Search

Cat scratch disease (CSD) is associated with Bartonella henselae (B. henselae) infection caused by cat scratches or bites. It typically presents with lymphadenitis and fever. However, there are atypical cases such as hepatosplenic CSD, which presents with specific lesions in the liver and spleen. Hemophagocytic lymphohistiocytosis (HLH) is a rare and severe multisystem disorder triggered by infections, cancers, or autoimmune diseases. We experienced a rare case of hepatosplenic CSD with HLH in a non-immunocompromised adult. A 78-year-old woman complained of fever and fatigue. Laboratory tests revealed anemia and liver dysfunction; abdominal contrast-enhanced computed tomography (CT) revealed splenomegaly and nodular hypodense areas in the spleen. In addition, the levels of ferritin and serum soluble IL-2R were markedly elevated, so clinical diagnosis of HLH was made. Positron emission tomography/CT revealed diffuse fluorodeoxyglucose uptake in the liver and spleen suggesting malignant lymphoma, while the pathological findings from liver biopsy suggested infectious diseases. Although she had no cat bites and scratches, she had many cats; therefore, serum B. henselae antibody titers were measured. The B. henselae IgG and IgM titer were 1:128 and 1:20; thus, she was diagnosed with hepatosplenic CSD. Patients with hepatosplenic nodular lesions and contact with cats should be considered for this disease. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer risk can be accurately predicted by measuring the methylation level of a single marker gene in gastric mucosa. However, the mechanism is still uncertain. We hypothesized that the methylation level measured reflects methylation alterations in the entire genome (methylation burden), induced by Helicobacter pylori (H. pylori) infection, and thus cancer risk. Methods: Gastric mucosa of 15 healthy volunteers without H. pylori infection (G1), 98 people with atrophic gastritis (G2), and 133 patients with gastric cancer (G3) after H. pylori eradication were collected. Methylation burden of an individual was obtained by microarray analysis as an inverse of the correlation coefficient between the methylation levels of 265,552 genomic regions in the person's gastric mucosa and those in an entirely healthy mucosa. Results: The methylation burden significantly increased in the order of G1 (n = 4), G2 (n = 18), and G3 (n = 19) and was well correlated with the methylation level of a single marker gene (r = 0.91 for miR124a-3). The average methylation levels of nine driver genes tended to increase according to the risk levels (P = 0.08 between G2 vs G3) and was also correlated with the methylation level of a single marker gene (r = 0.94). Analysis of more samples (14 G1, 97 G2, and 131 G3 samples) yielded significant increases of the average methylation levels between risk groups. Conclusions: The methylation level of a single marker gene reflects the methylation burden, which includes driver gene methylation, and thus accurately predicts cancer risk. [ABSTRACT FROM AUTHOR]

Patients with dengue fever usually present with fever and rash, but non-specific symptoms such as headache, myalgia, arthralgia, and digestive symptoms are sometimes seen. We report a case of dengue fever with digestive symptoms in a patient who traveled to Indonesia. A 35-year-old man presented with fever, diarrhea, headache, and arthralgia. He later developed generalized rash. Dengue fever was clinically suspected from the travel history and confirmed by laboratory tests. He tested positive for anti-dengue virus antibodies, so dengue fever was diagnosed. Dengue fever should be included in the differential diagnosis of patients with digestive symptoms after returning to Japan. [ABSTRACT FROM AUTHOR]

Many studies have investigated the ability to identify species from environmental DNA (eDNA). However, even when individual species are identified, the accurate estimation of their abundances by traditional eDNA analyses has been still difficult. We previously developed a novel analytical method called HaCeD-Seq (Haplotype Count from eDNA), which focuses on the mitochondrial D-loop sequence. The D-loop is a rapidly evolving sequence and has been used to estimate the abundance of eel species in breeding water. In the current study, we have further improved this method by applying unique molecular identifier (UMI) tags, which eliminate the PCR and sequencing errors and extend the detection range by an order of magnitude. Based on this improved HaCeD-Seq pipeline, we computed the abundance of Pacific bluefin tuna (Thunnus orientalis) in aquarium tanks at the Tokyo Sea Life Park (Kasai, Tokyo, Japan). This tuna species is commercially important but is at high risk of resource depletion. With the developed UMI tag method, 90 out of 96 haplotypes (94%) were successfully detected from Pacific bluefin tuna eDNA. By contrast, only 29 out of 96 haplotypes (30%) were detected when UMI tags were not used. Our findings indicate the potential for conducting non-invasive fish stock surveys by sampling eDNA. [ABSTRACT FROM AUTHOR]

