[Evaluation of a new transport medium (HP medium) for Helicobacter pylori].
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Culture Media↗
Biomedical subjects
M Nasu
Publications and source records attributed to M Nasu.
Cytotoxic effects of Helicobacter pylori on guinea pig gastric glands.
To study the cytotoxic effect of Helicobacter pylori on the gastric P3cosa, gastric glands harvested from guinea pigs were incubated with clinical isolates of H. pylori. H. pylori alone (H group), urea alone (U group), H. pylori plus urea (HU group), and H. pylori plus urea and the urease inhibitor acetohydroxamic acid (HUA group) were incubated with isolated gastric glands. The controls were incubated without additives. Incubation was for 30, 60 and 180 min at 37 degrees C in a microaerophilic atmosphere. The HU group showed an increase in the ammonia concentration and pH of the culture supernatant; release of lactate dehydrogenase (LDH) and glutamic oxaloacetic transaminase (GOT) into the supernatant owing to cell disruption was also increased. In the HUA group, since urease activity was inhibited, the ammonia concentration and pH were also significantly lower (p < 0.001), and LDH and GOT release into the supernatant was significantly reduced (p < 0.001-0.01). Observation by light and electron microscopy showed clear intracellular vacuolization of the gastric glands and adherence of H. pylori to the cell surfaces. These results suggest that ammonia, a metabolite of urea released by H. pylori urease, is one of the important factors in cytotoxicity in isolated gastric glands.
Ammonia↗
[Microbiological and clinical study of fungemia between 1981 and 1992].
Fungi were isolated from 113 (14.2%) of 789 patients with positive blood cultures at Oita Medical University Hospital between 1981 and 1992. The rates of fungemia increased in recent years, 13.9% (1981-1985), 12.1% (1986-1988) and 16.9% (1989-1992). The isolated fungi were Candida parapsilosis (25.7%), C. albicans (24.8%), C. tropicalis (14.2%), Trichosporon beigelii (10.6%), C. glabrata (8.0%) and so on. The major fungi were T. beigelii and C. glabrata in patients with hematologic malignancies, whereas they were C. albicans and C. parapsilosis in patients with non-hematologic diseases and C. glabrata increased in both groups. Prophylactic or emiric administration of antifungal agents probably influenced the difference of the causative organisms in the two groups.
Adolescent↗
Serum lipoprotein(a) concentrations are related to coronary disease progression without new myocardial infarction.
OBJECTIVE: To examine the association between serum lipoprotein(a) and angiographically assessed coronary artery disease progression without new myocardial infarction. PATIENTS AND DESIGN: 85 patients with coronary artery disease who underwent serial angiography with an interval of at least two years were studied. Progression of coronary artery disease was defined as an increase in diameter stenosis of 15% or more. Vessels on which angioplasty had been performed were excluded from the analysis. The patients were classified into two groups: a progression group without new myocardial infarction (n = 48) and non-progression group (n = 37). Risk factors including lipoprotein(a) were evaluated to see how they were related to progression without myocardial infarction. RESULTS: There were no differences between the two groups in the following factors: age, gender, the time interval between the angiographic studies, the distribution of the analysed coronary arteries, and history of well established coronary risk factors. Univariate analysis showed that serum lipoprotein(a) (P = 0.0002), cigarette smoking between the studies (P = 0.002), serum high density lipoprotein (P = 0.003), and serum low density lipoprotein (P = 0.01) were related to progression without myocardial infarction. Multivariate analysis selected two independent factors for progression without myocardial infarction: serum lipoprotein(a) (P = 0.003) and serum high density lipoprotein (P = 0.03). CONCLUSIONS: Serum lipoprotein(a) concentrations are closely related to the progression of coronary artery disease without new myocardial infarction. Lipoprotein(a) lowering treatment may be needed to prevent disease progression in patients with coronary artery disease and high serum lipoprotein(a).
Aged↗
Clinical significance of inferior ST elevation during acute anterior myocardial infarction.
