Biomedical subjects
Publications and source records attributed to S Fukudo.
Activation of corticotropin releasing hormone (CRH) receptor 2 (CRH-R2) reduces visceral sensitivity induced by colorectal distension in conscious rats. This finding is relevant to the increased interest in the potential use of therapeutic agents that act on CRH receptors in the treatment of irritable bowel syndrome.
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We tested the hypothesis that personality plays a role in cancer outcome in a population-based prospective cohort study in Japan. In July 1990, 41 442 residents of Japan completed a short form of the Eysenck Personality Questionnaire-Revised and a questionnaire on various health habits, and between January 1993 and December 1997, 890 incident cases of cancer were identified among them. These 890 cases were followed up until March 2001, and a total of 356 deaths from all causes was identified among them. Cox proportional-hazards regression was used to estimate the hazard ratio (HR) of death according to four score levels on each of four personality subscales (extraversion, neuroticism, psychoticism, and lie), with adjustment for potential confounding factors. Multivariable HRs of deaths from all causes for individuals in the highest score level on each personality subscale compared with those at the lowest level were 1.0 for extraversion (95% CI=0.8-1.4; Trend P=0.73), 1.1 for neuroticism (0.8-1.6; Trend P=0.24), 1.2 for psychoticism (0.9-1.6; Trend P=0.29), and 1.0 for lie (0.7-1.5; Trend P=0.90). The data obtained in this population-based prospective cohort study in Japan do not support the hypothesis that personality is associated with cancer survival.
The objective of this study was to investigate the association between alcohol consumption and the risk of total cancer, and to estimate the proportion of total cancer attributable to drinking habit in Japanese men. From June through August 1990, a total of 21 201 Japanese men completed a self-administered questionnaire on various health habits, including alcohol consumption. During 153 389 person-years of follow-up through December 1997, we identified a total of 882 cases of cancer. We used Cox proportional hazards regression to estimate the relative risk of total cancer according to categories of alcohol consumption. The risk for total cancer was significantly higher in ex-drinkers than never-drinkers. There was a dose-response relationship between the amount of alcohol consumed and the risk of total cancer among current drinkers: multivariate RRs in reference to never-drinkers (95% confidence intervals (CI)) were 1.1 (0.8-1.3), 1.3 (1.0-1.7), and 1.3 (1.1-1.7) in current drinkers who consumed less than 22.8 g, 22.8-45.5 g, 45.6 g or more alcohol per day, respectively (P for trend <0.001). Estimated 17.9% (95% CI 3.1-30.5) of total cancer risk was attributable to drinking habit. In our findings, approximately 20% of the total cancer cases in Japanese men may be prevented by alcohol control.
The relationship between the central processes of classical conditioning and conditioned responses of the gastrointestinal function is incompletely understood in humans. We tested the hypothesis that the rectosigmoid motility becomes conditioned with anticipatory painful somatosensory stimulus and that characteristic brain areas become activated during anticipation. In nine right-handed healthy male subjects, a loud buzzer (CS, conditional stimulus) was paired with painful transcutaneus electrical nerve stimulation to the right hand (unconditional stimulus). Rectosigmoid muscle tone measured by the barostat as the intrabag volume, phasic contractions of the bowel measured as the number of phasic volume events (PVEs), and regional cerebral blood flow assessed by positron emission tomography (PET), were measured before and after conditioning. Following conditional trials, the bag volume after CS alone did not show significant changes between before and after the stimulus, but the number of PVEs after 2-minute interval of the CS alone was significantly greater than that before the stimulus (P < 0.05). The PET data showed the conditioning elicited significant cerebral activation of the prefrontal, anterior cingulate, parietal and insula cortices (P < or = 0.001, uncorrected). Rectosigmoid motility can be conditioned with increase in phasic contractions in humans.
