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Serum biomarker tests are useful in delineating between patients with gastric atrophy and normal,healthy stomach

World Journal of Gastroenterology 2009年第7期15卷 853-859页

作者： Katsunori Iijima Yasuhiko Abe Ryosuke Kikuchi Tomoyuki Koike shuichi ohara Pentti Sipponen Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Department of Pathology Helsinki University Central HospitalJorvi Hospital

AIM:To study the value of serum biomarker tests to differentiate between patients with healthy or diseased stomach mucosa:i.***.those with Helicobacter pylori(H pylori)gastritis or atrophic gastritis,who have a high risk of gastric cancer or peptic ulcer diseases.METHODS:Among 162 Japanese outpatients,pepsinogen-(Pg-)and(Pg)were measured using a conventional Japanese technique,and the European GastroPanel examination(Pg and Pg,gastrin-17 and H pylori antibodies).Gastroscopy with gastric biopsies was performed to classify the patients into those with healthy stomach mucosa,H pylori non-atrophic gastritis or atrophic gastritis.RESULTS:Pg-and Pg assays with the GastroPanel and the Japanese method showed a highly significant correlation.For methodological reasons,however,serum Pg-,but not Pg,was twice as high with the GastroPanel test as with the Japanese test.The biomarker assays revealed that 5%of subjects had advanced atrophic corpus gastritis which was also verified by endoscopic biopsies.GastroPanel examination revealed an additional seven patients who had either advanced atrophic gastritis limited to the antrum or antrum-predominant H pylori gastritis.When compared to the endoscopic biopsy findings,the GastroPanel examination classified the patients into groups with "healthy" or "diseased" stomach mucosa with 94% accuracy,95% sensitivity and 93% specifi city.CONCLUSION:Serum biomarker tests can be used to differentiate between subjects with healthy and diseased gastric mucosa with high accuracy.

关键词：血清标志物检测胃癌患者健康幽门螺杆菌胃炎消化性溃疡疾病萎缩性胃炎 Hpylori 血清PG

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Brain activity following esophageal acid infusion using positron emission tomography

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World Journal of Gastroenterology 2010年第43期16卷 5481-5489页

作者： Shigeyuki Kobayashi Yasuhiko Abe Manabu Tashiro Tomoyuki Koike Katsunori Iijima Akira Imatani shuichi ohara Satoshi Watanabe Shin Fukudo Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Division of Cyclotron Nuclear Medicine Cyclotron and Radioisotope Center Tohoku University Division of Behavioral Medicine Tohoku University Graduate School of Medicine

AIM: To investigate symptoms and brain activity following esophageal acid infusion. METHODS: Fifteen healthy volunteers were recruited for the study. Hydrochloric acid (pH 1 and 2) and distilled water (pH 7) were randomly and repeatedly infused into the esophagus. The brain activity was evaluated by positron emission tomography. The severity of heartburn elicited by the infusion was rated on an auditory analog scale of 0-10.RESULTS: The severity of heartburn following each infusion showed a step-wise increase with increasing acidity of the perfusate. The heartburn scores were significantly higher in the second pH 1 infusion compared with the first infusion. Acid and distilled water infusion induced activation of various brain areas such as the anterior insula, temporal gyrus, and anterior/ posterior cingulate cortex. At pH 1 or 2, in particular, activation was observed in some emotion-related brain areas such as the more anterior part of the anterior cingulate cortex, parahippocampal gyrus, or the temporal pole. Strong activation of the orbitofrontal cortex was found by subtraction analysis of the two second pH 1 infusions, with a significant increase of heartburn symptoms. CONCLUSION: Emotion-related brain areas were activated by esophageal acid stimulation. The orbitofrontal area might be involved in symptom processing, with esophageal sensitization induced by repeated acid stimulation.

关键词： Esophageal acid infusion Brain imaging Positron emission tomography

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Identification of the layered morphology of the esophageal wall by optical coherence tomography

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World Journal of Gastroenterology 2009年第35期15卷 4402-4409页

作者： Satoshi Yokosawa Tomoyuki Koike Yasushi Kitagawa Waku Hatta Kaname Uno Yasuhiko Abe Katsunori Iijima Akira Imatani shuichi ohara Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine1-1Seiryo-machiAoba-kuSendai Miyagi 980-8574Japan

AIM:To assess each layer of the optical coherence tomography(OCT)image of the esophageal wall with reference to the histological structure. METHODS:Resected specimens of fresh pig esophagus was used as a model for the esophageal wall.We injected cyanoacrylate adhesive into the specimens to create a marker,and scanned them using a miniature OCT probe.The localization of these markers was assessed in the OCT images.Then we compared the OCT-imaged morphology with the corresponding histological section,guided by the cyanoacrylate adhesive markers.We prepared a second set of experiments using nylon sutures as markers. RESULTS:The OCT image of the esophageal specimen has a clear five-layered morphology. First,it consisted of a relatively less reflective layer; second,a more reflective layer;third,a less reflective layer;fourth,a more reflective layer;and fifth,a less reflective layer.Comparing the OCT images with marked histological sections showed that the first layer corresponded to stratified squamous epithelium; the second to lamina propria;the third to muscularis mucosa;fourth,submucosa;and fifth,muscularispropria with deeper structures of the esophageal wall.CONCLUSION:We demonstrated that the OCT image of the normal esophageal wall showed a five- layered morphology,which corresponds to histological esophageal wall components.

