Search

Background and Aim: There is no gold standard for making the diagnosis of autoimmune hepatitis (AIH), and the diagnosis of acute onset AIH (A‐AIH) is most challenging. A‐AIH sometimes develops into acute liver failure with poor prognosis if the diagnosis is delayed. Therefore, it is most important for the better prognosis to diagnose non‐severe A‐AIH early and treat appropriately. However, features in the early stage of A‐AIH are unclear. We examined initial characteristics of non‐severe A‐AIH in detail and tried to find novel clinical features for the early diagnosis. Methods: Clinical, biochemical, immunological, radiological, and histological features of 71 patients (54 women, mean age 57.9 ± 14.3 years) with non‐severe A‐AIH admitted to community hospitals between 2001 and 2022 were analyzed retrospectively. Result: Forty‐six had no symptom on onset and liver injuries were discovered by regular medical checkups. The mean duration from onset to consultation was 25.0 ± 29.3 days. Liver histology showed acute hepatitis in 59% and chronic hepatitis in 41%. Patients with symptoms revealed more male sex (P = 0.039), higher alanine aminotransferase (P < 0.001), higher total bilirubin (P < 0.001), and higher rate of histological acute hepatitis (P = 0.0013) than those without symptoms significantly. Male sex, presence of symptoms on onset, occurrence of jaundice in the course, and histological acute hepatitis were correlated. Conclusions: Sixty‐five percent of non‐severe A‐AIH patients were asymptomatic on onset, suggesting that A‐AIH would develop insidiously and present a longer clinical course than that reported. Male patients more often revealed true acute hepatitis clinically, biochemically, and histologically than female ones. [ABSTRACT FROM AUTHOR]

Aim: Diagnosis of acute onset autoimmune hepatitis (A‐AIH) has been difficult in that patients may not have typical clinicopathological features of AIH. In our previous reports of severe and fulminant AIH, two‐thirds of them showed radiological heterogeneity: hepatic heterogeneous hypoattenuation on unenhanced computed tomography (CT) reflecting heterogeneous distribution of massive hepatic necrosis (severe centrilobular necrosis), which would be beneficial for the diagnosis. In the present study, we analyzed non‐severe A‐AIH patients with or without radiological heterogeneity and tried to find novel clinical features for supporting the early diagnosis. Methods: Clinical, biochemical, immunological, radiological and histological features of 42 patients with non‐severe A‐AIH at community hospitals between 2010 and 2020 were analyzed. Results: Of 42, 28 patients on whom CT scans were performed and who could be fully analyzed were enrolled. Five patients showed hepatic heterogeneous hypoattenuation on unenhanced CT. There was no significant difference in clinical, biochemical, immunological and histological features at diagnosis between the two groups according to the presence of radiological heterogeneity, although mean minimum prothrombin time activity during the course was lower in patients with heterogeneity without statistical significance (p = 0.080). All responded to treatment well and achieved initial remission within 3 months. Conclusions: It is possible that patients with non‐severe A‐AIH show radiological heterogeneity reflecting centrilobular necrosis which is one of important diagnostic features of A‐AIH. Accordingly, radiological heterogeneity might be beneficial for the diagnosis of A‐AIH in combination with conventional clinicopathological features if it is detected in the absence of features suggestive of other liver diseases. [ABSTRACT FROM AUTHOR]

Tropical precipitation anomalies show very different patterns over the central‐eastern equatorial Pacific between the developing and decay phases of extreme El Niño despite similar patterns of sea surface temperature (SST) anomalies. Using observational data and atmospheric simulations for 1979–2018, we identified a meridional dipole mode of tropical precipitation variability, called the Pacific precipitation dipole mode (PPDM), which is critical for seasonally varying rainfall patterns related to extreme El Niño. We examined the mechanism of PPDM using a numerical model and found that the seasonal shift of the warm SST band in the eastern equatorial Pacific, when coupled with extreme SST anomalies, causes phase reversal of the PPDM. The PPDM can be regarded as a different manifestation of the El Niño/Southern Oscillation combination mode, as revealed by the surface wind anomalies, which also explains the distinct impact of extreme El Niño events over East Asia. Plain Language Summary: The rainfall patterns over the tropical Pacific are altered by the underling sea surface temperatures (SSTs). The patterns of rainfall anomalies, that is, deviation from climatological mean states, vary between the developing and decay seasons of extreme El Niño, despite similarity in patterns of SST anomalies. Using observational data and atmospheric simulations driven by observed SST for 1979–2018, we identified a meridional dipole mode of tropical rainfall variability that was asymmetric about the equator, called the Pacific precipitation dipole mode (PPDM). PPDM changes the polarity between autumn and spring, before and after the peak of extreme El Niño, and therefore is critical for seasonally varying rainfall patterns related to extreme El Niño. We examined factors that control the polarity of the PPDM by using a mechanistic model of the atmosphere and found that a coupling between SST anomalies associated with extreme El Niño and the seasonal cycle of the warm SST band in the eastern Pacific, migrating between the two hemispheres in a year, causes PPDM to change polarity between autumn and spring. The excitation of PPDM explains a distinct climatic impact over East Asia during extreme El Niño and also a feedback to extreme El Niño. Key Points: The second leading mode of tropical Pacific precipitation variability shows a meridional dipole pattern called the Pacific precipitation dipole mode (PPDM)PPDM amplifies and reverses its sign between developing and decay phases of extreme El Niño, indicating a nonlinear feature of ENSOCoupling between sea surface temperature anomalies and seasonal cycle in the eastern Pacific excites PPDM, which is a manifestation of ENSO combination mode [ABSTRACT FROM AUTHOR]

Purpose: To investigate which type of bond is more likely to be cleaved in functional groups in DNA including the nucleobases by the K-shell ionization of oxygen of DNA, and to determine whether the production of propenal is specific to the oxygen resonant excitation. To investigate the degradation pattern which depends on the type of nucleobase in the DNA monomer. Materials and methods: Calf thymus DNA film and four nucleotides (dAMP, TMP, dGMP, and dCMP) films were used as samples. Soft X-rays with energy of 560 eV were used to irradiate the samples, and the changes in the X-ray absorption near edge structure (XANES) spectra during the irradiation were measured. The XANES measurements were performed by using a 0.02 eV scanning photon energy step. Results: The difference spectra for DNA and nucleotides were similar to those for pyridine deprotonation. The oxygen K-edge regions in the difference spectra were all similar apart from the spectrum obtained at the resonant excitation energy of oxygen in DNA. The spectral change did not depend on the type of nucleotide. Conclusion: (1) Deprotonation of the nucleobase -NH is usually induced by core ionization of carbon, nitrogen, and oxygen; (2) propenal production is specific to the oxygen K-shell resonant excitation; and (3) the pattern of XANES spectral changes does not significantly depend on the type of nucleobase. [ABSTRACT FROM AUTHOR]

The soft X-ray beamline BL23SU at SPring-8 has undergone an upgrade with a twin-helical undulator of in-vacuum type to enhance the experimental capabilities of the endstations. The new light source with a fast helicity-switching operation allows not only the data throughput but also the sensitivity in X-ray magnetic circular dichroism (XMCD) to be improved. The operational performance and potential are described by presenting XMCD results of paramagnetic β-US2 measured with a 10 T superconducting magnet. [ABSTRACT FROM AUTHOR]

