We have studied the effectiveness of two regimens { Regimen A : Lansoprazole (LPZ) 30 mg, metronidazole (MNZ) 500 mg and amoxicillin (AMPC) 1500 mg for one week; Regimen B : LPZ 30 mg, MNZ 500 mg and clarithromycin (CAM) 400 mg for one week } for the treatment of Helicobacter pylori. We also studied the effectiveness of re-treatment with alternative regimens where an initial treatment failed. The study was conducted as a randomized controlled prospective trial using 147 patients infected with H. pylori. The cure rates of Regimens A and B were 87.0% (67/77) and 85.7% (60/70), respectively, and the accumulated success rates were 97.3% (71/73) and 98.5% (66/67) . The accumulated success rates were significantly higher than the cure rates obtained by the initial treatments. Of the 147 clinical isolates, 0 %, 6.1%, and 2.7% had primary resistance to AMPC, CAM and MNZ, respectively, while 0 %, 60%, and 100% developed secondary resistance to AMPC, CAM and MNZ, respectively. The cure rate was 100% (2/2) for strains that were sensitive to CAM but resistant to MNZ; and 33.3% (1/3) for strains that were resistant to CAM but sensitive to MNZ. The presence of resistance to CAM, but not MNZ, was directly related to the efficacy of treatment. From these results, we suggest that the eradication rate will be approximately 100% after treatment with the combination of LPZ 30 mg, MNZ 500 mg and either AMPC 1500mg or CAM 400 mg for one week.

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Multislice dynamic CT (MSDCT) is a new technology with a short scanning time. MSDCT in various scanning directions can be obtained using the multidetector-row CT with a multiplanar reformatting (MPR) technique. We evaluated the preliminary results of sagittal and coronal MSDCT reconstructed by MPR (MSDCT-MPR) in 15 patients with pathologically confirmed pituitary microadenomas. The maximum contrast between the normal anterior pituitary gland and the adenoma occurred approximately 50 seconds after the start of the injection of the contrast media. Microadenomas were depicted as less enhanced areas relative to normal pituitary tissue. In two patients, cavernous sinus invasion of the tumor was clearly detected. Early enhancement of the microadenoma was not identified. This development of the MSDCT-MPR technique provided necessary information for surgery. This is the first report, to our knowledge, of the MSDCT-MPR technique being used to demonstrate pituitary microadenomas.

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This study was conducted to establish the relationship between QT dispersion and QT duration due to incremental atrial pacing. The QT interval and dispersion were measured in 47 patients. Sixteen of the patients had ventricular tachycardia or ventricular fibrillation (VT/ VF) [10 with organic heart disease (OHD) and 6 without OHD] . The control group was 31 patients (15 with OHD and 16 without OHD) . The QT interval was measured from a surface 12-lead electrocardiogram in sinus rhythm and during incremental atrial paced rates, and was calculated using Bazett's formula. Moreover, the QT interval was divided into the interval between the onset of the QRS and the peak of the T wave (QT peak) and the interval between the peak of the T wave and the end of the T wave (QT end) . QT dispersion at rest was markedly increased in the VT/ VF with OHD group compared with that in the controls and the VT/ VF without OHD group (172±97.2 vs 78±41.1 vs 56.7±39.3 vs 52.5±25.9 p< 0.05) . In VT/ VF patients with OHD, QT dispersion decreased up to 100 beats per minute (bpm) due to the incremental atrial pacing, but increased beyond 100 bpm. The QTc minimum (QTc min) interval did not change with any of the pacing rates. The interval between QT peak and QT end is a nucleus of the fluctuation of the dispersion by the heart rate. The QT dispersion of the VT/VF with OHD patient group responded to heart rate changes.

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We investigated the epidemiological relationship between the personality styles of Japanese women and their eating habits and behaviors. We conducted a cross-sectional study on 157 female students in the nutritionist vocational school A in Tokyo, Japan. Participants answered questions relating to personality style and daily food intake and underwent physical and biochemical investigations. Multivariate analysis of lifestyle-related factors revealed a significant positive correlation between the personality type that tended to lose patience and overeating, and between the ‘internal-type’ score on the multiple health locus of control (MHLC) scale and energy intake. The ‘chance-type’ score was negatively correlated with exercise habit, and the ‘power-type’ score was positively correlated with the overeating score and the frequency of eating breakfast. The personality predisposition of the internal-type is to “control my own health by myself”, the opposite to that of the power-type, which is to “leave my health to specialists”. The internal-type and the power-type showed opposing trends in all lifestyle-related indices except for the frequency to eat breakfast. This study suggests that these personality predispositions are closely correlated with eating habits. Dietary advice should be given while paying sufficient attention to the personality predisposition of individual subjects.

