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Biomedical subjects

M Kimmey

Publications and source records attributed to M Kimmey.

7 recordsLinked to original sources
PubMed2000

Chronic atrophic gastritis and Helicobacter pylori infection among Japanese Americans in Seattle.

Gastric cancer is still a major cause of mortality due to cancer worldwide. The most common type of gastric cancer is intestinal type carcinoma, which usually occurs in stomachs containing chronic atrophic gastritis. Individuals with chronic atrophic gastritis are considered to be at increased risk for developing intestinal type carcinoma of the stomach. To examine the association between chronic atrophic gastritis and other gastric cancer risk factors, a cross-sectional study was conducted using serum samples and questionnaire information collected from 776 persons of full Japanese ancestry in the greater Seattle area in 1994. The presence of chronic atrophic gastritis and Helicobacter pylori infection was determined by measurement of serum pepsinogen levels and H. pylori antibodies, respectively. Based on multiple logistic regression, the significant predictors of chronic atrophic gastritis were age over 50 years, H. pylori infection, and 20 years or more lived in Japan. Alcohol consumption, smoking, prior peptic ulcer, and history of gastric cancer in parents were not significantly associated with chronic atrophic gastritis. The results imply that H. pylori infection since earlier life and other unknown exposure factors in Japan might have played an important role in the development of chronic atrophic gastritis.

Adult↗
PubMed1996

Clinical implications of endoscopic ultrasound: the American Endosonography Club Study.

BACKGROUND: Despite increased clinical use of endoscopic ultrasound (EUS), there are little data regarding complications of EUS or its impact on patient management. METHODS: A prospective multicenter study was completed to evaluate clinical outcomes of EUS. Before each EUS examination the endosonographer recorded further theoretical patient management plans as if EUS was unavailable. After the EUS, endosonographers recorded actual management plans based on EUS results. The actual management plan after EUS was compared to the theoretical management before EUS. Complications were assessed in short-term follow-up. RESULTS: Four hundred twenty-eight subjects were enrolled. Of subjects able to be evaluated, EUS changed the treatment plan in 74%. Management changes of major importance occurred in 120 patients (31% of subjects able to be evaluated) and included decisions regarding surgery (62 patients), decisions regarding nonsurgical invasive management (36 patients), and decisions regarding further follow-up (22 patients). When there was a change in management, the change was to less costly, risky, or invasive management in 55%, to more costly/risky/invasive in 37%, and to equally costly/risky/invasive in 8%. Short-term follow-up was completed in 81% of subjects, with six complications identified (1.7%). Three complications were mild, two were moderate, one severe, and none fatal. CONCLUSIONS: (1) Changes in management plan may occur in the majority of patients based on EUS results. (2) The management changes are often of major importance with regard to health care costs and safety, and are more often in the direction of less costly, risky, and invasive management. (3) EUS is safe in experienced hands.

Adolescent↗
PubMed1995

Familial pancreatic adenocarcinoma: association with diabetes and early molecular diagnosis.

We report a large pedigree in which pancreatic cancer is inherited in an autosomal dominant fashion. Diabetes and exocrine insufficiency was observed in all family members who eventually developed pancreatic cancer. The presence of diabetes, often years before the diagnosis of cancer, allowed identification of those people who had inherited the predisposing allele and who were thus at high risk for the development of malignancy. This family shows that genetic factors can have a striking effect on the development of pancreatic malignancy and diabetes mellitus. Moreover, preclinical diagnosis of pancreatic cancer in family members provided a unique opportunity to study early molecular changes that accompany the development of human pancreatic cancer. Finally, the molecular approach applied here to the early diagnosis of pancreatic cancer may prove valuable in this family for identification of subjects at risk.

Adenocarcinoma↗
PubMed1992

DNA aneuploidy in colonic biopsies predicts future development of dysplasia in ulcerative colitis.

The objective of the present study was to determine whether abnormal epithelial DNA content (aneuploidy) in colonic biopsy specimens from ulcerative colitis (UC) patients correlated with and predicted histological progression to dysplasia. Aneuploidy was absent in 20 low-cancer risk patients. In 81 high-cancer risk patients aneuploidy correlated significantly with the severity of histological abnormality (negative, indefinite, dysplasia, or cancer). Statistically our data suggest that many more biopsy specimens than are usually taken are needed to detect focal dysplastic lesions. Prospective study of 25 high risk patients without dysplasia revealed 5 with aneuploidy, all of whom progressed to dysplasia in 1-2.5 years, whereas 19 patients without aneuploidy did not progress to either aneuploidy or dysplasia within 2-9 years. Our data indicate that aneuploidy in mucosal biopsy specimens correlates with histological grade and identifies a subset of patients without dysplasia who are more likely to develop it. It was concluded that more frequent and extensive colonoscopic surveillance of this minority subset of high risk patients and less frequent surveillance in the remaining majority may reduce cost and detect more curable lesions.

Adolescent↗
PubMed1986

Ultrasound and the intestinal wall: experimental methods.

High-frequency, high-resolution ultrasound provides a new approach to imaging structures in the wall of the gastrointestinal tract. Questions about internal ultrasound include: is the ultrasound image specific for disease states, in which diseases will this technology add new and useful information not available from existing diagnostic studies, and what are the necessary characteristics for a system to accomplish these diagnoses? Answering these questions requires that precise correlations be made between the ultrasound image and pathology. We have developed a method to image a resected gastrointestinal tissue with ultrasound and to remove and examine the corresponding piece of tissue histologically. Changes in wall thickness, obliteration of layers, and changes in the characteristics of the tissue can be studied. We have shown that ultrasound can resolve the layers of the gut wall. This system should enable us to answer questions about which intestinal wall diseases are suitable for internal ultrasound imaging and characterize the engineering features of an optimal ultrasound system for clinical application.

Digestive System↗
PubMed1985

Infectious diarrhea.

Patients presenting to the emergency department with diarrhea should be evaluated for infectious causes. Information obtained from the history and physical examination should be used in deciding whether symptomatic treatment alone is sufficient or whether the patient's stool should be examined for pathogens. Antiperistaltic agents should be used only in selected patients, usually after the results of stool cultures are known to be negative. Antibiotic administration should be based on results of stool cultures and examination for parasites. Finally, the emergency physician should be familiar with the special situations of traveler's diarrhea, food-borne illness, and sexually transmitted enteric disease.

Adult↗