Hirohito Honda

Idoxifene and estradiol enhance antiapoptotic activity through estrogen receptor-beta in cultured rat hepatocytes.

Oxidative stress plays a causative role in the development of hepatic fibrosis and apoptosis. Estradiol (E2) is an antioxidant, and idoxifene is a tissue-specific selective estrogen-receptor modulator. We have previously demonstrated that E2 inhibits hepatic fibrosis in rat models of hepatic fibrosis and that the actions of E2 are mediated through estrogen receptors (ERs). This study reports on the antiapoptotic role of idoxifene and E2, and the functions of ER subtypes ER-α and ER-β in hepatocytes undergoing oxidative stress. Lipid peroxidation was induced in cultured rat hepatocytes with ferric nitrilotriacetate solution with idoxifene or E2. Oxidative stress-induced early apoptosis was linked to its ability to inhibit not only the expression of Bcl-2 and Bcl-XL but the production of antioxidant enzymes as well and to stimulate Bad expression. Hepatocytes possessed functional ER-β, but not ER-α, to respond directly to idoxifene and E2. Idoxifene and E2 suppressed oxidative stress-induced reactive oxygen species generation and lipid peroxidation, and their antiapoptotic effects on the activation of activator protein-1 and nuclear factor-κB, the loss of antioxidant enzyme activity, and Bcl-2 family protein expression in early apoptotic hepatocytes were blocked by the pure ER antagonist ICI 182,780. Our results indicate that idoxifene and E2 could enhance antiapoptotic activity through ER-β during oxidative damage in hepatocytes.

13C-Urea breath test, using a new compact nondispersive isotope-selective infrared spectrophotometer: comparison with mass spectrometry.

BackgroundThe 13C-urea breath test (13C-UBT) is the most commonly used noninvasive method of detecting Helicobacter pylori infection. The isotope ratio mass spectrometer (IRMS) is the most commonly used device for this test, but the UBiT-IR300 infrared spectrophotometer, which, by comparison, is a more compact, less expensive, and easier to use analytical device, has now become widely used in the clinical setting in Japan. The objective of this study was to examine the diagnostic performance of the 13C-UBT, using the UBiT-IR300.MethodsA multicenter open-label study was performed, in which the 13C-UBT was conducted using 100 mg of 13C-urea. Analysis of 13CO2 in the expired breath was performed by infrared spectroscopy and mass spectrometry, and assessment of H. pylori infection was performed by culture, histological examination, and rapid urease test.ResultsIn 255 cases of H. pylori infection diagnosed by biopsy methods, the 13C-UBTs, performed with two different 13C-ruea formulations, and using infrared spectroscopy for evaluation, showed a sensitivity of 97.7%, specificity of 98.0%, and accuracy of 97.8% (total number of evaluable cases, n = 505). The rate of agreement in the assessment of H. pylori infection between infrared spectroscopy and mass spectrometry was 100% (n = 505). The regression equation for infrared spectroscopy to mass spectrometry was y = 0.9822x − 0.0809 (n = 2542), with a correlation coefficient of r = 0.99989 (P = 0.0001).ConclusionsDiagnosis of H. pylori infection can be performed using infrared spectroscopy as well as mass spectrometry.

Comparison between a new 13C-urea breath test, using a film-coated tablet, and the conventional 13C-urea breath test for the detection of Helicobacter pylori infection.

BackgroundIn Japan, urea breath-testing includes mouth rinsing with water immediately after the ingestion of 13C-urea solution, to prevent false-positive results that are caused by oral bacteria with urease activity. Our objective was to evaluate the diagnostic performance of a urea breath test using a film-coated 13C-urea tablet and omitting mouth rinsing.MethodsThe study was a multicenter trial comparing the solution- and tablet-based urea breath tests (UBTs). Helicobacter pylori status was determined by histology, culture, and rapid urease testing.ResultsOf the 255 subjects who completed the study, evaluation of the tablet-based UBT was possible in 254, and comparison of the tablet-based UBT and the solution-based UBT was possible in 250 patients. When the assessment achieved by a combination of biopsy-based methods was used as a reference standard, the sensitivity, specificity, and accuracy of the tablet-based method were determined to be 97.7%, 98.4%, and 98.0%, respectively. When the results of the solution-based UBT were used as a reference standard, the sensitivity, specificity, and accuracy of the tablet-based UBT were determined to be 96.9%, 97.6%, and 97.2%, respectively.ConclusionsThe 13C-urea tablet-based method proved to be a simple and accurate test for the diagnosis of H. Pylori infection. Mouth rinsing was not required.

Relationship among gastric motility, autonomic activity, and portal hemodynamics in patients with liver cirrhosis

We examined the effects of the autonomic nervous function and the volume of portal blood flow to clarify the mechanism of the abnormal gastric motility in patients with liver cirrhosis.

