Changes in halitosis value before and after Helicobacter pylori eradication: A single-institutional prospective study.

BACKGROUND AND AIM: Although patients report either improved or worsened halitosis after Helicobacter pylori eradication therapy, such complaints are subjective. Only a few studies have objectively evaluated reports of changes in halitosis after H. pylori eradication; thus, this study aimed to investigate these changes after a successful H. pylori eradication. METHODS: Between February 2015 and October 2018, 56 347 patients visited the clinic. Informed consent for participation in this study was obtained from 164 patients scheduled to undergo upper gastrointestinal endoscopy due to halitosis. Of the 91 patients with H. pylori infection, the halitosis values were evaluated as Refres breath (RB) values using a Total Gas Detector™ System and compared before and after successful H. pylori eradication, as confirmed with urea breath testing. RESULTS: Among the 91 patients treated, 77 patients were successfully eradicated of H. pylori and had their Refres values measured (21 men and 56 women; mean age, 64.2 ± 11.5 years, including 10 smokers); among these 77 patients, 27 showed RB values of > 60. Their RB values significantly improved from 73.5 Â (95% confidence interval [CI], 64.1-82.9) to 59.4 Â (95% CI, 50.0-68.8) (P = 0.038). Of the 30 patients who could be followed up for > 2 years after successful H. pylori eradication, 8 with an RB value ≥ 60 showed significant RB value improvements from 77.9 Â (95% CI, 59.4-96.4) to 30.1 Â (95% CI, 11.6-48.6) (P = 0.0016). CONCLUSIONS: Helicobacter pylori eradication therapy could improve halitosis, and such improvement could be maintained even 2 years after successful eradication.

Efficacy of acotiamide on postprandial distress syndrome and epigastric pain syndrome depending on the estimated gastric acid secretion level.

BACKGROUND/AIMS: Gastric acid secretion is suspected to be a pivotal contributor to the pathogenesis of functional dyspepsia. The present study investigates the potential association of the gastric acid secretion estimated by measuring serum pepsinogen with therapeutic responsiveness to the prokinetic drug acotiamide. METHODS: Dyspeptic patients consulting participating clinics from October 2017 to March 2019 were prospectively enrolled in the study. The dyspeptic symptoms were classified into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Gastric acid secretion levels were estimated by the Helicobacter pylori infection status and serum pepsinogen using established criteria and classified into hypo-, normo-, and hyper-secretion. Each patient was then administered 100 mg acotiamide thrice daily for 4 weeks, and the response rate to the treatment was evaluated using the overall treatment efficacy scale. RESULTS: Of the 86 enrolled patients, 56 (65.1%) and 26 (30.2%) were classified into PDS and EPS, respectively. The estimated gastric acid secretion was not significantly different between PDS and EPS. The response rates were 66.0% for PDS and 73.1% for EPS, showing no significant difference. While the response rates were stable, ranging from 61.0% to 75.0% regardless of the estimated gastric acid secretion level among subjects with PDF, the rates were significantly lower in hyper-secretors than in non-hyper-secretors among subjects with EPS (42.0% vs 83.0%, P = 0.046). CONCLUSION: Although acotiamide is effective for treating EPS as well as PDS overall, the efficacy is somewhat limited in EPS with gastric acid hypersecretion, with gastric acid suppressants, such as proton pump inhibitors, being more suitable.

A yeast-based screening system identified bakkenolide B contained in Petasites japonicus as an inhibitor of interleukin-2 production in a human T cell line.

Ca2+ signaling is related to various diseases such as allergies, diabetes, and cancer. We explored Ca2+ signaling inhibitors in natural resources using a yeast-based screening method and found bakkenolide B from the flower buds of edible wild plant, Petasites japonicus, using the YNS17 strain (zds1Δ erg3Δ pdr1/3Δ). Bakkenolide B exhibited growth-restoring activity against the YNS17 strain and induced Li+ sensitivity of wild-type yeast cells, suggesting that it inhibits the calcineurin pathway. Additionally, bakkenolide B inhibited interleukin-2 production at gene and protein levels in Jurkat cells, a human T cell line, but not the in vitro phosphatase activity of human recombinant calcineurin, an upstream regulator of interleukin-2 production. Furthermore, bakkenolide A showed weak activity in YNS17 and Jurkat cells compared with bakkenolide B. These findings revealed new biological effects and the structure-activity relationships of bakkenolides contained in P. japonicus as inhibitors of interleukin-2 production in human T cells.