Background: We previously reported the development of pancreatic acinar cell metaplasia (PACM) in the glandular stomach of a duodenal contents reflux model (reflux model). Aims: We aimed to investigate the characteristics and histogenesis of PACM using a reflux model. Methods: A reflux model was created using 8-week-old male Wistar rats, which were killed up to 30 weeks postoperatively. Histological examination was performed to analyze the glandular stomach–jejunal anastomosis. Furthermore, electron microscopic images of PACM samples were compared with pancreatic and gastric glands removed from rats that had not undergone surgery. Immunostaining for α-amylase, HIK1083, TFF2, and Ki-67 was performed, and double fluorescent staining was carried out using antibodies against α-amylase and HIK1083, or α-amylase and TFF2. Results: In all reflux model rats, PACM was observed proximal to the glandular stomach–jejunal anastomosis, surrounded by pseudopyloric metaplasia. The number of chief cells was decreased in the deep part of the gland, where PACM occurred. Electron microscopy showed that PACM cells had greater numbers of rough endoplasmic reticulum tubules than chief cells, and exhibited pancreatic acinar cell morphology. Upon immunochemical staining, the regenerative foveolar epithelium and part of the pseudopyloric glands stained strongly positive for TFF2, whereas PACM cells were only weakly positive. Double fluorescent staining identified early lesions of PACM in the neck, which were double positive for α-amylase and TFF2, but negative for HIK1083. Conclusions: PACM could be induced by duodenal contents reflux. PACM originates from stem cells located in the neck of oxyntic glands during gastric mucosal regeneration. [ABSTRACT FROM AUTHOR]

Pyloric metaplasia (PM) and pseudopyloric metaplasia (PPM) are metaplastic changes resulting in pyloric-type glands in the gastric oxyntic mucosa that mainly occur in chronic gastritis caused by Helicobacter pylori (H. pylori) infection. Focusing on PM and PPM, we classified the histological changes in gastric mucosa according to the Updated Sydney System, using 314 biopsy specimens of gastric greater curvature of the middle body before H. pylori eradication (HPE). Next, the numbers of PM and PPM glands were counted in 47 specimens, and subjects were followed up over 10 years after HPE. PPM was recognized jointly with inflammation, activity, atrophy, and intestinal metaplasia, but PM was recognized more frequently than PPM as atrophy and intestinal metaplasia progressed. Both PM and PPM regressed significantly within 6 years after HPE. Additionally, we demonstrated that PM and PPM are not always coincident with spasmolytic polypeptide-expressing metaplasia (SPEM). In conclusion, PM and PPM are considered different modulations of the same line of differentiation, which are both reversible, with PM potentially emerging from PPM upon progression. [ABSTRACT FROM AUTHOR]

Gastrointestinal Dieulafoy's ulcer is a rare disease of unknown etiology. Dieulafoy's ulcer often presents in the stomach and is thought to cause about 5% of all gastrointestinal bleeds in adults, but can be found in any part of the gastrointestinal tract. Dieulafoy's ulcer corresponds to an arterial malformation in the submucosal space and can cause life-threatening hemorrhage. We report a case of the lower gastrointestinal bleeding from a cecal Dieulafoy's ulcer that was successfully treated with endoscopic clips. An 82-year-old woman had been diagnosed with hypertension and cerebral infarction. She had been using aspirin to prevent recurrent infarction. She was admitted to our hospital with hematochezia. Urgent colonoscopy revealed a small, reddish vascular malformation in the cecum. The lesion was suggestive of Dieulafoy's ulcer and was treated with endoscopic clips. The patient has since been discharged from our hospital without experiencing any further bleeding. Endoscopy is a useful method for diagnosing and treating Dieulafoy's ulcer. [ABSTRACT FROM AUTHOR]

A Stafne bone defect is a static bone depression in the mandible that is commonly observed in cortical bone near the mandibular angle. We herein present a rare case in which static bone depressions attached to the three major salivary glands were observed on panoramic radiography and computed tomography (CT). The three static bone depressions in the mandible were visualized on a panoramic radiograph and CT as oval radiolucent masses in a 68-year-old man. The CT numbers in the bone depressions ranged from 10 to 50 HU, and they were close to those of the respective salivary glands. Based on the CT numbers, the areas in the bone depressions were determined to be a normal parotid gland, sublingual gland, and submandibular gland. The patient underwent a follow-up examination and did not request further consultation. [ABSTRACT FROM AUTHOR]

Numerous studies, including our own, have revealed that positron emission tomography-computed tomography (PET/CT) using fluorine-18-labeled fluoro-2-deoxy- d-glucose (F-FDG) is effective for the diagnosis of oral cancers. Large amounts of new information about primary tumors and metastatic lymph nodes have been acquired, and the use of F-FDG PET/CT has been shown to improve diagnostic precision in determining both the pathological characteristics of primary oral cancers and the presence of metastatic lymph nodes. However, substantial variations in F-FDG uptake in the oral and maxillofacial regions have been identified, and the differential diagnosis of some oral cancers and metastatic lymph nodes remains difficult for radiologists. Therefore, based on the previous research, the aim of the present study was to review the basic and important points regarding the diagnosis of primary oral cancers and metastatic lymph nodes using F-FDG PET/CT. [ABSTRACT FROM AUTHOR]

