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1.
Digestion ; 104(5): 409-414, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37071981

RESUMEN

BACKGROUND: Colon capsule endoscopy (CCE) is useful as an alternative examination for patients in whom colonoscopy is difficult. The Japanese Association for Capsule Endoscopy has published a recommended regimen for CCE using castor oil, which is becoming a standard examination method for CCE in Japan. However, castor oil has an unpleasant flavor. Therefore, patient acceptance is not good. OBJECTIVES: The aims were to develop a castor oil-filled capsule and evaluate its feasibility and patient acceptance in a retrospective, comparative study. METHOD: A dissolution study of pig-derived gelatin capsules filled with castor oil was performed using artificial gastric juice. The CCE excretion rates within battery lifetime, CCE examination times, endoscopic colonic cleansing levels, and patient acceptability between CCE boosters with a castor oil-filled capsule and without castor oil were retrospectively compared using medical information, clinical data, and endoscopic findings at Takada Chuo Hospital from September 2016 to August 2019. RESULTS: The castor oil-filled capsules were completely disintegrated at approximately 1-3 min in artificial gastric juice. Bowel preparation with oil-filled capsules and without castor oil was performed in 27 and 24 patients, respectively. CCE excretion rates within battery life were 100% and 91.7% (p = 0.217), small bowel transit times were 115 min and 143 min (p = 0.046), colon transit times were 168 min and 148 min (p = 0.733), and adequate colonic cleansing rates were 85.2% and 86.3% (p = 1.000) in patients using bowel preparation with and without oil-filled capsules, respectively. Regarding acceptance, the taste was not problematic in 85.2%, and tolerability for the next CCE was 96.3%. CONCLUSIONS: CCE using a castor oil-filled capsule method achieved high examination performance and sufficient patient tolerability.


Asunto(s)
Endoscopía Capsular , Aceite de Ricino , Humanos , Animales , Porcinos , Endoscopía Capsular/métodos , Estudios Retrospectivos , Catárticos , Colonoscopía/métodos , Colon
2.
J Clin Biochem Nutr ; 67(3): 332-337, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33293776

RESUMEN

The Helicobacter pylori infection and functional dyspepsia are often coexisted. The effect of acotiamide, a drug for functional dyspepsia, on the result of Helicobacter pylori diagnosis has yet to be studied. We evaluated the influence of acotiamide on the results of Helicobacter pylori diagnosis in the 13C-urea breath test. Twenty patients with Helicobacter pylori-positive functional dyspepsia were treated with 100 mg of acotiamide three times a day for two weeks. Changes in 13C-urea breath test were investigated before and after administration, and two weeks after administration as the follow-up period. The 13C-urea breath test and the medical questionnaire of modified frequency scale for the symptoms of gastroesophageal reflux disease were conducted at every period. Nineteen patients were included for analysis. No patients showed negative in 13C-urea breath test at Weeks 2 and 4. On the symptom scale, dyspepsia and total scores decreased from Week 0 to Week 2 and increased from Week 2 to Week 4, and the improvement rates of the dyspepsia score at Week 2 was 63%. In conclusion, we confirmed that acotiamide is unlikely to influence the result of 13C-urea breath test and it may improve the symptoms of functional dyspepsia during Helicobacter pylori eradication treatment.

3.
J Clin Gastroenterol ; 47(3): 233-8, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23090037

RESUMEN

GOALS: To determine the susceptibility of Helicobacter pylori strains isolated from a Vietnamese population to 5 antibiotics. BACKGROUND: The incidence of antibiotic resistance in H. pylori infection is increasing worldwide and has become a leading cause for failure of treatment. Antibiotic susceptibility testing is very important to provide optimal regimens in a clinical setting. STUDY: We isolated 103 H. pylori strains from the gastric mucosa of H. pylori-infected patients from 2 areas in Vietnam (Ho Chi Minh and Hanoi) in 2008. Epsilometer test was used to determine the minimum inhibitory concentrations of amoxicillin, clarithromycin (CLR), metronidazole (MNZ), levofloxacin, and tetracycline. RESULTS: Among the 103 strains, the resistance rates were 0% (amoxicillin), 33% (CLR), 69.9% (MNZ), 18.4% (levofloxacin), and 5.8% (tetracycline). The resistant strains showed a high-level of resistance (≥ 256 µg/mL) to CLR, 23.5% (8/34), and MNZ, 29.1% (21/72). The resistance rate for CLR was significantly higher in Ho Chi Minh than in Hanoi (49% vs. 18.5%, P=0.001). Resistance to both CLR and MNZ was most commonly observed (24.3%). Two strains (1.9%) were resistant to 4 of the 5 antibiotics. No significant association was observed between antibiotic resistance rates and age, sex, or clinical outcomes of the patients. CONCLUSIONS: High incidence of resistance to CLR and MNZ suggests that standard triple therapies may not be useful as first-line treatment in Vietnam. Alternative strategies such as bismuth-based quadruple therapies or sequential therapy may be more effective in Vietnam.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Farmacorresistencia Bacteriana , Helicobacter pylori/aislamiento & purificación , Humanos , Incidencia , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Vietnam , Adulto Joven
4.
Scand J Gastroenterol ; 48(11): 1249-56, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-24079881

