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Biomedical subjects

K Haruma

Publications and source records attributed to K Haruma.

At least 145 records · Page 8Linked to original sources
PubMed1994

Quantitation of duodenogastric reflux and antral motility by color Doppler ultrasonography. Study in healthy volunteers and patients with gastric ulcer.

BACKGROUND: Our objective was to develop a simple, noninvasive method for evaluating duodenogastric reflux, along with antral motility and gastric emptying of a liquid meal. METHODS: Antral motility and gastric emptying were measured by ordinary ultrasonography after a meal of 400 ml consommé. Duodenogastric reflux was evaluated by means of color Doppler. In a preliminary in vitro study we demonstrated that the test meal (consommé) contained oil particles suitable as a marker for color Doppler. We then investigated duodenogastric reflux, antral motility, and gastric emptying of a liquid meal in 43 asymptomatic healthy volunteers and in 24 patients with gastric ulcer. RESULTS: This approach was feasible in 65 (97.0%) of the 67 subjects studied. Duodenogastric reflux was demonstrated in 26 (61.9%) of the 42 healthy volunteers and in 20 (87.0%) of the 23 patients with gastric ulcer. The frequency of the duodenogastric reflux and the reflux index were significantly increased in patients with gastric ulcer as compared with asymptomatic healthy volunteers. Gastric emptying and the motility index of antral contractions were significantly decreased in patients with gastric ulcer as compared with asymptomatic healthy volunteers. CONCLUSIONS: Ultrasonography with color Doppler is useful for evaluating abnormalities of gastroduodenal motility and can be used to understand the pathogenesis of such disorders.

Adult↗
PubMed1994

[The risk factors of lymph node metastasis in submucosal invasive gastric carcinoma--assessment of the indication for endoscopic treatment].

Recent advances in endoscopic diagnosis and treatments have increased the number of early gastric carcinomas being treated by endoscopic resection. However, the appropriate criteria for endoscopic resection of gastric carcinomas with submucosal invasion are not completely established. During the past 12 years from 1980 to 1992, 116 lesions in 116 patients were treated by surgical operation for differentiated type submucosal invasive gastric carcinoma. In this study, the risk factors of lymph node metastasis were investigated clinicopathologically. As the result, 1) Heterogeneity of submucosal invasive tumor margin was demonstrated in 19 (16%) of the 116 lesions of which predominant histology was differentiated adenocarcinoma. 2) Lymph node metastasis was demonstrated in 16 (16%) of the 97 lesions of which histology was differentiated type. 3) Significant risk factors of lymph node metastasis was demonstrated in submucosal massive invasion (sm3), papillary adenocarcinoma, INF gamma, lymph vessel involvement (ly(+)), and existence of ulcer (ul(+)). 4) Sm3 and papillary adenocarcinoma (pap) had a higher malignant potential than ly(+), INF gamma, and ul(+) by multivariate analysis using the logistic regression. 5) All lesions with both well differentiated adenocarcinoma (tub1) and sm minimal invasion (sm1) had no lymph node metastasis. These results suggested that the lesions with both well differentiated adenocarcinoma tub1 and sm1, which have no other risk factors such as ly(+), INF gamma, and ul(+), may be considered as the appropriate indication for endoscopic treatment of gastric submucosal carcinoma.

Adenocarcinoma, Papillary↗
PubMed1994

Regulation of antral peptides by administration of omeprazole to healthy men.

OBJECTIVES: We investigated the effects of short-term administration of omeprazole on the regulation of antral gastrin and somatostatin in 15 healthy men. METHODS: Seven of these men were administrated 20 mg, and eight were given 40 mg of omeprazole for 8 days each. All subjects were examined before the first dose and after the last dose. RESULTS: Each dose significantly increased the basal serum gastrin level. Although the dose of omeprazole 20 mg/day had no significant affect on the antral somatostatin content, omeprazole 40 mg/day increased the antral gastrin content and decreased the antral somatostatin content significantly. Both doses significantly increased in the antral gastrin mRNA level. However, neither dose significantly affected the antral somatostatin mRNA level. CONCLUSIONS: This study shows reciprocal changes between the antral content of gastrin and somatostatin following omeprazole administration. These results indicate that antral somatostatin may be involved in the hypersecretion of gastrin produced by omeprazole in humans.

