bluuebunny/crossref_metadata_2025 huggingface dataset:
Conversion of the tribes: societal antecedents and the growth of Singaporean poetry*
Authors: THUMBOO EDWIN
Published: February 2007

ABSTRACT: When discussing the writer's self, it is vitally important that we pay attention to questions of history and politics. This paper seeks to examine the individual self of the writer and the growth of Singaporean poetry in relation to the determining pressures of the past and the present. The centrality of the colonial experience and the recovery from the experience in terms of the political, economic, intellectual and psychological dimensions are themes crucial to this paper. The author examines how the poet seeks self‐definition as he interacts with the dialect, the vision, the social and cultural forces that surround him or her, in a challenging and creative fashion. This paper underlines the importance of seeking to understand the individual self in relation to the collective self.
Semiotics, experience, and the material self: an inquiry into the subject of the contemporary Asian woman writer*
Authors: LIM SHIRLEY GEOK‐LIN
Published: February 2007

ABSTRACT: Asian women writers in the twentieth century were and continue to be marginalized first by gender. In addition, in nations where national identity has been forcibly equated with a national‐language policy, the choice of writing in English is another reason for marginalization. And if the writer happens to be a member of a minority ethnic or regional group, she is further marginalized by the prevailing majority ethnic power structures. The author examines the work, problems and prospects of Asian women writers against this background. Her recollection of past experiences in Malaysia lends imaginative force to her comments and valuations. Some of the significant issues related to writing creatively in English in Asian countries are here examined from a feminist perspective.
‘Lingua franca’ negotiations: towards an interactional approach
Authors: FIRTH ALAN
Published: February 2007

ABSTRACT: Kachru [World Englishes, 9, 3–20 (1990)] observes that studies in English as a non‐native language are dominated by either ‘deficit’ or ‘deviational’ approaches. What is lacking, he notes, is an interactional approach, i.e. one which considers how language is used interactively to accomplish social goals. This paper attempts to develop the theme of an ‘interactional approach’ and discusses its theoretical underpinnings. The proposed method entails the adoption of ethnomethodological perspectives on social knowledge, combined with conversation analytic interests in detailing the locally managed character of spoken interaction. The setting of international (trading) negotiations, conducted in ‘lingua franca’ English, provides the focal point for discussion. The term ‘lingua franca’ English is introduced to describe the language used exclusively by and among non‐native speakers. A distinction is made between: (1) intranational lingua franca, and (2) international lingua franca. Finally, the notion of ‘internationalization’ of negotiating behaviour and language use is discussed.
PLANNING LANGUAGE EDUCATION
Authors: FARINA DONNA M.
Published: February 2007

Language Planning and Language Education. Edited by Chris Kennedy.
The social and functional power of Nigerian English
Authors: BAMIRO EDMUND O.
Published: February 2007

ABSTRACT: This paper employs the frameworks of sociolinguistics and social psychology to explore the social and functional power of Nigerian Pidgin English (NPE) as it is featured in the novels of two prominent Nigerian authors, Wole Soyinka and Chinua Achebe. It is argued that, although NPE has not risen to the position of the acrolect or the prestige variety, its social and functional power as an interpreter of the Nigerian social structure cannot be discounted. Thus, the analyses undertaken in this study not only demonstrate how NPE exposes the tension and conflict between the dominant and dominated groups in Nigeria, but also how it reveals the contempt and anger the dominated have for the dominant. NPE thus becomes a code that symbolizes the solidarity of the dominated class in Nigeria. Furthermore, the analyses not only demonstrate how the dominant class use NPE as an accommodation strategy, but also how some privileged members of the dominated groups employ NPE to maintain their communicative and social distance, thereby enforcing power relations and neutralizing cultural norms. The analyses also show how the codes of the dominated groups in Nigeria become the vehicle by which they are further exploited and subjugated by the dominant class.
Co‐articulation and social acceptability: pragmatic implications for world Englishes
Authors: NIHALANI PAROO
Published: February 2007

ABSTRACT: It has been asserted in the literature that allophonic variations are not only important for maintaining phonemic distinctions, but are also important for the purposes of social acceptability. This paper argues that the question of social acceptability and the concern for native‐like standards has been primarily viewed from the perspective of monolingual societies, and that social acceptability is not a linguistic issue; it has, rather, become an issue of social identity. Such an understanding has wider implications for world Englishes and the planning of ESL curricula in the Outer Circle.
English in Vietnam
Authors: DENHAM P. A.
Published: February 2007

