A microorganism with close immunohistological and genetic resemblance to Helicobacter pylori was found in the resected gallbladder mucosa of a 41-year-old woman. The woman was admitted to hospital complaining of fever and right hypochondrial pain. Cholecystectomy was carried out under the diagnosis of gallstones and cholecystitis. A microorganism resembling H. pylori (stained with H&E, Giemsa, and Wartin-Starry) was detected incidentally on pathological examination. The microorganism was also positive for immunohistochemical staining. An amplification reaction was seen on genetic examination by the polymerase chain reaction (PCR) method (urease beta-genes). Our findings suggest that H. pylori may be present in tissues other than gastric mucosa.
We previously reported the development of an integrated proteome platform, namely 2-Dimensional Image Converted Analysis of Liquid chromatography and mass spectrometry (2DICAL), for quantitative comparison of large peptide datasets generated by nano-flow liquid chromatography (LC) and mass spectrometry (MS). The key technology of 2DICAL was the precise adjustment of the retention time of LC by dynamic programming. In order to apply 2DICAL to clinical studies that require comparison of a large number of patient samples we further refined the calculation algorithm and increased the accuracy and speed of the peptide peak alignment using a greedy algorithm, which had been used for fast DNA sequence alignment. The peptide peaks of each sample with the same m/z were extracted every 1 m/z and displayed with along the horizontal axis. Here we report a precise comparison of more than 150 000 typtic peptide ion peaks derived from 70 serum samples (40 patients with uterine endometrial cancer and 30 controls). The levels of 49 MS peaks were found to differ significantly between cancer patients and controls (P < 0. T he incidence and morbidity of endometrial cancer have been rising in Western countries and Japan. In 1970, endometrial cancer constituted only 3% of all uterine cancers, but the proportion had increased to 40% by 1998.(1) The contemporary human lifestyle is characterized by excessive fat consumption, obesity, physical inactivity, high energy intake, hypertension, and a high serum glucose concentration, which are risk factors for endometrial cancer, (2)(3)(4)(5)(6) and therefore its incidence is predicted to increase further. Abnormal uterine bleeding is the most frequent initial symptom of endometrial cancer, but many other disorders including endometriosis, metroptosis, myoma uteri, and uterine sarcoma can also produce this symptom. Endometrial cancer is usually diagnosed by histological examination of endometrial tissue. However, endometrial biopsy is often associated with complications such as infection, bleeding and perforation of the uterus, and the development of an alternative safe test is therefore necessary for diagnosis of endometrial cancer.The circulating serum proteome holds great promise as a reservoir of information that will be applicable for diagnosis of various diseases. Various gel-based and MS-based quantitative analyses of plasma/serum proteins have been conducted actively to identify serum biomarkers that can be applied to blood tests.(7-10) HPLC with a flow rate of the nanoliter-per-minute order coupled with high-speed MS/MS scanning has especially attracted considerable attention because of its comprehensive protein identification capacity.(11-13) However, MS/MS is essentially not a method for quantification, and several attempts have been made to provide a quantitative dimension to nano-LC-MS/MS. Semi-quantification is possible to some extent by counting the number of peptides sequenced. (14-16) To achieve more accurate quantification, several labeling methods have been developed, (17)(1...
Objective Serological antibody test have been widely performed to detect the presence ofH. pylori, but they have not been used to evaluate the status of H. pylori after eradication. In this study we evaluated the diagnostic accuracy of a new serological test kit (E-plate) after eradication. Method Eradication ofH. pylori was performed in 100 patients by proton pump inhibitor (PPI)+amoxicillin (AMPC)+clarithromycin (CAM) or PPI+AMPCtherapy. Evaluation of H. pylori was done by culture, histology and rapid urease test before, and 8 weeks after, the treatment. Serological tests were also performed before and after treatment using the E plate. Cure was defined as no evidence of H. pylori at 8 weeks after the treatment. Receiver operating characteristic (ROC) analysis was performed to determine the ideal cut-off value for percentage change in the serological test.Result Success was obtained in 73 patients, failure in 20 patients and there were 7 dropouts. Serological test value was significantly decreased after treatment (44.3±29.6 U/ ml) compared to before treatment (94.8±73.2 U/ml) in the successful cases. In contrast, those with no significant change after treatment (62.7±31.3 U/ml) compared to before treatment (72.9±47.7 U/ml) were considered as failure cases. ROCanalysis revealed that cut-off values of a 20%, 30%, and 40%decrease on E plate result yielded a sensitivity of 95.5%, 92.4%, 71.2% and a specificity of73.3%, 84.2% , 94.7% , respectively. Conclusion The new E plate serological test kit for H, pylori was useful for distinguishing success from failure 8 weeks after completion of eradication therapy for H. pylori. (Internal Medicine 41: 780-783, 2002)
An intra-abdominal cyst is a rare complication of ventriculoperitoneal (VP) shunt. A 19-year-old male was admitted complaining of abdominal pain and distension, dysuria, constipation, headache, and fever. He had undergone a VP shunt for obstructive hydrocephalus caused by a cerebellar astrocytoma 16 years earlier, and had received shunt revision twice, 5 years and 3 months earlier, respectively. Examination on admission revealed neck stiffness, early papilledema, a mass in the lower abdomen, and abdominal muscular guarding with rebound tenderness. Laboratory studies showed leukocytosis of the peripheral blood and pleocytosis of the cerebrospinal fluid (CSF). Abdominal ultrasonograms and computed tomographic scans demonstrated a cystic lesion. Under the diagnosis of meningitis and local peritonitis with an intra-abdominal cyst, we sistemically administered antibiotics and externalized the shunt. However, since the cyst fluid could not be aspirated through the abdominal catheter, it was exchanged with a flexible catheter under fluoroscopic control, according to Seldinger's method. A total of 400 ml of cyst fluid was drained. Staphylococcus epidermidis was detected in both the cyst fluid and the CSF. After meningitis subsided, repositioning of the abdominal catheter into the other side of the abdomen was performed but resulted in shunt malfunction and meningitis due to the same organisms. After meningitis again subsided, the VP shunt was converted to a ventriculoatrial shunt. The clinical course was uneventful thereafter.
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