[Natural history and cancerous transformation of gastrointestinal polyps].
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Cell Transformation, Neoplastic↗
Biomedical subjects
T Yao
Publications and source records attributed to T Yao.
The postoperative recurrence of Crohn's disease: an analysis of 37 patients with Crohn's disease who underwent endoscopy during initial surgery.
A total 37 patients with Crohn's disease who underwent intraoperative endoscopy during resection of the affected intestine were evaluated in this study. The average age of the patients at surgery was 23.2 years. The residual lesions in the remaining intestine identified by intraoperative endoscopy were classified according to their pathologic profiles into three groups: A, B and C. In group A, comprising patients with longitudinal ulcers and/or a cobblestone appearance, 10 of 12 patients had recurrence. In 5 of these 10, the residual lesions were exacerbated and 2 required a further operation. The remaining 5 patients showed recurrence at the site of previous anastomosis and 2 of these 5 required additional surgery. In group B, comprising patients with small ulcers, aphthoid ulcers, or scars, and group C, comprising patients with no residual lesions, recurrence was observed in 13 of 16, and 3 of 9 patients, respectively. The recurrent lesions were all found proximal to, or at the site of previous anastomosis. Additional operations were performed on 3 of the group B patients. The findings of this study revealed that recurrence requiring additional surgery is more frequent at the site of anastomosis, regardless of the endoscopic appearance of the residual lesions.
Adolescent↗
Radiographic features in ischemic jejunoileitis: serial changes and comparison with pathologic findings.
Serial radiographic examinations of the small intestine, including double-contrast studies, were performed in 13 patients with ischemic jejunoileitis, nine with the stricturing form and four with the transient form. Thumbprinting was observed in five (38%) patients and thickening of the folds in four (31%) at the acute stage of the disease. Tubular narrowing with irregular contours and dilated proximal bowel was observed in six (46%) patients and appeared on day 27 or later. Pathologic findings of the resected specimen in eight patients with the stricturing form revealed annular stricture with relatively shallow ulcers; the irregular contours of the tubular narrowing on radiographs were consistent with a granular or nodular appearance and/or multiple fissures on pathologic study. Eccentric deformity and sacculation were demonstrated in only one patient with the stricturing form. In addition, double-contrast study revealed small ulcers in three (23%) patients. Our results indicate that radiographic findings accurately reflect the clinical course and pathologic findings in this disease.
Adult↗
A comparative study of once-a-day morning and once-a-day bedtime administration of 40 mg famotidine in treating duodenal ulcers.
A randomized controlled study comparing once-a-day morning and once-a-day bedtime administration of 40 mg famotidine in treating duodenal ulcers was carried out in 99 Japanese patients. Endoscopic examinations were performed at the baseline and repeated at 3-week intervals until healing was confirmed. Eighty-two patients fulfilled the evaluation criteria (38 in the morning group and 44 in the bedtime group). In 13 of these patients the antisecretory effects of these regimens were also assessed by 24 h intragastric pH monitoring. The healing rates were 66% after 3 weeks and 95% after 6 weeks in the morning group, and 57% after 3 weeks and 80% after 6 weeks in the bedtime group. The differences were insignificant between the two groups, but there was a higher healing rate tendency after 6 weeks in the morning group (0.05 less than P less than 0.10). Regarding pain subsidence, there were no significant differences between the two groups. Both treatments were significantly superior to the control group in increasing 24 h intragastric pH. The morning regimen was significantly superior to the bedtime regimen in suppression of daytime acidity. On the contrary, the bedtime regimen was significantly superior to the morning regimen in suppression of nocturnal acidity. These findings suggest that suppression of nocturnal acidity is important but not essential to promote duodenal ulcer healing and suppression of daytime acidity is equally important. Thus, once-a-day morning administration of 40 mg famotidine seems to be at least as effective as once-a-day bedtime administration of 40 mg famotidine in treating duodenal ulcers.
Adult↗
An HLA study on 149 Japanese patients with Crohn's disease.
