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Biomedical subjects

Shinsaku Fukuda

Publications and source records attributed to Shinsaku Fukuda.

At least 19 recordsLinked to original sources
PubMed2004

13C-Urea breath test, using a new compact nondispersive isotope-selective infrared spectrophotometer: comparison with mass spectrometry.

BACKGROUND: The (13)C-urea breath test ((13)C-UBT) is the most commonly used noninvasive method of detecting Helicobacter pylori infection. The isotope ratio mass spectrometer (IRMS) is the most commonly used device for this test, but the UBiT-IR300 infrared spectrophotometer, which, by comparison, is a more compact, less expensive, and easier to use analytical device, has now become widely used in the clinical setting in Japan. The objective of this study was to examine the diagnostic performance of the (13)C-UBT, using the UBiT-IR300. METHODS: A multicenter open-label study was performed, in which the (13)C-UBT was conducted using 100 mg of (13)C-urea. Analysis of (13)CO(2) in the expired breath was performed by infrared spectroscopy and mass spectrometry, and assessment of H. pylori infection was performed by culture, histological examination, and rapid urease test. RESULTS: In 255 cases of H. pylori infection diagnosed by biopsy methods, the (13)C-UBTs, performed with two different (13)C-ruea formulations, and using infrared spectroscopy for evaluation, showed a sensitivity of 97.7%, specificity of 98.0%, and accuracy of 97.8% (total number of evaluable cases, n = 505). The rate of agreement in the assessment of H. pylori infection between infrared spectroscopy and mass spectrometry was 100% ( n = 505). The regression equation for infrared spectroscopy to mass spectrometry was y = 0.9822x - 0.0809 ( n = 2542), with a correlation coefficient of r = 0.99989 ( P = 0.0001). CONCLUSIONS: Diagnosis of H. pylori infection can be performed using infrared spectroscopy as well as mass spectrometry.

Breath Tests↗
PubMed2004

Comparison between a new 13C-urea breath test, using a film-coated tablet, and the conventional 13C-urea breath test for the detection of Helicobacter pylori infection.

BACKGROUND: In Japan, urea breath-testing includes mouth rinsing with water immediately after the ingestion of (13)C-urea solution, to prevent false-positive results that are caused by oral bacteria with urease activity. Our objective was to evaluate the diagnostic performance of a urea breath test using a film-coated (13)C-urea tablet and omitting mouth rinsing. METHODS: The study was a multicenter trial comparing the solution- and tablet-based urea breath tests (UBTs). Helicobacter pylori status was determined by histology, culture, and rapid urease testing. RESULTS: Of the 255 subjects who completed the study, evaluation of the tablet-based UBT was possible in 254, and comparison of the tablet-based UBT and the solution-based UBT was possible in 250 patients. When the assessment achieved by a combination of biopsy-based methods was used as a reference standard, the sensitivity, specificity, and accuracy of the tablet-based method were determined to be 97.7%, 98.4%, and 98.0%, respectively. When the results of the solution-based UBT were used as a reference standard, the sensitivity, specificity, and accuracy of the tablet-based UBT were determined to be 96.9%, 97.6%, and 97.2%, respectively. CONCLUSIONS: The (13)C-urea tablet-based method proved to be a simple and accurate test for the diagnosis of H. Pylori infection. Mouth rinsing was not required.

Adult↗
PubMed2004

Effect of Helicobacter pylori eradication in the treatment of Japanese patients with chronic idiopathic urticaria.

BACKGROUND: Infection with Helicobacter pylori has been associated with chronic idiopathic urticaria (CIU). The aim of this study was to investigate the efficacy of H. pylori eradication in the treatment of patients with CIU. METHODS: Fifty patients with CIU (16 men and 34 women; age 25-75 years) and 100 sex- and age-matched control subjects were enrolled in the study. Presence of IgG antibody to H. pylori was examined by serology. H. pylori-seropositive patients with CIU received endoscopy to confirm H. pylori infection. Patients infected with H. pylori received eradication therapy comprising lansoprazole, amoxicillin, and either clarithromycin or metronidazole. At least 2 months after finishing the eradication therapy, a (13)C-urea breath test was performed, and the effect of eradication therapy on the CIU was scored, using a three-point scale, as complete remission, partial remission, or no improvement. RESULTS: In the 50 patients with CIU, 26 (52%) were H. pylori-seropositive, while 48% (48/100) of the control subjects were seropositive (statistically not significant). Nineteen out of the 26 patients with CIU infected with H. pylori received eradication therapy, and eradication was successful in 17 patients. In the 17 H. pylori-eradicated patients, 6 (35%) had complete remission and 11 (65%) had complete remission or partial remission. On the other hand, in the 9 patients without H. pylori eradication, only 2 (22%) showed partial remission and 7 (78%) had no improvement. CONCLUSIONS: Eradication of H. pylori would be a valid choice for patients with CIU, although the prevalence of H. pylori infection is not higher in patients with CIU than it is in controls.

