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.

Objective : To investigate the safety and effects of long-term administration of denopamine, β-1 stimulant, on the activities of daily living in heart failure patients.
Design : Case-series.
Methods : One hundred forty patients with mild to moderate chronic heart failure were administered denopamine at dose of 5 to 10 mg three times daily for 24 weeks. Concomitant circulatory system drugs such as digitalis, diuretics, vasodilator drugs, etc., were used without changing the administration method and dose. However, the use of a concomitant β-blocker was prohibited.
Results : Following administration of denopamine, the NYHA cardiac function classification improved by one degree or more in 50 patients (35.7%). The body weight decreased significantly from 54.9± 10.2kg (mean±SD) before administration to 54.0±10.2kg after administration (P<0.05), and the cardiothoracic ratio also decreased from 58.0±7.3% to 56.6±7.2% (P<0.001). No significant changes were observed in the heart rate, systolic blood pressure, or diastolic blood pressure. The activities of daily living improved by one level or more for 49 patients (51.6%). There were 36 withdrawal or dropout cases (patients' own convenience : 12 cases ; complications/accidental symptoms : 7 cases) during the investigation period. Four patients (2.9%) exhibited adverse reactions.
Conclusion : Denopamine seemed to improve the quality of life, which is one of the therapeutic purposes for patients with chronic cardiac failure. A large-scale study including investigation of the long-term prognosis for such patients needs to be performed.

A 66-year-old woman complained of dyspnea due to congestive heart failure, and was given a diagnosis of severe aortic insufficiency. Antiphospholipid syndrome and idiopathic thrombocytopenic purpura (ITP) had been diagnosed with 9 years previously. We planned preoperative plasma exchange and steroid pulse infusion to reduce the level of auto-antibodies for phospholipids. The aortic valve replacement was performed safely. Anticoagulant therapy with low molecular weight heparin and oral steroid therapy was administered after the operation to avoid thrombosis or bleeding. The patient's postoperative course was stable. She was discharged without any complication. In conclusion, preoperative plasma exchange and steroid pulse infusion, postoperative anticoagulant therapy and oral steroids resulted in a favorable outcome in a case of heart surgery for a patient with antiphospholipid syndrome.

The aim of this study was to clarify the comorbidities of patients with Leriche syndrome and ischemic heart disease. We enrolled 26 patients with Leriche syndrome and who had undergone preoperative coronary angiography were enrolled. The comorbidities of diabetes, hypertension, and coronary artery disease developed in more than half of Leriche patients with Leriche syndrome. Marked coronary artery disease was diagnosed in 14 patients, 7 of whom underwent coronary artery bypass surgery. The Revascularization procedures performed in patients with Leriche syndrome were anatomical aortofemoral bypass in 15 and an extra-anatomical axillofemoral bypass in 9. In 2 cases of extra-anatomical bypass, occlusion developed in the long-term.

It has been demonstrated that atrial fibrillation (AF) frequently occurs after coronary artery bypass grafting (CABG) and may cause cerebral infarction. The purpose of this research is to clarify the risk factors of AF in patients who underwent off-pump CABG (OPCABG). In this study, 142 patients (111 men and 31 women) were enrolled with an average age of 67 years old (range, 33-83). According to multivariate analysis, age and the preoperative peak early (E)/late (A) diastolic velocities ratio (E/A) were the independent predictors of postoperative AF. Patients who suffered from postoperative AF required a significantly longer hospital stay.

[Introduction]Recently, in the development of information technology, VDT workers are increasing rapidly. Physical and mental health symptoms associated with working at visual display terminals (VDTs) are controversial. However, there are few studies about the effect of acupuncture treatment on eye fatigue, neck and shoulder stiffness that many VDT workers have.
Therefore, in this prospective study, we examined the effect of acupuncture treatment for complaints of VDT workers.
[Methods]Sixty-one VDT workers participated as subjects (41 males, 20 females). Acupuncture sessions were performed once a week for four weeks. Acupuncture points were decided by the patient's muscleskeletal distress.
Disposable press tack needles were used. Visual Analogue Scale (VAS) was used to determine eye fatigue, neck and shoulder stiffness. Improvements of each VAS were evaluated. Then we analyzed improvement on shoulder and neck stiffness associated with eye fatigue.
[Results]The neck and shoulder distress of patients was reduced in four weeks by acupuncture treatment. A regular correlation between the improvement rate of eye fatigue and neck/shoulder stiffness was observed.
[Conclusion]The neck and shoulder stiffness was improved by acupuncture treatment. According to improved symptoms, eye fatigue was mitigated as well. Thus it was suggested that utility of acupuncture is high in the field of industrial medicine.

We reviewed our experience with 19mm size aortic valve prostheses for cases with small aortic annulus. Forty-six patients operated on between 1990 and Septembr 2002 were enrolled in this study. Clinical late assessment was performed to evaluate the incidence of valverelated complications, residual transprosthetic gradient, left ventricular mass index (LVMI), and NYHA functional class. Postoperative echocardiography was performed to evaluate hemodynamic performance of the prostheses. Follow up was 1 to 12.7 years (mean 5.3±3.6). There was no hospital mortality (0%). Actuarial survival rates at 10 years were 81.4±1.5%. The late postoperative peak gradient was 25±11mmHg. LVMI was significantly reduced in late phase. NYHA functional class significantly improved in the late period. Although 19mm size aortic valve prosthesis remains small transprosthetic pressure gradient, LVMI significantly reduced and patient activity was satisfactory maintained in the late period.