PubMed Health⌕ Search

Biomedical subjects

G Sugioka

Publications and source records attributed to G Sugioka.

At least 19 recordsLinked to original sources
PubMed1999

Diagnostic value of endoscopic retrograde pancreatography in chronic pancreatitis based on the new criteria proposed by the Japan Pancreas Society in 1995: comparison with the criteria proposed by the Japanese Society of Gastroenterology in 1983.

This study evaluated the new criteria for the diagnosis of chronic pancreatitis (CP) with endoscopic retrograde pancreatography (ERP) proposed by the Japan Pancreas Society in 1995 by comparing it with the older criteria of the Japanese Society of Gastroenterology proposed in 1983. No significant differences were noted between the two when the diagnostic sensitivity of ERP was considered in calcifying CP. Among 54 patients of noncalcifying CP (group I) with ERP diagnosis of moderate or advanced pancreatitis by the previous criteria, only one of 22 with the localized type was definite CP. The remaining 21 were ruled out as either definite or probable CP, and six were classified as having chronic obstructive pancreatitis based on the new criteria. In contrast, a diagnosis of definite CP was made not only for all the 32 patients with CP (group I) of diffuse type but also in 11 cases of CP (group II) with diffuse minimal pancreatitis showing irregular dilatation of the side branches with scattered distribution throughout the gland. In a series of 15 follow-up patients with CP (group II) having initial ERP diagnosis of minimal pancreatitis, CP group I developed in three of five cases of diffuse minimal pancreatitis, which is consistent with definite CP by the new criteria, whereas progression to this group of CP was found in none of the 10 patients with localized minimal pancreatitis. These results indicate that although localized CP is excluded from CP, the incidence of diffuse noncalcifying CP diagnosed by ERCP was increased with the new criteria, and detecting radiologic features with diffuse irregular dilatation of the branch ducts based on these criteria may lead to early diagnosis of CP.

Calcinosis↗
PubMed1996

Detection of K-ras point mutation at codon 12 in pure pancreatic juice collected 3 years and 6 months before the clinical diagnosis of pancreatic cancer.

We report herein a patient with K-ras point mutation at codon 12 that had been detected in pure pancreatic juice (PPJ) obtained 3 yr and 6 months before he was diagnosed with pancreatic cancer (PC). In this 73-yr-old man, PC was diagnosed by ERCP, which showed obstruction of the main pancreatic duct (MPD) at the borderline area between the body and tail of the pancreas. Distal pancreatosplenectomy was performed, and an advanced PC at the tail of the pancreas with a few metastatic nodules in the liver was confirmed. Retrospectively, a K-ras point mutation at codon 12 from GGT (glycine) to GAT (aspartic acid) was detected in the PPJ collected endoscopically 3 yr and 6 months earlier, as well as in the PPJ when PC was diagnosed and in the resected tumor tissue. Reevaluation of pancreatography from the ERCP performed at that time revealed a very mild stenotic lesion of the MPD, speculated to be a PC at a very early stage, at the body-tail border, but it was difficult to diagnose this lesion as a PC, based only on this morphological study. Accordingly, we believe that this is an interesting and valuable clinical case, indicating that K-ras mutation can precede clinical evidence, and its determination in PPJ could be a useful genetic test calling for a careful and extensive clinical investigation for early detection of PC.

Adenocarcinoma↗
PubMed1994

Aberrant hepatic duct connected with the main pancreatic duct by anomalous pancreato-biliary ductal union: case report.

An aberrant hepatic duct directly connected to the main pancreatic duct with anomalous arrangement of the pancreato-biliary ductal system is reported here, the first report of such a case, to our knowledge. A 53-year-old woman was admitted to our hospital because of cholecystolithiasis with abdominal pain in the right upper quadrant. Endoscopic retrograde cholangiopancreatography (ERCP) showed that an aberrant hepatic duct, which independently drained the right posterior segment of the liver, connected to the main pancreatic duct at a high insertion site distal to the sphincter area of the major papilla. The common bile duct (containing stones), on the other hand, united with the main pancreatic duct in a normal fashion. Cholecystectomy and bile duct lithotomy were performed. The aberrant hepatic duct was separated from the main pancreatic duct just above the junction, and was anastomosed side-by-side to the common hepatic duct. The embryologic development of this lesion is not clear, but is discussed in this report.

Anastomosis, Surgical↗
PubMed1993

Adrenocortical carcinoma with a giant pericardial mass.

A patient with a history of adrenocortical carcinoma presented with massive pericardial effusion and a giant pericardial mass. Death resulted from cardiac tamponade. At autopsy a large necrotic mass was histologically similar to the original adrenocortical carcinoma. We present this case and review the literature on metastatic pericardial disease.

Adrenal Cortex Neoplasms↗
PubMed1993

[Shortening of life expectancy in patients with membranous nephropathy--based on 20 years follow up study].

