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Background The relationship between bile acid reflux into the stomach and the risk of atrophic gastritis and intestinal metaplasia is still not well understood. Towards obtaining a better understanding, concentrations of bile acids were measured. Patients and Methods This study was carried out with the participation of 14 facilities in Japan, and 2283 samples were collected. The subjects with bile acid concentrations equal to or higher than the limit of detection were divided into four groups of equal size (group A: 0–25%, group B: 26–50%, group C: 51–75%, and group D: 76–100%). Thus, including the control group, there were five groups in total. The odds that the control group would develop atrophic gastritis and intestinal metaplasia was set as 1,and the odds ratios (OR) in groups A, B, C and D were calculated based on the odds in the control group. Results Regarding the development of atrophic gastritis, no increased risk was observed in either the Helicobacter pylori (H. pylori)-positive or -negative cases. The OR for the development of intestinal metaplasia were significantly higher, for both cases with and without H. pylori infection, in group D. Conclusion High concentrations of bile acid seem to be associated with an elevated risk of intestinal metaplasia.

腟スメア中に酵母様真菌を認め, さらにカンジダ属が分離同定された47例を対象として主に酵母細胞の形態的検討を行い, 細胞診検体の検鏡による種の推定とその精度について検討した.その結果, C. albicans酵母細胞は長径4μ以上が多く, 最も多くの小型酵母細胞をみた症例でさえも49%は長径4μ以上の酵母細胞であった。また, ほとんどの症例に仮性菌糸が観察された.C. glabntoは98.5%が長径4μ以下の酵母細胞であり, 長径5μ 以上の酵母細胞はきわめてまれであった.C. kruseiは4μ以上の酵母細胞としてみられたが, 6μ以上のものが多く, C. albicansに比べ長楕円形の酵母細胞が多かった.以上の結果は, 膣真菌症の原因菌として重要なC. albicansとC. glabntaを細胞診で鑑別しうる可能性を示唆するものであり, 早期診断や治療に役立つと考えられた.

In Europe and the United States, the incidence of esophageal adenocarcinoma has increased 6-fold in the last 25 years and currently accounts for more than 50% of all esophageal cancers. Barrett’s esophagus is the source of Barrett’s adenocarcinoma and is characterized by the replacement of squamous epithelium with columnar epithelium in the lower esophagus due to chronic gastroesophageal reflux disease (GERD). Even though the prevalence of GERD has recently been increasing in Japan as well as in Europe and the United States, the clinical situation of Barrett’s esophagus and Barrett’s adenocarcinoma differs from that in Western countries. In this paper, we focus on specific differences in the background factors and pathophysiology of these lesions.

The relationship between bile acid reflux into the stomach and the risk of atrophic gastritis and intestinal metaplasia is still not well understood. Towards obtaining a better understanding, concentrations of bile acids were measured.This study was carried out with the participation of 14 facilities in Japan, and 2283 samples were collected. The subjects with bile acid concentrations equal to or higher than the limit of detection were divided into four groups of equal size (group A: 0-25%, group B: 26-50%, group C: 51-75%, and group D: 76-100%). Thus, including the control group, there were five groups in total. The odds that the control group would develop atrophic gastritis and intestinal metaplasia was set as 1,and the odds ratios (OR) in groups A, B, C and D were calculated based on the odds in the control group.Regarding the development of atrophic gastritis, no increased risk was observed in either the Helicobacter pylori (H. pylori)-positive or -negative cases. The OR for the development of intestinal metaplasia were significantly higher, for both cases with and without H. pylori infection, in group D.High concentrations of bile acid seem to be associated with an elevated risk of intestinal metaplasia.

Cervicovaginal cytology has played an increasingly important role in detecting squamous and columnar epithelial lesions as columnar epithelial neoplasia of the uterine cervix has increased. We compared endocervical cell cytomorphology between smear-sampling devices. Results showed that columnar cells cluster incidence and appearance patterns differed greatly between devices. The cytobrush and Cervex brush proved more useful in detecting endocervical columnar cell abnormalities earlier than the cotton swab or the Cytopick.

New pyridone non-nucleoside reverse transcriptase inhibitors (NNRTIs) were prepared and several flexible routes to this class of inhibitor were identified. These NNRTIs were active inhibitors of the replication of wild-type and NNRTI-resistant HIV. Structure-based drug design was used to optimize the activity of the compounds against NNRTI-resistant mutants. The co-crystal structure of inhibitor 2b in the NNRTI binding pocket of HIV reverse transcriptase (HIVRT) is also described.

目黒区検診センターで昭和44～59年の16年間に子宮癌検診を行った61,691名のなかから972名の要精検者と102名の上皮内癌, 107名の浸潤癌が検出された.癌発見率は0.34%であった.地域医療機関の医師が鏡検した昭和45～53年 (前期) の9年間と細胞診スクリーナーおよび細胞診指導医にて判定した昭和54～59年 (後期) の6年間を比較検討した.前期の要精検率, 癌発見率はそれぞれ1.84, 0.36%で, 後期の要精検率, 癌発見率は1.58, 0.34%となり著しい差は認められなかつたが, 前期で要精検者と診断された細胞診の再検例では炎症異型が圧倒的に多くみられ, 偽陽性率は51.19%であった.一方, 後期の偽陽性率は約6%であり診断精度の向上が認められた.なお, 追跡調査で前, 後期を通じ330例の不明例があり, その頻度は38.6%と多く, 要再検者の追跡方法の確立は今後の重要な課題であることが示唆された.