Inhibition of melanin production and promotion of collagen production by the extract of Kuji amber.

Kuji amber is fossilized tree resin of the Late Cretaceous in Japan. In this study, new biological activities of ethanol extract of Kuji amber (EtOH ext.) and supercritical carbon dioxide fluid extract of Kuji amber (scCO2 ext.) were examined. Both EtOH ext. and scCO2 ext. inhibited melanin production in B16 mouse melanoma cells and promoted collagen production in human skin fibroblast SF-TY cells. The scCO2 ext. had more potent activity than that of EtOH ext. and may depend on the efficiency of the extraction. The main new biologically active compound in Kuji amber, kujigamberol had no activities against melanin production, however, it promoted collagen production at low concentrations. A biologically active compound having a different structure, spirolactone norditerpenoid, showed both the inhibition activity against melanin production and the promotion activity of collagen production in a dose dependent manner. EtOH ext. and scCO2 ext., which include both kujigamberol and spirolactone norditerpenoid, have not only anti-allergy activity, but also inhibit melanin production and promote collagen production.

Clinicopathological features of T1 colorectal carcinomas with skip lymphovascular invasion.

With recent advances in endoscopic treatment, many T1 colorectal carcinomas (CRCs) are resected endoscopically with a negative margin. However, some lesions exhibit skip lymphovascular invasion (SLVI), which is defined as the discontinuous foci of the tumor cells within the colon wall. The aim of the present study was to reveal the clinicopathological features of T1 CRCs with SLVI and validate the Japanese guidelines regarding SLVI. A total of 741 patients with T1 CRCs that were resected surgically between April 2001 and October 2016 in our hospital were divided into two groups: With SLVI and without SLVI. Clinicopathological features compared between the two groups were patient's gender, age, tumor size, location, morphology, lymphovascular invasion, tumor differentiation, tumor budding and lymph node metastasis. The incidence of T1 CRCs with SLVI was 0.9% (7/741). All cases with SLVI were found in the sigmoid colon or rectum. T1 CRCs with SLVI showed significantly higher rates of lymphovascular invasion than those without SLVI (P<0.01). In conclusion, lymphovascular invasion was a significant risk factor for SLVI in T1 CRCs, and for which surgical colectomy was necessary. The Japanese guidelines are appropriate regarding SLVI. Registered in the University Hospital Medical Network Clinical Trials Registry (UMIN000027097).

Interobserver and intra-observer consistency in the endoscopic assessment of colonic pit patterns.

BACKGROUND: The colonic pit pattern is recognized as an aid to the differential diagnosis between hyperplastic lesions, adenoma, and carcinoma, and is a focus for observation by magnification chromoendoscopy, especially in Japan. This study evaluated intra- and interobserver agreement of experienced endoscopists in the assessment of colonic pit patterns when using the Kudo classification. METHODS: A total of 220 magnification chromoendoscopic pictures of colonic lesions were selected, of which 215 were collected from a consecutive series of patients. The pictures were randomly displayed twice to 6 experienced endoscopists at an interval of 1 week. Each picture was assessed for predominant pit pattern by using the classification of Kudo. Histopathologic diagnosis also was predicted based on the pit pattern diagnosis. Kappa statistics were used to estimate intra- and interobserver variation. RESULTS: The mean (standard deviation) inter- and intra-observer kappa values for experienced endoscopists were 0.716 (0.031) and 0.810 (0.084), respectively. For prediction of histopathology according to the pit pattern diagnosis, the mean (standard deviation) inter- and intra-observer kappa values were 0.776 (0.032) (p = 0.001) and 0.862 (0.069) (p = 0.028), respectively. CONCLUSIONS: For experienced endoscopists, the inter- and intra-observer reproducibility of the classification of colonic pit pattern is good.