[Study on the recognition of upper abdominal symptoms by Japanese adults ].

Four hundred and sixty-three cases, who visited medical center for annual check-up, were enrolled in this study. All subjects were required to answer three symptoms in the ten upper abdominal symptoms and the frequency of these symptoms by which they might visit hospital to take medical care. Upper abdominal pain, nausea and chest pain were best three symptoms, which might cause hospital visit and only a few subjects thought that they make a hospital visit by heartburn, acid regurgitation and early satiety. More than 30% of subjects think that they might visit medical center for medical care when these symptoms occur over three times per week. In contrast, upper abdominal pain, nausea, vomiting, heartburn and early satiety were frequently observed in 100 patients, who visited medical center to take medical care. In addition, about half of patients visited medical center when these symptoms occurred every day.

Helicobacter pylori infection does not accelerate the age-related progression of arteriosclerosis: a 4-year follow-up study.

BACKGROUND AND AIM: Helicobacter pylori (H. pylori) infection has been reported to correlate with the onset of cardiovascular diseases. However, the relationship between H. pylori infection and the progression of arteriosclerosis has not been fully investigated. The aim of this study was to clarify the possible role of H. pylori infection in the development of arteriosclerosis. METHODS: Study subjects were 258 cases who attended their annual medical check-ups and were twice investigated by the parameters of arteriosclerosis at a 4-year interval. Arteriosclerotic parameters (systolic blood pressure [SBP]), ankle brachial index [ABI], and pulse wave velocity [PWV]) were measured non-invasively using an automatic device. H. pylori-infection status was determined by assaying serum anti-H. pylori IgG antibodies. The changes in the arteriosclerotic parameters during the 4 years were compared between H. pylori-seropositive and seronegative individuals. RESULTS: A total of 166 subjects (64.3%) were H. pylori-seropositive. After adjustment for gender, age, body mass index, and smoking and drinking habits, there were no differences in any of the arteriosclerotic parameters between the groups, not only at enrollment but after the 4 years, although the high-density lipoprotein cholesterol levels of the seropositive groups were significantly lower than those of seronegative groups. SBP and PWVs were significantly increased during 4 years in both the seropositive and seronegative groups. The percentage of changes in SBP and PWVs, which were calculated by ([values after 4 years--values at enrollment/values at enrollment] x 100), did not differ between the groups. CONCLUSION: H. pylori infection does not accelerate the age-related progression of arteriosclerosis in Japanese individuals.

Five-year follow-up study of patients with reflux symptoms and reflux esophagitis in annual medical check-up field.

AIM: To clarify changes in the prevalence of reflux symptoms and reflux esophagitis over a period of 5 years. SUBJECTS AND METHODS: Five hundred thirty-nine study subjects (male: 408, mean age 47.3 years) were assessed using a reflux symptom questionnaire and endoscopic examinations conducted twice, 5 years apart. RESULTS: At enrollment, 88 patients had reflux symptoms and 44 had reflux esophagitis (RE). After 5 years, 58 and 53 patients were diagnosed as having reflux symptoms and RE, respectively. Only 26% of the patients with reflux symptoms at enrollment had the symptoms after 5 years. The presence of reflux symptoms and an increase of BMI were significant risk factors for the presence of reflux symptoms after 5 years. CONCLUSION: Reflux symptoms frequently disappear after 5 years. It is difficult to identify individuals who will still have symptoms after 5 years on the basis of clinical characteristics.

Study of arteriosclerosis in patients with hiatal hernia and reflux esophagitis.

