The aim of this study was to investigate the strain heterogeneity of Helicobacter pylori (H. pylori) in saliva, gastric juice, and urine by nested PCR and the direct sequence method, and to clarify the mode of transmission by examining whether H. pylori in the stomach and saliva are identical.
Thirty-nine patients undergoing endoscopy were enrolled in this study. H. pylori DNA was assayed in 104 samples using two sets of primers, EHC-U/EHC-L and ET-5U/ET-5L. DNA sequencing was performed in 24 samples.
H. pylori DNA was detected in 39 gastric juice samples (100%) and in 28 saliva samples (71.8%). The prevalence in urine samples was 50% (13/26). All samples except one were identical with over 97% identity to the DNA sequence of H. pylori type strain J99 (USA).
Nested PCR was highly sensitive for detection of H. pylori DNA in saliva, and DNA sequencing may be useful to clarify the mode of transmission.

The aim of this study was to investigate the strain heterogeneity of Helicobacter pylori (H. pylori) in saliva, gastric juice, and urine by nested PCR and the direct sequence method, and to clarify the mode of transmission by examining whether H. pylori in the stomach and saliva are identical.Thirty-nine patients undergoing endoscopy were enrolled in this study. H. pylori DNA was assayed in 104 samples using two sets of primers, EHC-U/EHC-L and ET-5U/ET-5L. DNA sequencing was performed in 24 samples.H. pylori DNA was detected in 39 gastric juice samples (100%) and in 28 saliva samples (71.8%). The prevalence in urine samples was 50% (13/26). All samples except one were identical with over 97% identity to the DNA sequence of H. pylori type strain J99 (USA).Nested PCR was highly sensitive for detection of H. pylori DNA in saliva, and DNA sequencing may be useful to clarify the mode of transmission.

This is a case report evaluating the improvement of activities of daily living (ADL) after TKA in stroke patient with hemiplegia and knee osteoarthritis. The case was a 73-year-old female with left hemiplegia caused by cerebral infarction. She also suffered from severe bilateral knee osteoarthritis and obesity. The hemiplegia and knee dysfunction disturbed her ADL. When she was admitted to our hospital, her FIM motor subscore was 23 and body mass index (BMI) was 36.0. She went on a diet and continued rehabilitation. Her knees were treated conservatively. Six months after the stroke, her FIM motor subscore was 35 and BMI was 29.8. For the purpose of pain relief and improvement of range of motion, right TKA was performed seven months after stroke. And left TKA and lengthening of the gastrocnemius were performed eleven months after her stroke. Rehabilitation was continued carefully in order to avoid deep venous thrombosis. In addition, a left obturator nerve block was performed as treatment for spasticity of her hip adductor muscle. Fifteen months after the stroke, her FIM motor subscore was 77 and BMI was 25.7. TKA is a common treatment for osteoarthritis but when a patient has a stroke, it is difficult to determine whether to perform surgery or not. In this case, bilateral TKA achieved improvement of ADL. We suggest that even if a patient has stroke hemiplegia, TKA should be considered for knee osteoarthritis based on the appropriate assessment and careful risk management.

Objective To find out a proper way to detect green fluorescent protein (GFP). Methods Kidneys, livers and femurs from GFP transgenic mice and C57BL/6J wild type mice were employed for in vivo study.The samples were dehydrated with alcohol and acetone individually before embedding, then frozen, paraffin and resin sections were made for the detection of GFP. C3 P12 cells which derived from calvaria bone cells of GFP transgenic mouse were used for the detection of GFP in vitro. Cells were exposed to alcohol, acetone and PBS after paraformaldehyde fixation. Laser scanning microscopy was employed for GFP detection. Results In frozen sections, both kidney and liver samples which exposed to 4% buffered paraformaldehyde fixation had strong GFP signals, while GFP signal disappeared completely in fresh frozen sections without fixation. Much stronger GFP intensity was found in acetone treated samples than in alcohol treated paraffin sections, but without apparent difference in GFP intensity in acetone and alcohol treated resin samples. Acetone and alcohol made no difference in fixed C3 cells in different time courses. Conclusion Acetone treated paraffin sections are preferable for GFP detection.