Brain-gut interaction is considered to be a major factor in the pathophysiology of irritable bowel syndrome. However, only limited information has been provided on the influence of gastrointestinal tract stimulation on the brain. Our aim in this study was to determine the specific regions of the brain that are responsible for visceral perception and emotion provoked by distention of the descending colon in humans. Fifteen healthy males aged 22 +/- 1 participated in this study. Using a colonoscope, a balloon was inserted into the descending colon of each subject. After sham stimulation, the colon was randomly stimulated with bag pressures of 20 and 40 mmHg, and regional cerebral blood flow was measured by [(15)O] positron emission tomography. The subjects were asked to report visceral perception and emotion using an ordinate scale of 0-10. Colonic distention pressure dependently induced visceral perception and emotion, which significantly correlated with activation of specific regions of the brain including the prefrontal, anterior cingulate, parietal cortices, insula, pons, and the cerebellum. In conclusion, distention of the descending colon induces visceral perception and emotion. These changes significantly correlate with activation of specific regions in the brain including the limbic system and the association cortex, especially the prefrontal cortex.
BACKGROUND AND AIMS: Corticotropin releasing hormone (CRH) is a major mediator of the stress response in the brain-gut axis. Irritable bowel syndrome (IBS) is presumed to be a disorder of the brain-gut link associated with an exaggerated response to stress. We hypothesised that peripheral administration of alpha-helical CRH (alphahCRH), a non-selective CRH receptor antagonist, would improve gastrointestinal motility, visceral perception, and negative mood in response to gut stimulation in IBS patients. METHODS: Ten normal healthy subjects and 10 IBS patients, diagnosed according to the Rome II criteria, were studied. The tone of the descending colon and intraluminal pressure of the sigmoid colon were measured at baseline, during rectal electrical stimulation (ES), and at recovery after administration of saline. Visceral perception after colonic distension or rectal ES was evaluated as threshold values on an ordinate scale. The same measurements were repeated after administration of alphahCRH (10 micro g/kg). RESULTS: ES induced significantly higher motility indices of the colon in IBS patients compared with controls. This response was significantly suppressed in IBS patients but not in controls after administration of alphahCRH. Administration of alphahCRH induced a significant increase in the barostat bag volume of controls but not in that of IBS patients. alphahCRH significantly reduced the ordinate scale of abdominal pain and anxiety evoked by ES in IBS patients. Plasma adrenocorticotropic hormone and serum cortisol levels were generally not suppressed by alphahCRH. CONCLUSION: Peripheral administration of alphahCRH improves gastrointestinal motility, visceral perception, and negative mood in response to gut stimulation, without affecting the hypothalamo-pituitary-adrenal axis in IBS patients.
The hypothalamus, which is rich in histaminergic neurons, is highly sensitive to aversive stimuli such as stress. Histamine H3 receptors, which regulate histamine release from the presynaptic site, are associated with stress-induced brain activity. In this study, we investigated the changes of histamine content and histamine H1 and H3 receptors in the brains of rats subjected to stress induced through food deprivation and physical activity on a running wheel (food-deprived activity stress). For purposes of comparison, we also examined the stressful effects of forced swimming on the histaminergic neuron system of rats. The H3 receptor density rapidly declined in the acute phase of stress but gradually returned to the control level in the chronic phase. On the other hand, the H1 receptor slowly decreased and remained at a low level during the chronic phase. These results reveal that there is a discrepancy between the levels of H1 and H3 receptors in the acute and chronic phases of stress. Brain histamine content gradually increased during the late phase of both food-deprived activity stress and forced swimming stress. These changes presumably resulted in the inhibition of histaminergic neuronal activity in the chronic stress condition. In accordance with this hypothesis, the intraventricular administration of histamine significantly reduced the hyperactivity caused by food-deprived activity stress. Since extensive exercise and restricted feeding are thought to be associated with anorexia nervosa, the abnormalities in the histaminergic neuron system might contribute to trait status in anorexia nervosa.
