Suitable diagnostic methods for H. pylori infection after eradication therapy

Urease test, histology, culture, urea breath test(UBT) and stool antigen test are accurate tests for Helicobacter pylori diagnosis. General practitioners are now going to test peptic ulcer disease patients with these tests before and after in Japan. To test with high accuracy after eradication therapy, it is important that examination should be done over 4 weeks after cessation of treatment with PPI and antibiotics. UBT and stool antigen test are suitable tests for diagnosis of Helicobacter pylori infection after treatment.     

A case of a bacterial brain abscess presenting as symptoms of 'sudden stroke-like' onset

We report a case of a bacterial brain abscess presenting symptoms of 'sudden stroke-like' onset, associated with infective endocarditis. A 59-year-old woman experienced a sudden stroke-like onset of left hemiplegia. Computed tomography (CT) and magnetic resonance imaging (MRI) were performed on the day of ictus. No lesion responsible for the symptom was seen on either CT or a T2 weighted image (T2WI), but a diffusion-weighted image (DWI) revealed focal increased signal intensity in the right frontal lobe. An initial diagnosis of acute embolic infarction associated with infective endocarditis was made. Although the patient's neurological state had been stable, motor paresis of her left extremities became worse starting one month after her admission. MRI with gadolinium-diethylenetriaminepenta-acid (Gd-DTPA) at 37 days after admission showed an irregular-shaped ring-enhancement lesion located at the same place as the initial infarction, and in the left frontal lobe. Surgical drainage of the lesion in the right frontal lobe was performed, and diagnosed as a bacterial abscess. The exact mechanism of a bacterial brain abscess presenting with 'sudden stroke-like' onset is unknown, but various hypotheses have been proposed. One is that paroxysmal septic emboli lead to abscess formation within or near the area of embolic infarction. Our case showed that the creation of a brain abscess followed embolic strokes, and that this hypothesis was demonstrated by MRI carried out on the day of ictus.     

Ionic interaction of [<Superscript>11</Superscript>C]-<Emphasis Type="Italic">N</Emphasis>, α-dimethylbenzylamine (DMBA) in rodent brain

The [S] enantiomer of [11C]-N,alpha-dimethylbenzylamine (DMBA) was synthesized by N-methylation of [S]-alpha-methylbenzylamine, and its biodistribution in mice was measured. [11C]-[S]-DMBA was rapidly distributed into the brain, heart and lungs, and considerable long-term retention in the brain was observed. The radioactive metabolites in the plasma were analyzed by liquid chromatography. Kinetic analysis using unmetabolized [11C]DMBA in the plasma as the input function was performed employing a simplified two-compartment model. The estimated distribution volumes (DV) of [11C]DMBA in the brain and heart were 6.05 and 3.95, respectively. The right striatum of the rat brain was lesioned with ibotenic acid 2 weeks before the tracer experiment. Both in vitro and in vivo autoragiographic studies were performed, and revealed significant reduction of the radioactivity levels in the lesioned striatum. On the other hand, the regional cerebral blood flow, as measured by [14C]iodoantipyrine, was not significantly altered in the lesioned striatum. These results indicate that the ionic binding component for DMBA exists mainly in neural cells rather than in glial cells. [11C]DMBA might be a useful radiotracer for detection of neural cell loss in the brain.     

A new prognostic scoring system involving des-gamma-carboxy prothrombin as a useful marker for predicting prognosis in patients with hepatocellular carcinoma

A staging system for hepatocellular carcinoma was reported from Italy (CLIP). In this study, we evaluate the CLIP scoring system and establish a new scoring system for predicting the prognosis of patients with hepatocellular carcinoma. Patients (n=141) who were diagnosed and who underwent initial treatment at our single institution were recruited retrospectively into this study. We evaluated markers for prognosis, using a stratified Cox proportional hazard regression model and Kaplan-Meier survival analysis. CLIP score differentiated patients with different survival experiences by Kaplan-Meier estimated survival analysis. However, with respect the CLIP score, more than two thirds of patients were included in the early stage (CLIP 0-1), and the group with better prognosis than the survival rate of all patients was the only one with CLIP 0. Multivariate analysis revealed that des-gamma-carboxy prothrombin (DCP) >/=100 mAU/ml (relative risk, 2.06; P=0.0218) was statistically significant as a predictor of poor survival. A new prognostic scoring system included DCP classified patients to 6 well-balanced groups (score 0-5). The new prognostic scoring system 0 group (14.9% of the cohort) and the CLIP score 0 group (34.0% of the cohort) had a median survival of 66.9 and 61.6 months. The new prognostic scoring system performs better for prediction of survival than either the CLIP score or the Child-Pugh stage. In conclusion, the described scoring system provides more accurate prognostic information than the CLIP scoring system. It may help physicians decide more appropriate clinical and therapeutic management.     

