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Biomedical subjects

S Harasawa

Publications and source records attributed to S Harasawa.

At least 73 records · Page 4Linked to original sources

Gastric acid secretion and plasma gastrin response to test meal in patients with gastric cancer.

Gastric acid secretion and plasma gastrin response to test meals were examined in 110 patients with gastric cancer and a comparative study was made in accordance with depth of invasion, macroscopic shape, histological type, location and size of the lesion. Cases were classified into two large groups by the depth of invasion: early cancer (invasion was limited to the mucosa and submucosa) and advanced cancer (invasion reached the muscularis propria or deeper). Patients showed hypoacidity on the whole. Cases of early cancer showed significantly higher acid secretion than cases of advanced cancer, although no significant differences were observed in gastrin release. Among the cases of early cancer, cases of the elevated shape showed significantly lower acid secretion and higher gastrin release than cases of the depressed shape, and cases of the histologically differentiated type showed significantly higher acid secretion than cases of the undifferentiated type although no significant differences were observed in gastrin release. Among the cases of advanced cancer, cases with large carcinomas in the corpus tended to show low acid secretion and cases with large carcinomas in the antrum tended to show low gastrin release. High gastrin release was observed in cases of the Borrmann IV type with giant folds.

Aged↗

Relation between esophagogastric junction and esophageal function in patients with reflux esophagitis.

The relationship between the esophagogastric junction (Z-line pattern) and the functions of the esophagus was studied in patients with reflux esophagitis. We classified Z-line patterns as the Z0- type to Z4-type, depending on the shape and the level of the Z-line. Lower esophageal sphincter pressure (LESP) was measured by the open-tip infusion method and the acid clearance test was performed by Booth's method (15 ml of 0.1 HCL). The following results were obtained: 1. LESP was 15.5 +/- 5.6 cmH2O (M +/- SD) in normal subjects (Z0-type), it was 10.3 +/- 2.9 cmH2O in the Z1-type, 9.5 +/- 4.9 cmH2O in the Z2-type, 9.4 +/- 4.1 cmH2O in the Z3-type and 7.6 +/- 3.4 cmH2O in the Z4-type. There were statistically significant differences between the Z0-type and the other Z-line patterns (p less than 0.05, P less than 0.05, P less than 0.025, and P less than 0.025, respectively). 2. Acid clearance was expressed as the time until the pH returned to 5.0 due to swallowing at one-minute intervals. The results of the acid clearance test were 11.4 +/- 3.0 min in the Z0-type 18.3 +/- 7.0 min in The Z1-type, 20.3 +/- 5.6 min in the Z2-type, 24.1 +/- 5.7 min in the Z3-type and 24.5 +/- 7.4 min in the Z4-type. Acid clearances were significantly delayed along with the Z-line pattern (P less than 0.025, P less than 0.005 and P less than 0.005, respectively). 3. The patients with hiatal hernia consisted of five cases of the Z3-type and six cases of Z4-type. They had low LESP and delayed acid clearance. As mentioned above, the results of LESP ad acid clearance test were well correlated with Z-line patterns in patients with reflux esophagitis.

Aged↗

[Secretin].

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Duodenal Ulcer↗

Epidemio-hygieological aspects of gastric neoplasms in aged patients.

A 100-year-old male who died of gastric carcinoma was discussed and illustrated epidemiohygieologically. According to dynamic population statistics of the Health and Welfare Ministry of Japan, 418 persons over the age of 100 years died in 1979. Among them, 157 (38%) died of cardiovascular diseases and 49 (12%) died of pulmonary diseases, but only six died of neoplasms including two with gastric carcinomas (0.48%). To our knowledge no such case has been reported previously in the literature.

Adenocarcinoma↗

Gastric emptying in patients with gastric ulcers--effects of oral and intramuscular administration of anticholinergic drug.

