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Biomedical subjects

K Sumii

Publications and source records attributed to K Sumii.

At least 127 records · Page 7Linked to original sources
PubMed1992

Helicobacter pylori infection and gastroduodenal disease: a comparison of endoscopic findings, histology, and urease test data.

To determine the prevalence and significance of Helicobacter pylori (H. pylori) infection, biopsies of the antral mucosa were obtained from 139 patients and 43 asymptomatic volunteers. The specimens were examined by hematoxylin-eosin staining and the ureas test. The detection rate of H. pylori by histologic examination was 91.3% in patients with duodenal ulcer, 75.0% in those with combined duodenal and gastric ulcer, 63.6% in those with gastric ulcer, 22.9% in those with gastric carcinoma, 36.4% in those with gastric adenoma, 14.3% in those with gastric hyperplastic polyp, and 51.7% in those with gastritis, and the respective percentages detected by the urease test were 91.3%, 75.0%, 54.5%, 28.6%, 27.3%, 14.3%, and 44.8%. H. pylori was also detected in 10/43 (23.3%) asymptomatic healthy volunteers by histology and the urease test. The prevalence of H. pylori was significantly higher in the patients than in the asymptomatic healthy volunteers (p < 0.05). H. pylori was detected in 62.9% of patients with endoscopic erosive gastritis and in 97.9% of those with histologically proven chronic active gastritis. The urease test was positive in 77/82 patients who were histologically positive for the organism (sensitivity: 93.9%), and it was negative in 98/100 patients who were negative by histology (specificity: 98.0%). Thus, there was over 90% agreement between the urease test and histology. Our investigations showed that H. pylori was closely related to peptic ulcers and antral gastritis, and that the urease test provides a simple, rapid and accurate diagnosis of H. pylori infection.

Adult↗
PubMed1992

Rapid growth and difficulty of early detection of scirrhous carcinoma of the stomach.

We report six cases of scirrhous carcinoma of the stomach in which we were able to observe the natural history of serial radiographs. All the patients developed scirrhous carcinoma of the stomach in an observation periods ranging from 2 to 15 months (mean: 5.8 months). No abnormalities or obvious findings indicative of a carcinoma were detectable, on the prior radiographs, even when they were reviewed. Endoscopy was also performed in two patients during the observation period, and no lesions were detected. At the time of diagnosis, two patients were inoperable because of metastases and died of the disease 2 and 5 months later. Three patients died of the disease 5, 8, and 26 months after gastrectomy, respectively. Only one patient is free of disease 16 months after gastrectomy. Our findings suggest that the difficulty of detection and the rapid growth of this tumor may explain why it is seldom detected at an early stage and has a very poor prognosis.

Adenocarcinoma, Scirrhous↗
PubMed1992

Ultrasonographic assessment of inflammatory bowel disease.

Ultrasound examinations were performed in 36 patients with Crohn's disease, 28 with ulcerative colitis, and 50 with no bowel disease. The pathological findings were classified into three types and compared with the radiographic and/or colonoscopic findings. Crohn's disease and ulcerative colitis could be detected by ultrasonography with a sensitivity of 86% and 89%, respectively. The ultrasonographic features correlated with the radiographic/colonoscopic findings and with disease activity, but did not help much in making a differential diagnosis, although the location of the pathologic changes was helpful to some extent. In conclusion, ultrasonography can serve as a useful alternative diagnostic procedure that permits us to obtain information about transmural changes in inflammatory bowel disease.

Adolescent↗
PubMed1991

Evaluation of tumor growth rate in patients with early gastric carcinoma of the elevated type.

The growth rates of elevated-type early gastric carcinoma in 12 patients were determined chronologically using serial radiographs. Eight progressed from an early to an advanced stage during periods of observation ranging from 4-82 months (mean 31.7 months), while four patients were still in an early stage at final examination, despite an increase in tumor size. The tumor volume doubling months) but varied considerably among patients. Aggressive endoscopy should be performed for all elevated lesions of the stomach because they can harbor malignancy; some can grow rapidly as reported here.

Adenocarcinoma↗
PubMed1991

Regulation of rat antral gastrin and somatostatin gene expression during starvation and after refeeding.