BACKGROUND AND AIM: It has been reported that the prevalence of hiatal hernia (HH) and reflux esophagitis (RE) increases with age, as does the degree of arteriosclerosis. However, it has not been investigated whether or not arteriosclerosis is correlated with the presence of HH and RE. Therefore, we prospectively investigated the degree of arteriosclerosis in patients with HH and RE compared with subjects without HH and RE. METHODS: We prospectively enrolled 1683 people who visited Shimane Environment and Health Public Corporation for annual medical check-ups. All subjects were investigated by upper gastrointestinal endoscopy for the possible presence of HH and RE. Factors used for assessing cardiovascular risk were sex, age, body mass index (BMI), smoking and drinking habits, serum total cholesterol, triglyceride (TG), and high-density lipoprotein cholesterol (HDLC). Arteriosclerosis was investigated by measuring systolic blood pressure, heart-carotid pulse wave velocity (HCPWV), bilateral ankle brachial index (ABI) and heart-ankle PWV (HAPWV). RESULTS: The number of patients with HH and RE was 624 (37.1%) and 143 (8.5%), respectively. The HDLC level of the patients with HH was significantly lower, and the levels of BMI, TG and arteriosclerotic parameters were higher than those of the subjects without HH after adjusting for confounding factors (sex, age and smoking and drinking habits). Cardiovascular and arteriosclerosis parameters except for TG did not differ between the subjects with and without RE. CONCLUSION: Levels of arteriosclerosis parameters in patients with HH were higher than in those without HH. However, the association between arteriosclerosis and presence of RE was not clarified.

A study of arteriosclerosis in healthy subjects with HBV and HCV infection.

BACKGROUND: It is unclear whether infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) affects arteriosclerosis. We performed a cross-sectional study to clarify the effect of HBV and HCV infection on arteriosclerosis. METHODS: The study subjects were 1806 healthy individuals who visited Shimane Environment and Health Public Corporation for routine medical check-ups. Serum levels of total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, and blood glucose were investigated in all subjects. The degree of arteriosclerosis was assessed using systolic blood pressure, the bilateral ankle brachial index (ABI), the heart-carotid pulse wave velocity (HCPWV), and the heart-ankle PWV (HAPWV). These cardiovascular parameters were compared between control subjects and subjects with HBV and HCV infection, using analysis of covariance to adjust for confounding factors (sex, age, body mass index, and smoking and drinking). RESULTS: Of the 1806 subjects, 39 and 31 were diagnosed as positive for HBV and HCV infection, respectively. The remaining 1736 were considered to be the controls. Adjusted serum lipid levels in the subjects with HBV and those with HCV infection tended to be lower than those in the control subjects. Adjusted arteriosclerotic parameters in the subjects with HBV and HCV infection were similar to those in the control subjects, even after adjusting for serum lipid levels. CONCLUSIONS: Infection with HBV or HCV does not influence the severity of arteriosclerosis in healthy subjects.

Prevalence of endoscopically negative and positive gastroesophageal reflux disease in the Japanese.

OBJECTIVE: The frequency of gastroesophageal reflux disease (GERD) has not been fully investigated in the Asian population. The aim of this study was to investigate the prevalence of GERD, endoscopy-negative GERD (NERD), and erosive GERD in Japan, and the factors influencing disease prevalence. MATERIALS AND METHODS: A total of 2760 subjects (mean age 50.4 years, range 24-84 years) were prospectively enrolled in this multicenter study. GERD symptoms were assessed with the Japanese version of the Carlsson-Dent self-administered questionnaire (QUEST) and upper gastrointestinal endoscopy was performed on all study participants. RESULTS: A total of 495 (17.9%) individuals were diagnosed with GERD by the presence of erosive esophagitis at endoscopy and/or by the presence of GERD symptoms. Erosive esophagitis was diagnosed endoscopically in 195 (7.1%), and symptomatic GERD was diagnosed in 351 (12.7%) based on a QUEST score of over 6. Of these 351 subjects, 300 (10.9%) were considered to have NERD. Male gender, hiatal hernia, and mild gastric mucosal atrophy were significant positive predictive factors of erosive esophagitis by multiple regression analysis. Hiatal hernia ws the only significant predictor of GERD symptoms. Traditional Japanese foods, such as sweet cakes and rice cake, frequently exacerbated GERD symptoms. CONCLUSIONS: The prevalence of GERD in the Japanese was 17.9% and the prevalence rates of NERD and erosive esophagitis were 10.9% and 8.6%, respectively. The majority of symptomatic patients did not have endoscopically proven esophagitis. Hiatal hernia is the only important predictor of the presence of GERD symptoms.