Adult↗
PubMed1994

Helicobacter pylori infection and serum pepsinogen A, pepsinogen C, and gastrin in gastritis and peptic ulcer: significance of inflammation and effect of bacterial eradication.

OBJECTIVES: To study the relationship between Helicobacter pylori infection, gastric inflammatory scores, and fasting gastrin and pepsinogen A and C concentrations, and to evaluate the effect of treatment on these parameters. METHODS: Gastrin and pepsinogen A and C concentrations were measured in 36 patients with gastritis, 10 gastric ulcer patients, 12 duodenal ulcer patients, and in 15 subjects with normal gastric mucosa, by standard radioimmunoassay techniques. Fifteen patients with H. pylori infection underwent triple therapy (bismuth subsalicylate, amoxicillin, metronidazole) and were reassessed 1 month later. RESULTS: Fasting gastrin and pepsinogen A and C concentrations were significantly higher in H. pylori-positive gastritis and peptic ulcer patients than in subjects with normal mucosa and in patients with H. pylori-negative gastritis. There was a significant correlation between inflammatory scores and serum gastrin (r = 0.45, p < 0.0001), and pepsinogen A (r = 0.33, p < 0.006) and pepsinogen C (r = 0.55, p < 0.0001) concentrations. Neither sex nor age affected basal gastrin and pepsinogen concentrations. Eradication of H. pylori infection was successful in 12 patients and resulted in a significant fall in serum gastrin and in pepsinogen A and C concentrations, and in a concomitant improvement of the inflammatory scores. Serum peptide levels and gastritis scores were unchanged in those patients in whom H. pylori infection persisted. CONCLUSIONS: These findings suggest that hypergastrinemia and hyperpepsinogenemia are secondary to H. pylori infection and are related to mucosal inflammation.

Amoxicillin↗
PubMed1994

[Assessment for development of superficial colorectal neoplasm--endoscopic and clinicopathologic analysis of 149 submucosal invasive carcinomas].

We performed the endoscopic and clinicopathologic analysis for the development of superficial colorectal carcinoma, using 149 submucosal (sm) invasive colorectal carcinomas. It was observed that superficial colorectal carcinomas had a tendency to rise by their sm massive invasion. In this study, we judged that the sm colorectal carcinomas originated from superficial colorectal carcinoma were 37 (25%) of 149 lesions, and their distribution in the colon and rectum was similar to that of advanced colorectal carcinomas, although the lesions originated from non-superficial (polypoid) colorectal carcinoma did not show so tendency. On the other hand, sm colorectal carcinomas originated from superficial colorectal carcinoma contained the evident adenomatous components in 7 (19%) of 37 lesions and had significantly higher incidence of lymph node metastasis than those originated from non-superficial (polypoid) carcinoma. These results suspected the facts as follows; 1) Superficial early colorectal carcinoma may be compatible as the origin to advanced colorectal carcinoma and has higher malignant potential than non-superficial early carcinoma. 2) Superficial colorectal carcinoma might also have the route of the development of "adenoma-carcinoma sequence", as well as "de novo" histogenesis.

Adenoma↗
PubMed1993

Gastric emptying and bezoars in Japanese. Report of five cases.

Bezoars are conglomerates of undigested material in the stomach. Previous reports have shown that a decrease in secretion of pepsin and gastric acid and a delay in gastric emptying might contribute to their formation. To clarify the pathogenesis of the formation of gastric bezoars, we studied gastric emptying in five patients who presented with a bezoar. In addition, gastric acid secretion was studied in three of the cases. Gastric emptying was not delayed in any case, and there was no trend toward a decrease in gastric acid secretion. The five patients were successfully treated by the endoscopic fragmentation and enzymatic dissolution of the bezoars. We conclude that, in Japanese, factors other than a delay in gastric emptying are the main contributors to bezoar formation.

Aged↗
PubMed1993

Solitary pedunculated polypoid gastric gland heterotopia.