Since aberrant methylation at CpG sites is linked to the silencing of tumor suppressor genes, DNA methylation analysis is important for cancer diagnosis. We developed ferrocenylnaphthalene diimide (FND), which has two ferrocenyl moieties at the substituent termini, as an electrochemical indicator for hybridized DNA duplexes. In this study, we attempted to detect aberrant methylation of human telomerase reverse transcriptase gene ( hTERT), an efficient cancer marker, using FND-based hybridization coupled with electrochemical detection via a multi-electrode chip. [ABSTRACT FROM AUTHOR]

Improvements of atrophy and intestinal metaplasia which is seen after H. pylori eradication may be regarded as an important factor of gastric cancer prevention. Although many studies reported the alteration of gastric mucosa after H. pylori eradication, most of the results do not agree. Recently, two meta-analyses showed significant improvement of atrophy (one study showed improvement in both corpus and antrum, and the other showed improvement in corpus but not in antrum), whereas improvement of intestinal metaplasia was not shown in either corpus or antrum. However, one reason why conclusions are different is considered to be that the observation period after eradication was short, and another reason is considered to be that almost studies examined only two points in gastric mucosa for histological analysis. Further examination with a greater number of subjects and with longer follow up period should be required to clarify the mechanism of gastric injury and improvement of gastric mucosa, especially atrophy and intestinal metaplasia after H. pylori eradication. [ABSTRACT FROM AUTHOR]

Background: Atrophic gastritis and intestinal metaplasia (IM) are well known as precancerous lesions of gastric cancer. The present study evaluated the gastric mucosa for 10 years after H. pylori eradication at five points of the stomach as recommended by the updated Sydney system to clarify the relationship between H. pylori eradication and gastric cancer prevention. Methods: Among the comprised 373 patients, 323 were H. pylori-positive while 50 patients were H. pylori-negative. Patients with successful eradication underwent follow-up endoscopic examination every year. Biopsy specimens were taken from five points of the stomach, as recommended by the updated Sydney system, and were evaluated for the degree of gastritis prospectively. Results: Two hundred ninety-four out of the 323 H. pylori-positive patients successfully achieved eradication. Of the 197 patients on whom five-point biopsy was performed, the courses of 30 patients were able to be observed every year for 10 years after successful eradication. Inflammation, activity, and atrophy score at all five points were significantly reduced half a year to 6 years after eradication. IM scores fluctuated intensely up and down during all observation periods; however, IM score of the lesser curvature of the corpus continued decreasing gradually and showed a significant decrease 6 years after (0.97 ± 0.09 to 0.42 ± 0.17, P < 0.05). Conclusion: In 10 years after H. pylori eradication, atrophy at all sites and IM in the lesser curvature of the corpus gradually and significantly decreased. These results suggest that the improvement of gastric atrophy and IM might have association with the reduction of gastric cancer occurrence. [ABSTRACT FROM AUTHOR]

Background: Helicobacter hepaticus infection might be associated with liver and biliary tract diseases. To investigate its pathogenic role, the properties of anti- H. hepaticus serum antibody in patients with liver and diseases were elucidated. Methods: Serum samples were collected from 166 patients-69 with liver diseases, 38 with upper gastrointestinal diseases, 17 with lower gastrointestinal diseases, 26 with biliary tract diseases, and 16 with pancreas diseases; 30 control sera were obtained from 30 healthy blood donors. Serum samples were analyzed by enzyme-linked immunosorbent assay (ELISA) and western blot using the new monoclonal antibody HR II-51. Results: Anti- H. hepaticus serum antibody concentrations in patients with liver disease ( n = 69) were significantly increased compared with those in other disease groups ( p = 0.014 to <0.001). Particularly, liver cirrhosis ( n = 19) showed a significantly higher antibody level compared with other liver diseases ( n = 50, p = 0.005) and healthy donors ( n = 30, p = 0.0005), as well as a higher seroprevalence (68.4%) compared with other liver diseases ( p = 0.05) and healthy donors ( p = 0.004). Furthermore, the ELISA value in liver cirrhosis ( n = 19) was significantly higher than that in patients with hepatitis B virus (HBV)-and/or hepatitis C virus (HCV)-infected chronic hepatitis ( n = 15) (0.389 ± 0.084 vs. 0.350 ± 0.084, p = 0.029). However, there was no relationship between the total immunoglobulin concentration and the anti- H. hepaticus antibody level in each liver disease (Spearman's rank correlation coefficient [rs] < 0.225). Conclusions: H. hepaticus infection might play a role in the development of liver diseases; in particular, it might increase the risk of the development of HBV- and/or HCV-infected liver diseases. [ABSTRACT FROM AUTHOR]

