Biomedical subjects

T Fujioka

Publications and source records attributed to T Fujioka.

At least 127 records · Page 7Linked to original sources

PubMed1998

Highly sensitive urine-based enzyme-linked immunosorbent assay for detection of antibody to Helicobacter pylori.

BACKGROUND: Enzyme-linked immunosorbent assay (ELISA) has been widely used for detection of Helicobacter pylori (H. pylori), but sample collection is often invasive, complicated, and expensive. Urine samples can be obtained noninvasively and are easier and safer to handle than serum samples. A urine-based ELISA, if found to be accurate, would therefore be a useful alternative to serum-based tests for H. pylori. METHODS: An ELISA method was developed for detection of antibodies to H. pylori in urine. Its sensitivity and specificity were compared with those of three commercially available serum-based ELISA kits and the 13C urea breath test (13C-UBT) using samples from 99 healthy volunteers and 20 patients with gastric disorders. RESULTS: With the assumption that 13C-UBT results are 100% accurate, the sensitivity and specificity of the urinary ELISA were 99% and 100%, respectively, and the accuracy (99%) was superior to those of the three serum ELISAs tested. Immunostaining profiles on Western blot analysis using serum samples were almost identical to those obtained using paired urine samples. CONCLUSIONS: These findings suggest that the differences observed among ELISA test results may be due principally to differences between the profiles of antigen coated on plates for the assays, rather than to differences between antibodies in serum and urine. The urine-based ELISA (URINELISA H. pylori) developed in this study is very accurate and would be useful for screening H. pylori infection as an alternative to serum ELISAs.

Antibodies, Bacterial↗

PubMed1998

Gastric ulcer, atrophic gastritis, and intestinal metaplasia caused by Helicobacter pylori infection in Mongolian gerbils.

BACKGROUND: Helicobacter pylori infection is associated with gastroduodenal disease in humans. In this study we aimed to show this relationship directly in Mongolian gerbils. METHODS: The animals were challenged orally with H. pylori and killed 1, 2, 3, and 6 months after inoculation for histologic and anti-H. pylori antibody titer examination. RESULTS: The spiral bacteria were observed in the mucus and gastric pits of all infected animals. A severe infiltration of the lamina propria by polymorphonuclear and mononuclear cells was seen 1 month after H. pylori inoculation. The submucosa was infiltrated by mainly mononuclear cells with formation of lymphoid follicles. Erosion of the gastric mucosa appeared soon after inoculation, whereas gastric ulcers, gastritis cystica profunda, and atrophy with goblet cell metaplasia occurred between 3 and 6 months after inoculation. In the duodenal mucosa a mild inflammatory cell infiltration with ballooning and diminished number of duodenal glands was seen. The IgG anti-H. pylori antibody titer increased gradually after 2 months of inoculation. CONCLUSIONS: Since the gastritis, gastric ulcers, atrophic gastritis, and intestinal metaplasia that developed in Mongolian gerbils were similar to those observed in humans, this model may be useful to study the therapy of gastric ulcer and, with a longer observation period, to confirm a possible relationship between H. pylori and malignancy.

Animals↗

PubMed1998

Association of replication error positive phenotype with lymphocyte infiltration in endometrial cancers.

Microsatellite instability (MI) has been detected in certain sporadic cancers as well as in hereditary non-polyposis colorectal cancer (HNPCC). In order to determine the precise clinicopathological characteristics of MI in endometrial cancer, we examined 90 sporadic endometrial cancers (83 endometrioid adenocarcinomas, 3 adenosquamous carcinomas, 3 papillary serous carcinomas, and 1 clear cell carcinoma) and eight lesions of endometrial hyperplasia for replication error (RER) using polymerase chain reaction amplification of CA repeated microsatellite sequences at 15 loci. RER was observed in 23 (28%) of the 83 endometrioid adenocarcinomas at at least one locus and in 19 (23%) at two or more loci (RER+ phenotype) in the seven most commonly observed loci, but not in carcinomas of other histological types or in endometrial hyperplasia. Lymphocyte infiltration around carcinoma cells, which is one of the histological features seen in tumors from HNPCC, was severer in RER+ phenotype tumors (79%, 11/14) than in the RER- tumors (25%, 11/44) (marked/moderate infiltration versus slight, P < 0.001, chi 2 test), when 58 tumors with muscular invasion were examined. The RER+ phenotype was associated with a higher parity and gravidity (P < 0.05, Wilcoxon test). However, RER+ phenotype was not associated with tumor stage, histological grade, muscular invasion, lymph node metastasis or patient survival. In conclusion, MI occurs in a subset of endometrial cancers, which often show marked infiltration of lymphocytes around the tumor.