ABSTRACT: Vietnam's linguistic history exemplifies the close relationship between language and politics, with the latter influencing not only the choice of medium of instruction but also the foreign languages studied in Vietnam's schools and tertiary institutions. From 1975 until approximately 1989, the main foreign language was Russian; now it is English. This means that Vietnam, with a population of over 66 million may be added to the Expanding Circle. The ascendancy of English in Vietnam coincides with the decline in power of the rouble‐block countries and has occurred during a period when the Vietnamese government has promoted a freer market economy. As in other norm‐dependent countries, Vietnam's teachers of English attach great status to materials and methods developed by Inner Circle applied linguists, even though these may not be appropriate for Vietnamese conditions. At present, the English curriculum in Vietnamese schools aims primarily at developing reading skills, while at the tertiary level the focus depends on the type and purpose of the institution offering the program. The grammar–translation method is widely used. With the normalization of relations between Vietnam and Inner and Outer Circle countries, it is anticipated that linguists from these areas will have a greater influence than at present on English language teaching in Vietnam.
The English Language and the Gulf War: corpus linguistics, variation, and word‐formation
Authors: STACZEK JOHN J.
Published: February 2007

ABSTRACT: Television and print media during the 1991 Gulf War exposed the English‐speaking world to word‐formation patterns that produced neologisms and analogical forms. The language of the military briefing room became the language of media reportage. Established patterns were employed to create new forms with new meanings. The data are taken from the television and print media in the USA. This paper analyzes a corpus of data from television and radio broadcasts for purposes of assessing the open‐ended corpus as a source of variation, the productivity of forms, the extension of meaning, and the implications for the use of corpus data for teaching patterns of word‐formation in English.
Functions of two codes in Hong Kong Chinese
Authors: YAU MAN‐SIU
Published: February 2007

ABSTRACT: This paper studies the use of two codes in Hong Kong written media. A wide range of materials, including textbooks, magazines and popular entertainment books, were examined to determine the extent of the use of English in Chinese written texts. It is claimed that English is widely used in texts dealing with topics on technology and business, and reasons are suggested to explain this phenomenon.
The Philippine Refugee Processing Center: a case study
Authors: WESOLEK CATHY , GRANEY JOHN , STUEVE JEFF
Published: February 2007

ABSTRACT: The sociopolitical and linguistic context of the Philippine Refugee Processing Center makes it an interesting case study for those interested in formal language testing. This paper will examine the status of language testing in two ESL training programs in the Refugee Processing Center. We will also focus on three issues related to formal language testing: (1) what are the purposes of formal language tests according to various interest groups, (2) why there was resistance to formal language testing, and (3) what were some alternative forms of language assessment used in the two training programs.
World French takes on World English: competing visions of national and international languages
Authors: KIBBEE DOUGLAS A.
Published: February 2007

ABSTRACT: Until the late nineteenth century French was the dominant international language of modern Western Europe, and, with the spread of empire, many other areas around the globe. Now French itself feels threatened by the spread of English. The protection of the French language has both ‘negative’ and ‘positive’ aspects. On the negative, defensive side, purists rail against the specific qualities of English, and the social values these are said to represent. The rejection of English and specifically American influence on the French language is related to the rejection of modernity, and of the nation‐state based on shared political principles rather than shared culture. On the positive, offensive side, international French‐language organizations promote French as the language of francophone brotherhood. This co‐operative effort, however, conflicts with the traditional formulation and role of linguistic norms in French society. With the changing composition of French society, the definition of the nation‐state in France, and the conception of linguistic norms of French, may be in the process of changing.
Syntactic features of Englishization in Korean
Authors: BAIK MARTIN JONGHAK
Published: February 2007

ABSTRACT: Occurrences of syntactic changes due to language contact have been described as impossible (Whitney, 1867; Meillet, 1921), doubtful (Hockett, 1958), or limited and unexplainable (Wardhaugh, 1992). But the global influence of English has shown that syntactic features of language are not immune to change. This study discusses three sources in the process of contact and convergence of syntactic features in Korean and English: grammar‐oriented method of English education, the spread of English to Korean translation publications, and the use of English‐like structures in creative Korean publications. Thus structural patterns of English have indeed ‘moved from a tenuous existence in translations to an independent and productive life’(Kubler, 1985) in Korean. As examples of Englishized structure in Korean, nine morphosyntactic changes are discussed. These include the use of plural morphemes, tense markings, pronouns and possessive determiners, passive and causative constructions, and multiple modifying clauses.
Lexical innovation processes in Cameroon English
Authors: BOBDA AUGUSTIN SIMO
Published: February 2007