In our previous report on gastric emptying, we noted that delayed gastric emptying might be one of the etiological factors of gastric ulcers. Gastric emptying was measured using the acetaminophen method. The gastric emptying value was indicated as "microgram/ml", the acetaminophen concentration 45 min after test meal ingestion. In this study, the effects of an anticholinergic drug on gastric emptying were investigated in gastric ulcer patients. Oral and intramuscular administrations of butropium bromide (BB) were studied. The following results were obtained; 1. Oral administration of 10 and 15 mg of BB accelerated gastric emptying to a statistically significant degree (p less than 0.05), compared with the placebo in delayed gastric emptying cases in a dose-dependent manner (r = 0.978). 2. Intramuscular administration of small doses of BB (0.25 and 0.5 mg) also accelerated gastric emptying in delayed gastric emptying cases, but in general, intramuscular administration of BB (0.25-2.0 mg/person) inhibited gastric emptying in a dose dependent manner (r = -0.999). 3. Intramuscular administration of BB (0.25-2.0 mg/person) inhibited gastric emptying in a dose dependent manner in rapid gastric emptying cases (r = -0.977).

Acetaminophen↗

The coexistence of gastric cancer and duodenal ulcers.

The records of 356 gastric carcinoma patients who were treated surgically were reviewed. Among them, six patients (1.7%) had duodenal ulcers. Five cancers of the six patients were "early" gastric cancers classified as type "IIc" or "IIc + III" according to "The general rules for the gastric cancer study in surgery and pathology". The cancers of the six patients were located in the lower half of the stomach. Gastric secretion activity was normal in four and above normal in two cases. Three had signet ring cell carcinomas, two had poorly differentiated adenocarcinomas and one had a well differentiated adinocarcinoma. Our results were similar to other results reported in many papers. In Japan gastric carcinomas coexisting with duodenal ulcers were more often confirmed in the "early" gastric cancer stage. This is probably because endoscopic examinations of the stomach were more often performed in Japan than in other countries because of te large number of gastric disease patients. In addition, it is assumed that the growth of gastric cancer in the stomach is slow because of the very active gastric secretion.

Adenocarcinoma↗

The effect of test meals on the PED test.

The effects of test meals on the PFD (pancreatic function diagnostant) test, which was introduced as "the B.T.PABA test" in the previous reports, were studied. The higher the protein in the test meal, the lower the urinary excretion value of p-aminobenzoic acid (PABA) and the first 3-h of PABA excretion. By using a test meal containing protein, the differences in digestion-absorption disorders between gastrectomy procedures (Billroth I and Billroth II) were clarified. Therefore, a test meal which contains a suitable amount of protein should be used in the PFD test to improve diagnostic accuracy.

4-Aminobenzoic Acid↗

Hematemesis and Melena: gastritis.

The records of a total of 60 gastritis patients who showed hematemesis and/or melena are reviewed. The mean age was 40. The ratio of males to females was two to one. During the examination, 19 upper G-I lesions were confirmed in addition to gastritis. Sixteen patients had severe underlying diseases which were thought to be the cause of the bleeding tendency. Thirteen patients took alcohol or drugs which induced bleeding. Prognoses of the patients were relatively good when they were treated medically.

Adolescent↗

The PFD test for pancreatic disease patients.

The PFD test was performed on various pancreatic disease patients. The urinary PABA excretion rate was significantly lower in chronic pancreatitis patients and in pancreatic carcinoma patients than in the controls, but no difference was observed between PABA excretion in the two diseases. After surgery, PABA excretion values of pancreatic carcinoma patients were significantly lower than those of non-pancreatitis non-pancreatic carcinoma patients. This was thought to be caused by the difference in residual anastomosed pancreatic tissues. Mild to severe pancreatitis, fibrosis and/or fat necrosis were seen in the pancreatic tissues of carcinoma patients, but these changes were minimal in non-pancreatitis non-pancreatic carcinoma patients. The PFD test is useful in detecting decreases in pancreatic exocrine functions or measuring the grade of pancreatic disorders in various pancreatic diseases, although it can not be used to differentiate pancreatic diseases.

4-Aminobenzoic Acid↗

Lesions of the upper gastrointestinal tract in patients with chronic renal failure.