OBJECTIVES: To clarify the genesis and clinical significance of inferior ST elevation during acute anterior myocardial infarction. PATIENTS AND DESIGN: A total of 106 patients with first acute anterior myocardial infarction (< or = 6 h) were divided into two groups according to the presence (group A, n = 12) or absence (group B, n = 94) of ST elevation of > or = 1 mm in at least two of the inferior leads on the admission electrocardiogram. RESULTS: On admission electrocardiograms, group A had a smaller summed ST deviation in the lateral limb leads than group B. On emergency coronary arteriograms, the incidence of a wrapped left anterior descending artery was higher in group A than in group B (100% v 27%, P < 0.01). The incidence of occlusion of a left anterior descending artery distal to its first diagonal branch was higher in group A than in group B (100% v 46%, P < 0.01). Peak serum creatine kinase activity and in-hospital mortality tended to be lower in group A than in group B. Group A had better left ventricular ejection fraction and regional wall motion in the anterobasal and anterolateral regions in the chronic phase than group B. In contrast, regional wall motion in the diaphragmatic region was reduced to a greater extent in group A than in group B. CONCLUSIONS: Inferior ST elevation during acute anterior myocardial infarction appears only in the presence of a combination of a lesser degree of transmural ischaemic myocardium in the anterobasal and anterolateral wall together with transmural ischaemic myocardium in the inferior wall; in all cases there was occlusion of a wrapped left anterior descending artery distal to its first diagonal branch. Patients with such an ST elevation appear to have a better in-hospital prognosis than those without it.
Coronary Angiography↗
Traditional Chinese medicines improve the course of refractory leukemic lymphoblastic lymphoma and acute lymphocytic leukemia: two case reports.
A 34 year-old man with leukemic lymphoblastic lymphoma (LBL), who could not tolerate chemotherapy due to its side effects, was diagnosed to have an acute febrile disease by a traditional Chinese medical doctor, Lu Gan Fu. Zixuedan, a traditional Chinese remedy for dissipation of pathogenic heat and detoxification that could reduce WBC count including leukemic cells below 1000/microliters without intolerable side effects, was prescribed for treatment. A second case of acute lymphocytic leukemia (ALL) was a 41 year-old female who also could not tolerate chemotherapy. In her fourth recurrence, she started Chinese medicine including modified zixuedan, which gave her transient improvement followed by aggravation. Intake of previously ineffective cyclophosphamide in combination with Chinese medicine led to a dramatic improvement.
Adult↗
Mutations in the core promoter/enhancer II regions of naturally occurring hepatitis B virus variants and analysis of the effects on transcription activities.
The regulatory regions for transcription and replication of several hepatitis B virus (HBV) genomes from 19 patients having various forms of HBV infection were sequenced. Predominant mutations were found to occur naturally in nucleotide positions 1762 (A to T) and 1764 (G to A) in chronic hepatitis patients and in asymptomatic carriers after seroconversion, but were not observed in HBeAg-positive healthy carriers. Since these positions were located in the basic core promoter and the overlapping enhancer II regions situated within the core upstream region, transcriptional activity was examined by chloramphenicol acetyltransferase assay to determine if there was a possible difference between the mutant and wild-type HBV. However, no significant difference was detected upon comparison of the promoter and enhancer activities between mutant and wild-type HBV.
Base Sequence↗
Significance of urinary fibrin/fibrinogen degradation products in renal diseases measured by a highly sensitive ELISA.
The urinary fibrin/fibrinogen degradation products (FDP), as sensitive indicators of various renal disorders, have been measured by several methods. For their determination, a new and highly sensitive enzyme-linked immunosorbent assay not requiring the urine concentration has been developed. The study comprised 42 patients with nonnephrotic chronic glomerulonephritis (CGN), 23 patients with primary nephrotic syndrome (NS), and 29 healthy adults. The results were as follows: (1) the content of urinary FDP in normal subjects was 10.30 +/- 9.08 ng/ml; (2) the mean level of urinary FDP in both CGN and NS groups was significantly higher than in normal subjects; (3) in the CGN group itself there was a tendency for an increase of urinary FDP during more active forms of the disease, and (4) there was a significant correlation between urinary FDP and urinary protein in the CGN group, whereas no correlation was observed in the NS group. These results suggest that the major part of urinary FDP in the CGN group derives from the increased filtration, while its origin in the NS group is not related to increased filtration only, but may also have involved intraglomerular coagulation abnormalities. The newly developed enzyme-linked immunosorbent assay can detect urinary FDP levels lower than 3.9 ng/ml. Therefore, this method can be of great value in determining the degree of abnormalities of intraglomerular coagulation and fibrinolysis in renal diseases.
Adolescent↗
Early diagnosis and monitoring of human cytomegalovirus pneumonia in patients with adult T-cell leukemia by DNA amplification in serum.
A nested polymerase chain reaction (PCR) was used to detect human cytomegalovirus (HCMV) DNA in serum of patients with adult T-cell leukemia (ATL). Serum samples were collected consecutively from 11 patients with HCMV pneumonia diagnosed histopathologically and 7 HCMV-seropositive patients without HCMV disease. Serum samples obtained from 24 HCMV-seropositive healthy volunteers were used as controls. The HCMV DNA was detected in serum a mean of 14 days before the onset of HCMV pneumonia, which suggests that DNAemia exists prior to the development of HCMV pneumonia. The amount of viral DNA in serum increased with disease progression and decreased with disease improvement. Thus, the detection of HCMV DNA in serum by nested PCR is useful for monitoring and the early diagnosis of HCMV pneumonia in patients with ATL. In addition, quantitation of HCMV DNA may be useful for monitoring HCMV infection, because it appears to correlate with the activity of the disease.