ABSTRACT: Cameroon English (CamE) acquires new lexical items through diverse processes. It uses various kinds of loans from French, Pidgin English and indigenous languages, whose full incorporation into CamE has been established by earlier availability and acceptability tests. Internal processes responsible for lexical innovation include semantic extension, semantic shift, derivation by prefixation, suffixation, conversion and back derivation, compounding, clipping and reduplication. French does not only donate direct loans, but also permeates every other lexical innovation process. CamE lexis derived from the multiple processes described seems quite unique, so that generalization to or from other Englishes regarding these lexical innovation processes is rather unrealistic.
Norms and meaning potential
Authors: PETER STEVE
Published: February 2007

ABSTRACT: The spread of English offers sociolinguistics a unique venue to study sociolinguistic variables, including the question of norms and standards for English in its worldwide domain. This paper begins with a discussion of the factors in the spread of English, and proceeds to consider the process of nativization, with particular reference to the concept of meaning potential. In this context, the construct of concentric circles as proposed by Kachru (1987) is discussed and modified. After a brief excursus on communicative competence, the conclusion is reached that norms and standards for world Englishes are best considered as interactions of the meaning potential of the social semiotic and the linguistic form of the language.
Versification and reiteration in Hawai'i Creole English: ‘If nomo paila moen, awrail’.
Authors: MASUDA HIROKUNI
Published: February 2007

ABSTRACT:Hawai'i Creole English (HCE), habitually called ‘Pidgin’ by the locals in Hawai'i, is frequently regarded as a form of destructured Standard English (SE). Nevertheless, such an idea seems to derive from lay understanding about creole languages in general, and particular characteristics that HCE owns are not inferior to SE but are simply different from it. HCE as well as other creoles presents rule‐governed structures as Bickerton (1977, 1981, 1990), and Sato and Watson‐Gegeo (1992) indicate in syntax and discourse respectively. This evidence reconfirms the fact that HCE is not a debased version of SE but a newborn linguistic system, created by the first generation of creole speakers on the plantations 1890–1910. This paper explores and examines such rule‐governed characteristics of HCE by applying Hymes's Verse Analysis to its discourse processes. By focusing on two interesting aspects, i.e., versification and reiteration, it will be argued that the narrative structure in the language is poetic and metrical, and those structures might constitute part of narrative grammar in creole languages.
PHONOLOGICAL DESCRIPTIONS
Authors: Cole Jennifer
Published: February 2007

English Phonology by John T. Jensen.
English in foreign langauge education policy in Japan: Toward the twenty‐first century
Authors: KOIKE IKUO , TANAKA HARUMI
Published: February 2007

ABSTRACT: In this paper, we will try to show how foreign language education in Japan toward, and in, the twenty‐first century may be affected by the changing social, economic and political streams of thought, particularly by the educational policies of the Ministry of Education. In order to get a broader perspective, we will present a profile of Japan's natural and socio‐economic conditions, a brief history of foreign language and culture learning by the Japanese, and the Japanese government's foreign language education policies since the Meiji Restoration in 1868. Such background knowledge may contribute to understanding the plausible raison d'être of changing foreign language teaching in Japan.
A cognitive study of English loanwords in Japanese discourse
Authors: HAYASHI TAKUO , HAYASHI REIKO
Published: February 2007

ABSTRACT:Studies on English loanwords in Japan have been carried out from a variety of perspectives in the past but they have been mainly concerned with rhetorical aspects associated with images such as modernity and sophistication. The present study discusses the use of English loanwords in Japanese discourse from a cognitive perspective and reveals how the world knowledge of English loanwords is applied to a text and constitutes an integral component of the discourse production process both within and beyond the sentence level. Following the discussion of three cognitive concepts of plan, relational coherence and frame, which constitute our model of discourse for analysis, English loanwords used in Japanese spoken discourse are analyzed in five categories of coherence, and, finally, the implications of the study are discussed briefly.
English in Mauritius
Authors: FOLEY JOSEPH
Published: February 2007

