Reduced incidence of Helicobacter pylori infection in young Japanese persons between the 1970s and the 1990s

The activity of eight topoisomerase inhibitors was investigated against five clinical isolates of Pneumocystis carinii. Susceptibility tests were performed by inoculation of the organisms on to a cell monolayer and parasites were counted after 72 h incubation at 37 degrees C. Culture plates were added with Dulbecco's modified Eagle's medium containing serial dilutions of lomefloxacin, norfloxacin, ofloxacin, pefloxacin, rufloxacin, camptothecin, amsacrine and etoposide. Atovaquone, pentamide isethionate and co-trimoxazole were used as control drugs. Etoposide gave inhibition comparable to that observed with atovaquone. Poor activity was demonstrated by pefloxacin, while the other topoisomerase inhibitors had no significant effect.     

Role of gastrin/CCK-B receptor in the regulation of gastric acid secretion in rat

The aim of this study was to investigate whether gastrin regulates morphological changes and alpha-subunit gene expression in parietal cells through the gastrin/CCK-B receptor on enterochromaffin-like cells by histamine release. Treatment with 100 mg/kg of YM022, a potent and selective gastrin/CCK-B receptor antagonist, for one week in rats did not alter mRNA levels of histidine decarboxylase or H+, K+-ATPase. However, parietal cell morphology predominantly changed to the resting form, although the serum gastrin concentration was significantly increased. Additional treatment with YM022 and oral omeprazole, 100 mg/kg, for one week markedly suppressed the increases of mRNA levels of histidine decarboxylase and H+, K+-ATPase and completely blocked the morphological transformation of the parietal cells to a stimulated form induced by treatment with omeprazole alone. This indicates that the morphological transformation of parietal cells to an activated form with a subsequent increase in H+, K+-ATPase synthesis caused by hypergastrinemia is mediated by increased histidine decarboxylase gene expression in enterochromaffin-like cells via gastrin/CCK-B receptors.     

Endoscopic treatment of submucosal invasive colorectal carcinoma with special reference to risk factors for lymph node metastasis

A clinicopathological analysis of the risk factors for lymph node metastasis was performed in 177 patients with submucosal invasive colorectal carcinoma (CRC). The submucosal deepest invasive portion was histologically subclassified as well (W), moderately (M), or poorly (Por) differentiated. M type was further subdivided into moderately-well (Mw) and moderately-poorly (Mp) differentiated. The pattern of tumor growth was classified as polypoid growth (PG) and non-polypoid growth (NPG). Lymph node metastasis was detected in 21 (12%) of the 177 patients. Macroscopically, type IIc and IIa + IIc lesions showed a significantly higher incidence of lymph node metastasis (44% and 30%) than type IIa and I (4% and 8%). Regarding the histologic subclassification, Por and Mp lesions showed a significantly higher incidence of lymph node metastasis (67% and 37%) than W and Mw lesions (4% and 14%). NPG tumors showed a significantly higher incidence of lymph node metastasis (29%) than PG tumors (7%). The depth of submucosal invasion and lymphatic invasion (ly) were also significantly correlated with the incidence of lymph node metastasis (submucosal scanty (sm-s) invasion 4%, massive invasion 20%; ly(+) 23%, ly(-) 5%). None of the lesions with both sm-s invasion and of W or Mw type showed lymph node metastasis. These results indicate that submucosal invasive CRC with both sm-s invasion and of W or Mw type, which shows no ly, is the appropriate indication for endoscopic curative treatment.     

MUC-1 expression as a predictor of the curative endoscopic treatment of submucosally invasive colorectal carcinoma

PURPOSE: This study was undertaken to clarify the clinical significance of MUC-1 expression in the endoscopic treatment of colorectal carcinoma with submucosal invasion. METHODS: One hundred eighty-four colorectal carcinomas with submucosal invasion were examined. The depth of submucosal invasion was classified as scanty or massive. The histologic subclassification at the deepest invasive portion was defined as well-differentiated, moderately well-differentiated, moderately to poorly differentiated, poorly differentiated, or mucinous adenocarcinoma. MUC-1 expression was examined immunohistochemically at the deepest invasive portion. In addition, the Ki67 labeling index was also examined immunohistochemically. RESULTS: Lymph node metastases were detected in 28 (15.2 percent) of 184 lesions. Lesions with both scanty submucosal invasion and well-differentiated or moderately well-differentiated adenocarcinomas had no lymph node metastases. MUC-1 expression was detected in 88 (47.8 percent) of 184 lesions and correlated significantly with the presence of lymph node metastases. The Ki67 labeling index also correlated significantly with lymph node metastases. Furthermore, lesions with both MUC-1-negative and low Ki67 labeling index showed no lymph node metastases, even in lesions with massive submucosal invasion. Multivariate analysis indicated that MUC-1 expression was one of the most important risk factors for lymph node metastases and histologic grade among the clinicopathologic factors usually examined. CONCLUSION: MUC-1 expression is one of the accurate predictors of the presence of lymph node metastases among the clinicopathologic factors commonly used. Combined analysis of MUC-1 expression and Ki67 labeling index may be a useful indicator of lymph node metastases and may broaden the indications for the curative endoscopic treatment of carcinoma with massive submucosal invasion.     

