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Kentaro Sugano

Publications and source records attributed to Kentaro Sugano.

85 records · Page 5Linked to original sources

Aberrant expression of CDX2 in the gastric mucosa with and without intestinal metaplasia: effect of eradication of Helicobacter pylori.

BACKGROUND: The intestine-specific transcription factor CDX2 plays an important role in differentiation and maintenance of intestinal epithelial cells. Development and progression of intestinal metaplasia (IM) in the stomach is closely associated with Helicobacter pylori-gastritis. We investigated expression of CDX2 protein in the gastric mucosa with and without IM before and after eradication of H. pylori. MATERIALS AND METHODS: The subjects comprised five normal controls and 29 H. pylori-positive patients (15 with antral IM and 14 without IM), who were followed for 12 months after eradication of H. pylori. Biopsies were taken from the greater curvatures of the antrum and middle body. Expression of CDX2 was evaluated immunohistochemically using anti-CDX2 antibody. RESULTS: CDX2 expression was not found in controls. Strong nuclear staining was observed extensively in IM, but rarely in the gastric epithelium, except for the focal area in only four antral biopsies (three with and one without IM). Fine granular cytoplasmic staining was also observed in the perinuclear regions of IM and the gastric epithelial cells in half of the patients. In 13 of the 15 patients with IM, IM did not regress after eradication of H. pylori, and the extent of nuclear staining in IM did not change. The extent of cytoplasmic staining did not change either. CONCLUSIONS: Our results indicate that CDX2 expression in the gastric mucosa is found in patients with chronic gastritis and is closely associated with IM. CDX2 expression in IM or the gastric epithelial cells did not disappear after eradication of H. pylori.

Adult↗

Photodynamic effects on rabbit auricular veins after photosensitization with porfimer sodium: Implications of the results with respect to the treatment of esophageal varices with photodynamic therapy.

BACKGROUND: There are numerous clinical applications for photodynamic therapy in the GI tract. The principal reason for the wide variety of lesions amenable to photodynamic therapy is the ability to treat large areas of mucosa without the need for complete visualization. This report describes observed hemodynamic and histologic changes in rabbit auricles after photodynamic therapy and the feasibility of photodynamic therapy for esophageal varices. METHODS: Porfimer sodium and an argon-dye laser (630 nm, 300 mW/cm(2)) were used. Twenty rabbits were grouped according to porfimer sodium dose: group 1 (2.0 mg/kg, n = 10); group 2 (1.0 mg/kg, n = 6); group 3 (0.2 mg/kg, n = 4). Rabbit auricular veins were classified according to time duration of laser illumination: V(0), no illumination; V(5), 5 minutes; V(10), 10 minutes; V(15), 15 minutes. Hemodynamic changes were observed with a laser Doppler blood flow meter. Histologic changes were evaluated by light microscopy. RESULTS: For groups 1 and 2, there was a significant decrease in blood flow for V(15) after photodynamic therapy, but not in group 3. There was a significant difference in the grade of thrombus between V(5) and V(15) in groups 1 and 2, and between V(10) and V(15) in group 2. There was a significant difference in the grade of venous dilation (congestion) for V(15) between groups 1 and 3 (p < 0.05, Kruskal-Wallis test). CONCLUSIONS: Endoscopic photodynamic therapy could possibly improve the outcome for endoscopic treatment of esophageal varices beyond that achieved by sclerotherapy or band ligation alone.

Animals↗

Success rate of curative endoscopic mucosal resection with circumferential mucosal incision assisted by submucosal injection of sodium hyaluronate.

BACKGROUND: Circumferential mucosal incision around a lesion is effective for reliable endoscopic mucosal resection. However, mucosal incision with a needle knife is difficult, even with submucosal injection of normal saline solution. To make needle-knife incision easier and safer, sodium hyaluronate has been used rather than normal saline solution. The aim of this study was to evaluate the clinical outcome of endoscopic mucosal resection with circumferential mucosal incision assisted by submucosal injection of sodium hyaluronate. METHODS: For 70 gastric lesions treated by submucosal injection of sodium hyaluronate, the size of the lesion and the resection specimen, the en bloc resection rate, complications, and local recurrence during follow-up were assessed. RESULTS: The mean size of the lesions and resection specimens were, respectively, 19.9 mm and 30.0 mm. The en bloc resection rates were 89% (42/47) for lesions up to 20 mm in diameter and 48% (11/23) for those greater than 20 mm (1-20 mm vs. >20 mm, p = 0.0004). Three patients underwent surgery because of invasive cancer in the EMR specimen. During follow-up (median 14 months, range 3-38 months), 2 recurrent lesions were found. No major complication occurred. CONCLUSIONS: Submucosal injection of sodium hyaluronate is a reliable method with a high success rate for en bloc resection of lesions up to 20 mm in diameter. Mucosal incision with a needle knife can be performed safely with submucosal injection of sodium hyaluronate.

