. In all patients, the colon showed polyps that varied in histology and included adenoma, hamartomatous polyp, and ganglioneurofibroma. In addition, jejunal lymphangiomas were found in one of the three patients in whom the small intestine could be precisely evaluated. These findings suggest that the gastrointestinal involvement in Cowden's disease is characterized by various benign lesions, especially esophageal glycogenic acanthosis, numerous gastric hyperplastic polyps, and multiple hamartomatous polyps in the rectosigmoid colon. Detection of these gastrointestinal manifestations may lead to early diagnosis of this potentially malignant disease.

Adult↗

PubMed1994

Gastrointestinal involvement in tuberous sclerosis. Two case reports.

Two patients with tuberous sclerosis had multiple semispherical polyps in the large intestine, predominantly in the rectosigmoid colon. These were hamartomas with an excess of smooth muscle fibers in the stroma. In addition, the 21-year-old man had multiple tiny protrusions in the esophagus and oral fibroepithelial polyps. In the 31-year-old woman, who had pulmonary lymphangiomyomatosis with positive estrogen and progesterone receptors, hamartomatous gastric polyps, colonic leiomyoma, and adenomatous rectal polyps were also identified. Our findings suggest that gastrointestinal polyposis may be one of the phenotypes of tuberous sclerosis complex, possibly linking this disease with other hereditary polyposis syndromes.

Adult↗

PubMed1994

Effects of diet on experimentally induced intestinal ulcers in rats: morphology and tissue leukotrienes.

The effects of dietary pretreatment on longitudinal ulcers of the intestine induced by indomethacin given intracolonically were investigated in rats. The rats were pretreated with either standard diet or liquid meals. Intracolonic indomethacin (24 mg/kg/day) given for two days produced longitudinal ulcers and small scattered ulcers in the small intestine in the control rats that were receiving standard pelleted formula. Three days pretreatment with one of two types of liquid meals, low residual diet (LRD) or elemental diet (ED), significantly reduced the incidence (3% in ED group and 0% in the LRD group) and the length of the longitudinal ulcers in the small intestine. The caecum was affected in each dietary pretreatment group (67% in controls, 80% in LRD group, and 69% in ED group). Colonic ulcers that were located in a longitudinal fashion were found in 42% of LRD group, while these ulcers were less frequently found in the ED group (13%) and controls (0%). Development of ulcers in the caecum and in the colon of rats in ED and LRD groups was more delayed than that of small intestinal ulcers of control rats. In another experiment, pretreatment by ED significantly increased colonic tissue leukotriene B4 concentration when compared with that of controls. These findings suggest that the site of experimental enteropathy induced by indomethacin given intracolonically can be modified by dietary pretreatment. This animal model can be available for investigating differences in the pathophysiology of enteropathy according to the site of involvement.

Animals↗

PubMed1994

Clinical and magnetic resonance imaging study of extrapyramidal symptoms in multiple system atrophy.

Slit-hyperintensity in the outer margin of the putamen on T2 weighted MRI was found in 17 out of 28 patients with clinically diagnosed multiple system atrophy. Thirteen of these 17 patients showed extrapyramidal signs. Five patients had only unilateral slit-hyperintensity; four of them had contralateral rigidity; and one had bradykinesia. Despite mild rigidity, one case showed no slit-hyperintensity. One of the 14 cases with parkinsonism showed no hyperintensity, and four of the 14 cases without parkinsonism showed hyperintensity. On the other hand, slit-hyperintensity was not seen in any of 25 patients with clinically diagnosed Parkinson's disease. Putaminal slit-hyperintensity is a useful MRI feature in the differential diagnosis between Parkinson's disease and multiple system atrophy predominantly affecting the extrapyramidal system.

Aged↗

PubMed1994

Progressive encephalopathy in a Crohn's disease patient on long-term total parenteral nutrition: possible relationship to selenium deficiency.

The case of a patient with Crohn's disease complicated by progressive and irreversible encephalopathy, who had been on long-term total parenteral nutrition due to short bowel syndrome, is described. He initially experienced a disturbance of his vision, which was followed by various neurological symptoms during the next 3 years. These symptoms rapidly progressed until he finally developed consciousness disturbance. He also manifested erythrocytic macrocytosis, a low serum level of tri-iodothyronine and a high level of thyroxine. His blood levels of various trace minerals and vitamins were normal, except for selenium, which showed extremely low values. In addition, impaired plasma glutathione peroxidase activity was confirmed. After intravenous supplementation of selenium, macrocytosis, tri-iodothyronine and thyroxine values, and glutathione peroxidase activity all became normalized, yet he improved little neurologically. Our case suggests that long-term selenium deficiency may cause progressive and irreversible encephalopathy, and that careful monitoring of this mineral is necessary when an excessive period of total parenteral nutrition is being considered in the clinical setting.

