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Background Severe inflammation with necrosis and fibrosis of the gallbladder in acute cholecystitis increases operative difficulty during laparoscopic cholecystectomy. This study aimed to assess the use of preoperative MRI in predicting pathological changes of the gallbladder associated with surgical difficulty. Methods Patients who underwent both preoperative MRI and early cholecystectomy for acute cholecystitis between 2012 and 2018 were identified retrospectively. On the basis of the layered pattern of the gallbladder wall on MRI, patients were classified into three groups: high signal intensity (HSI), intermediate signal intensity (ISI), and low signal intensity (LSI). The endpoint was the presence of pathological changes of the gallbladder associated with surgical difficulty, such as necrosis, abscess formation and fibrosis. Results Of 229 eligible patients, pathological changes associated with surgical difficulty were found in 17 (27 per cent) of 62 patients in the HSI group, 84 (85 per cent) of 99 patients in the ISI group, and 66 (97 per cent) of 68 patients in the LSI group (P, Variations in the layered pattern of the gallbladder wall on MRI were significantly associated with fibrosis and necrosis of the gallbladder wall in acute cholecystitis. Intermediate to low signal intensity of the gallbladder wall on MRI had a sensitivity of 90 per cent and a specificity of 73 per cent for predicting pathological changes in the gallbladder wall associated with surgical difficulty during laparoscopic cholecystectomy for acute cholecystitis. The results indicate that MRI could be a novel method of predicting surgical difficulty in laparoscopic cholecystectomy. MRI could possilby predict surgical difficulty of cholecystectomy.

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions. © Copyright.

In Japan, inguinal hernia repair is widely performed with local anesthesia. The objective of this study was to evaluate safety and efficacy of intravenous dexmedetomidine as a sedation agent with local anesthesia in inguinal hernia repair. We performed this randomized, single-blind study for 200 patients who were scheduled to undergo inguinal hernia repair with local anesthesia. Patients were randomly divided into two groups (dexmedetomidine group: Group D, midazolam group: Group M). The primary outcome was to evaluate the safety of intravenous dexmedetomidine. Secondary outcomes were to analyze results of operators’ surveys and patients’ questionnaires and evaluate implementation of conscious sedation. Incidence of respiratory depression was significantly higher in Group M than Group D (p = 0.03). Other adverse events examined did not differ significantly. All three operators’ questionnaires indicated that results were better in Group D than Group M. More than 70% of patients in both groups were satisfied with the surgery. More than 80% of Group D patients and 74% of Group M patients achieved a state of conscious sedation. This study demonstrated that intravenous dexmedetomidine during hernia repair with local anesthesia is safe and the results were satisfactory to both operators and patients.

In this article, we propose a comprehensive computational model of the entire respiratory system which allows simulating patient-specific lungs under different ventilation scenarios and provides a deeper insight into local straining and stressing of pulmonary acini. We include novel 0D inter-acinar linker elements to respect the interplay between neighboring alveoli, an essential feature especially in heterogeneously distended lungs. The model is applicable to healthy and diseased patient-specific lung geometries. Presented computations in this work are based on a patient-specific lung geometry obtained from CT-data and composed of 60, 143 conducting airways, 30, 072 acini, and 140, 135 inter-acinar linkers. The conducting airways start at the trachea and end before the respiratory bronchioles. The acini are connected to the conducting airways via terminal airways and to each other via inter-acinar linkers forming a fully coupled anatomically based respiratory model. Presented numerical examples include simulation of breathing during spirometry test, measurement of a quasi-static pressure-volume curve using a supersyringe maneuver, and volume controlled mechanical ventilation. The simulations show that our model incorporating inter-acinar dependencies successfully reproduces physiological results in healthy and diseased states. Moreover, within these scenarios, a deeper insight into local pressure, volume, and flow rate distribution in the human lung is investigated and discussed.