Background: A strict correlation between Helicobacter pylori eradication and an increase in platelet count has previously been reported in patients with chronic idiopathic thrombocytopenic purpura (ITP). To clarify the pathogenesis of H. pylori-induced ITP and the factors predicting the platelet response to H. pylori eradication therapy, we evaluated the markers of atrophic gastritis in ITP patients. Methods: The study population comprised 31 H. pylori-infected patients with chronic ITP. After undergoing upper gastrointestinal endoscopy and gastric biopsy, all patients received H. pylori eradication therapy. The effect of H. pylori eradication on the platelet count was evaluated for up to 6-54 months after the therapy. The degree of endoscopic gastric atrophy, histological parameters in the gastric mucosa, and serum pepsinogen (PG) levels were compared between platelet responders and nonresponders to the therapy. Results: H. pylori was successfully eradicated in all patients and a platelet response was seen in 18 (58%) of these patients. The serum pepsinogen (PG) I/II ratio at pretreatment was significantly lower in responders than in nonresponders. The degree of endoscopic gastric atrophy was significantly more severe in responders than in nonresponders. Furthermore, the levels of histological parameters of activity, inflammation, and atrophy in the gastric corpus, but not in the gastric antrum, were significantly more severe in responders than in nonresponders,. Conclusion: The development of corpus atrophic gastritis may be a suitable condition for inducing thrombocytopenia. Evaluation of the serum, endoscopic, and histological markers of atrophic gastritis may assist in selecting patients with ITP who are more likely to respond to H. pylori eradication therapy. [ABSTRACT FROM AUTHOR]

Although two studies have indicated a possible link between Alzheimer's disease (AD) and Helicobacter pylori ( H. pylori) infection, these were reported from Europe, where the prevalence of H. pylori infection is not very high. In this study, the prevalence of H. pylori infection was examined in AD patients in Japan, where there is a high prevalence of H. pylori. Consecutive patients referred to the Memory and Dementia Outpatient Clinic from August 2002 to March 2009 were studied. H. pylori infection status was determined by measuring urinary levels of anti- H. pylori antibody (RAPIRUN). Multiple stepwise logistic regression analyses were used to examine the associations of AD with the main predictor variables. Of the 917 patients who visited the clinic, 385 were diagnosed as having AD. Ninety-seven patients did not have dementia and were considered controls. On univariate analysis, average age and the proportion of males were significantly higher in AD patients than in controls. There was no difference in the prevalence of H. pylori infection between patients with AD and controls (62.0% vs. 59.7%, p = 0.67, crude odds ratio (OR), 1.10). Multiple logistic regression analysis showed that older age and male sex, but not H. pylori status, were significantly associated with AD ( p < 0.001, p = 0.01, p = 0.83, respectively). The prevalence of H. pylori infection did not differ between AD patients and controls among Japanese subjects. The high prevalence of H. pylori in controls may contribute to the discrepancy with previous reports. [ABSTRACT FROM AUTHOR]

sustained virological response and improvement of liver function were achieved by low-dose interferon (IFN) therapy following curative treatment of initial and recurrent hepatocellular carcinoma (HCC) in an 83-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (CLC). Although a fourth HCC episode recurred 16 months after IFN therapy, it was successfully treated. The patient is still alive 6 years and 7 months after diagnosis of the initial HCC and has been in a tumor-free state for 19 months following treatment of the last HCC. The results of this case suggest that, given sufficient consideration of adverse effects, IFN therapy for HCV and repeated local treatment for HCC contribute to improving the prognosis even in the case of a CLC patient over 80 years of age whose condition is complicated by recurrent HCC. [ABSTRACT FROM AUTHOR]

Purpose: This study attempted to assess the value of the RAPIRUN test for the diagnosis of Helicobacter pylori infection in the Vietnamese population.Methods: We recruited 148 Vietnamese patients undergoing upper gastrointestinal endoscopy during which five gastric biopsies were taken; blood and urine samples were collected from each patient. Helicobacter pylori infection status was determined by a combination of three different methods, including culture, immunohistochemistry, and serum ELISA. RAPIRUN tests were performed using urine samples.Results: The sensitivity, specificity, and accuracy of the RAPIRUN test in these Vietnamese patients were 79.5, 90.7, and 84.5%, respectively.Conclusions: The RAPIRUN test is useful for the diagnosis of H. pylori infection in the Vietnamese population, showing high specificity, acceptable sensitivity, non-invasiveness, convenience, and rapidity. [ABSTRACT FROM AUTHOR]