Adenocarcinoma↗

Calcified bile duct stone not crushable by endotriptor or mechanical lithotriptor: case report.

When we remove bile duct stones in endoscopic retrograde cholangiopancreatography, we sometimes encounter the complication of basket impaction. In most cases, bile duct stones can be crushed with a mechanical lithotriptor. An endotriptor also is commonly used to resolve the problem of basket impaction. An endotriptor is more powerful than a mechanical lithotriptor in crushing stones. We report a case of basket impaction that was not resolved by means of an endotriptor. When abdominal radiography shows apparent calcified bile duct stone, it should be cautioned that the stone is sometimes too hard to be crushed, even with use of the endotriptor as well as a mechanical lithotriptor.

Aged↗

Identification of two distinct genotypes of hepatitis E virus in a Japanese patient with acute hepatitis who had not travelled abroad.

Two distinct hepatitis E virus (HEV) isolates, designated HE-JI3 and HE-JI4, were identified in a single patient with acute hepatitis in Japan, who had not travelled abroad. The HEV load of HE-JI3 at admission was 10(2) copies/ml, but that of HE-JI4 was tenfold higher at 10(3) copies/ml. The viraemia of HE-JI4 persisted for up to 16 days from admission, whereas HE-JI3 disappeared at 9 days after admission. The entire nucleotide sequence of the HE-JI4 isolate and partial nucleotide sequences of open reading frames (ORFs) 1 and 2 of the HE-JI3 isolate were determined. The full-length nucleotide sequence of HE-JI4 consisted of 7171 nucleotides excluding the poly(A) tail and contained ORF1 encoding 1684 amino acids, ORF2 encoding 671 amino acids and ORF3 encoding 114 amino acids. Sequence and phylogenetic analyses of the HEV genomes indicated that HE-JI4 was most closely related to an HEV isolate (T1) of genotype IV with the same strategy for translation of ORF2 and ORF3, but which differed from it by 16.5% over the entire genome. The HE-JI3 isolate showed the highest nucleotide identity (88.6-95.1%) to the genotype III HEVs, having higher identity to human and swine HEV isolates from the United States (US1, US2 and swUS1) than to those reported thus far from Japan (JRA1 and swJ570). The two co-infecting strains of HE-JI3 and HE-JI4 identified from the single patient shared only 80.1% nucleotide identity. These results indicate that multiple genotypes of HEV co-circulate in Japan, and that genotype IV comprises a remarkably heterogeneous group of HEVs.

Acute Disease↗

Gastrin biosynthesis in canine G cells.

Gastrin requires extensive posttranslational processing for full biological activity. It is presumed that progastrin is cleaved at pairs of basic amino acids by a prohormone convertase to form a glycine-extended intermediate (G-Gly) that serves as a substrate for peptidyl-glycine alpha-amidating monooxygenase (PAM), resulting in COOH-terminally amidated gastrin. To confirm the nature of progastrin processing in a primary cell line, we performed [(35)S]methionine-labeled pulse-chase biosynthetic experiments in canine antral G cells. Radiolabeled progastrin reached a peak earlier than observed for G-Gly or amidated gastrin. G-Gly radioactivity accumulated in G cells and preceded the appearance of radioactivity in amidated gastrin. The conversion of G-Gly to amidated gastrin was enhanced by the PAM cofactor ascorbic acid. To determine whether one member of the prohormone convertase family (PC2) was responsible for progastrin cleavage, G cells were incubated with PC2 antisense oligonucleotide probes. Cells treated with antisense probes had reduced PC2 expression, an accumulation of radiolabeled progastrin, and a delay in the formation of amidated gastrin. Progastrin in antral G cells is cleaved via PC2 to form G-Gly that is converted to amidated gastrin via the actions of PAM.

Animals↗

[Duodenal ulcer].

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Age Factors↗

[Dieulafoy's ulcer].

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Endoscopy, Gastrointestinal↗

[Guidelines in the management of gastric ulcer with special reference to elderly patients].

Special care must be taken for peptic ulcer disease in the elderly because of more frequent complications such as major bleeding that require hospitalization and may sometimes result in fatal outcome. In addition, elderly patients are more vulnerable to such complications due to accompanying systemic diseases such as cardiovascular, pulmonary or liver diseases. Therefore, it is important to prevent ulcer complications for the high-risk group in the elderly. For the prevention and treatment of ulcer disease in elderly patients, medication with fewer drug-interactions given in simple dose schedule is preferable for better compliance as well as for reducing side effects. Furthermore, consideration on cost-effectiveness of the treatment is increasingly important because of severe burden on the health insurance system. In an attempt to give better and more efficient management strategy for gastric ulcer, evidence-based clinical guideline is being prepared under the support of Japanese Ministry of Health and Welfare. Rational management of ulcer disease in the elderly, however, requires deliberate consideration of each patient status and stringent, inflexible application of the guideline should be avoided.

Aged↗