Factors affecting quality of ulcer healing after lansoprazole treatment

To evaluate endogenous and exogenous factors affecting the quality of ulcer healing produced by proton pump inhibitors, gastric acid pH, serum gastrin, and serum pepsinogen (PG) I and II were measured in peptic ulcer patients before and after treatment with lansoprazole 30 mg once daily. Lansoprazole achieved more rapid scarring in duodenal ulcer (n = 34), with a healing rate of 97.1% after 6 weeks, than in gastric ulcer (n = 56), with a healing rate of 92.8% after 8 weeks. Scarring was the most rapid in gastroduodenal ulcer (n = 8), with a healing rate of 100% after 8 weeks, but the rate of complete scarring was the lowest (37.5%). Lower gastric acidity and lower PG I:II ratio were associated with poor quality ulcer scarring in patients with gastric ulcers, but the opposite was true for those with duodenal and gastroduodenal ulcers. For gastric ulcers, not only ulcer size but also mucosal atrophy was an important factor in ulcer healing. Smoking and alcohol consumption had little effect on the quality of ulcer healing during treatment. These results suggest that there are a number of differences between gastric ulcers and duodenal ulcers in terms of the quality of ulcer healing after lansoprazole treatment.

Antigenic relationship between the house dust mite Dermatophagoides farinae and the predacious mite Phytoseiulus persimilis

We have examined the antigenic relationship between the house dust mite Dermatophagoides farinae and the predacious mite Phytoseiulus persimilis. Immunoblotting analysis demonstrated that there was a very weak antigenic cross-reactivity between these different suborder of mites but that this cross-reactivity was not attributed to D. farinaes major allergen's, Der fI and Der fII. These results suggest that P. persimilis might scarcely provoke allergic symptoms in patients sensitized to house dust mites.

Trypsin-like protease of mites: purification and characterization of trypsin-like protease from mite faecal extract Dermatophagoides farinae. Relationship between trypsin-like protease and Der f III

A serine protease from mite faecal extract, Dermatophagoides farinae, was purified using DEAE-Sephacel anion exchange chromatography and Superdex 75 pg gel chromatography. The molecular weight of this protease was 34 kD on SDS-PAGE under reducing conditions. The optimal pH and temperature of the protease were 8.0 and 47 degrees C, respectively. In addition, this protease cleaved arginyl or lysyl residue containing substrates selectively and was only inhibited by aprotinin, FUT-175, and soy bean trypsin inhibitor and not by chymostatin, E-64 and iodoacetic acid. These results show that our purified serine protease belongs to the trypsin-type. Purified trypsin-like protease was shown to be allergenic by enzyme-linked immunosorbent assay. Antigenicity of trypsin-like protease was completely different from those of Der f I and Der f II. Both, 20 N-terminal amino acid sequence and amino acid compositions of the purified protease were very similar to those of Der f III. Good similarities were found between trypsin-like protease and Der f III concerning physicochemical properties such as molecular weight on SDS-PAGE and ammonium sulphate solubility. Summarizing the above data, it can be concluded that a trypsin-like protease from mite faecal extract is actually the Der f III allergen and that it may be involved in the digestive process of the mite as it was found not in mite body but in mite faeces.

[Study of cell populations of bronchoalveolar lavage fluid in patients with pneumonia due to Chlamydia psittaci and Mycoplasma pneumoniae]

We have performed bronchoalveolar lavage (BAL) examination in 27 cases; 5 with Chlamydial pneumonia, 7 with Mycoplasmal pneumonia and 15 in the control group (5 non-smokers, 10 smokers), and the following results were obtained. 1. In Chlamydial pneumonia and Mycoplasmal pneumonia, the cell population of alveolar macrophages in BALF decreased (p < 0.01) and that of lymphocytes increased compared with control group (p < 0.01). 2. In all cases of Mycoplasmal pneumonia without peripheral eosinophilia, the cell population of eosinophils in BALF increased compared with cases of Chlamydial pneumonia (p < 0.05). These results indicate that lymphocytes played the main role in the immune host defense in Chlamydial pneumonia, whereas infiltration of lymphocytes and eosinophils into the pneumonic lesion occurred in Mycoplasma pneumoniae infection.