ABSTRACT: This paper gives an overview of the position of English in the island of Mauritius, where the dominant language of the home is a French‐based Creole but the language of government, judiciary and schooling is English. Language teaching in Mauritius has been traditionally structuralist. That is to say the pedagogical approach sees language systems consisting of a finite set of ‘patterns’ which act as models; there is a belief that repetition and practice result in the formation of accurate language habits and that ‘the basics’ must be taught before learners are encouraged to communicate their own thoughts and ideas. Only more recently has there seemed to be a need to place language (in particular English) in a meaningful setting where it can have a functional role in society. This means seeing language as part of the overall development of the human resources available in order to respond to the demands of the economy and society as a whole.
Getting into a flap!/t/ in New Zealand English
Authors: BAUER LAURIE , HOLMES JANET
Published: February 2007

ABSTRACT: This paper examines the constraints on the realizations of /t/ in New Zealand English. On the basis of a detailed examination of the speech of two similar speakers from the New Zealand ICE corpus, a series of allophonic rules is provided. It is then shown that the distribution of allophones for these speakers is not the same as for other speakers who have been previously analyzed. Part of the difference appears to be that different speakers assign /t/ to preceding or following syllables in different ways, which suggests that strategies of syllabification are not universally determined, but are sociolinguistically variable.
Losing voice: is final /z/ devoicing a feature of Maori English?
Authors: HOLMES JANET
Published: February 2007

ABSTRACT: This paper examines the distribution of word‐final /z/ in New Zealand English. This feature has attracted little attention in previous research, but it appears to be a feature which distinguishes between the English of Pakeha and Maori New Zealanders. The research reported in this paper describes the distribution of word‐final /z/ in a sample of 6,057 tokens produced by 97 New Zealanders from the Wellington Corpus of Spoken New Zealand English. The contributors contrast primarily on the dimensions of ethnicity, gender, and age, and the samples include both interview and conversational styles. The analysis identifies three main variants of word‐final /z/, a voiced variant, a partially devoiced variant and a totally devoiced or voiceless variant. The sociolinguistic distribution of the voiceless variant indicates that it is used significantly more often by Maori than by Pakeha, suggesting it may be a feature of ‘Maori English.’ The results also suggest that young Pakeha women may play an interesting role in relation to language change in New Zealand English. Tentative explanations are proposed for the patterns identified.
Spread of English and Westernization in Saudi Arabia
Authors: HAQ FAWWAZ AL‐ABED AL , SMADI OQLAH
Published: February 2007

ABSTRACT: There is a sense of fear among the Saudis that the use of English entails Westernization, detachment to the country, and a source of corruption to their religious commitment. The present study is an attempt to investigate the validity of such a fear. Moreover, the study aims at examining attitudes of university Saudi students towards the following issues: Westernization; national identity; and religious commitment. An earlier questionnaire developed by the researchers (in press) was used and distributed to 1,176 undergraduate university students representing all universities in KSA. The results of the study reveal that the use of English does not make the participants Westernized, neither their national identity gets weakened, nor their religious commitment becomes corrupted. Learning English is believed to be a religious and a national duty among the Saudis. The study concludes with implications and recommendation to establish a rigid language policy in KSA.
International graduate students and the spread of English
Authors: MUNRO VICKI R.
Published: February 2007

ABSTRACT: Because international graduate students often return to their native countries as educators, politicians, and business people, they have the potential to influence the spread of English, both directly and indirectly. Thus arises the question of whether they will be knowledgeable enough about language issues to make informed language policy decisions. Although the spread of English as an international language has generated much research, little has been done to consider the role these graduate students will play in such future policy making, or the role indirectly played by the universities they attend in forming these policies. This paper reports and interprets the results of an exploratory survey designed to discover how international graduate students think about and use English. In particular, the following aspects were considered: the functions and varieties of English, the worldwide role of English, and attitudes and changes in attitudes toward English. The research suggests that students tend to emphasize the instrumental role of English, to lack an awareness of issues such as the nativization of English, to support English as a world language largely because of inertia, and to hold more positive attitudes toward (American) English over time.
On the grammar of code‐switching
Authors: BHATT RAKESH M.
Published: February 2007

ABSTRACT: This paper explores an Optimality‐Theoretic approach (Prince and Smolensky, 1994) to account for the observed cross‐linguistic patterns of code‐switching. The proposal is premised on the simple assumption that code‐switching strives for well‐formedness. I assume that when the embedding constituents are mixed into the matrix language, the syntax operates to optimize well‐formedness. I show that optimization of well‐formedness in code‐switching follows from the (violable) ranked constraints. I will argue that the patterns of code‐switching emerge from the interactions among the ranked constraints.
VARIETIES OF ENGLISH
Authors: Algeo John
Published: February 2007