Adult↗
PubMed2004

Efficacy of metronidazole for the treatment of clarithromycin-resistant Helicobacter pylori infection in a Japanese population.

BACKGROUND: Eradication of Helicobacter pylori has become a common treatment for several diseases. There is an increase in antibiotic-resistant strains, which causes the failure of eradication. The aim of this study was to investigate the usefulness of metronidazole for the treatment of H. pylori infection in patients who failed eradication therapy. METHODS: Seventy H. pylori-positive patients who had failed eradication treatment with first-line triple therapy, which consisted of a proton pump inhibitor, amoxicillin, and clarithromycin, were enrolled into the study. Before the second-line therapy, patients underwent endoscopy to obtain H. pylori strains to test susceptibility to antibiotics. Lansoprazole (30 mg b.d.), amoxicillin (750 mg b.d.), and metronidazole (250 mg b.d.) were administered for 1 week, and the result was tested by 13C-UBT. RESULTS: H. pylori was isolated from 62 patients, and 52 of them (83.9%) were clarithromycin resistant. There was no amoxicillin- or metronidazole-resistant strain. No major adverse effects were seen, and all the patients completed the 1-week regimen. The eradication rates of lansoprazole-amoxicillin-metronidazole were 96.2% (51/53; 95% CI, 87.0%-99.5%) using both intention-to-treat analysis and per protocol analysis. CONCLUSIONS: Lansoprazole-amoxicillin-metronidazole triple therapy is an effective and promising second-line H. pylori eradication therapy in a north Japanese population, which has a low frequency of metronidazole resistance.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2004

Seasonal changes in mortality rates from main causes of death in Japan (1970--1999).

BACKGROUND: It is well recognized that the season of the year exerts an influence on some diseases and causes of death such as coronary heart diseases, stroke, infectious diseases and so on. METHODS: We evaluated the influence of seasonal changes on diseases and causes of death in Japan using the Japan Vital Statistics from 1970 to 1999 and recorded weather data (mean temperature), by a Fourier decomposition in a log linear regression model. RESULTS: Major influences of seasonal change with the highest rates in winter were seen on the following: the overall causes of death; infectious and parasitic diseases including tuberculosis; respiratory disease, including pneumonia and influenza; heart and cerebrovascular diseases; diabetes; and digestive diseases and accidents. Two peaks were seen in suicides, a large peak in April and a small peak in autumn. Cancer and homicides were little or not at all influenced by seasonality. There was no major difference in changes between the years studied, except for respiratory disease and tuberculosis, which showed a clear reduction in the seasonality effect from 1970 to 1999. CONCLUSIONS: To reduce the overall mortality rate and to prolong life expectancy in Japan, measures must be taken to reduce those mortality rates associated with seasonal differences, especially those causes of death which show a strong correlation with seasonal change: respiratory, heart, cerebrovascular, diabetes and infectious diseases.

Accidents, Traffic↗
PubMed2004

The prevention of colon carcinogenesis in rats by dietary cellulose is greater than the promotive effect of dietary lard as assessed by repeated endoscopic observation.

We developed a method which we used in the current study to observe the rat colon endoscopically. Our goal was to evaluate the entire course in the development of experimental large bowel tumors through serial observations in the same rat. We compared the effects of dietary lard and cellulose on rat colon tumorigenesis in a 2 x 3 factorial design. Sprague-Dawley rats (n = 90) were divided into 6 diet groups: rats were fed a diet without cellulose that contained 5, 10, and 15 g/100 g lard, or diets containing 15% cellulose diet (15 g cellulose/100 g diet) and the same concentrations of lard. The development of large bowel tumors induced by the administration of 1,2-dimethylhydrazine (25 mg/kg body weight) for 19 wk was examined endoscopically. Tumor induction rates in the 15% cellulose groups were lower than in the 0% cellulose groups (P = 0.008), independent of the lard concentration. These results suggest that the preventive effect of cellulose against large bowel tumorigenesis is greater than the promotive effect of fat under the current experimental conditions.

1,2-Dimethylhydrazine↗
PubMed2004

The fermentation of different dietary fibers is associated with fecal clostridia levels in men.