Nano-sized Nb2O5/carbon clusters composite material denoted as Ic, has been successfully synthesized by the calcination of NbCl5/epoxy resin complex I. MnO2-loaded Nb2O5/carbon clusters composite materials were also prepared by doping the MnO2 particles on the surface of Ic. The compositions of the synthesized composite materials were determined using inductively coupled plasma (ICP) spectroscopy, elemental analysis and surface characterization by transmission electron microscopy (TEM). The ultraviolet–visible (UV–Vis), and electron spin resonance (ESR) spectra of the composites were also measured. The reduction reaction of methylene blue with the calcined materials under the visible light irradiation has also been examined. The composite material Ic, reduced the methylene blue under the irradiation of visible light (λ > 460 nm). The MnO2-loaded Ic composite material could also decompose an aqueous silver nitrate solution by visible light irradiation and give O2 and Ag with a [O2]:[Ag] ratio of 1:4.

Nano-sized Ce 0.5 Hf 0.5 O 2 /carbon clusters composite material has been successfully obtained by the microwave-irradiated calcination of a Ce(acac) 3 /Hf(acac) 4 /epoxy resin complex. The compositions of the resulting composite materials were determined using inductively coupled plasma (ICP) spectroscopy, elemental analysis and surface characterization by X-ray diffraction (XRD) and transmission electron microscopy (TEM). The ultraviolet–vis (UV–vis), and electron spin resonance (ESR) spectra of the composites were also measured. ESR spectra suggest the possibility of an electron transfer in the process of carbon clusters → Ce 0.5 Hf 0.5 O 2 . The reduction reaction of methylene blue with the calcined materials under the visible light irradiation has also been examined.

Nano-structured TiO2/carbon clusters/Cr2O3 composite material has been successfully obtained by the microwave treatment of a TiO(acac)/Cr(acac)3/epoxy resin complex. The compositions of the composite materials were determined using ICP, elemental analysis and surface characterization by SEM–EDX, TEM and XRD. ESR spectral examinations suggest the possibility of an electron transfer in the process of TiO2 → carbon clusters → Cr2O3 with an oxidation site at TiO2 particles and a reduction site at Cr2O3 particles. The preliminary experimental results show that the calcined materials could decompose methylene blue under visible-light irradiation.

Calcination of a gallium-N-phenylene-N hybrid copolymer under an argon atmosphere gave nano-sized gallium nitride–carbon cluster composite material. ESR spectral examinations of the calcined materials reveals the possibility of an electron transfer in the process of gallium nitride → carbon clusters with an oxidation site at gallium nitride particles and a reduction site at carbon clusters. The calcined material was found to reduce methylene blue under visible light irradiation.

The calcinations of SnO 2 hydrosol/starch composite materials under an argon atmosphere gave nano-sized SnO 2 /Sn/carbon clusters composite materials. ESR and UV–vis spectral examinations suggest the possibility of light-responsive electron transfer from carbon clusters to SnO 2 and/or Sn particles.

Calcination of a samarium-O–phenylene-S–nickel-S–phenylene-O hybrid copolymer under an argon atmosphere gave Sm 2 O 3 –carbon cluster–Ni 3 S 4 composite material. ESR spectral examinations of the calcined materials revealed the possibility of a two-step electron transfer in the process of Sm 2 O 3 → carbon cluster → Ni 3 S 4 with an oxidation site at Sm 2 O 3 particles and a reduction site at Ni 3 S 4 particles. The calcined material was found to reduce methylene blue under visible light irradiation.

Calcination of a tantalum- O -phenylene- S -tin- S -phenylene- O hybrid copolymer under an argon atmosphere gave SnS–carbon clusters–Ta 2 O 5 composite material. Electron spin resonance (ESR) and X-ray photospectrometry (XPS) spectral examinations suggest the possibility of an electron transfer in the process of SnS → carbon clusters → Ta 2 O 5 with an oxidation site at SnS particles and a reduction site at Ta 2 O 5 particles. The calcined material could decompose methylene blue under visible light irradiation.

