[A case of goblet cell carcinoid of the appendix].
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Aged↗
Biomedical subjects
K Haruma
Publications and source records attributed to K Haruma.
[Clinical analysis on the course and prognosis of patients with Crohn's disease].
We analyzed 66 cases (47 males and 19 females) of Crohn's disease at Hiroshima University hospital from September 1975 to October 1994 to clarify the course and prognosis of Crohn's disease. The age at onset was 21.1 +/- 7.3 years old (mean +/- SD), terms between onset and diagnosis were 21.5 +/- 33.0 months (mean +/- SD) and observation period was 65.5 +/- 44.6 months (mean +/- SD). Sites of lesion were 18 ileum, 41 ileocolon and 7 colon. Thirty-one cases, 20 cases of which had intestinal obstruction, underwent surgical operation (12 ileum types, 18 ileocolic types, 1 colon type). The cumulative probability of surgery at one, five and ten years after onset of symptoms were 12.1%, 28.8% and 56.9%, respectively. As for cumulative probability of surgical operation at one, five and ten years after diagnosis were 25.8%, 36.7% and 74.4%, respectively. Results of the cumulative probability of surgery by anatomical involvement indicated that the ileum type had a statistically significantly higher risk than other types. In each analysis compliance to nutritional therapy was also an important prognostic factor. Overall, our results indicated that the site of lesion and the compliance to nutritional therapy were important factors which have an effect on the course and prognosis of Crohn's disease patients.
Adolescent↗
[Clinicopathologic evaluation on colorectal laterally spreading tumor (LST)].
Clinicopathologic characteristics of 92 colorectal laterally spreading tumors (LST) endoscopically or surgically resected were examined. Lesions were macroscopically classified into two categories according to their surface structure :(1) granular type (G type, 47 lesions), (2) flat type (F type, 45 lesions). The size (maximum diameter) of G type lesions was 24.7 +/- 11.3 mm (Mean +/- SD) and that of F type lesions was 14.2 +/- 7.4 mm. The size of G type lesions was significantly larger than that of F type lesions (p < 0.01). Among G type lesions, cancerous lesion was present in 2 (25.0%) of 8 lesions 10-14 mm in diameter, 2 (22.2%) of 9 lesions 15-19 mm in diameter and 19 (63.3%) of 30 lesions more than 20mm in diameter. Regarding F type lesions, cancerous lesion was present in 15 (46.9%) of 32 lesions 10-14 mm in diameter, 4 (80.0%) of 5 lesions 15-19 mm in diameter and 8 (100%) of 8 lesions more than 20mm in diameter. The incidence of carcinoma in F type lesions was higher than that in G type lesions irrespective of size. F type lesions with carcinoma showed a trend toward a higher frequency of submucosal invasion and F type lesions with adenoma revealed tendency of showing severe atypia in comparison with G type lesions. The adenomatous component of LST showed a tubulo-villous architecture in 13 (28.3%) of 46 G type lesions, however none of F type lesions had a tubulo-villous component. These results indicated that clinicopathologic characteristics of F type are obviously different from G type. Furthermore, F type had a higher malignant potential than G type and is thought to have a more important role as a precursor of colorectal carcinoma than G type.
Adenocarcinoma↗
Expression of amphiregulin in human gastric cancer cell lines.
BACKGROUND: Amphiregulin (AR) is a novel gene of the epidermal growth factor (EGF) family. The authors have already reported that AR mRNA was expressed by human gastric carcinoma cells at various degrees, and its expression was induced by the treatment with EGF or transforming growth factor-alpha (TGF-alpha). METHODS: To elucidate the biologic role of AR in the stomach carcinogenesis, the effect of AR on the cell growth and the expression of growth factor/receptor genes in TMK-1 and MKN-28 gastric carcinoma cell lines was examined. Furthermore, to determine whether AR acts as an autocrine growth factor for gastric carcinoma cells, the authors introduced an antisense phosphorothioate oligodeoxynucleotide (S-oligo) against AR mRNA to these two cell lines. RESULTS: AR stimulated the growth of TMK-1 and MKN-28 cells in a dose dependent manner. The growth-promoting effect of AR was as potent as that of EGF or TGF-alpha. AR antisense S-oligo induced significant growth inhibition of both TMK-1 and MKN-28 cells compared with the control random S-oligo. Moreover, AR induced mRNA expression for AR itself, TGF-alpha, and EGF receptor in both cell lines. CONCLUSIONS: These results overall suggest that AR acts as an autocrine growth factor for these two gastric carcinoma cell lines and evokes the cascade induction of EGF and the TGF-alpha/receptor system.