Adult↗

PubMed1994

Gastrointestinal amyloidosis: radiologic features by chemical types.

PURPOSE: To determine the correlation between the radiographic and histologic findings of amyloidosis according to chemical type of amyloid protein. MATERIALS AND METHODS: The 49 patients with amyloidosis were examined radiographically, and gastrointestinal tract biopsy specimens were studied histologically. RESULTS: Considerable differences were found between amyloid proteins. On immunohistochemical studies, amyloid A produced a coarse mucosal pattern with innumerable fine granular elevations, which reflected expansion of the lamina propria by amyloid deposits. Polypoid protrusions and invariable thickening of the folds were evident only in light chain protein, correlating with massive amyloid deposits in the muscularis mucosae and submucosa. beta 2-Microglobulin produced marked delay in transit time and dilatation of the small and large intestines, relating to extensive amyloid deposits in the muscularis propria. The prevalence of these radiographic changes was highest in the small intestine for every chemical type. CONCLUSION: Characteristic radiographic changes of each chemical type of amyloid protein can be detected well in the small intestine.

Adult↗

PubMed1994

Crohn disease: early recognition and progress of aphthous lesions.

PURPOSE: To clarify the radiographic appearance of the initial change an dprogression in Crohn disease. MATERIALS AND METHODS: Between 1984 and 1992, nine patients (seven men and two women, aged 16-34 years; mean, 20 years) with Crohn disease, who had evidence of only aphthous erosions or ulcers at the initial examination, underwent repeated radiography for up to 7 years 11 months (median, 4 years). RESULTS: In all patients, the stomach, duodenum, small intestine, and colorectum were involved, and the esophagus was affected in three patients. Subsequently, four of the nine patients had lesions that progressed from aphthous lesions to overt Crohn disease, including ileitis in two patients, colitis in one, and ileocolitis in one. Time intervals between the first visit and the progression varied from 9 months to 3 years 6 months. In all eight patients who underwent nutritional treatment, regression of the lesions was recognized, but three of the lesions progressed during interruption of the nutritional diet. CONCLUSION: Crohn disease may initially appear as diffuse aphthous lesions in the gastrointestinal mucosa.

Adolescent↗

PubMed1994

Mucosal prolapse syndrome: diagnosis with endoscopic US.

PURPOSE: To determine the value of endoscopic ultrasound (US) in the diagnosis of mucosal prolapse syndrome (MPS), also known as solitary ulcer of the rectum. MATERIALS AND METHODS: Three male and two female patients (age range, 17-66 years) with biopsy-proved MPS underwent endoscopic US. The average rectal wall thicknesses of the affected areas were compared with those of normal-appearing mucosa. RESULTS: The gross appearance of the rectal lesions was classified into three types: polypoid (n = 2), flat (n = 1), and ulcerative (n = 2). In all three types of lesions, endoscopic US demonstrated smooth, diffuse thickening of the third layer of the rectal wall; the other layers had minimal thickening. Neither a solid hypoechoic mass nor a transmural infiltrating lesion was visible, and the five-layer structure of the rectal wall was completely preserved. In the polypoid lesions, the third layer was winding as well as thickened, and microcystic components were occasionally found. CONCLUSION: Endoscopic US enabled differentiation of MPS from other conditions such as malignant neoplasia and Crohn disease.

Adult↗

PubMed1994

Aftereffects of high-intensity DC stimulation on the electromechanical performance of ventricular muscle.

To clarify the mechanisms underlying cardiac dysfunction after electrical defibrillation, we investigated the effects of direct current field stimulation (10 ms, 1-80 V/cm) on isolated guinea pig papillary muscles. Shocks (S2) > 15 V/cm lowered the plateau height of the S2-induced action potential and inhibited its terminal repolarization. Subsequent responses to basic stimuli (S1, 1.0 Hz) for 1-3 min were characterized by a decrease in the maximum diastolic potential, a shortening of action potential duration, and an increase of the developed tension. With S2 > 30 V/cm, a marked delay in repolarization of the S2-induced action potential was followed by oscillation of membrane potential, resulting in repetitive spontaneous activity and often refractoriness to S1 stimulation. The aftereffects were independent of the phase of S2 application. Most of the aftereffects were preserved in the presence of nifedipine (1 microM) or ryanodine (1 microM). Only sodium channel blockade by tetrodotoxin (10 microM) modified the aftereffects by depressing the generation of spontaneous activity. These findings suggest that strong shocks (> 15 V/cm) will produce abnormal arrhythmogenic responses probably through a transient rupture of sarcolemmal membrane (electroporation) leading to a disturbance of the ionic equilibrium of the myocyte.