Adult↗
Trichosporon beigelii pneumonia in patients with hematologic malignancies.
Trichosporon beigelii is a causative agent of hypersensitivity pneumonia in immunocompetent individuals and of invasive pneumonia in immunocompromised patients. The actual incidence and clinical manifestations of T beigelii pneumonia are obscure because the diagnosis is sometimes difficult. We studied eight patients with T beigelii pneumonia diagnosed by immunohistochemical investigation of lung tissue sections and/or isolation of the organism from the lung, sputum, or blood. All patients had underlying hematologic malignancies for which they had received cytotoxic chemotherapy, resulting in profound neutropenia. The clinical manifestations were persistent fever unresponsive to broad-spectrum antibiotic therapy, cough, bloody sputum, and rapidly progressive dyspnea. The chest radiographs showed diffuse alveolar infiltrates in four patients, diffuse interstitial infiltrates in one, patchy reticulonodular infiltrates in one, and focal alveolar infiltrates in two. Histopathologic examination demonstrated numerous centrally necrotic foci with minimal cellular inflammatory reaction, intra-alveolar hemorrhage, and edema. Trichosporon beigelii consisting of both yeast and hyphal forms was located predominantly in the alveolar vessels. In neutropenic patients with hematologic malignancies, this fungus appears to enter the lung not only through the airways but also via the hematogenous route. In vitro susceptibility testing indicated borderline susceptibility to amphotericin B and showed that some azoles were active against T beigelii at safely achievable serum concentrations.
Aged↗
[Treatment of aneurysm of aortic arch using selective cerebral perfusion].
The objective of this study is to evaluate safety and efficacy of the selective cerebral perfusion (SCP) for an adjunct to perform operation of aortic arch aneurysms. From November 1982 to June 1993, surgical treatment of aneurysm of aortic arch using SCP was performed in 22 patients. The hospital death was accounted in 5 cases (23%), the intraoperative stroke was observed in 3 cases (14%) and these patients died. The cause of intraoperative stroke was cerebral hypoperfusion due to multiple sclerosis of intracranial arteries or insufficient SCP. Variables of an increased operative risk seemed to be older age (over 70 y.o.) and rupture. SCP time more than 120 minutes did not promote the operative risk. Cerebral hypoperfusion was directly responsible for not only intraoperative stroke, but also operative death. Therefore, SCP seems effective and safe if hypoperfusion is prevented.
Aged↗
[A case report of heterochronic double cancer of the liver with type C liver cirrhosis].
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Adenoma, Bile Duct↗
[Is intraoperative monitoring of transesophageal echocardiography necessary for mitral valve repair?].
To clarify the clinical significance of the intraoperative monitoring for mitral valve repair by transesophageal echocardiography (TEE), we evaluated the correlation of color Doppler flow area of residual mitral regurgitation (residual MR area) between intraoperative and postoperative TEE. Subjects were 12 patients (average age was 54.7 years) underwent recently intraoperative TEE. These 12 patients were divided into two groups: Group A (MR area < 2.0 cm2; n = 8) and Group B (MR area > 2.0 cm2; n = 4). None of the 12 patients required second pump run. In all cases, residual MR area, as determined using intraoperative TEE, was less than 3.2 cm2. One month after surgery, the MR area did not showed an increase in Group A, while in Group B it decreased slightly in 2 cases, remained unchanged in 1 case and increased slightly in 1. Our findings do not support the usefulness of intraoperative monitoring with TEE. It seems difficult to predict the outcome of residual MR on the basis of the MR area alone. At present, we thought that, possibly, intraoperative monitoring with TEE is indispensable for mitral valve repair. A longer follow-up will be necessary to draw firm conclusions.
Echocardiography, Transesophageal↗
A case of nephrotic syndrome associated with ischemic colitis exhibiting thickening of the colon wall.
The patient was a 54-year-old male with proteinuria, which was first noted in 1984. Recently, the patient experienced aggravation of the proteinuria, which resulted in nephrotic syndrome. Renal biopsy revealed findings compatible with membranous nephropathy. While being treated with prednisolone (30 mg/day), the patient experienced intense abdominal pain of sudden onset, diarrhea, and melena. A tumor was demonstrated by abdominal ultrasonography and CT scan. A diagnosis of ischemic colitis was made by colonoscopy. FDP and fibrinogen levels were elevated, and abnormalities of the coagulation and fibrinolytic factors were found at the onset of the symptoms.
