Biomedical subjects

N Sakaki

Publications and source records attributed to N Sakaki.

At least 37 records · Page 2Linked to original sources

PubMed1995

An endoscopic study on relationship between Helicobacter pylori infection and endoscopic gastric ulcer scars.

A two-year endoscopic follow-up study of 45 gastric ulcer patients was conducted in order to ascertain the relationship between Helicobacter pylori infection, the transformation of ulcer scar patterns, and ulcer relapse during maintenance therapy. Endoscopic findings of gastric ulcer scar patterns, which established the quality of ulcer scars, were classified as follows: Sa, with a central depression, Sb, with a coarse regenerating mucosal pattern up to the center, and Sc, with a fine pattern. The proportion of ulcer relapses was 62% among 29 H. pylori-positive patients and 0% among 16 H. pylori-negative patients. In regard to the relationship between H. pylori infection and scar patterns, 94% of the H. pylori-negative patients displayed Sc scar patterns, while all the H. pylori-positive patients showed various scar patterns, ie, Sa in 38%, Sb in 28%, and Sc in 10%. Ulcer relapses in the H. pylori-positive cases were limited to the Sa and Sb groups (100% and 88%, respectively). In conclusion, our results indicate that H. pylori infection plays an important role in the transformation of the ulcer scar patterns which relate to ulcer relapse.

Cicatrix↗

PubMed1995

[Endoscopic mucosal resection for radical treatment of esophageal cancer].

Clinico-pathological results of patients with superficial esophageal cancer was reviewed to determine the indications of endoscopic mucosal resection (EMR) for esophageal cancer as a radical treatment and to evaluate clinical results of EMR. The analysis on eighty-seven cases with superficial esophageal cancer who underwent esophagectomy revealed no lymph node metastasis in any 0% of case with cancer confined to the lamina propria mucosae, 10% of cancer reaching the muscularis mucosae and 43% of cancer infiltrating the submucosa. These results suggested that the endoscopic mucosal resection should be indicated for patients with esophageal cancer confined to the lamina propria mucosae. The accuracy rate for estimating depth of invasion of mucosal cancer of the esophagus was 96%. We early established "the double channel technique" for resection of mucosal lesion of the esophagus with a major part of the submucosa, we used it for sixty-nine cases, and all were eventually discharged. Immediate complications of EMR were noted in 12.9% of all cases (mediastinal emphysema: 2.9%, ulcer bleeding: 10%) and the late complication in 7.2% (esophageal stricture due to scar formation: 5.8% and ulcer bleeding 5 days after EMR: 1.4%). All cases who developed stricture had mucosal defect over 3/4 the circumference. The cumulative 5-year survival rate of patients with esophageal mucosal cancer treated by EMR (86%) showed no significant difference from those treated by esophagectomy (83.2%). We to conclude that endoscopic mucosal resection is indicated for the patient with mucosal cancer confined to the lamina propria mucosae. One can expect an excellent prognosis by less invasive treatment than esophagectomy.

Esophageal Neoplasms↗

PubMed1995

The influence of Helicobacter pylori infection on the progression of gastric mucosal atrophy and occurrence of gastric cancer.

AIM: To study the effects of Helicobacter pylori infection on the progression of gastric mucosal atrophy and the development of gastric cancer. PATIENTS AND METHODS: We investigated the extension of the atrophic area as assessed on the basis of the Kimura-Takemoto atrophic patterns and the development of gastric cancer in a selected sample of 64 patients who were endoscopically followed up for more than 3 years, and who showed H. pylori infection by culture at the start of the investigation and at some stages during the follow-up. RESULTS: No progression of atrophy was observed in 14 patients who were H. pylori-negative at the beginning of the follow-up, whereas various degrees of expansion of the atrophic area were found in 22% of 50 positive cases. Well differentiated mucosal cancer was diagnosed in four patients during the follow-up. These patients displayed moderate to severe atrophy. At the beginning of the follow-up, 50% of patients were H. pylori culture-positive, but all patients had H. pylori antibodies in their blood. CONCLUSIONS: The results support the view that H. pylori infection influences the development of atrophic gastritis and is related to the pathogenesis of gastric cancer.

Adult↗

PubMed1995

Endoscopic diagnosis of gastritis in relation to Helicobacter pylori infection and subjective symptoms.

