Triple Therapy-Based on Tegoprazan,a New Potassium-Competitive Acid Blocker,for First-Line Treatment of Helicobacter pylori Infection: A Randomized,Double-Blind,Phase III,Clinical Trial

Background/AimsWe examined the efficacy and safety of tegoprazan as a part of first-line triple therapy for Helicobacter pylori eradication.MethodsA randomized, double-blind, controlled, multicenter study was performed to evaluate whether tegoprazan (50 mg)-based triple therapy (TPZ) was noninferior to lansoprazole (30 mg)-based triple therapy (LPZ) (with amoxicillin 1 g and clarithromycin 500 mg; all administered twice daily for 7 days) for treating H. pylori. The primary endpoint was the H. pylori eradication rate. Subgroup analyses were performed according to the cytochrome P450 (CYP) 2C19 genotype, the minimum inhibitory concentration (MIC) of amoxicillin and clarithromycin, and underlying gastric diseases.ResultsIn total, 350 H. pylori-positive patients were randomly allocated to the TPZ or LPZ group. The H. pylori eradication rates in the TPZ and LPZ groups were 62.86% (110/175) and 60.57% (106/175) in an intention-to-treat analysis and 69.33% (104/150) and 67.33% (101/150) in a per-protocol analysis (non-inferiority test, p=0.009 and p=0.013), respectively. Subgroup analyses according to MICs or CYP2C19 did not show remarkable differences in eradication rate. Both first-line triple therapies were well-tolerated with no notable differences.ConclusionsTPZ is as effective as proton pump inhibitor-based triple therapy and is as safe as first-line H. pylori eradication therapy but does not overcome the clarithromycin resistance of H. pylori in Korea (ClinicalTrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT03317223","term_id":"NCT03317223"}}NCT03317223).     

A TEN-YEAR HOSPITAL SURVEY OF EYELID CANCER

Two hundred and four cases of malignant eyelid tumours, managed at the Concord Hospital, were reviewed. These cases spanned a ten-year period between 1973 and 1982 and all were treated surgically. The nature of each tumour was confirmed by histopathological examination. Included in this review were the site of the tumour, the tumour pathology, the surgical management, the type of surgeon involved, the ocular complications, the management of recurrences and any mortality. The importance of preventing recurrences by adequate initial surgery with frozen section control is emphasized.     

Clinical exophthalmometry: a comparative study of the Luedde and Hertel exophthalmometers

Exophthalmometry, the quantitative assessment of the position of the globe in the orbit, is a clinically useful measurement. The purpose of this study was to examine the performance of a simple exophthal-mometer that would lend itself to accurate and convenient use in clinical practice. In this study, two observers independently performed exophthalmometry on 100 eyes using the Hertel and Luedde instruments. The results were compared between instruments and between observers. There was no statistically or clinically significant difference between measurements taken with the Luedde as compared with the Hertel instrument. The Luedde exophthal-mometer has a number of advantages over the Hertel exophthalmometer, and represents a simple, inexpensive and equally reliable means of evaluating clinically the anteroposterior position of the eye in the orbit.     

Effects of bee venom on the maturation of murine dendritic cells stimulated by LPS

Aim of study

This study was performed to elicit the effectiveness of bee venom (BV), a traditional immunosuppressive Korean acupuncture agent, on the maturation of dendrtic cells (DCs).

Materials and methods

Immature dendritic cells (iDCs) were generated from mouse bone marrow cells with GM-CSF. After 10 days of initial differentiation, DCs were activated with lipopolysaccharides (LPS) for another 48h in the presence or absence of BV. Surface molecule analysis, intracytoplasmic staining of cytokines, FITC-conjugated antigen uptake, and transwell migration assays were conducted with iDCs and activated DCs.

Results

Up-regulation of costimulatory molecules, typical of mature DCs (mDCs) was inhibited by addition of BV. Pro-inflammatory cytokines were also found to be reduced with BV treatment in LPS-stimulated DC. A decrease in antigen uptake upon the maturation of DC was reversed in low dose BV treated mDC. In addition, BV treated mDC demonstrated reduced directional migration in response to CCL21, a lymphoid chemokine which directs mDC.

Conclusions

BV may have a therapeutic effect an on abnormally activated immune status, such as autoimmune rheumatoid arthritis, through an immune-modulatory effect on DC.