Night shift work has often been associated with increasing degree and frequency of various psychologic complaints. The study examined whether psychologic states after night work are related to adaptive alterations of the cardiovascular and neuroendocrine systems. We studied 18 healthy nurses (age 29+/-2 years) engaged in a modified rapid shift rotation system (day work, 8:15-17:15; evening work, 16:00-22:00; night work, 21:30-8:30). Blood pressure, heart rate, RR interval variability (L/H and HF power spectrum for sympathetic and vagal activities), and physical activity were measured using a multibiomedical recorder for 24 h from the start of work during the night and day shifts. Plasma ACTH and cortisol concentrations were measured at the end of each shift and at 8:30 AM on a day of rest. Each subject's psychologic state was assessed using a validated questionnaire. Among the parameters measured, scores for confusion, depression, anger-hostility, fatigue and tension-anxiety were highest, and scores for vigor lowest, after a night shift. Systolic blood pressure and heart rate during work were lower during night shift than during day shift (119+/-2 vs. 123+/-1 mmHg, p<0.05 and 75+/-1 vs. 84+/-2 bpm, p<0.001, respectively). Both parameters were lower still (p<0.005 and p<0.05) when measured outside of the hospital under waking conditions following a night shift than following a day shift, even though the levels of physical activity were similar. The HF power spectrum of RR interval variability was greater not only during work (24.2+/-2.1 vs. 18.5+/-1.8 ms, p<0.005) but also during the awake period (29.1+/-2.5 vs. 24.4+/-2.6 ms, p<0.005) after the night shift compared with the day shift. Plasma ACTH and cortisol concentrations were lower after night work than in the day of rest (7.3+/-1.2 vs. 11.5+/-2.3 pg/ml, p<0.1 and 11.1+/-1.1 vs. 14.4+/-1.1 mg/dl, p< 0.05). Systolic and diastolic blood pressures during night shift work and the subsequent awake period correlated positively with scores for vigor and negatively with scores for confusion (p<0.05). Plasma ACTH and cortisol concentrations did not correlate with any psychologic scores. We conclude that psychologic disturbances after night work were associated with altered cardiovascular and endocrine responses in healthy nurses. Some of the psychologic complaints may be attributable to lower waking blood pressure.
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Altered visceral perception is thought to be included in the pathogenesis of functional dyspepsia. However, in previous studies, the assessment of visceral perception has been based solely on patients self-reported symptoms. Cerebral evoked potential (EP), either by mechanical or electrical stimulation (ES) of the visceral organ, is used to evaluate visceral perception via afferent neural pathways. In this study, we investigated the visceral perception in patients with functional dyspepsia by EP to eliminate the possibility of self-reported bias. EP responses were recorded by oesophageal ES at 37 cm from the nostril in 14 patients with functional dyspepsia and 14 normal healthy control subjects. Threshold levels of perception, peak latencies and peak-to-peak amplitudes of EP were evaluated. There was no difference in the sensory threshold between the dyspeptic patients and the control subjects (median 6 mA, range 2-12 mA, vs. 8 mA, range 6-14 mA; P= 0.09). There was a strong trend towards a decreased discomfort threshold in the patients when compared to the control subjects (median 14 mA, range 6-24 mA vs. 20 mA, range 14-26 mA; P = 0.05). The latency of the later EP peak (N2) among the patients (154 ¿ 4 ms) was significantly shorter than that of the control subjects (171 ¿ 3 ms, P < 0.01) although there was no difference between the earlier peaks (Ni and P1). There was also no difference in the amplitudes (Ni/Pi and P1/N2) of EP between the patients and the control subjects. Half of the patients (seven out of 14) complained of nausea during ES but the control subjects were unaffected. The latency of the first EP peak (Ni) in the patients with nausea was significantly shorter (66 ¿ 3 ms) than that of the patients without nausea (79 ¿ 4 ms, P 0.05) or among the control subjects (80 ¿ 3 ms, P < 0.05). These results suggest that dyspeptic patients may recruit a greater number of fast conducting myelinated nerve fibres that convey visceral afferent impulses to the brain and/or that dyspeptic patients may have an altered central processing of the visceral perception. We conclude that EP recording by oesophageal ES provides an objective measurement of altered visceral perception in patients with functional dyspepsia.
