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

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: 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

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

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

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

BACKGROUND/AIMS: Standard treatments are not available for hilar nonresectable cholangiocarcinoma (NCC). It is unknown whether combination therapy of photodynamic therapy (PDT) plus systemic chemotherapy is superior to PDT alone. METHODS: We retrospectively reviewed 68 patients with hilar NCC treated with either PDT plus chemotherapy (PTD-C) or PDT monotherapy (PDT-M). The primary endpoint was the mean overall survival rate. Secondary endpoints included the 1-year survival rate, risk of cholangitic complications, and outcomes, which were evaluated according to the chemotherapy protocol. RESULTS: More than 90% of the study population had advanced hilar NCC Bismuth type III or IV. In the PDT-M group (n=35), the mean survival time was 374 days compared with 520 days in the PDT-C group (n=33, p=0.021). The 1-year survival rate was significantly higher in the PDT-C group compared with the PDT-M group (88% vs 58%, p=0.001) with a significant reduction of mortality (hazard ratio, 0.20; 95% confidence interval, 0.07 to 0.58; p=0.003). Gemcitabine monotherapy resulted in a shorter survival time compared with the gemcitabine combination therapy (mean, 395 days vs 566 days; p=0.09). Cholangitic complications were observed at a similar frequency in the PDT-C and PDT-M groups. CONCLUSIONS: Combining repeated PDT with a gemcitabine-based combination therapy might offer a significant survival benefit in patients with hilar NCC.
Bismuth ; Cholangiocarcinoma* ; Drug Therapy* ; Humans ; Mortality ; Photochemotherapy* ; Retrospective Studies ; Survival Rate

PURPOSE: A major hepatobiliary resection (MHBR), liver resection of more than one lobe, has been recommended by some surgeons for advanced carcinomas (Ca) of the gallbladder (GB) and the hilar bile duct (HBD). However, high operative mortality and morbidity have been reported and its survival benefit has not been clearly documented. METHODS: We report the results of MHBR for such tumors to determine the safety and the effectiveness of this operation, which has been performed for GB Ca invading the right hepatic pedicle or liver bed by 2 cm or more and for HBD Ca of Bismuth type III or IV. The cases of fifty consecutive cases who received MHBR for GB Ca (n=11) or HBD Ca (n=39) during a 5 year-period were reviewed. RESULTS: Thirty right-sided and 20 left-sided hepatectomies were performed. There was no operative or hospital death. Minor and major complications developed in 64% of the cases. All the complications improved with conservative management, except two in which re operations were required, one due to portal vein thrombosis and the other to bleeding of the retro peritoneal dissection site. No specific factors were associated with the high complication rate. The long-term outcome of HBD Ca was better than that of GB Ca. In HBD Ca, differentiated cancer and less transfusion were associated with a better prognosis. CONCLUSION: MHBR was conducted with acceptable morbidity and no mortality. In terms of the long-term outcome, MHBR is recommended for HBD Ca whereas it should be considered more carefully for GB Ca.
Bile Ducts ; Biliary Tract* ; Bismuth ; Gallbladder ; Hemorrhage ; Hepatectomy ; Liver ; Mortality ; Prognosis ; Venous Thrombosis