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Biomedical subjects

T Yao

Publications and source records attributed to T Yao.

At least 289 records · Page 16Linked to original sources

Immunological studies on Crohn's disease. VIII. Diminished phagocytic activity in peripheral blood monocytes.

We have been examining superoxide production activity in patients with Crohn's disease and we noted an increase in this activity in peripheral whole blood and monocytes, determined by a luminol-dependent chemiluminescence. However, superoxide production and phagocytosis are different phenomena. To search for the "real" phagocytic capacity, we examined the phagocytic activity of peripheral blood monocytes and neutrophils in 20 Japanese patients with Crohn's disease, using automated laser flow cytometry. In contrast to the results obtained with the chemiluminescence assay, we found a decrease in the "real" phagocytic function in monocytes, yet there was no difference in the phagocytic ability in neutrophils. The phagocytic activity in patients with an active form of the disease was lower than that in patients with inactive form of the disease. These results provide pertinent information on the role of monocytes in Crohn's disease. The depressed phagocytic activity in monocytes from these patients may play some role in the pathogenesis of this disease.

Crohn Disease↗

Controlled trial comparing an elemental diet with prednisolone in the treatment of active Crohn's disease.

To determine whether an elemental diet or prednisolone would be more effective for treating acute Crohn's disease, a controlled trial was conducted on 20 patients with acute Crohn's disease who had never received specific treatment. The first ten patients were put on an elemental diet and the remaining ten were prescribed prednisolone for six weeks at an initial dose of 0.7 mg/kg/day. Patients were assessed using the simple activity index, body weight, erythrocyte sedimentation rate, C-reactive protein and alpha 2 globulin, serum albumin, and radiographic findings of bowel lesions. At six weeks, the patients on the elemental diet showed a significantly greater improvement in the activity index, inflammatory signs such as C-reactive protein and alpha 2 globulin, and radiographic findings of bowel lesions than did those on the steroid. Patients who were given steroids for six weeks and then treated with the elemental diet for four weeks showed improvement in the radiographic findings of bowel lesions and inflammation. The present study strongly suggests that elemental diet is superior to steroids for treating active Crohn's disease.

Adult↗

Granular cell tumor of the esophagus: endoscopic ultrasonographic demonstration and endoscopic removal.

A 35-yr-old Japanese man with a granular cell tumor of the esophagus that was removed by endoscopic polypectomy is presented. Radiography and endoscopy showed a 20 x 12 mm sessile protrusion in the distal esophagus. Endoscopic ultrasonography demonstrated the hypoechoic mass in the submucosa without continuity to the muscularis propria. The lesion was successfully treated by endoscopic polypectomy without complications. The cross-sections of the resected specimen were quite in agreement with the ultrasonographic findings. Endoscopic ultrasonography is valuable to assess the exact location and extent of the tumor, and to determine the indication for endoscopic polypectomy.

Adult↗

Endoscopic features of villous tumors of the colon: correlation with histological findings.

Data obtained from thirty patients with villous or tubulovillous tumors of the colon were examined in a search for correlations between histological and endoscopic features. There was a good correlation between the two findings. As villous elements became more prominent in the histology, finely granular and/or villous surface patterns, adherent mucus, and a characteristic color (slightly reddish with white spots) were seen more frequently in the endoscopic photographs. These findings are considered to be typical endoscopic features of villous tumor of the colon. Endoscopy using the sprayed dye technique is useful for visualizing the finely granular and/or villous surface pattern.

Colon↗

The relationship between the radiological and clinical features in patients with Crohn's disease.

A study has been made of 93 Japanese patients with Crohn's disease who had not undergone bowel resection at the time of diagnosis during the years 1969 to 1983. Ninety had longitudinal ulcers or a cobblestone appearance or both of the small intestine or colon or both on double contrast barium examination. The incidence of longitudinal ulcers in the small intestine was significantly higher than in the colon (P less than 0.001). Conversely the incidence of cobblestoning was higher in the colon than in the small intestine (P = 0.065). In patients with longitudinal ulceration, there was significantly lower Crohn's disease activity index (CDAI), ESR, and C-reactive protein. Patients with cobblestoning had a significantly higher CDAI, ESR and C-reactive protein, and significantly lower values of albumin, cholesterol in serum, serum iron, haemoglobin, and relative body weight. Our findings indicate that cobblestoning closely correlates with the disease activity of Crohn's disease, and that longitudinal ulceration has a negative correlation. Moreover, our results suggest that the high incidence of cobblestoning and low incidence of longitudinal ulcers in the colon and the reverse in the small intestine reflects the fact that colonic involvement renders the disease more severe than small intestine involvement only.