[A case report of pneumonia due to Chlamydia trachomatis with pleural effusion]

A 64-year-old male consulted our hospital with a 6-day history of malaise, body temperature to 38 degrees C, anorexia, and light headedness. The chest radiograph showed consolidation in the left lower lung area. Chest CT and ultrasonography revealed left pleural fluid. The pleural fluid was exudative (yellowish in color, protein 3.0 g/dl, Rivalta reaction positive, adenosine deaminase 19.4 U/L), and had a total cell count of 4.7 x 10(6)/ml with 45% lymphocytes, 40% histiocytes, and 15% polymorphonuclear leukocytes. He had kept a budgerigar, but we could not isolate Chlamydia from the pleural fluid or the pet bird. Transbronchial lung biopsy from left S10 revealed an increase of mononuclear leukocytes within the interstitial spaces, and the alveolar spaces contained polymorphonuclear leukocytes, fibrin, and organized alveolar exudate. Bronchoalveolar lavage cellular constituents were 50% lymphocytes, 27% neutrophils, and 23% macrophages. Serologic studies demonstrated C. trachomatis specific IgM antibody titers at 1:20 in a serum sample and at 1:10 in pleural fluid. We report a case of community-acquired pneumonia caused by C. trachomatis diagnosed by serologic studies.

Is a trypsin-like protease of mites a Der f III allergen?

A trypsin-like protease was purified from mite (Dermatophagoides farinae) fecal extract. In SDS-PAGE, the mite trypsin-like protease showed a single band at 34 kD. The purified trypsin-like protease possessed potent allergenic activity. Both the twenty N-terminal amino acid sequence and the amino acid composition of the purified protease were very similar to those of Der f III. These data strongly suggest that the trypsin-like protease in the mite is a Der f III allergen.

[Study on the bacteriological examination of sputum and bronchoscopy specimens from 31 cases with pneumonia due to Chlamydia psittaci]

We carried out the bacteriological examination of sputum and bronchoscopy specimens from 31 cases with pneumonia due to C. psittaci. The results obtained were as follows: 1. The positive culture of sputum and bronchoscopy specimens were 38.7% (12/31). 2. The organisms detected from them were 13 strains of gram-negative bacilli, 2 of gram-positive cocci and one gram-positive bacillus. 3. Significant differences were observed in the white blood cell count between the cases of positive culture and those of normal upper respiratory tract flora (p less than 0.05). From the results we conclude that it would be better that we add the proper antimicrobial drugs to chlamydial antibiotics in the treatment of patients with leukocytosis.

[A clinical study of twelve cases of drug-induced pneumonitis]

Twelve cases of drug-induced pneumonitis were clinically investigated. Treatment of antimicrobial agents in 8 cases of drug-induced pneumonitis ranged from 7-21 days (mean 12 days) and that of other drugs in 4 cases from 18-150 days (mean 70 days). The patients developed fever and dyspnea at a high rate of frequency. Abnormal laboratory findings included increased IgE (44%), eosinophilia (36%), and increased GOT and GPT in 33%. Chest X-ray films revealed a large reticulo-nodular or ground glass shadows in both lung fields. The results of lymphocyte stimulation tests were positive in 5 of 11 cases (45%). Eight cases demonstrated a rapid improvement by discontinuation of the drug and corticosteroid was administered in 4 cases. The drug received by the patient and their known risk of pulmonary toxicity should be kept in mind in order to reach a diagnosis of drug-induced pneumonitis and grasp the clinical picture of this disease. A provocation test is potentially dangerous, therefore it should not be carried out lightly.

Structure and mineral content in weight-bearing bones following hindlimb suspension in young rats

Responses of structure and mineral content in weight-bearing bones to 1-week hindlimb suspension were studied in growing rats. The weight, volume, and length of femur, tibia, and fibula were less in suspended rats than cage controls, although there was no significant difference in the weight/volume ratio. The diameter of mid-shaft, the thickness of cortical bone, and the ratio of cortical bone thickness to femur diameter were significantly less in the suspended rats. The width of marrow space showed no differences, suggesting that the cortical bone was mainly affected. The sum of mineral content and the mineral content per diameter in the cross section of femurs were decreased following suspension, suggesting a change in the internal structure of cortical bone. Data also indicated that the reduction of femur diameter was caused by decreased thickness which is accompanied by the decreased mineral content of the cortical bone. It was suggested that there is a close relationship between the responses of bones and muscles to hindlimb suspension of young rats, although the degree of weight loss was greater in muscles than in bones.

