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1.
Digestion ; 87(1): 34-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23343967

RESUMO

BACKGROUND: Functional dyspepsia (FD) is a heterogeneous disease characterized by various upper abdominal symptoms. The major mechanism of FD includes impaired fundic accommodation, delayed gastric emptying and visceral hypersensitivity. We developed a novel drinking-ultrasonography test to combine a drink test with ultrasonography to assess gastric motility and sensory function of FD patients. METHOD: Subjects were 20 healthy volunteers and 26 successive FD patients according to the Rome III criteria. The subjects ingested 200 ml of water at 2-min intervals 4 times (total 800 ml) through a straw. The maximum cross section of the proximal stomach was visualized before water intake, after each water intake, and 5 and 10 min after the completion of drinking using extracorporeal ultrasonography. Abdominal symptoms were evaluated using the visual analog scale (VAS) a total of 5 times. RESULTS: The mean cross-sectional area of the fornix after 800 ml of water intake was significantly lower in the FD group compared with the control group. In the FD group, marked abdominal symptoms developed immediately after initiation of water intake, and VAS score differed significantly (p < 0.01) between the control and FD groups at each time point. CONCLUSION: We developed the novel drinking-ultrasonography test which revealed abnormalities in gastric accommodation and sensation in patients with FD compared with healthy controls. This approach can be readily performed and allows the simultaneous evaluation of gastric accommodation, emptying and sensation.


Assuntos
Ingestão de Líquidos , Dispepsia/fisiopatologia , Esvaziamento Gástrico , Estômago/diagnóstico por imagem , Estômago/inervação , Adulto , Dispepsia/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Sensação/fisiologia , Ultrassonografia , Adulto Jovem
2.
Helicobacter ; 16(3): 210-6, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21585606

RESUMO

BACKGROUND AND AIMS: The results of a randomized controlled study and meta-analysis study have recently proved that Helicobacter pylori eradication has a preventive effect against the development of metachronous and primary gastric cancer. However, gastric cancer is sometimes detected after successful eradication. There is a lack of study about gastric cancers in eradicated patients. To clarify the characteristics of gastric cancers detected after H. pylori eradication, we analyzed the clinicopathological features of these cancers. METHODS: The subjects were 18 early-stage gastric cancer specimens resected from 17 patients who had received successful eradication of H. pylori from February 1995 to March 2009. The control group consisted of 36 specimens from noneradicated patients with persistent H. pylori infection who were matched with the subjects in age, sex, and depth of invasion. Clinicopathological features and mucin phenotypes of gastric cancer were clinically and immunohistologically evaluated. RESULTS: The average diameter of gastric cancer was smaller and Ki-67 index was lower in the eradication group. The morphological distribution of depression types was significantly lower in the control group. Immunohistochemical phenotyping revealed that 72.2% of the lesions in the eradicated group were complete gastric type or gastric predominant mixed type, whereas the percentages of gastric type and intestinal type in the control group were similar. CONCLUSION: Our findings indicate that the clinicopathological characteristics of gastric cancers detected after H. pylori eradication are different from those of gastric cancers in patients with persistent H. pylori infection. H. pylori eradication may suppress intestinalization during the development of gastric cancer.


Assuntos
Infecções por Helicobacter/complicações , Helicobacter pylori/fisiologia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia , Idoso , Estudos de Casos e Controles , Detecção Precoce de Câncer , Feminino , Seguimentos , Infecções por Helicobacter/tratamento farmacológico , Infecções por Helicobacter/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/microbiologia
3.
J Gastroenterol Hepatol ; 26(7): 1133-8, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21443666

RESUMO

BACKGROUND AND AIM: We have reported the characteristics of magnified endoscopic images of gastric mucosa-associated lymphoid tissue (MALT) lymphoma before and after treatment. In this study, we investigated the diagnostic efficacy of magnified endoscopic images for target biopsy and evaluation of clinical remission. METHODS: Twenty-one patients diagnosed with localized gastric MALT lymphoma were enrolled. Magnified endoscopy was performed prior to treatment and at a mean period of 1.8 months (1-6 months) after therapy (Helicobacter pylori eradication in 19 patients and radiation therapy in two patients). Microstructural pattern and abnormal vessels in the lesions were assessed, and corpus mucosa without lymphoma was divided into H. pylori-negative mucosa and H. pylori-positive mucosa. Biopsy was the gold standard in this study. RESULTS: Nonstructural areas with abnormal vessels were observed in all patients before treatment. Fifteen patients achieved pathological complete remission. Disappearance of nonstructural areas and abnormal vessels after therapy was associated with pathological remission. Sensitivities of these findings for diagnosis were 76.9% and 85.7%, respectively, and the specificities were 87.5% and 85.7%, respectively. H. pylori eradication therapy was invalid in three patients with H. pylori-negative mucosa in magnified images. CONCLUSIONS: Magnifying endoscopy may be useful for target biopsy of superficial gastric MALT lymphoma in clinical management.