Background and Aims: Infection with Helicobacter hepaticus is suggested to play a role in the pathogenesis of chronic liver disease in humans. However, reactive antigens among Helicobacter species make the development of an H. hepaticus ELISA test with high specificity difficult. A new monoclonal antibody from a hybridoma clone (HRII-51) showed high specificity to H. hepaticus without cross-reaction to other gastrointestinal bacteria. Methods: The molecular weight of HRII-51 immunoreactive antigen was examined by Western blot of H. hepaticus probed with the monoclonal antibody HRII-51. A HRII-51-immunoreactive antigen capture ELISA was prepared in which the specific antigen was anchored by HRII-51-immobilized ELISA plate. Accuracy of HRII-51 antigen capture ELISA was examined using sera obtained from mice inoculated with Helicobacter species. Specificity of HRII-51 antigen capture ELISA was compared to that of H. hepaticus antigen-based ELISA using human sera with absorption by H. pylori cell lysate. Results: HRII-51 immunoreactive antigen had a molecular weight of 15 kDa. Sensitivity and specificity of HRII-51 antigen capture ELISA were 87.0% and 97.6% in mice inoculated with Helicobacter species. In human sera, modification of the results by absorption with H. pylori lysate was smaller in HRII-51 antigen capture ELISA comparing with H. hepaticus-antigen-based ELISA. Conclusion: Use of the HRII-51 antigen capture ELISA would be a useful approach for the serodiagnosis of H. hepaticus infection in both experimental animals and humans. [ABSTRACT FROM AUTHOR]

The diagnosis of acute-onset autoimmune hepatitis (AIH) has been difficult because patients do not always show clinicopathological features typical of AIH. We examined the important requirements for a definitive diagnosis of acute-onset AIH. Clinical, biochemical, and pathological features of 18 acute-onset AIH patients (16 women, 2 men; mean age, 54.3 ± 12.3 years) with no history of liver disease and no signs of chronicity were examined. Mean ALT was 679 ± 431 IU/l, and mean T-Bil was 2.4 ± 2.9 mg/dl. Mean IgG was 1801 ± 446 mg/dl, with 7 patients (39%) showing normal levels. Antinuclear antibody was ≤1: 40 in 7 (39%). Liver histology showed severe activity in 17 (94%) of the patients and severe acute hepatitis in 7 (39%). Centrizonal necrosis and plasma cell accumulation were characteristic for acute-onset AIH. AIH score ranged from 7 to 18 (13.2 ± 3.8) before treatment. All patients were diagnosed and treated early and responded completely to therapy. Histological examination of the liver is necessary for early diagnosis of acute-onset AIH. Moreover, we should evaluate liver biopsy specimens precisely and should be ready for a timely initiation of corticosteroid therapy to improve the prognosis. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Anal fistulas are common in individuals with Crohn's disease (CD). We sought to evaluate the efficacy of oral spherical adsorptive carbon (AST-120) (Kremezin®; Kureha Corporation, Tokyo, Japan) for the treatment of intractable anal fistulas in patients with CD. METHODS: In this multicenter, randomized, double-blind, placebo-controlled trial, patients with CD and at least one active anal fistula under treatment were assigned to receive either AST-120 or placebo for 8 wk. Improvement was defined as a reduction of 50% or more from baseline in the number of draining fistulas observed at both 4 and 8 wk. Remission was defined by closure of all draining fistulas at both 4 and 8 wk. The Perianal Disease Activity Index (PDAI) and Crohn's Disease Activity Index (CDAI) were also assessed. RESULTS: In total, 62 patients were randomized, of whom 57 received AST-120 (N = 27) or placebo (N = 30). The improvement rate in the AST-120 group (37.0%) was significantly greater than that in the placebo group (10.0%) ( P= 0.025). The corresponding remission rates were 29.6% and 6.7%, respectively ( P= 0.035). PDAI significantly improved at both 4 and 8 wk with AST-120, compared to placebo ( P= 0.004 and P= 0.005, respectively). CDAI was also significantly improved at both 4 and 8 wk in the AST-120 group, compared to the placebo group ( P= 0.007 and P= 0.001, respectively). AST-120 treatment was well tolerated and no life-threatening adverse events were observed. CONCLUSION: AST-120 is useful for the control of intractable anal fistulas in CD patients. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: : To evaluate the clinical advantage of the ratio of serum ornithine carbamoyltransferase (OCT) to alanine aminotransferase (ALT) in the diagnosis of hepatocellular carcinoma (HCC). Design and methods: : Serum levels of hepatic enzyme markers and their combinations were evaluated and compared with those of two other markers for HCC. Results: : OCT/ALT was significantly higher in case of HCC than chronic hepatitis or liver cirrhosis. Its sensitivity (64.3%) was higher than those of alpha-fetoprotein and PIVKA-II (21.4% and 42.9%, respectively). Fluctuations of OCT/ALT before and after treatment were similar to those of alpha-fetoprotein. Conclusions: : OCT/ALT is a potent indicator for the diagnosis and the prognosis of HCC. [Copyright &y& Elsevier]

Objective. Differences in dietary habits may be one of the reasons that the incidence of inflammatory bowel disease has remained lower in Japan than in Western countries. We investigated whether a traditional Japanese medicine (Strong Wakamto®), based on Aspergillus oryzae koji, would exert any effect on experimental colitis in rats. Material and methods. Colitis was induced using an enema of trinitrobenzene sulfnic acid (TNBS) and ethanol. Strong Wakamto was administered for 28 days before induction of colitis and for 7 days thereafter, and the effect of this medicine was evaluated. Results. Treatment with 5% Strong Wakamto improved loss of body-weight, increased colon weight and significantly decreased the histological damage score for colon mucosa. Decreases in faecal Lactobacillus sp., superoxide dismutase activity and zinc concentrations, and the increased IL-1β expression in colonic tissue after TNBS enema were improved when Strong Wakamto was given. The present in vitro studies indicate that administration of Strong Wakamto prevents lipopolysaccharide-induced TNF-α production in human macrophages. Conclusions. Oral administration of Strong Wakamto mitigates experimental inflammatory bowel disease induced by TNBS enema in rats. The beneficial effects seem attributable to a combination of balancing microflora, immunomodulatory effects on gut macrophages, and enhancement of anti-superoxide activity in colonic tissues. [ABSTRACT FROM AUTHOR]

Background. Leukocytapheresis (LCAP) is an effective adjunct for patients with active ulcerative colitis (UC). Because LCAP may have the potential to remove and modulate not only leukocytes but also platelets, we evaluated the correlation between activated platelets and the therapeutic response to LCAP. Methods. Fourteen patients with severe UC received weekly LCAP for 5 consecutive weeks. Their average clinical activity index (CAI) and endoscopic index (EI) were 9.6 ± 3.4 and 10.9 ± 1.0, respectively. Their peripheral blood was sampled before and after every LCAP and stained with fluorescent antibodies to the activation-dependent surface antigens of platelets (CD63, CD62-P) prior to flow cytometry. Endoscopic evaluations were performed after the last LCAP. Results. Clinical remission (CAI < 4) was induced in 50% of the patients (7/14) after 5 weeks, and there were no significant differences observed in clinical background between the responder group (RG) and the nonresponder group (NG). In the RG, the populations of CD63+ (P < 0.03) and CD62-P+ (P < 0.05) platelets were significantly decreased after the first LCAP, and their reduction ratio decreased gradually with repeated LCAP. A significant improvement of the EI score, especially mucosal damage, was achieved in RG (P < 0.04) but not in NG. Conclusions. These results indicate that the therapeutic responses to LCAP were reflected in modulations of population and/or platelet functions, especially after the first session. The decrease of such activated platelets immediately after the first LCAP may be an early marker for predicting the response in patients with severe UC. [ABSTRACT FROM AUTHOR]

