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Biomedical subjects

S Asaki

Publications and source records attributed to S Asaki.

At least 55 records · Page 3Linked to original sources
PubMed1988

Endoscopic diagnosis and treatment of Dieulafoy's ulcer.

Dieulafoy's ulcer often develops unmanageable severe gastrointestinal hemorrhage and sometimes takes a fatal course. In the past surgical operations were considered to be the only life-saving measure for this lesion. Since 1979, 46 lesions of Dieulafoy's ulcer in 45 cases with active bleeding from exposed blood vessels were treated during emergency endoscopy by the hemostatic method of pure ethanol injection. Transient hemostasis was obtained in all cases. Rebleeding occurred in 5 cases (11%) and pure ethanol injection was performed again. Hemostasis was obtained in all cases, but one case again had rebleeding due to an overlooked Dieulafoy's ulcer located in the gastric fundus. Emergent surgical operation was performed in this case. No case required elective surgery and no deaths were attributed to bleeding. Our method achieved complete hemostasis at a rate of 98% (44 cases) for Dieulafoy's ulcer. The pure ethanol injection method is one of the most effective hemostatic methods for the Dieulafoy's ulcer.

Adult↗
PubMed1988

Efficacy of absolute ethanol injection for upper gastrointestinal massive bleedings with hemorrhagic shock.

We applied the absolute ethanol injection method in 182 cases of massive bleeding with hemorrhagic shock before the performance of emergency endoscopy in 627 cases of upper gastrointestinal bleeding at our department and five related institutions since June 1979. Following results were obtained: Temporary hemostasis could not be obtained in only 2 (1.1%) out of 182 cases; in the remaining 180 cases bleeding was ceased. Rebleeding was seen in 15 cases (8.2%) and new bleeding in 17 cases (9.3%). In 21 (66%) of these cases hemostasis was obtained again by the absolute ethanol injection method. Eight patients (4.4%) underwent emergency operation and 4 patients (2.2%) died from bleeding. The complete hemostasis was obtained in 170 cases (93.4%).

Adolescent↗
PubMed1987

Endoscopic findings of bleeding esophageal varices and experimental study.

It has been considered that the rupture of esophageal varices occurs with high incidences, and once bleeding occurs it sometimes cause fetal massive bleeding. However, from our experiences with the active application of emergency endoscopy, the incidence of bleeding from varix was unexpectedly low. From these results, we studied the rupture signs of esophageal varices in experiments on dogs and clinical cases. The actual rupture signs of varices were summarized as active bleeding, adhesion of fresh clot, mucosal protrusion in a conical shape and white discoloration of its top area and mucosal slight elevation and attachment of fibrin thrombi. Further studies, however, are required to determine whether there are any varicose bleedings which do not show the above rupture signs.

Adult↗
PubMed1987

Endocrine cells of gastric aberrant pancreas by PAP staining method.

Histopathological classification of gastric aberrant pancreas has been done by Heinrich's criteria. However in some case it was difficult to detect incomplete Langerhans' island consisting of several endocrine cells or a single endocrine cell by usual H-E staining. To identify the distribution of incomplete Langerhans' islands and endocrine cells, we applied an enzyme antibody method utilizing PAP method for 7 cases of gastric aberrant pancreas. It became easy to identify the endocrine cells such as single cell and islet cells by using the PAP method. In all 3 cases of aberrant pancreas classified as Heinrich type II and one of 2 case of type III, Langerhans' islands or endocrine small cell groups and single cells were found. The PAP staining method was useful to determine the Heinrich's classification of the aberrant pancreas.

Adult↗
PubMed1986

The effects of aging on physiological properties of fast and slow twitch motor units in the rat gastrocnemius.

The mechanical properties of individual motor units were studied in the medial gastrocnemius of old (26-30 months) rats anesthetized with urethane and chloralose. The data were compared with results from motor units in the same muscle of middle-aged (11-14 months) rats. In the old rats there was a significant increase in mean tetanic tension for type S (slow twitch) units, whereas there was a slight decrease for type F (fast twitch) units. Twitch contraction time after maximum post-tetanic potentiation was shortened in type F units, but not in type S units. Conduction velocity of motor axons decreased in both unit types, but more marked change was found in type F units. These findings suggest the differential effects of aging on type F and type S motoneurons.

Aging↗
PubMed1986

Utility of BID administration of cimetidine for gastric ulcer: a comparison with QID administration in a double blind manner.

The clinical efficacy of cimetidine for gastric ulcer was compared between the standard administration methods in Japan; 200 mg four times daily and 400 mg twice daily after breakfast and at bedtime in a double blind manner. It was found that the results obtained by 200 mg twice-daily administration were almost comparable to those obtained by the four-times-daily administration without statistically significant difference for healing rate, final global improvement in subjective and objective symptoms, incidence of adverse reactions and effects on laboratory tests. These findings resulted in that the twice-daily administration of cimetidine provides convenience for patients.