The 2005 ACG guidelines for the management of dyspepsia recommend eradication and proton pump inhibitors for patients who are H. pylori-positive and-negative, respectively. To establish Japanese guidelines for dyspepsia, we evaluated H. pylori status and endoscopic findings among outpatients with dyspepsia. The status of H. pylori in dyspeptic patients was determined by measuring urinary levels of anti- H. pylori antibody (RAPIRAN®). We then compared the endoscopic findings between H. pylori-positive and -negative patients. The prevalence of H. pylori among 258 dyspeptic patients was 47.8%, and increased with age (11.1% at age 10–19 years; >50% at age >50 years). The prevalence of H. pylori in each age-group tended to be lower among male than female dyspeptic patients. Endoscopy ( n = 138) showed that H. pylori-negative patients rarely had peptic ulcers or gastric cancer, and 84.7% had no endoscopic findings, which was significantly higher when compared to H. pylori-positive patients (67.3%) ( p = 0.029). Over half of the dyspeptic Japanese patients examined were negative for H. pylori. Patients who are H. pylori-positive should undergo endoscopy to rule out gastric malignancy, peptic ulcers and other diseases. [ABSTRACT FROM AUTHOR]

Pseudo-nitzschia multiseries loses most of its ability to produce domoic acid when it is cultured axenically. However, domoic acid production recovers when bacteria from the original culture are reintroduced to axenic cultures, indicating a bacterial association with domoic acid production in this species. In order to determine the role of bacteria in domoic acid production, an axenic strain prepared from a nonaxenic strain of P. multiseries was inoculated into media in cellophane tubes, which were then placed in a bottle containing the original nonaxenic culture. Both strains showed characteristic domoic acid production similar to that previously observed. Domoic acid level in the cells of the axenic strain in the tubes was much smaller than that of the cells outside the tubes. These results show that direct contact between living bacteria and P. multiseries is necessary for producing high levels of domoic acid in P. multiseries. [ABSTRACT FROM AUTHOR]

Domoic acid was found in bivalves belonging to the genus Spondylus collected randomly from the Philippines, Vietnam, Thailand and Ishigaki Island, Japan. This is the first report of domoic acid accumulating in bivalves from tropical waters. Large differences in domoic acid levels were observed among the Spondylus specimens collected from different areas. The Spondylus specimens from the Philippines and Vietnam showed higher levels of domoic acid whereas the level in Spondylus spp. from Thailand and Japan was low. The highest level of domoic acid—more than four times the safe consumption level of 20 μg/g whole tissue—was found in a specimen from the Philippines. On the other hand, bivalves other than Spondylus collected from the same area at the same time in the Philippines showed very low levels of domoic acid, showing that bivalves belonging to the genus Spondylus accumulate specifically high levels of domoic acid. These results suggest the wide distribution of causative phytoplankton in tropical waters. [ABSTRACT FROM AUTHOR]

Previously we reported that a significant level of domoic acid, a causative toxin for amnesic shellfish poisoning, was detected in bivalves belonging to a genus Spondylus from various tropical Asian countries. These findings indicate that causative plankton species for domoic acid widely distribute in these areas. In the present study, we monitored seasonal change of domoic acid level of Spondylus versicolor in association with that of plankton samples in Nha Phu Bay, Khanh Hoa, Vietnam from December 2004 to October 2005. The toxicity of S. versicolor showed distinct seasonal variation. During the period when domoic acid level of S. versicolor was increasing, a significant level of domoic acid was detected in the plankton samples, showing the correlation between these two parameters. These findings show that plankton causative for domoic acid occurred in the bay, and S. versicolor accumulate domoic acid during a bloom of the toxic plankton by food web transfer. [ABSTRACT FROM AUTHOR]

Tetrodotoxin (TTX) was detected by HPLC and LC-MS/MS in specimens of the horseshoe crab Carcinoscorpius rotundicauda collected from Tan Hai village, Vung Tau province, Vietnam, where cases of poisoning due to the consumption of horseshoe crab have frequently been reported. The soft tissue from 10 out of the 12 specimens analyzed showed considerable levels of TTX, making them unsafe for human consumption (81.2 ± 50.3 MU/g). Paralytic shellfish poisoning (PSP) toxins were also detected in all of the specimens, but the levels were low. These findings show that the frequency of occurrence of C. rotundicauda specimens with a high level of TTX is significantly high, and that the TTX is responsible for the food poisonings caused by the consumption of C. rotundicauda in this area. [ABSTRACT FROM AUTHOR]

A recent meta-analysis by Huang et al. clarified that Helicobacter pylori infection and nonsteroidal antiinflammatory drugs (NSAIDs) are important factors for peptic ulcer. The results showed that the risk for ulcer in NSAID(+)/ H. pylori(+) patients was 61.1 fold higher when compared with NSAID(−)/ H. pylori(−) patients. Some gastric ulcers detected in patients on NSAID therapy may actually be caused by H. pylori, but it is difficult to differentiate NSAID-induced gastric ulcer from H. pylori-induced gastric ulcer. Several studies have investigated the effects of H. pylori eradication on ulcer healing. One study reported that H. pylori eradication actually lowered the healing rate of gastric ulcers. Because there have been no studies finding that H. pylori eradication facilitates healing, H. pylori eradication is not recommended for NSAID users. Concerning the efficacy of H. pylori eradication in the prevention of NSAID-induced gastric ulcer, a meta-analysis concluded that among all patients on NSAID therapy, H. pylori eradication lowered the prevalence of ulcer, which was particularly marked in NSAID-naïve patients. When compared with those of proton pump inhibitors (PPIs), the preventative effects of H. pylori eradication were inferior. In Japan, national health insurance does not cover procedures that prevent or lower the risk for NSAID-induced ulcer. When administering NSAID to patients with risk factors, it is desirable to administer antiulcer agents. [ABSTRACT FROM AUTHOR]