We reviewed the current status of peroral cholangioscopy under duodenoscopic assistance, which allows direct visualization of the bile duct. Direct visual assessment may be a useful adjunct to endoscopic retrograde cholangiopancreatography (ERCP) for distinguishing malignant from benign bile duct lesions. Several clinical studies suggest the efficacy of peroral cholangioscopy for various bile duct lesions. However, solely cholangioscopic examination may be insufficient to confirm accurate differential diagnosis between benign and malignant strictures or tumor extension of bile duct carcinoma. Directed tissue acquisition in biliary strictures by using peroral cholangioscopy is another application that has not been properly studied because of the limited maneuverability of the long babyscope. Further improvement of suitable instruments and cholangioscopes are needed. [ABSTRACT FROM AUTHOR]

Background. Active Crohn's disease (CD) is often associated with elevated levels of platelets, granulocytes, and monocytes that are activated and resistant to apoptosis. The level of neutrophils in the intestinal mucosa has been quantitatively related to the severity of intestinal inflammation in CD. We postulated that patients with CD that is refractory to conventional medications might respond to a reduction of granulocytes and monocytes by adsorptive apheresis. Methods. Twenty-one patients with a CD activity index (CDAI) of 200-399 and unresponsive to standard medication, which included nutritional intervention, received granulocyte and monocyte adsorptive apheresis (UCAP) as an adjunct to their ongoing medication. (CAP was performed with an Adacolumn, which adsorbs granulocytes, monocytes, and a small fraction of lymphocytes (FcγR and complement receptor-hearing leucocytes). Patients received one GCAP session/week for 5 consecutive weeks. CDAI, International Organization for the Study of Inflammatory Bowel Disease (IOIBD), and IBD questionnaire (IBDQ) scores were evaluated. Results. During the initial conventional/nutritional therapy, no significant improvement was seen in any patient. However, at week 7 of GCAP therapy, significant improvements in CDAI, IOIBD, and IBDQ scores were observed. The CDAI, IOIBD and IBDQ scores before GCAP were 275.6 ± 54.2, 3.4 ± 1.4, and 152 ± 22, respectively. The corresponding values after GCAP were 214.8 ± 89.2 (P = 0.0005), 2.54 ± 1.5 (P = 0.0224), and 165 ± 29 (P = 0.0327), respectively. Conclusions. GCAP could he effective for inducing remission and improving quality of life in patients with active CD that is refractory to conventional therapy. [ABSTRACT FROM AUTHOR]

Discusses the case of a 25-year-old female patient presenting with steroid-resistant ulcerative colitis. White blood cell count; Platelet count; Erythrocyte sedimentation rate; Patient response to monocyte/granulocytapheresis and leukocytapheresis extracorporeal leukocyte removal therapies.

Background. The etiology of inflammatory bowel disease, which includes ulcerative colitis and Crohn's disease, has not yet been made clear. However, inflammatory bowel disease is recognized as a multifactorial disease, and innate genetic factors might contribute to the pathogenesis. Cytokine genes are thought to be important in inflammatory bowel disease. Recently, interleukin 18, cloned as a novel proinflammatory cytokine, has been implicated in inflammatory bowel disease, especially Crohn's disease. Methods. To identify germline mutations in patients with inflammatory bowel disease, the entire coding region of IL18 was examined using a DNA sequencing procedure. Results. No functional mutations were found, but a novel single nucleotide polymorphism (SNP) was identified as TCA/ TCC at codon 35. In patients with Crohn's disease, the frequency of TCC allele carriers was significantly higher than in healthy controls (χ² = 9.35, P = 0.002229, OR = 2.58, 95% CI = 1.39-4.80). Also, the magnitude of the association was more remarkable in females (χ² = 16.36, P = 0.000052, OR = 8.17, 95% CI = 2.73-24.41). The TCC allele at codon 35 of IL18 may increase the risk for Crohn's disease, especially in females. Conclusions. IL18 is probably one of several genes that determine susceptibility to Crohn's disease. [ABSTRACT FROM AUTHOR]

The distribution of the effective skew quadrupole field was measured in the newSUBARU storage ring. The driving term of the difference resonance for linear coupling was calculated and found to agree very well with the estimation from the correction by skew quadrupole magnets. The vertical dispersion is well explained by the obtained field distribution. [Copyright &y& Elsevier]

The beam size in newSUBARU strongly depends on the stored current of electron beam in the single-bunch mode operation. The measurement method is very simple, that is, just see the spot size of radiation from bending magnets by a CCD camera. In the single bunch mode operation, the blowup is explained by energy widening due to microwave instability. [Copyright &y& Elsevier]

Loss of heterozygosity (LOH) on chromosomes 13q, 16q and 17p has been associated with the progression of hepatocellular carcinoma (HCC). To investigate the prognostic impact of such LOH, we examined the metastasis-free survival of curatively resected HCC cases, in whom these LOHs were analyzed. Among the 49 HCC patients examined, the frequency of LOHs was 28% on 13q, 33% on 16q and 40% on 17p. The patients were followed up for metastatic recurrence after surgery and for analysis of the relationship between chromosomal changes and patients’ metastasis-free survival. Univariate survival analysis showed the presence of LOH on 16q, 17p and the number of chromosomes with LOH were significantly and negatively associated with metastasis-free survival, indicating that patients with LOH on multiple chromosomes had a poorer prognosis after surgery than those with LOH on a single chromosome or no LOH. Multivariate Cox survival analysis identified the presence of LOH on 16q and the number of chromosomes with LOH as the most significant independent negatively predictive factors for metastasis-free survival. These findings indicate that accumulation of chromosomal changes is associated with metastatic behavior, and that LOH on 16q was the most useful prognostic indicator for metastasis after curative resection of HCC.Copyright © 2002 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

It is important to study the effect of Helicobacter pylori infection on the permeability of the intestine. Permeability was evaluated by oral sucrose tolerance test using sucrose 25 g in 200 ml of water. Existence of H. pylori itself was associated with increased permeability of sucrose. Also, the permeability of sucrose increased as polymorphonuclear and lymphocyte infiltration increased. The increase of mucosal permeability suggests that antigens like protein penetrate into the body and result in systemic reactions. Thus, it is important to study the implication of increased permeability in relation not only to gastric diseases but also certain systemic diseases.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Discusses key issues concerning hepatocellular carcinoma that complicates autoimmune hepatitis without either corticosteroid therapy or hepatitis C viral infection. Key issues of interest; Analysis of pertinent topics and relevant issues; Implications on gastroenterology.