Adenocarcinoma↗

PubMed1998

Familial occurrence of congenital bile duct cysts.

Congenital bile duct cysts are now a well-documented anomaly of the biliary tree, and have become more common in Japan. Familial occurrence of congenital bile duct cysts, however, is extremely rare, with only six reported cases in the literature. We report a familial pattern of congenital bile duct cysts in a mother and her daughter. A 33-year-old female was admitted for evaluation of right upper quadrant abdominal pain and fever 6 days after an uneventful delivery of her second child. A computed tomography (CT) and ultrasound scan (US) revealed an obstructed biliary tract. Percutaneous transhepatic biliary drainage was then performed, and a cholangiogram revealed a Scholtz type B choledochocele without an anomalous connection of the pancreaticobiliary ducts. Endoscopic US demonstrated that the choledochocele was associated with a stone in the cyst. A pylorus-preserving pancreatoduodenal resection was performed, and a histological study revealed that the choledochocele was lined by biliary mucosa without evidence of malignancy. The newborn infant had an abdominal tumour. An US and CT revealed a congenital bile duct cyst. An operation was performed and the intraoperative cholangiogram showed an Alonso-Lej type I congenital bile duct cyst with an anomalous connection of the pancreaticobiliary ducts. Whether congenital bile duct cysts are hereditary remains to be elucidated.

Adult↗

PubMed1998

p53 expression in gastric mucosa with Helicobacter pylori infection.

Expression of p53 was examined immunohistochemically in the Japanese monkey model with Helicobacter pylori infection of the gastric mucosa to investigate the association between H. pylori infection and gastric carcinogenesis for a period of 4 years. In the course of these observations, from 3 years after H. pylori inoculation, nuclear staining for p53 was seen in the glandular cells of the mucosa infected with H. pylori, especially in the neck region of the glands. There was a gradual increase in the number of immunopositive cases among the infected animals. Three years after inoculation, three out of six cases, and 4 years after inoculation, four out of six cases exhibited positive staining for p53. Before inoculation, and up to 2 years after inoculation, the infected group showed no immunoreaction for p53. The non-infected group likewise displayed no immunostaining for p53 through 4 years of observation. These results suggest that p53 alterations occur in the H. pylori-infected gastric mucosa and that H. pylori infection may play an important role in gastric carcinogenesis.

Animals↗

PubMed1998

Renal small cell carcinoma (neuroendocrine carcinoma) without features of transitional cell carcinoma.

Seventeen cases of renal small cell carcinoma have been reported in the literature. Approximately half of the reported cases show combined features of transitional cell carcinoma. Presented herein is a case of renal small cell carcinoma in a 37-year-old Japanese male who had been treated for 10 years with famotidine for duodenal ulcer. He suffered from sudden-onset chest pain at presentation and myxoma of the right atrium was suspected. He was treated by atriotomy and a tumor was removed from the right atrium and pulmonary artery. Histological examination, however, revealed it to be small cell carcinoma. Accordingly, a radical operation was performed for the removal of a tumor found in the right kidney. Histological examination of the tumor confirmed the presence of renal small cell carcinoma without any features of transitional cell carcinoma. It is reported that long-term administration of an histamine 2 (H2) receptor antagonist may produce carcinoid tumors in rodents and enterochromaffin-like cell hyperplasia in humans. The possible relationship between neuroendocrine carcinoma and H2 receptor antagonist therapy is discussed.

Adult↗

PubMed1998

Biopsy sites suitable for the diagnosis of Helicobacter pylori infection and the assessment of the extent of atrophic gastritis.

OBJECTIVES: We performed this study to determine which biopsy sites in the stomach are suitable for the diagnosis of Helicobacter pylori infection and the assessment of the extent of atrophic gastritis. METHODS: Endoscopy was performed in 76 H. pylori-positive patients with histologically confirmed chronic gastritis. Biopsies were taken from the following six sites: the lesser curvatures of the mid-antrum (site 1), the angulus (site 2), the middle body (site 3), and the greater curvatures of the mid-antrum (site 4), the angulus (site 5), and the middle body (site 6) of the stomach. The extent of atrophic gastritis was assessed endoscopically as well as histologically, and patients were classified into five groups according to its extent. H. pylori status was assessed histologically. The histological severity of inflammation, activity, atrophy, and intestinal metaplasia was assessed according to the Updated Sydney System. The grades of these items were compared among the six biopsy sites in each group of patients. RESULTS: Site 6 was most reliable for the diagnosis of H. pylori infection, and site 4 was suitable for examining the status of H. pylori colonization in the antrum. Site 1, site 3, and site 6 were suitable for the assessment of the extent of atrophic gastritis. CONCLUSIONS: Our results indicate that for an accurate diagnosis and assessment, biopsies should be taken from the following four sites: the lesser curvatures of the mid-antrum (site 1) and middle body (site 3), and the greater curvatures of the mid-antrum (site 4) and middle body (site 6) of the stomach.