A solitary pedunculated gastric polyp in the gastric fundus was removed from an asymptomatic 36-year-old woman with normal gastric acid secretion and a normal serum gastrin level. This lesion exhibited distinctive histological features including prominent proliferation of pseudopyloric glands, fundic glands, foveolar epithelium and a fibromuscular stroma. Moreover, its surface was entirely covered by a layer of normal gastric epithelium. Biopsies of the background mucosa taken from the gastric fundus revealed only mild superficial gastritis. A gastric gland heterotopia was diagnosed because of its unique morphology.

Adult↗
PubMed1993

p53 gene mutations in gastric adenomas.

p53 gene alterations in ten gastric adenomas and one carcinoma arising in an adenoma were analyzed by deoxynucleotide sequencing. Three (30%) of the ten gastric adenomas had p53 gene mutations, one adenoma showing a frameshift mutation and two others showing silent mutations. In addition, two missense mutations occurred in the carcinoma arising in an adenoma. Histologically, the adenomas containing silent mutations revealed moderate dysplasia. Immunoreactivity to p53 protein was also examined in 61 gastric adenomas, 19 carcinomas arising in adenomas and 48 early well-differentiated adenocarcinomas of the stomach (these included the tumors analyzed by deoxynucleotide sequencing). No staining for p53 was seen in the pure adenomas, but positive immunoreactivity was observed in 27% of the adenocarcinomas and 10.5% of the carcinomas arising in adenomas. These results suggest that p53 gene mutation is an early event in gastric carcinogenesis and missense mutation may play a crucial role in the conversion from adenoma to adenocarcinoma.

Adenoma↗
PubMed1993

Expression of amphiregulin, a novel gene of the epidermal growth factor family, in human gastric carcinomas.

The expression of mRNA for amphiregulin (AR), a novel gene of the epidermal growth factor family, was examined in 8 human gastric carcinoma cell lines and 32 gastric carcinoma tissues as well as corresponding normal mucosa. Of the 8 gastric carcinoma cell lines, 7 expressed 1.4 kb AR mRNA at various levels. The expression of AR mRNA by TMK-1 and MKN-28 cells was increased by treatment with epidermal growth factor or transforming growth factor a. In surgical cases, all the gastric carcinoma tissues and their adjacent normal mucosa expressed AR mRNA. Interestingly, 20 (62.5%) out of 32 tumors expressed AR mRNA at higher levels than their corresponding normal mucosas (tumor/normal > or = 1.2). No obvious correlation was observed between the AR mRNA levels and the histological types or tumor staging of gastric carcinoma. Immunohistochemically, AR protein was localized to the cytoplasm and/or nucleus in tumor cells. These results suggest that AR produced by tumor cells may be involved in the pathogenesis and/or progression of human gastric carcinoma.

Adult↗
PubMed1993

Role of histamine2 receptor in increased expression of rat gastric H(+)-K(+)-ATPase alpha-subunit induced by omeprazole.

Omeprazole is a specific inhibitor in vivo of the functioning gastric acid pump, the H(+)-K(+)-adenosinetriphosphatase (ATPase), in the secretory canaliculus of the parietal cell. It has been shown previously that omeprazole in rats led to an increase in the mRNA for the alpha-subunit of the H(+)-K(+)-ATPase. Omeprazole causes a marked increase in circulating gastrin in this species, which in turn stimulates release of histamine from the enterochromaffin-like cell. The possible role of this pathway was investigated by the in vivo administration of famotidine, a potent H2 receptor antagonist. A single intraperitoneal dose of famotidine, 200 mg/kg, produced a transient hypergastrinemia peaking at 3 h and normalizing at 12 h, inhibition of secretion that lasted for 12 h, but no change in the level of the alpha-subunit mRNA or of beta-actin mRNA. In contrast, a single dose of omeprazole, 100 mg/kg, inhibited acid secretion and produced hypergastrinemia, peaking at 12 h, both effects lasting for the 24-h observation period. Omeprazole elevated the alpha-subunit mRNA transiently by more than threefold at 3 h, with normal levels being restored at 24 h. The administration of famotidine 1 h after omeprazole did not change the effects of omeprazole on acid secretion but elevated the gastrin levels further. There was now no elevation of the alpha-subunit mRNA for the first 6 h, but a small increase at 12 h and a further increase to approximately 2.5-fold at 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Usefulness of nucleolar organizer region staining in gastric myogenic tumors: correlation with ploidy by DNA flow cytometry.