Adolescent↗

Natural history of duodenal lesions in Japanese patients with familial adenomatosis coli (Gardner's syndrome).

The natural history of duodenal lesions was studied in 20 patients with familial adenomatosis coli/Gardner's syndrome. These patients were followed for an average of 7.1 yr (range 1 yr, 7 mo to 12 yr, 2 mo) and repeatedly examined by hypotonic duodenography, duodenofiberscopy, and biopsy. Tubular adenomas of the duodenum (less than 8 mm in diameter) were present in 18 (90%). During the follow-up period, there was a slight increase or decrease in the number of duodenal adenomas in 4 patients but no distinct change in 13. In the remaining patient (aged 49 yr), a polypoid lesion (17 mm in diameter) of the duodenal bulb, which had been overlooked at the initial examination, became an advanced cancer (50 x 30 mm in size) during 22 mo. Tubular adenomatous tissue of the duodenal papilla was detected in 11 patients (55%). Follow-up study of the lesions revealed no change in endoscopic and histologic findings in all but 1 patient, in whom there was a slight enlargement of the duodenal papilla, as seen at endoscopy. These findings suggest to us that in patients with this disease, duodenal adenomas do not require prophylactic surgery. However, careful repeated follow-up examinations with endoscopic biopsy should be performed, with endoscopic removal of larger polyps when possible.

Adenoma↗

Linear erosions on Kerckring's folds may be diagnostic of Zollinger-Ellison syndrome.

Endoscopy of the upper gastrointestinal tract was performed in eight patients with Zollinger-Ellison syndrome (ZES) and in 20 patients with stomal ulcer (non-ZES). All ZES patients had hypergastrinemia and a positive secretin provocation test. In three ZES patients studied before gastric surgery, edematous or erosive changes were present in the second portion of the duodenum. In the seven ZES patients studied postoperatively, examination revealed erosive changes in the distal portion of the duodenum and/or upper jejunum. These changes were frequently in a line on the uppermost part of Kerckring's folds. In the non-ZES patients, however, endoscopy revealed no erosive change in the distal part of the duodenum. We propose that such linear erosions on Kerckring's folds may be diagnostic of ZES.

Adult↗

Hypotensive effects of nifedipine in patients with primary hyperparathyroidism: case reports.

Nifedipine was administered orally to 2 patients with primary hyperparathyroidism before and after parathyroidectomy. The operation lowered serum calcium concentration and parathyroid hormone but did not alter plasma renin activity, plasma aldosterone concentration, and serum magnesium. The hypotensive effects of nifedipine were markedly enhanced with the decrease in serum calcium concentration following parathyroidectomy. Thus, the level of serum calcium concentration may modulate the hypotensive effect of nifedipine in humans.

Aged↗

[Intracerebroventricular administration of hypertonic saline inhibits the reabsorption of water and sodium in the proximal tubule].

In anaesthetized rats with unilateral section of the renal nerve, the effect of intracerebroventricular (icv.) administration of hypertonic saline on the reabsorption of water and sodium in the proximal tubule was investigated, using the lithium clearance method. After icv. administration of hypertonic saline, the lithium clearance (CLi to glomerular filtration rate (GFR) ratio increased from 0.37 +/- 0.04 to 0.51 +/- 0.05 (P less than 0.01) in the denervated kidneys and from 0.26 +/- 0.03 to 0.31 +/- 0.04 (P less than 0.05) in the innervated kidneys, respectively. GFR, urine flow rate (V), urinary sodium excretion (UNaV) and urinary potassium excretion (UkV) increased in both innervated and denervated kidneys, the increments of V, UNaV and UkV being greater in the denervated kidneys than in the innervated kidneys. In micropuncture experiments, icv. administration of hypertonic saline caused an increase in proximal tubule flow rate, from 24.42 +/- 1.84 nl/min to 31.86 +/- 3.09 nl/min, without significant change in proximal tubule fluid osmolality in the innervated kidneys. These data support the notion that the diuresis and natriuresis induced by icv. administration of hypertonic saline in the anaesthetized rat result from an increase in GFR and a decrease in the reabsorption of water and sodium in the proximal tubule. Humoral factors are probably involved in these responses.

Absorption↗

Factors influencing the healing rate of gastric ulcer under treatment with cimetidine.