Animals↗

PubMed1994

Left ventricular mass and subsequent blood pressure changes among middle-aged men in rural and urban Japanese populations.

BACKGROUND: It has been suggested that echocardiographically determined left ventricular mass (LVM) is useful in the prediction of hypertension. To examine the relation between LVM and subsequent blood pressure (BP) change, a 6- to 8-year follow-up was conducted in adult Japanese men. METHODS AND RESULTS: LVM was determined by M-mode echocardiography using the American Society of Echocardiography formula among 354 normotensive men aged 30 to 59 years from a rural community (n = 193) and from urban companies (n = 161) in Japan between 1979 and 1983. BP was remeasured 6 to 8 years after baseline in 148 rural men (77%) and 127 urban men (79%). For men whose BP was remeasured, the mean +/- SD LVM index (LVM/body surface area [g/m2]) at baseline was 117 +/- 22 in rural men and 99 +/- 15 in urban men (the difference, P < .001). For both populations, LVM index was positively associated with age and physical activity but not with body mass index. Associations of LVM index with usual alcohol intake and initial BPs were generally weak. According to linear regression analyses after controlling for these covariates at baseline, a 20-g/m2 greater LVM index at baseline was associated with a 5 mm Hg increase in systolic and a 4 mm Hg increase in diastolic BP during the subsequent 6 to 8 years for urban men. A 1-mm greater average ventricular wall thickness was associated with a similar BP increase. For rural men, positive associations of LVM index with BP increase existed but were weak. The weaker association between LVM index and BP increase in rural compared with urban men was probably the result of effects of higher physical activity, leading to a larger left ventricular internal dimension. The increase in systolic and diastolic BPs over the 6 to 8 years of observation was significantly related to baseline LVM index in rural and urban men with a smaller internal dimension (rural men, < or = 49 mm; urban men, < or = 47 mm) but not in those with larger dimensions. CONCLUSIONS: An increased LVM index predicts subsequent BP increase in middle-aged normotensive men in the presence of a normal or small internal dimension.

Adult↗

PubMed1994

High-density lipoprotein cholesterol and premature coronary heart disease in urban Japanese men.

BACKGROUND: The objective of this study was to examine the relation of high-density lipoprotein cholesterol (HDL-C) to coronary heart disease in Japanese men whose serum total cholesterol is low by Western standards. METHODS AND RESULTS: A prospective, observational study based on 7.7 years of follow-up for incidence of coronary heart disease and stroke was conducted. The subjects were 6408 middle-aged male workers aged 40 to 59 years at baseline in urban companies in Osaka, Japan, whose mean serum total cholesterol was 5.10 mmol/L. Mean HDL-C adjusted for age, total cholesterol, systolic blood pressure, alcohol intake, cigarette smoking, and body mass index was 1.27 to 1.28 mmol/L for men who developed coronary heart disease (n = 46) or definite myocardial infarction (n = 21) compared with 1.46 mmol/L for those free of cardiovascular disease (n = 6256; difference, P < .01). There was no significant difference in mean HDL-C between stroke cases (n = 33) and those free of cardiovascular disease. The incidence rates of coronary heart disease and definite myocardial infarction, adjusted for the other risk factors, were three to four times higher in the lowest HDL-C quartile (< 1.24 mmol/L) than the highest quartile (> or = 1.66 mmol/L), and there was a significant dose response for definite myocardial infarction. Serum total cholesterol was positively and significantly associated with coronary heart disease incidence. Furthermore, the inverse association for HDL-C was apparent among men with total cholesterol < 5.69 mmol/L (mean total cholesterol, 4.76 mmol/L) and men with total cholesterol > or = 5.69 mmol/L (mean total cholesterol, 6.26 mmol/L). CONCLUSIONS: Coronary heart disease incidence is inversely related to HDL-C in urban Japanese middle-aged men, whose mean total cholesterol (5.10 mmol/L) is relatively low.

Adult↗

PubMed1994

Two cases of parafilariasis in dairy cattle and treatment of hemorrhage with levamisole topical application.

On June and August in 1989, cutaneous hemorrhagic parafilariasis was found in two cattle among 30 pregnant dairy cattle transported from Hokkaido to Chiba Prefecture. One adult female worm each was recovered from the blood spot in both cattle. Ivermectin oral administration, dosage rate of 200 micrograms/kg body weight, had no effect on the occurrence of the blood spots. Topical application of levamisole on a blood spot at a 2.5% concentration showed to stop the bleeding within a few minutes after treatment. This method was very easy to use at the farm situation where cutaneous hemorrhagic parafilariasis sporadically occurred. The disease has not been found in Chiba Prefecture on a whole since those cases in 1989.

Administration, Topical↗