Adenocarcinoma↗
Significance of rapid urease test for identification of Helicobacter pylori in comparison with histological and culture studies.
Helicobacter pylori in the stomach is an etiological factor of gastritis and peptic ulcer. It is now considered that gastric cancer can be, at least in some cases, a late complication of H. pylori infection. In 123 consecutive endoscopic antral biopsies obtained from patients with the Okamoto Hospital, the specimens were subjected to the rapid urease test (RUT), histology (H&E stain), and culture, for the identification of H. pylori. The results of these methods were compared semi-quantitatively in order to evaluate these detection methods for identifying H. pylori. The results of these methods were found to agree well, with the Spearman's rank correlation coefficient between RUT and culture being 0.90 (P < 0.01) and that between histology and culture being 0.80 (P < 0.01). RUT is considered to be a very simple, sensitive, and highly specific test which enables the endoscopist to diagnose H. pylori infection.
Adult↗
Famotidine, a histamine-2-receptor antagonist, inhibits the increase in rat gastric H+/K(+)-ATPase mRNA induced by intravenous infusion of gastrin 17 and histamine.
We examined the effects of gastrin and histamine on rat gastric H+/K(+)-ATPase, the enzyme responsible for H+ secretion, gene expression in vivo. Gastrin 17 (G 17) or histamine dihydrochloride (histamine) was continuously infused through the femoral vein of anesthetized rats. Gastric H+/K(+)-ATPase mRNA levels were measured using northern blot analysis. Infusion of G 17 and histamine increased the H+/K(+)-ATPase mRNA level significantly compared with basal control level or vehicle control level (P < 0.01). However, pretreatment with famotidine, a potent histamine-2 (H2)-receptor antagonist, inhibited the increase of rat gastric H+/K(+)-ATPase mRNA following G 17 and histamine infusion. These findings indicate that both histamine and G 17 increase expression of H+/K(+)-ATPase mRNA by activating H2 receptor on the parietal cell.
Actins↗
Serum pepsinogen in screening for gastric cancer.
To establish a sensitive and efficient screening method for gastric cancer using serum pepsinogen, we investigated the characteristics of serum pepsinogen I and II levels and the I/II ratio and their cut-off points. We found that the pepsinogen I level and the I/II ratio were significantly lower in patients with gastric cancer than in control subjects, especially in patients with cancers of the differentiated type, the elevated type, and the depressed type without ulceration. However, sex, depth of invasion, and location of tumor did not correlate with the pepsinogen levels. A suitable cut-off point in screening for gastric cancer was a pepsinogen I level of less than 50 ng/ml and a I/II ratio of less than 3.0, as determined by receiver operator characteristics curves. The sensitivity, the specificity, and the accuracy of detection for all types of gastric cancer were approximately 55%, 75%, and 72%, respectively. If restricted to cancers of the elevated and the depressed type without ulceration, the sensitivity was approximately 85%, and the specificity and accuracy were approximately 76% and 77%, respectively. These results suggest that, in screening for gastric cancer when using pepsinogen levels and morphological examinations, the suitable cut-off point in regard to specificity is as stated above. However, regarding sensitivity, when the pepsinogen method is used alone, a pepsinogen I level of less than 70 ng/ml and a I/II ratio of less than 3.0 is acceptable.
Adenocarcinoma↗
Endoscopic treatment of submucosal invasive colorectal carcinoma with special reference to risk factors for lymph node metastasis.
