Background : Although Helicobacter pylori (H. pylori) may be a causative agent in gastric cancer, only a small number of those infected develop gastric cancer. Aims and Methods : We studied factors such as age, gender, histopathological differentiation, and ABO blood types. In 113 patients with gastric cancer and 18 with gastritis or gastroduodenal ulcer admitted from 1996 to 2000. Results : Men with positive H. pylori had significantly more differentiated gastric cancer and those with negative H. pylori had more undifferentiated gastric cancer. Woman showed the opposite distribution (p=0.023). Patients with H. pylori-positive gastric cancer and gastritis or gastro-duodenal ulcer had the same ABO blood type distribution as the general population but those with H. pylori-negative gastric cancer tended to be fewer A blood type and more AB and O blood type. Conclusion : In patients with H. pylori-positive gastric cancer, well-differentiated gastric cancer occurred significantly more of ten in men and poorly differentiated gastric cancer significantly more of ten in women. Although not statistically significant, H. pylori-negative gastric cancer tended to occur less in those who blood type A and more in those with AB and O type. Individual patient profiles thus require further study in gastric cancer and H. pylori infection in preventive medicine.

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Background & Aims : Phospholipase D (PLD) hydrolyzes phosphatidylcholine and produces lipid second messengers including phosphatidic acid (PA) and diacylglycerol (DG). Although cellular PLD has recently been recognized as an important signal-transmitting enzyme, the roles of PLD in pathophysiological conditions are largely unknown. The aim of this study is to elucidate the roles of PLD in the production of reactive oxygen metabolites in experimental rat colitis.
Methods : Colitis was induced in rats by oral administration of dextran sulfate sodium. Luminol amplified chemiluminescences of the colonic mucosa and polymorphonuclear leukocytes were both measured.
Results and Conclusions : Oleate-dependent PLD was activated in the colitic mucosa. Chemiluminescence and myeloperoxidase activity of the colitic mucosa were significantly higher than those of the control normal mucosa. Preincubation of the mucosa in vitro with PLD, PA, or DG significantly enhanced chemiluminescence of the colitic, but not of normal mucosa. On the other hand, administration of glycerol, which inhibits the production of PA and DG by PLD, significantly decreased chemiluminescence induced by exogenous PLD. In rat polymorphonuclear leukocytes suspension, the addition of PLD, PA, or DG significantly increased chemiluminescence and propranolol significantly decreased the chemiluminescence induced by both PA and DG. These results suggest that PLD in neutrophils may be relevant to the production of reactive oxygen metabolites in experimental rat colitis.

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Background & Aims : Myosin II is a typical motor protein and is classified either as non-regulated myosin, for example, skeletal muscle myosin, or as myosin regulated by phosphorylation or Ca-binding. Myosin II from Physarum polycephalum is a Ca-binding myosin. Although expression of myosin II as a recombinant protein is essential for the analysis of its structure, function and regulation, it is not easy. Successful examples are smooth muscle myosin II and Dictyostelium myosin II, both of which are regulated by phosphorylation. Myosin II regulated by Ca-binding has not yet been obtained. Here, I report the expression of heavy meromyosin (HMM), i.e., the motor domain of Physarum myosin II.
Method : I used baculovirus expression system. Sf9 cells were infected with the virus constructs.
Results and Conclusions : The recombinant HMM showed basal Mg²⁺-ATPase activity, which was activated by actin to a similar extent to native myosin purified from Physarum. Ca-binding activity of HMM was also comparable to that of the native myosin. In vitro motility assay showed that motor activity of HMM was sensitive to Ca²⁺. The present study is the first report of expression of the motor domain of a myosin II that is regulated by Ca-binding.

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Backgrounds & Aims : Most medical schools have acknowledged the importance of medical ethics education. Yet the methodology for such an education has to be established.
Methods : We used an 8-item questionnaire to survey the needs and expectations of medical students with regard to their medical ethics class.
Results : One hundred and nineteen first-year students voluntarily responded to this survey. Students from two different school years gave considerably similar responses. The opinions of many students were as follows : the medical ethics class should be offered, necessary and sufficient hours for such a class would be two or four semester hours, the course should not follow the National Examination for Physicians format, sessions consisting of both lectures and discussions are desirable, and the course should start in the first grade. They felt that a clinical doctor, a philosopher interested in medicine, or a medical professional who has studied philosophy and ethics would be most appropriate as the teacher in charge. The teachers' roles anticipated were to introduce actual ethical problems in a clinical setting, to provide coordinate axes for the opinions and values of each students, and to instigate arguments.
Conclusions : The items that provide the key to a plethora of medical ethics education concerns are 1) the cooperation between clinical doctors and philosophers and ethicists, 2) the introspective discussion oriented class format, and 3) an acceptance and ensuring of divergent perspectives.

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Background and Aim : To detect renal disorders at an early stage, urinary screening is recommended for 3-year-old children at regular physical checkups.
Patients and Methods : In the last 6 years, 104 children aged 3 years with urinary abnormalities underwent examination at Gunma Children's Medical Center. Of these, 87 had hematuria, 6 proteinuria, 10 leukocyturia, and 1 both hematuria and proteinuria.
Results : Among children with hematuria, 7 have benign familial hematuria, 1 nut-cracker phenomenon, and 1 idiopathic hypercalciuria. The remaining 78 were diagnosed with asymptomatic hematuria. Hematuria disappeared within 4 years in 17 of 35 with asymptomatic hematuria. Four of 6 with proteinuria had nephrotic syndrome. Renal ultrasonography showed small kidneys in 1 patient. The other had tubular proteinuria. A girl with both hematuria and proteinuria may have been suffered from purpura nephritis. All 10 with leukocyturia were girls, 4 with no abnormalities, but 6 with vulvovaginitis without urinary tract infection.
Conclusions : About 50% of hematuria in 3-year-old children with asymptomatic hematuria disappears by age 7. Proteinuria is a sign of nephrotic syndrome or congenital nephropathy. Most leukocyturia in girls is caused by vulvovaginitis, not urinary tract infection.

