Kazuya Hirakawa

Prevalence of non-ulcer dyspepsia in the Japanese population

Background : Non‐ulcer dyspepsia (NUD) is one of the most frequently encountered disorders in general practice in Western countries. The prevalence of this disorder in the Japanese, however, has not been fully investigated. This study is designed to clarify the characteristics and prevalence of dyspepsia in the Japanese.

Symptom relief in patients with reflux esophagitis: Comparative study of omeprazole, lansoprazole, and rabeprazole

Background and Aim:  Rabeprazole has a faster onset of antisecretory activity than omeprazole and lansoprazole. The aim of the present study was to clarify whether there is any difference in the speed of symptom relief in patients with reflux esophagitis following the administration of these three proton pump inhibitors (PPI).

Diagnostic accuracy of a new non‐invasive enzyme immunoassay for detecting Helicobacter pylori in stools after eradication therapy

Helicobacter pylori eradication therapy has been commonly performed for patients with peptic ulcer. An inexpensive, reliable, non‐invasive test would be useful for evaluation of the effectiveness of eradication therapy.

Primary Sclerosing Pancreatitis and Cholangitis

SummaryConclusionThe clinical course of our patient suggests the association between chronic pancreatitis and primary sclerosing cholangitis (PSC), as well as the usefulness of prednisolone for the treatment of this condition.BackgroundAlthough alterations in the pancreatic duct have been reported, the association between chronic pancreatitis and PSC remains uncertain.Methods and ResultsA long-term follow-up case of chronic pancreatitis accompanied by PSC is presented. A 58-yr-old man complaining of epigastric distress was admitted to our hospital in July 1990. Endoscopic retrograde cholangio-pancreatography (ERCP) showed a stricture of the distal common bile duct and a narrowing of the main pancreatic duct (MPD) with mild ectasia of its branches in the head of the pancreas. ERCP taken in June 1992 revealed localized narrowings in both the right and the left main hepatic ducts, and irregularity of the MPD through the entire pancreas. An ERCP taken in June 1996 showed a progression of the narrowings of the bile ducts. The patient was diagnosed as having chronic pancreatitis accompanied by PSC. ERCP revealed a remarkable improvement of the bile ducts after 4 wk of treatment with prednisolone.

Safety and efficacy of glucagon as a premedication for upper gastrointestinal endoscopy—a comparative study with butyl scopolamine bromide

Glucagon inhibits digestive motility and is used for endoscopic premedication; however, its effect on cardiopulmonary function during endoscopy has not yet been fully investigated.

Efficacy of ecabet sodium for Helicobacter pylori eradication triple therapy in comparison with a lansoprazole-based regimen

: The cytoprotective agent, ecabet sodium, inhibits urease activity and growth of Helicobacter pylori.

Helicobacter pylori Infection Accelerates Gene Expression of Glicentin in the Gastric Mucosa: Its Association with Intestinal Metaplasia of the Stomach

BACKGROUND Glicentin is an intestinal polypeptide hormone which seems to promote intestinal metaplasia (IM) in the gastric mucosa. The aim of this study was to clarify whether Helicobacter pylori infection accelerates glicentin gene expression. METHOD Glicentin mRNA was investigated by reverse-transcription polymerase chain reaction using gastric biopsies from 47 patients examined endoscopically and denying IM. RESULTS IM was observed in 18 (38.3%) cases histologically, but not in the other 29 (62.7%). Glicentin mRNA was significantly correlated with histological IM (P < 0.01) and was positively correlated with H. pylori infection (P < 0.05). CONCLUSION Our results indicate that H. pylori infection is associated with the induction of glicentin in the gastric mucosa, thus supporting the hypothesis that H. pylori infection accelerates IM of the stomach.

Comparative study of nizatidine and famotidine for maintenance therapy of erosive esophagitis

Background:  The therapeutic effect of combined administration of prokinetics and histamine H2 receptor antagonists (H2RA) in gastroesophageal reflux disease is reported to be superior to that of monotherapy with H2RA alone. In addition to its acid‐suppressing effect, the H2RA nizatidine also has a prokinetic action by suppressing acetylcholine esterase. The present multicenter, randomized controlled study was performed to investigate whether nizatidine is superior to famotidine, which does not suppress acetylcholine esterase activity, in maintenance therapy for erosive esophagitis. In addition, the question as to whether the grade of erosive esophagitis affects the non‐recurrence rate during the maintenance therapy with H2RA was also investigated.

Nonrotation of the midgut with appendiceal mucocele in an adult

Abstract: Nonrotation of the midgut in adults and appendiceal mucocele are both rare pathological conditions. We report here the first case of nonrotation of the midgut associated with appendiceal mucocele. The patient was a 51-year-old man admitted to hospital with ileus. An upper gastrointestinal series and a barium enema revealed nonrotation of the midgut without midgut volvulus and with a mass in the ileocecal area. Laparotomy revealed an appendiceal mucocele adhering to the urinary bladder and the rectum. The mucocele had partly ruptured; yellowish mucinous material had entered the abdominal cavity, resulting in pseudomyxoma peritonei. Histological examination revealed a mucinous tumor of the appendix with borderline malignancy. In this patient, the ileus was caused by the appendiceal mucocele rather than being caused by nonrotation of the midgut.

Diagnostic accuracy of a new non-invasive enzyme immunoassay for detecting Helicobacter pylori in stools after eradication therapy

Background: Helicobacterpylori (H pylori) eradication therapy has been commonly performedfor patients with peptic ulcer. An inexpensive, reliable, non-invasive test would be very useful for evaluation of the effectiveness of eradication therapy. In the course of investigations into techniques for detecting H pylori infection after eradication therapy, the diagnosticpotentialof a new non-invasive enzymeimmunoassay (HpSA)for H pylori antigen in stools was evaluated. Methods: One hundred and fifteen pepticulcerpatientswithH pylori infection(84 male,31 female; age range 22-81 years,mean54) receiveda courseof eradicationtherapy.Fourweeks after the end of the therapy, stool sampls were collectedfrom all patients and testedusing the HpSA.The diagnosticaccuracyof the HpSA EIA was evaluated in comparison with the the results of l3C-urea breath test (13C_ UBT). Results: After the eradication therapy, the H pylori status was negative in 106 (92%) cases and positive in 9 (8%), as assessed by 13C-UBT. On the other hand, HpSA stool test results were negativein 105 (91 %) cases and positive in 10 (9%). When the l3C-UBT was used as a gold-standard, the HpSA stool test showed 2 false positive and 1 false negative results, and the sensitivity and specificity were 89% and 98%, respectively, aftereradicationtherapy.The positiveand negativepredictive values of HpSA were 80% and 99%, respectively. Furthermore, a positive correlation (r=0.671, p<O.Oool) was found between the results of the 13C-UBT and the HpSA EIA. Conclusion: The HpSA stool test is potentiallyuseful for the diagnosisof H pylori infection4 weeksafter the end of eradicationtherapy. 2702