To search for possible immunogenetic roles in the pathogenesis of Crohn's disease, we examined the HLA-A, -B, -C, -DR and -DQ locus antigens in 149 Japanese patients with Crohn's disease. All patients were living on Kyushu island. We also examined the HLA of 136 healthy controls who resided in Kyushu. The results were compared with both controls throughout Japan and Kyushu controls. In Japanese patients with Crohn's disease, HLA-DR4, especially -DR4.1, and -DQ4 were more frequent than in the controls throughout Japan and in Kyushu. In light of these observations, an immunogenetic factor may have some role in the development of Crohn's disease. The susceptibility to Crohn's disease may relate to HLA-DR4, especially -DR4.1, and -DQ4, in Japanese patients.
Crohn Disease↗
Salmonella colitis: assessment with double-contrast barium enema examination in seven patients.
To completely rule out the possibility of ulcerative colitis, Crohn disease, and other diseases, the authors analyzed the radiographic findings at double-contrast barium enema examination performed in seven patients with colitis caused by Salmonella organisms. In all patients, bacteriologic confirmation of nontyphoid Salmonella infection and radiographs of the upper gastrointestinal tract were obtained. Total colonoscopy was performed in five patients and sigmoidoscopy in one patient. In all patients, the radiographic findings were retrospectively analyzed. The descending colon and sigmoid colon were affected in six patients, whereas the rectum was affected in none. The findings included fine mucosal granularity (seven patients), loss of haustration (six patients), many fine ulcerations (five patients), and multiple ulcers (two patients). The radiographic features simulated those of ulcerative colitis, except for absence of rectal abnormality. It is concluded that double-contrast barium enema examination is useful for detection of fine mucosal changes.
Adolescent↗
[Stimulation of the brain osmoreceptor attenuates the sensitivity of tubuloglomerular feedback in rats].
By using micropuncture technique and measuring inulin concentrations in plasma and tubular fluid, and tubular flow rate, single nephron glomerular filtration rate (SNGFR) was calculated. The effect of stimulation of the brain osmoreceptors on the sensitivity of tubulo-glomerular feedback in rats was observed. The SNGFR value measured at the proximal tubular (SNGFRp) was greater than that measured at the distal tubule (SNGFRd) of the same nephron. The difference between these two values (SNGFRp-d) was a measure of the extent of tubuloglomerular feedback (TGF). The SNGFRp-d value was reduced after intracerebroventricular administration of hypertonic saline (icv. HS), indicating that stimulation of the brain osmoreceptor can attenuate the sensitivity of TGF. The icv. HS-induced increase in renal plasma flow rate and glomerular filtration rate could be abolished by intravenous injection of furosemide, while natriuretic response persisted. These results suggest that icv. HS can alter renal hemodynamics via reduction of TGF, and confirm the claim that icv. HS can inhibit tubular reabsorption, which is responsible for the natriuretic response.
Animals↗
[Japanese clinical statistical data of patients with Crohn's disease].
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Adolescent↗
[Role of the hypophysis in the renal responses upon stimulation of the brain osmoreceptor].
The experiments were performed in rats anaesthetized with alpha-chloralose and urethane. Intracerebroventricular administration of hypertonic saline (icv. HS) resulted in an increase in renal plasma flow rate, glomerular filtration rate, urine flow rate, urinary sodium excretion, urinary potassium excretion, and osmolar clearance, and a decrease in free water clearance. These responses were abolished in hypophysectomized rats, but were not significantly affected by intravenous injection of vasopressin (VP) receptor (V1 and V2) antagonist. The urinary dopamine (DA) excretion did not change significantly after icv. HS. Moreover, administration of benserazide, an inhibitor of the enzyme L-aromatic amino acid decarboxylase that converts L-dopa to DA, did not attenuate the diuresis and natriuresis induced by icv. HS. These results suggest that the renal responses upon stimulation of the brain osmoreceptor are dependent on the integrity of the hypophysis, while the VP and DA are not essential to these renal responses. The hypophysial factors responsible for the icv. HS-induced renal responses remain to be explored.
Animals↗
[The effects of stimulation of the brain osmoreceptor on the tubular reabsorption of sodium, chloride and potassium in rats].
