Endosonographic features of a calcified mucinous gastric carcinoma.
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Adenocarcinoma, Mucinous↗
Biomedical subjects
T Okai
Publications and source records attributed to T Okai.
Endoscopic ultrasonography as a guide to strip biopsy removal of esophageal submucosal tumors.
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Adult↗
Comparison of lansoprazole and famotidine for gastric ulcer by endoscopic ultrasonography: a preliminary trial.
To compare the efficacy of lansoprazole and famotidine in the treatment of gastric ulcer, 24 patients with gastric ulcer were treated for 8 weeks. They were assessed by endoscopic ultrasonography (EUS), which provides cross-sectional images of the gastric wall as well as endoscopic images. Patients were randomly assigned to receive either lansoprazole 30 mg once daily (n = 12), or famotidine 20 mg twice daily (n = 12). The healing rate after 4 weeks of treatment was 80% in the lansoprazole group and 40% in the famotidine group. After 8 weeks of treatment, the respective healing rates were 100 and 72.7%. Healing to Sakita's S2 stage of scarring occurred significantly more often in the lansoprazole group than in the famotidine group after 4 weeks (50% vs. 0%; p < 0.05). After 4 weeks of treatment, the submucosal fibrous tissues detected by EUS were significantly less extensive in the lansoprazole-treated patients with deep ulcers (reaching the muscle layer or serosa) than in the famotidine-treated patients with deep ulcers (p < 0.01). These results suggest that lansoprazole may be more effective in ulcer healing than famotidine, particularly in patients with deep gastric ulcers.
2-Pyridinylmethylsulfinylbenzimidazoles↗
Histochemical demonstration of interleukin-2 in decidua cells of patients with preeclampsia.
PROBLEM: The objective of this study was to gain insight into the immunological aspects of preeclampsia. METHOD: The presence of interleukin-2 (IL-2) protein in the decidua was examined in five preeclamptic patients and seven normal pregnant women employing the immunohistochemistry. RESULTS: The decidua cells were strongly stained for IL-2 in four out of five preeclamptic patients, while only very weak, if any, staining was observed in all the uncomplicated pregnant women. CONCLUSIONS: IL-2 was clearly present in decidua cells in the preeclamptic setting, suggesting the possible involvement of immune-activation in the phathophysiology of preeclampsia.
Adult↗
Effect of liu-junzi-tang on the symptom of bitter taste in patients with chronic gastritis.
A symptom of bitter taste was found in 15 out of 82 patients with chronic gastritis that was diagnosed from symptoms and endoscopic findings. Liu-junzi-tang was very effective in 12 (80%) of the 15 patients. The symptom of bitter taste completely disappeared in 24.7 days on average after oral administration of Liu-junzi-tang in these 12 patients. In the remaining 3 patients, the symptom of bitter taste did not completely disappear, but was improved. Other symptoms associated with chronic gastritis and endoscopic findings were also improved in these patients. These findings indicate that Liu-junzi-tang may be a good remedy for the symptom of bitter taste in patients with chronic gastritis.
Adult↗
Endoscopic therapy for early gastric cancer. Utility of endosonography and evaluation of prognosis.
We analyzed 30 endoscopically treated patients with early gastric cancer in terms of the utility of endoscopic ultrasonography (EUS) and the evaluation of prognosis. Endoscopic therapy for early gastric cancer included strip biopsy, laser irradiation, and OK-432 injection. Examination of the depth of cancer invasion in the strip biopsy specimens showed that the diagnostic accuracy of EUS was 85.7%. Complete resection rate in strip biopsy was 82.8%, and the patients with incompletely resected cancer were successfully treated with laser irradiation and/or OK432 injection. The prognosis of the patients treated with strip biopsy was good. Three patients died of causes other than gastric cancer. Local recurrence and a heterochronous new lesion developed in six patients, but all of these cases were successfully treated with additional strip biopsy. All but one patient treated with laser irradiation and/or OK 432 injection survived during the study period. These results suggest that EUS is useful in determining the indication of endoscopic therapies and that prognosis is good in patients with early gastric cancer treated endoscopically.
Aged↗
[Mutation of the K-ras oncogene in pancreatic carcinoma, and application of its detection in pancreatic juice to diagnose pancreatic carcinoma].