The oxidation behavior of gamma alloys was investigated in air and scale spallation was observed. The gamma alloys were superior in oxidation behavior to binary TiAl alloys in both isothermal and cyclic exposure. The mass gain of the alloy with high Nb content was smaller than low Nb alloys at 760 and 815 °C, the difference between them decreased at 870 °C. The improved oxidation resistance of the alloys is attributable to Nb addition resulting from reduced TiO2 growth through the so-called doping effect. Not only the alloys with low Nb but also the high Nb alloys suffered from scale spallation, especially after longer and/or higher temperature exposure. The density of the scale formed on the gamma alloys was found to be about one half of bulk oxide (Al2O3, TiO2) and was comparable to that formed on binary TiAl alloys. The coefficient of the thermal expansion (CTE) of the gamma alloys was larger than that of the oxides and the alloying addition reduced the CTE value of the alloys. Although the Nb addition suppressed the oxide growth and reduced the CTE difference between alloy and oxides, the prevention of the scale spallation could not be attained by single addition of Nb.

The sequencing and annotation of the euchromatin of the Drosophila melanogaster genome provides an important foundation that allows neurobiologists to work back from the complete gene set of neuronal proteins to an eventual understanding of how they function to produce cognition and behavior. Here we provide a brief survey of some of the key insights that have emerged from analyzing the complete gene set in Drosophila. Not surprisingly, both the Caenorhabditis elegans and Drosophila genomes contain a conserved repertoire of neuronal signaling proteins that are also present in mammals. This includes a large number of neuronal cell adhesion receptors, synapse-organizing proteins, ion channels and neurotransmitter receptors, and synaptic vesicle-trafficking proteins. In addition, there are a significant number of fly homologs of human neurological disease loci, suggesting that Drosophila is likely to be an important disease model for human neuropathology in the near future. The experimental analysis of the Drosophila neuronal gene set will provide important insights into how the nervous system functions at the cellular level, allowing the field to integrate this information into the framework of ultimately understanding how neuronal ensembles mediate cognition and behavior.

Object. The pathogenesis of traumatic brain swelling remains unclear. The generally held view is that brain swelling is caused primarily by vascular engorgement and that edema plays a relatively minor role in the swelling process. The goal of this study was to examine the roles of cerebral blood volume (CBV) and edema in traumatic brain swelling.Methods. Both brain-tissue water and CBV were measured in 76 head-injured patients, and the relative contribution of edema and blood to total brain swelling was determined. Comparable measures of brain-tissue water were obtained in 30 healthy volunteers and CBV in seven volunteers. Brain edema was measured using magnetic resonance imaging, implementing a new technique for accurate measurement of total tissue water. Measurements of CBV in a subgroup of 31 head-injured patients were based on consecutive measures of cerebral blood flow (CBF) obtained using stable xenon and calculation of mean transit time by dynamic computerized tomography scanning after a rapid bolus injection of iodinated contrast material. The mean (± standard deviation) percentage of swelling due to water was 9.37 ± 8.7%, whereas that due to blood was −0.8 ± 1.32%.Conclusions. The results of this study showed that brain edema is the major fluid component contributing to traumatic brain swelling. Moreover, CBV is reduced in proportion to CBF reduction following severe brain injury.

Rare-earth-doped thin films were made by plasma-enhanced chemical vapour deposition using a complex containing chelating ligands and tetraethoxysilane. By this means of deposition, the film was successfully doped with terbium or erbium and the luminescence properties were investigated. In the case of -doped films, strong luminescence peaks from the level were observed during excitation by a KrF excimer laser. Upon thermal treatment at 800 or , luminescence peaks from the level appear. Under DC voltages, electroluminescence from the level was also observed.

