Helicobacter pylori (H. pylori) eradication therapy for peptic ulcers is performed at many facilities in Japan. The eradication regimens are consisted of the 7-day triple therapy using lansoprazole (LPZ) or omeprazole (OPZ) + amoxicillin (AMPC) + clarithromycin (CAM). In theses regimens, 2 types of antibacterial drug are included, the method of taking medicine has been problematic. In this study, we evaluated the usefulness of a packaged tablets and capsules that contain eradication drugs. (Product name: Lansap). Subjects and methods: The study was performed in 100 H. pylori positive patients with upper gastrointestinal disease. The regimen of the eradicating drugs was administration for 7 days of LPZ 60 mg + AMPC 1,500 mg + CAM 800 mg. The patients were randomly divided into two groups. One group was prescribed a package sets of tablets /capsules (package group) for taking the regimen, second group were prescribed the tablets /capsules from separate sets (conventional group) for taking the drugs. Eradication was evaluated by C-13 urea breath test 6-8 weeks after completion of the treatment. A questionnaire survey was also performed immediately after completion of the treatment regarding to forgetting to take the medicine, mistaking the dosage (quantity) of medicine, the total dose of medicine, and understanding of adverse effects of drugs. Results: The eradication rate (ITT) was 68.0% in the package group and 72.0% in the conventional group, showing no significant difference. Three and 7 patients forgot to take some drugs in the package and conventional groups, respectively, showing no significant difference. None and 2 patients mistook the dosage of medicine respectively. 29 and 26 patients felt that the total dose too much, respectively. As for understanding of adverse effects of drug, 24 and 25 patients understood them respectively. Conclusion: In H. pylori eradication therapy, package sets of eradication medicine are useful for prevention of mistaking the dosage of medicine.
Objective Serological antibody test have been widely performed to detect the presence of H. 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 of H. pylori was performed in 100 patients by proton pump inhibitor (PPI)+amoxicillin (AMPC)+clarithromycin (CAM) or PPI+AMPC therapy. 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. ROC analysis 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 of 73.3%, 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.
With the aid of proposals from a computer program for synthesis design, a new method of synthesizing azaspiranes has been developed. In this method, one starts with a suitable benzoic acid ester, which is subjected to Birch reduction. Then the anionic intermediate is alkylated with 1,2-dibromoethane. The product is subsequently reacted with an amine to give a spiro lactam. (c) 2006 Elsevier Ltd. All rights reserved.
We used transnasal ultrathin esophagogastroduodenoscopy (UT-EGD) to simultaneously perform realtime esophageal manometry and observe esophageal peristalsis. The subjects were 22 healthy volunteers and 10 patients with proton-pump inhibitor (PPI) dependent gastroesophageal reflux disease (GERD). We induced the primary peristaltic wave associated with swallowing and observed it endoscopically in the lower esophagus, at the same time measuring the intraesophageal pressure using a manometry catheter. The mean primary peristaltic amplitude associated with swallowing was 65.6 +/- 47.4 mmHg in the volunteer group, and 28.0 +/- 25.6 mmHg in the GERD group. Although peristalsis was observed endoscopically in the GERD group, in some cases incomplete peristalsis left a small but definite lumen and in these subjects, the primary peristaltic wave was almost flat. The use of an ultrathin transnasal endoscope makes possible simultaneous manometry and endoscopic observation of the esophagus. This combination should prove useful in the evaluation of esophageal peristaltic function, such as in the diagnosing of GERD.
A common cause of asthenopia is viewing objects from a short distance, as is the case when working at a VDT (Visual Display Terminal). In general, recovery from asthenopia, especially accommodative asthenopia, is aided by looking into the distance. The authors have developed a stereoscopic 3-D display with dynamic optical correction that may reduce asthenopia. The display does this by reducing the discrepancy between accommodation and convergence, thereby presenting images as if they were actually in the distance. The results of visual acuity tests given before and after presenting stereoscopic 3-D images with this display show a tendency towards less asthenopia. In this study, the authors developed a refraction feedback function that makes the viewer's distance vision more effective when viewing stereoscopic 3-D images on the this display. Using this function, refraction is fed back during viewing and the viewer gradually acquires distance vision. The results of the study suggest that stereoscopic 3-D images are more effective than 2-D images for recovery from asthenopia.