Evaluation of autonomic nervous function during upper gastrointestinal endoscopy using heart rate variability

Abstract: To investigate autonomic nervous function during upper gastrointestinal endoscopy, we analyzed R-R interval variability from electrocardiograms obtained during endoscopy. Holter electrocardiogram recordings were made before and after premedication, and during endoscopy. Time- and frequency-domain analyses of heart rate variability were performed in 54 subjects premedicated with scopolamine butylbromide (SB group) and in 66 subjects premedicated with glucagon (G group). To determine the effect of autonomic imbalance on arrhythmia generation during endoscopy, subjects with arrhythmias (A group) were compared with subjects without arrhythmias (N group). In the SB group, high frequency spectral power (HF power; 0.15 to 0.40 Hz), which reflects parasympathetic activity, decreased significantly after premedication, and decreased further during endoscopy (P < 0.01). Moreover, HF power before premedication or during endoscopy in the A group was significantly lower than that in the N group (P < 0.01). This study suggests that the measurement of HF power prior to endoscopy can identify subjects with reduced HF power. This should allow the prevention of cardiovascular complications related to premedication and endoscope insertion.

Incidence of hepatitis C virus (HCV) antibodies and HCV-RNA in blood donors and patients with liver diseases in the inshore area of the Yangtze River

The Nantong area is a high risk region for primary hepatocellular carcinoma (PHC) in the inshore area of the Yangtze River. However, no detailed data are available about hepatitis C virus (HCV) infection in this area. We examined the incidences of anti‐HCV and HCV‐RNA in blood donors with hepatitis B surface antigen (HBsAg)‐ and hepatitis B core antibody (HBcAb)‐negative and patients with chronic liver diseases in the Nantong area at Nantong Medical College, Jiangsu Province, the Peoples Republic of China. The incidences of HBV markers (HBsAg and/or HBcAb), anti‐HCV (C100‐3), second generation anti‐HCV, HCV‐RNA and any marker of HCV in the Nantong area were found to be: 0.0, 0.7, 0.4, 0.2 and 0.7% in donor bloods; 16.9, 0.0, 3.4, 15.7 and 16.9% in patients with acute hepatitis; 82.8, 2.7, 4.8, 7.5 and 10.2% in those with chronic hepatitis; 86.4, 4.5, 9.1, 4.5 and 11.4% in those with liver cirrhosis; 87.5, 6.3, 0.0, 0.0 and 6.3% in those with PHC; and 21.8, 1.3, 1.3, 0.0 and 1.3% in patients without liver diseases, respectively. Although the Nantong area is a high risk region for PHC, these data suggest that HCV infection is not an important aetiological factor for PHC in this area.

Epidemiological characteristics of the incidence of hepatitis C virus (C100-3) antibodies in patients with liver diseases in the Inshore Area of the Yangtze River

Abstract The Nantong area is an endemic region of hepatitis B virus (HBV) infection in the inshore area of the Yangtze River. However, no detailed data are available about hepatitis C virus (HCV) infection in this area. In this study recent reports are reviewed about the incidence of viral hepatitis and primary hepatocellular carcinoma (PHC) in China, and it is shown that the Nantong area is a high risk region for PHC. This study reports on the incidence of antibody to HCV (anti‐HCV) in patients with chronic liver diseases in the Nantong area; investigated in collaboration with members of the Nantong Medical College, Jiangsu Province, the Peoples Republic of China. The incidence of anti‐HCV (C100‐3) in the Nantong area was: 0.67% (three of 451) in donor blood; 0.0% (none of 89) in patients with acute hepatitis; 2.7% (five of 186) in those with chronic hepatitis, 4.5% (two of 44) in those with liver cirrhosis; 6.3% (one of 16) in those with PHC; and 1.3% (one of 78) in patients without liver disease. The incidence of hepatitis B surface antigen in the Nantong area was: 15.7% (14 of 89) in patients with acute hepatitis; 81.2% (151 of 186) in those with chronic hepatitis; 81.8% (36 of 44) in those with liver cirrhosis; 87.5% (14 of 16) in those with PHC; and 20.5% (16 of 78) in patients without liver disease. Although the Nantong area is a high risk region for PHC, these data suggest that HCV infection is not an important aetiological factor for PHC in this area.

Usefulness of a hemoglobin index determined by electronic endoscopy in the diagnosis of helicobacter pylori gastritis

In patients with Helicobacter pylori infection, gastric endoscopy usually shows diffuse mucosal redness that disappears after successful H. pylori eradication. However, some infected patients do not show such redness. Therefore, disagreement continues concerning the need for gastric endoscopy in suspected H. pylori infection.

Autonomic nervous activity before and after eradication of Helicobacter pylori in patients with chronic duodenal ulcer

Helicobacter pylori infection is involved in the formation of chronic peptic ulcer. However, a previously reported hypothesis concerning the involvement of central autonomic nervous disorder in this condition cannot be ruled out.

Serum amino‐terminal propeptide of type III procollagen and 7S domain of type IV collagen correlate with hepatic iron concentration in patients with chronic hepatitis C following α‐interferon therapy

Background: It has been reported that chronic infection with hepatitis C virus is associated with excess iron deposits in the liver of subjects who are neither alcoholics nor recipients of blood transfusions. However, little is known about the relationship between hepatic iron concentration (HIC) and the serum levels of hepatic fibrogenesis markers, which were caused by interferon therapy for chronic hepatitis C. Therefore, changes in the serum amino‐terminal propeptide of type III procollagen (P‐III‐P) and the 7S domain of type IV collagen (7S‐IV) in 16 patients treated with α‐interferon (IFN‐α) were studied, and their HIC and histological assessment evaluated. Hepatic iron concentrations were measured by using liver biopsy specimens obtained before and 6 months after the cessation of treatment.