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Biomedical subjects

T Shimoyama

Publications and source records attributed to T Shimoyama.

At least 19 recordsLinked to original sources

The effects of dietary fiber from Lagenaria scineraria (yugao-melon) on colonic carcinogenesis in mice.

BACKGROUND: The increasing trend of colon cancer in Japan is attributed to changes in dietary habits, that is, increased amounts of fat and decreased amounts of fiber in the diet. The effects of Japanese dietary fiber from Lagenaria scineraria (yugao-melon) on colonic carcinogenesis in mice were examined. METHODS: Eighteen ICR mice in each group were fed with either a basal diet or a diet containing 5%, 10%, or 20% of yugao powder for 35 weeks. All the mice received a weekly intraperitoneal injection of 1,2-dimethylhydrazine (DMH), 10 mg/kg body weight for 10 weeks. The effects of yugao powder on the mucosal and luminal variables involved in colonic carcinogenesis were then compared with those of wheat bran in the mice without any carcinogen treatment. RESULTS: The incidence of colon tumors (adenocarcinomas) was lower in the yugao powder diet groups than in the basal diet group at week 35 (24% vs. 50%, P < 0.05). The bile acid concentration in the colon was reduced in all the fiber diet groups except for the 5% yugao powder diet group. The colonic luminal pH acidified as yugao powder contents also increased in the yugao powder diet groups. The findings on the colonic short chain fatty acids, microflora, and mucosal fatty acids and ornithine decarboxylase activity were all inconsistent with a tendency to either develop or to inhibit carcinogenesis in both the fiber diet groups. CONCLUSIONS: Dietary fiber from yugao-melon suppressed DMH-induced colonic carcinogenesis in mice by lowering the bile acid concentration and pH in the colon. The results of the luminal and mucosal variables examined also suggested that the mechanisms of action of yugao powder against colonic carcinogenesis differed from those of wheat brain.

Adenocarcinoma

Detection of immunoreactive antigen, with a monoclonal antibody to measles virus, in tissue from a patient with Crohn's disease.

Using immunofluorescence (IF), we investigated reactive antigens present in Crohn's disease patients with monoclonal antibodies derived from cells infected with measles virus, but not with the subacute sclerosing panencephalitis virus. During immunoblotting, one monoclonal antibody (mAb 86) reacted with a polypeptide with a molecular weight of 36,000 dalton (M; matrix protein) in measles virus-infected cells. This monoclonal antibody displayed a positive reaction only with tissues from patients with Crohn's disease by the IF test. It did not react with samples from patients with other chronic inflammatory bowel diseases, such as ulcerative colitis. Other monoclonal antibodies to the measles virus protein, and monoclonal antibodies to Herpes simplex virus type 1 did not react with the same tissue samples. The role of measles virus infection and/or a viral antigen (possibly the M protein) as a causative agent in Crohn's disease poses a challenging avenue for further research.

Antibodies, Monoclonal

Effect of leukotriene C4D4 antagonist on colonic damage induced by intracolonic administration of trinitrobenzene sulfonic acid in rats.

We examined the effects of eicosanoid antagonists on colonic damage induced by trinitrobenzene sulfonic acid (TNB) in a rat inflammatory bowel model. TNB (30 mg) dissolved in 0.25 ml of 50% ethanol, was given intrarectally. The appropriate doses of ONO-1078 (a leukotriene C4D4 antagonist), ONO-4057 (a leukotriene B4 antagonist), and OKY-046 (a thromboxane A2 synthetase inhibitor) were given to obtain the same blood level, either 4 h before (pre-treatment model) or 24 h after (the post-treatment model) the administration of TNB (n = 8 in all groups). Drugs were given once daily for 6 days through a gastric feeding tube. Autopsy was performed on the 7th day. Colonic damage was assessed in terms of colonic damage scores, and myeloperoxidase (MPO) activity and eicosanoid concentrations in colonic tissues were measured. Compared with the group given TNB alone, the colonic damage score was reduced to 10% in the pre-treatment model with ONO-1078, but the score was not reduced in other groups, MPO activity was not changed in any group. The concentration of leukotriene C4 was reduced with ONO-1078 treatment, in both pre- and post-treatment models. These results demonstrated that a leukotriene C4D4 antagonist reduced colonic inflammation; however, its anti-inflammatory effect was limited in this colitis model.

Animals

Proton pump inhibitors for Helicobacter pylori eradication in patients with peptic ulcer.

