ABSTRACT
Effects of three plant extracts (Hordeum vulgare L., Apocynum Venetum L., Brasenia schreberi J.F.G mel.) on human gingival fibroblasts were examined. As a result, we observed the promoting effect of the extract of Hordeum vulgare L. and the extract of Apocynum Venetum L. respectively on FGF2 and FGF7 production. Moreover, the mixture of the three plant extracts showed the effect of improving the changes in type I collagen gene expression and matrix metalloproteinase 1 gene expression by LPS addition. Next, a dentifrice containing the three plant extracts was subjected to human efficacy trials. We measured periodontal pocket depth, attachment level, bleeding on probing and saliva TNFα as an indicator of periodontal disease. The results suggest that the dentifrice formulated with the three plant extracts were effective for the improvement of periodontal disease.
ABSTRACT
Recently, the relevance of Helicobacter pyroli (H. pylori) infection to atrophic gastritis and gastric cancer in has been elucidated. Therefore, to diagnose H. pylori infection is important for suspecting the existence of those diseases of the stomach. We investigated the relationships of the H. pylori IgG antibody to H. pylori infection, atrophic gastritisor various stomach lesions to understand the significance and usefulness of evaluating the antibody level in the annual multiphasic health check-up participants. The subjects in this study were 148 people (male: 93, female: 55, average age: 56.4) in Toride city, which is located in the suburb of Tokyo. They had visited our hospital for medical checkups. Eighty-seven subjects underwent upper gastric endoscopy and 55 (63%) tested positive for H. pylori IgG antibody and H. pylori infection was confirmed in 41 (75%). Although 32 subjects tested negative for the antibody, 8 cases (25%) was diagnosed with H. pylori infection. The frequencies of positive antibody in atrophic gastritis, erosion and ulcer, fundic gland polyp, hyperplastic foveolar polyp, adenoma and malignancy were 17%, 70%, 61%, 77%, 31%, 62%, 0% and 100%, respectively. On the other hand of 80 subjects were who underwent barium X-ray examination, 44 tested positive for the antibody (55%). The frequency of positive antibody in no lesion, depressed lesion, elevated lesion and malignant lesion were 61%, 59%, 36% and 100%, respectively. Taken together, H. pylori antibody was a good marker for H. pylori infection and the positive antibody indicated high frequencies of atrophic gastritis and malignancy. Therefore, advices to have participants who have a positive antibody should be strongly an endscopic examination stomach lesions.
ABSTRACT
We examined the usefulness of serum leptin concentration as an index for the diagnosis of fatty liver. Twenty-two patients diagnosed with fatty liver by abdominal ultrasonography, participated in this study together with 7 indinduels as controls. As laboratory findings showed, body fat percentage (29.5±1.4 vs 19.1±1.6%, P<0.001), BMI (25.7±0.7 vs 20.8±1.0 kg/m2, P<0.005), procollagen III peptide (P III P) (0.58±0.04 vs 0.42±0.04 U/ml, P<0.05), and serum leptin levels (7.3±1.0 vs 2.9±0.5 ng/ml, P<0.001) were significantly higher in the fatty liver group than in the control group. Serum leptin levels were correlated significantly with body fat percentage (r=0.76, P<0.0001) and BMI (r=0.61, P<0.001), though there was a significant correlation between serum leptin levels and liver-kidney contrast (r=0.47, P<0.05) only in males. In addition, when the fatty liver group was classified into two groups by GPT levels, m-GOT (mitochondrial glutamate-oxaloacetate transaminase) (8.6±1.0 vs 5.7±1.0 IU/l/37°C, P<0.05) and P III P (0.65±0.06 vs 0.49±0.04 U/ml, P<0.05) were significantly higher in the elevated GPT group than in the normal GPT group.These results suggest that serum leptin levels may be indicative of fatty liver and that fatty liver is not always a reversible disease.
