Management of Helicobacter pylori

Meta-analysis has shown that successful Helicobacter pylori eradication therapy improved atrophic gastritis and intestinal metaplasia. Moreover, successful eradication therapy against atrophic gastritis has led to the suppression of the incidence of metachronous gastric cancer. Thus, the Japanese Society for Helicobacter Research concluded that all ‘H. pylori-infected persons’ should be considered for eradication therapy, irrespective of any background diseases. Successful eradication can prevent transmission of this bacterium, and recent publications show that curing H. pylori infection seems to reduce the risk of gastric cancer

Systematic review and meta-analysis: the relationship between the Helicobacter pylori dupA gene and clinical outcomes

<p>Abstract</p> <p>Background</p> <p>In 2005, the first disease-specific <it>Helicobacter pylori </it>virulence factor that induced duodenal ulcer and had a suppressive action on gastric cancer has been identified, and was named duodenal ulcer promoting gene (<it>dupA</it>). However, the importance of the <it>dupA </it>gene on clinical outcomes is conflicting in subsequent studies. The aim of this study was to estimate the magnitude of the risk for clinical outcomes associated with <it>dupA </it>gene.</p> <p>Methods</p> <p>A meta-analysis of case-control studies which provided raw data on the infection rates with the <it>dupA</it>-positive <it>H. pylori </it>detected by polymerase chain reaction was performed.</p> <p>Results</p> <p>Seventeen studies with a total of 2,466 patients were identified in the search. Infection with the <it>dupA</it>-positive <it>H. pylori </it>increased the risk for duodenal ulcer by 1.41-fold (95% confidence interval [CI], 1.12-1.76) overall. Subgroup analysis showed that the summary odds ratio (OR) was 1.57 (95% CI, 1.19-2.06) in Asian countries and 1.09 (95% CI, 0.73-1.62) in Western countries. There was no association between the presence of the <it>dupA </it>gene and gastric cancer and gastric ulcer. Publication bias did not exist.</p> <p>Conclusion</p> <p>Our meta-analysis confirmed the importance of the presence of the <it>dupA </it>gene for duodenal ulcer, especially in Asian countries.</p

Helicobacter pylori from gastric cancer and duodenal ulcer show same phylogeographic origin in the Andean Region in Colombia

Background: A recent report has shown that the phylogenetic origin of Helicobacter pylori based on multi-locus sequence typing (MLST) was significantly associated with the severity of gastritis in Colombia. However, the potential relationship between phylogenetic origin and clinical outcomes was not examined in that study. If the phylogenetic origin rather than virulence factors were truly associated with clinical outcomes, identifying a population at high risk for gastric cancer in Colombia would be relatively straightforward. In this study, we examined the phylogenetic origins of strains from gastric cancer and duodenal ulcer patients living in Bogota, Colombia. Methods: We included 35 gastric cancer patients and 31 duodenal ulcer patients, which are considered the variant outcomes. The genotypes of cagA and vacA were determined by polymerase chain reaction. The genealogy of these Colombian strains was analyzed by MLST. Bacterial population structure was analyzed using STRUCTURE software. Results: H. pylori strains from gastric cancer and duodenal ulcer patients were scattered in the phylogenetic tree; thus, we did not detect any difference in phylogenetic distribution between gastric cancer and duodenal ulcer strains in the hpEurope group in Colombia. Sixty-six strains, with one exception, were classified as hpEurope irrespective of the cagA and vacA genotypes, and type of disease. STRUCTURE analysis revealed that Colombian hpEurope strains have a phylogenetic connection to Spanish strains. Conclusions: Our study showed that a phylogeographic origin determined by MLST was insufficient for distinguishing between gastric cancer and duodenal ulcer risk among hpEurope strains in the Andean region in Colombia. Our analysis also suggests that hpEurope strains in Colombia were primarily introduced by Spanish immigrants. © 2014 Shiota et al

Cloning, expression analysis, and tissue distribution of esp-1/testisin, a membrane-type serine protease from the rat

Esp-1/testisin, a serine protease abundantly expressed in human and mouse testis, is presumed to play an important role in the process of spermatogenesis and fertilization. In this study, we cloned an esp-1/testisin cDNA from rats, and analyzed its expression and tissue distribution. The isolated cDNA consisted of 1099 nucleotides with a single open reading frame encoding 328 amino acids and an expected molecular mass of 36.6 kDa. The deduced amino acid sequence of rat Esp-1/Testisin had 89% and 62% identity with its murine and human counterparts, respectively, and appeared to be a trypsin-type serine protease with a hydrophobic region at the C-terminus. By quantitative real-time polymerase chain reaction analysis, rat esp-1/testisin mRNA was predominantly expressed in testis, as in human and mouse. However, its immunohistochemical distribution was predominantly in the elongated spermatids at steps 12 to 19, and not in the primary spermatocytes and round spermatids. This different distribution profile suggests that Esp-1/Testisin plays a role in species-specific proteolytic events during spermatogenesis and fertilization