South Asian English: Structure, Use, and Users, Edited by Robert J. Baumgardner.
Understanding Population Health Terminology
Authors: KINDIG DAVID A.
Published: February 2007

Population healthis a relatively new term, with no agreement about whether it refers to a concept of health or a field of study of health determinants. There is debate, sometimes heated, about whether population health and public health are identical or different. Discussions of population health involve many terms, such asoutcomes,disparities,determinants, andrisk factors, which may be used imprecisely, particularly across different disciplines, such as medicine, epidemiology, economics, and sociology. Nonetheless, thinking and communicating clearly about population health concepts are essential for public and private policymakers to improve the population's health and reduce disparities. This article defines and discusses many of the terms and concepts characterizing this emerging field.
Culture of Helicobacter pylori: Effect of Preimmersion of Biopsy Forceps in Formalin
Authors: Yousfi Mahmoud M. , Reddy Rita , Osato Michael S. , Graham David Y.
Published: February 2007

Background.Treatment of antibiotic‐resistant Helicobacter pylori should be based on bacterial sensitivity testing that requires the ability to isolate the bacterium from gastric mucosal biopsies. The aim of this study was to determine whether the yield for detecting H. pylori infection by culture is reduced by immersion of biopsy forceps in formalin prior to obtaining the specimen.

Materials and Methods.Gastric antral mucosal biopsies (100 specimens) from 50 patients were obtained for culture of H. pylori. An antral biopsy was taken for culture, and with the same forceps a biopsy was taken for histological examination. The biopsy specimen was removed by shaking, whereas the forceps was immersed in 10% buffered formalin for the histological investigation. The forceps was then used without rinsing to obtain a second specimen for culture from an area adjacent to the first site. H. pylori status was determined by histological assessment with the Genta stain and a rapid urease test.

Results.Fifty patients with H. pylori infection documented by histological inquiry and positive rapid urease testing entered the study; 29 had duodenal ulcers, 5 had gastric ulcers, 1 had mucosal associated lymphoid tissue (MALT) lymphoma, and 15 were without ulcer disease. The results of culture both before and after immersion in formalin were identical. One patient had both cultures negative; the sensitivity of culture for detection of H. pylori infection was 98% (95% confidence interval =93%‐100%).

Conclusion. Preimmersion of biopsy forceps in formalin does not adversely affect the ability to culture H. pylori.
Comparison of One or Two Weeks of Lansoprazole, Amoxicillin, and Clarithromycin in the Treatment of Helicobacter pylori
Authors: Moayyedi Paul , Langworthy Harriet , Shanahan Kate , Tompkins David S. , Dixon Michael F. , Chalmers Douglas M. , Axon Anthony T. R.
Published: February 2007

BackgroundThe simplest, most effective, and least expensive Helicobacter pylori therapy remains to be determined. Two weeks of 30 mg lansoprazole bid, 1 gm amoxicillin bid, and 500 mg clarithromycin bid (LAC2) had been shown to be an effective therapy for H. pylori. The aim of this study was to assess whether 1 week of this regimen (LAC1) would have a similar efficacy.

Materials and Methods.
H. pylori‐positive patients assessed histologically, by rapid urease test, microbiologically, and by a 13C‐urea breath test (13C‐UBT) were randomized to receive either LAC1 or LAC2 in a single‐center open study. Patients were interviewed 1 to 3 days after completion of therapy to evaluate adverse events and compliance. Efficacy was determined by 13C‐UBT at least 4 weeks after antibiotic therapy.

Results.Seventy evaluable patients were randomized to receive LAC1 (n = 33) and LAC2 (n = 37). Of the 33 LAC1 patients, 30 (91%) were treated successfully (95% confidence interval (CI) = 76–98%), compared with 32 of 37 (86%) in the LAC2 group (95% CI = 71–96%). There was no difference in efficacy between the two groups (Fisher's exact test p= 1.0; 95% CI =–10.3%–19.2%). Patients taking LAC1 experienced significantly fewer severe adverse events than those taking LAC2 (Mann‐Whitney U test). One of 64 patients had primary resistance to clarithromycin, and treatment was unsuccessful in this case. Six of the 7 remaining treatment failures developed secondary resistance to clarithromycin.