Jejunal lipomatosis with diverticulosis: report of a case

We herein report the very rare case of a 68-year-old Japanese man with multiple jejunal lipomatosis and diverticulosis. He was admitted to our hospital with the chief complaint of melena and anemia. A barium study of the small bowel showed multiple lipomatosis and diverticulosis. An approximately 200-cm length of the jejunum was therefore resected. Thereafter, two diverticula and 215 lipomas were recognized in the resected specimen. A pathological examination showed mature adipose tissue with fibrous septa in the submucosal and muscularis propria. These findings were thus suggested to be due to the attenuation of the muscularis propria. The complications of lipomatosis are also discussed.     

A clinical study of pepsinogen I and II producing gastric carcinomas

Anti-human pepsinogen (PG) I and II monoclonal antibodies were used in an immunohistochemical study of 56 cases of gastric carcinoma (37 early stage and 19 advanced stage). We examined the relationship between positivity of the carcinoma for producing PG I and II and serum PG I and II levels. We found that in 2 cases (3.6%), the carcinoma produced PG I and in 11 cases (19.6%), it produced PG II. Early gastric carcinomas and differentiated-type carcinomas produced PG II more frequently than advanced and undifferentiated-type carcinomas. Also, type II c carcinomas and carcinomas located in the C area of the stomach produced PG II more frequently. But there was no significant difference between PG I and II-positive and negative cases in relation to both serum PG I and II levels. Moreover, the rate of positivity did not correlate with cases of abnormally high levels of serum PG I and II, (except in 1 case with abnormally high serum PG I in which PG II was produced.) These results suggest that there is no significant relationship between PG I or II-producing gastric carcinomas and serum PG levels. Furthermore, we examined PG II-producing and non-producing carcinomas in relation to the grade of inflammation, atrophy and intestinal metaplasia in gastric mucosa. However, there was no statistically significant difference among these factors. Only serum PG I and II levels were related to these parameters.     

Autoimmune pancreatitis: CT and MR characteristics

OBJECTIVE: Our goal was to elucidate the CT and MR imaging characteristics in patients with autoimmune pancreatitis, which is a reversible chronic pancreatitis with an autoimmune cause. CONCLUSION: On CT and MR imaging, a capsulelike rim, which is thought to correspond to an inflammatory process involving peripancreatic tissues, appears to be a characteristic finding of autoimmune pancreatitis. Also, diffuse pancreatic enlargement along with hypointensity on T1-weighted MR images and delayed enhancement on dynamic CT and MR studies are other features of this disorder.     

Correlation of ratio of serum pepsinogen I and II with prevalence of gastric cancer and adenoma in Japanese subjects

OBJECTIVE: Gastric cancer (GC) and adenoma (GA) are reported to be related to atrophic gastritis, in which the serum pepsinogen (PG) I level and the PGI/PGII ratio (I/II ratio) are reduced. To verify that the finding of a low PG level increases the risk for GC and GA, we investigated the correlation between low PG levels and the prevalence of GC and GA in individuals. METHODS: The 2,039 subjects (734 Japanese men, mean age 68.5 yr, and 1,305 women, mean age 66.7 yr), selected from among 10,996 local residents who underwent health check-ups based on reductions in their serum PG levels, underwent upper gastrointestinal endoscopy. RESULTS: Gastrointestinal endoscopy detected 21 GCs and 15 GAs. The prevalence of GC was higher than that in the residents without low serum PG. The percentage of early stage of GC (90%) was significantly higher than that of GC detected in unscreened residents (56.9%). The prevalence of GC in men was closely and significantly correlated with the I/II ratio (r = 0.935, p = 0.0063), whereas there was less correlation with age (r = 0.842, p = 0.0734). The prevalence of GA was also closely and significantly correlated with the I/II ratio in men (r = 0.881, p = 0.0203), but not with age (r = 0.163, p = 0.7928). In women the prevalence of GC (r = 0.744, p = 0.090) and GA (r = 0.678, p = 0.1392) did not correlate as strongly with the I/II ratio, although the highest prevalence was seen in the group with the lowest I/II ratio. CONCLUSION: Our study verified that a low I/II ratio signifies a high risk for GC and GA and that measuring serum PG levels can be used as a screening method for GC and GA.     

A Hybrid Approach to Online and Offline Partial Evaluation

This article presents a hybrid method of partial evaluation (PE), which is exactly as precise as naive online PE and nearly as efficient as state-of-the-art offline PE, for a statically typed call-by-value functional language.PE is a program transformation that specializes a program with respect to a subset of its input by reducing the program and leaving a residual program. Online PE makes the reduction/residualization decision during specialization, while offline PE makes it before specialization by using a static analysis called binding-time analysis. Compared to offline PE, online PE is more precise in the sense that it finds more redexes, but less efficient in the sense that it takes more time.To solve this dilemma, we begin with a naive online partial evaluator, and make it efficient without sacrificing its precision. To this end, we (1) use state (instead of continuations) for let-insertion, (2) take a so-called cogen approach (instead of self-application), and (3) remove unnecessary let-insertion, unnecessary tags, and unnecessary values/expressions by using a type-based representation analysis, which subsumes various monovariant binding-time analyses.We implemented and compared our method and existing methods—both online and offline—in a subset of Standard ML. Experiments showed that (1) our method produces as fast residual programs as online PE and (2) it does so at least twice as fast as other methods (including a cogen approach to offline PE with a polyvariant binding-time analysis) that produce comparable residual programs.