Adult↗

PubMed1998

In vitro cytotoxic effects of vacuolating cytotoxin produced by clinical isolates of Helicobacter pylori.

The vacuolating cytotoxin produced by Helicobacter pylori is considered to be one virulence factor causing peptic ulceration. In this study, we examined the activity of vacuolating cytotoxin in induction of intracellular vacuolation of rabbit gastric epithelial cells (RGECs). We used culture supernatants of H. pylori as a source of vacuolating cytotoxin and quantitated cytotoxic activity by the MTT method. Intracellular vacuolation of RGECs was observed in the presence of 36 of 57 (63%) clinically isolated H. pylori strains. However, there were no differences in the incidence of H. pylori strains with positive vacuolating cytotoxin (Tox+) among patients with gastritis, gastric ulcers or duodenal ulcers. The MTT assay showed that the cytotoxic activity of H. pylori supernatants obtained from patients with gastric ulcers was significantly higher than in patients with gastritis (p < 0.01), but was not different to duodenal ulcer patient supernatants. Similar results were also observed in Tox+ isolates, however, there were no significant differences between patients with regard to the incidence of vacuolating cytotoxin-negative isolates. Although our data may not indicate a clear correlation between prevalence of vacuolating cytotoxin and clinical manifestations, they suggest that H. pylori harboring vacuolating cytotoxin may particularly induce damage to the gastric epithelium in patients with gastric ulcers.

Animals↗

PubMed1998

Sensitive detection of Helicobacter pylori in gastric aspirates by polymerase chain reaction.

The detection of Helicobacter pylori in gastric aspirate was examined by using the polymerase chain reaction (PCR) method for amplifying a specific fragment of the urease gene A. The ability of PCR to amplify H. pylori-specific DNA was analyzed by Southern hybridization with an internal oligonucleotide probe. Twenty-two H. pylori strains from clinical isolates and reference strains were studied, and all H. pylori strains yielded a 356-bp product that hybridized with the oligonucleotide probe, whereas no amplification was evident with 18 non-H. pylori strains. This could detect as little as 50 CFU of H. pylori in pure culture and 0.1 pg of purified chromosomal DNA. A total of 50 dyspeptic patients were examined for the presence of H. pylori by culture, the rapid urease test and histological examination of antral biopsy samples as well as by PCR in gastric juice aspirate samples. The gold standard for the presence of H. pylori was established by minimum concordance of two of three tests performed on biopsy specimens. With this gold standard, 34 of the 50 patients were considered to harbor H. pylori infection. PCR correctly identified 32 (94.1%) of these 34 infected patients. PCR had the best combination of sensitivity and specificity in assessing the correct diagnosis of H. pylori as compared with those of the rapid urease test and culture. Moreover, we established a fast and simple method for use by improvement of DNA extraction. PCR of the gastric aspirate was shown to be a sensitive and specific procedure which may be an attractive alternative to methods currently used for diagnosis of H. pylori infection.

Adult↗

PubMed1998

[In vitro activities of faropenem against clarithromycin resistance Helicobacter pylori isolates].

Agar dilution and semi-solid agar dilution were used to determine the MIC of faropenem (FRPM) against 24 H. pylori isolates. FRPM was active against clarithromycin resistance H. pylori isolates. And, the MICs obtained by both methods were in agreement. The results suggest that FRPM was not affected by pH and is a clinically useful oral antibiotic for the eradication therapy of H. pylori infections.

Anti-Bacterial Agents↗

PubMed1998

[A mechanism of clarithromycin resistance in Helicobacter pylori].

