Search PubMed⌕ Search

Biomedical subjects

S Hisamichi

Publications and source records attributed to S Hisamichi.

142 records · Page 8Linked to original sources

Early endoscopic features of stomach cancer and its mode of growth.

To establish the earliest sign of stomach cancer in endoscopy and to reveal the subsequent morphologic changes of the lesion, we studied retrospectively 41 cases of stomach cancer. The eariest sign consisted of redness, small polypoid lesions, flat mucosa with slight unevenness and small depressed lesions. There was no clear correlation between the observation period and the size of cancer lesion in cases of early stomach cancer. In cases of advanced cancer, however, the observation period correlated with the size of cancer lesion to a certain extent, and the correlation between the area of cancer (Y cm2) and the observation period (X months) gave a linear equation of Y = 0.68X-3.13.

Aged↗

Observations on benign gastric ulcer simulating gastric carcinoma.

We have re-evaluated over-diagnosed cases which were first diagnosed, pre-operatively, as gastric cancer yet later confirmed as benign lesion (excavated lesion, in particular) in the post-operative histological examination of resected stomachs. We have experienced a total number of 1,358 cases which, being detected through mass survey, were diagnosed as cancer and, consequently, operated upon. On the other hand, 61 benign cases were misdiagnosed as cancer, 28 cases being protruded lesions and 33 cases excavated lesions. Among the misdiagnosed cases of excavated lesions, 27 cases were gastric ulcers or their scars, the remaining 6 cases being gastritis or gastric erosion. In 22 out of 33 cases of misdiagnosis, the wrong diagnosis was made by relying solely upon X-ray and endoscopy. Even after the addition of cytology, there were still 9 cases of misdiagnosis. Since, however, biopsy was introduced, there have been only 2 cases of wrong diagnosis. We may safely say that through these findings the absolute necessity of biopsy for the attainment of an accurate diagnosis of early gastric cancer has been sufficiently attested.

Biopsy↗

Mass screening program for prostatic diseases with transrectal ultrasonotomography.

A special chair-type apparatus for transrectal ultrasonotomography was developed in our laboratory 3 years ago. We did a mass screening program for prostatic disease, using this equipment as the primary study in the system. The 132 apparently normal men evaluated ranged in age from 40 to 76 years (mean 55.0). The 48 patients suspected of having prostatic disease underwent secondary studies, consisting of the usual urological examinations. Prostatic disease was detected in 24 cases, including 18 cases of benign prostatic hyperplasia. Thus, the model program revealed an extraordinarily high prevalence of latent prostatic disease among apparently normal older men.

Adult↗

Barium enema examination using a remote controlled positive and negative contrast media inflator.

In a series of 30 patients, barium enema examination of the colon was performed via a remote controlled air and contrast media inflator. With this apparatus, introduction and elimination of air and barium into the colon can be accomplished at a freely adjustable rate of injection by remote control. Fluoroscopy time is significantly reduced and the operator is not exposed to radiation.

Adult↗

Mass gastric examinations of prisoners at Miyagi Prison in Japan.

Mass examinations of the stomach were carried out on 79 convicts over 40 years of age confined in the Miyagi Prison, Japan. Of the 79 subjects, 11.9% were found to need detailed examination of the stomach which disclosed gastric polyp in one case and scar from gastric ulceration in one. None was found to have carcinoma of the stomach. Complaints of symptoms were obviously more frequent with the convicts as compared with a control group. There was not, however, a significant depression in efficiency of this group examination by photofluorography, as compared with the usual gastric mass examination on general inhabitants.

Adult↗

Roentgenological and endoscopic findings of malignant lymphoma.

Roentgenological and endoscopic characteristics of malignant lymphoma of the stomach were studied referring to the gross pathological appearance of the tumors. Based on the results obtained, we classified malignant lymphoma of the stomach into four types, i.e., superficial, ulcer, polypoid and giant fold types.

Endoscopy↗

Evaluation of mass screening program for stomach cancer.

Particular method and program of mass survey examination of gastric cancer were introduced into Miyagi Prefecture and the results accumulated during the past 14 years are presented. During this period, 1,427 cases of gastric cancer (0.18%), as well as many cases of other diseases of the stomach and duodenum, were found by the mass survey. 450 cases were those of early cancer in which invasion of carcinoma was limited to the mucosa and submucosa. The ratio of surgically confirmed early cancer cases to all the stomach cancer cases was 36.4%. Almost in all cases of early stomach cancer there were neither complaints nor clinical symptoms; that is, they were the cases of so-called preclinical cancer of the stomach. The prognosis after surgery of early stomach cancer was remarkably favorable with a five-year survival rate over 90% and the death rate due to stomach cancer was actually decreased in the surveyed population.

Adult↗

Extraventricular lesions demonstrated by gastric photofluorographic study.

In a mass survey for diseases of the stomach with photofluography, lesions other than those of the stomach were studied in 85,040 subjects. Gastric lesions were detected in 2.17%, while other lesions were found in 1.97%, giving an approximately similar ratio. Duodenal lesions were found most frequently and in 1.47%, followed by intraabdominal calcification in 0.44%. Among duodenal lesions, duodenal ulcer was seen in 0.14%, and duodenal diverticulum in 0.34%. Among diseases with abdominal calcifications, calcification of lymph nodes was found most frequently and in 0.24%, followed by cholelithiasis in 0.085% and urolithiasis in 0.004%. Lower esophageal lesions were found in 0.05%, in which esophageal diverticulum was the most frequent and found in 0.034%.

Adult↗

Screening for gastric cancer.

Mass screening for gastric cancer in Japan has been conducted nationwide since 1960. The total number of examinees in 1985 amounted to 5,161,876 and 6,240 cases (0.12%) of gastric cancer were detected. Approximately half of these cases were early stage cancers. According to the studies of mass gastric screening in the Miyagi Prefecture, Japan, the sensitivity of the screening test by the indirect x-ray method was 82.4%, and the specificity was 77.2%. The positive predictive value was 1.78%. Recently, mortality from gastric cancer has been decreasing in Japan. Many studies have been carried out to investigate the relationship between the decreasing trend of mortality from cancer of the stomach and the effectiveness of mass gastric screening. From these studies and from time trend analyses of incidence and death rates, case-control studies, nonexperimental cohort studies, etc., it is believed that mass screening for gastric cancer is effective in reducing the death rate from cancer at this site.

Evaluation Studies as Topic↗

Clinical significance of nocturnal blood pressure monitoring.

Although there are certain technical problems in determining nocturnal BP by ambulatory BP monitoring, the information provided on nocturnal BP has possible clinical significance. Short-term BP variability, an elevated BP during sleep and amplitude and sleep of nocturnal BP decline might be responsible for cardiovascular mortality. Furthermore, circadian BP variation might also be responsible for cardiovascular morbidity and mortality. The nocturnal BP level, even in extreme dippers with diurnal hypertension, is equivalent to or higher than that in normotensive subjects. Antihypertensive effects of drugs with different pharmacologic properties positively correlate with basal ambulatory BP. Therefore, there is a critical BP level at which the antihypertensive effect disappears. The critical BP level for each drug is in normal BP range but not in the hypotensive range. Therefore, an antihypertensive regimen would be safe even in extreme-dipper hypertension without excessive nocturnal hypotension, and might even be beneficial because of the decreasing amplitude and speed of the nocturnal BP decline. We conclude that an antihypertensive drug regimen should control BP throughout a 24-h period regardless of circadian BP variation.

Antihypertensive Agents↗