RESUMEN

OBJECTIVE: Although Helicobacter pylori (H. pylori) eradication has been shown to inhibit gastric cancer, it does not completely suppress it. Therefore, risk factors of gastric cancer development following H. pylori eradication were examined. MATERIAL AND METHODS: A total of 2355 patients (1501 males and 824 females) underwent successful eradication of H. pylori. Endoscopic atrophy, histological gastritis, atrophy, intestinal metaplasia (IM), and operative link for gastritis assessment (OLGA) staging were subsequently evaluated. RESULTS: Following eradication, 33/2355 patients (25 males and 8 females) developed gastric cancer. Compared to a nongastric cancer group that was matched according to gender and age, the incidence of endoscopic atrophy (3.52 ± 1.45 vs. 4.85 ± 1.18, p < 0.001), histological atrophy at the greater curvature of the antrum (1.42 ± 0.80 vs. 1.95 ± 0.86, p = 0.0059), inflammation (2.05 ± 0.59 vs. 2.33 ± 0.66, p = 0.031), IM at the greater curvature of the corpus (0.06 ± 0.30 vs. 0.24 ± 0.54, p = 0.029), the ratio of OLGA-stage 0-II/III, IV (13/8 vs. 55/11, p = 0.038) were significantly higher for the gastric cancer group. Multivariate analysis also showed the highest odds ratio (6.26, 95% confidence interval or CI, 1.28-30.60, p = 0.023) for IM at the greater curvature of the corpus. CONCLUSIONS: Severe endoscopical atrophy, OLGA staging, histological atrophy at the antrum, inflammation, and particularly IM at the corpus, were identified as risk factors for gastric cancer development following H. pylori eradication. Therefore, eradication should be performed before these predictors develop.


Asunto(s)
Mucosa Gástrica/patología , Infecciones por Helicobacter/patología , Infecciones por Helicobacter/terapia , Helicobacter pylori , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Anciano , Antibacterianos/uso terapéutico , Atrofia/microbiología , Atrofia/patología , Estudios de Cohortes , Femenino , Mucosa Gástrica/microbiología , Gastritis/microbiología , Gastritis/patología , Gastritis/terapia , Gastroscopía , Humanos , Masculino , Metaplasia/microbiología , Metaplasia/patología , Persona de Mediana Edad , Inhibidores de la Bomba de Protones/uso terapéutico , Factores de Riesgo
5.
Int J Geriatr Psychiatry ; 28(7): 756-65, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23007970

RESUMEN

OBJECTIVE: The purpose of this study is to examine whether the reversal of compromised regional cerebral blood flow (rCBF) in older patients with major depressive disorder (MDD) is dependent on specific parameters of selective serotonin reuptake inhibitor (SSRI) treatment and to examine the efficacy of such treatment. METHODS: Forty-five patients with moderate MDD were studied following 8 weeks of treatment with SSRIs. Twelve patients displayed a positive response to SSRIs, whereas 33 patients did not respond to SSRI treatment. A comparison group of 30 healthy volunteers was also studied. The age of all participants was greater than 50 years. Age, gender, and the Hamilton Rating Scale for Depression scores were examined. The rCBF was assessed using 99mTc-ethyl cysteinate dimer single photon emission computed tomography after SSRI treatment. RESULTS: The rCBF levels in the right middle frontal cortex in non-responsive MDD patients were lower compared with responsive MDD patients. Compared with healthy controls, non-responders had significantly lower rCBF levels in the bilateral middle frontal cortex and insula and had significantly higher rCBF levels in the bilateral inferior frontal cortex and left middle temporal cortex. Compared with healthy controls, responders had significantly higher rCBF levels in the left inferior frontal, middle temporal, precentral, and fusiform gyrus. We found no changes in single photon emission computed tomography between pre-treatment and post-treatment stages for the responders to SSRI treatment. CONCLUSION: Hypoperfusion in older, non-responsive MDD patients was primarily localized in the middle frontal cortex. It is possible that the responders to SSRI treatment at baseline already displayed higher rCBF values in the frontal regions.


Asunto(s)
Antidepresivos/uso terapéutico , Circulación Cerebrovascular/efectos de los fármacos , Cisteína/análogos & derivados , Trastorno Depresivo Mayor/tratamiento farmacológico , Compuestos de Organotecnecio , Radiofármacos , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéutico , Tomografía Computarizada de Emisión de Fotón Único/métodos , Anciano , Anciano de 80 o más Años , Encéfalo/irrigación sanguínea , Encéfalo/diagnóstico por imagen , Estudios de Casos y Controles , Circulación Cerebrovascular/fisiología , Trastorno Depresivo Mayor/diagnóstico por imagen , Trastorno Depresivo Mayor/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad
6.
Tohoku J Exp Med ; 229(4): 279-85, 2013 04.
Artículo en Inglés | MEDLINE | ID: mdl-23603454