Effects of hot deep seawater bathing on the immune cell distribution in peripheral blood from healthy young men

Objectives Deep seawater (DSW) utilization technology has been developed for the fields of medicine and health, among others. To clarify the health effects of DSW as compared with surface seawater (SSW) or tap water (TW), we investigated the changes of immune cell distribution of the peripheral blood, or subjective judgment scores, after hot water bathing. Methods Ten healthy young men were immersed for 10 min in DSW, SSW and TW heated to 42°C. Blood samples were collected before bathing, immediately after bathing and 60 min after bathing. Total and differential numbers of leucocytes and lymphocyte subsets (CD3, CD4, CD8, CD19, CD16, and CD56) were examined using an automated hematology analyzer and a flow cytometer, respectively. The subjective judgment scores were obtained by an oral comprehension test. Results Since the pre-bathing leukocyte count in the TW group was significantly different from those in the DSW and SSW groups, we excluded the findings of TW bathing from consideration. In hot DSW bathing, CD8-lymphocytes increased significantly immediately after bathing (p<0.05), in contrast to hot SSW bathing, in which no significant changes were detected in the lymphocyte subsets. Additionally, there were no significant changes between repeated measurements in the subjective judgment scores, though the score of thermal sensation in SSW bathing showed a significantly higher value immediately after bathing than before bathing (p<0.01). Conclusions Our findings suggest that increased CD8-lymphocytes in hot DSW bathing may improve human immune function as well as hot springs do, as compared with SSW bathing. Although hot DSW bathing may have the ability to change human immune cell distribution, well-designed studies are needed to clarify the health effects including not only DSW and SSW but also TW.     

Blind endobronchial insertion of a movable bronchial blocker attached to an endotracheal tube, Univent tube

The endotracheal tube with a movable bronchial blocker, Univent tube, used to effect one-lung ventilation is easy to use in endotracheal intubation. However, problems are often encountered when inserting the blocker into the bronchus. We herein describe a method which enables the easy blind insertion of the blocker into the left or right bronchus. The techniques of inserting the blocker into the left main stem bronchus will be described. With the patient in a supine position, the head of the patient is moved to the left. The operator then places his right hand fingers near the cricoid and presses to displace the larynx of the patient toward the right. While performing this procedure, the operator advances the blocker using the left hand. Finally, using a bronchoscope, the placing of the blocker is to be ascertained in an appropriate position inside the left bronchus. When strong resistance is left, the blocker should be retracted, the force of laryngeal displacement is altered and, then, the blocker is inserted again in a resistance-free manner. We have so far experienced no complications such as severe tracheobronchial hemorrhage, tracheobronchial perforation of laryngeal dislocation. We herein describe a useful and simple method for inserting the bronchial blocker of the Univent tube into the bronchus.     

Effect of pravastatin on coronary plaque volume

A volumetric analysis by 3-dimensional intravascular ultrasound revealed that lipid-lowering therapy with pravastatin significantly reduced coronary plaque volume. The changes in plaque volume were inversely correlated with the changes in plasma levels of high-density lipoprotein cholesterol but not with changes in levels of total cholesterol or low-density lipoprotein cholesterol.     

Evaluation of Carboxymethylpullulan as a Novel Carrier for Targeting Immune Tissues

Purpose. To demonstrate the potential of carboxymethylpullulan (CMPul) as a carrier for targeting immune tissues, and to find whether immune tissues could be set as the target of an immunosuppressant to treat autoimmune diseases. Methods. The biodistribution of CMPul was investigated to evaluate its potency as a carrier for targeting immune tissues. Furthermore, an immunosuppressant-CMPul conjugate was prepared and its suppressive effect on rat adjuvant arthritis was examined. Results. The disappearance rate of ³H-labeled CMPul from the blood circulation was much slower than that of ³H-labeled pullulan (Pul) after intravenous injection to normal rats. The concentration of ³H-labeled CMPul in the spleen and lymph nodes was much higher than that of ³H-labeled Pul at 24 hours after the injection, whereas the concentration of ³H-labeled CMPul in the liver was significantly lower than that of ³H-labeled Pul. A similar targeting property of ³H-labeled CMPul for these immune tissues was observed in arthritic rats. A conjugate composed of a novel immunosuppressant PA-48153C and CMPul showed a suppressive effect on rat adjuvant arthritis judging from a reduction of the arthritic index and spleen weight and an increase of body weight. Conclusions. CMPul is expected to be a promising carrier for targeting immune tissues with an immunosuppressant to enable treatment of autoimmune diseases.     

Synthesis of poly(vinyl alcohol) having a thiol group at one end and new block copolymers containing poly(vinyl alchohol) as one constitent

Poly(vinyl alcohol) (PVA) and poly(vinyl acetate) having a thiol group at one end were synthesized by free-radical polymerization of vinyl acetate in presence of thioacetic acid as a chain transfer agent followed by treating with sodium hydroxide/methanol and ammonia, respectively. It was found that block copolymers containing the PVA sequence as one constituent were obtained by the redox-initiated polymerization of some vinyl monomers, for example, acrylic acid (AA) and acrylamide (AAm), using PVA having a thiol end group as reductant and an oxidant such as potassium bromate and potassium persulfate.