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Biomedical subjects

Y Wagatsuma

Publications and source records attributed to Y Wagatsuma.

58 records · Page 4Linked to original sources

Alpha-fetoprotein producing Barrett's esophageal adenocarcinoma: a case report.

A 59-year-old man was admitted to our hospital with upper abdominal pain. His serum alpha-fetoprotein (AFP) level was very high, 1500 ng/ml. Upper gastrointestinal endoscopy revealed depressed lesion at 36 cm from the upper incisors, with columnar epithelium lining the esophagus circumferentially to the oral side of the lesion. Histological examination of biopsy specimens revealed a tubular adenocarcinoma as well as the presence of gastric columnar epithelium with intestinal metaplasia. Immunohistochemistry demonstrated AFP in the tumor cells. From these results, a diagnosis of AFP-producing esophageal adenocarcinoma occurring in Barrett's esophagus, a condition which is extremely rare in Japan, was established. Computed tomography (CT) showed multiple metastasis on the liver and wide-ranging lymph node metastasis. Chemotherapy was not effective and the patient died about 2 months after the start of treatment. The AFP-producing esophageal adenocarcinoma presented here had biological characteristics similar to those of AFP-producing gastric cancer.

Adenocarcinoma↗

Study on endoscopic esophageal mucosal resection with ligating device. I--Clinical study.

BACKGROUND/AIMS: EEMRL (endoscopic esophageal mucosal resection with a ligating device) has become increasingly popular. In this article, we review 13 clinical cases of EEMRL. METHODOLOGY: Since 1993, we have performed EEMRL to treat 15 lesions in 13 patients. Twelve squamous cell carcinomas (mucosal cancer in 10 and submucosal cancer in 2) were included among the 15 lesions. RESULTS: EEMRL failed to achieve complete resection of the 2 submucosal lesions (3.0 and 2.8 cm in maximum diameter). However, esophageal lesions could be removed successfully when 2.5 cm or less in maximum diameter. The procedure was not associated with any complication. CONCLUSIONS: Our clinical study showed that this technique may be indicated for esophageal cancer with a maximum diameter < or = 2.5 cm and confined to the mucosa. EEMRL is a technically easy and minimally invasive therapy which could be useful for the treatment of early esophageal cancer.

Aged↗

Study on endoscopic esophageal mucosal resection with ligating device. II--Experimental study.

BACKGROUND/AIMS: This study reports on animal experiments regarding the safety of endoscopic esophageal mucosal resection with a ligating device (EEMRL), as well as the amount of mucosa which can be removed by this technique, the depth of resection and the feasibility of piecemeal resection. METHODOLOGY: Three experiments were performed in six mongrel dogs under general anesthesia. RESULTS: When EEMRL was done without submucosal injection of saline, resection reached the muscular layer and caused esophageal perforation. The average dimensions of the mucosal pieces resected using 8-, 10-, and 12-mm devices was 13 x 10 mm, 18 x 15 mm, and 22 x 18 mm, respectively. Resection reached the mid-plane of the submucosa and the depth was almost uniform. After piecemeal resection, there was no macroscopically visible mucosa at the resection site and each mucosal piece was resected along the mid-plane of the submucosa. CONCLUSIONS: The experimental study indicated that submucosal injection of saline is essential to prevent esophageal perforation. It also showed that EEMRL allows resection up to the mid-plane of the submucosa, that the 12-mm device allows en bloc resection of lesions < or = 15 mm in diameter and that EEMRL is suitable for piecemeal resection.

Animals↗

Highly symptom-aware children were heavily infected with urinary schistosomiasis in southern Ghana.

OBJECTIVES: To assess the relationship between the infection status of children and their knowledge, attitudes, beliefs, and practices (KABP) related to urinary schistosomiasis. DESIGN: Questionnaire survey. SETTING: Nine schools in eight rural communities (total population: 4,636) in Ga and South Akuapem Districts, Ghana. SUBJECTS: Four hundred and six children attending primary and secondary schools. MAIN OUTCOME MEASURE: Schistosoma haematobium infection status of children and their KABP. RESULTS: Of 354 children who responded and also submitted their urine samples, 297 (83.9%) tested positive for S. haematobium and the intensity of infection was 90 (95% CI: 74 to 110) eggs per 10 ml urine. General knowledge variables such as the knowledge of symptoms (p < 0.001), and knowledge of swimming or bathing in the river as a transmission route (p < 0.001) showed significant association for higher prevalence and intensity of infection. Treatment-seeking behaviour was not associated with the lower prevalence or intensity of infection. Practice variables such as washing clothes in the stream (p < 0.001) and fishing in the stream (p < 0.01) were significantly associated with both higher prevalence and higher intensity of infection. Children who knew of contact with river water as a transmission route reported more water contact activities (p < 0.001). CONCLUSION: This study showed that highly symptom-aware people were heavily infected, and people frequently exposed to infested water were heavily infected. Moreover, highly symptom-aware people never constituted a group whose exposure was slight. Why was awareness of disease symptoms and general knowledge of the disease not linked to low infectivity? Why didn't awareness result in avoidance of infested water sources? This report highlights the urgent need to address these important questions in future research.

Adolescent↗