RESUMEN

Although the vast majority of depressed patients visit primary health care clinics, they often remain undiagnosed and untreated. Therefore, early detection in primary care settings is important. There is a high correlation between number of physical symptoms and the presence of depression, yet little has been reported regarding this relationship in Japanese primary care clinics. We examined number of physical symptoms and depression in a department of general medicine of a Japanese hospital. We included patients with unexplained symptoms after multiple tests to rule out organic diseases. Twenty-one common symptoms were assessed using a symptom checklist. Depression was diagnosed using the Patient Health Questionnaire-9, a self-administered questionnaire designed to diagnose depression. Among 386 patients, 105 (27.2%) (average age: 49.7 ± 20.9 years, 28 men and 77 women) met the criteria for depression. Among the 21 symptoms, 14 were significantly more frequent in patients with depression than in those without depression. When patients had neither general fatigue, nor sleep disturbance nor appetite loss, none met the criteria for depression. Number of symptoms was significantly higher in patients with compared with those without depression. The prevalence of depression increased with number of symptoms: 2% (2/100) for 0 or 1 symptom, 42.4% (42/99) for four to five symptoms and 68.7% (22/32) for more than nine symptoms. Japanese primary care physicians can often rule out depression when patients have neither general fatigue, nor sleep disturbance nor appetite loss. A diagnosis of depression should be considered in patients who report multiple physical symptoms.


Asunto(s)
Depresión/diagnóstico , Depresión/epidemiología , Atención Primaria de Salud/métodos , Adulto , Factores de Edad , Anciano , Depresión/patología , Disomnias/patología , Fatiga/patología , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Prevalencia , Factores Sexuales , Estadísticas no Paramétricas , Encuestas y Cuestionarios , Pérdida de Peso
7.
Dig Endosc ; 25(3): 288-94, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23369024

RESUMEN

AIM: Non-steroidal anti-inflammatory drugs have the potential to injure the mucosa of the upper digestive tract and small bowel, whereas celecoxib (a selective cyclooxygenase-2 inhibitor) has less influence on the entire digestive tract mucosa. The present study was conducted to compare the extents of small bowel mucosal injury induced by celecoxib and loxoprofen (the most frequently used non-steroidal anti-inflammatory drugs in Japan). METHODS: Ten healthy adult males were given celecoxib (200 mg/day, Group C) and loxoprofen (180 mg/day, Group L) in a cross-over design for 14 days, and the influence of each drug on small bowel mucosa was evaluated by comparing pre- and post-treatment capsule endoscopy findings. We measured the percentage of patients with small bowel mucosal injury following administration of these drugs as primary endpoint. Additionally, mean number of small bowel mucosal injuries per subject was analyzed as secondary endpoint. RESULTS: The percentage of subjects experiencing small bowel mucosal injury as primary endpoint was 10% in Group C and 70% in Group L after treatment. This magnitude of the difference of between Group C and Group L was statistically significant (P = 0.031). The number of small bowel mucosal injuries as secondary endpoint differed significantly between the two groups, and the influence of celecoxib on small bowel injury was less than that of loxoprofen. CONCLUSION: These results indicate that celecoxib has less influence on small bowel mucosa than loxoprofen and can be used safely.


Asunto(s)
Antiinflamatorios no Esteroideos/efectos adversos , Inhibidores de la Ciclooxigenasa 2/efectos adversos , Intestino Delgado/efectos de los fármacos , Fenilpropionatos/efectos adversos , Pirazoles/efectos adversos , Sulfonamidas/efectos adversos , Adulto , Antiinflamatorios no Esteroideos/administración & dosificación , Endoscopía Capsular , Celecoxib , Estudios Cruzados , Inhibidores de la Ciclooxigenasa 2/administración & dosificación , Humanos , Japón , Masculino , Persona de Mediana Edad , Fenilpropionatos/administración & dosificación , Pirazoles/administración & dosificación , Sulfonamidas/administración & dosificación
8.
Nihon Rinsho ; 71(8): 1442-8, 2013 Aug.
Artículo en Japonés | MEDLINE | ID: mdl-23967677

RESUMEN

Helicobacter pylori (H. pylori) is a major pathogen of chronic atrophic gastritis, intestinal metaplasia, and gastric cancer. Atrophic gastritis and intestinal metaplasia are recognized as precancerous lesion of gastric cancer. Many studies reported that H. pylori eradication had the preventive effect of gastric cancer. Moreover many studies mentioned the improvement of gastric atrophy and/or intestinal metaplasia. Two meta-analysis indicated the improvement of atrophic gastritis but not of intestinal metaplasia. In our study, intestinal metaplasia improved at lesser curvature of the corpus six years after eradication. H. pylori eradication has benefit for gastric cancer prevention provably due to improvement of the precancerous lesion such as atrophic gastritis and intestinal metaplasia. Especially, H. pylori eradication before the appearance of atrophy and intestinal metaplasia has been considered to be effective in inhibiting the development of gastric cancer. Therefore, improvement or elimination of chronic gastritis with H. pylori eradication might have possibility of gastric cancer inhibition.