Only a few reports have compared the fermentation of pectin and cellulose using the hydrogen-breath test, and no studies have examined the relation between the hydrogen breathing pattern and colonic microflora. Using breath-hydrogen measurements, we investigated whether different dietary fibers (DFs) were fermented differently and whether there were individual differences after ingestion of the same DF; we also examined the relation between individual fecal microflora and the fermentation of DF. Results of hydrogen tests in 14 men were compared after they had ingested 20 g of pectin, 20 g of cellulose, or 6 g of lactulose (a DF-like substance). We examined the relation between the breath hydrogen results and the subjects' fecal microflora. We defined significant fermentation (i.e., positive cases) as a continuous rise in hydrogen in the expiratory air of >19 ppm. The subjects were divided into 3 groups according to their hydrogen breath test pattern, i.e., positive for lactulose and pectin (Group LP, n = 4); positive for lactulose alone (Group L, n = 7); and negative for pectin, cellulose, and lactulose (Group N, n = 3). Individual differences were noted in subjects from Group LP and Group L. The detection frequency of lecithinase-negative clostridia was higher in Group LP than in the other groups (P < 0.05), and the detection frequency and the number of lecithinase-positive clostridia were higher in Groups LP and L than in Group N (P < 0.05). These findings suggest that the Clostridium species are associated with hydrogen production. The hydrogen breath test results of DFs depend on both the type of DF and the individual colonic microflora. The amount and constitution of colonic microflora might be predicted by the hydrogen-breath test using different DFs.

Adult↗
PubMed2004

Nutritional effects of supplementing liquid-formula diet with dietary fiber on elderly bed-ridden patients.

In the past few decades, the number of bed-ridden elderly patients has been increasing. This group of patients is frequently fed with a liquid formula diet. The aim of this study was to evaluate the usefulness of a liquid formula diet containing dietary fiber (DF) for elderly bed-ridden patients. Eighteen elderly, bed-ridden patients were given L-3 Fiber, a DF-containing liquid formula diet (DF-LFD), for 4 weeks, while a number of parameters were monitored, including serum levels of total cholesterol, triglyceride, total protein, creatinine, uric acid, glucose, sodium, potassium, and calcium, urine protein/sugar, and defecation frequency. Total protein, albumin and total cholesterol significantly increased following the administration of the DF-LFD, associated with an average increase in body weight of 1.94 kg (5.0%). Defecation frequency significantly increased one week after DF-LFD administration was started, but this effect was transient. Although a few patients complained of nausea, vomiting or abdominal pain, no severe side effects were seen. In conclusion, DF-LFD supplementation appears to be beneficial for elderly bed-ridden patients, and can increase nutritional-related parameters, such as body weight, total protein, albumin and total cholesterol, without severe side effects.

Aged↗
PubMed2003

Environmental factors affect colon carcinoma and rectal carcinoma in men and women differently.

BACKGROUND AND AIMS: Colon cancer is thought to be more closely associated with environmental factors than rectal cancer, but evidence is currently insufficient. We examined whether there are differences in the degree of environmental effect on colon cancer and rectal cancer in Japan. METHODS: We performed a birth cohort analysis for colon and rectal cancers using Japanese vital statistics from 1950 to 1998 and analyzed time trends by cancer site and gender. RESULTS: The mean annual increase in age-adjusted mortality rate from colon cancer was greater than that from rectal cancer and was greater in men than in women. In men left colon cancer showed the greatest rate of increase whereas cancer of the right colon showed only a slight change. Although left colon cancer rapidly increased until the middle 1980s and thereafter showed no change, right colon cancer showed no change until the middle 1980s and thereafter rapidly increased in men. However, the rates of increase in left colon cancer were greater than those in right colon cancer until the middle 1980s, after which a reversal in trend was seen in women. Birth cohort analysis indicates that for all cohorts the mortality rates at the same age were higher in the recent cohorts than in the previous ones. This trend was more marked for colon cancer than for rectal cancer and was stronger among men than among women. CONCLUSION: Colon cancer is more closely associated than rectal cancer with environmental factors, and this association is more pronounced in men than in women. Consequently cancers at these two sites should not be combined in studies of the role of lifestyle factors in causing these neoplasms. Furthermore, the causes of these diseases may differ in men and women.

Adolescent↗
PubMed2003

Morphologic criteria using biopsy specimens to define the risk of gastric cancer in patients with Helicobacter pylori infection.