A process for producing 5-amino-3-methylpyrazole which comprises reacting hydrazine with a reaction intermediate prepared from 2,3-dichloropropene and hydrocyanic acid and containing at least one compound selected from the group consisting of 3-chloro-3-butenonitrile and 2,3-butadienonitrile. A process for producing 5-amino-4-chloro-3-methylpyrazole which comprises chlorinating the 5-amino-3-methylpyrazole obtained above in the presence of hydrochloric acid.
Background and AimThe new developed ultrathin transnasal endoscope, the GIF-XP290N, makes possible a resolving power similar to the GIF-H260 at a distance of 3mm. In this study, using the GIF-XP290N, we evaluated whether endoscopic diagnosis (discrimination between benign and malignant) of gastric lesions is possible using nonmagnified narrow-band imaging (NBI) endoscopy. MethodsThe subjects were 255 consecutive patients who underwent screening of the gastrointestinal tract using new ultrathin transnasal endoscopy. Their average age was 65.211.4 years. The male-female ratio was 2.5:1. All cases were examined using conventional white-light imaging (WLI) and nonmagnified NBI. When a depressed lesion was detected in the stomach, it was examined using WLI, then NBI close examination (at about 3mm). We observed the mucosal structure of the lesion using close visualization with NBI. Concerning mucosal structural changes, we looked for a clear demarcation line between the lesion and the surrounding mucosa, and loss, irregularity, or nonuniformity of the lesion mucosal microsurface pattern. ResultsA total of 52 depressed lesions were examined. The histological diagnosis was cancer for 8 lesions, and noncancer for 44 lesions. WLI examination yielded a sensitivity of 50.0% (4/8), specificity of 63.6% (28/44), and accuracy 61.5% (32/52). On the other hand, NBI close examination yielded a sensitivity of 87.5% (7/8), specificity of 93.2% (41/44), and accuracy of 92.3% (48/52), significantly higher. ConclusionNBI close examination using ultrathin transnasal endoscopy enables mucosal diagnosis even without magnification and was considered to be an effective technique for improving endoscopic diagnosis.
Microsomal triglyceride transfer protein (MTP) is involved in the assembly and secretion of triglyceride-rich lipoproteins from enterocytes and hepatocytes. JTT-130 is a novel intestine-specific MTP inhibitor, which has been shown to be useful in the prevention and treatment of dyslipidemia, obesity, and diabetes. JTT-130 has also been shown to suppress food intake in a dietary fat-dependent manner in rats. However, whether JTT-130 enables changes in food preference and nutrient consumption remains to be determined. Therefore, the aim of the present study was to investigate the effects of JTT-130 on food preference in rat under free access to two different diets containing 3.3% fat (low-fat diet, LF diet) and 35% fat (high-fat diet, HF diet). JTT-130 decreased HF diet intake and increased LF diet intake, resulting in a change in ratio of caloric intake from LF and HF diets to total caloric intake. In addition, macronutrient analysis revealed that JTT-130 did not affect carbohydrate consumption but significantly decreased fat consumption (P < 0.01). These findings suggest that JTT-130 not only inhibits fat absorption, but also suppresses food intake and specifically reduces food preference for fat. Therefore, JTT-130 is expected to provide a new option for the prevention and treatment of obesity and obesity-related metabolic disorders. =20
The present study was designed to evaluate the usefulness and safety of bipolar hemostatic forceps, known as a less invasive and highly safe means of thermal coagulation used for hemostasis in cases of non-variceal upper gastrointestinal bleeding. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis. The study involved 39 cases where hemostasis was attempted with bipolar forceps to deal with non-variceal upper gastrointestinal bleeding, including 28 cases of gastric ulcer, six cases of duodenal ulcer, three cases of bleeding after endoscopic submucosal dissection (ESD), one case of Mallory-Weiss syndrome and one case of postoperative bleeding from the anastomosed area. There were 34 males and five females, with a mean age of 63.6 years. Bipolar forceps were the first-line means of hemostasis in cases of oozing bleeding (venous bleeding), pulsatile or spurting bleeding (arterial bleeding) and exposed vessels without active bleeding. The primary hemostasis success rate was 92.3%, and the re-bleeding rate was 0%. In cases where the bleeding site was located along the tangential line or in cases where large respiration-caused motions hampered identification of the bleeding site, hemostasis by means of coagulation was easily effected by application of electricity while the forceps were kept open and compressed the bleeding area. In addition, there were no complications. This technique of bipolar forceps is simple, safe and unlikely to induce complications, and is therefore promising as a new technique of endoscopic hemostasis.