Significance of sucrose permeability test in detecting early gastric cancer and changes of permeability after endoscopic mucosal resection.

BACKGROUND/AIMS: To evaluate the diagnostic value of sucrose permeability test (SPT) with special reference to early gastric cancer (EGC), and to assess the changes of urinary sucrose level after treatment of gastric damage: gastric ulcer (GU) or EGC. METHODOLOGY: Ninety subjects were included in this study, that is; 18 patients with GU, 25 EGC, 17 advance gastric cancer (AGC), and 30 healthy volunteers (HV). SPT was conducted before treatment in all the subjects, and in 6 patients each with GU and EGC after treatment- proton pump inhibitor for GU and endoscopic mucosal resection for EGC. Diagnostic values were calculated based on cut-off values estimated from the ROC curves. RESULTS: The mean amount of sucrose excreted into urine in HV, GU, EGC, and AGC was 50.8 +/- 28.0 mg, 225.9 +/- 201.1 mg, 170.2 +/- 86.4 mg, and 426.2 +/- 155.0 mg, respectively, showing significant differences between HV and gastric disease groups (p < 0.01). The sensitivity for detecting GU, EGC, and AGC was 94.4%, 88.0%, and 100%, respectively. Sucrose excretion in GU and EGC was significantly decreased after treatment (262.4 +/- 121.2 to 80.6 +/- 42.1, and 246.0 +/- 136.9 to 139.1 +/- 69.2, p < 0.05 and p < 0.001, respectively). CONCLUSIONS: SPT was considered useful to detect not only GU or AGC but also EGC with a high sensitivity. A significant decrease of sucrose excretion was observed after treatment in EGC.

[The antiemetic effect of dexamethasone during continuous subcutaneous infusion of morphine for postoperative pain relief].

BACKGROUND: Dexamethasone is known to reduce the incidence of postoperative nausea and vomiting, associated with perioperative intrathecal, epidural, or intravenous morphine. However, the effect of dexamethasone on subcutaneous morphine is unclear. Therefore, we evaluated the antiemetic effect of intravenous dexamethasone during continuous subcutaneous infusion of morphine for postoperative pain relief. METHODS: Twenty patients scheduled for spinal surgery under general anesthesia were enrolled in this randomized, double-blind, and placebo-controlled study. The dexamethasone group (n=10) received dexamethasone 8 mg and the saline group (n=10) received the same amount of saline before the induction of anesthesia. Anesthesia was maintained with propofol and fentanyl. Postoperative pain was treated with continuous subcutaneous morphine via a patient-controlled analgesia device. Postoperatively patients were assessed during 48 hours for nausea and vomiting. RESULTS: Nausea or vomiting ascribable to the subcutaneous morphine developed in 40% of the patients in each group (P:NS). CONCLUSIONS: Our results suggest that the single dose of dexamethasone (8 mg) does not reduce postoperative nausea and vomiting associated with continuous subcutaneous infusion of morphine after spinal surgery.