The incidence of the point mutation of K-ras oncogene at codon 12 in surgical or autopsy specimens of pancreatic carcinoma (PC) is reportedly extremely high ranging from 75 to over 90%, and the K-ras mutation found in PC is almost exclusively present in codon 12. The GGT to GAT transition of the 12th codon is observed in more than 50% of PC of Japanese patients, although the incidences of transition of GGT to CGT, GTT, and GAT are essentially equal in PC of European countries. With this point in mind, the authors attempted to detect K-ras mutations in DNA obtained from pancreatic juice (PJ) collected endoscopically. K-ras mutations at codon 12 were found in 55% of 20 PC patients by PCR and ASO probe hybridization method, and in 80% of 25 PC patients by PCR-RFLP method. On the other hand, K-ras mutations were negative in PJ from chronic pancreatitis with one exception by PCR-RFLP method. Other authors also reported almost the same results. These results suggest that analysis of K-ras oncogene in PJ can be useful for qualitative diagnosis of PC, and would be expected as a novel tool for early detection of PC.
DNA, Neoplasm↗
Serum levels of c-erbB-2 protein in digestive diseases.
The clinical significance of the measurement of c-erbB-2 oncogene product was evaluated. The subjects consisted of 404 patients, including 248 with cancer of the digestive organs and 128 with benign digestive diseases. Serum c-erbB-2 protein levels were measured by sandwich immunoenzyme assay. The positive rates of c-erbB-2 protein, at a cut-off value of 17.0 U/ml, were, for cancers: hepatocellular carcinoma 61.6%, biliary tract cancer 54.8%, pancreatic cancer 25.0%, esophageal cancer 33.3%, gastric cancer 16.9%, and colorectal cancer 5.0%. For benign digestive diseases, the rates were: liver cirrhosis 63.3%, chronic hepatitis 43.2%, acute hepatitis 42.9%, other liver diseases 42.8%, cholelithiasis 30.0%, and chronic pancreatitis 0%. Serum c-erbB-2 protein levels were significantly correlated with the markers of hepatic functional reserve, the indocyanine green retention rate and the hepaplastin test. These findings suggest that serum c-erbB-2 protein levels are greatly influenced by liver dysfunction and that their clinical usefulness as a serum tumor marker is questionable.
Adult↗
Measurement of sialylated stage-specific embryonic antigen-1 in pure pancreatic juice for the diagnosis of pancreatic cancer.
The diagnostic significance of measuring sialylated stage-specific embryonic antigen-1 (SLX) in pure pancreatic juice was evaluated in 20 patients with pancreatic cancer, 43 with chronic pancreatitis, 13 with cholecystolithiasis, and 15 control individuals. Four fractions of pure pancreatic juice were collected sequentially from the pancreatic duct by endoscopic cannulation. The SLX levels in all four fractions of pure pancreatic juice were significantly higher in patients with pancreatic cancer than in controls. On the other hand, patients with chronic pancreatitis or cholecystolithiasis did not have SLX levels that significantly differed from those of controls in any fraction. When the cut-off value was set as the mean concentration +2 times the standard deviation of the control values, the positive rates of SLX in the first fraction (washout phase) and the third fraction (secretory phase) of pure pancreatic juice from pancreatic cancer were 55% (11/20) and 40% (8/20), respectively. Although the false positive rates in the first fraction were high in chronic pancreatitis (30%) and cholecystolithiasis (31%), such high SLX levels in the third fraction were found only in one (2%) patient with chronic pancreatitis and in one (8%) with cholecystolithiasis. The specificities of the test for pancreatic cancer in the first fraction and the third fraction were 70% (39/56) and 96% (54/56), respectively. These results indicate that the measurement of SLX in the third fraction of pure pancreatic juice is useful as a specific marker for pancreatic cancer.
Chronic Disease↗
Transvaginal sonographic appearance of hemorrhagic functional ovarian cysts and their spontaneous regression.