To examine the relationship between type A behavior pattern and hypercholesterolemia, we recruited 109 primary hypercholesterolemic patients without treatment for hyperlipidemia (30 males and 79 females) and then classified them according to Maeda's questionnaire into two groups; type A group (16 males and 35 females, aged 73.1 +/- 8.7) and type B group (14 males and 44 females, aged 71.3 +/- 8.7). We studied serum total cholesterol, serum triglyceride and BMI. Serum total cholesterol was shown significantly higher in type A group than that in type B (233.0 +/- 22.8 vs 223.9 +/- 14.2 p < 0.01) and BMI lower (24.0 +/- 3.9 vs 25.4 +/- 3.9 p < 0.05), however, there was no significant difference in serum triglyceride between two groups (148.96 +/- 8.2 vs 134.0 +/- 48.8). Although there was no significant difference in BMI, serum total cholesterol was significantly higher in the women's group and in the 60s. This study suggests that type A behavior pattern is related to lipid metabolism, however we should take gender and age into consideration to study the relationship between type A behavior pattern and lipid metabolism.
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Psychophysiological stress has been shown to increase 70,000 mol. wt heat shock protein messenger RNAs with northern blotting in rats. However, its localization is unknown. With in situ hybridization, we tested our hypothesis that restraint water-immersion stress may induce heat shock cognate protein 70 messenger RNA expression simultaneously with some morphological changes selectively in the hippocampus of rats. Stress for 6 h significantly increased heat shock cognate protein 70 messenger RNAs in the hippocampus, with maximal intensity in the CA3 subfield of the Ammon's horn and to a lesser extent in CA2. Stress for 12 h significantly increased heat shock cognate protein 70 messenger RNAs in the whole hemisphere including the cerebral cortex, the thalamus, the hypothalamus, and the hippocampus with the highest density in CA3. Heat shock cognate protein 70 messenger RNA in rats with stress for 6 h followed by recovery for 6 h significantly increased at CA3 and CA2 compared with the controls or rats stressed for 6 h without recovery. No overt histological changes were detected in neuronal or glial cells in the slides of hematoxylin-eosin or Cresyl Violet staining. These results show that psychophysiological stress induces heat shock cognate protein 70 messenger RNA in the most stress-vulnerable brain structure, hippocampal CA3, probably for cytoprotection.
BACKGROUND: Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and abnormal bowel habits. IBS patients sometimes complain of sleep disturbance, depression, and various autonomic symptoms. Our hypothesis is that the central nervous system (CNS) might play a role in the pathogenesis of IBS. METHODS: We conducted two experiments using an electroencephalogram (EEG) to evaluate brain activity while at rest and during mental arithmetic stress with pharmacologic neostigmine administered to IBS patients. The first experiment was conducted on 48 conscious and relaxed patients (24 IBS patients and 24 normal controls). EEG recordings were evaluated for visual and power spectrum data. In the second experiment colonic manometric studies combined with EEG recordings were performed in 21 of 24 IBS patients and 8 of 24 normal controls under mental arithmetic stress and the administration of neostigmine. RESULTS: Inspection of the EEG showed significantly greater EEG abnormality in the IBS patients (29.2%) than in the controls (4.2%) (P < 0.02). In the power spectrum analysis of the EEG the IBS patients showed significantly greater beta power percentage than did the normal subjects (P < 0.02). A significant positive correlation was observed between the colonic motility index and beta power percentage after the administration of neostigmine, 10 microg/kg, only in the IBS patients (P < 0.05). CONCLUSION: A brain dysfunction as indexed by the EEG suggests an electrophysiologic brain-gut interaction in IBS.