Asunto(s)
Antibacterianos/uso terapéutico , Erradicación de la Enfermedad , Gastritis/etiología , Infecciones por Helicobacter/prevención & control , Helicobacter pylori , Neoplasias Gástricas/etiología , Enfermedad Crónica , Gastritis/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Humanos , Neoplasias Gástricas/tratamiento farmacológico
9.
J Clin Microbiol ; 50(3): 876-83, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22189111

RESUMEN

The incidence of gastric cancer in Okinawa is lowest in Japan. Some previous reports using small number of strains suggested that the high prevalence of Helicobacter pylori with Western-type cagA in Okinawa compared to other areas in Japan might contribute to the low incidence of gastric cancer. It has still not been confirmed why the prevalence of Western-type cagA strains is high in Okinawa. We examined the association between the virulence factors of H. pylori and gastroduodenal diseases in Okinawa. The genotypes of cagA and vacA of 337 H. pylori strains were determined by PCR and gene sequencing. The genealogy of these Western-type cagA strains in Okinawa was analyzed by multilocus sequence typing (MLST). Overall, 86.4% of the strains possessed cagA: 70.3% were East-Asian type and 16.0% were Western type. After adjustment by age and sex, the presence of East-Asian-type cagA/vacA s1m1 genotypes was significantly associated with gastric cancer compared to gastritis (odds ratio = 6.68, 95% confidence interval = 1.73 to 25.8). The structure of Western-type CagA in Okinawa was different from that of typical Western-type CagA found in Western countries. Intriguingly, MLST analysis revealed that the majority of Western-type cagA strains formed individual clusters but not hpEurope. Overall, low prevalence of gastric cancer in Okinawa may result from the high prevalence of non-East-Asian-type cagA strains. The origin of Western-type cagA strains in Okinawa may be different from those of Western countries.


Asunto(s)
Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Variación Genética , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/patología , Helicobacter pylori/patogenicidad , Factores de Virulencia/genética , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , ADN Bacteriano/química , ADN Bacteriano/genética , Femenino , Gastritis/microbiología , Gastritis/patología , Genotipo , Infecciones por Helicobacter/complicaciones , Helicobacter pylori/clasificación , Helicobacter pylori/genética , Helicobacter pylori/aislamiento & purificación , Humanos , Japón , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Tipificación de Secuencias Multilocus , Reacción en Cadena de la Polimerasa , Análisis de Secuencia de ADN , Neoplasias Gástricas/microbiología , Neoplasias Gástricas/patología , Adulto Joven
10.
J Clin Gastroenterol ; 46(4): 297-301, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22298090

RESUMEN

GOALS: To determine whether the presence of dupA Helicobacter pylori (H. pylori) influences the cure rate of primary eradication therapy. BACKGROUND: Several virulence factors of H. pylori have been reported to affect the efficacy of the eradication rate. However, no study has investigated whether the presence of dupA affects eradication failure. STUDY: The presence of dupA was evaluated in 142 H. pylori strains isolated from 142 patients with gastrointestinal diseases. Of these patients, 104 received primary eradication therapy for 1 week. The risk factors for eradication failure were determined using univariate and multivariate analyses. RESULTS: Among 142 strains, 44 (31.0%) were dupA positive. There was no association between dupA status and gastroduodenal diseases (P>0.05). The clarithromycin (CLR) resistance rate was generally lower in the dupA-positive than in the dupA-negative group (20.4% vs. 35.7%, P=0.06). However, dupA prevalence was higher in the eradication failure group than in the success group (36.3% vs. 21.9%). Among the CLR-resistant H. pylori infected group, the successful eradication rate was significantly lower in patients infected with dupA-positive H. pylori than dupA-negative H. pylori (P=0.04). In multivariate analysis adjusted for age, sex, and type of disease, not only CLR resistance but also dupA presence was independent risk factors for eradication failure (adjusted odds ratio=3.71; 95% confidence interval,1.07-12.83). CONCLUSIONS: Although CLR resistant was more reliable predictor, the presence of dupA may also be an independent risk factor for eradication failure.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Factores de Virulencia , Adulto , Anciano de 80 o más Años , Antibacterianos/administración & dosificación , Claritromicina/administración & dosificación , Claritromicina/farmacología , Estudios de Cohortes , Farmacorresistencia Bacteriana , Quimioterapia Combinada , Femenino , Infecciones por Helicobacter/virología , Helicobacter pylori/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Inhibidores de la Bomba de Protones/administración & dosificación , Inhibidores de la Bomba de Protones/farmacología , Estudios Retrospectivos , Insuficiencia del Tratamiento , Adulto Joven
11.
Digestion ; 85(2): 126-30, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22269293

