Efficacy of a 1‐week rabeprazole triple therapy for eradicating Helicobacter pylori and ulcer healing: an ‘in‐clinical‐practice’ study

OBJECTIVE: To determine the efficacy and tolerability of a 1‐week treatment regimen consisting of rabeprazole and two antibiotics, clarithromycin and amoxicillin, in the eradication of Helicobacter pylori in an ‘in‐clinical‐practice’ setting. METHODS: Patients selected had unequivocal evidence of H. pylori infection based on urease test and histology of antral and corpus biopsies obtained at endoscopy. Patients with complicated ulcers were not included. Patients received rabeprazole 10 mg b.i.d., clarithromycin 500 mg b.i.d. and amoxicillin 1 g b.i.d. for 1 week and were assessed for successful eradication at least 4 weeks after completion of therapy by repeat gastroscopy and gastric biopsies. Eradication was defined as absence of bacteria in both antral and corpus biopsies tested by histology and urease test. Ulcer patients did not receive continued acid suppression therapy following the 1‐week course of treatment. RESULTS: The study recruited 205 patients of whom 25 were not compliant with the medications or defaulted on follow‐up and were therefore not included in the per‐protocol analysis. Eradication of H. pylori was successful in 166/180 of patients on per‐protocol analysis (92.2% [95% CI: 87.3, 95.7]) and in 169/205 patients on intention‐to‐treat analysis (82.4% [95% CI: 80.5, 90.2]; P = 1.000). There were 47 patients with active ulcers: DU 27, GU 18, DU/GU 2. Overall, ulcer healing was achieved in 42 of 44 (95.5%) patients who had successful eradication of H. pylori infection, but ulcers did not heal in any of the three patients (DU 2, GU 1) who did not eradicate the infection. Of the total group, 199 were assessed for compliance and side‐effects of treatment. Side‐effects were in general mild and tolerable. Of 14 patients who were not compliant with medication, 4 (2.0%) attributed it to side‐effects of treatment (increased abdominal pain, dizziness and taste disturbances) and the remaining 10 did not give specific reasons. The most common side‐effect was bitter taste, reported by 39.2% of patients. Other side‐effects, such as giddiness, increased abdominal pain, lethargy, loose bowel motions and skin rash, were mild and found in only a small percentage of patients. CONCLUSIONS: The rabeprazole 1‐week triple therapy with amoxicillin and clarithromycin is effective in eradicating H. pylori in an ‘in‐clinical‐practice’ setting. The treatment was well tolerated by patients. Good ulcer healing was achieved with short‐course H. pylori eradication therapy without the need for continued acid suppression.     

Human <Emphasis Type="Italic">PTCHD3</Emphasis> nulls: rare copy number and sequence variants suggest a non-essential gene

Background  

Copy number variations (CNVs) can contribute to variable degrees of fitness and/or disease predisposition. Recent studies show that at least 1% of any given genome is copy number variable when compared to the human reference sequence assembly. Homozygous deletions (or CNV nulls) that are found in the normal population are of particular interest because they may serve to define non-essential genes in human biology.     

Impact of screening blood donors for hepatitis C antibody on posttransfusion hepatitis: a prospective study with a second-generation anti-hepatitis C virus assay

BACKGROUND: Hepatitis C is the major cause of posttransfusion hepatitis. Blood components that are positive for antibody to hepatitis C virus (anti-HCV) can transmit posttransfusion hepatitis. STUDY DESIGN AND METHODS: To investigate the effect on posttransfusion hepatitis of screening blood donors with a second-generation test for anti-HCV, 249 transfusion recipients who underwent cardiovascular surgery were prospectively followed. Six recipients who were positive for anti-HCV before transfusion and 51 subjects with incomplete follow-up were excluded from this study. RESULTS: Eleven (13.8%) of 80 subjects who received unscreened blood had two successive serum alanine aminotransferase levels > 90 U per L. Seven (8.8% of total) developed anti-HCV and HCV RNA and two (2.5% of total) developed IgM antibody to cytomegalovirus (IgM anti-CMV). By contrast, 3 (2.7%) of the 112 subjects who received anti-HCV-screened blood had two successive serum alanine aminotransferase levels > 90 U per L. None of these three developed anti-HCV and HCV RNA, but two (1.8% of total) showed the development of IgM anti-CMV. The study shows that screening for anti- HCV in blood donors with a second-generation test almost abrogated posttransfusion viral hepatitis C. CONCLUSION: After anti-HCV screening, other body fluid-transmitted viruses such as CMV may become important in posttransfusion hepatitis.     