A clinicopathological analysis of the risk factors for lymph node metastasis was performed in 177 patients with submucosal invasive colorectal carcinoma (CRC). The submucosal deepest invasive portion was histologically subclassified as well (W), moderately (M), or poorly (Por) differentiated. M type was further subdivided into moderately-well (Mw) and moderately-poorly (Mp) differentiated. The pattern of tumor growth was classified as polypoid growth (PG) and non-polypoid growth (NPG). Lymph node metastasis was detected in 21 (12%) of the 177 patients. Macroscopically, type IIc and IIa + IIc lesions showed a significantly higher incidence of lymph node metastasis (44% and 30%) than type IIa and I (4% and 8%). Regarding the histologic subclassification, Por and Mp lesions showed a significantly higher incidence of lymph node metastasis (67% and 37%) than W and Mw lesions (4% and 14%). NPG tumors showed a significantly higher incidence of lymph node metastasis (29%) than PG tumors (7%). The depth of submucosal invasion and lymphatic invasion (ly) were also significantly correlated with the incidence of lymph node metastasis (submucosal scanty (sm-s) invasion 4%, massive invasion 20%; ly(+) 23%, ly(-) 5%). None of the lesions with both sm-s invasion and of W or Mw type showed lymph node metastasis. These results indicate that submucosal invasive CRC with both sm-s invasion and of W or Mw type, which shows no ly, is the appropriate indication for endoscopic curative treatment.
Adenocarcinoma↗
Helicobacter pylori infection is associated with low antral somatostatin content in young adults. Implications for the pathogenesis of hypergastrinemia.
BACKGROUND: Recent studies on the role of Helicobacter pylori in the pathogenesis of duodenal ulcers have focused on the mechanism by which H. pylori infections cause exaggerated gastrin release. METHODS: We determined meal-stimulated serum gastrin concentrations and antral somatostatin content in 24 asymptomatic volunteers (6 H. pylori-infected, 18 H. pylori-uninfected). Somatostatin content was determined by radioimmunoassay in biopsy specimens obtained from the antrum. RESULTS: Fasting and integrated 2-h gastrin concentrations were significantly higher in H. pylori-positive volunteers than in H. pylori-negative volunteers (fasting, 111 +/- 16.3 pmol/l versus 53.4 +/- 3.5 pmol/l; p < 0.05; integrated 2-h, 267 +/- 41.2 pmol/l versus 70.1 +/- 2.1 pmol/l; p < 0.01). Antral somatostatin content was 0.764 +/- 0.173 ng/mg and 2.931 +/- 0.414 ng/mg in H. pylori-positive and -negative volunteers, respectively (p < 0.01). CONCLUSIONS: Low antral somatostatin content may cause hypergastrinemia in asymptomatic healthy volunteers, and H. pylori may contribute to the pathogenesis of duodenal ulcer, through this mechanism.
Adult↗
Helicobacter pylori infection, serum gastrin, and gastric acid secretion in teen-age subjects with duodenal ulcer, gastritis, or normal mucosa.
BACKGROUND: Many studies have confirmed the close association of Helicobacter pylori with duodenal ulcer (DU) in adults. However, in the subtype of DU known as 'childhood' or 'early onset DU' genetic factors seem to play a prominent role in the pathogenesis. The aim of this study was to investigate the prevalence of H. pylori in teen-age subjects with DU, gastritis, and normal mucosa and to examine the relationship of H. pylori to serum gastrin levels and gastric acid secretion. METHODS: Sixty-one teen-age subjects (24 with DU, 14 with gastritis, and 23 normal subjects) were investigated for the presence of H. pylori, antral histology, gastrin levels, basal acid output (BAO), and maximal acid output (MAO). RESULTS: All 24 patients with DU and 8 of 14 with gastritis were infected with H. pylori; none of the normal subjects were infected. Mean gastritis scores and fasting serum gastrin levels were significantly higher in patients with DU or H. pylori-positive gastritis than in subjects with H. pylori-negative gastritis or normal mucosa (p < 0.05). The difference in serum gastrin levels was also significant when patients with DU were compared with those with H. pylori-positive gastritis (p < 0.05). BAO and MAO were significantly higher in patients with DU than in subjects with H. pylori-positive gastritis or normal mucosa (p < 0.05), but there was no difference between subjects with H. pylori-positive gastritis and those with normal mucosa. CONCLUSION: H. pylori infection is associated closely with teen-age DU and gastritis and with hypergastrinemia but does not affect BAO and MAO in most infected teen-age subjects.