RESUMEN

BACKGROUND AND AIM: Helicobacter pylori has been shown to cause atrophic gastritis and intestinal metaplasia (IM), both of which are precancerous lesions. To clarify the mechanism by which H. pylori eradication prevents gastric cancer, we monitored atrophy and IM improvement in gastric mucosa over a long period after H. pylori eradication. METHODS: We monitored 118 patients (72 males, 46 females; mean age 61.3 ± 5.1 years) for a mean of 8.6 years (range 5-13) after successful H. pylori eradication. Biopsy specimens were taken from the greater curvatures of the antrum (A2) and the corpus (B2). RESULTS: Atrophy was significantly decreased in patients with successful H. pylori eradication, both at A2 (from 1.60 ± 0.09 to 1.02 ± 0.08; p < 0.001) and B2 (from 0.71 ± 0.10 to 0.02 ± 0.02; p < 0.001), and IM score was significantly decreased at B2 (from 0.17 ± 0.12 to 0.00 ± 0.00; p < 0.05), but not at A2 (from 0.60 ± 0.11 to 0.43 ± 0.09; p = NS). In patients without successful eradication, however, there were no differences in scores over time. Before eradication, IM score was significantly higher in males than in females, both at A2 (0.81 ± 0.12 vs. 0.25 ± 0.10; p < 0.05) and B2 (0.32 ± 0.08 vs. 0.07 ± 0.04; p < 0.05). CONCLUSION: We were able to monitor the gastric mucosa for a mean of 8.6 years after H. pylori eradication, the longest period reported to date. Significant improvements in gastric atrophy and IM after H. pylori eradication may decrease the risk of gastric cancer.


Asunto(s)
Mucosa Gástrica/patología , Gastritis Atrófica/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori/efectos de los fármacos , Intestinos/patología , Antibacterianos/uso terapéutico , Biopsia , Femenino , Estudios de Seguimiento , Mucosa Gástrica/microbiología , Gastritis Atrófica/patología , Infecciones por Helicobacter/patología , Humanos , Masculino , Metaplasia , Persona de Mediana Edad , Factores Sexuales , Neoplasias Gástricas/prevención & control
12.
Scand J Gastroenterol ; 46(3): 287-92, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21073372

RESUMEN

OBJECTIVE: Helicobacter pylori eradication therapy alone cannot heal gastric ulcers in Japanese patients. Irsogladine has previously been shown to accelerate the healing of gastric ulcers after H. pylori eradication therapy. And we previously reported that histamine H(2) receptor antagonists inhibit gastric ulcer relapse after H. pylori eradication therapy. We therefore compared the efficacy of irsogladine with famotidine as appropriate treatments for ulcers after eradication therapy. METHODS: Gastric ulcer patients with H. pylori infection (n = 119) were randomized to treatment with irsogladine 4 mg/day (n = 60) or famotidine 40 mg/day (n = 59) following 1-week H. pylori eradication therapy. After treatment, assessments of gastric ulcer healing were performed. RESULTS: The ulcer healing rates in patients receiving irsogladine and famotidine were 85.2% (46/54) and 79.6% (43/54), respectively, and were not significantly different (p = 0.4484). In the famotidine group, the healing rate was significantly lower in patients who drink alcohol than in those who do not (60.0% vs. 91.2%; p = 0.0119). However, in the irsogladine group the healing rate did not differ between patients who drink alcohol and those who do not. Furthermore, the healing rate in smokers was significantly higher in the irsogladine group (88.0%) than in the famotidine group (59.1%) (p = 0.0233). CONCLUSIONS: Irsogladine and famotidine are both acceptable in treatment after H. pylori eradication therapy in gastric ulcer patients. Findings also suggest that irsogladine is more beneficial than famotidine in patients who drink alcohol and smoke.


Asunto(s)
Antiulcerosos/uso terapéutico , Famotidina/uso terapéutico , Helicobacter pylori , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Úlcera Gástrica/tratamiento farmacológico , Triazinas/uso terapéutico , Anciano , Consumo de Bebidas Alcohólicas , Antiulcerosos/administración & dosificación , Esquema de Medicación , Famotidina/administración & dosificación , Femenino , Infecciones por Helicobacter/tratamiento farmacológico , Antagonistas de los Receptores H2 de la Histamina/administración & dosificación , Humanos , Masculino , Persona de Mediana Edad , Fumar , Úlcera Gástrica/microbiología , Resultado del Tratamiento , Triazinas/administración & dosificación
13.
BMC Gastroenterol ; 11: 141, 2011 Dec 22.
Artículo en Inglés | MEDLINE | ID: mdl-22189161

RESUMEN

BACKGROUND: Specific genotypes of several virulence factors of Helicobacter pylori (eg, cagA-positive, vacA s1, oipA "on" and babA-positive) have been reported to be predictors of severe clinical outcomes. Importantly, the presence of these genotypes correlates with each other. We hypothesized that novel virulence genes correlate with the presence of cagA. Therefore, we aimed to find novel candidate virulence genes that correlate with cagA and examined the association of these genes with clinical outcomes in Colombian and Japanese populations. METHODS: cagA-associated genes were selected based on previous H. pylori genome microarray data. A total of 343 strains (174 from Colombia and 169 from Japan) were examined for the status of cagA, vacA, and candidate genes by polymerase chain reaction and dot blot. RESULTS: Microarray data showed that 9 genes were significantly correlated with the presence of cagA. Among the 9 genes, the functions of 4 were known, and we selected these 4 genes as candidate genes (hp0967, jhp0045, jhp0046, and jhp0951). The prevalences of cagA, vacA s1/m1 genotype, and hp0967 were significantly higher in Japan than Colombia, whereas those of jhp0045 and jhp0046 were more prevalent in Colombia than Japan. The prevalences of jhp0045 and jhp0046 in cagA-positive cases of gastric cancer were significantly higher than those from gastritis in Colombia (P = 0.015 and 0.047, respectively). In contrast, the prevalence of 4 candidate genes was independent of clinical outcomes in Japan. CONCLUSIONS: jhp0045 and jhp0046 might be novel markers for predicting gastric cancer in cagA-positive cases in Colombia, but not in Japan.