Management of patients with malignant biliary obstruction remains controversial. We reviewed our current status of biliary stenting for malignancy. The initial step in our management is endoscopic nasobiliary drainage, which is used not only for preoperative drainage but also to decide whether or not surgery is appropriate treatment. Although a metal stent has a longer patency time than a plastic stent, it costs up to thirty-fold more than the latter in Japan. Therefore, stent selection, metal or plastic, should be dependent on the expected prognosis of each patient with malignant biliary strictures. In the present paper, we also discuss the efficacy of the covered metal stent and stenting for malignant hilar obstruction. [ABSTRACT FROM AUTHOR]

Aim: To determine whether low fat diet or high fat diet would be more effective for preventing flare-up of Crohn's disease, we conducted a prospective randomized clinical controlled 12-months trial. Methods: Two hundred and twenty patients with inactive Crohn's disease after nutritional therapy with elemental diet (Elental) were enrolled into this study. They had never received treatment with prednisolone or immunosuppressive drug before and after maintenance therapy of this trial. These patients received 12-months elemental diet course with either a low fat diet or a high fat diet. Patients were assessed using Crohn's Disease Activity Index (CDAI), body weight, erythrocyte sedimentation rate, C-reactive protein, retinol binding protein, serum albumin, and serum fatty acid levels. Results: Fifteen patients were intolerant of the elemental diet and were withdrawn from the trial within 3 months. Two hundred and five patients completed 12 months treatment on each regimen. Clinical remission due to Crohn's Disease Activity Index (CDAI) was maintained in 84 of the 101 patients on low fat diet (<30g/day) compared with 40 of the 104 patients assigned to high fat diet (>50g/day). There was a trend for patients receiving high fat diet an increase in the value of their CDAI. There was significant difference in outcome between the two groups, including symptoms, need for hospitalization, need for surgery, new complication, nutritional status, or recurrence. Conclusions: The present study strongly suggests that low fat diet with an elemental diet plus omega-3 fatty acid is superior to high fat diet for preventing relapse of Crohn's disease. [ABSTRACT FROM AUTHOR]

To identify the bonding sites of initial radiation interaction with DNA and to trace the following chemical reaction sequences on the pathway of damage induction, we carry out a spectroscopy XIL (X-ray induced luminescence) using soft X-ray synchrotron radiation. This is a nondestructive analysis of the excited intermediate species produced in a molecular mechanism on the damage induction pathway. We introduce aqueous samples of UMP (uridine-5'-monophosphate) in the vacuum by the use of a liquid micro-jet technique. The luminescence in the region of UV-VIS (from visible to ultraviolet) radiation induced after the absorption of monochromatic soft X-ray by aqueous UMP is measured with sweeping the soft X-ray energy in the region of 370–560 eV. The enhanced XIL intensities for aqueous UMP in the region of soft X-ray of 410–530 eV (in "water window" region) are obtained. The enhancement of XIL intensities in the UV-VIS region, relative to the water control, is explained by the excitation and ionization of a K-shell electron of nitrogen atoms in the uracil moiety. The enhanced XIL intensities do not match the structure of XANES (X-ray absorption near-edge structure) of the aqueous UMP. This suggests that the XIL intensities reflect the quantum yields of luminescence, or the quantum yields for conversion by UMP of an absorbed X-ray into UV-VIS radiation. In this paper, spectra of luminescence are shown to be resolved by combining low pass filters. The filtered luminescence spectra are obtained at the center of gravity (λc) of the band pass wavelength regions at λc = 270nm, 295 nm, 340 nm, 385 nm, 450 nm, and 525 nm., which show a trend similar to the fluorescence of nucleobases induced by ultraviolet radiation. It is concluded that the origin of the observed XIL is the hydrated uracil moiety in aqueous UMP, decomposition of which is suppressed by the migration of excess charge and internal energy after the double ionization due to Auger decay. [ABSTRACT FROM AUTHOR]

Abstract: Background: Despite the restricted distribution to mitochondria of hepatocytes in the periportal region, ornithine carbamyltransferase (OCT) have been suggested to be a sensitive marker in addition to type-I arginase (ARG), even in centrilobular damage of the liver. We attempted to confirm the universal advantages of ARG and OCT in the evaluation of hepatotoxicity induced by toxicants, and to clarify whether the character of a marker is a more important factor than its localization in its clinical superiority. Methods: Rats were administered carbon tetrachloride, allyl alcohol, d-galactosamine, lipopolysaccharide, and concanavalin A and the course of damage was monitored by serum ARG and OCT, together with alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Results: The significant increase in the serum levels of the markers was faster in ARG and OCT than AST and ALT. Further, the extent of the increase at the peak was always higher in ARG and OCT than in AST and ALT. Conclusion: The superiority of ARG and OCT over AST and ALT in the detection of hepatotoxicity seems universal, at least in toxicant-induced acute liver injuries. The apparent faster appearance of mitochondria-derived enzyme, OCT, in serum than cytosol-derived enzyme, ALT, shows that leakage into the circulation is dependent on the marker rather than its localization. [Copyright &y& Elsevier]

Abstract: Background: The ratio of ornithine carbamoyltransferase (OCT) to alanine aminotransferase (ALT) or glutamate dehydrogenase (GDH) in serum has been suggested as an indicator for the diagnosis of hepatocellular carcinoma and alcoholic liver disease, respectively. However, the mechanisms responsible for the increase in these ratios are still unclear. Methods: Wistar rats were pretreated with lipopolysaccharide (LPS) or gadolinium chloride (GD) before being administered with thioacetamide (TAA, 200 mg/kg, ip). Serum OCT and ALT levels were compared with control values. Half-lives of the enzymes in circulation were evaluated after the intravenous injection of the purified enzymes into rats with or without the pretreatment. Results: The serum level of OCT at 24 h after the administration of TAA was significantly lower in the LPS-treated group, and not influenced by pretreatment with GD. The half-life of OCT was prolonged from 1.06±0.14 to 2.07±0.29 h (p <0.05) by the pretreatment with GD, but not influenced by the administration of LPS. No change was observed in the clearance of GDH or ALT among the pretreatments. Conclusions: Leakage into and clearance from the circulation of OCT are influenced by whether Kupffer cells are activated or not. OCT alone or in combination with other markers may be a useful indicator for Kupffer cell activation as well as mitochondrial damage in hepatic cells. [Copyright &y& Elsevier]

Abstract: Background: We evaluated the usefulness of serum type-I arginase (ARG) and ornithine carbamoyltransferase (OCT) in thioacetamide (TAA)-induced acute and chronic liver injury in rats. Methods: In an acute injury model, we measured the time-courses of serum concentrations of ARG and OCT using ELISA, together with AST and ALT using biochemical enzymatic assays after a single administration of TAA (200 mg/kg, i.p.). In the chronic model, TAA was repeatedly administered (20 mg/kg/day, p.o.) for 16 weeks and serum concentrations of the enzymes were evaluated. Results: In the acute model, the concentrations of the enzymes were increased in a similar manner, peaking 24 h after the administration, and ARG showed the earliest and greatest increase among the enzymes tested. In the chronic model, the serum concentration of OCT was significantly increased only 1 week after oral treatment, while concentrations of the other enzymes were increased at 8 to 12 weeks. In the histological analysis, TAA treatment damaged hepatocytes in both the acute and chronic model. Conclusions: These results clearly show the usefulness of ARG and OCT for the evaluation of acute and chronic liver injury, respectively. [Copyright &y& Elsevier]

The authors proposed a method for creating a prediction model for dynamically predicting the load curve in a power distribution system whose composition varied day by day, and then validated its effectiveness for comparisons with measured current values. In the results, the authors divided power distribution lines into interval increments using the contract power category composition ratio and then created a prediction model for various interval patterns based on the substantial dependence of the consumer load curve on contract type. Furthermore, when confirming the prediction precision using their model, the authors found that the absolute average error was 7.7 A, with 95% within 30 A. The relative average error rate was confirmed at 9.6%. Upon systematizing the current value prediction method and performing opinion surveys and evaluations of users running trials in the power distribution system operation business, the authors were able to confirm that the prediction precision of their method was sufficient for the system's needs. © 2005 Wiley Periodicals, Inc. Electr Eng Jpn, 153(2): 14–27, 2005; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/eej.20146 [ABSTRACT FROM AUTHOR]

