著者

瓜田 純久 杉本 元信 三木 一正

出版者

公益社団法人におい・かおり環境協会

雑誌

におい・かおり環境学会誌 (ISSN:13482904)

巻号頁・発行日

vol.37, no.2, pp.99-104, 2006 (Released:2006-10-27)

参考文献数

20

被引用文献数

1 1

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現代の医療では非侵襲的に多くの情報を得ることが求められている.採血さえも不要な呼気試験は,検査方法を工夫すると,多くの消化管情報を得ることができるが,その中心は水素・メタンガスの測定である.空腹時の呼気中水素は消化管発酵反応の指標と考えられているが,その再現性は低く,解釈は難しい.そこで,試験食を負荷して呼気中水素・メタンガスの経時的な変化から病態を評価する方法が一般的である.非吸収型の炭水化物,食物繊維などは小腸で吸収されず,大部分が大腸へ到達し,腸内細菌の発酵反応で分解される.この際発生する水素・メタンガスの時間,量からガス発生部位を推定し,消化管通過時間,細菌の異常増殖を診断することができる.発酵生成物が腹部症状を惹起する場合もあり,消化管での発酵の程度を把握することは重要である.今回,臨床現場における水素・メタンガス測定の実際を述べる.

著者

三木 一正

出版者

JAPAN SOCIETY OF NINGEN DOCK

雑誌

健康医学 : 日本人間ドック学会誌 (ISSN:09140328)

巻号頁・発行日

vol.17, no.1, pp.96-99, 2002-05-31

被引用文献数

1

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Gastric cancer, despite a recent decline in incidence, is still the second leading cause of cancer death in Japan. The measurement of serum pepsinogens has recently drawn attention as an alternative to photofluorography, given its lower cost and simplicity. The sensitivity of the pepsinogen test method has been reported as 80%, specificity 70%and positive predictive value 1.5%, respectively, from the results of the study of the Grant-in-Aid for Cancer Research from the Ministry of Health Labour and Welfare, Japan in 1998. We studied several trials (Toyama Prefecture, Adachi City, Tokyo Metropolitan Cancer Detection Center, Isesaki Municipal Hospital Oneday Human Dry Dock, etc) to compare the accuracy between the two screening methods for gastric cancer and to elucidate the usefulness of the pepsinogen test method under the support of the Grant in 2000. In summary, the pepsinogen test method is superior to the conventional Xray method, although these results show overestimated the relative sensitivity of pepsinogen test method compared with Xray method because pepsinogen test method was conducted as prevalent screening while Xray method was done as incidental screening. At present, no studies have directly examined whether the pepsinogen test method reduced gastric cancer mortality. Pepsinogen test method may be used as a screening test for high risk subjects with atrophic gastritis, rather than a tool for cancer itself, and systemic endoscopic surveillance of this group may be useful. These strategies would require empirical assessment, using mortality as an endpoint.