The tubular reabsorption of sodium, chloride and potassium was studied with micropuncture technique and electron probe X-ray microanalysis before and following intracerebroventricular administration of hypertonic saline (icv. HS) in rats. At the late proximal convoluted tubules, the fractional delivery of sodium increased from 53.0 +/- 2.1% to 66.0 +/- 2.9% (P < 0.01), the fractional delivery of chloride increased from 65.4 +/- 3.4% to 78.2 +/- 3.9% (P < 0.05), but the fractional delivery of potassium and tubular fluid osmolarity were unaltered. At the early distal convoluted tubules, the fractional delivery of sodium increased from 8.2 +/- 0.9% to 13.6 +/- 1.8% (P < 0.05), the fractional delivery of chloride increased from 5.4 +/- 0.8% to 9.5 +/- 1.4% (P < 0.05), the tubular fluid osmolality increased from 139.8 +/- 6.9 mOsm/kg H2O to 181.3 +/- 15.6 mOsm/kg H2O2 whereas fractional delivery of potassium did not show significant change. Under the condition of diuresis provoked by the intravenous administration of furosemide the kaliuresis induced by icv. HS was abolished, while the icv. HS-elicited diuresis and natriuresis remained unaffected. These results indicate that stimulation of the brain osmoreceptor inhibits the proximal tubular reabsorption of sodium chloride which in turn enhances sodium-potassium exchange in the distal tubules and collecting ducts.
Absorption↗
[Hypolactasia in Japanese Crohn's patients].
20 g lactose load test, BHT and LTT done simultaneously were examined in 32 Crohn's disease patients and 51 healthy volunteers. Hypolactasia frequency were examined. A rise in hydrogen concentration > 20 parts per million (ppm) above the base line during breath hydrogen test and maximum blood sugar rise during lactose tolerance test were considered to indicated Hypolactasia. High rates, 50% by BHT and 72.5% by LTT, of primary adult hypolactasia were found in healthy volunteers as previously reported. Higher rates, 83.3% by BHT and by LTT (p < 0.05), were observed in Crohn's disease patients. There were higher rates in small intestine type Crohn's disease (91.6% by BHT, 92.3% by LTT) compare with healthy volunteers but no difference were found with large intestine type Crohn's disease.
Adult↗
Coincident occurrence of granular cell tumor of the stomach with an early gastric carcinoma.
In a 41-yr-old Japanese woman, a rare coincident lesion composed of granular cell tumor and early gastric adenocarcinoma was detected in the stomach. Beneath the poorly differentiated adenocarcinoma almost limiting to the mucosa, the granular cell tumor measuring 1.2 x 0.8 cm was spreading mainly in the submucosa without forming polypoid nodule. To the best of our knowledge, this is the first published report on this type of coincidence. Immunohistochemically, the cells of the granular cell tumor were strongly positive for S-100 protein, but negative for muscle markers (HHF 35, desmin), some of which connected with perineural Schwann cells surrounding small vessels in the submucosa. These features suggested that granular cell tumor in our case arose from Schwann cells surrounding small vessels in the submucosa of the stomach.
Adenocarcinoma↗
[A modified microanthrone method for the determination of inulin on nanogram scale].
The establishment of a method of determining minute amount of inulin on nanogram scale is essential for applying micropuncture technique to kidney research. In this experiment, we modified a classical microanthrone method which was used by Dirks et al. to determine inulin contained in tubular fluid. A spectrophotometer was installed with a special microcuvette to suit the colorimetry of 10 microliters solution. Linear relation between inulin concentration and absorption was observed in the range of inulin concentration from 2 to 32 nl per 10 microliters anthrone reagent. The accuracy of this microanthrone method was evaluated with inulin recovery test, the mean recovery rate being 101.2 +/- 3.5%. Since tubular fluid did not interfere with the determination of inulin, the tubular fluid which contained inulin could be added directly to anthrone reagent in actual practice. The mean single nephron glomerular filtration rate measured with this modified microanthrone method in 21 rats was 34.9 +/- 1.8 nl/min, which coincided well with the values reported in literature. The results indicate that the measurement of inulin with the above-mentioned microanthrone method is reliable and suitable for the micropuncture study.
Animals↗
[Effect of brain osmoreceptor stimulation on the function of superficial nephrons in the rat].