Background Methods. To determine the role of p53/ARF alteration in hepatocarcinogenesis, we examined 44 HCCs for mRNA expression, deletion, mutation, and promoter hypermethylation of the p14ARF gene; alterations of p53 were also analyzed in the same series of HCCs. Results. Homozygous deletion, spanning from exon 1 β to exon 2, was found in 1 HCC mutations within exon 2 were found in 2 HCCs, but no promoter hypermethylation was detected. All 3 HCCs with p14ARF alteration were well differentiated. Twelve of the 44 HCCs (27.2%) showed immunohistochemical evidence of p53 alteration; however, only 1 of the tumors with p53 alteration was well differentiated. TaqMan polymarase chain reaction (PCR) indicated that the expression of p14ARF in HCCs was higher than in that in all but three of the corresponding non-tumorous tissues (P < 0.0001), and increased expression of p14ARF seemed to be associated with poorly differentiated phenotype. Absence of p14ARF expression was seen in only one HCC, with homozygous deletion of the p14ARF gene. Conclusions. Compared with p53 alteration, p14ARF alteration does not occur frequently, but may play a role in a subset of Japanese HCCs in the early stage of hepatocarcinogenesis. On the other hand, overexpression of p14ARF was frequently observed in HCC, especially in poorly differentiated tumors, probably reflecting oncogenic stimuli in these tumors. The INK4a/ARF locus encodes p16INK4a and p14ARF, both of which are crucial for two tumor suppressor pathways, retinoblastoma (RB)/p16INK4a and p53/ARF. Inactivation of RB/p16INK4a was frequently reported, but alterations of the p14ARF gene in hepatocellular carcinoma (HCC) in the Japanese population have been insufficiently analyzed. [ABSTRACT FROM AUTHOR]

An 18-year-old woman was treated with leukocytapheresis (LCAP) for her combined ulcerative colitis (UC) and aortitis syndrome (AS). Because a close relationship between these two diseases has been suspected based on their etiological and/or pathological findings, we had hypothesized that LCAP, which has satisfactory effects on inflammatory bowel disease such as UC and Crohn's disease might be effective for both her UC and her AS. After informed consent, LCAP therapy was performed once a week for a total of 7 times. Endoscopic remission of the UC was observed. Even though there were no significant improvements in her subjective symptoms of AS such as side-neck pain and dizziness, objective evidence of improvement was obtained when the patient's condition was compared before and after LCAP by angiography, angio-magnetic resonance imaging, and the plethysmogram of her fingertips. These results suggest that LCAP may be valuable as a new adjunct therapy for AS. [ABSTRACT FROM AUTHOR]

p16, cyclin D1 and retinoblastoma protein (pRB) regulate G[sub 1] to S transition and are commonly targeted in various cancers. However, few studies have simultaneously examined all components of the p16/cyclin D1/pRB pathway (RB pathway) in hepatocellular carcinoma (HCC). To clarify the role of the disruption of the RB pathway in HCC, we analyzed p16, pRB and cyclin D1 in 47 HCCs. Inactivation of p16 was detected in 30 of 47 HCCs (64%) by Western blot analysis and significantly correlated with hypermethylation of the promoter of this gene. pRB expression was found to be absent in 13 of 47 HCCs (28%) by immunohistochemistry. We found that 38 of 47 HCCs (81%) contained at least one inactivation in either pRB or p16. Furthermore, there was a significant inverse correlation between p16 and pRB inactivation (p = 0.041). Overexpression of cyclin D1 was detected in 5 of 47 HCCs (11%) by immunohistochemistry. The cases with cyclin D1 overexpression exhibited an advanced clinicopathological appearance and also contained inactivation of pRB and/or p16. These findings suggest that inactivation of pRB and/or p16 is a major event in human hepatocarcinogenesis, while cyclin D1 overexpression may confer additional growth advantages to the tumor in addition to pRB and/or p16 inactivation in HCC.Copyright © 2001 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Immediately after the Great Hanshin Earthquake in Kobe in 1995, the recurrence rate of peptic ulcer in patients infected with Helicobacter pylori was higher than that in patients in whom H. pylori had been eradicated. We evaluated the influence of H. pylori infection on stress-induced gastric mucosal injury in Mongolian gerbils and C57BL/6 mice. These animals were immersed in water for 30, 120, and 720 min 12 weeks after inoculation with H. pylori, and then killed to assess gastric mucosal damage, and to measure cytokine production (interleukin [IL]-1beta, IL-4, IL-6, and IL-10; interferon [IFN]-gamma; and tumor necrosis factor [TNF]-alpha) in the gastric tissue of the mice. The stress treatment for 30 min resulted in a significantly higher bleeding rate and bleeding index among infected gerbils and mice compared with results in uninfected animals. Conversely, the bleeding and ulcer indexes were significantly higher in uninfected gerbils after 720 min of the stress treatment than in infected gerbils. Prior to the stress treatment, gastric IL-1beta and IFN-gamma production was significantly higher in the infected group than in the uninfected group. After 120 min of the stress treatment, TNF-alpha production was increased in the infected group, and IL-1beta and IL-10 production was increased in the uninfected group. However, the production of these cytokines showed no change at 30 min of the stress treatment. These results suggest that H. pylori infection influences the development of gastric mucosal injury in the early phase of stress exposure; cytokines do not play a major role in this process. [ABSTRACT FROM AUTHOR]

The N K-edge X-ray absorption near edge structure (XANES) spectra of the purine-containing nucleotide, guanosine 5'-monophosphate (GMP), in aqueous solution are measured under various pH conditions. The spectra show characteristic peaks, which originate from resonant excitations of N 1s electrons to n * orbitals inside the guanine moiety of GMP. The relative intensities of these peaks depend on the pH values of the solution. The pH dependence is explained by the core-level shift of N atoms at specific sites caused by protonation and deprotonation. The experimental spectra are compared with theoretical spectra calculated by using density functional theory for GMP and the other purine-containing nucleotides, adenosine 5'-monophosphate, and adenosine 5'-triphosphate. The N K-edge XANES spectra for all of these nucleotides are classified by the numbers of N atoms with particular chemical bonding characteristics in the purine moiety. [ABSTRACT FROM AUTHOR]

Background To prevent gastric cancer, a test-and-treat strategy for Helicobacter pylori has been proposed. This retrospective study assessed the clinical features, efficacy and safety of treatment for H. pylori infection in children and adolescents. Methods Questionnaires concerning the clinical features and treatment of H. pylori in children and adolescents were sent to doctors in 2013. It included questions on patient background, H. pylori-associated disease, first- and second-line treatment, success or failure of eradication, resistance to antibiotics, and occurrence of adverse events. In 2014, serious adverse events associated with treatment were analyzed. Results Invitation letters and questionnaires were sent to 1097 doctors, of whom 409 (37.3%) participated. Finally, 332 patients (mean age, 11.6 ± 3.4 years; male, n = 200) treated from 1997 to 2013 were analyzed. H. pylori-associated gastritis, iron deficiency anemia, and duodenal ulcer occurred most frequently. Success rates for first- and second-line treatments were 73.1% and 79.6%, respectively. Seventy-six H. pylori strains were analyzed for resistance to amoxicillin ( AMPC) and clarithromycin ( CAM), and 64 were analyzed for resistance to metronidazole ( MNZ). CAM resistance was most frequent, occurring in 43.4% of patients; that of MNZ was 21.9%. Adverse events were observed in 13.8% of cases. In total, 587 cases of H. pylori infection were analyzed and no serious adverse events were observed. Conclusions Treatment for H. pylori in children and adolescents is safe, but further studies on treatment regimens should be conducted to improve eradication rates and monitor increasing CAM resistance. [ABSTRACT FROM AUTHOR]

