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

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: 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: An optimal treatment for Helicobacter pylori (H. pylori) infection in children has not yet been established. In this study, the efficacy and the tolerability of triple therapy with colloidal bismuth subcitrate (CBS), amoxicillin and metronidazole, were evaluated in comparison with dual therapy with CBS and amoxicllin. METHODS: Eighty-six children with H. pylori infection, aged 6 years to 14 years, were enrolled in this study. H. pylori infection was confirmed by endoscopic antral biopsy with an rapid urease test, culture and a modified Giemsa stain. The children were considered positive for H. pylori infection if culture was positive or if both modified Giemsa staining and CLO test were positive. The children were treated with one of the following three regimens. Dual therapy with CBS for 4 weeks and amoxicillin for 2 weeks (Group I. n=57: 1993.8-1995.1), Triple therapy with CBS for 4 weeks, amoxcillin for 2 weeks and metronidazole for 2 weeks (Group IIa. n=11: 1995.2-1995.7), and Triple therapy with CBS for 2 weeks, amoxicillin for 2 weeks and metronidazole for 2 weeks (Group IIb. n=18 : 1995. 8-1996. 6). A 50mg/kg/d dose of amoxcillin was aclministered, and that of CBS was 7-8mg/kg/d, and that of metronidazole was 20mg/kg/d. About one month after the cessation of treatment, eradication of H. pylori was evaluated with repeated endoscopic biopsy. RESULTS: H. pylori eradication rate was 61.4% (35/57) in Group I, 90.9% (10/11) in Group IIa, and in the absence of H. pylori 88.9% (16/18) of Group IIb was done by means of an urease test, culture and a modified Giemsa stain (P=0.012). The overall proportion of eradication of H. pylori infection was 89.7% (26/29) by triple therapy and 61.4% (35/57) by dual therapy (P=0.007). However, there was no statistically significant difference in eradication rate between the 2-week triple therapy (IIb) and the Denol 4-week triple therapy (IIa)(P=0.86). Side effects : All patients in three treatment groups were tolerated well with little and mild side effects (P=0.258). CONCLUSION: The 2-week triple therapy with CBS, amoxcillin, and metronidazole would be a highly effective and safe treatment regimen for H. pylori infection in children.
Amoxicillin ; Azure Stains ; Biopsy ; Bismuth ; Child* ; Colloids ; Helicobacter pylori* ; Helicobacter* ; Humans ; Metronidazole ; Urease ; Withholding Treatment

BACKGROUND/AIMS: The success of Helicobacter pylori eradication is limited by antibiotic resistances, and the primary resistance to metranidazole seems to be high. In this study, the frequency af metronidazole resistance and the eradication rate in metronidazole-resistant H. pylori strain was evaluated. METHODS: Sixty-eight patients were tested for metronidazole resistance using microdilution broth, the E test and disk diffusion method. Twenty-two patients were treated for 14 days with amoxicilline 2000 mg, metronidazole 750 mg, and tripotassium dicitrate bismuth 1200 mg. RESULTS: Metronida-zole resistance was 46% (31/68). The eradication rates for H. pylori was 91.7% in patients with metronidazole-sensistive strains and 70% in patients with metronidazole-resistant strains. CONCLUSIONS: Metronidazole resistance was high (46%) in Korea, however, triple therapy was an efficient method of eradicating H. pylori in both metronidazole sensitive and resistant strains.
Amoxicillin ; Bismuth ; Diffusion ; Helicobacter pylori* ; Helicobacter* ; Humans ; Korea ; Metronidazole* ; Peptic Ulcer

BACKGROUND/AIMS: Photodynamic therapy (PDT) in unresectable cholangiocarcinoma has been associated with improved survival. We report a single tertiary care center experience over the past 6 years. METHODS: Fifty-five patients with unresectable cholangiocarcinoma received PDT between 2004 and 2010. Plastic stents were placed after PDT to prevent cholangitis. RESULTS: Twenty-seven patients (49%) showed Bismuth type IV, 22 (41%) showed Bismuth type III, and six (10%) showed Bismuth type I and II. Twenty patients (37%) received chemotherapy and radiation therapy, five (9%) received chemotherapy only; and one (2%) received radiation therapy only. Mean number of PDT sessions was 1.9+/-1.5 sessions (range, 1 to 9). Mean survival duration was 293+/-266 days (median, 190; range, 25 to 1,332). PDT related complications included three (5%) facial burn, three (5%) photosensitivity, and two (3%) rash. Kaplan-Meier analysis comparing the survival means of patients who received PDT and chemotherapy/radiation therapy (median survival 257 days; 95% confidence interval [CI], 166 to 528) versus who received PDT only (median survival 183 days; 95% CI, 129 to 224) showed no significant difference (log-rank p=0.20). CONCLUSIONS: PDT has a measurable impact on survival in unresectable cholangiocarcinoma but requires aggressive stenting posttherapy.
Bismuth ; Burns ; Cholangiocarcinoma ; Exanthema ; Humans ; Kaplan-Meier Estimate ; Photochemotherapy ; Plastics ; Stents ; Tertiary Care Centers ; Triazenes

BACKGROUND/AIMS: Several rescue therapies have been recommended to eradicate Helicobacter pylori infection in patients with a failure of first-line eradication therapy, but they still fail in more than 20% of cases. The aim of this study was to evaluate the efficacy and safety of levofloxacin, metronidazole, and lansoprazole (LML) triple therapy relative to quadruple therapy as a second-line treatment. METHODS: In total, 113 patients who failed first-line triple therapy for H. pylori infection were randomly assigned to two groups: LML for 7 days and tetracycline, bismuth subcitrate, metronidazole and lansoprazole (quadruple) for 7 days. RESULTS: According to intention-to-treat analysis, the infection was eradicated in 38 of 56 patients (67.9%) in the LML group and 48 of 57 (84.2%) in the quadruple group (p=0.042). Per-protocol analysis showed successful eradication in 38 of 52 patients (73.1%) from the LML group and 48 of 52 (92.3%) from the quadruple group (p=0.010). There were no significant differences in the adverse effects in either treatment group. CONCLUSIONS: LML therapy is less effective than quadruple therapy as a second-line treatment for H. pylori infection. Therefore, quadruple therapy should be considered as the primary second-line strategy for patients experiencing a failure of first-line H. pylori therapy in Korea.
2-Pyridinylmethylsulfinylbenzimidazoles ; Bismuth ; Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Metronidazole ; Ofloxacin ; Organometallic Compounds ; Tetracycline