Background and aims: Gastric acid secretion is downregulated by Helicobacter pylori infection and upregulated after its eradication, but the mechanisms are still unclear. We examined the effects of H pylori eradicatio...Background and aims: Gastric acid secretion is downregulated by Helicobacter pylori infection and upregulated after its eradication, but the mechanisms are still unclear. We examined the effects of H pylori eradication on the number of parietal cells and on expression of molecules functioning in acid secretion in the human gastric mucosa. Methods: We enrolled 111 consecutive men with chronic gastritis induced by H pylori. Biopsy specimens were endoscopically obtained before and 12 weeks after successful eradication of H pylori and parietal cell numbers were counted. mRNA expression levels of H+/K+-adenosine triphosphatase (H+/K+-ATPase), anion exchanger 2, M3 muscarinic receptor, intrinsic factor, and interleukin 1βwere determined with a real time reverse transcriptase-polymerase chain reaction method. The severity of gastric atrophy was evaluated using the serum pepsinogen I/II ratio. Results: No significant difference was observed in parietal cell numbers before and after H pylori eradication. Median mRNA expression levels of H+/K+-ATPase in the gastric mucosa increased 250-fold after H pylori eradication accompanied by attenuation of interleukin 1β. Alarge increase in H+/K+-ATPase expression was observed even in patients with severe atrophic gastritis. In contrast, fold increases in mRNA expression levels, including intrinsic factor, anion exchanger 2, and M3 muscarinic receptor, after eradication therapy, were limited to 1.4, 2.3, and 2.5 times, respectively. Conclusions: In the absence of alteration of parietal cell number, gastric H+/K+-ATPase mRNA expression was markedly restored after successful Hpylori eradication, suggesting a central role for the restoration of H+/K+-ATPase expression in gastric acid secretion recovery after H pylori eradication.展开更多
Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomogra...Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomography (OCT) and to investigate the relationship between postoperative VF defects and RNFL damage. Design: Retrospective interventional case series. Participants: Thirty-four eyes of 32 patients with idiopathic macular holes that underwent vitrectomy between January 2001 and March 2003 were included in this study. Eyes were divided into 3 groups according to the occurrence of postoperative VF defects and the use of indocyanine green for internal limiting membrane peeling during surgery: 11 eyes with VF defects after indocyanine green-assisted vitrectomy (group 1),9 eyes without VF defects despite the use of indocyanine green (group 2),and 14 eyes without VF defects that underwent vitrectomy without indocyanine green (group 3). Methods: Retinal nerve fiber layer thickness in each of 4 quadrants (superior,inferior,nasal,temporal)was measured with OCT. Main OutcomeMeasure: Retinal nerve fiber layer thickness around the optic disc. Results: The mean RNFL thickness in 3 of 4 quadrants (superior,nasal,inferior) in group 1 was significantly less than that in the corresponding quadrant in groups 2 and 3 (P < 0.01). In the temporal quadrant,there was a significant difference between groups 1 and 3 (P=0.02),but not between groups 1 and 2. The RNFL thickness in group 1 was significantly less in 3 quadrants in operated eyes than in fellow eyes (P< 0.05). Conclusions: The RNFL thickness was reduced in eyes with VF defects after indocyanine green-assisted vitrectomy for macular holes,suggesting that the postoperativeVF defectsmay have been caused by RNFL damage relating to the use of indocyanine green.展开更多
Background: The inability to pass endoscopes beyond strictures is a considerable problem in patients with a colonic stricture. Methods: In patients with bowel obstruction, we have modified the insertion method for dou...Background: The inability to pass endoscopes beyond strictures is a considerable problem in patients with a colonic stricture. Methods: In patients with bowel obstruction, we have modified the insertion method for double-balloon endoscopy with a long, transnasal decompression tube. Observations: We have succeeded in reaching the proximal side of the stricture from the oral approach across the entire small bowel in a patient. Conclusions: This modified double-balloon enteroscopy is useful for patients with bowel obstruction in whom a long decompression tube is already placed.展开更多
文摘Background and aims: Gastric acid secretion is downregulated by Helicobacter pylori infection and upregulated after its eradication, but the mechanisms are still unclear. We examined the effects of H pylori eradication on the number of parietal cells and on expression of molecules functioning in acid secretion in the human gastric mucosa. Methods: We enrolled 111 consecutive men with chronic gastritis induced by H pylori. Biopsy specimens were endoscopically obtained before and 12 weeks after successful eradication of H pylori and parietal cell numbers were counted. mRNA expression levels of H+/K+-adenosine triphosphatase (H+/K+-ATPase), anion exchanger 2, M3 muscarinic receptor, intrinsic factor, and interleukin 1βwere determined with a real time reverse transcriptase-polymerase chain reaction method. The severity of gastric atrophy was evaluated using the serum pepsinogen I/II ratio. Results: No significant difference was observed in parietal cell numbers before and after H pylori eradication. Median mRNA expression levels of H+/K+-ATPase in the gastric mucosa increased 250-fold after H pylori eradication accompanied by attenuation of interleukin 1β. Alarge increase in H+/K+-ATPase expression was observed even in patients with severe atrophic gastritis. In contrast, fold increases in mRNA expression levels, including intrinsic factor, anion exchanger 2, and M3 muscarinic receptor, after eradication therapy, were limited to 1.4, 2.3, and 2.5 times, respectively. Conclusions: In the absence of alteration of parietal cell number, gastric H+/K+-ATPase mRNA expression was markedly restored after successful Hpylori eradication, suggesting a central role for the restoration of H+/K+-ATPase expression in gastric acid secretion recovery after H pylori eradication.
文摘Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomography (OCT) and to investigate the relationship between postoperative VF defects and RNFL damage. Design: Retrospective interventional case series. Participants: Thirty-four eyes of 32 patients with idiopathic macular holes that underwent vitrectomy between January 2001 and March 2003 were included in this study. Eyes were divided into 3 groups according to the occurrence of postoperative VF defects and the use of indocyanine green for internal limiting membrane peeling during surgery: 11 eyes with VF defects after indocyanine green-assisted vitrectomy (group 1),9 eyes without VF defects despite the use of indocyanine green (group 2),and 14 eyes without VF defects that underwent vitrectomy without indocyanine green (group 3). Methods: Retinal nerve fiber layer thickness in each of 4 quadrants (superior,inferior,nasal,temporal)was measured with OCT. Main OutcomeMeasure: Retinal nerve fiber layer thickness around the optic disc. Results: The mean RNFL thickness in 3 of 4 quadrants (superior,nasal,inferior) in group 1 was significantly less than that in the corresponding quadrant in groups 2 and 3 (P < 0.01). In the temporal quadrant,there was a significant difference between groups 1 and 3 (P=0.02),but not between groups 1 and 2. The RNFL thickness in group 1 was significantly less in 3 quadrants in operated eyes than in fellow eyes (P< 0.05). Conclusions: The RNFL thickness was reduced in eyes with VF defects after indocyanine green-assisted vitrectomy for macular holes,suggesting that the postoperativeVF defectsmay have been caused by RNFL damage relating to the use of indocyanine green.
文摘Background: The inability to pass endoscopes beyond strictures is a considerable problem in patients with a colonic stricture. Methods: In patients with bowel obstruction, we have modified the insertion method for double-balloon endoscopy with a long, transnasal decompression tube. Observations: We have succeeded in reaching the proximal side of the stricture from the oral approach across the entire small bowel in a patient. Conclusions: This modified double-balloon enteroscopy is useful for patients with bowel obstruction in whom a long decompression tube is already placed.
