No abstract available.
Bismuth* ; Gentamicins* ; Mercuric Chloride*

BACKGROUND/AIMS: Albis(R) is a newly developed drug comprised of ranitidine, bismuth and sucralfate. The aim of the study was to demonstrate the efficacy and safety superiority of Albis(R) compared to Stillen(R) for treating erosive gastritis. METHODS: This study was a randomized, double-blind, multi-center trial. The primary endpoint was 2 weeks of treatment. RESULTS: Of the 229 patients in the intention-to-treat (ITT) population, 87 from the Albis(R), and 96 from the Stillen(R) group were included in the per protocol (PP) analysis. The endoscopic improvement rate was not different between the Albis(R)(R) group and the control in both the PP (42.5%, 39.6%) and ITT (35.3%, 34.5%) populations. The endoscopic cure of erosion was also not different in the Albis(R) group than that in the control group in both the PP (32.3%, 31.3%) and ITT (27.6%, 27.4%) populations. The endoscopic improvement rate for hemorrhage, edema, and erythema were also not different between the two groups in both the PP and ITT populations. No statistically significant differences were observed for adverse events between the two groups. CONCLUSIONS: Half of the approved dose of Albis(R) for peptic ulcers was superior to Stillen(R). A low dosage of Albis(R) is more cost efficient and safe than that of Stillen(R).
Bismuth ; Edema ; Erythema ; Hemorrhage ; Humans ; Peptic Ulcer ; Ranitidine ; Sucralfate

The chewing-related neuronal mechanism underlying stress relief, was evaluated by use of fMRI. For this purpose we examined the effect of chewing a moderately hard gum without any taste (X type, Lotte Co. LTd., Tokyo) on brain activation caused by a noisy sound stress, on plasma levels of catecholamines and ACTH. The stress significantly increased the blood oxygenation level-dependent (BOLD) signals in the amygdala and the medial prefrontal cortex, and elevated plasma levels of noradrenaline, dopamine and ACTH. However, this chewing suppressed not only the stress-induced increase in BOLD signals in these two regions, but also the stress-induced elevation in plasma levels of these catecholamines and ACTH. The results suggested that chewing might be a useful therapy for reducing stress.
Stress ; Mastication ; Adrenocorticotropic hormone measurement ; Plasma ; Stress bismuth subsalicylate

Stress induced by disaster is experienced to varying degrees by all respondents, and is known to evoke psychophysiological reactions. In this study, we investigated the relationships between earthquake-related life events and posttraumatic stress symptoms. A total of 380 adults were surveyed one year after the 1995 Hanshin-Awaji earthquake in Japan. The questionnaire included items concerning earthquake-related life events, emotional support and posttraumatic stress disorder (PTSD) symptoms. As a result, after controlling for demographic variables, earthquake-related life events were significantly related to the grade of posttraumatic stress and its three components: re-experience, avoidance and arousal, in both male and female subjects. Male subjects who currently had lower emotional support showed higher scores of posttraumatic stress and arousal. In conclusion, a higher experience of earthquake-related life events appears to be an important risk factor for development of poor mental health status following an earthquake disaster.
Earthquakes ; Life events ; seconds ; Stress bismuth subsalicylate ; Stress

Objectives: Several studies have reported that the secretory immunoglobulin A (S-IgA) concentration in saliva is an indicator of psychological stress. The aim of this study was to clarify the relationship between S-IgA and the stress from academic examinations. Methods: S-IgA levels in 10 medical student volunteers from the second year course between May 4 and July 13, 2000 were examined using the ELISA method. Results: There was a tendency for S-IgA in saliva to be higher on the day before academic examinations and during them, and lower on the days between these examinations. Conclusions: It may be possible to use this measurement to monitor psychological stress in students and workers.
Upper case ess ; Immunoglobulin A measurement ; Saliva ; Stress bismuth subsalicylate ; Daily

PURPOSE: Extended liver resection may provide long-term survival in selected patients with Bismuth type IV hilar cholangiocarcinoma (HCCA). The purpose of this study was to identify anatomical factors that predict curative-intended resection. METHODS: Thirty-three of 159 patients with Bismuth type IV HCCA underwent major hepato-biliary resection with curative intent (CIR) between 2000 and 2010. Disease extent and anatomical variations were analyzed as factors enabling CIR. RESULTS: CIR ratio with hilar trifurcation bile duct variation (13/16) was significantly higher than that with other bile duct variation types (18/25). Hilum to left second bile duct confluence and tumor infiltration over left second bile duct confluence lengths in right-sided CIR were significantly shorter than those lengths in left-sided CIR (10.8 +/- 4.9 and 2.7 +/- 0.8 mm vs. 16.5 +/- 8.4 and 7.0 +/- 5.3 mm, respectively). Left-sided CIR patients had a marginally higher proportion of tumors invading < or =5 mm over the right second confluence than that in right-sided CIR patients (13/17 vs. 6/16; P = 0.061). The 3-year survival rate after CIR (28%) was significantly higher than after non-CIR (6.1%). CONCLUSION: We recommend the criteria of CIR as bile duct variation type, length of hilum to contralateral second bile duct confluence, and extent of tumor infiltration over the second confluence for Bismuth type IV HCCA.
Bile Ducts ; Bismuth* ; Cholangiocarcinoma* ; Humans ; Klatskin's Tumor ; Liver ; Survival Rate