✓ Cerebrospinal fluid (CSF) dynamics were correlated to the changes in ventricular size during the first 3 months posttrauma in patients with severe head injury (Glasgow Coma Scale score ≤ 8, 75 patients) to distinguish between atrophy and hydrocephalus as the two possible causes of posttraumatic ventriculomegaly. Using the bolus injection technique, the baseline intracranial pressure (ICP), pressure volume index, and resistance for CSF absorption (R0) provided a threedimensional profile of CSF dynamics that was correlated with ventricular size and Glasgow Outcome Scale (GOS) score at 3, 6, and 12 months posttrauma. Patients were separated into five different groups based on changes in ventricular size, presence of atrophy, and CSF dynamics. Group 1 (normal group, 41.3%) demonstrated normal ventricular size and normal ICP. Group 2 (benign intracranial hypertension group, 14.7%) showed normal ventricular size and elevated ICP. Group × (atrophy group, 24%) displayed ventriculomegaly, normal ICP, and normal R0. Group 4 (normal-pressure hydrocephalus group, 9.3%) had ventriculomegaly, normal ICP, and high R0. Group 5 (high-pressure hydrocephalus group, 10.7%) showed ventriculomegaly and elevated ICP with or without high R0. The GOS score in the nonhydrocephalic groups (Groups 1, 2, and 3) was better than in the hydrocephalic groups (Groups 4 and 5). It is concluded from these results that 44% of head injury survivors may develop posttraumatic ventriculomegaly. Posttraumatic hydrocephalus, as identified by abnormal CSF dynamics, was diagnosed in 20% of survivors and their outcome was significantly worse. This study demonstrates the importance of using CSF dynamics as an aid in diagnosis of posttraumatic hydrocephalus and identifying those patients who may benefit from shunt placement.

The 43-kD protein is a peripheral membrane protein that is in approximately 1:1 stoichiometry with the acetylcholine receptor (AChR) in vertebrate muscle cells and colocalizes with it in the postsynaptic membrane. To investigate the role of the 43-kD protein in AChR clustering, we have isolated C2 muscle cell lines in which some cells overexpress the 43-kD protein. We find that myotubes with increased levels of the 43-kD protein have small AChR clusters and that those with the highest levels of expression have a drastically reduced number of clusters. Our results suggest that the 1:1 stoichiometry of AChR and 43-kD protein found in muscle cells is important for AChR cluster formation.

YBa2Cu3O7-x thin films were grown on vicinally polished MgO(001) substrates using a reactive rf-magnetron sputtering technique. We studied the effects of the vicinal cut on growth orientations and transport properties. The c-axis directions of all the films were stongly influenced by the substrate surface normal, with weak alignment to the substrate [001]MgO direction. No significant dependence of Tc's on vicinal angles was observed. However, Jc's were strongly degraded with vicinal angle. Jc's were also anisotropic to the vicinal direction. A vicinal cut affected the growth of YBCO films to increase the density of weak links.

Coat-color patterns of 20 C3H/HeN++BALB/cA chimeras produced by using the same colony of mice in a series of experiments, were quantitatively analyzed, by means of a video-image analysis system developed by Tachi (1988, 1989). In those chimeras, proportion of the two allogeneic components, i.e., C3H/HeN and BALB/cA, was relatively well balanced between the right and the left halves of the pelts, whereas between the anterior and the posterior regions it was unbalanced in favor of BALB/cA components in the anterior region. To interpret the results, a computerized geometrical model intended to simulate the hypothetical conditions of chimeric germ layers during early embryogenesis, was constructed. From the model, it was proposed that the seemingly high selection pressure for the BALB/cA components in the anterior region of this particular group of chimeras, might have been caused because the initial steps of the determination of the cranio-caudal axis took place in the regions of the primary ectoderm where BALB/cA, rather than C3H/HeN blastomeres were predominant. Possible variations in the alleles of the genes regulating the germ layer differentiation, might conceivably be the cause for the observed tendencies.

An electrolytic technique employing a double cell system has been used to measure the diffusivity D of hydrogen in PdBH solutions containing up to 0.12 atom fraction B in the temperature range 273–350 K. The presence of B-atoms cause the H-diffusivity to decrease by about a factor of 2 at the maximum B-content studied. The individual Arrhenius plots of ln D vs (1/ T ) are all linear and the corresponding apparent activation energies for H-diffusion decrease by ∼4 kJ/mol in the B-content range studied. The results have been interpreted in terms of a model based upon rate theory and a statistical mechanical treatment of the thermodynamic properties of this system.