Subject(s)
Fatty Liver , Leptin , SerumABSTRACT
A 65-year-old man was referred to our hospital in April 2003 with a pancreas tumor detected by a thorough medical checkup. Computed tomography (CT) showed swelling of the pancreatic body and tail, and magnetic resonance cholangiopancreatography (MRCP) showed only the main pancreatic duct in the head of the pancreas. Diagnosing autoimmune pancreatitis, we observed the patient without medication. However, one year later CT showed stenosis of the splenic artery and portal vein accompanied by development of collateral circulation around the pancreas. He had no symptoms, and CT showed no changes in the pancreatic swelling.;;He was admitted to our hospital on January 6, 2005, presenting with a history of jaundice which first appeared on January 1, 2005, and increased collateral circulation around the pancreas with pancreatic swelling were seen on CT. We started prednisolone therapy at 40 mg/day for exacerbation of autoimmune pancreatitis. Serum bilirubin levels improved from 11.9 mg/dl to 2.5 mg/dl, and pancreatic swelling also improved four weeks after starting therapy.;;We present a rare case of autoimmune pancreatitis that developed marked collateral circulations.
Subject(s)
Tomography, X-Ray Computed , Pancreatitis , Collateral CirculationABSTRACT
Eosinophilic gastroenteritis (EG) is characterized by infiltration of eosinophils into the wall of the digestive tract, and the clinical spectrum seems to depend on the predominant site of eosinophilic infiltration of the wall.<BR>We experienced four cases of EG, and two of them (Cases, 1 and 2) manifested massive ascites, suggesting the principal lesion is located on the serous coat. Case 3 manifested abdominal pain and vomiting, and muscle layer involvement of the duodenum was detected by ultrasonography and CT scan. In case 4, epigastralgia was a main symptom. An endoscopic examination revealed marked redness and erosion of the gastric mucosa associated with massive infiltration of eosinophils. In this case, mucosal involvement seemed to be the main lesion because hypertrophy of the gut wall thickness was not found by ultrasonography and CT scan.<BR>Although the pathogenesis of this disease is obscure, allergic mechanism may play an important role. Three cases had histories of allergic diseases, and steroid therapy resulted in prompt disappearance of symptoms.
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There is a theory that excessive treament for terminally ill patients is one of the factors in soaring medical costs. To evaluate this theory, we examined the changes in medical expenditures for our inpatients: 41 patients with lung cancer and 69 patients with liver cancer hospitalized for treatment of the department of internal medicine, and 90 patients with stomach cancer and 100 patients with colon cancer hospitalized for surgery from July to December 1997. They were divided to two groups: the patients of group A received active treatment, and the patients of group B received conservative treatment. We selected 10 people randomly from each group, and compared the changes in medical costs.<BR>The cost was significantly low in group B compared with group A. We examined the change in the cost every 5 days. Until 6 days before leaving our hospital, the cost is high sugnificantly in group A compared with group B. The difference between group A and group B in the cost of treatment for lung cancer, and stomach cancer patients disappeared in 5 days before leaving hospital. The cost of treatment for lung and liver cancer patients of group A was a little higher than the average hospitalization fee of internal medicine. Also, the cost of group A stomach cancer patients was a little higher than the averge hospitalization fee of surgery, though there was no difference between the cost of treatment for group A colon cancer patients and the average hospitalization feeof surgery. The fee of group B of either disease was half or less of an average fee for medical treatment.<BR>From this study, no evidence was found that the excessive life prolongation treatment for terminally ill patients was done. So, using authentic data, we should discuss the justifiability of the theory that the excessive treatment for terminally ill patients is one of the factors contributing to a boost in medical costs.
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Tranilast, an anti-allergic drug, was originally made in Japan, and is now being frequently used. Though ill effects of Tranilast in urology have been known widely, the adverse effect of Tranilast on liver function has been scarcely reported. Having experienced 7 cases of liver disease due to cholestasis by the drug, we summarized these cases and reported the characteristics of liver injury induced by the drug.<BR>All the patients, who had took Tranilast orally and developed liver injury, first manifested hematuria and micturition pain, and then developed jaundice. Though the degree of liver injury was various depending on individuals, the clinical course turned better about 27 days after cessation of Tranilast.
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We report a case of a 16-year-old boy with Marfan's syndrome who underwent Bentall's procedure on a diagnosis of acute aortic dissection (DeBakey type II). He was readmitted with pyrexia 5 months after the initial operation. Methicillin-resistant <i>Staphylococcus epidermidis</i> (MRSE) was detected by blood culture and transesophageal echocardiography revealed a vegetation adherent to the entry of a remaining false lumen just distal to the distal anastomosis. Although antimicrobial therapy was employed, an arterial embolism developed in the right popliteal artery. CT scan revealed dilatation of the false lumen, and consequently, emergency surgery was performed. The intima of the distal aortic end was partially out of the suture line and the vegetation adhered at that point. Re-replacement of the ascending aorta, omental transposition, and embolectomy of the right femoral artery were performed and resulted in a satisfactory course.