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We investigated the effects of the herbal medicines, Daisaiko-to-kajio (DSJ), Byakko-ka-ninjin-to (BNT) and Hachimi jio-to (HJT) on the lipid metabolism in Lep^ob/Lep^ob (C57BL/6J) ob/ob mice, that are animal models of obesity and non-insulin-dependent diabetes mellitus ( NIDDM) . DSJ and BNT 500 mg/kg/day inhibited the increase in triglyceride (TG) levels in the ob/ob mice. However, glucose 6-phosphate dehydrogenase and malic enzyme (ME) as fatty acid synthetic enzymes, and the /β-oxidative enzymes as metabolic enzymes of TG in the liver were not effected by herbal administration. We demonstrated that DSJ and BNT are effective for the treatment of hypertriglyceridemia in ob/ob mice.

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Aortopexy is performed in infants with tracheomalasia, and thymectomy of the left lobe is often required in this operation. This study aimed to ascertain the effect of thymectomy on the cellular immunity in young mice. Spleen weights and the distributions of splenic lymphocytes on the cell cycle were not significantly changed during the cell cycle, however the DNA histogram showed a significant increase in the S phase fraction on the addition of Con A after third-quarter thymectomy compared with a sham operation. This result suggests that the residual thymus after subtotal thymectomy may continue to play an important role in the cellular immunity.

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We investigated the clinical significance of serum anti-CagA antibody in peptic ulcer patients infected with Helicobacter pylori and assessed its association with histologic changes in gastric mucosa. The subjects were 62 Japanese patients with H. pylori infection and endoscopically diagnosed peptic ulcers (24 men and 19 women with gastric ulcers and 14 men and 5 women with duodenal ulcers) . Serum samples were assayed for the presence of antibodies to CagA with an enzyme-linked immunosorbent assay procedure. The cagA gene was assayed in the gastric juice of 42 of the 62 patients. Histologic examinations were performed according to the histologic classification of the Updated Sydney System. Serum anti-CagA antibody was detected in 76.7% of patients with gastric ulcer and in 73.7% of those with duodenal ulcer. Among the patients with duodenal ulcers, the scores of chronic inflammatory cell infiltration were significantly higher in seropositive patients than in seronegative patients (P=0.020) . Serum titers of anti-CagA antibody correlated with scores of chronic inflammatory cell infiltration (r=0.525, P=0.026) . The cagA gene of H. pylori was detected in the gastric juice of 28 of 29 patients with gastric ulcers and all in 13 patients with duodenal ulcers. The absence of anti-CagA antibody in the serum does not necessarily reflect the absence of the cagA gene of H. pylori. However, serum titers of anti-CagA antibodies correlated with chronic inflammatory cell infiltration into the gastric mucosa of the duodenal ulcer patients. This may indicate that infection with cagA-positive strains of H. pylori is associated with chronic inflammation in the gastric mucosa of Japanese patients with duodenal ulcers.

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A 31-year-old woman was admitted to the hospital because of soiling and anal pain. She had a normal delivery on the 3 rd of August 2000 and a mediolateral episiotomy was performed. Fourth-degree laceration was identified at delivery and a gynecologist performed the primary suture. Surgery was carried out on the 12th of March 2001 after recovery from inflammation at the tear site. Anal ultrasound examination revealed a defect of the anterior external sphincter muscle. The sphincter, levator ani, anal canal epithelium and vaginal mucosa were repaired. She has been well, with no evidence of recurrence, for 10 months. Eight months after surgery, she was able to recommence a normal sexual life both physically and psychologically. A manometric study performed 5 months after surgery revealed that maximum squeeze pressure had increased 2.5 fold. Success in treatment of patients with tears should be measured not only in terms of successful long-term closure but also in terms of the patient's satisfaction with postoperative incontinence and sexual life.

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We present a case of metastatic leiomyosarcoma of the pancreas diagnosed by needle biopsy under computed tomography, and development of obstructive jaundice 8 years after resection of a left tibial leiomyosarcoma. A 58-year-old woman was admitted to our hospital with jaundice. Computed tomography and magnetic resonance image showed a 2.5 cm mass in the head of the pancreas. We obtained a biopsy from the tumor that showed histopathological features identical to those of the leiomyosarcoma in the left tibia resected 8 years ago. The lesion was suspected as metastatic leiomyosarcoma of the pancreas and the patient underwent pylorus-preserving pancreatoduodenectomy.

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