Measurements have been made of the solubility of hydrogen in Pd-B solid solutions containing B in the range 0–12 at.% in equilibrium with H 2 -gas at a pressure of 1.01 × 10 5 N/m 2 and in the temperature range 625–1111 K. Thermodynamic functions derived from the isobar measurements show that the behavior of H in the binary matrix is highly non-ideal. This behavior has been shown to be consistent with a statistical model based upon first-order mixing statistics in which H-atoms experience a repulsive interaction with respect to “isolated” B-atoms in the matrix, but an attractive interaction with respect to B-B nearest neighbor pairs.

Cytotoxin-associated gene A (cagA) is the major virulence factor of Helicobacter pylori strains and affects the clinical outcome of patients. Blood group antigen binding adhesin (BabA) helps the strains adhere to the epithelial cell layer and is the most important adhesin of H. pylori.We tried to study the association between the status of babA2 and cagA in H. pylori strains and histological gastritis. methods: Thirty-six patients were included. RNA was extracted from two frozen biopsy samples of the antrum and corpus, respectively, and cagA/babA2 genotypes were analyzed with reverse transcription polymerase chain reaction and direct sequencing. Two gastric specimens of the antrum and corpus, respectively, were also stained with hematoxylin and eosin to analyze H. pylori-related gastritis.In the antrum, 56% of the specimens were babA2 positive and in the corpus 53%. The gastritis scores of activity and inflammation were associated with the presence of babA2 in antrum specimens but not in corpus specimens. cagA gene encoding in the CagA EPIYA-D region was detected in all samples, and the sequence was completely identical between those from the gastric corpus and antrum.babA2 expression is heterogeneous and correlated with the extent of gastritis in the antrum, but not in the corpus, whereas cagA shows a monotonous genotype.

To investigate whether curing Helicobacter pylori infection improves symptoms over the long-term in Japanese patients with nonulcer dyspepsia and fundic atrophic gastritis.Ninety H. pylori-positive dyspeptic patients with fundic atrophic gastritis were enrolled in this study. We performed a randomized double-blind placebo-controlled trial comparing triple therapy (n=45) with that of placebo alone (n=45). Inflammation and mucosal atrophy were scored according to the Updated Sydney System. Symptoms were scored on a scale of 0 to 3 for six items. Fasting samples of gastric juice were taken before endoscopy, and gastric pH was determined. Serum gastrin and pepsinogen levels were measured, and body mass index was determined. These patients were followed up for 3 years, and all measures were evaluated both before and after therapy.Significant improvement in dyspeptic symptoms and gastritis scores, significant decrease in gastric pH, and significant increase in body mass index were found after 3 years eradication in nonulcer dyspepsia patients treated successfully for H. pylori infection. There were no significant changes in the placebo group.Our study shows that eradicating of H. pylori results in significant long-term reduction in symptoms of nonulcer dyspepsia with fundic atrophic gastritis.

Clarithromycin has been administered to patients in Japan since 1991. Clarithromycin-resistant Helicobacter pylori strains have been on the rise in Japan. We obtained H. pylori isolates between 1989 and 2000 and examined mutations of the 23S rRNA gene, which are closely associated with clarithromycin resistance. Isolates were obtained from 356 patients with H. pylori infection treated at the Hiroshima University. Sixty-one of the patients received clarithromycin-based H. pylori eradication therapy. Mutations of the 23S rRNA gene were examined by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) followed by sequencing analysis. Mutant strains were found in 42 of the 356 patients (11.8%). The prevalence of mutant strains increased from 0 to 20.4% during the 12-year study period. The prevalence increased to more than 10% by 1995 and then to more 20% after 1999. The H. pylori eradication rate was significantly higher in patients with wild-type strains than in patients with mutant strains (72.0 vs. 36.4%, p = 0.024). Our data indicate that clarithromycin-resistant H. pylori strains have increased rapidly since 1995 and that the effectiveness of clarithromycin-based H. pylori eradication therapies may soon be compromised. Other new therapies may be necessary as first-line treatments in Japan.