It is not certain whether the life expectancy of patients with membranous nephropathy is shorter than that of an age-matched healthy population. Forty-one patients (21 males, 20 females) aged between 16 and 70 years (average age: 33.3 years) were followed for 20 years. The patients were divided into two groups: group I (n = 18), consisting of patients in whom nephrotic syndrome persisted for more than two years or until death, and group II (n = 23), consisting of patients except for group I. The non-survival criteria are death or renal death. Twelve patients (29.3%) died during the study period. Eight patients belonged to group I and 4 to group II. The causes of death in group I patients were end-stage renal failure in 3 cases, ischemic heart disease in 1 case, subarachnoid hemorrhage in 1 case, malignancy in 2 cases, suicide in 1 case, and those in the group II patients were pneumonia, malignancy, cerebral softening, and diabetes mellitus, respectively. Eight patients who died in group I had a significantly longer difference between their actual life span (ALS) and life expectancy (LE) and a significantly smaller ratio of ALS to LE than the patients who died in group II (ALS-LE: -29.9 +/- 4.5 years in group I vs. -9.0 +/- 6.8 years in group II, p < 0.05, ALS x 100/LE: 22.5 +/- 8.0% in group I vs. 80.9 +/- 25.2% in group II, p < 0.05). In group I, the ratio of observed to expected death was 4.76 (95% confidence interval, 2.05 to 9.37) and significantly higher than that of the control population. In group II, however, the ratio was 1.09 (95% confidence interval, 0.30 to 2.80), and the difference from the control population was not statistically significant. These results suggest that longstanding nephrotic syndrome is associated with a shortened life expectancy in patients with membranous nephropathy.

Adolescent↗
PubMed1992

[Steroid pulse therapy in rapidly progressive glomerulonephritis].

In an attempt to clarify the indication and efficacy of the methylprednisolone pulse therapy (1000 mg x 3 times) for rapidly progressive glomerulonephritis (RPGN), 3 patients with the disease were carefully followed and the clinical course during and after the treatment were precisely analysed. According to the declination rate of reciprocals of serum creatinine (1/Cr), one patient were divided into the acute type (-1.00 x 10(-2) dl/mg/day or less) and the others into the subacute type (more than -1.00 x 10(-2) dl/mg/day). In the patient of acute type, renal biopsy revealed cellular crescent formation in 93.8% of glomeruli observed. One course of the pulse therapy resulted in a decrease in Cr from 3.0 mg/dl to 1.3 mg/dl and transformation of cellular crescents to fibrocellular or fibrous crescents. In the other two patients of subacute type, crescents were observed in 72.7% and 72.0% of glomeruli observed, and 87.5% and 38.9% of them were composed of cellular crescents respectively. Initial courses of the pulse therapy resulted in decreases of Cr from 3.5 mg/dl to 2.4 mg/dl and from 3.0 mg/dl to 1.4 mg/dl respectively. Additional courses, given because of insufficient reduction of Cr in the former, induced a further lowering to 1.3 mg/dl, and because of re-elevation of Cr to 2.2 mg/dl and remaining of cellular crescents in 20% in the latter, induced a decrease of Cr to 1.5 mg/dl and disappearance of cellular crescents.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

[Effects of methylprednisolone pulse therapy on progressive IgA nephropathy].

In order to estimate the effects of methylprednisolone pulse therapy on progressive IgA nephropathy, clinical parameters in eight patients with the disease were compared between before and after the therapy. In this study progressive IgA nephropathy was defined as follows; 24 hour urinary protein excretion was (++) or more and renal biopsy carried out just before the therapy revealed crescents, inevitably including cellular crescents, in 10% or more glomeruli observed. Methylprednisolone 1000 mg a day was intravenously administered for three consecutive days and the therapy was repeated with an interval of 4 days. The additional third course was given in two patients, in whom significant decrease in urinary protein had not been obtained after the original two courses of the therapy. Oral prednisolone 20 mg a day started simultaneously was tapered one month later to maintenance daily doses of 5-10 mg. After the pulse therapy urinary protein excretion was significantly decreased in every patient with a mean decrease from 2.3 +/- 0.5 (0.8-5.5)g to 1.1 +/- 0.3 (0-2.8)g (p less than 0.05). Glomerular filtration rate (GFR) was increased from 83 +/- 11 (31-115) ml/min to 96 +/- 10 (44-130) ml/min (p less than 0.05). In the initial biopsy crescents were observed in 25 +/- 7 (19-57)% of glomeruli observed and 20-100% of these were composed of cellular crescents. Complete loss of cellular crescents in 6 patients and a marked decrease from 73% to 33% in another were demonstrated by the second biopsies performed after the pulse therapy. These results suggested that the methylprednisolone pulse therapy significantly reduced urinary protein excretion and improved renal function through suppression of new crescent formation as well as transformation of cellular crescents to fibrocellular or fibrous crescents.

Administration, Oral↗
PubMed1989

[Three cases of single coronary artery].

