Pancreatic carcinoma difficult to differentiate from duodenal carcinoma.
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Biomedical subjects
Publications and source records attributed to T Kasugai.
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The stimulating effect of AOC-tetragastrin, caerulein, Histalog and secretin on human gastric acid and pepsin secretion was studied in gastric ulcer patients. The pattern of gastric acid and pepsin secretion after the administration of caerulein was closely resembled to that of gastrin. Slight increase of pepsin secretion after gastrin or caerulein could be based on "wash-out" action caused by the increase of acid secretion after the stimulants. Stimulating effect on gastric pepsin secretion of histalog and secretin would be independent of gastric acid secretion.
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The results of direct vision biopsy and cytology for the diagnosis of early gastric cancer during the periods from 1964 to 1969 and from 1970 to 1974 were compared. From 1964 to 1969 the diagnostic accuracy of gastric biopsy was 94.7% at the initial examination and 97.3% in the final diagnosis, while washing cytology under direct vision gave a diagnostic accuracy of 83.0% at the first washing and 93.3% in the final cytologic diagnosis. Because of such a high yield of gastric biopsy, it was the procedure of the first choice from 1970 to 1974, giving a diagnostic accuracy of 96.7% at the initial examination and 99.4% in the final biopsy diagnosis with only one suspicious case. The cytologic examination by brushing has, therefore, become supplementary to biopsy in cases where a stenosis proximal to a tumor obscures the definitive tissue.
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A case of tuberculosis of the esophagus is presented in a patient with pulmonary tuberculosis. The patient, complaining of dysphagia, had esophagoscopic examination which showed a submucosal tumor with central ulceration. Tissue biopsy, under direct vision from the tumor mass, confirmed the diagnosis of tuberculosis. The patient has been asymptomatic under treatment. Both esophageal and pulmonary lesions are largely improved.
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Endoscopic retrograde cholangiopancreatography can become a safe and easy procedure by means of sterilization of the instruments. Administration of antibiotics or chemotherapeutic agents, both systemically and mixed with the contrast material, and measurement and control of the injection pressure of the contrast medium using a manometer are employed to achieve as aseptic an operation as possible. For diagnosis of pancreatic cancer in its early stage, as well as diagnosis of minimal and moderate chronic pancreatitis, opacification should extend into not only the main pancreatic duct, but also branches of the pancreatic duct and fine pancreatic ducts. The procedure is one of the most reliable methods for the detection of diseases of pancreatic and biliary systems, especially for the diagnosis of space-occupying lesions such as malignant tumors, and chronic inflammatory changes of the pancreas, as well as differential diagnosis in jaundiced patients.
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