This paper proposes a gestural instruction learning algorithm for robots which move in response to video information. Applying the algorithm to an actual moving robot in a trajectory learning experiment confirms that it enables a robot to understand, on the same level that a dog might, both the meaning of a human macro sign (i.e. a figure-eight sign) and the qualitative sense inherent in a human macro qualitative instruction (i.e. a figure-eight trajectory with a large width). The proposed algorithm refines the robot moving trajectory through the use of a fuzzy associative memory system. It is demonstrated that the use of macro qualitative instructions in the proposed algorithm enables trajectory learning to be attained more quickly than with the use of micro instructions in a conventional algorithm. >

A feasibility experiment on an automatic signature verification system based on writing pressure was conducted using a new device sensing the z-axis component of writing pressure. The data acquisitions were conducted over a half a year for checking both subjects' and device stabilities. The DP (dynamic programming) matching method provided 6% error rates for type I and type II errors. The nature of signature writing pressure was investigated.

To investigate the effect of the eradication of Helicobacter pylori on histological gastritis.: Twenty-six patients with moderate to severe atrophy received successful eradication therapy of H.pylori. Four patients dropped out and 22 were followed up prospectively for 5 years. The grades of gastritis were estimated from gastric biopsy specimens. The grade of intestinal metaplasia was also evaluated by dye-endoscopy using methylene blue (methylthioninium chloride). The serum levels of pepsinogen, gastrin and anti-parietal cell antibody were also determined.: The grades of atrophy decreased in patients with successful eradication therapy in the gastric corpus (before vs. 5 years after eradication, 2.09 +/- 0.15 vs. 0.91 +/- 0.17; P0.01) and in the antrum (2.14 +/- 0.17 vs. 1.36 +/- 0.17; P0.01). The levels of intestinal metaplasia were also decreased in the corpus (0.91 +/- 0.24 vs. 0.50 +/- 0.16; P0.05) and in the antrum (1.41 +/- 0.20 vs. 1.00 +/- 0.16; P0.05), which was also demonstrated by the methylene blue (methylthioninium chloride) staining method (33.4 +/- 8.2% vs. 23.0 +/- 6.5%; P0.05). The improvement of corpus atrophy correlated well with the high serum level of pepsinogen I (P = 0.005), but showed no correlation with the levels of anti-parietal cell antibody.: These results suggest that gastric atrophy and intestinal metaplasia are reversible events in some patients.

We investigated an antiinflammatory effect of rebamipide [2-(4-chlorobenzoylamino)-3-[2(1H)-quinolinon-4-yl] propionic acid], a gastroprotective agent, in H. pylori-associated gastritis. Eighty-six patients with H. pylori-positive chronic gastritis were enrolled: 53 were treated with rebamipide (300 mg daily for 12 months) and 33 served as controls. Significant decreases in mononuclear cell infiltration into the antrum and corpus were noted in the rebamipide treatment group (before vs after, 1.42 +/- 0.15 vs 1.02 +/- 0.15; P0.01 and 1.60 +/- 0.15 vs 1.21 +/- 0.14; P0.05, respectively). Levels of infiltrating neutrophil were also decreased in the antrum (before vs after, 0.98 +/- 0.14 vs 0.70 +/- 0.13; P0.05) and were associated with a decrease in iNOS production. Sera from patients treated with rebamipide showed a significant decrease in gastrin (276.3 +/- 58.3 pg/ml vs 173.0 +/- 34.2 pg/ml; P0.05), whereas no change was observed in the control group. These suggest that long-term rebamipide treatment improved histologic gastritis and decreased serum gastrin levels in H. pylori-associated gastritis.

Our previous study demonstrated that Helicobacter pylori eradication was less effective in smokers than in non-smokers. Cetraxate is an anti-ulcer drug that increases gastric mucosal blood flow.To evaluate the effect of cetraxate combined with new triple therapy for the eradication of H. pylori in smokers.This study had a single-centre, double-blind, randomized non-placebo design. A total of 106 consecutive H. pylori-positive smoking patients were randomly allocated to one of two regimens: one group received omeprazole (20 mg), amoxycillin (1500 mg), and clarithromycin (600 mg) for 7 days (OAC, n=55). The other group recieved OAC plus cetraxate (600 mg) for 7 days (OAC + CET, n=51). The success of H. pylori eradication was evaluated by histology and the 13C-urea breath test at 4 weeks after completion of treatment.By intention-to-treat analysis, the H. pylori eradication rate was 55% in the OAC group and 92% in the OAC + CET group (P0.01). By per protocol analysis, the H. pylori eradication rate was 58% in the OAC group and 94% in the OAC + CET group (P0.01).Cetraxate combined with new triple therapy increases the eradication of H. pylori in smokers.

