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1.
J Gastroenterol ; 39(7): 629-34, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15293132

RESUMEN

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.


Asunto(s)
Pruebas Respiratorias , Enfermedades Gastrointestinales/microbiología , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori , Urea , Isótopos de Carbono , Estudios Cruzados , Enfermedades Gastrointestinales/diagnóstico , Humanos , Espectrometría de Masas , Sensibilidad y Especificidad , Espectrofotometría Infrarroja
2.
J Gastroenterol ; 39(7): 621-8, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15293131

RESUMEN

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.


Asunto(s)
Pruebas Respiratorias , Enfermedades Duodenales/diagnóstico , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori , Gastropatías/diagnóstico , Urea/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Isótopos de Carbono , Estudios Cruzados , Enfermedades Duodenales/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Soluciones , Gastropatías/microbiología , Comprimidos
3.
Life Sci ; 74(7): 897-907, 2004 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-14659978

RESUMEN

Oxidative stress plays a causative role in the development of hepatic fibrosis and apoptosis. Estradiol (E2) is an antioxidant, and idoxifene is a tissue-specific selective estrogen receptor modulator. We have previously demonstrated that E2 inhibits hepatic fibrosis in a rat model of hepatic fibrosis induced with dimethylnitrosamine (DMN), and suppresses activation of the nuclear factor (NF)-kappaB proinflammatory transcription factor in cultured rat hepatocytes undergoing oxidative stress. This study reports on the antioxidant and antiapoptotic role of idoxifene and E2 in the DMN model of hepatic fibrosis. The DMN model rats were administered with idoxifene or E2, and were examined activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx) and expression of Bcl-2 family proteins in the liver. During the course of hepatofibrogenesis after DMN treatment, serum levels of lactate dehydrogenase (LDH), a biomarker for necrosis, and hepatic levels of malondialdehyde (MDA), an end product of lipid peroxidation, increased rapidly for 3 days. On day 14, serum LDH levels normalized, and hepatic fibrosis developed with increased levels of MDA and collagen and decreased production of SOD and GPx in the liver. Fibrotic liver also showed downregulation of Bcl-2 and Bcl-X(L) expression and upregulation of Bad expression. Idoxifene and E2 suppressed DMN-mediated necrosis, lipid peroxidation, the loss of antioxidant enzyme activity, and proapoptotic status in Bcl-2 family protein expression as well as hepatic fibrosis. These findings indicate that, in addition to their antiinflammatory and antifibrotic action, idoxifene and E2 could enhance antioxidant and antiapoptotic activity in hepatic fibrosis in rats.


Asunto(s)
Antioxidantes/uso terapéutico , Apoptosis/efectos de los fármacos , Estradiol/uso terapéutico , Antagonistas de Estrógenos/uso terapéutico , Cirrosis Hepática Experimental/tratamiento farmacológico , Tamoxifeno/análogos & derivados , Tamoxifeno/uso terapéutico , Administración Oral , Animales , Proteínas Portadoras/metabolismo , Dimetilnitrosamina/toxicidad , Modelos Animales de Enfermedad , Quimioterapia Combinada , Estradiol/administración & dosificación , Técnica del Anticuerpo Fluorescente Indirecta , Regulación de la Expresión Génica , Glutatión Peroxidasa/metabolismo , Inyecciones Intraperitoneales , L-Lactato Deshidrogenasa/sangre , Hígado/efectos de los fármacos , Hígado/metabolismo , Hígado/patología , Cirrosis Hepática Experimental/sangre , Cirrosis Hepática Experimental/patología , Masculino , Malondialdehído/sangre , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Ratas , Ratas Wistar , Superóxido Dismutasa/metabolismo , Tamoxifeno/administración & dosificación , Proteína Letal Asociada a bcl , Proteína bcl-X
4.
Dig Dis Sci ; 48(3): 570-80, 2003 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12757172