Colitis, Ischemic↗
[Mitral valve repair for infectious endocarditis].
Fourteen patients with mitral regurgitation resulting from infectious endocarditis underwent mitral valve repair between December 1988 and July 1994. There were nine males and five females aged from 14 to 70 years (mean 40.2 +/- 19.7 years). Three patients had active endocarditis. Time between the onset of endocarditis symptoms and surgery ranged from 1 to 24 months (mean 8.3 months). Bacterial findings were Streptococcus in eight patients, Staphylococcus in one, and unknown in five. All macroscopically infected tissue was excised in patients with active endocarditis. Carpentier's reconstructive techniques were mainly used. There were no hospital deaths. Mean follow-up was 29 months and complete. Thirteen patients were in New York Heart Association functional class I and one in class II. There were no late deaths, reoperations, recurrent endocarditis, thromboembolic events, or other valve-related morbidity. We conclude that mitral valve repair is an attractive procedure in patients with mitral regurgitation resulting from infectious endocarditis.
Adolescent↗
[Essential thrombocythemia transformed to minimally differentiated acute myeloid leukemia].
A 64-year-old female diagnosed for essential thrombocythemia was treated with MCNU 50 mg four times in the course of the disease. Six months after the last administration, in May 1991, she was admitted because of decreasing thrombocyte count and appearance of blasts in the peripheral blood. On admission, laboratory findings were as follows: WBC 700/microliters with 5% of blasts, RBC 331 x 10(4)/microliters, and PLT 17.9 x 10(4)/microliters. Bone marrow aspiration revealed hypocellular marrow with 39% blasts. About 5% of the blasts were positive for myeloperoxidase by electron microscopy analysis. Leukemic cells were positive for CD 7, 13, 33 and 34, negative for other lymphoid lineage markers, and demonstrated no rearrangement of TCR-beta, gamma and IgH genes. Although she was treated with low-dose cytosine arabinoside, no response was observed. Subdural hematoma and sequential pneumonia developed and the patient died eight months after leukemic transformation. In conclusion, we think that the leukemic transformation might have been developed in the natural course of essential thrombocythemia in the present case. However, we cannot exclude the influence of MCNU.
Cell Transformation, Neoplastic↗
Significance of urinary fibrin/fibrinogen degradation products (FDP) D-dimer measured by a highly sensitive ELISA method with a new monoclonal antibody (D-D E72) in various renal diseases.
To diagnose the abnormalities of coagulation-fibrinolysis in various renal diseases, we developed a new monoclonal antibody (D-D E72) against fibrin/fibrinogen degradation products D-dimer (FDP D-dimer) and established a highly sensitive enzyme-linked immunosorbent assay (ELISA) for its measurement. FDP D-dimer was assessed in 102 patients with various renal diseases, and the following results were obtained: 1. The mean level of urinary FPD D-dimer in 32 normal controls was 0.69 +/- 0.60 ng/ml (mean +/- SD). 2. The level of urinary FDP D-dimer was significantly higher in primary nephrotic syndrome group (NS), chronic renal failure group (CRF) and in the group of diabetic nephropathy (DM) than in the control group. However, no difference was observed in the level of urinary FDP D-dimer between non-nephrotic chronic glomerulonephritis group (CGN) and control group. 3. No significant correlation was revealed between D-dimer and urinary protein in CGN and NS groups. These results suggest that in addition to plasma filtration the urinary FDP D-dimer in NS, CRF and DM may be also related to abnormalities of secondary fibrinolysis in intra-glomerular fibrin deposits.
Adolescent↗
[Serum pepsinogen response to therapy for Helicobacter pylori associated gastro-duodenal disease].
We investigated the effect of H. pylori therapy on serum concentrations of pepsinogens on 87 patients of gastro-duodenal disease. In addition, we intended to see whether serum pepsinogen can serve as markers of response to H. pylori eradication. In 48 successfully eradicated cases, there was a significant decrease in gastritis score, and was a significant fall in serum pepsinogen II (PG II) level, and was a significant increase in pepsinogen I/II ratio (PG I/II ratio). In contrast, no change in gastritis score, PG II, and PG I/II ratio were observed in 39 unsuccessfully eradicated patients. No change in serum pepsinogen I (PG I) level was observed in both groups. In provisional successfully eradicated cases in PG II of decrease greater than 30% in after treatment, there was a sensitivity of 83.3% and a specificity of 89.7%. For the PG I/II ratio of increased greater than 30% in after treatment, the sensitivity was 95.8%, and the specificity was 94.9%. These findings suggest that PG II, PG I/II ratio can be useful for clinical evaluation of eradication therapy.
Adolescent↗