[The penetration of ofloxacin and enoxacin into the alveolar spaces in rats]

Ofloxacin (OFLX) or Enoxacin (ENX) was intramuscularly administered at a dose of 100 mg/kg to rats (normal and pneumonia model). Bronchoalveolar lavage (BAL) was performed at 30 min after administration and concentrations of OFLX or ENX in the recovery fluid were determined. Total recovery amounts of OFLX from 10 BAL procedures were 64.7 +/- 18.7 micrograms in the normal group and 126.5 +/- 16.1 micrograms in the pneumonia group, and the amounts of ENX were 15.6 +/- 4.6 micrograms in the normal group and 32.8 +/- 6.1 micrograms in the pneumonia group. Regarding the ratio of total recovery amounts in BAL to serum concentrations of OFLX or ENX, the pneumonia group was higher than the normal group and the ratio of OFLX was higher than that of ENX. Regarding the ratio of total recovery amount in BAL to the amount in lung parenchyma, the ratio of OFLX was higher than that of ENX, but there was no significant difference between the normal group and the pneumonia group in the ratio of OFLX or ENX. With regard to the ratio of the amount of OFLX or ENX in lung parenchyma to their serum concentrations, the ratio was higher in the pneumonia group than in the normal group, but there was no significant difference between OFLX and ENX. Based on the above results, it was concluded that the permeability of OFLX into epithelium of blood capillary is the same as that of ENX, but the permeability of OFLX into alveolus epithelium is superior to that of ENX.(ABSTRACT TRUNCATED AT 250 WORDS)

[Combination chemotherapy including cisplatinum, vindesine and mitomycin C for non-small cell lung cancer]

Thirty-five patients with non-small cell lung cancer (adenocarcinoma: 15, squamous cell: 15, large cell: 5, Stage I: 3, II: 1, IIIA: 8, IIIB: 5, IV: 18) were treated with combination chemotherapy, CDDP 80 mg/m2 day 1, VDS 3 mg/m2 days 1 & 8, and MMC 8 mg/m2 day 1. This regimen was repeated two times at intervals of four weeks. Sixteen partial responses were observed (response rate of 45.7%), and the median duration of survival for responders was 12.6 +/- 7.5 months and for nonresponders 10.1 +/- 4.8 months. Statistically there was no difference between them, but a survival from the onset of therapy of responders was significantly better (p less than 0.05) than that of non-responders. Toxicity was tolerable with myelosuppression, chemotherapy-induced nausea and vomiting.

[The effect of modified sham-feeding on gastrin-stimulated gastric secretion in patient with duodenal ulcer]

Patients with duodenal ulcer were classified into responders to H2-receptor antagonist and non-responders in whom duodenal ulcer did not heal within three months with the antagonist. In these patients and healthy controls, modified sham-feeding (MSF) test was performed to elucidate the pathophysiological differences between these groups, especially vagal activity of acid output. After tetragastrin 4 micrograms/kg/hr infusion for one hour, MSF was superimposed to the infusion (G + MSF). The acid output of non-responders (8 cases) and controls (8 cases) significantly increased in G + MSF. On the other hand, the acid output of responders (6 cases) significantly decreased. The acid output of non-responders in G + MSF was also significantly higher than that of controls. The results suggest that vagal activity of non-responders is higher than responders, and that there is disturbance of inhibitory mechanism in vagal system.

[A case report of psittacosis and chlamydial isolation from a dead pet bird]

A 33-year-old previously healthy woman was seen at this hospital after a week of fever and nonproductive cough. A roentgenogram of the chest showed consolidation in the left upper and middle lung fields. Transbronchial lung biopsy from left S1 + 2 revealed an increase of mononuclear leukocytes within the interstitial spaces and slight cell infiltration with in the alveoli. Bronchoalveolar lavage cellular constituents showed 47% alveolar macrophage, 38% lymphocytes and 15% neutrophils. She had kept a parakeet, which died just after her illness. We could isolated organisms from the liver, spleen, kidney, lung, heart and bowel of her pet bird revealing C. psittaci by Giemsa stain, three days after it was buried in the ground. She was given three hundred mg of ofloxacin per day orally for fourteen days and the clinical effect was good. The in vitro activity of ofloxacin was 0.75 microgram/ml.