RESUMEN

Oxidative stress plays a causative role in the development of hepatic fibrosis and apoptosis. Estradiol (E2) is an antioxidant, and idoxifene is a tissue-specific selective estrogen-receptor modulator. We have previously demonstrated that E2 inhibits hepatic fibrosis in rat models of hepatic fibrosis and that the actions of E2 are mediated through estrogen receptors (ERs). This study reports on the antiapoptotic role of idoxifene and E2, and the functions of ER subtypes ER-alpha and ER-beta in hepatocytes undergoing oxidative stress. Lipid peroxidation was induced in cultured rat hepatocytes with ferric nitrilotriacetate solution with idoxifene or E2. Oxidative stress-induced early apoptosis was linked to its ability to inhibit not only the expression of Bcl-2 and Bcl-XL but the production of antioxidant enzymes as well and to stimulate Bad expression. Hepatocytes possessed functional ER-beta, but not ER-alpha, to respond directly to idoxifene and E2. Idoxifene and E2 suppressed oxidative stress-induced reactive oxygen species generation and lipid peroxidation, and their antiapoptotic effects on the activation of activator protein-1 and nuclear factor-kappaB, the loss of antioxidant enzyme activity, and Bcl-2 family protein expression in early apoptotic hepatocytes were blocked by the pure ER antagonist ICI 182,780. Our results indicate that idoxifene and E2 could enhance antiapoptotic activity through ER-beta during oxidative damage in hepatocytes.


Asunto(s)
Apoptosis , Estradiol/análogos & derivados , Estradiol/farmacología , Antagonistas de Estrógenos/farmacología , Hepatocitos/efectos de los fármacos , Receptores de Estrógenos/metabolismo , Tamoxifeno/análogos & derivados , Tamoxifeno/farmacología , Animales , Antioxidantes/farmacología , Western Blotting , Células Cultivadas , Receptor beta de Estrógeno , Femenino , Citometría de Flujo , Fulvestrant , Hepatocitos/metabolismo , Hígado/citología , Hígado/fisiopatología , Masculino , Microscopía Confocal , Estrés Oxidativo , Ratas , Ratas Wistar , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
5.
J Med Invest ; 50(1-2): 64-71, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12630570

RESUMEN

The study examines the clinical significance of guanase (GU) measurement in patients with hepatitis C. 688 patients in whom either ALT was abnormal, or in whom HBsAg or HCVAb was detected in the serum, were enrolled into this study. The percentage of cases in which normal ALT while elevated GU was compared among the different disease groups. Then, the percentage of cases with normal ALT but elevated GU was compared between HBV and HCV groups. For the entire population, a significant correlation was observed between ALT and GU (r=0.872). The overall percentage of cases with normal ALT but elevated GU activity was 11.4%. In HCV group, 449 cases had normal ALT. Of these cases, 20.3% had elevated GU, while ALT was normal. Before 1989, no test to check donated blood for HCV antibody was available. However, screening of donated blood for high GU was associated with a reduced incidence of post-transfusion hepatitis. This is probably because following the screening, blood donated by patients with hepatitis C who had normal ALT but elevated GU was rejected. After the introduction of HCV antibody measurement, GU measurement is still useful to reveal the pathophysiological condition in-patients with chronic hepatitis type C.


Asunto(s)
Guanina Desaminasa/sangre , Hepatitis C Crónica/enzimología , Alanina Transaminasa/sangre , Biomarcadores , Donantes de Sangre , Comorbilidad , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B Crónica/epidemiología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C Crónica/epidemiología , Humanos , Incidencia , Japón/epidemiología , Tamizaje Masivo , Estudios Prospectivos , Sensibilidad y Especificidad
6.
J Med Invest ; 49(3-4): 163-71, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12323006

RESUMEN

Mortality rates from chronic liver diseases (CLD) such as liver cirrhosis and hepatocellular carcinoma have been reported to be higher in Tokushima prefecture, although its causes remain unclear. To clarify the causes of CLD in Tokushima prefecture, we evaluated the positive rates of HBs antigen and anti-HCV antibody and the mortality rates from CLD in patients with liver diseases and blood donors after dividing the entire Tokushima prefecture into 8 district boundaries of health centers. In addition, to evaluate the causes of the higher frequency of CLD and the relationship between the development of CLD and viruses, medical examinations were performed in 2 mountain villages in Tokushima prefecture where the drift of population was limited and the mortality rates from CLD differed from each other. As a result, it was found that HCV infection was the major cause of the higher mortality rates from CLD in Tokushima prefecture. Although there were marked regional differences in the mortality rates from CLD, they were mainly due to different rates of HCV infection.


Asunto(s)
Hepatopatías/mortalidad , Adulto , Anciano , Donantes de Sangre , Carcinoma Hepatocelular/epidemiología , Enfermedad Crónica , Femenino , Anticuerpos contra la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/sangre , Hepatitis B Crónica/epidemiología , Anticuerpos contra la Hepatitis C/sangre , Hepatitis C Crónica/epidemiología , Humanos , Japón/epidemiología , Cirrosis Hepática/epidemiología , Pruebas de Función Hepática , Neoplasias Hepáticas/epidemiología , Masculino , Persona de Mediana Edad , Dinámica Poblacional , Población Rural , Estudios Seroepidemiológicos
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