Mitsutaka Kumamoto

Nodular gastritis in Japanese young adults: endoscopic and histological observations

BackgroundEndoscopic findings of nodular gastritis (NG) are characterized by the presence of Helicobacter pylori infection and follicular gastritis. A possible association with diffuse-type gastric cancer has recently been suggested from observations in Japanese. Our aim was to analyze antral nodularity and histological scores in young adults.MethodsSubjects (55 men and 45 women; age range, 18–25 years) with upper gastrointestinal (GI) symptoms or positive H. pylori antibodies underwent endoscopy. One specimen each was obtained from the greater and lesser curvatures (curves) of the corpus and from those of the antrum. Endoscopic appearance was assessed using 0.2% indigo carmine, and histopathological grading was evaluated by the updated Sydney System.ResultsAntral nodularity was identified in none of 17 H. pylori-negative subjects and in 55 of 83 (66.3%) H. pylori-positive subjects. By the distribution of nodular or granular elevated lesions in the antrum, NG was divided into diffuse (n = 27) or nondiffuse (n = 28) types. The diffuse-type NG predominantly affected women (odds ratio, 3.9; 95% confidence interval, 1.5–10). The atrophy scores in the lesser curve of the antrum were significantly higher in the nondiffuse than in the diffuse group. However, the scores for activity, inflammation, and H. pylori density were not significantly different among the three groups.ConclusionsDiffuse-type NG depended on sex, and antral nodularity seemed to change from the diffuse to the nondiffuse type in association with atrophy.

Spontaneous Complete Regression of High Grade Non-Hodgkin's Lymphoma Morphologic, Immunohistochemical, and Gene Amplification Analyses

Background. Spontaneous regression of non‐Hodgkins lymphoma, occasionally reported in low grade groups, is a rare phenomenon in high grade groups. Clonal proliferation has not been confirmed in the majority of reported cases. In this woman, age 58 years, who had been diagnosed as having high grade immunoblastic lymphoma after excision of a single cervical lymph node, the remaining bilateral cervical, inguinal, and axillary adenopathy regressed completely without any cytotoxic treatments 22 days after biopsy. At the time of this writing, the patient has been free of disease for 24 months.

Subclinical syphilitic hepatitis, which was markedly worsened by a Jarisch-Herxheimer reaction

Early syphilitic hepatitis is uncommon and tends to be overlooked. However, the diagnosis of this disease is important, because appropriate treatment results in rapid resolution of the hepatitis. We report a case of subclinical early syphilitic hepatitis exaggerated by a Jarisch-Herxheimer reaction. This reaction helped to realize the diagnosis in this case.

Effectiveness of Daikenchuto, a Traditional Japanese Herbal Medicine, in Accelerating Capsule Endoscopy Transit Time- A Prospective Pilot Study

Capsule endoscopy (CE) is an effective and non-invasive method to exam lesions in the small intestine [1][2]. The battery life is a limiting factor for CE examinations. In approximately 20% of the cases, parts of the small intestine cannot be observed due to the delayed passage of the capsule through the small intestine, and thus it is necessary to shorten the passage time [3][4]. Currently, there is no consensus on the preparation of patients to improve the passage of CEs through their digestive tract, and the establishment of a standardized preparatory treatment is necessary. The purpose of this study was to investigate whether the pre-exam administration of Daikenchuto shortens the time during which a CE remains in the small intestine, and to improve the speed at which the capsules reach the large intestine.