Conclusions.LAC1 is as effective as LAC2 and is associated with less toxicity. Posttreatment clarithromycin resistance is common in patients who do not experience success with therapy.
Helicobacter pylori Infection in Congestive Gastropathy
Authors: Bahnacy A. , Kupcsulik P. , Elés Zs , Jàray B. , Flautner L.
Published: February 2007

Background.This study determines the prevalence and significance of Helicobacter pylori infection in portal hypertensive patients.

Materials and Methods.Patients numbered 118 and consisted of 90 patients with portal hypertension (66 men; 24 women; mean age, 49.1 ± 2.1 years) and 28 noncirrhotic patients with nonucler dyspepsia, (12 men; 16 women; mean age, 47.6 ± 2.8 years), who made up the control group. In all patients, diagnostic upper endoscopy was performed, and gastric biopsies were taken for histological examination and diagnosis of H. pylori.

Results.Of the portal hypertensive patients, 42 (47%) had congestive gastropathy, 11 (26%) of whom were positive for H. pylori. and 48 (53%) did not have gastropathy, 12 (25%) of whom were positive for H. pylori. In the control group, 15 of 28 (54%) were positive for H. pylori. H. Pylori was found less frequently in congestive gastropathy patients than in the control group. We found also that the presence and severity of congestive gastropathy is independent of H. pylori status.

Conclusions.We conclude that the role of H. pylori in the pathogenesis of congestive gastropathy is unlikely, and we suggest that there is no need for its routine eradication in cirrhotic patients.
Triple Therapy with Lansoprazole, Clarithromycin, and Amoxicillin for the Cure of Helicobacter pylori Infection: A Short Report
Authors: Riff Dennis S. , Kidd S. , Rose Pamela , Haber Marian , Weissfeld Alice , Siepman Nancy
Published: February 2007

BackgroundGiven the therapeutic potential of proton pump inhibitor‐based triple therapy for successful cure of Helicobacter pylori infection, we evaluated the efficacy and safety of lansoprazole with clarithromycin and amoxicillin in an open‐label, single‐center study.

Materials and Methods.
H. pylori‐positive patients self‐administered lansoprazole, 30 mg; clarithromycin, 500 mg; and amoxicillin, 1 gm bid for 14 days. Patients were assessed pretreatment, at which time the presence of H. pylori was documented by rapid urease test, culture, or histology, following study drug administration (week 2) for a brief evaluation only, and at least 4 weeks posttreatment (week 6), which included endoscopy with collection of biopsy specimens for culture and histology testing.

Results.Primary clarithromycin and metronidazole resistance were observed in 6% (2 of 30) and 43% (13 of 30) of study patients, respectively. One month after the end of therapy, H. pylori infection was cured in 23 of 25 patients (92%; 95% confidence interval, 74%‐99%). The triple‐therapy regimen was well‐tolerated; 17% of patients (5 of 30) reported mild to moderate adverse effects during the treatment period.

Conclusion.A 2‐week, triple‐drug combination of lansoprazole, clarithromycin, and amoxicillin is highly effective for cure of H. pylori infection. Additionally, the triple‐drug combination was well‐tolerated by patients infected with H. pylori.
Seven‐Day Triple Therapy with Lansoprazole, Clarithromycin, and Metronidazole for the Cure of Helicobacter pylori Infection: A Short Report
Authors: Schwartz Howard , Krause R. , Siepman Nancy , Haber Marian , Weissfeld Alice , Kid S. , Rose Pamela , Sahba B.
Published: February 2007

BackgroundTo refine our understanding of anti‐Helicobacter pylori treatment regimens further, we evaluated the efficacy and safety of lansoprazole given in combination with clarithromycin and metronidazole for 7 days in an open‐label, multicenter study.

Materials and Methods.
H. pylori‐positive patients self‐administered lansoprazole, 30 mg; clarithromycin, 500 mg; and metronidazole, 500 mg bid for 7 days. Patients were assessed at pretreatment, at which time the presence of H. pylori was documented by rapid urease test or histology and culture, following study drug administration (week 1) for a brief evaluation only, and at least 4 weeks posttreatment (week 5), including endoscopy with collection of biopsy specimens for culture and histology testing.