Assuntos
Biópsia/métodos , Mucosa Gástrica/patologia , Gastroscopia/métodos , Linfoma de Zona Marginal Tipo Células B/patologia , Neoplasias Gástricas/patologia , Mucosa Gástrica/microbiologia , Helicobacter pylori/isolamento & purificação , Humanos , Linfoma de Zona Marginal Tipo Células B/radioterapia , Estudos Retrospectivos , Neoplasias Gástricas/radioterapia , Resultado do Tratamento , Gravação em Vídeo
4.
J Gastroenterol Hepatol ; 25(10): 1631-5, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20880171

RESUMO

BACKGROUND AND AIM: The concomitant use of non-steroidal anti-inflammatory drugs is a risk factor for low-dose aspirin (LDA)-associated upper gastrointestinal toxicity. Lafutidine is an H2-receptor antagonist with gastroprotective activity, produced by acting on capsaicin-sensitive afferent neurons. To evaluate the preventive effect of lafutidine on gastric damage caused by LDA alone and by the combination of both LDA and loxoprofen, we conducted a clinical study using healthy volunteers. METHODS: A randomized, double-blinded, placebo-controlled, crossover study was carried out. Sixteen healthy volunteers without Helicobacter pylori infection were randomly assigned to two groups. Both groups received 81 mg of aspirin once daily for 14 days (on days 1 to 14) and 60 mg of loxoprofen three times daily for the last 7 days (on days 8 to 14). Placebo or 10 mg of lafutidine was administered twice daily for 14 days in each group. After a 2-week washout period, placebo and lafutidine were crossed over. Endoscopic findings of gastric mucosal damage were evaluated according to the modified Lanza score. RESULTS: The mean modified Lanza score was 2.19 ± 1.06 (SD) for aspirin plus placebo as compared with 0.50 ± 0.77 for aspirin plus lafutidine (P < 0.001), and 3.00 ± 1.56 for aspirin plus loxoprofen and placebo as compared with 1.25 ± 1.37 for aspirin plus loxoprofen and lafutidine (P < 0.01). CONCLUSIONS: The addition of loxoprofen to LDA increases gastric mucosal damage. Standard-dose lafutidine significantly prevents gastric mucosal damage induced by LDA alone or LDA plus loxoprofen in H. pylori-negative volunteers. Larger controlled studies are needed to strengthen these findings.


Assuntos
Acetamidas/uso terapêutico , Aspirina/efeitos adversos , Mucosa Gástrica/efeitos dos fármacos , Antagonistas dos Receptores H2 da Histamina/uso terapêutico , Fenilpropionatos/efeitos adversos , Piperidinas/uso terapêutico , Piridinas/uso terapêutico , Gastropatias/prevenção & controle , Acetamidas/administração & dosagem , Administração Oral , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Aspirina/administração & dosagem , Estudos Cross-Over , Inibidores de Ciclo-Oxigenase/administração & dosagem , Inibidores de Ciclo-Oxigenase/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Endoscopia Gastrointestinal , Feminino , Mucosa Gástrica/patologia , Antagonistas dos Receptores H2 da Histamina/administração & dosagem , Humanos , Masculino , Fenilpropionatos/administração & dosagem , Piperidinas/administração & dosagem , Piridinas/administração & dosagem , Gastropatias/induzido quimicamente , Gastropatias/patologia , Resultado do Tratamento , Adulto Jovem
5.
Digestion ; 82(3): 162-6, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20588028

