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

BACKGROUND/AIMS: This study assessed the efficacy of a rifaximin plus levofloxacin-based rescue regimen in patients that had failed both triple and quadruple standard regimens for the eradication of Helicobacter pylori. METHODS: We treated patients for H. pylori between August 2009 and April 2011. The triple regimen consisted of combined treatment with amoxicillin, clarithromycin, and pantoprazole for 1 week. For failed cases, a quadruple regimen of tetracycline, metronidazole, bismuth dicitrate, and lansoprazole for 1 week was administered. The rescue regimen for persistently refractory cases was rifaximin 200 mg t.i.d., levofloxacin 500 mg q.d., and lansoprazole 15 mg b.i.d. for 1 week. RESULTS: In total, 482 patients were enrolled in this study. The eradication rates associated with the first and second regimens were 58% and 60%, respectively. Forty-seven out of 58 patients who failed with the second-line regimen received rifaximin plus levofloxacin-based third-line therapy. The eradication rate for the third regimen was 65%. The cumulative eradication rates were 58%, 85%, and 96% for each regimen, respectively. CONCLUSIONS: A rifaximin plus levofloxacin-based regimen could be an alternative rescue therapy in patients with resistance to both triple and quadruple regimens for the eradication of H. pylori.
2-Pyridinylmethylsulfinylbenzimidazoles ; Amoxicillin ; Bismuth ; Clarithromycin ; Helicobacter ; Helicobacter pylori ; Humans ; Metronidazole ; Ofloxacin ; Rifamycins ; Tetracycline

Since its introduction in 1993, Mineral Trioxide Aggregate (MTA) has been shown to be superior to others in sealing, biocompatibility, and many other aspects of clinical endodontics. MTA is primarily Portland cement with bismuth oxide as a radiopacitifier. Although some studies suggested that the reasonable-priced Portland cement could be used instead of MTA, but MTAs are different from Portland cement in its composition, especially in heavy metal contents. Therefore, clinicians should be meticulous adapting the Portland cement as a MTA substitute.
Aluminum Compounds ; Bismuth ; Calcium Compounds ; Drug Combinations ; Endodontics ; Glutamates ; Guanine ; Oxides ; Silicates ; Pemetrexed

Since the development of guidelines for the diagnosis and treatment of Helicobacter pylori infection in 1998, the Korean College of Helicobacter and Upper Gastrointestinal Research proposed revised guidelines in 2009 and 2013. The revised guideline in 2013 recommends triple therapy including conventional proton pump inhibitor (PPI), clarithromycin, and amoxicillin for 7 days as the primary eradication regimen. When clarithromycin resistance is suspected, quadruple therapy including PPI, metronidazole, bismuth, and tetracycline for 7~14 days is recommended as an alternative primary regimen for H. pylori eradication. Bismuth-containing quadruple therapy is recommended in cases of H. pylori eradication failure when the initial treatment was triple therapy. When initial bismuth-containing quadruple therapy fails to eradicate H. pylori, it is very difficult to create a secondary regimen. There is paucity of evidence regarding these secondary regimens. In addition, due to the declining eradication rates of primary regimens in recent years, other potential combinations including sequential and concomitant therapies have been considered.
Amoxicillin ; Bismuth ; Clarithromycin ; Diagnosis ; Helicobacter pylori* ; Helicobacter* ; Korea* ; Metronidazole ; Proton Pumps ; Tetracycline

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