What variables were associated with the inducibility of ventricular fibrillation during electrophysiologic stimulation test in patients without apparent organic heart disease?

SummaryObjectiveThe purpose of our study was to determine what variables were associated with ventricular fibrillation (VF) induced during electrophysiological stimulation test in patients without apparent organic heart disease.MethodsOur study evaluated 77 patients (51±15 years) who underwent electrophysiological stimulation test, signal averaging, and Na+ channel-blocker challenge test (pilsicainide test). The subjects were divided into two groups, the Brugada group and non-Brugada group. Further, the patients were divided into three subgroups on the base of symptoms (8, 7 symptomatic; 9, 13 syncope; 28, 12 asymptomatic group; in the Brugada and non-Brugada groups, respectively). Multivariate analyses evaluated the association between baseline clinical factors and the induction of VF.ResultsThe inducibility of VF was significantly (p<0.0001) higher in the Brugada group (n=33, 73%) than the non-Brugada group (n=4, 13%). The multivariate analysis demonstrated that symptoms (odds ratio (OR) 31.6; 95% confidence interval (CI): 2.3–430.6; p<0.01), type 1 electrocardiogram after pilsicainide test (OR 21.3; CI: 1.7–272.2; p<0.02), and syncope (OR 13.5; CI: 1.2–158.8; p<0.05) were strongly associated with the inducibility of VF, but not with family history, type 1 electrocardiogram in control, positive in late potential, maxΔST elevation (≧200μV) after pilsicainide test.ConclusionsThe symptoms, syncope, and type 1 electrocardiogram after pilsicainide test were independently associated with the electrophysiological substrate of VF in patients without apparent heart disease

High-Sensitivity Real-Time Imaging of Dual Protein-Protein Interactions in Living Subjects Using Multicolor Luciferases

Networks of protein-protein interactions play key roles in numerous important biological processes in living subjects. An effective methodology to assess protein-protein interactions in living cells of interest is protein-fragment complement assay (PCA). Particularly the assays using fluorescent proteins are powerful techniques, but they do not directly track interactions because of its irreversibility or the time for chromophore formation. By contrast, PCAs using bioluminescent proteins can overcome these drawbacks. We herein describe an imaging method for real-time analysis of protein-protein interactions using multicolor luciferases with different spectral characteristics. The sensitivity and signal-to-background ratio were improved considerably by developing a carboxy-terminal fragment engineered from a click beetle luciferase. We demonstrate its utility in spatiotemporal characterization of Smad1–Smad4 and Smad2–Smad4 interactions in early developing stages of a single living Xenopus laevis embryo. We also describe the value of this method by application of specific protein-protein interactions in cell cultures and living mice. This technique supports quantitative analyses and imaging of versatile protein-protein interactions with a selective luminescence wavelength in opaque or strongly auto-fluorescent living subjects

Distinct Clinic-Pathological Features of Early Differentiated-Type Gastric Cancers after Helicobacter pylori

Background. Gastric cancer is discovered even after successful eradication of H. pylori. We investigated clinic pathological features of early gastric cancers after H. pylori eradication. Methods. 51 early gastric cancers (EGCs) from 44 patients diagnosed after successful H. pylori eradication were included as eradication group. The clinic-pathological features were compared with that of 131 EGCs from 120 patients who did not have a history of H. pylori eradication (control group). Results. Compared with control group, clinic-pathological features of eradication group were characterized as depressed (p<0.0001), reddish (p=0.0001), and smaller (p=0.0095) lesions, which was also confirmed in the comparison of six metachronous lesions diagnosed after initial ESD and subsequent successful H. pylori eradication. Prevalence of both SM2 (submucosal invasion greater than 500 μm) and unexpected SM2 cases tended to be higher in eradication group (p=0.077, 0.0867, resp.). Prevalence of inconclusive diagnosis of gastric cancer during pretreatment biopsy was also higher in the same group (26.0% versus 1.6%, p<0.0001). Conclusions. Informative clinic pathological features of EGC after H. pylori eradication are depressed, reddish appearances, which should be treated as a caution because histological diagnosis of cancerous tissue is sometimes difficult by endoscopic biopsy

Gastric-and-Intestinal Mixed Intestinal Metaplasia Is Irreversible Point with Eradication of Helicobacter pylori

Abstract Helicobacter pylori (H. pylori) represents an important factor in the development of atrophic gastritis, intestinal metaplasia (IM), and gastric cancer. Eradication of H. pylori has been reported to prevent gastric cancer only in cases without atrophy or IM. However, histological changes with eradication have yet to be fully clarified. We evaluated 38 H. pylori-positive cases before and after eradication at the gland level; pyloric glands were classified as showing gastric proper (G) and IM gland types, with the latter including gastric-and-intestinal mixed IM (GI-IM) and solely intestinal IM (I-IM), depending on the remaining gastric phenotypes. On eradication, acute and chronic inflammation attenuated rapidly and gradually, respectively, whereas levels of MUC5AC and MUC6 expression were not markedly altered. Gland width, size of nuclei and cytoplasm and their ratio in surface foveolar epithelium, the number of Ki-67-positive cells and the length of the proliferating zone in each gland were significantly decreased in G glands after eradication compared with those in GI-IM and I-IM. The number of mitotic phase cells, positive for phosphorylated histone H3 at serine 28, was increased in both types of IM compared to that in G glands in the H. pylori-infected state, but unexpectedly remained unchanged with eradication. These results suggest that GI-IM, as the beginning of IM, could represent a histological irreversible point with eradication and be considered as a &quot;histological point of no return&quot;

Images of colonic real-time tissue sonoelastography correlate with those of colonoscopy and may predict response to therapy in patients with ulcerative colitis

<p>Abstract</p> <p>Background</p> <p>Real-time tissue sonoelastography (EG) is a new non-invasive technique that visualizes differences in tissue strain. We evaluated the usefulness of EG in patients with ulcerative colitis (UC) by investigating the association between EG and colonoscopic findings and disease activity.</p> <p>Methods</p> <p>Thirty-seven UC patients undergoing EG and colonoscopy were invited to enroll. EG findings were classified as normal, homogeneous, random, or hard, and colonoscopic findings as normal, mucosal edema and erosion, punched-out ulcer, and extensive mucosal abrasion. Clinical findings were evaluated using clinical activity index (CAI) scores for each patient at colonoscopy.</p> <p>Results</p> <p>On EG, 10 cases were classified as normal, 11 as homogeneous, 6 as random, and 10 as hard. EG findings showed a significant correlation those of colonoscopy (<it>p </it>< 0.001). Seven of 10 (70%) normal-type patients were in the remission phase, while all 6 random-type patients were in the active phase. Among active-phase patients, 4 of 7 (57%) homogeneous-type patients responded to steroid or leukocytapheresis therapy, while 3 of 6 (50%) random-type patients required treatment with cyclosporine. Three of 10 (30%) hard-type patients required colectomy.</p> <p>Conclusions</p> <p>In this small series, EG findings reflected colonoscopic findings and correlated with disease activity among patients with UC.</p