In the years that followed the issuance in 2000 of the Guidelines for the Management of Helicobacter pylori Infection in Japan by the Japanese Society for Helicobacter Research (JSHR), a number of major issues arose, including the emergence of H. pylori strains resistant to clarithromycin as part of primary eradication therapy, and this led to the Guidelines being revised by the JSHR in 2003. While the JSHR aimed in the 2000 Guidelines to prepare clinicians for the task ahead in view of H. pylori eradication therapy becoming available, the JSHR went a step further in the 2003 Guidelines to include more evidence-based recommendations to address clinical and institutional challenges and issues of interest in the management of H. pylori infection in Japan. Thus, a number of diseases were upgraded to either class A or B indications for H. pylori eradication, including mucosa-associated lymphoid tissue lymphoma (class A), and after endoscopic mucosal resection for early gastric cancer, atrophic gastritis, and gastric hyperplastic polyp (all class B), with further diseases such as extragastric disease also included as class C indications requiring further examination. Concern was expressed over reliance on a single diagnostic test for H. pylori infection, which is in place due to institutional constraints. Metronidazole was also recommended for use in the place of clarithromycin as part of a second-line eradication regimen in light of increasing clarithromycin resistance, although metronidazole remains to be approved for health insurance coverage. Finally, areas requiring further clinical research and endeavors, including establishment of second-line eradication therapy, were also proposed in the 2003 Guidelines to point the way for the future. [ABSTRACT FROM AUTHOR]

Background. Two main pathogenic factors, bile reflux and Helicobacter pylon infection, have been identified in the remnant stomach, but it is still unclear which factor is important in the pathogenesis of gastritis in the remnant stomach after distal gastrectomy. Methods. In 184 patients who had had distal gastrectomy performed using the Billroth-I procedure (B-I; n-106), Billroth-II procedure (B-II; n-36), and jejunal interposition (J-I; n- 42) we examined the severity of remnant gastritis endoscopically and carried out examinations for H. pylon infection and histological examination. Results. The endoscopic severity of remnant gastritis was grade 1 or more in 101 of the 106 B-I patients (95.3%) and in all 36 B-II patients (100%). But, of the 42 J-I patients, the grade was 0 in 33 (78.6%). The endoscopic severity of remnant gastritis was significantly milder for J-I than for B-I (P < 0.001) and B-II (P < 0.001). H. pylon infection was confirmed in 59 of the 106 B-I patients (55.6%), 21 of the 36 B-II patients (58.3%), and 32 of the 42 J-I patients (76.1%). The rate of H. pylon infection was higher for J-I patients than for B-I (P < 0.05), but not for B-II patients (P = 0.1495). The severity of chronic and active inflammatory cellular infiltration tended to be inverse proportional relation with the endoscopic severity of the remnant gastritis. Furthermore, the histological inflammation and activity scores of H. pylon-positive patients were higher than those of H. pylon-negative patients, without regard to the endoscopic grade of gastritis. Conclusions. Reconstruction techniques play an important role in the prevention of bile reflux, and we found that endoscopically more severe remnant gastritis was associated with a lower rate of H. pylon infection and with a lower degree of inflammatory cellular infiltration. [ABSTRACT FROM AUTHOR]

Helicobacter pylori is considered to have a close association with gastric cancer. Many epidemiological studies have shown a strong association between chronic H. pylori infection and subsequent development of gastric carcinoma in humans. To clarify this link more clearly, it is necessary to use this bacterium in experimental studies to develop gastric carcinoma in suitable experimental animals. Persistent H. pylori infection was seen in the Japanese monkey model, and has recently been achieved in the Mongolian gerbil model. In these models, the sequential histopathological changes in the gastric mucosa are very similar to those in humans. The Japanese monkey model showed advances in atrophic change and p53 point mutations in the gastric mucosa during long-term observation. The Mongolian gerbil model demonstrated that H. pylori infection enhances gastric carcinogenesis in combination with known carcinogens such as N-methyl- N-nitrosourea (MNU) and N-methyl- N-nitro- N′-nitrosoguanidine (MNNG), and also showed that H. pylori infection alone can result in the development of gastric carcinoma. These important results provide a starting point for further studies to clarify the mechanism of gastric carcinogenesis as a result of H. pylori infection and assist in the planning of eradication therapy to prevent gastric carcinoma. [ABSTRACT FROM AUTHOR]