关键词：形态鉴定断层扫描光学相干氰基丙烯酸酯胶粘剂食道标记定位组织结构组织切片

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Incidence of reflux esophagitis and Helicobacter pylori infection in diabetic patients

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World Journal of Gastroenterology 2008年第20期14卷 3212-3217页

作者： Ken Ariizumi Tomoyuki Koike shuichi ohara Yoshifumi Inomata Yasuhiko Abe Katsunori Iijima Akira Imatani Tomoyoshi Oka Tooru Shimosegawa Division of Gastroenterology TohokuUniversity Graduate School of Medicine Sendai Miyagi9808574 Japan Division of Diabetes and Metabolic Diseases Tohoku University Graduate School of Medicine Sendai Miyagi 9808574 Japan

AIM: To investigate the incidence of reflux esophagitis (RE) and H pylori infection in the diabetic patient. METHODS: The incidence of RE and H pylori infection were investigated in 85 patients with diabetes mellitus and the results were compared with controls. RESULTS: The incidence of RE in diabetic patients was 17.6%. Although this tended to be higher in diabetic patients, there were no statistically significant differences between diabetic patients and controls. The incidence of H pylori infection in diabetic patients was 53.7% but no statistically significant difference was seen between diabetic patients and controls in the incidence of H pylori infection. CONCLUSION: No significant differences could be seen between diabetic patients and controls in the incidence of RE and H pylori infection.

关键词：糖尿病食管炎幽门螺杆菌细菌感染

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Early effects of Lansoprazole orally disintegrating tablets on intragastric pH in CYP2C19 extensive metabolizers

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World Journal of Gastroenterology 2008年第13期14卷 2049-2054页

作者： Hatsushi Yamagishi Tomoyuki Koike shuichi ohara Toru Horii Ryousuke Kikuchi Shigeyuki Kobayashi Yasuhiko Abe Katsunori Iijima Akira Imatani Kaori Suzuki Takanori Hishinuma Junichi Goto Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine 1-1 Seiryou-Machi Aobaku Sendai 9808574 Japan Division of Clinical Pharmacy Tohoku University Graduate School of Pharmaceutical Sciences 1-1 Seiryou-Machi Aobaku Sendai 9808574 Japan Division of Pharmacotherapy Tohoku University Graduate School of Pharmaceutical Sciences Department of Pharmaceutical Sciences Tohoku University Hospital 1-1 Seiryou-Machi Aobaku Sendai 9808574 Japan

AIM: To compare rabeprazole (RPZ; 10 mg) with Lansoprazole orally disintegrating tablets (LPZ; 30 mg OD) in terms of antisecretory activity and blood drug concentration after a single dose. METHODS: Eight H pylori-negative cytochrome P450 (CYP) 2C19 extensive metabolizers were assigned to receive a single oral dose of RPZ 10 mg or LPZ 30 mg OD. Twelve hour intragastric pH monitoring was perform- ed on the day of treatment. Blood samples were also collected after the administration of each drug. RESULTS: LPZ 30 mg OD induced a significantly earlier rise in blood drug concentration than RPZ 10 mg; consequently, LPZ 30 mg OD induced a significantly earlier rise in median pH in the third and fourth hours of the study. CONCLUSION: In H pylori-negative CYP2C19 extensive metabolizers, LPZ 30 mg OD induced a significantly faster inhibition of gastric acid secretion than RPZ 10 mg.

关键词：兰索拉唑口服药片胃液酸度血药浓度细胞色素

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Stronger inhibition of gastric acid secretion by lafutidine, a novel H_2 receptor antagonist, than by the proton pump inhibitor lansoprazole

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World Journal of Gastroenterology 2008年第15期14卷 2406-2410页

作者： Hatsushi Yamagishi Tomoyuki Koike shuichi ohara Toru Horii Ryousuke Kikuchi Shigeyuki Kobayashi Yasuhiko Abe Katsunori Iijima Akira Imatani Kaori Suzuki Takanori Hishinuma Junichi Goto Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of Medicine Sendai 9808574 Japan Division of Clinical Pharmacy Tohoku University Graduate School of Pharmaceutical Sciences Sendai 9808574 Japan Division of Pharmacotherapy Tohoku University Graduate School of Pharmaceutical Sciences and Department of Pharmaceutical Sciences Tohoku University Hospital Sendai 9808574 Japan