Factors influencing the healing rate were evaluated by multivariate analysis on 148 patients with gastric ulcer who were under treatment with cimetidine at a daily dose of 800 mg. Factors used were age, sex, therapeutic environment, duration of present ulcer pain, past history of gastric ulcer, the amount of tobacco, alcohol, and coffee consumed before and during the treatment, the period until symptoms disappeared after the commencement of the treatment, and the characteristics of the ulcers themselves. Of these factors, the five factors that had a significant delaying effect on the healing of gastric ulcers were: 1) having a past history of gastric ulcers, 2) symptoms not disappearing within 1 wk after the commencement of the treatment, 3) size over 20 mm, 4) ulcer located in an angle, and 5) round or oval shape of the ulcer. The patients with less than one of the unfavorable factors (n = 36) had the best healing rate (97.2%), compared with those with two (n = 61), three (n = 39), or four or more (n = 12) unfavorable factors. The healing rate of the latter three groups was 75.4%, 53.8%, and 33.3%, respectively (p less than 0.01). Thus, a prognostic score based on these five factors represents the severity of gastric ulcers with regard to the healing in patients prescribed cimetidine.

Cimetidine↗

[Fecal fat excretion rate in patients with Crohn's disease--comparison of a diet containing 50 g/day of fat with elemental diet with an addition of 50 g/day butter fat].

Fecal fat excretion rate was determined by the method of Van de Kamer in 31 patients with Crohn's disease and six healthy controls, when fed by the diet containing 50 g/day of fat. Patients with jejuno-ileitis and those with partial and extensive resection showed a significantly greater excretion rate compared with patients with ileitis and healthy controls, however, there was no significant difference between patients with ileitis and healthy controls. In this study, the fecal excretion rate was less than 10 g/day in non-operated cases. Our results seems to be smaller than those in previous studies from the western countries. Fecal fat excretion rate was determined in 12 patients with non-operated Crohn's disease and six healthy controls, when fed by the additional 50 g/day butter fat during the elemental diet. With ingestion of the additional 50 g/day butter fat during elemental diet, fecal fat excretion rate was significantly increased in the patients with non-operated Crohn's disease than the results of the diet containing 50 g/day fat, but not significantly changed in the healthy controls. This result suggest that determination of fecal fat excretion rate with fed by the additional 50 g/day butter fat during elemental diet is a useful test for detecting a mild fat malabsorption in non-operated Crohn's disease.

Adolescent↗

[HLA study in 108 Japanese patients with Crohn's disease].

We attempted to clarify the association between HLA and Crohn's disease. HLA-A, -B, -C, -DR and -DQ locus antigens in 108 Japanese patients with Crohn's disease were analyzed and the results were compared with findings of 472 healthy Japanese. In patients with Crohn's disease there was a strong positive association with HLA-DR4 (chi 2 = 14.086, Pc less than 0.005, RR = 2.231), and a weak positive association with HLA-B51, -Bw54, -DRw12, -DRw13 and -DRw52. While there was a strong negative association with HLA-DR2 (chi 2 = 10.194, Pc less than 0.025, RR = 0.435), DQw1 (chi 2 = 14.680, Pc less than 0.001 RR = 0.442) and DQw3 (chi 2 = 7.760 Pc less than 0.025 RR = 0.549), and a weak negative association with HLA-B7. In conclusion, susceptibility to Crohn's disease may relate to HLA-DR4, especially HLA-DR4.1, in Japanese patients.

Adolescent↗

Natural history of gastric adenomas in patients with familial adenomatosis coli/Gardner's syndrome.

The natural history of gastric adenomas was studied in 26 patients with familial adenomatosis coli (FAC)/Gardner's syndrome. The patients were followed for an average of 6.8 years (1 year, 5 months to 15 years 4 months) and examined repeatedly using gastric radiography, endoscopy, and biopsy. Gastric adenomas were present in 13 (50%). During the follow-up period, there was a new appearance of gastric adenomas in six patients but no distinct change in number, size, and histologic features in the remaining seven patients. In a 51-year-old man, an antral adenoma that measured 13 mm in diameter and had an irregular central depression did not change in size or morphology during 4 years and 1 month, but malignant change was evident at the time of endoscopic biopsy. The findings indicate that in patients with this disease, gastric adenomas require careful repeated follow-up examinations using endoscopic biopsy and, if feasible, endoscopic removal is recommended.

Adenoma↗