Although Helicobacter pylori (H. pylori) infection is associated with gastric cancer most patients infected with H. pylori do not develop gastric cancer. Gastric biopsy specimens were taken from 49 patients with early intestinal-type gastric cancer and from 49 age- and sex-matched control subjects. Histological features of gastritis were graded according to the updated Sydney System. Mononuclear cell infiltration of the corpus, and intestinal metaplasia of the angle increased the risk of developing gastric cancer. Probability of gastric cancer (PCA) was calculated using these two parameters. The specificities of 70 < PCA for gastric cancer patients, and PCA < 30 for non-cancer subjects were 94 and 95%, respectively. PCA < 20 was observed only in control subjects. Calculation of PCA, which requires only two biopsy specimens, may be useful to define the patients at high or low risk of intestinal-type gastric cancer among patients infected with H. pylori.

Biopsy↗
PubMed2003

The resistant starch level of heat moisture-treated high amylose cornstarch is much lower when measured in the human terminal ileum than when estimated in vitro.

According to the definition of resistant starch (RS), the true value of foodstuff-derived RS can be assessed only from that found in the contents of the terminal ileum. To date, a few methods exist for in vivo measurement of RS in the terminal ileum, but their accuracy is questionable. The aim of this study was to quantify the level of RS in the terminal ileum to determine its true value as dietary fiber (DF). Volunteers (n = 7 men) were given a test meal containing 10 g of heat moisture-treated high amylose cornstarch (HMT-HAS) containing 8.8 g of RS as measured by Englyst's method. A double-lumen tube was positioned in the terminal ileum using the endoscopic retrograde bowel insertion method (ERBI). Intestinal contents were aspirated, and the amount of RS was measured as the glucose concentration (Englyst's method), and compared with the values for RS administrated orally using the same method. The mean amount of HMT-HAS-derived RS collected in the terminal ileum was 3.37 +/- 0.95 g (mean +/- SD), which was 34.5 +/- 9.7% of the in vitro RS value. Furthermore, there were large individual differences in recoveries, ranging from 22.2 to 47.5%. The measured amount of HMT-HAS-derived RS was much smaller in our in vivo study than that measured in vitro, suggesting that in vitro measurement may inaccurately estimate the RS and DF levels of foodstuffs. The problem is further compounded by the large individual in vivo variations in RS values from subjects consuming identical diets.

Adult↗
PubMed2003

Dietary fat attenuates the benefits of an elemental diet in active Crohn's disease: a randomized, controlled trial.

OBJECTIVES: Although an elemental diet has been established as the primary treatment for patients with Crohn's disease, the influence of dietary fat on the elemental diet remains unclear. We have designed the first randomized, controlled trial for elemental diets containing different fat percentages in patients with active Crohn's disease. METHODS: Each patient was randomized to receive one of three dose levels of fat in an elemental diet (Elental) for 4 weeks: 10 patients received low fat (3.06 g/day), 10 patients received medium fat (16.56 g/day) and eight patients received high fat (30.06 g/day). The additional fat was composed of long-chain fatty acids. All patients were evaluated using the International Organization of Inflammatory Bowel Disease rating, plus C-reactive protein level and erythrocyte sedimentation rate, which were measured at weekly intervals. RESULTS: Although the International Organization of Inflammatory Bowel Disease rating, C-reactive protein level and erythrocyte sedimentation rate in the low-fat group decreased, the values in the medium- and high-fat groups fluctuated during the study. The remission rate after 4 weeks in each group was 80%, 40% and 25% for patients in the low-, medium- and high-fat groups, respectively. CONCLUSIONS: When the fat consisted of long-chain triglycerides, a high amount of this fat in the elemental diet formula decreased its therapeutic effect against active Crohn's disease.

Adult↗
PubMed2003

Characteristics of attenuating effects of rebamipide, an anti-ulcer agent, on oxidative burst of human neutrophils.

The aim of this study was to characterize the effects of rebamipide on the oxidative burst of human neutrophils. The neutrophil oxidative burst was measured in the presence of rebamipide and cimetidine using lucigenin- or luminol-dependent chemiluminescence (LgCL or LmCL). Rebamipide inhibited the LmCL response stimulated with opsonized zymosan, 12-myristate 13-acetate phorbol, and calcium ionophore in a dose-dependent manner, but the LgCL response was inhibited when neutrophils were stimulated with opsonized zymosan. LmCL response was also dose-dependently attenuated by rebamipide even in the presence of cimetidine. Thus, addition of rebamipide to H(2)-receptor antagonists can be considered for the treatment of gastric mucosal injury associated with oxidative stress.