The relationship between endoscopic findings associated with gastritis, Helicobacter pylori infection, and subjective symptoms was investigated to establish methods for a simple endoscopic diagnosis of gastritis. The subjects comprised 102 patients who had no localized lesions in the upper gastrointestinal tract. The proportion of anti-H. pylori IgG antibody (GAP IgG)-positive cases was 67% and that of culture-positive cases was 47%. The results of the present investigation showed that the histologic diagnosis of gastritis according to the Sydney System was definitely correlated with H. pylori infection as determined by both culture and serologic techniques. The endoscopic findings were categorized as either atropic changes (discoloration and/or transparency of vessels) or erosive changes (erosion). H. pylori infection was found to be related to atropic changes, whereas subjective symptoms correlated well with erosive changes. The results demonstrated the utility of categorizing endoscopic findings related to gastritis as either atropic changes, which are closely related to H. pylori infection, or erosive changes, the main cause of subjective symptoms.

Adult↗

PubMed1994

[Importance of Helicobacter pylori infection and pepsinogen titer in hemodialysis and renal transplantation patients in Japan].

Helicobacter pylori (Hp) infection is thought to play an important role in for the pathogenesis of atrophic gastritis and even gastric carcinoma. The ratio of Pepsinogen I/II (P I/II) also shows good correlation with atrophic gastritis and gastric ulcer. Since many hemodialysis (HD) and renal transplantation patients suffer from gastrointestinal problems, we investigated the importance of Hp infection and P I/II in these patients. Serum Hp IgG was measured by EIA. Pepsinogen titer was measured with antipepsinogen antibody-bearing beads and anti-pepsinogen antibody. Hp positive HD patients accounted for 50.7% of the subjects. Of the renal transplantation patients, 23.5% were positive with lower values than the HD patients. The value of P I/II in all patients with a high Hp positive titer also was low (under 3). In conclusion, serum IgG antibody to Hp and P I/II exhibit good correlation and both are useful for the diagnosis of atrophic gastritis in chronic renal failure.

Adult↗

PubMed1993

The relationship between endoscopic findings of gastric ulcer scar and ulcer relapse.

Regenerated mucosal patterns that appeared during the healing of chronic gastric ulcers were observed and assessed in detail by magnifying endoscopes. Three patterns of ulcer scarring were distinguished: Sa with central depression, Sb with a coarse regenerated mucosal pattern, and Sc with a fine mucosal pattern. From a study on the relationship between the depth of ulcer confirmed histologically and the endoscopic findings of the scar, a clear distinction could be made endoscopically between U1-IV scar with a well-demarcated scarring zone, U1-III scar with an unclear boundary, and U1-II scar without a distinct scar area. Scar patterns were also related to ulcer depth. Analysis of the relationship between an ulcer relapse and the scar pattern demonstrated that the ulcer relapse rate over a 2-year follow-up period was 84% in Sa, 33% in Sb, and 0% in Sc.

Adult↗

PubMed1993

[Helicobacter pylori and gastric cancer in view of relation to atrophy of background gastric mucosa].

To make clinical assessment regarding the role of Helicobacter pylori (H. pylori) in the occurrence of gastric cancer, we examined serological and microbiological positive rate of H. pylori and histological and endoscopic findings of atrophic gastritis of background mucosa in 149 gastric cancer patients, 136 gastric ulcer patients, 82 chronic gastritis cases and 46 normal control. Serological H. pylori positive rate examined using GAP-IgG in 43 gastric cancer patients was 95%, which was significantly higher than normal control (4%) but the same level as in chronic gastritis cases (87%) and gastric ulcer patients (93%). While, Microbiological H. pylori positive rate by culture was 62% in 149 gastric cancer, 7% in normal control, 74% in chronic gastritis and 80% in gastric ulcer. H. pylori infection and the degree of lymphocyte infiltration were significantly correlated and H. pylori was frequently detected in the cases with mild and moderate atrophic gastritis in all groups. No difference was observed in H. pylori positive rate between the well and poorly differentiated cancer cases; 96% and 94% by GAP-IgG, 57% and 66% by culture, respectively. As a conclusion, it was suspected that the relation between H. pylori infection and gastric cancer was indirect and associated with atrophic process of background mucosa.

Atrophy↗

PubMed1992

[Sequential MTX and 5-FU therapy of gastric cancer with systemic bone metastasis and disseminated intravascular coagulation].