A silver-staining technique to identify nucleolar organizer region-associated proteins (Ag-NOR) was applied to 55 gastric myogenic tumors. The mean numbers of Ag-NOR in the nucleus were: leiomyoma (30 cases), 2.0 +/- 0.6 (mean +/- SD); low-grade leiomyosarcoma (11 cases), 3.0 +/- 0.7; and high-grade leiomyosarcoma (14 cases), 3.9 +/- 0.7. The Ag-NOR counts were compared with DNA ploidy as determined by flow cytometry in 46 tumors. The Ag-NOR counts were significantly different in the aneuploid leiomyosarcomas (4.1 +/- 0.6: mean +/- SD) and diploid leiomyosarcomas (2.9 +/- 0.6: mean +/- SD). Thus, this parameter may serve as an objective histological discriminant for malignancy.

Adult↗
PubMed1993

Characteristics of teen-age patients with juvenile duodenal ulcer. Relation between inherited hyperpepsinogenemia I and duodenal ulcer.

We analyzed environmental factors, family history of peptic ulcer, gastric acid secretion, and serum levels of pepsinogen I (PG I) and gastrin in 56 juvenile patients with duodenal ulcer and 39 normal teenage subjects. Basal acid output and maximal acid output were significantly higher in our duodenal ulcer patients than in controls without ulcer (both, p < 0.01), and patients with duodenal ulcer showed significantly higher serum levels of PG I and gastrin than the controls (both, p < 0.001). There were no significant differences in any environmental factor between the patients and controls. Fifteen of the 17 patients who had one or both parents with hyperpepsinogenemia I had high serum PG I levels. Over half of the duodenal ulcer patients had high serum gastrin levels, irrespective of family history of hypergastrinemia. Our findings suggest that hyperpepsinogenemia I and hypergastrinemia are important characteristics and that genetic background, particularly the inheritance of a gastric mucosal trait expressed as hyperpepsinogenemia I, is frequently involved in the pathogenesis of juvenile duodenal ulcer.

Adolescent↗
PubMed1993

Gastric acid secretion, serum pepsinogen I, and serum gastrin in Japanese with gastric hyperplastic polyps or polypoid-type early gastric carcinoma.

We determined the maximum secretion of gastric acid and the fasting serum levels of pepsinogen I and gastrin in Japanese patients with gastric hyperplastic polyps or polypoid-type early gastric carcinoma, comparing those findings with observations in control subjects. Both the maximum acid secretion and fasting levels of serum pepsinogen I were significantly lower in the patients with gastric hyperplastic polyps or polypoid-type early gastric carcinoma than in the controls. Fasting serum gastrin levels were significantly higher in the patients with gastric hyperplastic polyps than in the other two groups of subjects. These data demonstrated that the combination of hypochlorhydria, a low level of pepsinogen I, and hypergastrinemia (type-A gastritis) was common in the patients with gastric hyperplastic polyps, whereas hypochlorhydria and a low pepsinogen I without hypergastrinemia (type-B gastritis) were common in those with polypoid-type early gastric carcinoma.

Aged↗
PubMed1993

[Comparison of endoscopic therapy and conventional surgery for the treatment of early gastric cancer in elderly patients].