[The clinical effectiveness of OFLX in the treatment of chlamydial pneumonia]

We treated three patients of chlamydial pneumonia with OFLX, two patients were diagnosed as psittacosis and one as pneumonia associated with TWAR strain by serologic test. Three hundred mg of OFLX was orally administered three times per day and the duration of treatment was from seven to fourteen days, and we compared the clinical effectiveness of OFLX in three cases (mild: 1, moderate: 2) with that of MINO in eleven cases (mild: 3, moderate: 8), who were administered two hundred mg of MINO two times per day orally or intravenously. We isolated C. psittaci from three pet birds including case 2 and the in vitro activity of OFLX and MINO against three strains of C. psittaci was determined. Clinical effectiveness were observed and obtained results were as follows. 1) In OFLX group, three patients judged as "Good", and in MINO, one patient as "Excellent", ten as "Good". 2) The duration of pneumonic shadow was 9.33 +/- 3.21 in OFLX group, 10.3 +/- 3.50 in MINO group, and there was no significant difference between both groups. 3) The in vitro activity of OFLX and MINO against 3 strains was 0.78-1.56 micrograms/ml and 0.025 microgram/ml, respectively. From these results, it was concluded that OFLX was considered to be a useful antichlamydial agent in the treatment of mild or moderate cases of chlamydial pneumonia.

[Follow-up study of bone grafts to the alveolar clefts]

Clinical follow-up study after the grafting with fresh autogenous iliac bone to the alveolar clefts in cleft lip and palate patients was carried out up to 2 years post operation. Twenty two patients were examined, to whom grafts of iliac cortical or iliac marrow bone was carried out by the First or the Second Department of Oral Surgery, Kagoshima University Dental School from July, 1985 to April, 1988. Their cleft types were classified as 18 unilateral and 4 bilateral cleft lips and palates. The ages at bone grafting were ranged from 8 years 9 months to 17 years 6 months, and the average of which was 12 years 3 months. Nine of these patients were grafted with the cortical bone, and the other 13 were grafted with the marrow bone. The perforations at alveolar clefts were covered with the tongue flap in 10 clefts of 10 patients, while they were covered with the local mucous flap in 15 clefts of 12 patients. Among these patients, dental casts, X-ray radiograms and oral pictures of 15 patients were surveyed postoperatively. Results were as follows: 1) Contours of the alveolar clefts were well corrected in 9 patients, especially in those cases of pre-operatively expanded unilateral clefts, grafted with the marrow bone and covered with the local mucous flaps. 2) The viable rate of grafted bone was 100.0% for the marrow bone, while it was 62.5% for the cortical bone.(ABSTRACT TRUNCATED AT 250 WORDS)

[Study of the receptor for P. aeruginosa on tracheal cells and in tracheobronchial mucin]

Adhesion of P. aeruginosa to normal and injured rat tracheas was examined. Rat tracheas were injured by exposure to 0.1N HCl for 10 min, and incubated with P. aeruginosa. Adhesion was quantitated by direct count of the number of bacteria attached to a fixed surface area as viewed by scanning electron microscopy. P. aeruginosa adhered to injured tracheas much more than to normal tracheas. The adhesion of P. aeruginosa, preincubated with mucin and sugars, to acid injured trachea was examined. Mucin, N-acetylneuraminic acid and N-acetyl-D-galactosamine inhibited the adhesion of P. aeruginosa to injured tracheas, but not N-acetylglucosamine, L-fucose, D-mannose and D-galactose. Periodate oxidation and neuraminidase treatment of acid injured tracheas reduced the adhesion of P. aeruginosa. These data suggest that N-acetylneuraminic acid (sialic acid) is the receptor for P. aeruginosa or a part of the receptor in acid injured rat trachea and in tracheobronchial mucin.