Results.Of the 60 patients enrolled in the study, 59 had confirmed H. pylori infection, and 51 were included in an intent‐to‐treat analysis of efficacy. Primary metronidazole and clarithromycin resistance were observed in 84% and 8% of study patients, respectively. One month after the end of therapy, H. pylori infection was cured in 40 of 51 patients (78%); 95% confidence interval, 65%–89%). The triple‐therapy regimen was well‐tolerated, with only 2 patients (4%) requiring premature withdrawal from the study due to treatment‐related adverse events. Taste perversion (15.0%) and diarrhea (11.7%) were the most frequently reported adverse events possibly or probably related to study medication during the treatment period.

Conclusion.Despite a high prevalence of metronidazole resistance, a 1‐week, triple‐drug combination of lansoprazole, clarithromycin, and metronidazole is effective treatment for and well‐tolerated by patients with H. pylori infection.
Comparative Evaluation of Selective and Nonselective Media for Primary Isolation of Helicobacter pylori from Gastric Biopsies
Authors: Martínez María José Fresnadillo , Rincón Manuel Rodríguez , De Castro Ana María Blázquez , Sánchez Enrique García , Sánchez José E. García , Martín Ignacio Trujillano , Sánchez Miguel Cordero , Alvarez Pedro Alvarez , Bouza José Paz , García‐Rodríguez José A.
Published: February 2007

Background.

In this study, we compared and evaluated the efficacy of five culture media for the primary isolation of Helicobacter pylori from gastric biopsies.

Materials and Methods.

A total of 1,174 biopsies (antrum and corpus) taken from 587 patients were plated in parallel on two selective media—Skirrow’s medium and brain‐heart infusion (BHI) agar supplemented with 10% sheep blood, polymyxin B, vancomycin, trimethoprim, and amphotericin B (HPA medium), and on three nonselective media—chocolate agar with Isovitalex, Columbia blood agar, and BHI‐10% sheep blood agar.

Results.

An isolation rate of 57.9% (680 of 1,174) was obtained with a combination of all media. HPA medium gave the highest isolation rate, 99.4% (676 of 680). Chocolate agar, Columbia blood agar, brain‐heart blood agar, and Skirrow’s medium showed very poor performance (23.5%, 28.5%, 65.9%, and 71% of all isolates, respectively). The number of cultures in HPA medium discarded due to contamination was only 2 (0.32%). There was no difference in the positive rate of culture in HPA medium between the antrum and the corpus of the stomach.

Conclusions.

The HPA medium is superior to Skirrow’s medium and nonselective media in promoting growth of H. pylori and, on the basis of these results, we recommended the use of HPA medium for primary isolation of H. pylori from gastric biopsies.
Invasive Helicobacter‐Like Organisms in Feline Gastric Mucosa
Authors: Serna Jorge Humberto , Genta Robert M. , Lichtenberger L.M. , Graham David Y. , El‐Zaatari Fouad A.K.
Published: February 2007

Background.

Helicobacter‐like organisms (HLOs) usually are present in the stomachs of cats. Although the histopathology of natural (H. felis or H. heilmannii) infections has been reported, their invasion into the lymphoid aggregates has not been described previously.

Materials and Methods.

Gastric tissues were obtained from 17 adult cats living in a natural urban environment. Biopsy sites were selected by the presence of urease on the mucosal surface stained by Genta stain and periodic acid–Schiff stain.

Results.

Spiral organisms morphologically similar to H. felis or to H. heilmannii were detected in all the cats, distributed predominantly over the oxyntic mucosa. Seven cats had prominent lymphoid follicles with germinal centers within the oxyntic mucosa, and in six of these seven cats, extracellular organisms were present within the lymphoid follicles. Scattered organisms also were found over sites of gastric metaplasia in the duodenum of six cats.

Conclusions.

This study extends previous observations by showing that HLO infection in cats is associated with large lymphoid follicles in the stomach. In additon, HLOs were demonstrated submucosally within gastric lymphoid follicles and on patches of gastric metaplasia in the duodenum.
Ranitidine Bismuth Citrate with Clarithromycin for the Eradication ofHelicobacter pyloriand for Ulcer Healing
Authors: Pounder Roy E. , Wyeth John W. , Duggan Annette E. , Bailey Robert J. , Louw Japie A. , Ohlin Bo
Published: February 2007

Background.

In a pilot study, ranitidine bismuth citrate (RBC; Pylorid, Tritec) in coprescription with clarithromycin achieved aHelicobacter pylorieradication rate (based on13C urea breath test alone) of 83%. The aim of the current study was to validate this finding by using three diagnostic tests and a larger group ofH. pylori–positive patients with active duodenal ulcer.