Carcinomatous involvement of the hilum and mediastinum: computed tomographic and magnetic resonance evaluation

Magnetic resonance (MR) imaging and computed tomography (CT) were compared in 20 patients who had primary lung tumors, and the results were correlated with findings at surgery and pathologic evaluation. Both studies demonstrated a similar ability to detect hilar and mediastinal tumor. MR imaging detected more enlarged nodes in the mediastinum, but in several patients these enlarged nodes did not contain tumor. Consequently, MR imaging has a slightly higher false-positive rate in the evaluation of the mediastinum. Both modalities were highly sensitive, with specificity limited by the presence of enlarged benign lymph nodes in this series of patients.     

Torsion of the upper lobe in pneumothorax

A rounded density is occasionally seen hanging down from the hilus in the presence of a large pneumothorax. To find an explanation for this appearance, the authors obtained a right-sided bronchogram on a baboon, after which they induced pneumothorax on the same side. This experiment demonstrated that the rounded density is formed by a twisted and atelectatic upper lobe.     

顺铂壳聚糖微球的制备及特性研究

对顺铂壳聚糖微球的制备、载药量、大小及分布、形态及表面状态、体外释放及降解性进行了研究。微球用乳化-化学交联技术制备,平均粒径为74.80μm,顺铂含量为20.83%±0.36%。电镜扫描显示,微球球形圆整,表面粗糙。生理盐水中放置1h微球轻微溶胀,其体外释药符合一级方程,微球经⁶⁰Co辐射灭菌达到无菌要求。犬肝动脉栓塞后一个月,病理切片可见栓塞区仍有壳聚糖微球存在。     

去氢紫堇碱对兔血小板TXB2及主动脉6—Keto—PGF1 PGF1α含量的影响

去氢柴堇碱(dehydrocorydaline,DHC)是从罂栗科植物延胡索块茎中提取的一种季胺类生物碱(其结构式如下)。实验证实延胡索治疗冠心病的有效成分为DHC。DHC对心血管系统的药理研究也有报道。近年的实验证明DHC有升高血小板内cAMP含量的作用并抑制ADP诱导的血小板第四因子(PF_4)的释放。本实验通过观察DHC对体内血栓形     

Central nervous system pharmacology of Baker's antifolate (NSC139105) in man

Radiolabelled Baker's Antifolate (BAF) was administered to 6 patients undergoing surgical resection of intracerebral tumors. Levels of radioactivity in resected tumor and edematous brain adjacent to tumor were generally higher than levels in concurrent plasma samples and were generally comparable to levels in temporalis muscle. Levels in tumor cyst fluid were far lower than concurrent plasma levels and levels in surrounding tumor. Chromatography was performed on tumor from 2 patients and revealed that only a small proportion of the radioactivity represented unchanged BAF. The major metabolite present in tissues was 1 000 times less potent as an inhibitor of dihydrofolate reductase than was BAF.Five patients had cerebrospinal fluid (CSF) sampled following administration of tracer doses of radio-labelled BAF. Radioactivity levels were far lower in CSF than in plasma. Levels of radioactivity in the CSF were also far lower than levels in tumor and brain samples from other patients and were slightly lower than tumor cyst fluid levels. Two patients had CSF collected after they received therapeutic doses of BAF. In these patients, both CSF and plasma were assayed using a dihydrofolate reductase inhibition assay. As with tracer dose studies, CSF concentrations of BAF were substantially lower than were concurrent plasma concentrations.Thus it appears that only very low concentrations of BAF are attainable in human CSF and intracerebral tumor, although a metabolite which is a very weak inhibitor of dihydrofolate reductase attains high concentrations in tumor.The abbreviations used are: BAF Baker's Antifolate - CNS Central Nervous System - CSF Cerebrospinal Fluid Supported by grant number CA-14528 and Contract CM-53773 from the National Cancer Institute. Presented in part at the 70th annual meeting of the American Association for Cancer Research, New Orleans, Louisiana, May, 1979.     

Hepatic micrometastases in the rat: ferrite-enhanced MR imaging

A rat tumor model was used to evaluate the ability of ferrite-enhanced magnetic resonance (MR) imaging to demonstrate hepatic metastases smaller than 1 cm. Twenty-eight rat livers were inoculated with 5 X 10(5) mammary carcinoma cells and imaged with a 0.6-T MR system. Non-enhanced and ferrite-enhanced images were analyzed and correlated with autopsy findings for each rat. Lesion detection rates correlated closely with cancer-to-liver contrast-to-noise ratios. Ferrite-enhanced MR imaging demonstrated significantly more lesions than non-enhanced imaging (P less than .05) and decreased the threshold size for lesion detectability (less than 2 mm). Ferrite also enabled more accurate measurements of the lesions (r = .96).