Adolescent↗
PubMed1986

New bioptic method for submucosal tumor of the gastrointestinal tract.

Biopsy for the submucosal tumor has not been established and it is extremely rare that tumor tissues are obtained by usual biopsy forceps except in cases showing ulceration. Moreover, tumor tissues from the ulcerated site often showed degeneration or necrosis, and are difficult for pathohistological diagnosis. In addition, the biopsies are often associated with bleeding. We have developed a new biopsy method. Briefly, a small amount of pure ethanol is injected topically into the surface of submucosal tumor to produce a small ulcer for biopsy, and several days later a biopsy specimen is obtained from the exposed tumor at the ulcer bottom. We performed this method for 12 lesions in 12 cases. In 64 of 100 bioptic specimens, tumor tissue was obtained and in all cases pathohistological diagnosis could be established. We believe this method will be important to determine the indication of endoscopic treatment or surgical operation, and for follow up observation.

Adult↗
PubMed1985

Multiinstitutional evaluation of local injection of absolute ethanol as the new hemostatic method for upper G-I tract bleeding.

Local injection of absolute ethanol was proven effective for hemostasis of gastrointestinal bleeding in our fundamental (Asaki et al. 1983a) and clinical (Asaki et al. 1983b) studies. The purpose of the present paper is to report the results obtained in 258 hemorrhagic foci in 152 unselected cases treated with this method at 6 major hospitals in the Tohoku area in Japan. Sixty (39%) of these 152 cases had shock symptoms due to hemorrhage. Gastric and duodenal ulcers were responsible for the hemorrhage in about 90% of the cases in which our method was applied to hemostasis. Eighty-nine (59%) of the 152 cases had some form of complications such as malignant tumors or liver cirrhosis. Hemorrhage due to postoperative stress ulcer after major surgeries including renal implantation or laryngectomy for resection of cancer was seen in 20 cases (13%). The condition of hemorrhage immediately before the treatment with our technique was classified as spouting hemorrhage for 8 foci (3%), pulsating hemorrhage for 22 foci (9%), adhesion of clot for 179 foci (69%), and hemorrhage from veins and capillaries for 49 foci (19%). In all of these cases temporary hemostasis was obtained. Rebleeding occurred in 17 cases (7%) including 5 cases in which hemostasis was successfully obtained by the repeated use of our method. In 4 of the 17 cases, in which repeated endoscopy was infeasible, emergency surgery was performed. In the remaining 8 lesions in 8 cases, new bleeding or rebleeding occurred more than 1 week after the initial hemostasis had been obtained. Six of these 8 cases died from rebleeding due to DIC syndrome. With our method complete hemostasis was obtained in 144 of 152 cases (95%) including 11 cases (7%) which underwent elective surgical operation.

Adolescent↗
PubMed1985

New trial of endoscopic treatment for gastric submucosal tumors.

Recently conservative treatment of gastric submucosal tumors is increasing in spite of the absence of definite criteria for histological diagnosis. We have developed a new method of endoscopical treatment of gastric submucosal tumors that have submucosographically intraluminal Pattern I or II, or partly intramural Pattern III. For such tumors with a maximum diameter less than 5 cm, Ist step: partial resection is carried out with the use of high-frequency electric currents, IInd step: for the residual tumor tissue, in vivo tissue solidification is undertaken by local injection of absolute ethanol to induce necrotic exfoliation of the tumor tissue and to prevent of hemorrhage.

Adult↗
PubMed1985

Diagnosis of submucosal tumors by injecting a water soluble contrast medium: diagnosis of extra-gastric tumors and gastric varices.

Extra-gastric compression caused tumescent lesions that are difficult to differentiate from gastric submucosal tumors, and gastric varices similar in appearance to circumscribed tumors were sometimes experienced clinically. Up to now, the differential diagnosis of these lesions has been done by the palpation through x-ray examination or the tactile test under endoscopic examination. Even by the recent use of the CT scan, the differential diagnosis still remains unsatisfactory except in a few specific cases. Under these present circumstances, submucosography is recommended for routine screening test for outpatients. Our method is simple, safe and time-saving. Recently, it has become easy to diagnose hemangiomas as well as varices in the stomach by application of submucosography. Accordingly, in the cases of vascular tumors or tumescent lesions caused by extra-gastric compression, the risk of incidental major bleeding or perforation can be prevented by using the submucosography.

Adult↗
PubMed1985

Diagnosis of the depth of cancer invasion by submucosography.

A new method was developed to diagnose the depth of cancer invasion using submucosography combined with special charcoal suspension containing mitomycin C, and applied to 8 cases of gastric cancer. Correct diagnosis of the depth of the cancer invasion was obtained in 7 of the 8 cases. As some cases of early gastric cancer can be treated endoscopically, it is important to know the condition of the invasion before any treatment is performed.

Aged↗