Prevention of the rehaemorrhage of bleeding peptic ulcers: effects of Helicobacter pylori eradication and acid suppression.

AIM: This study aimed to investigate the consequences of Helicobacter pylori eradication and acid suppression on rehaemorrhage caused by bleeding peptic ulcers. METHODS: A total of 320 patients who had been diagnosed with bleeding peptic ulcers between January 1994 and December 2001 were included in the study. Cases between 1994 and 1997, prior to the introduction of eradication therapy, were assigned to group A, whereas those between 1998 and 2001, after the eradication therapy, were assigned to group B. RESULTS: Of the 320 cases, 162 were designated as group A (113 gastric ulcers and 49 duodenal ulcers) and 158 as group B (116 and 42, respectively). Rehaemorrhage occurred in 24 cases (15%) and five cases (3%) in groups A and B, respectively, presenting a significantly decreased rate of rehaemorrhage in group B. Among those without eradication, rehaemorrhage was observed in 15 of 128 cases (12%) that received treatment with histamine(2)-receptor antagonist (famotidine), and 14 of 142 cases (10%) treated with proton-pump inhibitors, with no significant difference between the two. CONCLUSIONS: Helicobacter pylori eradication lowered the rates of rehaemorrhage. Treatment with histamine(2)-receptor antagonist or proton-pump inhibitors did not produce a difference in the rate of rehaemorrhage.

Bundle formation of smooth muscle desmin intermediate filaments by calponin and its binding site on the desmin molecule.

Smooth muscle basic calponin, a major actin-, tropomyosin-, and calmodulin-binding protein, has been examined for its ability to interact with desmin intermediate filaments from smooth muscle cells using sedimentation analysis, turbidity changes, chemical cross-linking, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI TOF/MS), and electron microscopic observations. Calponin interacted with desmin intermediate filaments in a concentration-dependent manner in vitro. The binding of calponin to desmin produced dense aggregates at 30 degrees C. The dense aggregates were observed by electron microscopy to be composed of large anisotropic bundles of desmin filaments, indicating that calponin forms bundles of desmin filaments. The addition of calmodulin or S100 to the mixture of calponin and desmin caused the removal of calponin from the desmin filaments and inhibited bundle formation in the presence of Ca(2+), but not in the presence of EGTA. Calponin-related proteins including G-actin, tropomyosin, and SM22, had little effect on the binding of calponin to desmin filaments, whereas tubulin weakly inhibited the binding. Desmin had little influence on the calponin-actin and calponin-tubulin interactions using the zero-length cross-linker, EDC. Domain mapping with chymotryptic digestion showed that the binding site of calponin resides within the central a-helical rod domain of the desmin molecule. The chemical cross-linked products of calponin and synthetic peptides (TQ27, TNEKVELQELNDRFANYIEKVRFLEQQ; EE24, EEELRELRRQVDALTGQRARVEVE) derived from the rod domain were detected by MALDI TOF/MS. Furthermore, the calponin-desmin interaction was significantly inhibited by the addition of EE24, but only slightly by TQ27. These results suggest that calponin may act as a cross-linking protein between desmin filaments as well as among intermediate filaments, microfilaments and microtubules in smooth muscle cells.

[A case of paraganglioma of urinary bladder in a 96-year-old female].

A 96-year-old woman was referred to our hospital with gross hematuria. Cystoscopy, computed tomography and magnetic resonance imaging revealed a submucosal bladder tumor. Incomplete transurethral resection was performed with no intraoperative complications. The histopathological diagnosis of nonmalignant paraganglioma was confirmed by immunohistochemical staining. This patient is the oldest of the 49 patients with paraganglioma of the urinary bladder reported in the Japanese literature.

[A case of Paget's disease with progressive sensorineural hearing loss involved in the bilateral bony labyrinths].

Paget's disease of the bone is a chronic, progressive disease of unknown etiology characterized by abnormal bony resorption and deposition. It is a common skeletal disease in Europe and North America, while in Japan it is very rare. Paget's disease of the temporal bone has been reported to cause hearing loss frequently. We report a 50-year-old woman with Paget's disease who had progressive bilateral sensorineural hearing loss and right vestibular dysfunction. CT and 3 Dimensional CT (3D-CT) images demonstrated resorption of the entire bony labyrinth and its surroundings on both sides and that the temporal bone elsewhere remained intact. Bone scans revealed disease symmetrically in the bilateral otic capsules. Previous studies indicated that the bone changes in Paget's disease in the petrous pyramid begin in areas best supplied with marrow tissue and that the otic capsule is relatively spared until advanced changes are present in the remainder of the petrous pyramid. But, this patient mainly had foci in the bilateral otic capsules and the pattern was similar to cochlear otosclerosis. 3D-CT was useful for differentiation of Paget's disease and cochlear otosclerosis. The pattern of the affected areas indicated that this is a very rare situation even in the reports of Europe and North America, where the disease is rather common.

[Within-day and day-to-day variations of serum M-CSF levels in healthy volunteers].

We have investigated on within-day and day-to-day variations of serum M-CSF levels in healthy volunteers (ranges of age: 20-21 years old). M-CSF levels in serum were measured using enzyme-linked immunosorbent assay (ELISA). Serum M-CSF levels in early morning were 1.31 +/- 0.30 ng/ml (mean +/- SD, n = 10) in male volunteers, 1.50 +/- 0.13 ng/ml (n = 10) in female volunteers. No significant difference was observed between male and female volunteers in serum M-CSF levels. No significant within-day variations in serum M-CSF levels were also observed. Serum M-CSF levels in period of thirteen days in each individual person were almost constant (n = 5). The inverse correlation was observed between M-CSF levels and number of neutrophils. The correlation, however, was not observed between M-CSF levels and number of monocytes. The present results suggest that there are mechanisms in vivo which maintain serum M-CSF in a constant level in each individual person.

Dermatofibrosarcoma protuberans is a unique fibrohistiocytic tumour expressing CD34.

Dermatofibrosarcoma protuberans (DFSP) is a slow growing, locally invasive tumour whose differentiation from other fibrohistiocytic tumours sometimes poses serious diagnostic problems. We investigated CD34 expression immunohistologically in various fibrohistiocytic tumours including dermatofibroma, DFSP, malignant fibrous histiocytoma (MFH), infantile myofibromatosis, fibrosarcoma, hypertrophic scar and keloid. Among these, DFSP was unique in that tumour cells themselves expressed CD34, whereas in other tumours. CD34 expression was observed only on vascular endothelial cells amongst the tumour cells. Until now, there have been no reports of useful immunohistological markers for DFSP. CD34 expression by the tumour cells can be an extremely useful marker in establishing a definitive diagnosis of DFSP.

[Long-term follow-up of thallium-201 myocardial scintigraphy in acute myocardial infarction--clinical significance of reverse redistribution during acute period].

To clarify the viability of myocardium in acute myocardial infarction, we examined 18 patients scintigraphically. They underwent rest or stress imaging and delayed imaging of thallium-201 during acute, convalescent and chronic periods. During acute period, a scintigraphic finding of the delayed filling in was observed in 9 cases (50%; Redistribution group). Worsening of the delayed image was observed in 6 cases (33%; Reverse redistribution group). No scintigraphic change of the perfusion defect was observed in 3 cases (17%; No change group). In reverse redistribution group, a remarkable improvement of the delayed image was observed through acute, convalescent and chronic periods. In redistribution group and no change group, no significant improvement was observed. We conclude that the myocardium of the reverse redistribution region during acute period may be viable. In the reverse redistribution region, recanalization of the coronary artery possibly protects myocardial damage from necrosis.