We investigated the effects of omeprazole or lansoprazole on peptic ulcer healing, eradication of Helicobacter pylori (Hp) and abdominal symptoms. A prospective, randomized study was performed for the administration of omeprazole or lansoprazole. Hp-positive peptic ulcer patients (n = 86) were randomly assigned to two groups. Gastric ulcer patients received omeprazole 20 mg once daily or lansoprazole 30 mg once daily for 8 weeks. Duodenal ulcer patients were given omeprazole 20 mg once daily or lansoprazole 30 mg once daily for 6 weeks. Endoscopy was performed at baseline, at the end of therapy, and 4 weeks after stopping therapy. The colony factor units (CFUs) of Hp in biopsy specimens were examined. The CFUs of Hp in gastric and duodenal ulcer were significantly decreased at 4 weeks after stopping lansoprazole therapy. We conclude that Hp eradication by combined use of lansoprazole with antibiotics appears to be a promising therapy.

2-Pyridinylmethylsulfinylbenzimidazoles

Eradication of Helicobacter pylori with lansoprazole and clarithromycin in gastric ulcer patients.

This study attempted to determine the efficacy of lansoprazole plus clarithromycin therapy in the eradication of Helicobacter pylori in gastric ulcer patients. The influence of H. pylori eradication on healing and relapse of ulcers was also studied. Thirty-nine patients received either lansoprazole 30 mg daily for 8 weeks (group 1) or clarithromycin 200 mg twice daily for 2 weeks and lansoprazole 30 mg daily for 8 weeks (group 2). Before treatment, H. pylori status was evaluated by a rapid urease test and histologic examination. H. pylori clearance and eradication were evaluated by a rapid urease test, polymerase chain reaction, and a [13C]urea breath test. Clearance of H. pylori was 0% in group 1 and was 33% in group 2. Eradication of H. pylori was 0% in group 1 and 21% in group 2. Although all five ulcers were healed in patients with H. pylori eradication, ulcers were not healed in the five patients without eradication. Relapse of ulcer was observed in three patients in whom eradication had failed. In this study, for H. pylori-positive gastric ulcer patients, better results were obtained when lansoprazole plus clarithromycin therapy was used, and H. pylori eradication was achieved.

2-Pyridinylmethylsulfinylbenzimidazoles

Combination therapies with a proton pump inhibitor for Helicobacter pylori-infected gastric ulcer patients.

We investigated the eradication and recurrence rate of Helicobacter pylori-infected gastric ulcer patients by combination therapies. Eighty-six H. pylori-positive gastric ulcer patients were assigned randomly to one of seven groups: I, omeprazole 20 mg (n = 9); II, lansoprazole (LPZ) 30 mg (n = 16); III, LPZ 30 mg plus plaunotol 480 mg (n = 13); IV, LPZ 30 mg plus ecabet sodium 2 g (n = 11); V, LPZ 30 mg plus clarithromycin 600 mg (the first 2 weeks; n = 11); VI, LPZ 30 mg plus plaunotol 480 mg plus clarithromycin 600 mg (the first 2 weeks; n = 13); and VII, LPZ 30 mg plus ecabet sodium 2 g plus amoxicillin 1,500 mg (the first 2 weeks; n = 13). All therapy was for 8 weeks except where otherwise noted. H. pylori eradication rates as diagnosed by culture, histology, urease test, and [13C]urea breath test 4 weeks after stopping therapy were 0, 0, 8, 45, 6, 46, and 62%, respectively, in groups I-VII. No patient achieving H. pylori eradication suffered recurrence. The combination therapies with proton pump inhibitors in addition to antibiotics and antiulcer agents are safe and effective in H. pylori eradication.

2-Pyridinylmethylsulfinylbenzimidazoles

Two cases of symptomatic elongated styloid process.

Two cases of elongated styloid process are reported. The first occurred in a 27-year-old man whose only complaint was pain when moving the jaw, and its differential diagnosis was comparatively simple. The second case occurred in a 33-year-old woman, for whose condition differential diagnosis was more difficult, as she presented many symptoms, including neuralgic pain in the face and neck, pain in the pharynx when swallowing, and pain in the region of the temporomandibular joint, radiating to the subauricular and submandibular regions. Following surgical shortening of the elongated styloid process through an intraoral approach, both patients' symptoms disappeared or were improved.

Adult

Surgical advancement of the mandible through sagittal ramus osteotomy.

The sagittal split-ramus osteotomy (SSRO) technique has gained widespread acceptance, for it can be easily adapted to correct a wide variety of mandibular abnormalities. However, in spite of its many advantages, numerous investigators have reported postoperative relapse following mandibular advancement surgery. SSRO was performed on four patients with deficiency of mandibular growth which had led to characteristic protrusion of the maxilla. In three of the four cases, postoperative skeletal relapse occurred, which was corrected by postoperative orthodontic treatment.