Antral gastrin and somatostatin gene expression during starvation and after refeeding with liquid meals of varying composition were studied. Northern and slot-blot hybridization analyses showed that starvation caused a marked decrease in antral gastrin messenger RNA (mRNA) level by 12 hours associated with an increase in somatostatin mRNA. After 48 hours of fasting, antral gastrin mRNA was 26% and somatostatin mRNA was 136% of their prefasting levels. Refeeding caused increased 2-hour integrated gastrin mRNA levels after liquid peptone (+45%), phenylalanine (+31%), and olive oil (+13%), but no changes were observed with glucose or saline solutions. Integrated 2-hour immunoreactive antral gastrin content was increased after peptone (+106%), phenylalanine (+68%), and olive oil (+32%) meals but was not increased after glucose (-11%) or saline (-10%). In some cases, both gastrin mRNA and peptide responses could be measured as early as 15 minutes. The same nutrients that increased gastrin mRNA levels caused decreased 2-hour integrated somatostatin mRNA levels; peptone (-30%), phenylalanine (-28%), and olive oil (-21%), but neither glucose nor saline, altered somatostatin mRNA levels. These results suggest that antral gastrin and somatostatin genes were regulated in opposite directions, in a coordinate manner, by specific gastric nutrients that stimulate gastrin release.

Animals↗
PubMed1991

Rapid growth of untreated esophageal squamous-cell carcinoma in 10 patients.

We documented the natural history of esophageal carcinoma and its rapid growth by measuring the change in tumor diameter radiographically in 10 patients during an observation period because the diagnosis had been missed. Nine men and one woman (age range, 48-74 years; mean, 60 years) were included in the study. Eight patients had undergone esophagography for gastrointestinal complaints and had lesions missed on the initial interpretation that were apparent on retrospective review after the patient had returned with more severe complaints and undergone repeat studies; two patients had refused treatment. The tumor was squamous-cell carcinoma in all. The treatment-free retrospective observation period ranged from 4 to 19 months (mean, 12.2 months) and was shorter for elevated (mean, 9.2 months) than for depressed lesions (mean, 16.8 months). The longitudinal diameter increased from 10-100 mm initially (mean, 30.5 mm) to 32-150 mm (mean, 74.9 mm). No correlation existed between the increase in size and histologic features. This documentation of the rapid increase in the size of esophageal carcinoma involving at least the submucosa confirms clinical impressions of the aggressive nature of this lesion and offers an explanation of why this disease is seldom detected at an early stage and long-term survival is so poor after the early stage of disease.

Carcinoma, Squamous Cell↗
PubMed1991

Gastric mucosa in female patients with fundic glandular polyps.

To evaluate the characteristics of the gastric mucosa in women with fundic glandular polyps, we examined gastric acid secretion, fasting serum levels of pepsinogen I and gastrin, and gastric histology in 11 female patients with fundic polyps, and compared the results with 30 female controls without endoscopic abnormalities and 50 female patients with gastric foveolar hyperplastic polyps. No significant difference was found in gastric and secretion and fasting serum levels of pepsinogen I and gastrin between the patients with fundic glandular polyps and the control subjects. Histological examination showed that atrophic gastritis was generally not found in the patients with fundic glandular polyps. In contrast, gastric acid secretion and fasting serum levels of pepsinogen I were significantly lower and serum gastrin levels were significantly higher in the patients with foveolar hyperplastic polyps than in the other two groups. Also, patients with foveolar hyperplastic polyps had a higher prevalence and further advanced atrophic gastritis in the fundus than did the other two groups. Our investigations demonstrated that fundic glandular polyps arise from gastric mucosa without atrophic gastritis, whereas foveolar hyperplastic polyps develop from mucosa affected by atrophic gastritis, especially type A gastritis.

Female↗
PubMed1991

Endoscopic therapy for gastric cancer in patients more than 80 years old.

We prospectively studied 17 gastric cancer patients who were more than 80 yr old, in whom endoscopic therapy was performed. The patients were divided into two groups: the first group included 13 patients in whom curative treatment was attempted, and in 11 (85%) a curative response was achieved. Two patients in this group showed a positive gastric biopsy after 1 and 2 yr, respectively, of therapy: one patient is under current treatment with laser therapy, and the other patient underwent surgery with resection of the stomach. The second group included four patients in whom treatment was aimed at prolonging survival or palliation, and in all four patients, a successful response was obtained. Therefore, our results demonstrate that endoscopic therapy is effective for the treatment of gastric cancer patients over 80 yr old.

Aged↗
PubMed1991

Immunoreactive transforming growth factor alpha is commonly present in colorectal neoplasia.

Surgical specimens from 19 patients with invasive colorectal cancers and 12 specimens of normal mucosa from the same patients were examined immunohistochemically for the production of the immunoreactive (IR-) transforming growth factor (TGF)-alpha and IR-epidermal growth factor (EGF) with an anti-TGF-alpha monoclonal antibody (MAb) OAL-MTG01 and anti-EGF MAb KEM-10. Immunoreactive TGF-alpha was detected in 16 (84.2%) of 19 colorectal cancers. In contrast, there was no IR-TGF-alpha in the gland cells of normal mucosa. Immunoreactive EGF was detected in 7 (36.8%) of 19 colorectal cancers and 1 (8.3%) of 12 cases of normal mucosa. The production of both IR-TGF-alpha and IR-EGF in colorectal cancer did not differ by histologic type and Dukes' stage. Immunoreactive TGF-alpha was detected at significantly higher incidence than IR-EGF in colorectal cancer. These results indicate that IR-TGF-alpha should prove valuable as a possible tumor marker in colorectal cancers, and it may be very useful in understanding the biology of colorectal cancer.