The first choice for the treatment of gastric cancer is surgery. Presently, endoscopic therapy offers the possibility of cure for some types of early gastric cancer, especially among aged or poor surgical risk patients and has obtained excellent results. During the past 13 years and 6 months from April 1978 to September 1991, 55 lesions in 52 patients aged over 75 years old were treated by endoscopic therapy. During this same period, 57 patients aged over 75 years old were surgically treated for early gastric cancer. In this study we evaluated the efficacy of endoscopic therapy for the treatment of early gastric cancer, and furthermore we compared endoscopic therapy with surgery in relation to prognosis, complications and quality of life. The analysis of endoscopic treatment showed that in 72.7% of our cases local cure was obtained. Generally, early gastric cancers less than 20 mm, of well differentiated type, restricted to the mucosa and without ulceration are suitable for endoscopic therapy. Local cure could be achieved in more than 90% of these cases. Among the 52 patients treated by endoscopic therapy, there were residual lesions after treatment in in 4 patients. They died of advanced disease or metastatic liver tumor. These patients were poor surgical risks and for this reason surgery was contraindicated. Analysis by the Kaplan-Meier method showed that in comparison with conventional surgery, endoscopic therapy showed better results in the first two years of follow up and almost the same results after three years.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Gastric emptying in elderly patients with cerebral vascular diseases and the effect of trimebutine].

The authors investigated gastric emptying in 18 elderly patients with cerebral vascular diseases using the acetaminophen method. Subjects were divided into 2 groups according to their levels of daily activity. One group consisted of 10 comatose patients (71-92 years old), the other consisted of 8 patients (74-95 years old) who could walk by themselves. We also investigated gastric emptying in 6 comatose patients (38-83 years old) because of other diseases such as amyotrophic lateral sclerosis and in 11 elder controls (75-95 years old). In elderly controls, the acetaminophen concentration at 45 minutes was 9.08 +/- 1.71 micrograms/ml. In comatose patients due to cerebral vascular diseases, the concentration was 3.89 +/- 1.60 micrograms/ml, which showed significantly delayed gastric emptying (p < 0.05). In patients with cerebral vascular diseases who could walk, the concentration was 6.51 +/- 0.99 micrograms/ml. In comatose patients by another diseases, the concentration was 5.82 +/- 1.13 micrograms/ml. We suspected that delayed gastric emptying is related to the comatose state. Trimebutine significantly (p < 0.01) improved gastric emptying in comatose patients with cerebral vascular diseases.

Adult↗
PubMed1993

[A clinical study of pepsinogen I and II producing gastric carcinomas].

Anti-human pepsinogen (PG) I and II monoclonal antibodies were used in an immunohistochemical study of 56 cases of gastric carcinoma (37 early stage and 19 advanced stage). We examined the relationship between positivity of the carcinoma for producing PG I and II and serum PG I and II levels. We found that in 2 cases (3.6%), the carcinoma produced PG I and in 11 cases (19.6%), it produced PG II. Early gastric carcinomas and differentiated-type carcinomas produced PG II more frequently than advanced and undifferentiated-type carcinomas. Also, type II c carcinomas and carcinomas located in the C area of the stomach produced PG II more frequently. But there was no significant difference between PG I and II-positive and negative cases in relation to both serum PG I and II levels. Moreover, the rate of positivity did not correlate with cases of abnormally high levels of serum PG I and II, (except in 1 case with abnormally high serum PG I in which PG II was produced.) These results suggest that there is no significant relationship between PG I or II-producing gastric carcinomas and serum PG levels. Furthermore, we examined PG II-producing and non-producing carcinomas in relation to the grade of inflammation, atrophy and intestinal metaplasia in gastric mucosa. However, there was no statistically significant difference among these factors. Only serum PG I and II levels were related to these parameters.

Adult↗
PubMed1992

The level of a transcription factor Sp1 is correlated with the expression of EGF receptor in human gastric carcinomas.

The expression of the transcription factor Sp1 and EGF receptor (EGFR) was examined on human gastric carcinoma cell lines and gastric carcinoma tissues as well as corresponding normal mucosa in order to clarify the mechanism of overexpression of EGFR gene without gene amplification. All 7 carcinoma cell lines expressed Sp1 mRNA, the levels of which were closely correlated with the expression of EGFR mRNA except for one cell line. The gel retardation analysis revealed that the levels of Sp1 mRNA were parallel to its DNA binding activities. In 18 surgical cases, 12 tumors expressed Sp1 mRNA at higher levels than normal mucosa. The cases with overexpression of Sp1 showed the high level of EGFR mRNA. These results suggest that overexpression of Sp1 in tumor cells may induce overexpression of EGFR without gene amplification in human gastric carcinomas.

Adult↗