Adult

[An enzyme-linked immunosorbent assay determining anti-principal neutralizing determinant antibodies using synthetic peptides deduced from cDNA sequences of HIV-1 V3 loop domain].

The V3 domain, one of the hypervariable regions of gp 120 in HIV-1 possesses principal type-specific neutralizing determinant (PND). The V3 domain has the epitopes for class I major histocompatibility antigens of cytotoxic-T lymphocyte and helper-T-lymphocyte recognition sites, and also has major determinants for cell tropism towards macrophage, microglia, and human brain-derived fibroblast. Therefore, establishment for the assay of anti-PND antibodies in patients with HIV-1 infection appears to be important for the estimation on developing AIDS in these patients. We here describe a simple enzyme-linked immunosorbent assay (ELISA) for the measurement of anti-PND antibodies found in Japanese hemophiliacs. ELISA was performed using synthetic peptides, each 15 amino acid residues deduced from cDNA sequences of seven HIV-1 V3 domain mutants, which include 5 North-American and European strains (IIIB, MN, RF, SC, and WMJ-2) and 2 African strains (Af1. Con and Af2, Con). The specific antibody binding to each peptide was determined after subtraction of the non-specific binding from the total. In 49 control sera from healthy individuals with HIV-1 antibody negative, the absorbance (M +/- 1SD) at 405 nm was -0.002 +/- 0.064. Then, the cut off value was determined to be M + 4SD. In 48 hemophiliac sera with HIV-1 antibody negative, the absorbance was uniformly less than the cut off value. However, among 44 hemophiliac sera with HIV-1 antibody positive, the anti-PND antibodies were detected in the following frequencies; 2 for IIIB, 20 for MN, 1 for RF, 1 for Af1. Con, and 5 for Af2. Con.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Serodiagnosis

[The use of a laryngeal mask in a newborn infant with Nager acrofacial dysostosis].

A newborn female infant born at 41 week gestation with Nager acrofacial dysostosis had no congenital abnormalities in her parents and closed relatives. Her mother had uncomplicated pregnancy and normal delivery. Endotracheal intubation was attempted, because she developed apnea on her delivery, but it was not successful. She was transported immediately to our university hospital with mask ventilation. A laryngeal mask was placed after several trials of intubation, and ventilation was carried out successfully. We consider that the use of a laryngeal mask is one of the best ways in a case of difficult intubation.

Abnormalities, Multiple

Double-blind comparative study of sulfasalazine and controlled-release mesalazine tablets in the treatment of active ulcerative colitis.

To evaluate the effect of a controlled-release mesalazine tablet, in patients with ulcerative colitis (UC), a multicenter double-blind study was carried out, using sulfasalazine (500 mg tablet) as the control drug. The mesalazine tablet contained 250 mg of ethyl cellulose-coated mesalazine granules. The patients were assigned to two groups, one to receive mesalazine tablets (1500 mg/day) and a sulfasalazine placebo (group M) and the other to receive sulfasalazine tablets (3000 mg/day) and a mesalazine placebo (group S). The test medications were administered orally for 4 consecutive weeks. The study subjects were selected from among patients with mild to moderate active UC, and 118 patients were enrolled. Concomitant use of steroids and immunosuppressors was prohibited during the study period. Of the 118 patients, 9 dropped out. A total of 109 complete records were thus obtained, 52 in group M and 57 in group S. There was no difference in the improvement of clinical symptoms and endoscopic findings between the two groups. The overall safety, based on adverse reactions and laboratory data, was higher, at 86.5%, for group M (n = 52), compared to 66.7% for group S (n = 57). The general usefulness, based on the improvement and safety, was higher, at 65.3%, for group M (n = 49), compared to 45.6% for group S (n = 57). The controlled-release mesalazine tablet thus appears to be useful in the treatment of mild to moderate active UC.

Adult

Leukocytapheresis therapy with leukocyte removal filter for inflammatory bowel disease.