Adolescent↗
Pernicious anemia and Helicobacter pylori infection in Japan: evaluation in a country with a high prevalence of infection.
OBJECTIVES: To evaluate the degree of gastritis and the prevalence of Helicobacter pylori in Japanese patients with pernicious anemia (PA). METHODS: Histological assessment for mucosal atrophy and inflammation was performed in gastric biopsy specimens taken from 24 Japanese patients with PA and from 24 age- and sex-matched controls. The prevalence of H. pylori was evaluated by Giemsa staining and serum IgG antibodies. Serum gastrin and pepsinogens were determined by radioimmunoassay. RESULTS: All patients with PA had severe fundic atrophic gastritis, and 17 (71%) also had antral atrophic gastritis. Thirteen (54%) of 24 age- and sex-matched controls had fundic atrophic gastritis, and 15 (62%) also had antral atrophic gastritis. Mucosal inflammation was identified in the fundus of all 24 patients and in 15 (62%) controls and in the antrum of 22 (92%) patients and 16 (67%) controls. H. pylori was not detected by Giemsa staining or serum IgG antibodies to H. pylori in any patient with PA but was present in 16 (67%) controls. Serum gastrin levels were significantly higher, and serum pepsinogen I, II, and the I/II ratio were significantly lower in patients than in controls (p < 0.001). CONCLUSIONS: Our results confirm that H. pylori infection is infrequent in PA and is unlikely to be a factor in producing type A gastritis in PA.
Adult↗
The relationship between gastric secretion and type of early gastric carcinoma.
To determine the relationship between gastric secretion and gastric carcinoma, we investigated gastric acid secretion and the fasting serum levels of pepsinogen I and gastrin in 50 Japanese patients with early gastric carcinoma. After the histological and macroscopic type of carcinoma had been determined, results were compared with findings in 50 Japanese control subjects whose gastric mucosa was endoscopically normal. The maximum gastric acid secretion and fasting levels of serum pepsinogen I were significantly lower in intestinal type gastric carcinoma than in diffuse type carcinoma and in the controls. They were also significantly lower in the non-ulcerative (elevated or flat) type than in the ulcerative (depressed) type of carcinoma. The serum gastrin levels in patients with early gastric carcinoma of either the intestinal or diffuse type were higher than those in the control subjects, though the difference was not significant. Gastric acid secretion and serum pepsinogen I levels were related with both the histological and macroscopic types of gastric carcinoma. These findings suggest that the serum pepsinogen I level might be useful as a maker for early gastric carcinoma of the intestinal type.
Adult↗
[Effect of octreotide on gastric and duodenal motility].
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Animals↗
Inhibitory action of CCK-OP on rat proximal colon.
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Acetylcholine↗
Proliferating cell nuclear antigen expression at the invasive tumor margin predicts malignant potential of colorectal carcinomas.
BACKGROUND: Proliferative activity may be a useful measure of malignant potential for a variety of tumors. Colorectal carcinomas contain multiple cell populations with different biologic properties. The invasive tumor margin is thought to represent the area with the highest metastatic potential. METHODS: Cell proliferation at the invasive tumor margin of 49 specimens of advanced colorectal carcinoma was assessed by immunohistochemical staining of proliferating cell nuclear antigen (PCNA) and compared with clinicopathologic findings. RESULTS: Colorectal carcinomas showed a wide range of PCNA labeling indexes (LI), reflecting variation in proliferative activity. The PCNA LI of tumors showing venous invasion (mean, 51.7% +/- 16.2%) was significantly higher than that of tumors without venous invasion (mean, 36.7% +/- 18.2%; P < 0.01). A strong association was observed between the PCNA LI and the metastatic potential of colorectal carcinoma; the PCNA LI of tumors showing lymph node metastasis (mean, 50.5% +/- 17%) was significantly higher than that of tumors without nodal involvement (mean, 39.8% +/- 18.5%; P < 0.05). In addition, the PCNA LI of tumors metastatic to liver (mean, 55.2% +/- 15.7%) was significantly higher than that of tumors without liver metastasis (mean, 41.0% +/- 17.6%; P < 0.01). Correlation with histologic features at the invasive tumor margin showed that a higher PCNA LI was associated with less differentiated tumors (P < 0.05). CONCLUSION: Evaluation of the PCNA LI at the invasive tumor margin may help identify colorectal carcinomas that have a higher malignant potential.
