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The clearance of the esophagus is to transport food boluses from the pharynx to the stom- ach through peristaltic motion. This occurs through the primary peristaltic wave, triggered by swallowing, passing from the upper to lower esophagus in a sequence of contractions and relaxations. Investigation modalities for evaluation of esophageal clearance function include esophageal manometry (included high resolution manometry), esophageal radiography (barium swallow), esophageal scintigraphy, ultrasonography, impedance methods and com- bination with transnasal endoscopy and manometry. Of these, evaluation of esophageal clear- ance is conducted quantitative assessment of esophageal motility as well as transient lower esophageal sphincter relaxation(TLESR) in reflux esophagitis.

We summarized proton pump inhibitors(PPI) and histamine H2-receptor antagonist (H2B) with reference to acid-related disease. The both drugs act process of gastric acid secretion in parietal cell of stomach. Inhibition of H2B is reversible, but that of PPI is irreversible, so period of acting in PPI is longer than that in H2B. PPI is more effective than H2B in treatment of acid-related disease. Especially PPI is recommended the first choice in GERD and NSAID ulcer.

This year eradication of H. pylori was applied for not only peptic ulcer but also chronic gastritis on National insurance system. However recently decrease in first line eradication rate of H. pylori using PPI/AC regimen. Certainly eradication rate after 2000 decreased in intention to treat (ITT) and per protocol(PP) compared to that before 2000. This tendency was induced by increase in CAM-resistant H. pylori. But after 2007 eradication rate decreased only in ITT, eradication rate didn't decrease in PP. That tendency was induced by bad compliance and evaluation of the eradication.

Gastrointestinal injuries induced by anti-coagulant agents, especially low-dose aspirin (LDA) increased. Concomitant usage of LDA and NSAIDs, LDA and anti-coagulant are risk factor of upper gastrointestinal (UGI)-bleeding. Time of UGI-bleeding occurred in early periods after starting of LDA and NSAIDs. H. pylori infection and LDA interact synergic and negative synergic with reference to gastric mucosal injury.

H. pylori infection and low-dose aspirin (LDA) are not only independent causal factors of peptic ulcer and gastrointestinal bleeding, they also have synergistic and additive effects. H. pylori infection rate has drastically decreased over the past decade to 34.3% amongst people in their 40's, 28.0% amongst those in their 30's, and 15.7% amongst those in their 20's. Therefore, LDA are expected to become more important factor of peptic ulcer in the near future. The incidence of peptic ulcer induced by LDA was 15.8% (16/101) in authors' hospital. Deep ulcers(more than proper muscularis layer) were only 4 cases, shallow ulcers(submucosal layer) were 12 cases. All deep ulcers were gastric ulcers (3 H. pylori positive, 1 negative), on the other hand shallow ulcers were 8 gastric ulcers (3 H. pylori positive, 5 negative), and 4 duodenal ulcers (1 H. pylori positive, 3 negative). Majority of peptic ulcers induced by LDA were shallow, and independent on H. pylori infection.

It is reported that ultra-thin transnasal esophagogastroduodenoscopy (TN-EGD) reduces pharyngeal discomfort and is more tolerable for the patients. Ultra-thin transnasal endoscopy has been reported as inferior to transoral conventional EGD (TO-EGD) in terms of image quality, suction, air insufflation and lens washing, due to the smaller endoscope caliber. TN-EGD should be conducted slowly, with short distance observation, and also with image-enhanced endoscopy. With reference to image-enhanced endoscopy, chromoendoscopy method (indigocarmine) is suitable for gastric neoplasm, on the other hand optical digital method (NBI) and digital method (i-scan, FICE) is suitable for esophageal neoplasm. TN-EGD is applied in various gastrointestinal (GI) procedures such as percutaneous endoscopic gastrostomy, nasoenteric feeding tube placement, endoscopic retrograde cholangiopancreaticography with nasobiliary drainage, long intestinal tube placement in small bowel obstruction, esophageal manometry.

Peroxisome proliferator-activated receptor gamma (PPARgamma) is a ligand-dependent transcription factor that has a central role in the regulation of insulin sensitivity and adipocyte differentiation. Expression of PPARgamma has been reported in the kidney, including medullary collecting ducts, glomeruli and tubular cells. Thiazolidinediones (TZDs) are synthetic PPARgamma agonists and are used widely in patients with type 2 diabetes. It has been gradually discovered that TZDs have various other actions, such as vascular protective, anti-inflammatory, anti-fibrotic and anti-proliferative actions, over and above their effects on glucose and lipid metabolism. In this review, we will focus on current knowledge and insights on the role of PPARgamma agonists in kidney diseases, especially in diabetic nephropathy, non-diabetic kidney diseases and dialysis therapy.

Chronic fatigue syndrome (CFS) is a complex disease and has no laboratory biomarkers, which makes diagnosis of CFS difficult. Several research groups challenged to identify genes specific for CFS; however, there are no overlaps between studies. The U.S. Centers for Disease Control and Prevention reported remarkable gene expression profiles of a large scale cohort study recruited 227 people. Reported genes were mostly different from the previously reported genes, again featuring the complexity of CFS. Separately, we identified 9 genes that were significantly and differentially expressed between CFS patients and healthy subjects using an original microarray. The changes in expression of 9 genes were confirmed by quantitative PCR. We also demonstrated the usefulness of 9 genes for differential diagnosis of CFS.

Type I interferons (IFNalpha/beta) are central mediators for antiviral responses. Using a functional cloning strategy, we have identified a molecule designated IPS-1. IPS-1 overexpression caused antiviral responses by producing type I IFN and IFN-inducible genes through activation of IRF3, IRF7 and NF-kappaB. TBK1 and IKKi protein kinases were required for the IPS-1-mediated IFN induction. IPS-1 contains an N-terminal caspase recruiting domain (CARD)-like structure that mediates interaction with the CARD of RIG-I and Mda5, cytoplasmic RNA helicases sensing RNA viruses. Reduction of IPS-1 by siRNA blocked IFN induction by virus infection. Thus, IPS-1 is an adapter that mediates RIG-I- and Mda5-dependent antiviral responses.

Enzyme immunoassay (EIA) is one of the most popular non-isotopic immunoassay methods, with various clinical applications. After radioimmunoassay was developed by Yalow and Berson, its competitive binding principle was combined with enzyme labeling techniques and its application has been expanded by developing various procedures. Theoretically, EIA is more sensitive than RIA, being able to measure levels as minute as some attomole levels. Automated enzyme immunoassay systems have further improved its intra-laboratory variation, but relatively large variations among different reagent kits must be improved. Highly sensitive EIA systems should allow wider clinical applications.

E-3810 and AG-1749, new proton pump inhibitors, were administrated in single doses or over a long period of time in order to evaluate their effect on the rat stomach. E-3810 inhibited gastric acid secretion for a shorter period of time than AG-1749 in both the single dose and long-term administration. While hypergastrinemia persisted with long-term administration of AG-1749, serum gastrin levels returned to normal upon cessation of treatment with E-3810. Both E-3810 and AG-1749 caused vacuolar formation of parietal cells and an increase in gastric acid secretion after cessation of long-term treatment, suggesting that these changes are common after treatment with proton pump inhibitors.