BACKGROUND/AIMS: Hilar cholangiocarcinomas have an extremely poor prognosis. Although endoscopic bilateral metal stenting with the "stent in stent" technique using a Y stent is currently employed to treat patients with an unresectable hilar cholangiocarcinoma, this method has limited application in cases of tight strictures. Furthermore, insertion of stents into the Y stent side (first stent side) is problematic in cases of tumor recurrence. We evaluated the clinical efficacy of the use of endoscopic bilateral metal stenting with the Zilver stent. METHODS: Seven patients with an unresectable Bismuth type III or IV hilar cholangiocarcinoma were included in this study. For endoscopic bilateral metal stenting, we first inserted a Y stent with a central wide-open mesh. The Zilver stent was placed into the contralateral hepatic duct through the central portion of the Y stent. RESULTS: Both technical and functional success was achieved in seven patients (100%). The early complication rate was 0%, and late complications due to tumor recurrence occurred in 2 out of 7 (28.6%) patients. These patients were managed by the placement of additional stents or with the use of percutaneous transhepatic biliary drainage. CONCLUSIONS: We suggest that a combination technique using Y and Zilver stents improves bilateral stenting for patients with advanced hilar cholangiocarcinoma and facilitates stent reinsertion in cases of tumor recurrence.
Bismuth ; Cholangiocarcinoma ; Constriction, Pathologic ; Hepatic Duct, Common ; Humans ; Prognosis ; Recurrence ; Stents

PURPOSE: The Helicobacter pylori stool antigen (HpSA) enzyme immunoassay is a non-invasive test for the diagnosis and monitoring of H. pylori infection. But, there are few validation studies on the HpSA test after eradication in children. The aim of this study was to assess the diagnostic accuracy of HpSA enzyme immunoassay for the detection of H. pylori to confirm eradication in children. METHODS: From January 2001 to October 2003, 164 tests were performed in 146 children aged 1 to 17.5 years (mean 9.3+/-4.3 years). H. pylori infection was confirmed by endoscopy-based tests (rapid urease test, histology, and culture). All H. pylori infected children were treated with quadruple regimens (Omeprazole, amoxicillin, metronidazole and bismuth subcitrate for 7 days). Stool specimens were collected from all patients for the HpSA enzyme immunoassay (Primier platinum HpSA). The results of HpSA tests were interpreted as positive for OD> or =0.160, unresolved for 0.140< or =OD<0.160, and negative for OD<0.140 at 450 nm on spectrophotometer. RESULTS: 1) One hundred thirty-one HpSA tests were performed before treatment. The result of HpSA enzyme immunoassay showed three false positive cases and one false negative case. The sensitivity, specificity, positive predictive value, and negative predictive value of HpSA enzyme immunoassay before treatment were 96.4%, 97.1%, 90%, and 99%, respectively. 2) Thirty-three HpSA enzyme immunoassay were performed at least 4 weeks after eradication therapy. The results of HpSA enzyme immunoassay showed two false positive cases and one false negative case. The sensitivity, specificity, positive predictive value, and negative predictive value after treatment were 88.9%, 91.7%, 80%, and 95.7%, respectively. CONCLUSION: Diagnostic accuracy of the HpSA enzyme immunoassay after eradication therapy was as high as that of the HpSA test before eradication therapy. The HpSA enzyme immunoassay was found to be a useful non-invasive method to confirm H. pylori eradication in children.
Amoxicillin ; Bismuth ; Child* ; Diagnosis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoenzyme Techniques* ; Metronidazole ; Platinum ; Sensitivity and Specificity ; Urease

BACKGROUND/AIMS: There has been a substantial decline in Helicobacter pylori (H. pylori) cure rates with standard triple therapy in recent years. Therefore, great emphasis has been placed on second line treatment for its successful eradication. The aim of this study was to evaluate the efficacy of bismuth based quadruple therapy as a second line treatment for H. pylori infection. METHODS: From January 2001 to December 2007, the hospital records of 215 patients who failed to the standard triple therapy were reviewed retrospectively. The patients were treated with bismuth based quadruple therapy (PPI, bismuth 120 mg qid, metronidazole 500 mg tid, and tetracycline 500 mg qid). The successful eradication of H. pylori was defined as negative result from histology, CLO test or (13)C-urea breath test. RESULTS: Eradication rates by intention-to-treat (ITT) and per-protocol (PP) analyses with quadruple therapy were 64% (137/215) and, 91% (137/151) respectively. The eradication rates were not significantly different according to diseases, duration of treatment, area and proton pump inhibitors. The PP eradication rates for the years from 2001 to 2007 were not significantly different. CONCLUSIONS: The bismuth based quadruple therapy is still effective as the second line treatment for the eradication of H. pylori.
Bismuth ; Breath Tests ; Helicobacter ; Helicobacter pylori ; Hospital Records ; Humans ; Metronidazole ; Proton Pump Inhibitors ; Retrospective Studies ; Tetracycline

Helicobacter pylori infection causes peptic ulcer, gastric cancer and gastric mucosa-associated lymphoid-tissue lymphoma. H. pylori eradication has played a major role in the prevention and treatment of these diseases. The guidelines for the diagnosis and treatment of H. pylori infection in Korea recommends standard triple therapy consisting of proton pump inhibitor, clarithromycin and amoxicillin as the first line eradication therapy and quadruple therapy including bismuth in case of clarithromycin-resistant H. pylori infection. However, the eradication rate of conventional first line therapy of H. pylori infection has been decreasing during the last decade. Recently the eradication rates of standard triple therapy in Korea is reported to be lower than 80% and sometimes even lower than 70% (intention-to-treat). Therefore, the need for new first line eradication regimens has been rising. Sequential therapy, concomitant therapy and tailored therapy have been introduced as new options for first line therapy. However, they have yet to be proven as standard therapy and need further studies.
Amoxicillin ; Bismuth ; Clarithromycin ; Diagnosis ; Helicobacter pylori* ; Korea ; Lymphoma ; Peptic Ulcer ; Proton Pumps ; Stomach Neoplasms