Antigens, Neoplasm↗
Relationship between Helicobacter pylori infection and gastric acid secretion in young healthy subjects.
We studied the relationship between Helicobacter pylori (H. pylori) infection and gastric acid secretion, along with fasting serum gastrin levels, in 55 asymptomatic healthy volunteers under 30 years old (29 H. pylori-positive, 26 H. pylori-negative). Mean scores of antral gastritis were significantly higher in H. pylori-positive subjects than in H. pylori-negative subjects. There was no significant difference in both basal and maximal acid output between H. pylori-positive and H. pylori-negative subjects. Fasting serum gastrin levels were significantly higher in H. pylori-positive subjects than in H. pylori-negative subjects. Sex did not significantly affect gastritis scores, gastric acid secretion, or fasting serum gastrin levels, although maximal acid output was slightly higher in H. pylori-negative men than in H. pylori-positive men. Our results suggest that H. pylori infection has no direct effect on gastric acid secretion in young healthy subjects, although it induces hypergastrinemia.
Adult↗
Effect of octreotide on gastrointestinal pressure profiles in health and in functional and organic gastrointestinal disorders.
The somatostatin analogue, octreotide, restores normal pressure profiles in disorders of upper gut motility. This study aimed to evaluate the acute effects of octreotide in five healthy subjects and in 50 consecutive patients with functional (n = 22) or organic (n = 28) dysmotility. Antroduodenojejunal manometry was performed during three hours' fasting, for two hours after a standard meal, and 30 minutes after subcutaneous injection of 50 micrograms octreotide. Antral motility, before and after octreotide, and characteristics of spontaneous migrating motor complexes and octreotide induced activity fronts were compared. Octreotide inhibited antral motility and induced a small intestinal activity front followed by motor quiescence in all healthy subjects and patients. The duration and propagation velocity of activity fronts were greater than those of spontaneous migrating motor complexes. Thirty per cent of activity fronts began simultaneously at different levels of small bowel, and in 20%, a second, normally propagated activity front developed within 30 minutes of octreotide injection. Octreotide induces rapidly propagated, long activity fronts, even in patients with neuropathology, and this may initially facilitate the intestinal propulsion of chyme. Propulsion may not occur, however, if octreotide induces simultaneous activity fronts or if the activity front is followed by prolonged quiescence. Inhibition of antral motility suggests that octreotide may not be effective in gastroparesis.
Adolescent↗
Effect of histamine on rat gastric H(+)-K(+)-ATPase alpha-subunit expression.
The H(+)-K(+)-adenosinetriphosphatase (ATPase) is expressed in the parietal cell and is responsible for acid secretion by the stomach. Histamine binds to an H2 receptor and activates adenylate cyclase and intracellular calcium concentration ([Ca2+]i) elevation, stimulating acid secretion. It has been shown that omeprazole administered to rats increases serum gastrin and transiently increases the level of mRNA for the alpha-subunit of the pump, but this increase is blocked by the presence of the H2-receptor antagonist, famotidine [A. Tari, G. Yamamoto, K. Sumii, M. Sumii, Y. Takehara, K. Haruma, G. Kajiyama, V. Wu, G. Sachs, and J. H. Walsh. Am. J. Physiol. 265 (Gastrointest. Liver Physiol. 28): G752-G758, 1993]. These observations suggest that the release of histamine induced by gastrin is essential for the increase of the expression of mRNA induced by omeprazole. Infusion of histamine at 15 mumol.kg-1.h-1 i.v. for 1 h increased the alpha-subunit mRNA level by 144 +/- 2.4% and induced a stimulated morphological appearance of the parietal cell. These changes were inhibited completely by the competitive H2-receptor antagonist famotidine, which elevated gastric pH and serum gastrin. Famotidine also reduced the level of H(+)-K(+)-ATPase mRNA compared with control animals. No change in the expression of beta-actin mRNA was observed in any group of animals. These data provide direct evidence for histamine stimulation of H(+)-K(+)-ATPase alpha-subunit gene expression by activation of the H2 receptor.
Animals↗