Peptic ulcer is involved with Helicobacter pylori infection and antibiotic regimens are primary treatments. An optimal therapeutic regimen for eradication of Helicobacter pylori remains uncertain due to variable efficacy. The objectives of this study were to evaluate the efficacy of omeprazole based antibiotic regimens in bacterial eradication, healing of peptic ulcer and to identify factors affecting efficacy. Seventy-seven patients were enrolled in the prospective, open-trial from November 1997 to Setember 1998. H. pylori infection was identified with endoscopy, H. pylori stain and rapid urease test. The first group (OAC7) received omeprazole 20 mg twice daily for 4 weeks which were the same schedule for all, amoxicillin and clarithromycin 500 mg three times daily for 1 week; the second group (OAC14), for 2 weeks on the same regimen as the first; and the last group (OACD) has taken bismuth in addition to the OAC7 regimen for 1 week. Eradication of H. pylori and healing of peptic ulcer were evaluated with endoscopy and tests for H. pylori before and after treatments. There were no significant differences in eradication rates; 77% in OAC7, 76% in OAC14, 81% in OACD (p=0.935) and healing rates; 82% in OAC7, 71% in OAC14, 95% in OACD (p=0.179), respectively. Compliance had an relationship with eradication rates significantly among regimens (p=0.049). Twenty three cases (29%) complained of the minor side effects. In conclusion, OAC7 was better in convenience of dosing schedule and showed fewer side effects with shorter duration and lower cost while There were no significant differences in efficacy among regimens.
Lymphocytic gastritis (LG) is a rare subtype of chronic gastritis. It is defined as dense proliferation of intraepithelial lymphocytes (IELs) more than 25 lymphocytes per 100 epithelial cells. The known major causes of LG are celiac disease and Helicobacter pylori infection. H. pylori associated LG (HpLG) has more enhanced cytotoxic and apoptotic tendencies than chronic H. pylori gastritis. A 12-year-old girl with postprandial epigastric pain was diagnosed HpLG on endoscopic biopsy. After the 1st eradication therapy, H. pylori bacilli were still found, and urea breathing test was positive. Although the endoscopic finding was partially improved, clinical symptoms and histologic finding were persisted. We could achieve the improvement of clinical symptoms and disappearance of IELs after the 2nd eradication. The discordant of histopathologic and endoscopic improvement occurred after the 1st eradication therapy of HpLG. Therefore the clinical and histopathologic evaluation should be considered as well as endoscopic findings.
Helicobacter pylori (H. pylori) infection is associated with gastroduodenal diseases such as gastritis, peptic ulcer diseases, gastric adenocarcinoma, and mucosa-associated lymphoid tissue lymphoma. Furthermore, various extragastroduodenal diseases have been suggested to be related with H. pylori infection. Although no single factor has been considered the cause of gastroesophageal reflux disease (GERD), a negative association was found between the prevalence of H. pylori and GERD severity. Additionally, the role of eradication therapy of H. pylori in reflux esophagitis is controversial, and a significant correlation was found between successful H. pylori eradication rate and reflux esophagitis development. H. pylori infection remains an inconclusive and important issue in GERD. Thus, more experimental studies are necessary to elucidate the potential mechanisms.
Kim, Youngsik;Kim, Yongkwan;Lee, Sook-Young;Lee, Kyoung-Ki;Lee, Kyung-Hyun;Song, Jae-Chan;Oem, Jae-Ku
Korean Journal of Veterinary Service
/
v.42
no.2
/
pp.117-120
/
2019
Bovine viral diarrhea Virus (BVDV) infections cause respiratory, gastrointestinal, and reproductive problems, such as infertility, abortion, stillbirth, and sickly offspring. Many countries have reduced the economic damage through the application of different control programmes, and some have successfully eradicated BVD. Detection and elimination of cattle persistently infected (PI) with BVDV is important for BVD eradication because PI cattle are a main source of BVD transmission. In this study, the prevalence of Korean native cattle persistently infected (PI) with BVDV was investigated and determined in 49 farms with 3,050 cattle. The all samples were collected by ear notch sampling. Korean native cattle with initial positives on antigen-ELISA (Ag-ELISA) were sampled again after 3~4 weeks and cattle with second positives in both Ag-ELISA and immunohistochemistry (IHC) were identified as PI cattle. Among the 49 farms, 14 (28.6%) farms had at least more than one PI cow and 21 (0.69%) of 3,050 cattle were determined as PI cattle. As a result of this work, it is suggested that national BVD eradication program is required to reduce economic losses by BVDV infection in Korean cattle industries.