Our previous work with lithium clearance method indicated that the diuresis and natriuresis induced by intracerebroventricular administration of hypertonic saline (icv. HS) resulted from an increase in glomerular filtration rate and a decrease in water and sodium reabsorption in the proximal tubules. In the present study, we further observed the effect of icv. HS on the glomerular filtration rate and proximal convoluted tubular and loop reabsorption in the superficial nephrons with micropuncture technique. After icv. HS, single nephron glomerular filtration rate increased from 39.6 +/- 1.9 nl/min to 48.8 +/- 2.0 nl/min (P less than 0.001), late proximal convoluted tubular fluid flow rate increased from 20.5 +/- 1.4 nl/min to 28.4 +/- 2.0 nl/min (P less than 0.01), and the ratio of tubular fluid inulin concentration to plasma inulin concentration decreased from 1.98 +/- 0.08 to 1.69 +/- 0.05 (P less than 0.01). Calculated fractional proximal convoluted tubular fluid reabsorption decreased from 49.2 +/- 2.2% to 41.7 +/- 1.8% (P less than 0.001), while calculated absolute proximal convoluted tubular fluid reabsorption did not change significantly. These results coincided with the observation with lithium clearance method. In addition, icv. HS increased absolute loop fluid reabsorption but decreased fractional loop fluid reabsorption. The present data suggest that stimulation of the brain osmoreceptor increases the glomerular filtration rate and decreases the reabsorption capacity of the proximal convoluted tubule in the superficial nephrons, both these responses result in an increase in the load of the loop of Henle with a secondary change in loop reabsorption. However, the results of the present study do not rule out the possibility that icv. HS may also inhibit the loop reabsorption directly.
Animals↗
A comparative study of once-a-day morning and once-a-day bedtime administration of 40 mg famotidine in treating gastric ulcers.
A randomized controlled study comparing once-a-day morning and once-a-day bedtime administration of 40 mg famotidine in treating gastric ulcers was carried out in 179 Japanese patients. Endoscopic examinations were performed at the baseline and repeated at 4-wk intervals until healing was confirmed. One hundred and sixty-four patients fulfilled the evaluation criteria (81 in the morning group and 83 in the bedtime group). The healing rates were 50.7% after 4 wk and 88.9% after 8 wk in the morning group and 46.5% after 4 wk and 74.7% after 8 wk in the bedtime group. The difference was statistically significant after 8 wk. Significant reductions from baseline for overall pain, beginning during the first 3 days, were likewise found in the two treatment groups. However, the pain severity in hunger state 1 wk after treatment was significantly higher in the bedtime group than in the morning group. Thus, once-a-day morning administration of 40 mg famotidine seems to be superior to once-a-day bedtime administration of 40 mg famotidine in treating gastric ulcers.
Adult↗
An index of disease activity in patients with ulcerative colitis.
Quantification of disease severity was studied in 72 patients with ulcerative colitis, who had undergone total 85 clinical courses. We performed a multiple stepwise regression analysis, according to Truelove and Witts' classification, with disease severity as a dependent variable, and with 18 clinical, laboratory, and endoscopic parameters as independent variables. Results showed that disease severity in patients with ulcerative colitis is significantly influenced by five factors, namely, bloody stool, bowel movements, erythrocyte sedimentation rate (ESR), hemoglobin (Hb), and serum albumin. The activity index (AI) developed for ulcerative colitis is expressed as follows: AI = 60 x blood stool + 13 x bowel movements + 0.5 x ESR - 4 x HB - 15 x albumin + 200. Index values below 150, values between 150 and 220, and values above 220 nearly corresponded to mild, moderate, and severe disease, respectively, in Truelove and Witts' classification. We believe that the activity index is useful in evaluation of the effect of medical treatment in patients with ulcerative colitis. Its most important value will be in therapeutic trials.
Adolescent↗
Effects of nutritional therapy on chemiluminescence in Crohn's disease.
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Crohn Disease↗
Double-contrast radiographic features in primary small intestinal lymphoma of the 'western' type: correlation with pathological findings.
Eighteen patients with 20 primary lesions of small intestinal lymphoma of the 'Western' type were examined to determine the double-contrast radiographic features of the disease with pathological correlation. The radiographic appearances on double-contrast study were divided into five groups: polypoid (3 lesions), stricturing (6), non-stricturing (3), aneurysmal (3), and intussusception (5). In the first four groups, ulceration, signs of submucosal tumour, and displacement of adjacent loops were frequent. Two early lesions confined to the submucosal layer were also seen. There was a close association between the radiographic appearance and macroscopic findings of the resected specimens, including the cross section of the tumour, but no correlation with the cell type. These results indicate that the double-contrast study accurately reflects the morphological changes of primary small intestinal lymphoma.
Adolescent↗