Aim The outcome of acute liver failure (ALF) is influenced by its etiology, making etiological consideration of ALF important. However, specific etiology could not be identified in 30-40% of adult patients in a Japanese nationwide survey. We examined our patients with severe (SH) and fulminant hepatitis (FH) of indeterminate etiology for the better understanding of ALF. Methods We investigated 106 adult patients with SH or FH including 24 of indeterminate etiology between 2000 and 2013, retrospectively. Results Of 24 patients, 12 were men. Seventeen were SH and seven FH (three FH acute type and four FH subacute type). Eighty-three percent of patients were positive for antinuclear antibody. Seventeen recovered without liver transplantation (LT), two received LT and five died without LT. Histology of 15 patients showed a pattern of acute hepatitis (massive necrosis in four, submassive necrosis in one, severe acute hepatitis in two and acute hepatitis in eight). The involvement of immune-mediated liver injury was histologically suggested in some patients. Conclusion There was no large cluster of etiology in our patients with indeterminate cause. The causes of ALF of indeterminate etiology were the mixture of various minor or rare ones, if precise diagnosis of acute AIH was done. Outcome of our patients with indeterminate cause was not poor if they were treated as early as possible after the diagnosis of severe disease. Careful examination of unknown viral infection, drugs, toxins, undefined metabolic disorders and histology may help detect some of these etiologies. [ABSTRACT FROM AUTHOR]

Background Infection of Helicobacter pylori mainly occurs in childhood. In Japan, incidence of gastric cancer is still high in the senior citizen population, but little is known about the current H. pylori infection status among children or their family members. Methods As a population-based study, the prevalence of H. pylori infection and change in infection status over a 1-year interval in children were determined. Family members of some participants were also invited to participate in the study to determine their infection status. All children of specific ages attending 16 schools in Sasayama, Hyogo Prefecture, were invited to participate. H. pylori infection was determined by the stool antigen test and diagnosis confirmed by polymerase chain reaction and the urea breath test. Results Helicobacter pylori prevalence was 1.9% among 689 children aged 0-8 years in 2010 and 1.8% among 835 children aged 0-11 in 2011. No feco-conversion was observed in 430 children aged 0-8 years (170 were aged 0-4 years) who provided follow-up stool samples after 1 year. The prevalence of infection was 6% (2 of 33) and 38% (6 of 16) in mothers of negative and positive probands ( p = .04), respectively, and 12% (3 of 25) and 50% (8 of 16) ( p = .01), respectively, in fathers. Conclusion Helicobacter pylori prevalence in Japanese children is approximately 1.8%, which is much lower than that reported in Japanese adults. New infection may be rare. Parent-to-child infection is thought to be the main infection route of the infrequent infection for children in Japan. [ABSTRACT FROM AUTHOR]

Serum antibodies against pathogenic bacteria play immunologically protective roles, and can be utilized as diagnostic markers of infection. This study focused on Japanese child serum antibodies against Helicobacter pylori, a chronically-infected gastric bacterium which causes gastric cancer in adults. Serological diagnosis for H. pylori infection is well established for adults, but it needs to be improved for children. Serum samples from 24 children, 22 H. pylori (Hp)-positive and 2 Hp-negative children, were used to catalogue antigenic proteins of a Japanese strain CPY2052 by two-dimensional electrophoresis followed by immunoblot and LC-MS/MS analysis. In total, 24 proteins were identified as candidate antigen proteins. Among these, the major virulence factor, cytotoxin-associated gene A protein (CagA) was the most reactive antigen recognized by all the Hp-positive sera even from children under the age of 3 years. The major antigenic part of CagA was identified in the middle region, and two peptides containing CagA epitopes were identified using a newly developed peptide/protein-combined array chip method, modified from our previous protein chip method. Each of the epitopes was found to contain amino acid residue(s) unique to East Asian CagA. Epitope analysis of CagA indicated importance of the regional CagA antigens for serodiagnosis of H. pylori infection in children. [ABSTRACT FROM AUTHOR]

Highlight: [•] We studied the feasibility and the laterality of measurements of chest wall volume variation during tidal breathing in the lateral position in healthy subjects by optoelectronic plethysmography. [•] Chest wall volume measurements during quiet breathing in the lateral position have high measuring accuracy. [•] Chest wall volume changes were lower on the dependent side in the lateral position than on the non-dependent side because of the decrease in abdominal rib cage and abdomen volume changes. [ABSTRACT FROM AUTHOR]

Highlights: [•] XANES for adenine nucleotides in aqueous solutions at N K-edge are measured. [•] XANES spectra showed pH value dependence. [•] The pH value dependence is explained as due to protonation of N1 atom in adenine. [•] This explanation is consistent with the published results for gas phase adenine. [ABSTRACT FROM AUTHOR]

Background Rapid urine- HpAb is reported to be a reliable test of Helicobacter pylori infection in adults, but there are no data on the application of the test in children. The aim of this study was to evaluate the accuracy of a urine-based enzyme-linked immunosorbent assay (urine- HpELISA) and immunochromatography (rapid urine- HpAb) kit for anti- H. pylori immunoglobulin G antibody in children. We compared its sensitivity and specificity in reference to the 13 C-urea-breath test ( UBT) and H. pylori stool antigen test ( HpSA). Methods In total, 101 Japanese children without significant upper-abdominal symptoms were included (mean age, 7.1 years; range 2-15 years). Their sensitivity and specificity were evaluated in reference to the UBT and HpSA. Results Thirty-seven children were judged H. pylori-positive and 64 negative by the UBT and HpSA. No discrepancy in the results was observed between UBT and HpSA. Urine- HpELISA showed 91.9% sensitivity and 96.9% specificity with an accuracy of 95.0%. Rapid urine- HpAb showed 78.4% sensitivity and 100% specificity with an accuracy of 92.1%. Seven false negative results for rapid urine- HpAb were from children aged younger than 10 years, and their antibody titers of urine- HpELISA were lower than true positives. Conclusions For the diagnosis of H. pylori infection in Japanese children, both tests are non-invasive, inexpensive, reliable and easy-to-perform methods giving satisfactory accuracy, although the sensitivity of the rapid urine- HpAb kit was inferior to that of the urine- HpELISA kit, especially in children aged younger than 10 years, showing relatively low titer of H. pylori antibody. [ABSTRACT FROM AUTHOR]

Background and Aim: Two types of stool antigen tests have been used in the management of Helicobacter pylori infection. Testmate Pylori Antigen enzyme immunoassay (TPAg EIA) is a direct sandwich enzyme immunoassay (EIA) while Testmate Rapid Pylori Antigen (Rapid TPAg) is performed using immunochromatography. The aim of this study was to study the characterization and usefulness of these tests. Methods: Accuracy of both tests was studied using 111 fecal samples obtained from H. pylori-positive or -negative patients. Cross-reactivity was examined with four other Helicobacter spp. and five fecal bacteria in humans. To estimate the sensitivity of both kits, we tested H. pylori clinical strains. We also examined the diagnostic performances of both tests after the storage for 12 months. Results: The accuracy of both Testmate kits was 100% in fecal samples from 111 patients. No cross-reactivity was observed in both Testmate kits in five fecal bacteria and four other Helicobacter spp. TPAg EIA and Rapid TPAg showed positive results in 1342 of 1344, and 483 of 485 clinical strains, respectively. Diagnostic performances was maintained for 12 months when TPAg EIA was stored at 4°C and Rapid TPAg at 30°C. Conclusions: We examined the details of high accuracy of TPAg EIA and Rapid TPAg. The diagnostic performance of both kits was maintained after storage for up to 1 year. The two types of tests would be useful in the management of H. pylori infection. [ABSTRACT FROM AUTHOR]