AIM: To compare the antisecretory activity and plasma drug concentrations of a single oral dose of 10 mg lafutidine, a novel H2 receptor antagonist, with those of the proton pump inhibitor lansoprazole (LPZ) 30 mg. METHODS: Ten volunteers without H pylori infection participated in this crossover study comparing lafutidine 10 mg with LPZ 30 mg. Intragastric pH was monitored for 6 h in all participants, and blood samples were collected from four randomly selected individuals after single-dose administration of each drug. RESULTS: The median intragastric pH was significantly higher in individuals who received lafutidine 10 mg than in those who received LPZ 30 mg 2, 3, 4, 5, and 6 h after administration. Maximal plasma drug concentration was reached more promptly with lafutidine 10 mg than with LPZ 30 mg. CONCLUSION: In H pylori-negative individuals, gastric acid secretion is more markedly inhibited by lafutidinethan by LPZ.

关键词：胃病胃酸分泌物抑制剂拮抗体

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Prevalence of gastroesophageal reflux symptoms in a large unselected general population in Japan

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World Journal of Gastroenterology 2008年第9期14卷 1358-1364页

作者： Hatsushi Yamagishi Tomoyuki Koike shuichi ohara Shigeyuki Kobayashi Ken Ariizumi Yasuhiko Abe Katsunori Iijima Akira Imatani Yoshifumi Inomata Katsuaki Kato Daisuke Shibuya Shigemitsu Aida Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of MedicineSendai CityJapan Miyagi Cancer Society Sendai CityJapan Department of Gastroenterology Sendai City Hospital Sendai cityJapan Division of Gastroenterology Tohoku University Graduate School of MedicineSendai CityJapan

AIM:To examine the prevalence of gastroesophageal reflux disease (GERD) symptoms in a large unselected general population in Japan. METHODS: In Japan, mature adults are offered regular check-ups for the prevention of gastric cancer. A notice was sent by mail to all inhabitants aged > 40 years. A total of 160 983 Japanese (60 774 male, 100 209 female; mean age 61.9 years) who underwent a stomach check up were enrolled in this study. In addition, from these 160 983 subjects, we randomly selected a total of 82 894 (34 275 male, 48 619 female; mean age 62.4 years) to evaluate the prevalence of abdominal pain. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a 1 mo period. RESULTS: The respective prevalences of the symptoms in males and females were: heartburn, 15.8% vs 20.7%; dysphagia, 5.4% vs 7.8%; and abdominal pain, 6.6% vs 9.6%. Among these symptoms, heartburn was significantly high compared with the other symptoms, and the prevalence of heartburn was significantly more frequent in females than in males in the 60-89-year agegroup. Dysphagia was also significantly more frequent in female patients. CONCLUSION: The prevalence of typical GERD symptoms (heartburn) was high, at about 20% of the Japan population, and the frequency was especially high in females in the 60-89 year age group.

关键词：胃食管反流症胃痛吞咽困难腹痛日本人

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Tongue-like Barrett's esophagus is associated with gastroesophageal reflux disease

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World Journal of Gastroenterology 2008年第26期14卷 4196-4203页

作者： Hatsushi Yamagishi Tomoyuki Koike shuichi ohara Shigeyuki Kobayashi Ken Ariizumi Yasuhiko Abe Katsunori Iijima Akira Imatani Yoshifumi Inomata Katsuaki Kato Daisuke Shibuya Shigemitsu Aida Tooru Shimosegawa Division of Gastroenterology Tohoku University Graduate School of MedicineSendai 980-8574Japan Miyagi Cancer Society Sendai980-0011Japan Department of Gastroenterlogy Sendai City HospitalSendai 984-8501Japan

AIM:To test this hypothesis of barrett esophagus (BE) classified into two types and to further determine if there was any correlation between the shape of endoscopically suspected esophageal metaplasia (ESEM), prevalence of reflux esophagitis (RE) and heartburn. METHODS: A total of 6504 Japanese who underwent endoscopy for their annual stomach check-up were enrolled in this study. BE was detected without histological confirmation that is ESEM. We originally classified cases of ESEM into 3 types based on its shape: Tongue-like (T type), Dome-like (D type) and Wave-like (W type) ESEM. The respective subjects were prospectively asked to complete questionnaires concerning the symptoms of heartburn, dysphagia, and abdominal pain for a one-month period. RESULTS: ESEM was observed in 10.3% of 6504 subjects (ESEM < 1 cm, 9.4%; 1 cm ≤ ESEM < 3 cm, 1.7%; ESEM ≥ 3 cm, 0.5%). The frequency of ESEM was significantly higher in males compared with female subjects. Statistical analysis showed that the prevalence of heartburn and RE were significantly higher in the T type ESEM than in the W type ESEM (P < 0.05). CONCLUSION: The T type ESEM was strongly associated with reflux symptoms and RE whereas the W type ESEM was not associated with GERD.

关键词：消化系统疾病胃食管反流病消化功能巴雷特食道

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