Helicobacter pylori infection and gastric mucosal atrophy in two ethnic groups in Nepal

Serum anti-Helicobacter pylori antibodies and pepsinogens (PGs) have been used as gastric cancer screening and gastric mucosal status markers. Nepal is a low risk country for gastric cancer. However, the mountainous populace in the northern region culturally linked to Tibet as well as Bhutan, a neighboring country, have a high risk of GC. We collected gastric biopsy specimens and sera from 146 dyspeptic patients living in Kathmandu, Nepal. We also examined the sera of 80 volunteers living in the mountainous regions of the Himalayas. The optimal cut-off was calculated for serum biomarkers against the histology. Kathmandu patients (43.8) were serologically positive for H. pylori infection, which was significantly lower than that for the mountainous (61.3, P = 0.01). The same results also found in the prevalence of PG-positivity, PG I levels and PG I/II ratios (P = 0.001, P < 0.0001 and P = 0.03, respectively). Moreover, the PG I/II ratios were significantly, and inversely correlated with the OLGA score (r = -0.33, P < 0.009). The low incidence of gastric cancer in Nepal can be attributed to low gastric mucosal atrophy. However, the mountainous subjects have high-risk gastric mucosal status, which could be considered a high-risk population in Nepal

Identification of helicobacter pylori infection in symptomatic patients in Surabaya, Indonesia, using five diagnostic tests

The prevalence of Helicobacter pylori infection in Indonesia is controversial. We examined the H. pylori infection rate in 78 patients in a hospital in Surabaya using five different tests, including culture, histology, immunohistochemistry, rapid urease test, and urine antibody test. Furthermore, we analysed virulence factors in H. pylori strains from Indonesia. The H. pylori infection rate was only 11·5 in all patients studied, and 2·3 of Javanese patients and 18·0 of Chinese patients were infected (P = 0·01). Although severe gastritis was not observed, activity and inflammation were significantly higher in patients positive for H. pylori than in patients negative for H. pylori. Among genotypes identified from five isolated strains, cagA was found in four; two were vacA s1m1. All cagA-positive strains were oipA 'on' and iceA1 positive. We confirmed both a low H. pylori infection rate and a low prevalence of precancerous lesions in dyspeptic patients in a Surabaya hospital, which may contribute to the low incidence of gastric cancer in Indonesia. © 2014 Cambridge University Press

A Report on Overseas Teaching Practicum by Graduate Students in Elementary/Secondary Schools in the United States（Ⅺ）

This paper reports on the 11th overseas teaching practicum in the U.S. 12 students joined this year’s program and they observed and conducted lessons in English in three local public schools in North Carolina after careful and repeated preparation sessions in Japan. Many of them did lessons on crosscultural understandings and a few taught subject contents. Through the trail to convey messages in English, their foreign language, students learned the role of verbal and nonverbal language and the more universal way to explain topics to children who are unfamiliar with what re taught. And they also learned and noticed the cultural differences and similalities between the two countries. It seemed that students realized that the two countries share many things in common such as what chidren are like, teachers’ attitude toward children and challenges they are facing, and people’s kindness. These learning was no substitute experience for the participants and it is hoped that their experience will be passed to the next generation when they become teachers

シカク ショウガイシャ ユウドウヨウ ブロックトウ ノ リヨウ ジョウキョウ チョウサ

For the project of National Institute of Technology and Evaluation (NITE) on standardization of visibility of tactile walking surface indicators (TWSIs) for visually impaired people, we conducted a survey on TWSIs use in 154 subjects (91 males and 63 females) with low vision, aged 14-90 years (mean=60.2). The results showed that 49% of the subjects used TWSIs when they walked, with the most common usage being walking while looking at TWSIs for guidance (45%), followed by walking on TWSIs without a white cane (33%). The other 51% gave reasons why they did not use TWSIs, which included 60% of them who did not need TWSIs for mobility, while the other 30% could not use them due to insufficient visibility, for example, the TWSI colors being too similar to background. Our study also clarified that over 60% of people with low vision walk by themselves every day. To assure the safety of walking for visually impaired people, the visibility of TWSIs must be standardized as soon as possible