UNLABELLED: Sequential therapy consisting of methotrexate (MTX) and 5-FU was performed together with the administration of heparin and FOY in 10 cases of gastric cancer with disseminated intravascular coagulation (DIC) causing systemic bone metastasis. The ages of the subjects ranged from 29 to 65 years (median: 49 years) with systemic bone metastasis and bone marrow carcinosis observed in all cases. Histological types consisted of 6 cases of poorly differentiated adenocarcinoma, 2 cases of signet-ring cell carcinoma, and one case each of mucocellular and tubular adenocarcinoma. Therapy consisted of intravenous injection of 30 mg-100 mg/m2 (one case, 20 mg) of MTX followed three hours later by intravenous injection of 600 mg/m2 of 5-FU weekly. Determination of DIC was made in accordance with the DIC diagnostic standards of the Ministry of Health and Welfare, and determination of tumor effectiveness was based on gastric cancer handling codes. RESULTS: PR was observed in 3 cases. Diffuse metastasis observed in the entire lung field disappeared in one case, while remarkable improvement was observed in systemic bone metastasis in scintigram findings for the other 2 cases. All 3 cases were able to be discharged. Reduction of DIC score and absence of pain were observed in 8 cases. Based on the above, aggressive implementation of this treatment method is suggested.

Adenocarcinoma↗

PubMed1992

[Magnifying endoscopic observation on the effect of a proton pump inhibitor on the healing process of gastric ulcer].

The effect of a proton pump inhibitor on the healing process of gastric ulcer was investigated through magnifying endoscopic observation of the regenerated mucosa. The findings were the same obtained as those by stereoscopic microscopic observation of the effect of conventional drugs. Namely, a structureless red area consisting of one layer of regenerated epithelium was the first to procede forward the ulcer base, and a radially arranged roughly striated pattern of regenerated mucosa, in which gastric glands were formed. The regenerated mucosa changed from a striated to a granular pattern. In a shallow ulcer, the ulcer scar showed a fine gastric mucosal pattern similar to that of the surrounding area. The strong inhibition of gastric acid secretion by a proton pump inhibitor is believed to raise no problems in the healing process of peptic ulcer. The magnifying endoscopic observation also disclosed that the protruding granulation disappeared gradually and changed to concave regenerated epithelium, suggesting that the ulcer base protrusion, which has been considered as an adverse effect of strong acid secretion inhibitors, has no influence on the healing of the ulcer.

Adenosine Triphosphatases↗

PubMed1990

Possible involvement of kinins in cardiovascular changes after alcohol intake.

Japanese healthy male subjects were divided into two groups, i.e., a normal aldehyde dehydrogenase (ALDH) group with a low Km isozyme of ALDH for acetaldehyde, and a deficient group without it. After intake of 0.4 g/kg alcohol, the deficient group showed high levels of blood acetaldehyde, facial flushing including an increased pulse rate and a fall in diastolic blood pressure, while the normal group did not manifest these changes. In the deficient group, the total kininogen concentration gradually decreased after alcohol intake due to a reduction in low molecular weight kininogen, and plasma prekallikrein remained unchanged. The normal group showed no significant changes in any of these values after alcohol intake. In an in vitro study with pooled plasma, the low concentrations of urinary kallikrein caused a decrease in the low molecular weight kininogen only. These results suggest that kinins released by acetaldehyde-induced activation of glandular kallikreins are associated with the changes in cardiovascular symptoms in deficient group which display flushing after alcohol intake.

Acetaldehyde↗

PubMed1989

Inhibitory effect of ethanol on endothelium-dependent vascular responsiveness.

The effect of ethanol was studied on the endothelium-dependent vascular responses in isolated rat aortic strips. Ethanol depressed the endothelium-dependent relaxation induced by acetylcholine and ATP but not that induced by the calcium ionophore, A23187. Endothelium-independent relaxation in response to sodium nitroprusside, a soluble guanylate cyclase activator, was not depressed by ethanol. On the other hand, ethanol significantly enhanced the contractile response to clonidine, an alpha 2-adrenoceptor agonist, in endothelium-intact strips and depressed it in endothelium-denuded strips. These results suggest that ethanol can inhibit endothelium-dependent relaxation by acting on endothelial cells but not on smooth muscle cells, and can also suppress an inhibitory effect of the endothelium on alpha 2-adrenoceptor-mediated vasoconstriction.

Acetylcholine↗

PubMed1988