[Helicobacter pylori infection and gastroduodenal diseases. From the point of view of surgery].
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Gastric Mucosa↗
Biomedical subjects
S Kato
Publications and source records attributed to S Kato.
Omeprazole-based dual and triple regimens for Helicobacter pylori eradication in children.
OBJECTIVE: To evaluate the efficacy and safety of omeprazole-based dual and triple regimens for the treatment of children with Helicobacter pylori infection. METHODS: Twenty-two patients (3 with gastric ulcer, 12 with duodenal ulcer, and 7 with nodular gastritis alone) were studied. Twelve ulcer patients also had nodular gastritis. The dual regimen included a 2-week course of omeprazole (0.6 mg/kg twice a day) and amoxicillin (30 mg/kg twice a day) (n = 10), and the triple regimen included the dual regimen plus clarithromycin (15 mg/kg twice a day) (n = 12). In patients with active ulcers, omeprazole once daily was administered for another 4 weeks. Endoscopic biopsies were taken before therapy and 4 weeks after completion of a 2-week course of therapy, and patients were followed for 6 months. The gastritis score (grade 0 to 3) and serum anti-H pylori IgG antibody titers were also determined. RESULTS: The regimens were tolerated by all patients. Eradication rates for the dual and triple regimens were 70% and 92%, respectively. Active ulcers completely healed within 6 weeks. Patients with nodular gastritis alone showed different clinical responses to therapy. Pretreatment histology showed chronic gastritis in all patients. Successful H pylori eradication significantly reduced the mean gastritis score from 2.9 to 1.3, but unsuccessful eradication did not reduce it. The disappearance of antral nodularity often coincided with the success of eradication. Successful eradication significantly decreased pretreatment serum anti-H pylori IgG antibody titers by 29% at 1 month, by 52% at 3 months, and by 67% at 6 months. Side effects were mild and were reported in 23% of patients. CONCLUSION: An omeprazole-based regimen is safe and may be a better option for eradication of H pylori in children. Antral nodularity is a macroscopic marker of H pylori infection.
Adolescent↗
Effect of theophylline on hypoxic pulmonary vasoconstriction in awake rats.
Whether or not theophylline inhibits hypoxic pulmonary vasoconstriction in vivo still remains uncertain. We therefore studied the effect of theophylline on hypoxic pulmonary vasoconstriction in awake rats. Two days before hemodynamic measurement, indwelling catheters were placed. Animals were divided into three groups; Group-H (20 mg/kg of theophylline), Group-L (8 mg/kg of theophylline), Group-S (saline). At the day of hemodynamic measurement, animals breathed 21% and 10% O2 gas. [{Pulmonary vascular resistance (PVR) during 10% O2-PVR during 21% O2}/PVR during 21% O2] x 100 was termed as hypoxic pulmonary vasoconstriction (HPV). The first HPV measurement was followed without drug administration and then the second HPV measurement was performed with theophylline or saline infusion. Post-theophylline HPV was divided by pre-theophylline HPV to normalize individual variation. Ratio of post-theophylline HPV to pre-theophylline HPV was 0.49 +/- 0.10, 0.77 +/- 0.23, 1.06 +/- 0.33 in Group -H, -L, -S, respectively (means +/- S.E.M). Ratio of post-theophylline HPV to pre-theophylline HPV was significantly less in Group-H than in Group-S. This result suggests that theophylline used in the present study (18.6-26.9 micrograms/ml) attenuates hypoxic pulmonary vasoconstriction in the unanesthetized rat.
Animals↗
Afferent migration of the Kurloff cells via lymphatics into the thymus of estradiol-treated guinea pigs.
The spatial distribution and migration of Kurloff cells containing PAS-positive large inclusion bodies in the thymus of estradiol-treated guinea pigs were histochemically studied by a combination of light and electron microscopy. Male guinea pigs were examined at various intervals from 7 days to 3 months after a single subcutaneous injection of estradiol. Differentiation of lymphatics from blood capillaries was performed by a 5'-nucleotidase (5'-Nase) staining method and the occurrence of Kurloff cells within 5'-Nase-positive lymphatics was confirmed by ultrastructural histochemistry. Several Kurloff cells first appeared at 7 days within lymphatics in the thymic capsule or interlobular connective tissues. At 12-15 days after estradiol administration, a lymphatic accumulation, a so-called "lymphatic center", was seen in the thymic septa even though few Kurloff cells were present within the thymic parenchyma. The "lymphatic center" contained many Kurloff cells located in its periphery and in the surrounding marginal sinus which communicated with the thymic interlobular lymphatics. At 21 days after estradiol, Kurloff cells were preferentially accumulated along the corticomedullary junction extravascularly. Later the distribution was more diffuse. The conspicuous accumulation of Kurloff cells in the corticomedullary region could reflect an inability of Kurloff cells to use blood vessels as a route for migration. These findings strongly suggest the afferent migration of Kurloff cells into the thymus via lymphatics.