Endoscopy of the upper gastrointestinal tract was performed on 84 patients with end-stage chronic renal failure undergoing hemodialysis. Gastric acid secretion and fasting plasma gastrin levels were also examined in these patients. Hemorrhagic gastritis was most frequently observed (23 cases) followed by erosive gastritis (18 cases). No patients had gastric ulcers. Duodenal ulcers were observed in only two patients. Gastrointestinal bleeding was observed in 15 cases (17.9%). Thirteen of these 15 cases had hemorrhagic gastritis, one of which had a duodenal ulcer as a complication. Fasting plasma gastrin levels (359.6 +/- 336.5 pg/ml) were significantly higher than those of normal subjects (35.2 +/- 37.1 pg/ml), but no acceleration in gastric acid secretion was observed either in the basal condition (BAO 0.8 +/- 0.7 mEq/h) or following tetragastrin stimulation (MAO 9.0 +/- 6.9 mEq/h). Our results were inconsistent with the previous reports that high frequencies of peptic ulcers and increased gastric acid secretion were observed in patients with chronic renal failure. Our data suggest that the defensive factors rather than the aggressive factors of the gastroduodenal mucosa may be involved in chronic renal failure.

Adolescent↗

[Practice of endoscopy].

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Cholangiopancreatography, Endoscopic Retrograde↗

B.T.PABA test: a new absorption test.

B.T.PABA has been evaluated as a new pancreatic exocrine function diagnostant. In this study, it was used as a new absorption test. After ingestion of 1 gm of B.T.PABA and the test meal, PABA in 6-h collected urine was determined. The urinary PABA excretion rate in Billroth I type postgastrectomy patients, 8-14 days after surgery, was lower than that of controls and that in Billroth II patients, 10-14 days after surgery, was the lowest of the three. However, the PABA excretion values of postgastrectomy patients 10 months to 20 years after surgery recovered nearly to the normal level of PABA excretion. These decreases in PABA excretion were considered to be caused by postgastrectomy digestion-absorption impairment. In addition, there was a significantly high correlation between the conventional 131I-labeled albumin absorption test and the B.T.PABA test. Therefore, it was concluded that the B.T.PABA test can be used as a simple absorption test.

4-Aminobenzoic Acid↗

Hematemesis and melena: Endoscopic examination.

Today, gastrointestinal endoscopy has become a routine examination. In our "Endoscopy center", about five hundred gastroscopies are performed every month. It has been said in many reports that endoscopy, especially emergency endoscopy, is an effective method of discovering sources of bleeding. In this report, we also emphasize that emergency endoscopy is effective in diagnosing upper gastrointestinal bleeding on the basis of reviewing 318 endoscopic examinations.

Adolescent↗

Hematemesis and melena: Mallory-Weiss syndrome.

The records of 29 patients with Mallory-Weiss tears diagnosed by endoscopy are reviewed. Ingestion of alcohol was a chief cause of bleeding. Single tears were the largest in number and 68% of the lacerations were seen just distal to the esophago-cardial junction. Lacerations occurred more frequently on the right lateral wall of cardia than on the left lateral wall. Most of these lesions were mild and could be treated medically except for two cases which were surgically treated.

Adolescent↗

Hematemesis and melena: gastric ulcer.

Differences in distribution of age, hemoglobin values, location and number of ulcers, activities of gastric secretion, associated conditions, treatment and prognoses between bleeding and non-bleeding gastric ulcer patients were studied. The ages of bleeding patients were distributed more widely than those of non-bleeding patients and the number of patients over 70 years of age was greater in bleeding patients than in non-bleeding patients. Associated conditions of bleeding patients were more serious than those of non-bleeding patients and some bleeding patients showed coagulation disorders. Fifteen out of 17 bleeding patients were treated and well controlled surgically, and seven out of 62 bleeding patients who were treated medically died. In this study, the exact cause which made the difference between bleeding ulcers and non-bleeding ulcers could not be found. Bleeding ulcer patients with associated conditions did not always die directly from bleeding, but the bleeding decreased their general condition and, as a result, they died. Therefore, surgical treatment is the first choice in these patients if their conditions will tolerate such treatment.

Adult↗