Domoic acid production was screened in the Nitzschia-like strains of benthic diatom collected from Ishigaki Island (subtropical area), Tohoku District of Japan (temperate area) and Manila Bay, the Philippines (tropical area). Domoic acid was detected in 88 out of 183 strains collected from these areas. The cellular domoic acid content of these strains ranged from 0.1 to 15.3 pg/cell. All the strains positive for domoic acid production were identified as Nitzschia navis-varingica, a new domoic acid-producing benthic diatom species that was recently found in Vietnam. This species was collected only from brackish water. These results indicate that domoic acid-producing N. navis-varingica is distributed widely in brackish water from tropical to temperate areas. [ABSTRACT FROM AUTHOR]

Polymerase chain reaction (PCR) products were obtained when the total RNA prepared from the axenically cultured cells of Pseudo-nitzschia multiseries was amplified by using primers that were designed from the 16S ribosomal RNA (rRNA) region of a bacterium isolated from the cells of Alexandrium tamarense, although the amount of the products was low. Some sequences of the PCR products were identical to those of bacteria that were isolated from the cultured medium of the original nonaxenic culture of Pseudo-nitzschia multiseries strain. These results suggest that P. multiseries possesses intracellular bacteria that originate from the environmental water. [ABSTRACT FROM AUTHOR]

Background Methods. The subjects of the study were 64 adult volunteers who tested positive for H. pylori infection by the serum antibody method. Eight classes of anti-ulcer drugs used in Japan were administered at their usual doses to these subjects: lansoprazole, a proton pump inhibitor (PPI); nizatidine, an H[sub 2]-receptor antagonist (H[sub 2]RA); and polaprezinc, ecabet sodium, rebamipide, teprenone, cetraxate hydrochloride, and sucralfate, all mucoprotective agents. The study drugs were randomized for administration to the subjects, and each of the drugs was administered for 14 consecutive days. The UBT was performed on days 0, 14, and 21. Results. The mean Δ[sup 13]C‰ in the lansoprazole group was significantly decreased on day 14, to below 10‰, in 4 of 16 subjects, and in 1 of the 4 subjects, the test result was negative, with the Δ[sup 13]C‰ falling to 1.7‰. The value returned to baseline 1 week after the discontinuation of lansoprazole. The other drugs administered had no significant effect on the result of the UBT, except that the mean Δ[sup 13]C‰ showed a tendency to decrease after the administration of ecabet sodium and rebamipide. Conclusions. Administration of a PPI may produce a false-negative UBT result, while other anti-ulcer drugs, for the most part, have little effect on the result of the UBT when used alone. The [sup 13]C-urea breath test (UBT) is a simple test for the diagnosis of Helicobacter pylori infection, but several factors have been reported to affect the results of this test. In this study, the effects of the anti-ulcer drugs used in Japan on the results of the UBT were determined. [ABSTRACT FROM AUTHOR]

Striped bonito Sarda orientalis larvae and juveniles were reared in a laboratory from hatching to 14 days post hatching, and the development of their digestive system was investigated histologically. On day 2 (first feeding day), the larval-type digestive system was differentiated. On day 3, a blind sac with densely distributed gastric glands developed and pyloric ceca appeared, suggesting that the digestive system was attaining adult-type structure. The yolk was completely absorbed on day 4. Bonito larvae preyed on rotifers and/or Artemia nauplii on day 2, but almost the whole gut was occupied by fish larvae from day 4. In the striped bonito, the adult-type digestive system was established right after first feeding, and this precocious development was well synchronized with the appearance of piscivory. [ABSTRACT FROM AUTHOR]

Background. p53 gene mutations are believed to play a critical role in the development of gastric carcinoma. We examined the relation between Helicobacter pylori infection and p53 gene mutations of the gastric mucosa in human and animal models. Methods. To detect the original p53 DNA sequences of the Japanese monkey and Mongolian gerbil, the p53 genes of these animals were amplified using the nested polymerase chain reaction method with primers for the human p53 gene. Direct DNA sequencing of exons 5, 6, 7, and S of the p53 genes was performed by the dyedeoxy terminator method for gastric mucosa of humans, the Japanese monkey, and the Mongolian gerbil. The expression of p53 was examined immunohistochemically in a Japanese monkey model. Results. Mutations of the p53 gene were identified in 52.4% of human H. pylori-positive mucosa and in 100% of monkey H. pylori-positive mucosa. However, no mutations of the p53 gene were found in the H. pylori-positive gastric mucosa of Mongolian gerbils. There were no mutations in H. pylori-negative gastritis mucosa of humans, monkeys, or Mongolian gerbils. Nuclear staining of p53 was seen in the glandular cells of the H. pylori-infected mucosa of Japanese monkeys, especially in the neck region of the glands. Conclusions. These findings demonstrate that the H. pylori infection can induce p53 point mutations in humans and the Japanese monkey and appear to be involved in the pathway leading to dysplasia or carcinoma. However, our direct DNA sequencing method showed no p53 mutations in the Mongolian gerbil model at present. Further studies with this model are needed. [ABSTRACT FROM AUTHOR]