Adult↗
PubMed2002

New method for the determination of fecal consistency and its optimal value in the general population.

BACKGROUND: Although fecal consistency is an important factor, there has been only one study measuring this parameter. We developed a new method to measure fecal consistency and studied the relationship between fecal consistency and other fecal factors, including water content and weight. METHODS: The new method is a modification of the method of Exton-Smith and used an even balance. Subjects in the initial trial were 26 healthy women. Subsequently, fecal consistency was measured in a representative sample of the general Japanese population, in order to evaluate the optimal value to maintain large bowel function. RESULTS: Correlations between fecal consistency and fecal water content and weight were statistically consistent, although not highly correlated with each other. The optimal mean value was around 300 cm2: 'normal' in 'subjective defecatory state', 295.5 cm2 and 305.2 cm2; 'once/day' in 'defecation frequency', 296.1 cm2 and 310.2 cm2; 'soft and plump' in 'fecal characteristics', 293.6 cm2 and 298.3 cm2, in males and females, respectively. The coefficient of variation of this method ranged from 5.2% to 6.3%. CONCLUSIONS: This method is thought to be applicable to large-scale epidemiological surveys. The optimal value of fecal consistency in the general population was evaluated at approximately 300 g/cm2.

Adult↗
PubMed2002

Production of chemokines and reactive oxygen species by human neutrophils stimulated by Helicobacter pylori.

BACKGROUND: Bacteria have different characteristics in stimulation of human neutrophils to produce reactive oxygen species (ROS) and chemokines. This study examined the ability of Helicobacter pylori to induce production of ROS and chemokines by human neutrophils. METHODS: H. pylori strains (1.5 x 108 CFU/ml) were cocultured with 5 x 104 neutrophils isolated from healthy subjects. Samples were incubated with human serum with or without IgG antibodies to H. pylori. ROS production was measured using luminol-dependent chemiluminescence (LmCL), and the concentrations of chemokines (IL-8, RANTES, MIP-1alpha and MCP-1) were measured by ELISA. RESULTS: The mean of the highest LmCL (peak height; PH) value stimulated by H. pylori was 3318 in the absence of serum. PH increased to 4687 when incubated with anti-H. pylori antibody-positive sera (p <.001) but antibody-negative sera did not affect LmCL response. The mean final concentration of IL-8 produced in the absence of serum was 142.6 pg/ml. Increased IL-8 production was seen by addition of antibody positive serum (p <.01). IL-8 production was not significantly correlated with production of ROS. On the other hand, H. pylori stimulation did not induce neutrophil production of RANTES, MIP-1alpha or MCP-1. CONCLUSIONS: H. pylori was capable of inducing IL-8 production by human neutrophils, but not C-C chemokines. Production of C-X-C dominant chemokine by neutrophils is consistent with the pathological characteristics of H. pylori-induced gastritis, where persistent neutrophil infiltration is present.

Cells, Cultured↗
PubMed2002

Cyclooxygenase-2 expression is increased in early intestinal-type gastric cancer and gastric mucosa with intestinal metaplasia.

OBJECTIVE: Cyclooxygenase-2 (COX-2) expression is increased in gastric cancer. We examined COX-2 expression in early stage gastric cancer and background mucosa to elucidate the role of COX-2 in gastric carcinogenesis. METHODS: Thirty-three early gastric cancers obtained from 30 patients infected with Helicobacter pylori were studied. Twenty-three patients had an intestinal, four patients had a diffuse, and three patients had both an intestinal and a diffuse type cancer. Expression of COX-2 protein was detected by immunohistochemistry by counting the number of positive staining cells per 100 cells. RESULTS: Mean COX-2 expression was 84.1 (SD 11.4) in 26 intestinal type cancers and was significantly higher than that in seven diffuse type cancers (23.1 +/- 9.7) (P < 0.001). In three patients who had both the intestinal and the diffuse type cancer, COX-2 expression was 92, 90 and 83 in the intestinal type cancer and only 25, 24 and 7 in the corresponding diffuse type cancer. In 18 patients who had intestinal metaplasia (15 had incomplete metaplasia), COX-2 expression was 60.2 (24.2) in the crypts with metaplasia while it was only 16.8 (10.7) in the crypts without metaplasia (P < 0.001). CONCLUSIONS: COX-2 expression may be associated with the carcinogenesis of the intestinal type gastric cancer and, speculatively, inhibition of COX-2 might have preventative effects on the intestinal type gastric cancer.

Cyclooxygenase 2↗
PubMed2002

[Rebamipide].

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Alanine↗