We examined the role of capsaicin-sensitive afferent neurons in pH-dependent gastrin secretion in the rat stomach. The change in serum gastrin levels relative to changes in luminal pH (using omeprazole for luminal alkalization or 0.1 N HCl for luminal acidification) was studied after oral administration of 4% lidocaine or capsaicin-induced ablation of afferent neurons. The increase of serum gastrin levels by luminal alkalization was significantly inhibited (50%) after administration of 4% lidocaine. Capsaicin pretreatment (125 mg/kg subcutaneously over two days) inhibited the change in serum gastrin levels both the luminal alkalization (38%) and acidification (66%). Antral gastrin contents, somatostatin contents, gastrin mRNA expression, and somatostatin mRNA expression were not significantly affected by capsaicin pretreatment. Our results indicate that capsaicin-sensitive afferent neurons participate in the secretion of gastrin by luminal alkalization and inhibition of gastrin by luminal acidification.

Although several recent studies have shown that the eradication of Helicobacter pylori provokes reflux oesophagitis, the results are conflicting.To investigate the prevalence of reflux oesophagitis in patients after eradication of H. pylori and consider its association with hiatal hernia and corpus gastritis.A total of 286 patients who underwent H. pylori eradication therapy and 286 age- and disease-matched H. pylori-positive controls who did not undergo eradication therapy were followed prospectively. All patients and controls underwent endoscopy at 1-year intervals or when upper gastrointestinal symptoms recurred. The presence of hiatal hernia and histology of the gastric corpus were evaluated at the time of initial endoscopy.The estimated prevalence of reflux oesophagitis within 3 years was 18% after eradication therapy and 0.3% without therapy. Patients who developed reflux oesophagitis after therapy had a greater prevalence of hiatal hernia (P=0.0008) and more severe corpus gastritis (P=0.0005) before therapy. Cumulative prevalence of reflux oesophagitis was 26% in patients with hiatal hernia, 7.7% in those without hiatal hernia, 33% in those with corpus atrophic gastritis and 13% in those without corpus atrophic gastritis. When patients had both hiatal hernia and corpus gastritis, the prevalence of reflux oesophagitis was 37%. The newly developed reflux oesophagitis was classified as mild in 35 out of 36 (97%) patients who developed reflux oesophagitis after eradication therapy.Eradication of H. pylori increased the prevalence of reflux oesophagitis in our patient group. The presence of hiatal hernia and corpus gastritis are closely related to the development of reflux oesophagitis after H. pylori eradication therapy.

An NH4OH extract from seed shell of Pinus koraiensis Sieb. et Zucc. inhibited infections of rotavirus and enterovirus in cultured rhesus monkey kidney MA 104 cells. Antiviral activity of the extract was attributable to interference with virus adsorption, rather than to inhibition of virus replication after adsorption.

Recent studies (K. Komoto et al., Am. J. Gastroenterol., 93: 1271-1276, 1998) have shown that Helicobacter pylori infection is associated with gastric cancer. However, the mechanism of H. pylori in carcinogenesis has not been clarified. H. pylori infection leads to a sustained production of reactive nitrogen species that may contribute to cause DNA damage. In this study, we examined the expression of inducible nitric oxide synthase (iNOS) and nitrotyrosine in gastric mucosa. The expression of iNOS and nitrotyrosine was examined by immunohistochemistry in 93 patients who initially underwent gastric biopsies between 1975 and 1992. Thirty-four individuals were later found to have gastric cancer at least 2 years after the initial biopsies (group A). The other 59 subjects have shown no evidence of gastric cancer during long-term follow-up. Fifty-one of these patients were positive for H. pylori (group B), and eight were negative for H. pylori (group C). The expression of iNOS and nitrotyrosine in the gastric mucosa was significantly higher in H. pylori-positive groups A and B than in H. pylori-negative group C. Among the H. pylori-positive patients, the expression of iNOS and nitrotyrosine was significantly higher in group A than in group B. These results suggest that high production of iNOS and nitrotyrosine in the gastric mucosa infected with H. pylori may contribute to the carcinogenesis of gastric cancer.