Antibodies↗
PubMed1991

Superficial esophageal carcinoma: a report of 27 cases in Japan.

Twenty-seven patients with superficial esophageal carcinoma were investigated to determine their clinical and pathological features. All 21 male patients were habitual drinkers, and 17 were heavy smokers. Histological examination showed that three tumors were intraepithelial, five were mucosal, and 19 were submucosal. Fifteen of the 27 patients were asymptomatic, including seven of the eight with intraepithelial or mucosal carcinoma. Twelve of the 13 patients with polypoid tumors had submucosal invasion, whereas two patients with flat tumors and four of the seven with erosive tumors had either intraepithelial or mucosal carcinoma. Six of the eight patients with intraepithelial or mucosal carcinoma had normal routine radiological studies. All these eight patients had no lymph node involvement, whereas four of the 19 with submucosal carcinoma had lymph node metastases. An aggressive approach to endoscopy in asymptomatic high-risk individuals (middle-aged male drinkers and smokers) may increase the detection of early esophageal carcinoma, although the cost-effectiveness should be evaluated further. In addition, in the interest of prevention, our results show that encouraging people to stop smoking and limit their alcohol intake to an occasional drink might be an important factor in lessening the risk for esophageal carcinoma.

Adult↗
PubMed1990

Multiplicative effect of hyperpepsinogenemia I and non-secretor status on the risk of duodenal ulcer in siblings.

In a search for genetic markers of duodenal ulcer, serum pepsinogen I level, ABO blood groups and secretor status were determined in 89 siblings of 34 duodenal ulcer families. Duodenal ulcer patients were likely either to have hyperpepsinogenemia I or to be non-secretors on a familial basis, but not to have an increased frequency of blood group O. The frequency of duodenal ulcer in the siblings was highest in hyperpepsinogenemia I/non-secretor and lowest in normopepsinogenemia I/secretor. Therefore, the influence of two genes, hyperpepsinogenemia I and non-secretor, on the risk of duodenal ulcer is multiplicative. These results provide evidence on the hypothesis of polygenic inheritance of duodenal ulcer.

ABO Blood-Group System↗
PubMed1990

Regulation of gastric somatostatin gene expression.

Regulation of somatostatin gene expression was studied in the rat gastric antrum. Antral total RNA was isolated from animals during starvation and after refeeding, or under gastric neutralization by fundectomy or by omeprazole treatment. Northern blot analysis using cRNA probe synthesized from a cloned rat somatostatin cDNA demonstrated a single hybridizing band, approximately 850 nucleotides in length, which is present in the antrum. Quantitative slot blot analyses were able to detect significant changes of somatostatin mRNA levels in total RNA as low as 5 micrograms. Somatostatin mRNA levels increased significantly after 12 hours of fasting (144% of control) and remained elevated throughout the 4-day fasting period. Upon refeeding with solid food and phenylalanine, antral somatostatin returned to the prefasted level in 2 hours. Refeeding with olive oil or saline depressed somatostatin mRNA significantly within 30 to 60 minutes but did not attain the prefasted state. Fundectomy and omeprazole resulted in maximal inhibition of antral somatostatin mRNA levels by 77% and 78%, respectively. The present in vivo results indicate that somatostatin gene expression in the stomach is regulated by luminal factors that include pH and specific nutrients. Future studies based on this phenomenon can expand knowledge of the interactions between gastric endocrine cells and the gastric environment.

Achlorhydria↗
PubMed1990

Studies of regulation of gastrin synthesis and post-translational processing by molecular biology approaches.

We have examined the regulation of gene expression and post-translational processing of progastrin by starvation and feeding in rats. An oligonucleotide complementary to rat preprogastrin cDNA was used in RNA blot and hybridization analysis to measure gastrin mRNA levels. A region-specific antibody raised against the predicted amino acid sequence of the carboxyl terminal extension of progastrin was used for quantitation of progastrin peptides. The effects of starvation and of refeeding on rat antral gastrin mRNA and pro-hormone peptide levels were examined in rats starved for 48 h and after refeeding with a solid meal. Antral gastrin mRNA concentrations decreased to a plateau level (30% of the nonstarved control) after 48 h of starvation. Immunoreactive gastrin concentration decreased threefold, but progastrin processing intermediates did not decrease significantly during fasting. Following refeeding, significant increases in antral mRNA level were detected in 1 h, and peak levels were reached by 2 h (more than two times higher than starved control). There was a rapid and significant decrease in progastrin immunoreactivity within 30 min, followed by a significant increase in gastrin immunoreactivity 2 h after refeeding. These data suggest that rapid increases of blood and tissue gastrin levels in response to food may be associated with increases in both gastrin gene expression and post-translational processing of progastrin.