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Many reports say that DWI (diffusion-weighted-image) is very useful for the diagnosis of cerebral infarction, especially in the acute phase, but it is difficult to have a fine image because DWI is very sensitive to artifacts caused by the “body-move” of the patient.<BR>About the degree of MPG (motion probing gradient), criteria are yet to be established. Many persons try in their own way. With MPG5, the intensity of CSF and that of the focal lesion are almost equal, so that it is difficult to distinguish infarcts from adjacent ventricles.<BR>The stronger the degree of MPG is, the more artifacts or noises we get, We recommend MPG6 or 7 in the right-left direction.
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Seven years ago, we began the “Toride Project” which aimed at organized care, mainly on based a low-protein diet (LPD), for chronic renal failure patients. This project cumulatively involved 486 patients, and 219 of them have been followed up at our hospital.<BR>In this paper, we report the 12 patients who had before shown progressive deterioration of renal function and turned out stable (less than 5% change) in creatinine clearance (Ccr) for 12-54 months after involved in the project. Their diseases were chronic glomerulonephritis (CGN; 10 cases) and nephrosclerosis (NSC; 2 cases), and the mean Ccr was 20.9±1.3 (SE) ml/min (16-32 ml/min). All of them carried out the well maintained LPD (0.62±0.02 g/kg/day), and showed relatively low urinary protein excretion (UPE; 0.4±0.2g/day). In contrast, 10 other cases (CGN; 9, NSC; 1) showed persistent deterioratiom of renal function even if they continued the LPD (0.60±0.02 g/kg/day). They significantly showed higher UPE (1.6±0.3 g/day, p<0.05) than the 12 cases mentioned above. Moreover, frequent examination revealed that the day-to-day change in their protein intake was more widely distributed (coefficient of variation; 19.5±1.3% vs 10.8±0.6%, p<0.05).
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We report our experience with percutaneous endoscopic gastrostomy (PEG) to assess the safety and usefulness of the PEG. We reviewed 21 cases (mean age, 72 years), including 20 patients with neurological impairment and one patient with cancer of the stomach.<BR>Though two minor complications (wound infection and bleeding from the stomach) occurred, wound infection healed with antibiotics and bleeding stopped spontaneously. Six of these patients died (3 died from pneumonia, 2 from respiratory failure, and 1 from stomach cancer), but there were no PEG-related deaths. After PEG procedure, serum protein, albumin and cholesterol improved significantly. PEG was not only safe but also effective for the nutritional support and the 4-year survival rate was 56%. By this method, moreover, half of the patients could leave hospital and return home.<BR>In conclusion, PEG, is thought to be the procedure of choice for the long-term enteral nutrition.
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A 61-year-old man, who had previously undergone quadruple coronary artery bypass graft surgery, was successfully treated for proximal descending aortic aneurysm using hypothermic circulatory arrest via a left thoracotomy. Preoperative angiograms revealed that the left internal thoracic artery bypass graft to the LAD was patent, and that the aneurysm was located at the descending aorta just distal to the left subclavian artery. Operative procedures were as follows. A left thoracotomy incision was made through the 4th intercostal space. The common femoral artery and vein were cannulated, and the venous cannula was positioned in the right atrium. The patient was cooled by partial cardiopulmonary bypass until the EEG was isoelectric (24°C rectal temperature), and then circulation was arrested. Left ventricular decompression was not performed. After opening of the aneurysm, proximal anastomosis was performed first at the aorta just distal to the left subclavian artery. Another arterial cannula, connected to the Y-shaped arterial line, was inserted into the graft, and perfusion to the brain was restored through this cannula. Distal anastomosis was then completed, and routine cardiopulmonary bypass was reestablished. After the heart was defibrillated, the patient was rewarmed to 34°C before discontinuing the bypass. Circulatory arrest time and total cardiopulmonary bypass time were 17 minutes and 139 minutes, respectively. Postoperative recovery was uneventful.
ABSTRACT
A 66-year-old man with an abdominal aortic aneurysm and coexisting horseshoe kidney is reported. The aneurysm was successfully replaced by a prosthetic graft without resection of the renal isthmus. Because of renal blood supply and location of renal isthmus, aortic reconstruction presents a significant technical problem. Preservation of multiple renal arteries may be facilitated by preoperative aortography, and retraction of the renal isthmus offers good operative exposure.