OBJECTIVES: To obtain information on the characteristic feature of transvaginal sonograms of hemorrhagic functional ovarian cysts (HFOCs) and their natural course. METHODS: Thirty-four cases of suspected HFOC based on our tentative criteria were ultrasonically followed-up for 3 months. After the study period, the sonographic findings and their changes with time were analyzed. RESULTS: Twenty-four cases were clinically diagnosed as HFOCs, as the masses disappeared naturally. At the first examination, 5 cases (20.8%) showed a diffuse echogenic pattern which seems to consist of a blood clot, 9 (37.5%) were mixed pattern with a clearly demarcated solid part, 3 (12.5%) were hyperechoic sponge-like reticular pattern and 7 (29.2%) were cysts including vague echo inside which looked cotton-like. Seven masses (29.2%) disappeared within 2 weeks and the remaining had a different sonographic appearance with time until they disappeared finally within 8 weeks. CONCLUSIONS: HFOCs show the characteristic changes in transvaginal sonographic appearance and can be diagnosed by short-term follow-up.
Female↗
Endoscopic ultrasonography in the diagnosis of extraluminal compressions mimicking gastric submucosal tumors.
We evaluated the diagnostic usefulness of endoscopic ultrasonography (EUS) in 19 patients with extragastric compression. In these 19 cases, the causes of the compression were normal organs or structures in 16 cases (splenic artery 7, spleen 5, normal pancreas two, gall-bladder one, colon one) and extraluminal tumors in three cases (two hepatic hemangiomas, one neurogenic tumor of the omentum minor). In 12 of these 19 cases, the site of the submucosal compression was located in the upper part of the stomach. All three tumors were confirmed by other procedures, and in the remaining 16 patients with compression by normal organs or structures, negative follow-up results (mean: 14 months) supported the absence of a true submucosal tumor. EUS was 100% accurate in the differentiation of an extragastric compression from a submucosal tumor, and in the identification of the compressing organ. EUS was also far superior to other procedures, such as ultrasonography and CT. It significantly shortens the diagnostic procedure, especially in patients with compressions by normal extraluminal structures, making other diagnostic modalities unnecessary.
Adult↗
Interferon-induced pancreatic injury.
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Aged↗
Congenital diaphragmatic hernia treated by perinatal stabilization.
The delay of surgery in conjunction with high-frequency oscillation ventilation combined with preoperative stabilization is a standard treatment for congenital diaphragmatic hernia neonates in the high-risk group. A new protocol of perinatal stabilization with this preoperative stabilization has been developed at the University of Tokyo Hospital. The most important components of this method of perinatal stabilization are cesarean section and the injection of morphine and pancuronium through the umbilical vein prior to ligation of the umbilical cord. In order to benefit from this treatment, congenital diaphragmatic hernia patients should be diagnosed antenatally by ultrasonography and be delivered by cesarean section. This protocol of perinatal stabilization appears effective in congenital diaphragmatic hernia patients.
Fatal Outcome↗
Long-term follow-up of mitomycin C nephropathy.
Two cases of mitomycin C nephropathy, which occurred after postoperative chemotherapy for advanced gastric cancer, were followed up for 6 (case 1) and 10 years (case 2). Hemolytic uremic syndrome developed 68 days (case 1) and 160 days (case 2) after the last administration of MMC with a total dose of 60 mg (case 1) and 40 mg (case 2). Serum creatinine levels were normalized in case 1 and they remained at about 2 mg/dl in case 2. Hyporeninemic hypoaldosteronism was transiently seen in case 2. These data suggest that recovery from the acute phase of hemolytic uremic syndrome leads to a good long-term prognosis in MMC nephropathy.
Hemolytic-Uremic Syndrome↗
Rapidly progressive pulmonary alveolar proteinosis in a patient with chronic myelogenous leukemia.
A 46-year-old man with chronic myelogenous leukemia (CML) was admitted to our hospital because of high fever. The chest radiographs showed bilateral groundglass-like infiltrates in the perihilar region. Transbronchial lung biopsy (TBLB) and autopsy revealed PAS-positive granular materials characteristic of pulmonary alveolar proteinosis (PAP). He had received interferon-alpha since the time of CML diagnosis. Busulfan had never been administered. Altered cell-mediated immunity was thought to be closely related to the development of PAP.
Disease Progression↗
[Perinatal outcome of pregnancies following therapy of infertility].