Objectives : Comparative review was rendered to evaluate strengths and weaknesses of two common treatment approaches of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. A typical symptom of headache from hypertension was chosen for substantial approach of this review. Methods : Pros and cons of two different approaches to disease were evaluated based on literatures and texts focusing treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. Headache can be correlated with hypertension yet it can be induced by multiple other factors, and headache may/may not accompany hypertension. Hypertension is an example of treatment based on syndrome differentiation from disease and headache can be an example of treatment based on syndrome differentiation. Results : Treatment based on syndrome differentiation can give more autonomy and flexibility in approach to the disease, Intuition, experience, and traditional medical theory can be applied with ease. However, management and eradication of diseases are difficult and standardization of treatment is not easy among practitioners. Treatment based on syndrome differentiation from disease incorporated merits of both eastern and western medicines, achieving more evidence based diagnosis and treatment. Eradication and standardization of disorders are possible with the latter approach. Conclusions : Comparing two systems of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease with emphasis on hypertension and headache yielded medical values. Treatment based on syndrome differentiation from disease appears to be superior in medical values and effectiveness, but further evaluation and interest are needed to make advancement in Korean traditional medicine.
Yeniova, Abdullah Ozgur;Uzman, Metin;Kefeli, Ayse;Basyigit, Sebahat;Ata, Naim;Dal, Kursat;Guresci, Servet;Nazligul, Yasar
Asian Pacific Journal of Cancer Prevention
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v.16
no.13
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pp.5199-5203
/
2015
Background: Helicobacter pylori (H.pylori) is associated with chronic gastritis, peptic ulcers, gastric adenocarcinomas and mucosa associated tissue lymphomas. Cytotoxin associated gene A (CagA) is one of the virulence factors of H.pylori. It is hypothesized that reactive oxygen species (ROS) play roles in H.pylori associated disease especially in development of gastric adenocarcinoma. Individuals infected with H.pylori bearing CagA produce more ROS than others. 8-hydroxydeoxyguanosine (8OHdG) is an in vitro marker of DNA damage and oxidative stress. The aim of this study was to investigate the relationship between 8OHdG level, H.pylori infection and CagA and alterations of serum 8OHdG level after H.pylori eradication. Materials and Methods: Patients admitted with dyspeptic complaints and upper gastrointestinal endoscopy were assessed. H.pylori was determined from histopathology of specimens. Serum 8OHdG levels of three groups (H.pylori negative, H. pylori positive CagA negative and H.pylori positive CagA positive) were compared. Patients with H.pylori infection received eradication therapy. Serum 8OHdG levels pretreatment and posttreatment were also compared. Results: In total, 129 patients (M/F, 57/72) were enrolled in the study. Serum 8OHdG level of H.pylori negative, H. pylori positive CagA negative and H.pylori positive CagA positive groups were significantly different ($5.77{\pm}1.35ng/ml$, $5.43{\pm}1.14ng/ml$ and $7.57{\pm}1.25ng/ml$ respectively, p=0.05). Furthermore, eradication therapy reduced serum 8OHdG level ($6.10{\pm}1.54ng/ml$ vs $5.55{\pm}1.23ng/ml$, p=0.05). Conclusions: Individuals infected with H.pylori bearing CagA strains have the highest serum 8OHdG level and eradication therapy decreases the serum 8OHdG level. To the best of our knowledge this is the first study that evaluated the effect of CagA virulence factor on serum 8OHdG level and the effect of eradication therapy on serum 8OHdG levels together. Eradication of CagA bearing H.pylori may prevent gastric adenocarcinoma by decreasing ROS. 8OHdG level may thus be a good marker for prevention from gastric adenocarcinoma.
Kim, Sung Eun;Kim, Nayoung;Park, Seon Mee;Kim, Won Hee;Baik, Gwang Ho;Jo, Yunju;Park, Kyung Sik;Lee, Ju Yup;Shim, Ki-Nam;Kim, Gwang Ha;Lee, Bong Eun;Hong, Su Jin;Park, Seon-Young;Choi, Suck Chei;Oh, Jung Hwan;Kim, Hyun Jin
The Korean Journal of Gastroenterology
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v.72
no.6
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pp.286-294
/
2018
Background/Aims: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. Methods: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. Results: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. Conclusions: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.