Asunto(s)
Antígenos Bacterianos/genética , Proteínas Bacterianas/genética , Gastritis/genética , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Neoplasias Gástricas/genética , Colombia/epidemiología , Cartilla de ADN/química , Gastritis/epidemiología , Gastritis/microbiología , Genotipo , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/genética , Helicobacter pylori/patogenicidad , Humanos , Immunoblotting , Japón/epidemiología , Análisis por Micromatrices , Reacción en Cadena de la Polimerasa , Prevalencia , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/microbiología
14.
J Pathol ; 221(1): 96-105, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20217874

RESUMEN

Although genomic copy number aberrations (CNAs) of gastric carcinoma at the advanced stage have already been extensively characterized by array comparative genomic hybridization (array CGH) analysis, those of gastric carcinoma in situ (CIS) are still poorly understood. Furthermore, no reports have demonstrated correlations between CNAs and histopathological features of gastric adenoma. In this study, we investigated CNAs of 20 gastric CISs (Vienna category 4.2) and 20 adenomas including seven low-grade adenomas (LGA; Vienna category 3) and 13 high-grade adenomas (HGA; Vienna category 4.1), using oligonucleotide-based array CGH. The most frequent aberrations in CIS were gains at 8q (85%) and 20q (50%), and losses at 5q (50%) and 17p (50%), suggesting that these CNAs are involved in the development of CIS. We found that the pattern of CNAs in HGA was quite different from that in LGA. The most frequent CNAs in HGA were gains at 8q (62%) and 7pq (54%), whereas those in LGA were gain at 7q21.3-q22.1 (57%) and loss at 5q (43%). Interestingly, gains at 8q and 7pq, both of which occurred most frequently in HGA, were not detected in any cases of LGA. Of note, 8q gain was detected most frequently in both HGA and CIS but was undetected in LGA. Since HGA is believed to have a higher risk of progression to invasive carcinoma than LGA, these data suggest that 8q gain is important for the malignant transformation of gastric adenoma.


Asunto(s)
Adenoma/genética , Carcinoma in Situ/genética , Neoplasias Gástricas/genética , Adenoma/patología , Anciano , Anciano de 80 o más Años , Carcinoma in Situ/patología , Transformación Celular Neoplásica/genética , Aberraciones Cromosómicas , Hibridación Genómica Comparativa , Progresión de la Enfermedad , Femenino , Perfilación de la Expresión Génica/métodos , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Modelos Genéticos , Neoplasias Gástricas/patología
15.
J Gastroenterol Hepatol ; 26(9): 1451-6, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21592227

RESUMEN

BACKGROUND AND AIM: jhp0562 and ß-(1,3)galT (jhp0563) of Helicobacter pylori have been suggested as novel virulent factors; however, the clinical associations and functions of these genes remain unclear. We examined the prevalence of jhp0562, ß-(1,3)galT, and cagA in the United States (US) and Japanese populations. METHODS: A total of 308 strains (171 from the US and 137 from Japan) were examined for the status of jhp0562, ß-(1,3)galT, and cagA by polymerase chain reaction. RESULTS: There were significant differences in the status of jhp0562, ß-(1,3)galT and cagA between the US and Japanese populations (P < 0.001). In the US, the prevalence of ß-(1,3)galT was significantly lower in strains isolated from patients with duodenal ulcer (DU) or gastric ulcer (GU) than those with gastritis (47.8% and 32.1% vs 72.0%, P < 0.01), and the absence of ß-(1,3)galT was an independent factor discriminating DU and GU from gastritis (adjusted odds ratios, 4.21 and 8.52; 95% confidence intervals, 1.75 to 10.12 and 2.76 to 26.33, respectively). In the US, the prevalence of the jhp0562-positive/ß-(1,3)galT-negative genotype was significantly higher in strains from DU and GU patients than in those from gastritis patients (50.0%, 67.9%, and 24.4%, P < 0.01) and the cagA status was significantly correlated with that of jhp0562 and inversely correlated with that of ß-(1,3)galT. In contrast, the prevalence of these three genes was not significantly different in Japan. CONCLUSIONS: jhp0562 or ß-(1,3)galT can be used to discriminate peptic ulcers from gastritis in the US, but not in Japan.