The purpose of the present study was to indicate the relationship between health-related quality of life (HRQOL) measures, the daily rhythm of oral temperature (OT), and lifestyle. Five-hundred young men volunteered to participate in this study. Their OT, measured using a digital thermometer, was recorded every 2h from the time they woke up to the time they went to sleep for 1 week. The daily rhythm of OT was calculated as a quadratic function using the 1-week data. The HRQOL was measured using the Short-Form 36-Item Health Survey version 2 (SF-36v2). The participants were divided into 3 groups: a high-value group (HG) with ≥ 55 points of each summary score and each subscale score, a middle-value group (MG) with score > 45 and < 55 points, and a low-value group (LG) with score ≤ 45 points. Lifestyle was assessed in terms of eating habits, sleeping and exercise, and the presence of unidentified complaints. At the mental component summary, the OT at the time of waking up and the peak OT in the HG were significantly higher than those in the LG. At the physical and mental component summary, lifestyle in the HG was more favorable. These data suggest that the daily rhythms of OT may reflect the mental health status of an individual. The entraining factors in circadian variation might play a role in improving mental health and reducing unidentified complaints. In conclusion, there appears to be an association between mental health status, lifestyle, and daily rhythms of OT.

Locally advanced breast cancer (tumor > 5 cm, widespread infiltration of the skin and muscle, or metastases to lymph nodes) is difficult to resect by surgery, and even when it is resectable, there is a high probability of local recurrence and distant metastasis. Therefore, systemic therapy should be administered first. However, as cutaneous infiltration progresses, the patient's quality of life is impaired by pain, bleeding, presence of exudates, and a foulsmelling odor. Treatment with Mohs paste with systemic therapy can control symptoms associated with skin infiltration and can also be expected to decrease tumor volume.Herein, we report a case in which a tumor was resected following Mohs paste and systemic chemotherapy administration, and the skin defect was reconstructed with a latissimus dorsi myocutaneous flap. We also review the literature for previously reported cases of breast cancer involving Mohs paste.

Seventy patients with rheumatic valvular disease were evaluated with preoperative CT scanning. The correlation of the obtained CT images to the operative findings were examined. Left atrial thrombi were found in 24 cases at the operation. CT scan had detected thrombi in 19 cases (79.2%) and echocardiography in 15 (62.5%). CT failed to find them in 5 cases in which the left atrial thrombi were less than 3g. Echocardiogram, however, failed to detect thrombi in 9 cases, the largest being 14g. There were 15 cases with left atrial calcification, in which 10 cases had left atrial thrombi. Nine cases out of these 10 cases had rough left atrial surface after thrombectomy. Early postoperative CT of 10 with left atrial calcification showed recurrent left atrial thrombi in 4 (40%) cases. Mitral valve calcification was found in 42 cases during operation. CT scan was able to detect it in 40 (95.2%), while echocardiogram detected in 34 cases (81.0%) (p<0.05). All mitral valves with calcification required replacement. Out of 30 cases with non calcified mitral valves, 9 underwent OMC, and the other 21 underwent mitral valve replacement. Aortic valve calcification was found in 9 out of 11 cases with aortic stenosis. All has been diagnosed by CT scan. In conclusion, 1. In detecting the left atrial thrombi, CT scan was superior to echo-cardiography, and provided useful information for planning the operative procedure including atrial approach and valvular manipulation. 2. CT scan could detect calcification of left atrial wall which had high incidence of thrombus formation and rough left atrial surface. 3. CT scan could detect calcification of both mitral and aortic valve, and showed the severity of valvular structural changes.