ABSTRACT: The survey on scallop toxicity in association with causative dinoflagellates was conducted when the cultured scallops Patinopecten yessoensis were found to accumulate paralytic shellfish toxins in late November of 1997 at Otsuchi Bay, Iwate Prefecture, Japan. Alexandrium catenella was observed in high density at the beginning of the survey. The cell density of A. catenella decreased and completely disappeared in early December. The scallop toxicity also decreased with decrease of the cell density of A. catenella. The toxin profile of the scallop was similar to that of natural and cultured cells of A. catenella isolated from the Bay, showing that scallop toxicity is due to A. catenella. This is the first case in which paralytic shellfish toxins were confirmed in scallops during a bloom of A. catenella in Sanriku coast of Iwate Prefecture. [ABSTRACT FROM AUTHOR]

SUMMARY: Cultured cells of the dinoflagellate Alexandrium tamarense were fed to four species of bivalves and an ascidian to examine the interspecific differences in the ability to accumulate paralytic shellfish toxins. The specimens of each species were reared in the same tank. All the species ingested almost all the cells fed and became toxic. Marked individual differences in toxin accumulation was observed in all the species. However, the average amounts of accumulated toxins increased during feeding. When the animals were fed on the same amount of cells, they accumulated almost the same amounts of toxins, indicating that interspecific differences in toxin accumulation observed in nature is due to the difference in ingestion behavior of the animals under natural conditions. [ABSTRACT FROM AUTHOR]

SUMMARY:The activity of bacterial extracts to transform gonyautoxins to saxitoxins was found to be due to glutathione. This activity was also found in another thiol compound, 2-mercaptoethanol. These thiol compounds did not reduce 1-N-OH of gonyautoxin 1 and 4. Interestingly, the stable intermediate conjugates of paralytic shellfish toxins and thiol compounds were formed in the course of the reaction, which demonstrates that this is a two-step reaction consisting of formation of intermediate and degradation of the intermediate to saxitoxins. [ABSTRACT FROM AUTHOR]

Background: In Prader-Willi syndrome (PrWS), marked obesity is the most serious and common complication, contributing significantly to morbidity and mortality. Because of the associated psychosocial difficulties, bariatric surgery appears to be the only effective treatment. Case Report: A 30-year-old man with PrWS weighing 108 kg (BMI 50 kg/m2), underwent Roux-en-Y gastric bypass (RYGBP). 3 months before the RYGBP, he weighed 146 kg (BMI 68.5), partly because of heart failure. 18 months after RYGBP, he weighed 92.4 kg (BMI 43.3), with no postoperative complications. Moreover, he showed considerable increase in serum HDL-cholesterol levels with reciprocal reduction in LDL-cholesterol after the surgery. Conclusion: RYGBP resulted in satisfactory weight loss and improvement in serum lipid profile in a Japanese morbidly obese patient with PrWS. [ABSTRACT FROM AUTHOR]

Reports on the high level of diarrheic shellfish poisoning (DSP) toxins accumulated in Perna viridis during a bloom of Dinophysis caudata and Dinophysis miles in Sapian Bay, Panay Island, Philippines. Precipitation of water samples; Observation of D. caudata and D. miles in water samples; Analysis of DSP toxins using high-pressure liquid chromatography.

Deals with a study which describes the morphology and toxicity of Alexandrium minutum Halim found in northern Vietnam. Prevalence of paralytic shellfish poisoning (PSP) in Southeast Asia; Information on the plankton samples used in the study; Overview of the high-performance liquid chromatography analysis for PSP.

Advanced colorectal cancer harbors extensive intratumor heterogeneity shaped by neutral evolution; however, intratumor heterogeneity in colorectal precancerous lesions has been poorly studied. We perform multiregion whole-exome sequencing on ten early colorectal tumors, which contained adenoma and carcinoma in situ. By comparing with sequencing data from advanced colorectal tumors, we show that the early tumors accumulate a higher proportion of subclonal driver mutations than the advanced tumors, which is highlighted by subclonal mutations in KRAS and APC. We also demonstrate that variant allele frequencies of subclonal mutations tend to be higher in early tumors, suggesting that the subclonal mutations are subject to selective sweep in early tumorigenesis while neutral evolution is dominant in advanced ones. This study establishes that the evolutionary principle underlying intratumor heterogeneity shifts from Darwinian to neutral evolution during colorectal tumor progression. Advanced colorectal cancers are characterised by intra-tumour heterogeneity dictated by neutral evolution. Here the authors analyse early colorectal tumours by whole-exome sequencing and find that Darwinian evolution determines the fate of early lesions in colorectal adenoma and carcinoma in situ. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor about evaluation of the Helicobacter pyloristool antigen (HpSA) assay for diagnosing infection and confirming eradication after treatment.