Asunto(s)
Proteínas Bacterianas/genética , Úlcera Duodenal/microbiología , Gastritis/microbiología , Glicosiltransferasas/genética , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Úlcera Gástrica/microbiología , Factores de Virulencia/genética , Adulto , Anciano , Antígenos Bacterianos/genética , Técnicas de Tipificación Bacteriana , Distribución de Chi-Cuadrado , Diagnóstico Diferencial , Úlcera Duodenal/epidemiología , Úlcera Duodenal/patología , Endoscopía Gastrointestinal , Femenino , Mucosa Gástrica/microbiología , Mucosa Gástrica/patología , Gastritis/epidemiología , Gastritis/patología , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/patología , Helicobacter pylori/enzimología , Helicobacter pylori/patogenicidad , Humanos , Mucosa Intestinal/microbiología , Mucosa Intestinal/patología , Japón/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Valor Predictivo de las Pruebas , Prevalencia , Medición de Riesgo , Factores de Riesgo , Úlcera Gástrica/epidemiología , Úlcera Gástrica/patología , Estados Unidos/epidemiología
16.
J Gastroenterol Hepatol ; 26(4): 688-93, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21054521

RESUMEN

BACKGROUND AND AIMS: Recently, we successfully produced an anti-East-Asian-type CagA-specific antibody called α-EAS Ab, which is specifically immunoreactive only with East-Asian-type CagA but not Western-type CagA. In this study, the correlations between Helicobacter pylori CagA protein diversity and gastric mucosal condition was investigated using immunohistochemical staining with α-EAS Ab in Japan. METHODS: There were 254 H. pylori-positive patients enrolled in this study. α-EAS Ab was used to determine the CagA phenotype instead of cagA sequencing, and, moreover, the histological findings and endoscopic gastric mucosal condition were evaluated according to the updated Sydney System and the Kimura-Takemoto classification system, respectively. RESULTS: A total of 224 (88.2%) of the patients were immunoreactive for α-EAS Ab. The remaining 30 (11.8%) were negative for α-EAS Ab, suggesting that they were infected with either Western-type CagA or CagA-negative strains (i.e. non-East-Asian-type CagA strains). The grades of activity of gastritis, mucosal atrophy and intestinal metaplasia according to the updated Sydney System were significantly higher in patients infected with East-Asian-type CagA strains than those infected with non-East-Asian-type CagA strains. The grade of endoscopic gastric mucosal atrophy evaluated using the Kimura-Takemoto classification system was similar. All 28 strains isolated from patients with gastric cancer possessed the East-Asian-type CagA. CONCLUSIONS: Infection with East-Asian-type CagA H. pylori was more closely associated with gastric mucosal atrophy and gastric cancer than infection with non-East-Asian-type CagA H. pylori. The efficiency of immunohistochemical analysis for CagA should be equivalent to that of cagA sequencing.


Asunto(s)
Antígenos Bacterianos/análisis , Proteínas Bacterianas/análisis , Mucosa Gástrica/microbiología , Gastritis/microbiología , Infecciones por Helicobacter/microbiología , Helicobacter pylori/química , Inmunohistoquímica , Adulto , Anciano , Anciano de 80 o más Años , Atrofia , Biopsia , Femenino , Mucosa Gástrica/patología , Gastritis/patología , Gastroscopía , Infecciones por Helicobacter/patología , Humanos , Japón , Masculino , Metaplasia , Persona de Mediana Edad , Fenotipo , Valor Predictivo de las Pruebas , Índice de Severidad de la Enfermedad , Adulto Joven
17.
Clin Lab ; 57(7-8): 481-7, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21888011

RESUMEN

BACKGROUND: ODK-0702 is a stick-type urinary Helicobacter pylori (H. pylori) antibodies detection kit, developed to improve the original housing type urinary H. pylori antibodies detection kit "RAPIRUN H. pylori Antibody". This stick-type kit is designed for the efficient daily medical practice at hospital or clinic, public or school health checkup, to detect H. pylori infection. The aim of this study was to evaluate the performance and correlation of this kit with the original kit and the ELISA kit. METHODS: Control kits were "RAPIRUN H. pylori Antibody" (Kit A) and "URINELISA H. pylori Antibody" (Kit B). Urine samples were obtained from 249 subjects scheduled for upper endoscopy, 99 subjects suspected of having upper gastrointestinal disease, and 150 subjects receiving health checkups. Rates of agreement in results between ODK-0702 and the control kits were investigated. RESULTS: High agreement rates of 98.4% (245/249) and 88.8% (221/249) were found between ODK-0702 and the kits, Kit A and B, respectively. In patients, the agreement rates of ODK-0702 as compared to Kit A and B were 99.0% (98/99) and 88.9% (88/99), respectively. In control subjects, the agreement rates of ODK-0702 as compared to Kit A and B were 98.0% (147/150) and 88.7% (133/150), respectively. CONCLUSIONS: ODK-0702 enabled rapid testing within 15 minutes and showed equivalent performance as control kits, being clinically very useful in the diagnosis of H. pylori infection.