Peste des petits ruminants (PPR) is considered to be one of the main constraints to enhancing the productivity of goats and sheep in regions where it is present and becoming endemic. PPR was recognized in Pakistan in early 1990s but got importance during the Participatory Disease Surveillance (PDS) of Rinderpest Eradication Campaign. Lot of research work has been initiated during last decade towards disease epidemiology, risk factor recognition, laboratory diagnosis, vaccination and demonstration of control strategies. Although there are ongoing projects working towards the progressive control of the disease in country yet there is need to have a national level control program for PPR. Also there is need to have comprehensive social economic surveys, disease hot spot recognition and identification of role of other species in disease transmission. With combined efforts of local and national authorities and political will, there is high likelihood that this devastating disease can be controlled and eventually eradicated in near future.
Between January 2010 and March 2011, there were three outbreaks of foot and mouth disease (FMD) in South Korea. Over 3.45 million animals (5,660 farms) were slaughtered, which was 33.3% of the existing pigs, 8.4% of dairy cows and 3.4% of cattle. FMD disaster costs were estimated at around three billion Korean won. Nine civil servants were killed, over 150 people were wounded and 4,788 landfills were confronted with a pollution problem. Vaccination and slaughter are the two basic alternatives for eradication of FMD. Altho ugh slaughter is more violent, risky and expensive than vaccination, the Korean government had chosen only slaughter eradication by the end of 2010. Even though over three million animals were killed, FMD spread out over most of the country. Finally, the government chose to begin vaccination. Following vaccination, outbreaks decreased dramatically. The purpose of this report is a cultural analysis of the related decision-making process, laws and systems. For the culture analysis, we utilize interviews, symposiums, laws, FMD manual, government reports and press releases. In conclusion, we found that the FMD massacre was influenced by cultural and organizational factors. The cultural factors were economism, cheapening of the value of life, biased perceptions and fears. The organizational factors were a closed process of decision-making, monopoly system, a small homogeneous group and group-think. Therefore, more studies will be needed for those factors of FMD disasters in national-scale cases.
Background: Helicobacter pylori (H. pylori) remains an important cause of gastric cancer and peptic ulcer disease worldwide. Treatment of H. pylori infection is one of the effective ways to prevent gastric cancer. However, standard triple therapy for H. pylori eradication is no longer effective in many countries, including Thailand. This study was designed to evaluate the efficacy of adding bismuth and probiotic to standard triple therapy for H. pylori eradication. Materials and Methods: In this prospective single center study, H. pylori infected gastritis patients were randomized to receive 7- or 14-day standard triple therapy plus bismuth with probiotic or placebo. Treatment regimen consisted of 30 mg lansoprazole twice daily, 1 g amoxicillin twice daily, 1 g clarithromycin MR once daily and 1,048mg bismuth subsalicylate twice daily. Probiotic bacteria composed of Bifidobacterium lactis, Lactobacillus acidophilus and Lactobacillus paracasei. Placebo was conventional drinking yogurt without probiotic. CYP2C19 genotyping and antibiotic susceptibility tests were also done. H pylori eradication was defined as a negative $^{13}C$-urea breath test at least 2 weeks after completion of treatment. Results: One hundred subjects were enrolled (25 each to 7- and 14-day regimens with probiotic or placebo). Antibiotic susceptibility tests showed 36.7% metronidazole and 1.1% clarithromycin resistance. CYP2C19 genotyping revealed 40.8%, 49% and 10.2% were rapid, intermediate and poor metabolizers, respectively. The eradication rates of 7- or 14 regimens with probiotics were 100%. Regarding adverse events, the incidence of bitter taste was significantly lower in the 7- day regimen with the probiotic group compared with 7- day regimen with placebo (40% vs. 64%; p=0.04). Conclusions: The 7-day standard triple therapy plus bismuth and probiotic can provide an excellent cure rate of H. pylori (100%) in areas with low clarithromycin resistance such as Thailand, regardless of CYP2C19 genotype. Adding a probiotic also reduced treatment-related adverse events.
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