The aim of this study was to elucidate the mechanism of clarithromycin (CAM) resistance in laboratory strains and clinical isolates of Helicobacter pylori. The CAM resistance in laboratory strains was induced in vitro by CAM exposure. The majority of CAM-resistant strains were highly resistant to CAM (MICs > 100 micrograms/ml). These CAM-resistant strains also showed cross resistance to azithromycin, rokitamycin and clindamycin. The sites of point mutations in these resistant strains were identified as follows; the conserved domain V of genes encoding 23S rRNA were amplified first by PCR and this PCR products (1.4 kb) were subsequently digested with BsaI and MboII and RFLP patterns were analyzed. 1.4 kb amplicons of CAM-susceptible strains yielded two DNA bands of 1000 bp and 400 bp when digested with BsaI but no digestion product was seen by MboII digestion. In contrast to this, two types of RFLP patterns were observed for the resistant strains induced in vitro by CAM; one was the formation of three bands (700 bp, 400 bp and 300 bp) after BsaI digestion, and the other was the formation of two bands (approximately 700 bp) by MboII digestion. RFLP patterns of CAM-susceptible and CAM-resistant clinical isolates obtained from patients before and after CAM medication were similar to those observed for the CAM-susceptible strains and CAM-resistant strains developed in the laboratory. These results strongly suggest that the CAM resistance of H. pylori was caused by point mutation of 23S rRNA.

Anti-Bacterial Agents↗

PubMed1998

Serological assessment of the early response to eradication therapy using an immunodominant outer membrane protein of Helicobacter pylori.

Eradication of Helicobacter pylori infection cures gastritis and prevents recurrence of peptic ulcers. Endoscopy is usually used to evaluate the effectiveness of eradication therapy. We designed a new noninvasive assay system for the early evaluation of eradication of H. pylori infection in which a crude H. pylori outer membrane protein preparation (HPOmp) is used as an antigen, and we determined the sensitivity and specificity of the serological assay system. Immunoblot analysis showed that anti-HPOmp antibodies reacted to a protein with a molecular mass of approximately 29 kDa. In those patients who responded to therapy, the anti-HPOmp immunoglobulin G (IgG) titers measured by enzyme-linked immunosorbent assay (ELISA) at 1 month after the end of therapy were significantly lower than those before treatment (34.8% reduction; P < 0.001), and the posttreatment reduction in the antibody titer was significantly greater than that of the titer measured with a commercially available anti-H. pylori IgG ELISA (34.8% versus 16.1%; P < 0.001). When a 25% reduction of anti-HPOmp IgG titer at 1 month after the end of treatment was taken as the cutoff value for H. pylori eradication, the sensitivity and specificity of our new assay were 75% (51 of 68 treatment responders) and 96% (22 of 23 nonresponders), respectively. Our results indicate that the novel serological test with HPOmp might be a clinically useful tool for assessment of eradication of H. pylori.

Adolescent↗

PubMed1998

Diversity in protein synthesis and viability of Helicobacter pylori coccoid forms in response to various stimuli.

The viability of the coccoid forms of Helicobacter pylori was evaluated by assessing protein synthesis. Metabolic labeling studies showed the synthesis of proteins and the specific protein profiles of H. pylori coccoids produced under various conditions. Harsh conditions such as aerobiosis and starvation (lack of horse serum) in the culture did not affect the synthesis of proteins in the coccoids. Lowering of the pH to that of gastric secretions induced expression of several proteins in the coccoids. However, the coccoids produced under prolonged microaerobic conditions exhibited a profile of acid stress-induced protein expression different from that induced by aerobiosis or starvation. Our data suggest that coccoid H. pylori exhibits diversity in viability following exposure to different stresses and that the response to acid stress of coccoid H. pylori could be involved in infection of the host stomach.

Acids↗

PubMed1998

Lung cancer: intermittent irradiation synchronized with respiratory motion--results of a pilot study.

PURPOSE: To test the feasibility of a system for intermittent irradiation synchronized with respiratory motion in a clinical setting. MATERIALS AND METHODS: A newly developed gate pulse controller that starts and stops irradiation at a chosen phase of the respiratory cycle by controlling a linear accelerator was used in six patients with lung cancer. A laser displacement sensor was used for the detection of respiratory motion. Three patients underwent radiation therapy during the cycles between 50% expiration and 50% inspiration (step 1), and three patients underwent radiation therapy during the cycles between 70% expiration and 30% inspiration (step 2). RESULTS: The system functioned well; irradiation was verified with portal verification radiography in all six patients. The range of the tumor position during synchronized irradiation was detectable with fast portal localization radiography. The treatment times for steps 1 and 2 were 1.38-1.71 and 2.03-2.18 times longer, respectively, than those for conventional irradiation. CONCLUSION: Synchronized irradiation with the authors' system allowed convenient and reliable reduction of the target volume. Further study is needed to standardize the system for clinical use.

Clinical Protocols↗

PubMed1998

Stress and brain angiotensin II receptors.