Animals↗
PubMed1990

Effects of inhibition of gastric secretion on antral gastrin and somatostatin gene expression in rats.

Antral gastrin and somatostatin mRNA concentrations were measured in rats during gastric neutralization produced either by resection of the acid-secreting portion of the stomach (fundectomy) or by omeprazole treatment. Fundectomy caused increases in gastrin mRNA concentrations to 570% of sham control after 4 days and to 650% after 28 days. Daily administration of omeprazole resulted in significant dose- and time-dependent increases in antral gastrin mRNA concentrations. Four-day treatment with omeprazole caused threefold increased gastrin mRNA. Antral somatostatin mRNA concentrations decreased significantly after fundectomy to 66% of sham control after 4 days and to 23% after 28 days. Omeprazole produced a more profound decrease in somatostatin mRNA to 22% of the vehicle control after 4 days. Antral beta-actin mRNA concentrations did not differ significantly between control and experimental animals. Transcription of gastrin mRNA in isolated antral mucosal nuclei, measured by a nuclear run on technique, was significantly increased after omeprazole treatment in vivo. Increases in plasma and antral gastrin concentrations in response to gastric neutralization were closely associated with increases in gastrin mRNA and were accompanied by reductions in somatostatin mRNA in the antrum. However, fundectomy produced relatively greater increases in gastrin mRNA and lesser reductions in somatostatin mRNA than observed after omeprazole pretreatment.

Amanitins↗
PubMed1990

Recurrence of duodenal ulcer and elevated serum pepsinogen I levels in smokers and nonsmokers.

We determined serum pepsinogen I (PG I) levels by radioimmunoassay in 472 patients with duodenal ulcer and 141 normal subjects to investigate whether serum PG I levels were related to cigarette smoking, and in 225 patients to determine whether the recurrence of duodenal ulcer was related to serum PG I levels or cigarette smoking. Serum PG I levels were not influenced by cigarette smoking in either patients with duodenal ulcer or normal subjects. The recurrence rate of duodenal ulcer not under maintenance therapy was significantly higher in hyperPG I patients than in normoPG I patients, regardless of their smoking habits. Only in hyperPG I patients was the recurrence rate in smokers higher than in nonsmokers. Patients under maintenance therapy showed similar results. Multilogistic regression indicated that hyperPG I had a greater effect than cigarette smoking on ulcer recurrence. These findings indicate that serum PG I levels are not influenced by smoking, and the important characteristic in patients with recurrent duodenal ulcers is the increased serum PG I levels.

Adolescent↗
PubMed1990

[The ornithine decarboxylase activity of the gastric remnant mucosa: the effect of the duodenal juice with bile on the gastric mucosa].

Using male Wister rats, the ornithine decarboxylase (ODC) activity in the fundic mucosa has been determined from the duodenal juice with bile of a reflux model. The activity at 24 hours postoperatively presented a value approximately 18 times higher than the preoperative level. Though this level declined subsequently, it still was approximately two times higher four weeks later. The ODC activity in the corporal mucosa of humans was compared in 25 normal persons, in 21 patients with a gastric adenoma in 29 patients with a gastric cancer, in 20 patients who had undergone a Billroth I operation and in 20 patients who had undergone a Billroth II operation. No differences in ODC activity were observed among those with a gastric adenoma, a gastric cancer, and normal cases but significantly higher values were seen in cases with a remnant stomach, particularly those who had undergone Billroth II reconstructive surgery. Further, this activity tended to be especially high from 5 to 15 years postoperatively in cases with a gastric remnant.

Aged↗
PubMed1990

Endoscopic therapy in patients with inoperable early gastric cancer.

The efficacy and safety of endoscopic therapy was investigated prospectively in 42 patients with 44 early gastric cancers who were not candidates for surgery. Thirty-five of the 44 lesions (80%) were treated by endoscopic therapy alone. Adequate tumor resection was possible in lesions less than 2 cm in diameter, in those of the protruding, flat, and erosive types, and in those located in the antrum. None of the 35 patients who were judged completely cured by the initial therapy developed recurrence or lymph node metastases in the follow-up period (range, 3-114 months; mean, 37 months). Therefore, endoscopic therapy appears effective in the treatment of patients with early gastric cancer when the risks of surgery are too high.

Aged↗