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Biomedical subjects

M Iida

Publications and source records attributed to M Iida.

At least 721 records · Page 40Linked to original sources
PubMedDate not supplied

Endoscopic and biopsy findings of the upper digestive tract in patients with amyloidosis.

Endoscopic and biopsy findings of the esophagus, stomach, duodenum, and colorectum were studied in 37 patients with amyloidosis involving the gastrointestinal tract. Endoscopic examinations revealed fine granular appearance, polypoid protrusions, erosions, ulcerations, and mucosal friability in many cases. These findings were most marked and noticed most often in the second portion of the duodenum. The frequency of amyloid deposition in the biopsy specimens was as follows; 100% in the duodenum, 95% in the stomach, 91% in the colorectum, and 72% in the esophagus. The degree of amyloid deposition in the duodenum, which was the highest of the entire gastrointestinal tract, significantly correlated with the frequency of endoscopic findings such as fine granular appearance and polypoid protrusions. Therefore, the two endoscopic findings described above are characteristic of this disease and may reflect amyloid deposition in the mucosa or submucosa of the alimentary tract. Our results indicate that for a diagnosis of amyloidosis, it is important to examine the upper gastrointestinal tract, especially the duodenum, using endoscopy and biopsy techniques.

Adult↗
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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↗
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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↗
PubMedDate not supplied

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↗
PubMedDate not supplied

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↗
PubMedDate not supplied

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↗
PubMedDate not supplied

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↗
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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↗
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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↗
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The role of pulsatility in end-organ microcirculation after cardiogenic shock.

To estimate the effectiveness of pulsatility in end-organ microcirculation after cardiogenic shock, experimental studies using swine were done. Cardiogenic shock was produced in 14 pigs by ligating the left anterior descending branches so that mean aortic pressure dropped to 60% of the control value. After inducing shock, left atrial to ascending Ao bypass was initiated. A pneumatic pulsatile pump (Zeon Medical Inc, Tokyo, Japan) was used in seven pigs (Group P) and a centrifugal pump (BP-80, BioMedicus Inc, Minneapolis, MN) in seven (Group NP). In both groups, about half the usual cardiac output was supported for 3 hr, maintaining mean aortic pressure at approximately 100 mm Hg. The pulse pressure was 36.6 +/- 4.6 mm Hg in Group P, and 14.3 +/- 1.5 mm Hg in Group NP. Epicardial and endocardial regional flows recovered after assist in both groups. There were no significant differences between the two groups. However, liver tissue flow, renal cortex flow, and stomach mucous flow in Group P was significantly higher than those of Group NP after support (p < 0.05). In addition, arterial blood ketone ratio in Group P was 0.61 +/- 0.13 vs 0.39 +/- 0.06 in Group NP, a significant difference (p < 0.05). These results suggest that in uneven blood flow distribution of end organs after cardiogenic shock, pulsatility was effective in improving and maintaining function and microcirculation of end organs, preventing multiorgan failure.

Animals↗
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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↗
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Can short-latency vestibulospinal reflexes in lower leg muscles be elicited by tapping the head?

A gentle tap on the forehead evoked short-latency motor responses in the sternocleidomastoid muscle, which may be vestibulocollic reflexes with characteristics similar to those elicited by clicks. We tested this paradigm in subjects standing upright, in order to determine the differential effects of taps on the forehead on the patterns and latencies of spinal stretch and vestibulospinal reflexes, which are important for postural control. Taps on the forehead elicited short-latency inhibitory electromyographic responses in both gastrocnemius muscles with a mean latency of 48.3 +/- 3.1 ms (onset) to 98.3 +/- 6.3 ms (end). Taps on the sternum elicited similar responses from the gastrocnemius muscles, indicating that vestibular stimulation is not essential for eliciting these responses. Both responses may play a role in predetermining the strategy for correcting body perturbations. The actual reflex is probably elicited by somatosensory input from the neck, which converges with vestibular input for the multisensory control of posture.

Acceleration↗
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Is vitamin E depleted in Crohn's disease at initial diagnosis?

We measured serum and red blood cell concentrations of vitamin E and serum lipid concentrations in 13 inpatients at the initial diagnosis of Crohn's disease and compared them with those of 12 healthy controls. Although the serum concentrations of vitamin E were significantly lower in the patients with Crohn's disease than in the controls, the red blood cell concentrations of this vitamin did not differ between the two groups. The serum concentrations of total lipids and total cholesterol were decreased in the patients with Crohn's disease. A significant correlation was found between the red blood cell concentration of vitamin E and the serum vitamin E/serum total lipids ratio in both the groups. There was no correlation between the Crohn's disease activity index and serum or red blood cell levels of vitamin E. These findings suggest that the lowered serum vitamin E levels in patients with Crohn's disease are a symptom of hypolipidemia, and that vitamin E deficiency may not actually become a serious problem in patients diagnosed with Crohn's disease.

Adolescent↗
PubMedDate not supplied

Comparison of horizontal nystagmus in different head positions: a study by damped pendular rotation test.

Damped pendular rotation was given with the initial maximum speed of 180 degrees/s. The subject's head was tilted forward at an angle of 30 degrees from the upright position, or kept in the upright position, or tilted backward at 30 degrees from the upright position. Electronystagmography was used to evaluate the maximal slow-phase eye velocity (mx SPEV) of the horizontal nystagmus. Differences existed in mx SPEVs of the horizontal nystagmus for the head-tilted positions at 30 degrees forward or backward and that obtained in the upright position. The mx SPEV of the horizontal nystagmus in the upright position was higher than those acquired in the head-tilted positions.

Adult↗
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Evaluation of the vertical semicircular canal function by the pendular rotation test: a study on patients with benign paroxysmal positional vertigo.

The pendular rotation test (non-damped) in a head-tilted position, 60 degrees backward and then rotated 45 degrees either to the right or left, was performed in 6 patients with benign paroxysmal positional vertigo. The stimulus mode was amplitude = 360 degrees, frequency = 0.1 Hz, and the maximal speed = 114 degrees/s. By this test procedure, it was possible to evaluate the excitability of vertical semicircular canals. Using an infra-red CCD camera and a personal computer system, the evoked nystagmus was analysed. A statistically significant difference (p < 0.05) in the maximal slow-phase eye velocity of vertical nystagmus was found between those from the anterior semicircular canal and those from the posterior semicircular canal. The excitability of the posterior semicircular canal in the affected ear was found to be lower than that of the anterior semicircular canal.

Adult↗