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Background & Aims : Prokinetics have been used in combination with polyethylene glycol electrolyte lavage solution (PEG-ELS) to reduce the volume of lavage solution and to ensure the preparation. However, prokinetics sometimes accompany troublesome side effects including fatal ones. The aim of this study is to elucidate the usefulness of mosapride citrate, which has fewer side effects, for colonoscopy lavage preparation.
Methods : Eighty-two patients were randomly assigned to receive 2, 000 ml of PEG-ELS with sennoside (control group) or 1, 500 ml of PEG-ELS with sennoside and mosapride citrate (mosapride group). Colonoscopists blinded to group assignment scored the adequacy of colon cleansing. Time to lavage solution ingestion, time and number of motions to the appearance of clear excretion, and side effects were recorded.
Results and Conclusions : The mosapride group had a favorable trend in the overall colon cleansing and a significant superiority in the residual foam over the control group. Side effects had a tendency to be less frequent in the mosapride group. Time to lavage solution ingestion was significantly reduced in the mosapride group. Mosapride citrate coadministered with sennoside and 1500 ml of PEG-ELS is applicable to bowel preparation with favorable colon cleansing and good patient acceptability.

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Background & Aims : To evaluate the effects of cryopreservation and setting an eye on changes in the blood Estradiol (E₂), Progesterone (P₄) levels and thickness of the endometrium before and after the transfer.
Methods : We studies whether these parameters can give us a clue to the mechanism leading to implantation and pregnancy from January 1999 to December 2000, 269 patients underwent 860 thawed embryo transfers.
Results and conclusions : 57 out of 269 cases achieved pregnancy, the pregnant rate being 21.2%. Abortion occurred in 23 cases, the abortion rate being 40.3%. No significant difference was found in mean age, mean number of embryo transfer, total score of embryo transfer in the Veeck's classification and mean score of embryo transfer between the pregnant and non pregnant cases. Pregnant cases tended to have many embryos of high grade transferred. No significant difference was found in blood E₂, P₄ levels and thickness of the endometrium in the pregnant and non pregnant cases.
There was no difference in mean age, mean number of embryo transfer, total score of embryo transfer in the Veeck's classification, mean score of embryo transfer and number of grades between the pregnant continuation cases and abortion cases. The cases of abortion showed a relatively high blood E₂, level compared with the cases of clinically continued pregnancy. No difference in the blood P₄ level and thickness of the endometrium was found between the two. The changes in these parameters can be used a guide in predicting prognosis of the pregnancy.

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Background & Aims : Although aortic valve replacement (AVR) is the only effective treatment for patients with aortic stenosis (AS), it is generally recognized that the surgical risk increases with age.
Methods : We examined the outcome of surgical management for AS in patients above 70 years of age in comparison with younger ones to determine whether age was a risk factor.
Results : We obtained relatively good results in 3-and 5-year mortality (17% and 25%) in the elder group which were not significantly different from the younger group (5% and 13%). Perioperative factors were not significantly different between the two group. Elderly patients had significantly smaller body surface areas (BSAs) (1.43 ± 0.15 vs. 1.53 ± 0.16m²) and smaller valves (20.5 ± 1.8 vs. 22.0±2.0mm). The age was significantly correlated with the BSA (correlation coefficient=-0.433, p<0.001) and the valve size (Spearman's σ=-0.414, p<0.005). The valve size was also significantly correlated with the BSA (Spearman's σ=0.612, p< 0.0001).
Conclusions : The risk of AVR in patients with AS was not significantly increased by age and AVR may be performed with good results in both short-and long-term outcomes.

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We report a case of an extrahepatic growth type cavernous hemangioma of the liver accidentally found in traffic accident. Submucosal tumor of the stomach was suspected based on abdominal computed tomography (CT), magnetic resonance imaging (MRI), and upper gastrointestinal barium studies. Angiography showed an extrahepatic growth type cavernous hemangioma of the liver. The lateral segment of the liver was partially resected to avoid the risk of rupture of the tumor protruding from the liver surface. The excised tumor was 5.5 × 5.0 × 5.0 cm and weighted 50 g. Histopathologically, a diagnosis of cavernous hemangioma was made. The incidence of cavernous hemangioma is the highest of all benign liver tumors, but the extrahepatic growth is rare.

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We report an operated case of a solid and cystic tumor of the pancreas. A 14-year-old woman referred for an upper abdominal mass was found in computed tomography (CT) and magnetic resonance imaging (MRI) to have a well-defined cystic tumor of the body or tail of the pancreas. Angiography showed a hypervascular tumor at that site. The tumor was resected under a of a diagnosis solid and cystic tumor of the pancreas. Laparotomy showed the 8.0 × 12.0 × 12.0 cm tumor to be well encapsulated. No infiltration into the pancreas was noted. On section, the tumor was well encapsulated with a thick fibrous capsule and consisted of solid, cystic lesions with severe necrotic degeneration and hemorrhage. The histopathological diagnosis of the tumor was solid and cystic tumor of the pancreas.

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[in Japanese]

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