Pulse-wave velocity and cardiovascular risk factors in subjects with Helicobacter pylori infection.

BACKGROUND: Helicobacter pylori infection has been reported to correlate with the onset of cardiovascular diseases. However, the relationship between H. pylori infection and the development of arteriosclerosis has not been fully investigated. We performed a cross-sectional study to clarify the possible role of H. pylori infection in the development of arteriosclerosis. METHODS: The subjects were 996 cases who attended their annual medical check-up between April and August 2001. H. pylori infection status was determined by assaying serum anti-H. pylori immunoglobulin G antibodies. Total cholesterol, high-density lipoprotein cholesterol (HDLC), triglyceride, fasting blood glucose, hemoglobin A1c and leukocyte levels were determined. Arteriosclerotic parameters (systolic blood pressure (SBP), ankle brachial index (ABI) and pulse-wave velocity (PWV)) were measured non-invasively using an automatic device. The data for H. pylori-seropositive and -seronegative individuals were compared. RESULTS: Five hundred and seventy-three subjects (57.5%) were H. pylori-seropositive. After adjustment for sex, age, body mass index, and smoking and drinking habits, the HDLC levels of the seropositive and seronegative groups differed markedly (55.0 vs 58.0 mg/dL, P < 0.0001). Although there were no differences between the overall adjusted SBP and ABI values, the PWV was higher in H. pylori-seropositive than -seronegative young (<39 years old) individuals (heart-carotid PWV: 632.2 vs 589.7 cm/s, P = 0.027). These differences tended to disappear with aging. CONCLUSIONS: The degree of arterial stiffness in H. pylori-positive young subjects is higher than that in H. pylori-negative young subjects. However, no difference between the arterial stiffness values of H. pylori-seropositive and -seronegative elderly individuals was observed.

Pharmacokinetics and cell trafficking dynamics of 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol hydrochloride (FTY720) in cynomolgus monkeys after single oral and intravenous doses.

The pharmacokinetics and cell trafficking dynamics of 2-amino-2-[2-(4-octylphenyl)ethyl]propane-1,3-diol hydrochloride (FTY720), a novel immunosuppressive agent, were examined in cynomolgus monkeys (three males and three females). After single doses of 0.1 mg/kg p.o. or i.v. bolus and 1 mg/kg p.o. were administered to the animals, the concentrations of FTY720, and the numbers of lymphocytes, CD20+CD2-B cells, and CD2+CD20-T cells in blood were measured over 23 days. A linear three-compartment model characterized the time course of FTY720 concentrations with a terminal half-life of about 31 h, clearance of about 0.53 l/h/kg, and bioavailability of about 38%. The dynamic responses were not area under the curve (or dose) proportional for either males or females. An indirect response model with a distribution pool captured the cell trafficking data for all doses for each cell type, where initial blood counts (R(0)) were about 7650, 2100, and 5250 cells/microl; maximum fractional inhibition (I(max)) about 0.88, 0.85, and 0.91; influx (k(in)) about 6014, 1312, and 5662 cells/microl/h; efflux (k(out)) about 0.798, 0.555, and 1.08 h(-1); intercompartmental k(cp) about 0.134, 0.192, and 0.082 h(-1); and intercompartmental k(pc) rate constants about 3.9 x 10(-4), and 0.016 and 8.9 x 10(-6) h(-1) for lymphocytes, B cells, and T cells, respectively. The inhibition concentration IC(50) was about 0.48 microg/l for all cells, which was remarkably low. The apparent distribution volumes of peripheral pool (V(p)) were markedly larger than blood volume (V(b)) for all cells. The I(max) for cell trafficking was achieved at doses smaller than that producing graft protection, indicating stronger central than peripheral effects of this drug. The profound cell trafficking effects of FTY720 can be readily captured and interpreted with an extended indirect response model.