RESUMO

BACKGROUND: Functional dyspepsia (FD) is a heterogeneous disease characterized by various upper abdominal symptoms. The major mechanism of FD symptoms includes impaired fundic accommodation, delayed gastric emptying, and visceral hypersensitivity. We developed a novel drinking-ultrasonography test to combine a drink test with ultrasonography to assess gastric motility and sensory function of FD patients. METHOD: Subjects were 60 successive FD patients according to the Rome III criteria. A drinking-ultrasonography test was performed after subjects had fasted. The subjects ingested 200 ml of water at 2-min intervals 4 times (total 800 ml) through a straw. The maximum cross section of the proximal stomach was visualized before water intake, after each water intake, and 5 and 10 min after the completion of drinking using extracorporeal ultrasonography. Abdominal symptoms were evaluated using the visual analog scale (VAS) a total of 5 times. The normal range of cross-sectional area and VAS were set using average +/- standard deviations of 33 healthy volunteers. Cases outside the normal range were diagnosed with a motor or sensory disorder. RESULTS: The drinking-ultrasonography test classified FD patients into four groups without adverse effect or trouble. The distribution of each group was 27% in the normal group, 15% in the impaired relaxation group, 10% in the delayed emptying group, and 48% in the visceral hypersensitivity group. There was no significant correlation between the pathophysiological classification and subtypes of FD defined by the Rome III criteria. CONCLUSION: We developed a novel drinking-ultrasonography test that was effective in classifying FD patients according to pathophysiological features.


Assuntos
Ingestão de Líquidos , Dispepsia/diagnóstico por imagem , Motilidade Gastrointestinal , Dispepsia/classificação , Dispepsia/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Células Receptoras Sensoriais/fisiologia , Estômago/fisiopatologia , Ultrassonografia , Água
6.
J Clin Biochem Nutr ; 48(3): 245-50, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21562646

RESUMO

Low-dose acetylsalicylic acid has been widely used. We evaluated small bowel and gastric injuries during acetylsalicylic acid administration using video capsule endoscopy and gastroduodenal endoscopy. We also investigated blood flow using contrast-enhanced ultrasonography. Six healthy volunteers were enrolled in this preliminary study. The subjects were administered 100 mg of enteric-coated aspirin daily for 14 days. Video capsule endoscopy and gastroduodenal endoscopy were simultaneously performed before administration and on days 1, 3, 7 and 14. Contrast-enhanced ultrasonography was performed before administration and on day 2, and 8. Video capsule endoscopy after administration of low-dose acetylsalicylic acid revealed small bowel mucosal damages of petechiae and erythema in all cases, and denuded area in one case. The total number of lesions in the small bowel increased according to duration of low-dose acetylsalicylic acid administration. However, the total number of lesions in the stomach peaked on day 3. Contrast-enhanced ultrasonography showed that the time-intensity curve peak value and Areas under the curves after acetylsalicylic acid administration were reduced. We observed not only gastric mucosal injuries but also small intestinal injuries with short-term low-dose acetylsalicylic acid administration. Acetylsalicylic acid administration also caused a decrease in small intestinal blood flow. Contrast-enhanced ultrasonography is useful for evaluation blood flow in the small bowel mucosa.

7.
World J Gastroenterol ; 17(2): 226-30, 2011 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-21245996

RESUMO

AIM: To investigate the relationship between low-dose aspirin-induced small bowel mucosal damage and blood flow, and the effect of rebamipide. METHODS: Ten healthy volunteers were enrolled in this study. The subjects were divided into two groups: a placebo group given low-dose aspirin plus placebo and a rebamipide group given low-dose aspirin plus rebamipide for a period of 14 d. Capsule endoscopy and contrast-enhanced ultrasonography were performed before and after administration of drugs. Areas under the curves and peak value of time-intensity curve were calculated. RESULTS: Absolute differences in areas under the curves were -1102.5 (95% CI: -1980.3 to -224.7, P = 0.0194) in the placebo group and -152.7 (95% CI: -1604.2 to 641.6, P = 0.8172) in the rebamipide group. Peak values of time intensity curves were -148.0 (95% CI: -269.4 to -26.2, P = 0.0225) in the placebo group and 28.3 (95% CI: -269.0 to 325.6, P = 0.8343) in the rebamipide group. Capsule endoscopy showed mucosal breaks only in the placebo group. CONCLUSION: Short-term administration of low-dose aspirin is associated with small bowel injuries and blood flow.


Assuntos
Aspirina/administração & dosagem , Intestino Delgado/irrigação sanguínea , Intestino Delgado/efeitos dos fármacos , Adulto , Alanina/administração & dosagem , Alanina/análogos & derivados , Antiulcerosos/administração & dosagem , Área Sob a Curva , Velocidade do Fluxo Sanguíneo , Meios de Contraste/farmacologia , Estudos Cross-Over , Método Duplo-Cego , Endoscopia/métodos , Humanos , Masculino , Placebos , Quinolonas/administração & dosagem , Resultado do Tratamento , Ultrassonografia/métodos
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