OBJECTIVEAlkaline phosphatase (ALP) and osteocalcin (OC) are the markers of new bone formation. Quantitative study of ALP and OC in the process of new bone formation helps to understand the ongoing of this cascade and contributes to make diagnosis in clinical treatment.

METHODS8-week-old male C57BL/6J mice and primary osteoblasts from neonatal C57BL/6J mice calvaria were used in this experiment. HE staining, Northern blot and Real Time PCR methods were employed to detect the histological changes and the expression pattern of ALP and OC.

RESULTSIn vivo study showed that after fracture the expressions of both ALP and OC kept on increasing which were peaked on the 10 day, then started decreasing gradually. In vitro study on primary osteoblasts showed that the expressions of ALP and OC reached peak on the 14th day in differentiation culture medium and started decreasing from this time point till the 21st day.

CONCLUSIONThe expression of ALP and OC in the process of new bone formation parallels with the development of osteoblasts, it increases with the differentiation of osteoblasts and becomes decreasing with the maturation of osteoblasts. The reciprocal relationship between the expression pattern of ALP and OC and development of osteoblast helps to maintain homeostasis.

Alkaline Phosphatase ; Animals ; Bone and Bones ; Cell Differentiation ; Male ; Mice ; Mice, Inbred C57BL ; Osteoblasts ; Osteocalcin ; Skull

OBJECTIVETo detect the expression of osteoclast related factors, tumor necrosis factor-alpha (TNF-alpha), receptor activator of NF-kappaB ligand (RANKL) and tartrate-resistant acid phosphatase (TRAP), in the process of bone remodeling.

METHODS8-week-old male C57BL/6J mice were employed in this study to detect the expression of osteoclast related factors by real time PCR.

RESULTSTNF-alpha, RANKL and TRAP were up regulated in the process of bone remodeling, they reached the peak on day 2, 5 and 10 individually after injury.

CONCLUSIONOsteoclast related factors also participate in bone remodeling, which depends on the delicate balance between bone formation and bone resorption.

Animals ; Bone Resorption ; Male ; Mice ; Mice, Inbred C57BL ; NF-kappa B ; Osteoclasts ; Osteogenesis ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B ; Tumor Necrosis Factor-alpha

BACKGROUND/AIMS: Peyer's patches (PPs) are aggregates of lymphoid follicles that are mainly located in the distal ileum; they play a major role in mucosal immunity. We recently reported that patients with ulcerative colitis (UC) have alterations in PPs that can be detected using narrow-band imaging with magnifying endoscopy (NBI-ME). However, the usefulness of NBI-ME in UC treatment as a whole is still unknown. METHODS: We collected NBI-ME images of PPs from 67 UC patients who had undergone ileocolonoscopy. We evaluated changes in the villi using the "villi index," which is based on three categories: irregular formation, hyperemia, and altered vascular network pattern. The patients were divided into two groups on the basis of villi index: low (L)- and high (H)-types. We then determined the correlation between morphological alteration of the PPs and various clinical characteristics. In 52 patients who were in clinical remission, we also analyzed the correlation between NBI-ME findings of PPs and clinical recurrence. RESULTS: The time to clinical recurrence was significantly shorter in remissive UC patients with H-type PPs than in those with L-type PPs (P<0.01). Moreover, PP alterations were not correlated with age, sex, disease duration, clinical activity, endoscopic score, or extent of disease involvement. Multivariate analysis revealed that the existence of H-type PPs was an independent risk factor for clinical recurrence (hazard ratio, 3.3; P<0.01). CONCLUSIONS: UC patients with morphological alterations in PPs were at high risk of clinical relapse. Therefore, to predict the clinical course of UC, it may be useful to evaluate NBI-ME images of PPs.
Colitis, Ulcerative* ; Endoscopy* ; Humans ; Hyperemia ; Ileum ; Immunity, Mucosal ; Multivariate Analysis ; Peyer's Patches* ; Recurrence* ; Risk Factors ; Ulcer*