Angiotensin II (ANG II) has been recognized recently as one of the stress hormones that participate in various stress-induced responses, including sympathetic (pressor, tachycardiac, and hyperthermic) and neuroendocrine responses. Brain ANG II receptors have been identified in many brain regions involved in the stress responses. During stress-exposure, ANG II increases in the plasma and in the brain. Central administration of ANG II induces stress responses, whereas central blockade of ANG II receptors results in the inhibition of the sympathetic and neuroendocrine responses to stress. All these findings indicate that ANG II and its receptors contribute to the development of various sympathetic and neuroendocrine responses during stress exposure. This review focuses on the role of brain ANG II receptors in the stress-induced responses.

Adrenocorticotropic Hormone↗

PubMed1998

[The results of a long-term follow-up for patients with stage Ta bladder cancer, especially regarding those with multiple recurrences].

OBJECTIVE: We reviewed our series of stage Ta bladder cancer patients with a long-term follow-up in order to clarify the prognosis of these patients, especially those who have repeated recurrences. MATERIALS AND METHODS: A retrospective study was done on 88 patients with stage Ta bladder cancer who were treated between 1971 and 1990 at our hospital. All patients reviewed were followed up for at least 5 years. RESULTS: Fifty-three patients out of 88 had recurrence, and the number of recurrences ranged from one to eleven. In the first recurrence, the 5- and 10-year recurrence-free rates were 53.4% and 37.1%, respectively. In the second recurrence, those rates were 25.7% and 15.9%, respectively. Comparisons of the recurrence-free rates between the first recurrence and that of more than 2 times yielded statistically significance (p < 0.01). On the other hand, when the recurrence-free rates of those patients showing recurrence more than 2 times were compared no statistical significance was observed among them. In addition, most patients with multiple recurrences also tended to show a long tumor-free period at some point. In eight patients a stage-up of > or = T1 developed during the study period. No characteristics of the tumors, including the multiplicity of the recurrence, was found to correlate with the stage-up. CONCLUSIONS: Most patients with multiple recurrences demonstrated a long tumor-free period at some point, and, moreover, in some of those patients there was also a possibility that no further recurrence occurred. In addition, frequent recurrence was not associated with increased incidence of stage-up. Based on these findings, multiple recurrence is not thought to be an especially ominous sign, and therefore bladder-preserving therapy is indicated for such patients.

Adult↗

PubMed1998

[A case of laparoscopic nephrectomy for ectopic vaginal ureter in a child].

An 11-year-old girl presented with continuous incontinence since infancy. Neither intravenous pyelography nor renal scintigraphy demonstrated the left upper urinary tract, but a very small left kidney was detected close to the 3rd lumbar vertebrae on computed tomography (CT). After cystoscopy, the patient was diagnosed with ectopic vaginal ureter and hypoplastic kidney. Laparoscopic nephrectomy was performed. Before surgery, a ureteral occlusion catheter was inserted through the meatus which opened in the vagina. The catheter was very useful for locating the small kidney during surgery. The procedure was successful and the surgical duration was short (123 min.) with only slight hemorrhage (15 ml). The patient was able to attend school on the seventh postoperative day. We recommend laparoscopic surgery for the treatment of ectopic ureter.

Child↗

PubMed1998

Inhibition of tumor growth and angiogenesis by vitamin D3 agents in murine renal cell carcinoma.

PURPOSE: To investigate the effect of active vitamin D3(VD) agents on tumor growth and metastasis. MATERIALS AND METHODS: BALB/c mice were inoculated with murine renal cancer Renca and graded doses of 1,25-dehydrovitamin D3 or 1- hydrovitamin D3 were given intraperitoneally every other day beginning on day 1, 3, or 7 and ending on day 9, 11, or 15. Direct cytocidal activity and angiogenic activity were evaluated by 48-hour MTT assay and by the colorimetric method, respectively. RESULTS: Both VD agents inhibited tumor growth and prolonged the life span of Renca-bearing mice in a dose-dependent manner and both suppressed tumor growth in athymic mice and euthymic mice with eliminated NK activity. Marginal body-weight loss without appreciable hypercalcemia was observed in mice given VD agents. When treatment was delayed on day 7, the VD agents failed to inhibit tumor growth. The MTT assay showed no direct cytotoxicity of VD agents on Renca. Tumor angiogenesis was inhibited to 46 to 30% of the control level by VD agents. Furthermore, VD agents reduced pulmonary and hepatic foci in the metastatic models. CONCLUSIONS: These results suggest that VD agents may be effective as a treatment for renal cell carcinoma, especially when micrometastases are involved.

Animals↗