Asunto(s)
Anticuerpos Antibacterianos/orina , Gastritis/diagnóstico , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/inmunología , Inmunoglobulina G/orina , Juego de Reactivos para Diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antibacterianos/inmunología , Reacciones Cruzadas , Reacciones Falso Negativas , Femenino , Gastritis/microbiología , Gastritis/orina , Infecciones por Helicobacter/orina , Humanos , Inmunoglobulina G/inmunología , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto Joven
18.
BMC Gastroenterol ; 10: 114, 2010 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-20920280

RESUMEN

BACKGROUND: The rate of H. pylori infection in Vietnam is reportedly high, but the spectrum of H. pylori-associated gastroduodenal diseases has not been systematically investigated. Moreover, despite the similarities of ethnicity and diet, the age-standardized incidence rate of gastric cancer in the northern city of Hanoi is higher than that in the southern city of Ho Chi Minh, but the reason for this phenomenon is unknown. The virulence of Vietnamese H. pylori has also not been investigated in detail. METHODS: Individuals undergoing esophagogastroduodenoscopy were randomly recruited. H. pylori infection status was determined based on the combined results of culture, histology, immunohistochemistry, rapid urine test and serum ELISA. Peptic ulcer (PU) and gastroesophageal reflux disease was diagnosed by endoscopy, and chronic gastritis was determined histologically. H. pylori virulence factors were investigated by PCR and sequencing. RESULTS: Among the examined patients, 65.6% were infected with H. pylori. The prevalence of infection was significantly higher in those over 40 years of age than in those aged ≤40. Chronic gastritis was present in all H. pylori-infected individuals, 83.1% of whom had active gastritis, and 85.3% and 14.7% had atrophy and intestinal metaplasia, respectively. PU was present in 21% of infected patients, whereas its incidence was very low in non-infected individuals. The prevalence of PU was significantly higher in Hanoi than in Ho Chi Minh. The prevalence of vacA m1, which has been identified as an independent risk factor for PU in Vietnam, was significantly higher among H. pylori isolates from Hanoi than among those from Ho Chi Minh. CONCLUSIONS: H. pylori infection is common in Vietnam and is strongly associated with PU, active gastritis, atrophy and intestinal metaplasia. vacA m1 is associated with an increased risk for PU and might contribute to the difference in the prevalence of PU and gastric cancer between Hanoi and Ho Chi Minh.


Asunto(s)
Enfermedades Duodenales/epidemiología , Infecciones por Helicobacter/epidemiología , Helicobacter pylori/aislamiento & purificación , Gastropatías/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Anticuerpos Antibacterianos/análisis , Estudios Transversales , ADN Bacteriano/análisis , Enfermedades Duodenales/diagnóstico , Enfermedades Duodenales/microbiología , Endoscopía Gastrointestinal , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por Helicobacter/diagnóstico , Infecciones por Helicobacter/microbiología , Helicobacter pylori/genética , Helicobacter pylori/inmunología , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Prevalencia , Factores de Riesgo , Distribución por Sexo , Gastropatías/diagnóstico , Gastropatías/microbiología , Vietnam/epidemiología , Adulto Joven
19.
Dig Dis Sci ; 55(1): 89-93, 2010 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-19241167

RESUMEN

PURPOSE: This study attempted to assess the value of the RAPIRUN test for the diagnosis of Helicobacter pylori infection in the Vietnamese population. METHODS: We recruited 148 Vietnamese patients undergoing upper gastrointestinal endoscopy during which five gastric biopsies were taken; blood and urine samples were collected from each patient. Helicobacter pylori infection status was determined by a combination of three different methods, including culture, immunohistochemistry, and serum ELISA. RAPIRUN tests were performed using urine samples. RESULTS: The sensitivity, specificity, and accuracy of the RAPIRUN test in these Vietnamese patients were 79.5, 90.7, and 84.5%, respectively. CONCLUSIONS: The RAPIRUN test is useful for the diagnosis of H. pylori infection in the Vietnamese population, showing high specificity, acceptable sensitivity, non-invasiveness, convenience, and rapidity.


Asunto(s)
Anticuerpos Antibacterianos/orina , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori/inmunología , Adolescente , Adulto , Anciano , Recuento de Colonia Microbiana , Ensayo de Inmunoadsorción Enzimática , Femenino , Infecciones por Helicobacter/orina , Helicobacter pylori/aislamiento & purificación , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Juego de Reactivos para Diagnóstico , Sensibilidad y Especificidad , Vietnam , Adulto Joven
20.
Antimicrob Agents Chemother ; 53(7): 3097-9, 2009 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-19380599

RESUMEN

Sitafloxacin showed MICs of less than or equal to 0.5 microg/ml against 105 isolates of Helicobacter pylori, including 44 isolates with mutations in the gyrA gene. The highest MICs for garenoxacin and levofloxacin were 8 and 64 times, respectively, higher than the highest MICs observed for sitafloxacin.


Asunto(s)
Antibacterianos/farmacología , Girasa de ADN/genética , Fluoroquinolonas/farmacología , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/genética , Levofloxacino , Pruebas de Sensibilidad Microbiana , Mutación , Ofloxacino/farmacología
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