Background: Acute onset autoimmune hepatitis (AIH) shows acute presentation like acute hepatitis and does not have typical clinicopathological features of AIH. There is no gold standard for making the diagnosis. Therefore, losing the timing of starting immunosuppressive therapy, some of the cases develop into severe or fulminant form and have poor prognosis.Aims: Our aim was to elucidate the efficacy of intravenous glycyrrhizin in decreasing alanine aminotransferase (ALT) level in the early stage of acute onset AIH.Methods: Thirty-one patients were defined as acute onset AIH based on our uniform criteria, and were enrolled in this study. We prospectively treated 17 patients with sufficient doses (100 ml/day) of intravenous glycyrrhizin (SNMC) at an early stage (SNMC group), and treated 14 patients of severe disease with intravenous glycyrrhizin and corticosteroids (CS) (SNMC + CS group). We examined their clinical and biochemical features and treatment responses.Results: The ALT level could be controlled at an early stage using SNMC with no significant difference compared with SNMC + CS, and responsiveness to the therapy was determined by the disease severity at the time of starting therapy rather than the time duration from onset to therapy. Recovery rate was higher in the SNMC group than in the SNMC + CS group (P = 0.035).Conclusions: The early introduction of sufficient doses of SNMC might prevent disease progression in patients with acute onset AIH. SNMC can be used safely and be useful for patients with difficult-to-diagnose acute liver disease as an 'initial' treatment tool to improve liver inflammation before starting disease-specific treatments. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of autoimmune hepatitis (AIH) is already difficult, and that of acute-onset AIH with atypical features is even more challenging, even though the revised original diagnostic criteria created by an international AIH group were widely accepted and incorporated into clinical practice. Aims: Recently, simplified diagnostic criteria were proposed. We compared the performance parameters of the simplified scoring system in patients with acute-onset AIH and examined its usefulness and limitations. Methods: Fifty-five patients with acute-onset AIH (29 non severe, 14 severe and 12 fulminant) were assessed according to the simplified scoring system and compared with the revised original one. Results: Of the 55 patients, 22 (40%) were diagnosed as ‘definite’AIH, 28 (51%) as ‘probable’ and five (9%) as ‘non diagnostic’ based on the revised original scoring system. By the simplified scoring system, six (11%) were diagnosed as ‘definite’ AIH, 16 (29%) as ‘probable’ and 33 (60%) as ‘nondiagnostic’. Anti-nuclear antibody titres did not differ among the three groups. The immunoglobulin G level was higher in fulminant than in non-severe patients (P = 0.01). Sixty-five percent showed acute hepatitis (massive necrosis, submassive necrosis and severe acute hepatitis) and 35% showed chronic hepatitis. Conclusions: The revised original scoring system performed better in patients with acute-onset AIH than the simplified scoring system. [ABSTRACT FROM AUTHOR]

Objective. Stool antigen tests using monoclonal antibody are used to test the results of eradication therapy of Helicobacter pylori. A newly developed test using multiple monoclonal antibodies is considered to have higher sensitivity. The aim of this study was to examine whether monoclonal antibody-based stool antigen tests are equally applicable to determine the results of eradication therapy. Materials and methods. Stool specimens obtained from patients infected with H. pylori were diluted by human stool and tested by both Testmate pylori antigen enzyme immunoassay (TPAg EIA) and Premier Platinum HpSA PLUS (HpSA ELISA II). A total of 239 patients infected with H. pylori received eradication therapy and 5-8 weeks after finishing the treatment, stool samples were tested by TPAg EIA and HpSA ELISA II. On the same day of stool collection, all the patients received 13C-urea breath test (UBT). Results. After 5× dilution, optical density (OD) values of TPAg EIA were significantly reduced and three out of four stool specimens were tested negative after 10× dilution. By contrast, three specimens were tested positive even after 100× dilution by HpSA ELISA II. In the determination of eradication therapy, accordance between the two tests was 95.8%. Among 199 patients who tested negative by both stool antigen tests, 10 patients were positive by UBT. Overall accordance of TPAg EIA and HPSA ELISA II to UBT was 91.2% and 95.4%, respectively (NS). Conclusions. Although reduction of OD values was seen in TPAg EIA, it did not seem to cause false negative results in stool samples after eradication therapy. Both TPAg EIA and HpSA ELISA II were equally useful to determine the results of eradication therapy comparing with UBT. [ABSTRACT FROM AUTHOR]

Background: Triple therapy with amoxicillin, clarithromycin, and a proton-pump inhibitor is a common therapeutic strategy for the eradication of Helicobacter pylori ( H. pylori). However, frequent appearance of clarithromycin-resistant strains is a therapeutic challenge. While various quinones are known to specifically inhibit the growth of H. pylori, the quinone 1,4-dihydroxy-2-naphthoic acid (DHNA) produced by Propionibacterium has strong stimulating effect on Bifidobacterium. We were interested to see whether DHNA could inhibit the growth of H. pylori in in vitro or in vivo experimental setting. Materials and Methods: The minimum inhibitory concentration (MIC) of DHNA was determined by the agar dilution method. The inhibitory action of DHNA on the respiratory activity was measured by using an oxygen electrode. Germ-free mice infected with H. pylori were given DHNA in free drinking water containing 100 μg/mL for 7 days. Results: DHNA inhibited H. pylori growth at low MIC values, 1.6–3.2 μg/mL. Likewise, DHNA inhibited clinical isolates of H. pylori, resistant to clarithromycin. However, DHNA did not inhibit other Gram negative or anaerobic bacteria in the normal flora of the human intestine. Both H. pylori cellular respiration and adenosine 5′-triphosphate (ATP) generation were dose-dependently inhibited by DHNA. Similarly, the culture filtrates of propionibacterial strains inhibited the growth of H. pylori, and oral administration of DHNA could eradicate H. pylori in the infected germ-free mice. Conclusions: The bifidogenic growth stimulator DHNA specifically inhibited the growth of H. pylori including clarithromycin-resistant strains in vitro and its colonization activity in vivo. The bactericidal activity of DHNA was via inhibition of cellular respiration. These actions of DHNA may have clinical relevance in the eradication of H. pylori. [ABSTRACT FROM AUTHOR]

Objective. A higher incidence of infectious disease has been documented in U.S. regions bordering Mexico compared with non-border areas. We assessed the prevalence of important gastrointestinal infections in Ciudad Juarez, Mexico, and El Paso, Texas, the largest binational community along the U.S-Mexico border. Methods. Fecal specimens from a sample of the asymptomatic population representing all ages were tested for Helicobacter pylori (H. pylori), Cryptosporidium spp., Giardia spp., and other intestinal parasitic pathogens using flotation, immunoassays, and/or polymerase chain reaction. We also measured indicators of microbiological contamination of drinking water, hands of food preparers, and kitchen surfaces. Results. Overall, of the 386 participants, H. pylon was present in 38.2%, Taenia spp. in 3.3%, Giardia spp. in 2.7%, Cryptosporidium spp. in 1.9%, Entamoeba dispar in 1.3%, and Ascaris lumbricoides and Necator americanus in 0.3% of the study subjects; Cyclospora spp. and Entamoeba histolytica were not found. H. pylori infection was associated with handwashing (prevalence ratio [PR] = 1.3, 95% confidence interval [CI] 1.0, 1.8). Taenia spp. was found more often on the U.S. side (PR=8.6, 95% CI 2.3, 30.8). We did not find an association between these infections and the occurrence of total coliforms or fecal coliforms on kitchen surfaces. In addition, Escherichia coli was not found in any drinking water sample. Conclusion. The study results indicated that H. pylori and Taenia spp. infections may be highly prevalent along the U.S.-Mexico border. Additional research is necessary to adequately characterize the prevalence, as well as determine whether interventions that reduce these infections are warranted. [ABSTRACT FROM AUTHOR]