Duodenal gastrinoma is recognized as a relatively common cause of Zollinger-Ellison syndrome, but its clinical and biological features are not well known. Here we report a case of duodenal gastrinoma with lymph node metastasis which was confirmed by pathology examinations. Hypergastrinemia and gastric acid hypersecretion were documented, but the secretin test showed negative results. An enlarged peripancreatic lymph node lying close to the pancreas head was the only positive finding on preoperative imaging studies. The results of the selective arterial secretin injection (SASI) test suggested that the primary tumor was located in the gastrinoma triangle. Finally, surgical exploration was carried out and a submucosal tumor, approximately 15 mm in size, was detected by intraoperative palpation at the posterior wall of the proximal portion of the duodenum. Intraoperative pathology examination demonstrated metastases to regional lymph nodes. The present case calls attention to the unique features of duodenal gastrinomas, which differ from those of pancreatic origin: a highly malignant potential for its small size, and submucosal location in the proximal duodenum. The SASI test is recommended for assessing the location of a primary lesion if it cannot be identified by various conventional imaging studies.
BACKGROUND: Corticotropin-releasing hormone (CRH) plays a key role in modulating intestinal motility in stressed animals. AIMS: To evaluate the effect of CRH on intestinal motility in humans and to determine whether patients with irritable bowel syndrome (IBS) have an exaggerated response to CRH. SUBJECTS: Ten IBS patients diagnosed by Rome criteria and 10 healthy controls. METHODS: CRH (2 micrograms/kg) was intravenously administered during duodenal and colonic manometry and plasma adrenocorticotropic hormone (ACTH) was measured by radioimmunoassay. RESULTS: CRH induced motility of the descending colon in both groups (p < 0.001) and induced greater motility indexes in IBS patients than in controls (p < 0.05). CRH produced duodenal phase III motor activity in 80% of the subjects and duodenal dysmotility in 40% of IBS patients. Abdominal symptoms evoked by CRH in IBS patients lasted significantly longer than those in controls (p < 0.05). CRH induced significant increases in plasma ACTH levels in both groups (p < 0.001) and produced significantly higher plasma ACTH levels in IBS patients than in controls (p < 0.001). CONCLUSION: Human intestinal motility is probably modulated by exogenous CRH. The brain-gut in IBS patients may have an exaggerated response to CRH.
We evaluated the possibility that serotonin (5-HT) mediates defecation induced by corticotropin-releasing hormone (CRH) exogenously administered or released from the central nervous system by stress via the 5-HT3 receptor in rats. Intracerebroventricular (i.c.v.) injection of CRH (1, 3, and 10 micrograms/rat) dose dependently increased the number of stools excreted in rats, whereas intravenous (i.v.) injection of up to 100 micrograms/kg CRH did not affect defecation. alpha-Helical CRH-(9-41) and 5-HT3 receptor antagonists ramosetron and azasetron inhibited CRH (10 micrograms i.c.v.)-induced defecation in a dose-dependent manner with ED50 values of 4.3 micrograms/kg i.v., 3.8 micrograms/kg p.o., and 70.4 micrograms/kg p.o., respectively. alpha-Helical CRH-(9-41) also inhibited CRH-induced defecation by i.c.v. injection with an ED50 value of 0.078 microgram/rat. In contrast, ramosetron and azasetron injected i.c.v. had no effect on CRH-induced defecation. alpha-Helical CRH-(9-41), ramosetron, and azasetron reduced defecation caused by restraint stress with ED50 values of 0.32, 3.6, and 19.7 micrograms/kg i.v., respectively. These results indicate that CRH exogenously administered or released from the central nervous system by stress peripherally promotes the release of 5-HT, which in turn stimulates defecation through the 5-HT3 receptor.