5'-Nucleotidase↗
Enzyme-histochemical demonstration of the intramural lymphatic network in the monkey jejunum.
The structural organization of the intramural lymphatic networks in the jejunum of the Japanese monkey (Macaca fuscata) was studied by an enzyme-histochemical method using whole-mount preparations of tissue layers. A distinction between the lymphatics and the blood vessels was made by light microscopy using 5'-nucleotidase (5'-Nase)-alkaline phosphatase (ALPase) double staining. In each tissue specimen, the reaction product for 5'-Nase activity was localized in the lymphatic vessels, whereas that for ALPase activity was restricted to blood vessels. The mucosal layer exhibited an irregular network of tubular lymphatics connecting to the central lymphatics in the villi. The submucosal layer revealed a horizontal mesh-like network consisting of tubulo-saccular lymphatics. A dense maze-like network of lymphatics was distributed throughout the myenteric layer. The lymphatic networks were independent of the blood vessels. The present results indicate the usefulness of the enzyme-histochemistry of whole-mount preparations of the laminar layers for demonstration of the structure and distribution of the lymphatic system in the intestinal wall.
5'-Nucleotidase↗
Vertebral artery dissection not detected by initial angiography--case report.
A 57-year-old male presented with subarachnoid hemorrhage caused by vertebral artery dissection. The first cerebral angiogram on the day of ictus found minimal caliber change with lower contrast density at the V4 segment, but repeat angiography showed typical segmental narrowing of the artery on the 14th day. Repeat angiography with magnetic resonance imaging in the subacute stage would be useful to identify the cause of "angiogram-negative" subarachnoid hemorrhage.
Cerebral Angiography↗
[Effects of administration of Clostridium butyricum to patients receiving long-term tube feeding].
In patients who require total parenteral or enteral nutrition the intestinal lining may atrophy and the ability to absorb nutrients may be lost. To prevent atrophy of the small intestine, we administered a suspension of Clostridium butyricum to elderly patients receiving tube feeding, and then measured the activation of serum diamine oxidase and the number, form, water content, and bacteria content of stools, indicators of intestinal structure. We found a significant increase in diamine oxidase activity and an improvement in stool condition: the number of stools per day decreased, form improved, and water content and the number of aerobic bacteria decreased significantly. These results indicate that in patients receiving long-term tube feeding, administration of Clostridium butyricum can restore condition to a near-normal state.
Aged↗
1 beta-Methyl-2-(5-substituted pyrrolidin-3-ylthio)carbapenems. 2. Synthesis and antibacterial activity of 5-aminopropyl and 5-aminopropenyl pyrrolidine derivatives.
The synthesis and biological activity of (1 R, 5S, 6S)-2-[(3S, 5S)-5-substituted pyrrolidin-3-ylthio]-6-[(R)-1-hydroxyethyl]-1-methyl-1- carbapen-2-em-3-carboxylic acid, in which aminopropyl, aminopropenyl, and aminopropynyl groups were introduced as substituents, are described. Aminopropyl and aminopropenyl derivatives showed potent in vitro and in vivo antibacterial activity against Gram-positive and Gram-negative bacteria including P. aeruginosa.
Animals↗
Virtual reality (VR) techniques in orthopaedic research and practice.
Modeling the musculoskeletal joint system using biomechanical analysis and computer graphics techniques allows us to visualize normal, diseased and reconstructed joint function. This model can be used to study the loading of bones and joints under theoretical and simulated activities. In this study, intact cadavers were imaged using MRI, CT scanning and cryo-sectioning techniques. Using sequential pixel information of bone and soft tissue boundaries collected from digital camera images, MRI and CT scans, the volumetric models of the musculoskeletal joint system are reconstructed. "Descriptive geometry" techniques which treat bones as rigid bodies and cartilage, ligament and muscles as deformable bodies were used to construct the model. Joint resultant forces and moments were determined using an inverse dynamics formulation, while ligament tension, joint contact pressure, and bone stresses are solved through a simplified Rigid Body Spring Modeling technique and the Finite Element Method. The results under static and dynamic loading activities can be visualized using interactive computer graphics. The advantages of such a model are the elimination of the need for large numbers of intact cadaveric specimens, and the unprecedented capability to study joint loading responses under normal, abnormal and surgically reconstructed states. Such a model and its analytical capability are ideal for pre-operative planning and computer-assisted orthopaedic surgery. This Visual, Interactive, Computational, and Anatomic Model(VICAM) and its associated analysis capability represent the next generation of technology which will have an enormous impact in orthopaedic research, education and patient care.
Biomechanical Phenomena↗
[Anesthetic management of a pediatric patient with non-Fukuyama type congenital muscular dystrophy].