Background: Over the past few years, the profile of Helicobacter pylori infection has changed in Japan. In particular, the relationship between H. pylori and gastric cancer has been demonstrated more clearly. Accordingly, the committee of the Japanese Society for Helicobacter Research has revised the guidelines for diagnosis and treatment of H. pylori infection in Japan. Materials and Methods: Four meetings of guidelines preparation committee were held from July 2007 to December 2008. In the new guidelines, recommendations for treatment have been classified into five grades according to the Minds Recommendation Grades, while the level of evidence has been classified into six grades. The Japanese national health insurance system was not taken into consideration when preparing these guidelines. Results: Helicobacter pylori eradication therapy achieved a Grade A recommendation, being useful for the treatment of gastric or duodenal ulcer, for the treatment and prevention of H. pylori-associated diseases such as gastric cancer, and for inhibiting the spread of H. pylori infection. Levels of evidence were determined for each disease associated with H. pylori infection. For the diagnosis of H. pylori infection, measurement of H. pylori antigen in the feces was added to the tests not requiring biopsy. One week of proton-pump inhibitor-based triple therapy (including amoxicillin and metronidazole) was recommended as second-line therapy after failure of first-line eradication therapy. Conclusion: The revised Japanese guidelines for H. pylori are based on scientific evidence and avoid the administrative restraints that applied to earlier versions . [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of the present study was to determine whether additional intraductal ultrasound (IDUS) to confirm complete stone clearance decreases the recurrence rate of common bile duct stones for a 3-year period after endoscopic papillotomy (EPT). Methods: IDUS was carried out with a thin-caliber ultrasonic probe (diameter 2.0 mm, frequency 20 MHz) via transpapillary route after stone extraction. If IDUS showed evidence of residual stones and/or sludge, endoscopic management was performed until IDUS examination was negative. A prospective study was conducted on 59 consecutive patients undergoing additional IDUS after stone extraction between January 1996 and May 2003 (IDUS group). The recurrence rate of common bile duct stones was compared with a historical control group (August 1988 to December 1995) consisting of cases that did not undergo IDUS (non-IDUS group). Potential risk factors for recurrence of common bile duct stones were assessed by univariate and multivariate analysis on logistic regression. Results: In 14 of 59 patients (23.7%), IDUS detected small residual stones not seen on cholangiography. The recurrence rate was 13.2% (17 of 129 patients) in the non-IDUS group and 3.4% (two of 59 patients) in the IDUS group ( P < 0.05). Multivariate analysis subsequently identified non-IDUS status as an independent risk factor for recurrence (odds ratio 5.12, 95% CI 1.11–23.52, P = 0.036). Conclusions: Additional IDUS to confirm complete stone clearance after EPT decreases the early recurrence rate of common bile duct stones. [ABSTRACT FROM AUTHOR]

Ulcerative colitis (UC) is regarded as confined to the colorectum; however, there are several case reports showing upper gastrointestinal involvement. The aim of this study was to examine the prevalence and characteristics of gastroduodenitis associated with UC (GDUC). Esophagogastroduodenoscopy with biopsies was prospectively performed on 250 UC patients (134 men, 116 women; mean age, 42 years; 162 with colectomy, 163 with pancolitis). Criteria for GDUC were created on the basis of endoscopic and histological comparisons with non-UC controls, and the prevalence and characteristics were statistically analyzed. GDUC was defined endoscopically as friable mucosa (erosive or ulcerative mucosa with contact or spontaneous bleeding), granular mucosa (multiple white spots almost without a red halo), or, conditionally, multiple aphthae (multiple white spots surrounded by a red halo, clinically excluding other disorders such as Crohn’s disease). The prevalence of GDUC was 19/250 (7.6%). The clinical characteristics included more extensive colitis, lower dose of prednisolone, higher prevalence of pouchitis, and longer postoperative period. In our population, the presence of pancolitis and a lower dose of prednisolone were significant risk factors for developing GDUC in multivariate analysis. The high prevalence of GDUC suggests that the gut inflammatory reaction in UC may not be restricted to the large intestine. Administered steroids might conceal GDUC, and more aggressive UC such as active pancolitis may be related to the development of GDUC. [ABSTRACT FROM AUTHOR]

Aim: Helicobacter pylori is known to enhance gastric carcinogenesis induced by chemical carcinogens. We previously demonstrated that infection with H. pylori strain SS1 did not enhance such carcinogenesis in C57BL/6 mice. Whether this result was due to the bacterial strain SS1 or to the experimental host, C57BL/6 mice, should be addressed. Therefore, we examined whether H. pylori strains introduced to the same host (Mongolian gerbils) differed in carcinogenicity. Materials and Methods: H. pylori TN2GF4 strain (CagA(+), VacA(+)) and SS1 strain (CagA functionally(–), VacA(–)) were infected to Mongolian gerbils (n = 126). In the first experiment (induction of gastritis), histologic change in gastric mucosa of gerbils infected by H. pylori (TN2GF4, SS1, vehicle) without N-methyl- N-nitrosourea (MNU) at 1 month or 6 months was assessed. In the second experiment (experimental carcinogenesis), H. pylori (TN2GF4, SS1, vehicle) was inoculated to the gerbils after administration of MNU for 10 weeks, and the number of cancers and histopathologic changes at week 54 were assessed. Results: In the first experiment, activity and inflammation in the TN2GF4 group were significantly greater than in the SS1 group at 1 month, while no significant difference was noted at 6 months. On the other hand, intestinal metaplasia and atrophy were significantly greater with TN2GF4 than with SS1 at 6 months but not at 1 month. In studies on experimental carcinogenesis, microscopically, 47.8% (11/23), 26% (7/26), and 0% (0/26), of animals had gastric adenocarcinoma in the MNU + TN2GF4 group, MNU + SS1 group, and MNU alone group, respectively. Conclusion: Both H. pylori strains, TN2GF4 and SS1, promoted carcinogenesis in Mongolian gerbils. The severity of gastritis and destruction and restoration of gastric mucosa may be related to gastric carcinogenesis. That the SS1 strain significantly accelerated carcinogenesis only in Mongolian gerbils and not in C57BL/6 mice suggests the crucial role of host factors in carcinogenesis by H. pylori infection. [ABSTRACT FROM AUTHOR]

Abstract: Background: We developed a new enzyme-linked immunosorbent assay (ELISA) for ornithine carbamoyltransferase (OCT) and evaluated its usefulness. Methods: Recombinant human OCT expressed in E. coli was used as an antigen to obtain the monoclonal antibodies for this assay. Results: The reactivity of the antibodies to native OCT as well as recombinant OCT was enhanced at alkaline pH (8.5–10), and the assay''s sensitivity was markedly improved. The antibodies react identically with native and recombinant OCT at pH 9.4. The dilution test showed a good linearity between dilution ratios and the concentrations. Different concentrations of OCT added were recovered on average at 90.4%. There was a good correlation between OCT protein levels in the ELISA and OCT enzyme activities (r =0.987, p <0.0001). A significant difference in the serum level of OCT was observed between chronic hepatitis patients (110.7±80 ng/ml) and healthy subjects (34.4±20.7 ng/ml) (p <0.0001). The serum levels of OCT between sexes differed significantly in the healthy subjects (p <0.0001). Conclusions: Our newly established ELISA for OCT using monoclonal antibodies is sensitive enough for clinical application. [Copyright &y& Elsevier]