The mucin core peptide MUC1 often is detectable in colorectal carcinoma (CRC) tissue and cell lines. However, whether MUC1 in CRC correlates with tumor histogenesis and progression is unclear. We studied the relationship between MUC1 expression in intramucosal CRC and clinicopathologic features, expression of Ki-67, and p53 protein, and apoptosis.The intramucosal CRC we studied included 140 endoscopically or surgically resected lesions, including 106 low-grade carcinomas and 34 high-grade carcinomas. De novo carcinoma, defined as carcinoma with no adenomatous component, represented 9 of 140 tumors. Three macroscopic types were identified: 57 lesions were polypoid, 55 were superficial and flat, and 28 were granular-type laterally spreading tumors (G-LST). MUC1, Ki-67, and p53 expression were examined immunohistochemically. Apoptotic cells were identified by in situ DNA nick end labeling.MUC1 expression in high-grade carcinomas was significantly more frequent (p0.01) than in low-grade carcinomas; expression in adenomas was almost nil. MUC1 expression in polypoid carcinomas was significantly more frequent (p0.05) than in superficial carcinomas or G-LST. MUC1 expression in carcinomas with p53 expression was significantly more frequent (p0.01) than in carcinomas not expressing p53. No significant correlation was found between expression of MUC1 and Ki-67 labeling index. MUC1 was expressed more frequently in carcinomas with relatively high apoptotic index (p0.01). MUC1 expression did not differ between de novo carcinomas and those developing from adenomas.The results suggest that MUC1 is likely to be expressed in the course of colorectal carcinoma development when p53 protein is overexpressed and apoptosis is prominent.

Recent studies have shown that the eradication of Helicobacter pylori results in a gastric acid secretion which decreases to normal levels in patients with duodenal ulcer disease. The aim of this study was to evaluate the effect of eradication of H. pylori in a 24-h study of gastric acidity in patients with atrophic gastritis of the corpus.Intragastric acidity was measured by continuous 24-h pH monitoring, and the histology of the gastric antrum and corpus were evaluated in 14 H. pylori-positive patients with histologically proven atrophic gastritis of the corpus (10 men, 4 women; mean age, 57 years) before and 1 year after anti-H. pylori therapy.H. pylori was absent in 13 of 14 patients 1 year after treatment. Both gastritis and atrophy scores were significantly lower after eradication therapy (P0.01). The 24-h median pH and the percentage of 24-h pH readings above 4.0 units were significantly decreased after eradication therapy (from 5.12 +/- 0.36 to 2.69 +/- 0.21, and from 65.5 +/- 6.6% to 28.2 +/- 6.1%, P0.01, respectively.)Eradication of H. pylori increases 24-h gastric acidity in patients with atrophic gastritis of the corpus. Improvement of the histology of the gastric antrum and corpus may lead to the normalization of gastric acidity.

Jefferson's classification (1938) has been used to localize lesions of the cavernous sinus. However, we think this classification is sometimes incorrect in identifying localization based on clinico-anatomical evidence. We investigated the efficacy of the newly proposed Ishikawa's classification. Based on the analysis on serial sections of human cavernous sinus, it classifies the locus of the lesion into three groups: anterior, middle, and posterior, corresponding to the location of the intracranial orifice of the optic canal and of the penetration of the maxillary nerve into the cavernous sinus. The subjects were 162 cases with cavernous sinus lesions. They were classified by the two methods. There was a total of 111 cases (69%) of unclassified cases in Jefferson's classification and 45 (28%) in Ishikawa's classification. The anterior type was frequently encountered in cases caused by inflammations and both posterior and whole types were caused by tumors in Ishikawa's classification. It was concluded that Ishikawa's classification is clinically useful to identify and classify the localization of cavernous sinus lesions.