Non-Fukuyama type congenital muscular dystrophy (n-FCMD), a subtype of progressive muscular dystrophy (PMD), is a very rare autosomal recessive disorder. N-FCMD is characterized by severe and progressive motor weakness and atrophies of proximal muscles during the infant period. A 9-year-old boy with n-FCMD underwent elective surgery for muscle release around the hip joints bilaterally. As many perioperative complications related with volatile anesthetics and muscle relaxants had been reported in the anesthetic management of PMD, these drugs were thought to be contraindicated in patients with n-FCMD. Because n-FCMD seemed to have very similar pathogenesis with PMD, caudal epidural block was chosen, supplemented with the administration of diazepam, pentazocine and nitrous oxide. The operation and anesthesia were conducted uneventfully. No complications occurred postoperatively.
Adjuvants, Anesthesia↗
[Molecular mechanism of tissue-specific actions of oestrogen].
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Animals↗
[Thoracic epidural anesthesia for cholecystectomy in a patient after Fontan procedure].
A 12 year-old boy who had received modified Fontan procedure was scheduled for cholecystectomy. Anesthesia was maintained with thoracic epidural anesthesia (Th8-9) and O2-N2O-sevoflurane under mechanical ventilation through the endotracheal tube. Transeshophageal echo cardiography and mixed venous oxygen saturation (SvO2) were used for hemodynamic monitoring. The combined use of epidural anesthesia and volatile anesthetics decreased central venous pressure, left ventricular end diastolic volume, left ventricular ejection fraction and SvO2. These hemodynamic problems were easily solved by infusion therapy and a low dose of dopamine. On the other hand, there were also some hemodynamic benefits such as inhibition of tachycardia and suppression of an increase in pulmonary vascular resistance due to surgical stress. Moreover, patient returned to normal spontaneous breathing with complete analgesia during the early phase after surgery. CVP and SvO2 increased to preoperative values in the recovery room. From these results, we conclude that satisfactory results can be obtained with epidural anesthesia for upper abdominal surgery after Fontan procedure.
Anesthesia, Epidural↗
[Long-term effects of a selective alpha 1-adrenergic inhibitor on right and left ventricular masses in patients with chronic pulmonary disease].
We examined the effect of one year of treatment with the selective alpha 1-adrenergic inhibitor doxazosin on right ventricular mass (RV mass), left ventricular mass (LV mass), and arterial blood gases. The subjects were 24 outpatients (18 men and 6 women, mean age 68.3 +/- 9.4 years) with chronic pulmonary disease complicated by hypertension who were clinically stable. One year of drug therapy was associated with significant decreases both in systolic pressure (159 +/- 15.2 vs 125.8 +/- 14.1 mmHg, p < 0.05, n = 24), and in LV mass index (101.0 +/- 13.4 vs 97.6 +/- 11.8 gm-2, p < 0.05), n = 24). We obtained the RV mass index by multiplying the thallium score RV/LV count and the LV mass index obtained by echocardiography. One year of drug therapy was associated with a significant increase in RV mass index (42.9 +/- 31.2 vs 53.6 +/- 30.5 gm-2, p < 0.05, n = 8). Vital capacity decreased (2.18 +/- 1.95 vs 1.95 +/- 0.57 l, p < 0.05, n = 24), but PaO2 improved (77.3 +/- 17.2 vs 82.2 +/- 2.4 mmHg, p < 0.05, n = 24). These data indicate that doxazosin can decrease blood pressure and can depress the left ventricle with no adverse effect on oxygenation in patients with chronic pulmonary disease complicated by hypertension. The worsening of RV hypertrophy may have been caused by a mechanism different from the one that caused LV hypertrophy, and by an increase in the work load on the right ventricles secondary to lung deterioration.
Adrenergic alpha-Antagonists↗
[Biochemical marker of alcoholic liver disease].
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Alanine Transaminase↗
[Effect of alcohol on patients with diabetes, hypertension or cardiovascular disease].
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Alcohol Drinking↗
[Fatal pulmonary embolism during knee surgery under epidural anesthesia].
A 36 year old male patient suddenly died of pulmonary embolism during the second application of a pneumatic tourniquet undergoing tibial fracture repair. Pulmonary artery angiography using Swan-Ganz catheter demonstrated that the left and right pulmonary arteries were occluded except the partial left upper lobe. PaO2 was below 7 mmHg, and cardiopulmonary resuscitation was not possible. Autopsy showed massive emboli completely blocking the both pulmonary arteries.
Adult↗
[Hypereosinophilia after allogeneic bone marrow transplantation. A possible role of IL-5 overproduction by donor T-cells chronic GVHD].
Chronic graft-versus-host disease (GVHD) is thought to result from abnormalities of several cytokine regulations in vivo. We analyzed interleukin-5 (IL-5) production by peripheral lymphocytes in a patient showing hypereosinophilia associated with chronic GVHD after allogeneic bone marrow transplantation. IL-5 production by activated T-lymphocytes which are known to play a major role in chronic GVHD was upregulated when stimulated by PMA + ionomycin. Therefore, hypereosinophilia observed in our patient may be correlated with IL-5 production in donor T-lymphocytes.
Adolescent↗