Natural history of duodenal ulcer detected by the gastric mass surveys in men over 40 years of age

In a gastric mass survey with photofluorography performed on 10,605 male office workers over 40 years of age, 456 cases of duodenal ulcer (4.3%) were detected. These cases were scheduled to be followed up every 6 months with endoscopy and without any anti-ulcer drugs. Two hundred and seventy-six of the cases, including 169 cases with craters and 107 cases with scars, were followed up for 2 years. Forty-one of 169 craters (24.3%) had healed, and 21 of 107 scars (19.6%) had relapsed at 6 months. At 24 months 36 of 169 craters (21.3%) had healed, and 31 of 107 scars (29.0%) had relapsed. Sixty-four and a half per cent of the ulcers that showed crater at entry remained at the crater stage, and 62.6% of ulcer scars at entry remained healed at every endoscopy during the trial period. With regard to the cases' background, cigarette smoking adversely affected the natural history of the duodenal ulcer. However, years after onset, previous treatment, history of overt bleeding, and alcohol and coffee consumption did not affect the present ulcer activity.

[Hemagglutinating activity of Escherichia coli isolated from the respiratory tract in comparison with those isolated from urine feces and blood]

Various bacteria with pili are able to agglutinate human and animal red blood cells. Hemagglutinating activity of 131 strains of Escherichia coli isolated from respiratory tract (24 strains), urine (64 strains), feces (36 strains) and blood (7 strains) were tested using human type A, guinea pig, bovine and chicken erythrocytes. Concerning the hemagglutination activity for erythrocytes from at least one of four species (human, guinea pig, bovine, chicken), the strains isolated from respiratory tract showed a higher level than those isolated from feces (p less than 0.01) or those isolated from blood (p less than 0.1). Agglutination of human erythrocytes: Of 131 strains, mannose-sensitive agglutination was observed in 31 strains, mannose-resistant agglutination in 40 strains and non-agglutination in 60 strains. More agglutinated strains were isolated from the respiratory tract than those isolated from blood but not with statistical significance (p less than 0.1). Agglutination of guinea pig erythrocytes: Of 131 strains, mannose-sensitive agglutination was observed in 56 strains, mannose-resistant agglutination in 10 strains and non-agglutination in 65 strains. More agglutinated strains were isolated from the respiratory tract than from urine, feces and blood (p less than 0.01), and of those, 89% were mannose-sensitive agglutination. Agglutination of bovine erythrocytes: Of the 131 strains, mannose-sensitive agglutination was observed in 4 strains, mannose-resistant agglutination in 6 strains and non-agglutination in 121 strains. Therefore, only a few agglutinated strains were seen.(ABSTRACT TRUNCATED AT 250 WORDS)

[Correlations between masticatory performance in chewing gum method and occlusion as well as dento-facial morphology]

In order to examine the characteristics of the chewing gum masticatory test, the amount of sugar elution, the chewing time and the amount of sugar elution per second were measured in 109 young adults (93 males and 16 females), after 70 strokes of mastication. Their sex differences, differences among various occlusions, correlations with occlusal areas of the buccal teeth and correlations with roentgen cephalometrics were analyzed. 1. There was no sex difference in the amount of sugar elution. However, chewing time was shorter and the amount of sugar elution per second was higher in males than in females. 2. Compared with the normal occlusion group, the amount of sugar elution was significantly lower in the crowding and anterior cross bite groups (Inoue's classification), and in the Class III malocclusion group (Angle's classification) in males. The amount of sugar elution per second was also significantly lower in the crowding and anterior cross bite groups. However, significant differences could not be found for chewing time. 3. The amount of sugar elution per second was significantly correlated with occlusal areas in males and total samples. 4. The amount of sugar elution was significantly correlated with less than ANB and less than L 1 to MP in males, with less than L 1 to MP in total samples. The chewing time was significantly correlated with S-N, N-Me, N-ANS, S'-Ptm' in females. The amount of sugar elution per second was significantly correlated with less than SNA and less than L 1 to MP in males, and with A'-Ptm', Cd-Go, Go-Pog', Cd-Gn, less than SNA, less than L 1 to MP, less than MP-SN and gonial angle in total samples. 5. It is concluded that the chewing gum masticatory test is highly correlated with occlusion and dento-facial morphology. In particular, amount of sugar elution per second was thought to be a useful measure for masticatory performance in clinical orthodontics.