Leukocytapheresis (LCAP) with a leukocyte removal filter was administered to 44 patients with inflammatory bowel disease (IBD), diagnosed as ulcerative colitis (UC) in 25 and Crohn's disease (CD) in 19. Clinical and blood examinations showed no side effects in any of the patients. During intensive therapy, clinical improvement was recognized in 21 of the 25 UC patients (84%), 8 of whom had an excellent response, and in 16 of the 19 CD patients (84.2%), 4 of whom had an excellent response. The clinical improvement continued throughout the maintenance therapy in 19 of the UC patients (76%) and in 12 of the CD patients (63.2%). In both the UC and the CD patients, flow cytometry study showed that those who had improved generally had high values for the percentages of HLADR+, HLADR+CD3+, HLADR+CD8+, and CD11a+CD8+ cells before the first LCAP, and that these values decreased to near the normal range after both intensive and maintenance therapy. In the patients who showed poor response, in contrast, the values had been at or near normal before the initial LCAP administration. The clinical improvement and the findings on flow cytometry suggest that LCAP exerts an immuno-modulatory effect and is an effective therapy for patients with IBD in whom conventional drug treatments have failed.

Case-Control Studies

Long-term follow-up study of ulcerative colitis in Japan.

To clarify the long-term prognosis of Japanese patients with ulcerative colitis, we investigated the cumulative colectomy rate and the survival rate, and compared the results with reports from Western countries. The subjects were 778 patients who had visited 8 hospitals from 1973 to 1990. A total of 114 of the 778 patients (14.7%) had required colectomy and 21 (2.7%) had died. These rates were higher in the patients who had total colitis, and in those who had acute fulminant type of severe type. There were no significant differences in these rates according to age of onset (under 29 years, 30-49 years, and more than 50 years). The cumulative colectomy rate increased rapidly within 2 years after onset. Thereafter, the rate increased gradually, by 1%-2% per year. In patients with total colitis, 14.1% required colectomy within 2 years. The age at onset had no effect on this rate. The cumulative survival rate decreased gradually throughout the first 10 years, the rate being 96.2% in the 10th year. No deaths occurred in the 11-18th years after onset. Despite our inclusion of more patients with total or severe colitis, our results were similar to or slightly superior to those reported from Western countries; this may be attributed to a temporal bias.

Adolescent

Efficacy of nutritional therapy for active Crohn's disease.

We investigated the effect of nutritional therapy with an elemental diet (ED) for active Crohn's disease. One hundred and thirty-nine patients with Crohn's disease were enrolled in this study. Remission was judged to be present when the International Organization of Inflammatory Bowel Disease score was < or = 1 and the CRP and ESR values were within the respective normal ranges. An amount of 30kcal per 1kg of ideal body weight (IBW) per day was administered enterally, and the effect on the induction of remission in relation to various patient background factors, such as disease type, history of bowel resection, and the presence/absence of complications, was determined. An excellent remission rate was achieved in those patients to whom an adequate amount of ED could be administered. Remission rates were lower in the patient groups with any of the following complications: stenotic bowel lesions, abdominal masses, fistulas, and anal lesions. Even in those groups in which stenotic lesions or abdominal masses were present, when adequate amounts of ED could be administered, the remission rate did not differ from that in the groups without these complications. The remission rates in the groups with and without fistulas at any site, including fistulas in the anal region, were 40.0% and 82.5%, respectively, with remission being considerably easier to achieve in the patients without fistulas. Similarly, remission was difficult to achieve when anal lesions were present. These results suggest that, for active Crohn's disease, nutritional therapy with ED ( > or = 35kcal/kg IBW) should be enthusiastically administered, and in patients in whom the presence of complications necessitates therapy for 3 months or more, this point be considered to indicate a possible surgical approach.

Adult

Combination therapy with mucosal protective agent for the eradication of Helicobacter pylori.

OBJECTIVE: To investigate the effect of plaunotol in combination with proton-pump inhibitors on Helicobacter pylori eradication in patients with gastric ulcer. PATIENTS AND METHODS: We studied 65 H. pylori-positive gastric ulcer patients. They were randomly assigned to five treatment groups: omeprazole (group I, n = 8), lansoprazole (group II, n = 13), lansoprazole+plaunotol (group III, n = 12), lansoprazole+clarithromycin (group IV, n = 16) and lansoprazole+plaunotol+clarithromycin (group V, n = 16). Ulcer status was diagnosed by endoscopy and H. pylori status by culture, histology, a urease test and a urea breath test at baseline, and after 8 and 12 weeks. The clearance and eradication rates were compared in each group. RESULTS: The healing rates in groups I-V were 100, 92, 100, 100 and 100%, respectively; clearance rates were 0, 23, 42, 50 and 75%, respectively; and eradication rates were 0, 0, 8, 38 and 69%, respectively. CONCLUSION: Combination therapy with plaunotol is efficacious for the eradication of H. pylori in gastric ulcer patients.

Anti-Bacterial Agents