Single coronary artery has been considered a minor coronary anomaly without clinical importance. With the wide spread of coronary angiography, however, the disease has been reported to develop complications at a high rate, such as angina, myocardial infarction and arrhythmia. We report three patients with single coronary artery with several complications. Case 1: A 56-year-old woman having a past history of diabetes mellitus and myocardial infarction was admitted because of the recently developed frequent attacks of effort angina. Treadmill test was positive and thallium-201 exercise myocardial scintigraphy revealed redistribution in the lateral wall. Ascending aortogram suggested that the right coronary artery (RCA) arose from the left sinus of Valsalva. An injection into the right sinus of Valsalva revealed no coronary ostium. Selective left coronary angiogram resulted in the diagnosis of single coronary artery (Smith's type 2) with 90% stenosis in the left circumflex artery (LCX). Left ventriculogram showed hypokinesis in the anterolateral wall. PTCA performed on this patient revealed clinical and nucleomedical improvement. Case 2: A 48-year-old man experienced chest pain and syncope. Electrocardiogram revealed ST-elevations in II, I and a VF, sinus bradycardia and atrioventricular junctional rhythm. Angiography resulted in the diagnosis of single coronary artery (Smith's type 2) with 75% stenosis in the RCA. Ergonovine test was positive. Case 3: A 69-year-old man complained of chest pain. Electrocardiogram showed complete right bundle branch block, sinus bradycardia and atrioventricular junctional rhythm. Cardiac catheterization revealed that this was also a case of single coronary artery (Smith's type 2) with no significant stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

Hypereosinophilic syndrome with extensive myocardial involvement and mitral valve thrombus instead of mural thrombi.

A 68-year-old woman complained of repeated signs of congestive heart failure during the last 10 years. Clinical examination revealed persistent marked eosinophilia of the peripheral blood. Postmortem examination of the heart revealed multiple thrombo-embolic materials of the small vascular lumina throughout the myocardium, associated with marked perivascular and stromal infiltration of eosinophils, many foci of myocardial necrosis, and diffuse myocardial fibrosis. There was also an organizing thrombus in the posterior mitral valve. Neither subendocardial fibrosis, overlying mural thrombi in the endocardium, pulmonary infiltration of eosinophils nor systemic granulomatous or healed vasculitis in the lungs and other organs were found. The disease is preferably consistent with a diagnosis of hypereosinophilic syndrome of Hardy et al., a group of ill-defined and overlapping conditions, and best descriptively termed as eosinophilic interstitial myocarditis.

Aged↗
PubMed1982

T cell-mediated cytotoxicity against HBsAg-coated Chang cells in patients with chronic hepatitis: evidence for cytotoxicity mediated by delayed hypersensitivity T cell reaction.

T lymphocytes from 7 (21%) of 34 patients with chronic hepatitis showed positive cytotoxicity against HBsAg-coated Chang cells. This positivity was observed in HBsAg-negative patients having positive blast transformation responses to HBsAg, as well as in patients convalescing and recovered from acute B hepatitis. Levels of S-GPT in these patients were not different from those showing no cytotoxicity. T cell-mediated cytotoxicity against HBsAg-coated hepatocytes in HBsAg-negative patients thus may have no significant pathogenetic role in destruction of hepatocytes and may represent anamnestic response of sensitized T lymphocytes to HBsAg. Positive cytotoxicity against HBsAg-coated Chang cells was also found in 3 of 17 patients with HBsAg-positive chronic hepatitis. All positive cases exhibited blast transformation responses to HBsAg and low HBsAg titers in their sera. Levels of S-GPT in these patients were significantly higher than in those showing no cytotoxicity, suggesting possible presence of T cell-mediated liver cell damage in these patients. T lymphocytes from asymptomatic HBsAg carrier showed no cytotoxicity to HBsAg-coated hepatocytes and no blast transformation responses of lymphocytes to HBsAg. From the results of the parallel occurrence of T cell-mediated cytotoxicity and blast transformation responses to HBsAg, and of presence of lymphotoxin in the supernatant co-cultured HBsAg and cytotoxicity-positive lymphocytes, it seemed likely that T cell-mediated cytotoxicity in our system might be mediated by lymphokine produced by T cells as a result of delayed hypersensitivity reaction in vitro.

Cells, Cultured↗
PubMed1978

Hepatoma development during long term follow-up period of liver cirrhosis.

An attempt was made to elucidate the pathogenesis of hepatoma. The material comprises 20 cases which were followed up more than 3 years after diagnosed liver cirrhosis and verified by autopsy. Hepatoma was found in 10 out of these 20 cases (50%). The follow-up period of these 10 cases with hepatoma was from 3 to 9.5 years (the mean value; 5.5 years). All 10 cases were not heavy drinkers, and showed liver cirrhosis of the mixed type by autopsy. HBsAG was positive in 6 out of 8 cases by RIA method (75%), and alpha-f was also detected in 5 of 7 cases by RIA method (70%). On the contrary, only 2 out of 10 cases without hepatoma were HBsAG positive (20%). The present results indicate that HBsAG positive liver cirrhosis of the mixed type is closely related to hepatoma in our country.

Adult↗