Sawako Kato

Endoscopic identification of Helicobacter pylori gastritis in children.

Aim:  The role of endoscopic findings in deciding whether to biopsy the gastric mucosa of children remains unclear. The present study attempted, for the first time, to identify the value of endoscopic features for diagnosis of Helicobacter pylori (Hp) infection in children.

Food allergy after cord blood transplantation in children

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906 Evaluating Liver Stiffness and Steatosis in Children Using FibroScan

Background and Aims: Fibroscan (Echosens,France) is a new non invasive tool for measuring liver stiffness and steatosis. It has mainly developed to evaluate chronic liver disease in adult, but usefulness and appropriate inspection method in children has not been established. We report our experience of Fibroscan to evaluate liver stiffness and steatosis in children. Methods: Pediatric patients diagnosed or suspected to have liver disease were evaluated for controlled attenuation parameter (CAP) and elasticity value (E value) using Fibroscan from August 2013 to November 2014. Results: In total, 20 procedures were performed for 19 patients (14 male, average age 11.5 year). CAP was 100 to 348 dB/m, and E value was 3.2 to 21.3 kPa. E values were higher than 10 kPa in three patients, one after receiving liver transplantation, one post Fontan procedure and one Alstrom syndrome. Liver biopsy was performed in four of them (2 Non-alcoholic steatohepatitis:NASH), 1 congenital liver fibrosis, 1 Wilsons disease) at almost the same time and E value was correlated with histological fibrosis stage (F 1-2) in them. CAP and the degree of steatosis in the liver tissue were correlated in NASH patients. After treatment not only the blood data such as transaminase and HOMA-IR but also CAP and E value of the patient of NASH were improved (CAP 323 to 299 dB/m, E value 7.7 to 4.5 kPa). Conclusion: Fibroscan might be useful for evaluating and following up liver stiffness and steatosis of children with liver disease as well as adult.

Tu1932 Endoscopic Features of Food Protein-Induced Proctocolitis in Neonates and Infants

Background and aim: Intestinal-type gastric carcinomas progress through chronic inflammation and atrophic gastritis. Heat shock protein 27(HSP27), a stress-induced molecular chaperone, inhibit reactive oxygen species (ROS) accumulation. In previous reports have been suggested that HSP27 plays an important role in inflammation and carcinogenesis. We investigated HSP27 expression in gastric neoplasia and background gastric mucosa to assess its involvement in gastric carcinogenesis. Methods:We used real-time quantitative polymerase chain reaction to examine HSP27 expression in gastric neoplasias and in gastric mucosae of 30 patients with intraepithelial neoplasias and in gastric mucosae of 30 patients without gastric neoplasia. Immunohistochemical staining was performed on 30 advanced gastric cancer tissues. Results: HSP27 expression was negatively associated with atrophic gastritis. HSP27 expression in the background gastric mucosa of those without gastric neoplasia(P= 0.004).In tumor necrosis factor -treated gastric cancer cell,HSP27 knockdown increased cell death and ROS accumulation that link inflammation to cancer. Poorly differentiated tumors most frequently had high HSP27 levels. Dedifferentiated of cancer cells is associated with an epithelial-mesenchymal transition signaling pathway. In gastric cancer MKN-1 cells, HSP27 knockdown upregulated E-cadherin and downregulated vimentin and smooth muscle actin, but this did not occur in MKN-74 cells. Conclusion: HSP27 expression in gastric mucosae is negatively correlated with intraepithelial neoplasia, a probable precursor to gastric cancer and HSP27 expression in cancer is positively correlated with poor differentiation.