To evaluate the risks involved in post infertility pregnancy, the perinatal outcomes of 571 patients with infertility treatment in 9 institutions were analyzed by questionnaire retrospectively. The rate of multiple pregnancy and premature delivery was 14.5% (83/571) and 13.3% (76/571) respectively. Multiple pregnancies occurred in 33 cases with ovulation induction, 22 cases with artificial insemination by the husband (AIH) and 25 cases with in-vitro fertilization by embryo transfer (IVF). Premature deliveries occurred in 32 cases with ovulation induction. 26 cases with AIH and 14 cases with IVF. Three babies were dead and 4 babies were handicapped. In single post infertility pregnancy, the rate of premature birth was twice as high (9.0%) as in normal controls. The mortality rate was 0.45% (2/449), which was higher than that of controls. This suggests that post infertility pregnancies tend to result in multiple pregnancy and premature birth. In addition, in single post infertility pregnancies there was the possibility of poor perinatal outcome.
Adult↗
[Clinical usefulness of tumor markers associated with pancreatic cancer].
Most of the recently developed tumor antigens detected by monoclonal antibodies are sugar chains and frequently associated with blood group substance. By immunohistochemical studies, we evaluated mainly the clinical usefulness and significance of the serum assay of CA-50 classified as a type 1 sugar chain, sialyl SSEA-1 as a type 2 sugar chain, and ST-439 with an undetermined structure, as well as their clinicopathological significance. In addition, the value of measurement of CA19-9, ST-439, and SLX in pure pancreatic juice (PPJ) was investigated. Furthermore, the clinical usefulness of K-ras mutation at codon 12 (KRM) in PPJ was studied. The incidence of serum CA19-9 among tumor markers was highest in pancreatic cancer (81%), but relatively high in benign diseases. On the other hand, both serological and immunohistological studies showed that sialyl SSEA-1 and ST-439 were highly specific for the tumor, whereas they appeared in serum or tumor less frequently than CA19-9 or CA-50 carrying the type 1 sugar chain. The accuracy of the tumor markers (CA19-9, sialyl SSEA-1, and ST-439) for pancreatic cancer, was almost equal (77% to 80%) and higher than that of CEA (69%). However, a highly positive correlation between sialyl SSEA-1 and ST-439 was revealed as well as among type 1 sugar chains in malignant diseases. Therefore, we conclude that the combination assay with CA19-9 or a similar tumor marker, sialyl SSEA-1 or ST-439, and CEA would be appropriate for the screening of pancreatic cancer. When the cut off value was set as the M + 2SD of the controls, significantly elevated concentrations of CA19-9 in PPJ were found in the secretory phase in 90% of the patients with pancreatic cancer (PC) and 66% of the patients with chronic pancreatitis (CP). Although increased concentrations of CA19-9 in PPJ have no cancer specificity, measurement of CA19-9 in PPJ can be used as a sensitive marker for some pancreatic disorders. On the other hand, concentrations of ST-439 and SLX in PPJ were significantly increased only in PC, and their incidences were 50% and 40%, respectively. They have a high tumor-specificity, but their incidences were not as high as initially expected.(ABSTRACT TRUNCATED AT 400 WORDS)
Antigens, Tumor-Associated, Carbohydrate↗
[Advanced system for real-time fetal breathing movements tracking using pulsed Doppler ultrasound].
Utilization of the fetal behavioral information in clinical medicine requires the development of an automated monitoring technique. As previously reported, the off-line signal processing of the low frequency Doppler signals by high accuracy displacement estimation made it possible to measure fetal breathing movements (FBM). However, there were several problems to solve before clinical application. We propose an advanced system that provides real-time calculation. The multi-channel pulsed doppler device was newly developed by modifying the Doppler ultrasound module of the cardiotocograph (CTG). A new signal processing algorithm was designed to produce real-time measurements. To improve the resolution, the backing module was attached to the probe. On-line signal processing produced a successful real-time and continuous calculation of displacement inside tissue. By means of an on-line 2/3 Hz high pass filter, the very low frequency noises and the artifacts derived from maternal respiration etc. were removed. The signal/noise ratio was obviously increased and the waves of fetal tissue movements due to FBM were easily recognized in real-time LCD outputs. Although there is a limitation in measuring accuracy as far as using modified CTG units, the results demonstrate that our system has commendable quality in FBM tracking.
Computer Systems↗