Methods.

In a blinded study, 95 patients were given either 4 weeks of treatment with RBC, 400 mg bid, alone (RBC400, n = 31) or RBC, 400 mg bid or 800 mg bid, in coprescription with clarithromycin, 250 mg qid for 14 days, followed by 14 days of RBC, 400 mg bid, alone (RBC400+CLAR and RBC800+CLAR, respectively; n = 32 for each). Rates of ulcer healing at week 4 and ofH. pylorieradication (assessed by antral and corpus urease tests and histology and by13C urea breath test) at week 8 were compared, together with the incidence of adverse events.

Results.

All three regimens were effective at duodenal ulcer healing and were tolerated well. The coprescription regimens gave significantly higher observedH. pylorieradication rates (82% and 74% for RBC400+ CLAR and RBC800+CLAR) compared with RBC400 (0%;p< .001).

Conclusions.

RBC in dual therapy with clarithromycin provides excellentH. pylorieradication therapy and is an effective duodenal ulcer healing drug.
Relationship Between the Eff icacy of Amoxicillin and Intragastric pH for the Treatment of Helicobacter pylori Infection
Authors: Kleveland Per M. , Waldum Helge L. , Brenna Eiliv , Aase Steinar , Mæland Johan A.
Published: February 2007

Background.

Proton pump inhibitors are reported to enhance the efficacy of antibiotics in the treatment of Helicobacter pylori infection. An elevated intragastric pH is considered to be an important factor for this increased antimicrobial efficacy. The aim of this study was to assess the effect of different doses of lansoprazole on 24‐hour intragastric pH and to correlate the effect of amoxicillin on the cure rate for H. pylori infection with the intragastric pH obtained during lansoprazole treatment.

Patients and Methods.

Thirty‐six duodenal ulcer patients who tested postively for H. pylori as assessed by a rapid urease test, culture, and histological evaluation were allocated randomly to dual treatment with amoxicillin, 3 gm/day, and lansoprazole in different doses ranging between 30 and 180 mg/day for 2 weeks. A 24‐hour intragastric pH measurement was taken in all patients on the fifth day of treatment. H. pylori status was determined by culture and histological workup 6 weeks after cessation of the amoxicillin‐lansoprazole medication.

Results.

The H. pylori infection was treated successfully in 19 of 32 patients who completed the dual therapy (per protocol, 59.4%). The median intragastric pH in patients who were treated successfully was 4.4 (95% confidence interval [CI] = 3.7– 4.7), as compared to 4.0 (95% CI = 3.5– 4.5) in patients who were not treated successfully ( p = .47, Wilcoxon’s rank sum test). The median percentage of time that the intragastric pH exceeded 4 was not different in the two groups ( p = .77). Administration of lansoprazole in doses exceeding 30 mg induced only a moderate additional increase in intragastric pH.

Conclusions.

Profound inhibition of gastric acid secretion seems not to be necessary to improve the effect of amoxicillin on the cure rate for H. pylori infection in patients with duodenal ulcers.
Helicobacter pylori Genotypes Inf luence Serum Pepsinogen C Levels
Authors: Plebani Mario , Basso Daniela , Navaglia Filippo , DiMario Francesco
Published: February 2007

Background.

Infection from Helicobacter pylori significantly influences pepsinogen A (PGA) and C (PGC) levels in serum. Increased PGA and PGC serum levels are observed in H. pylori positive patients, while a significant decrease is observed after eradication. Little is known about the relative role of H. pylori cytotoxic strains in this phenomenon. The aim of our study was to assess the influence of cagA genotype on circulating levels of PGA and PGC.

Materials and Methods.

We studied 81 consecutive H. pylori positive patients, 64 H. pylori negative patients and 18 healthy controls. H. pylori was evaluated histologically in two antral and two body biopsies (Giemsa and/or Warthin Starry staining). Extracted DNA was then submitted for PCR amplification of both the urease A and cagA genes. A serum obtained from each patient before endoscopy was used for specific radioimmunoassay measurement of PGA and PGC.

Results.

The urease A gene was found in all H. pylori positive patients, the cagA gene was detected in 55 H. pylori positive patients and in none of the H. pylori negative patients. PGA and PGC levels were significantly higher in H. pylori positive than in H. pylori negative patients. A significant association was found between cagA and raised serum PGC levels in patients with antral gastritis but not in patients with peptic ulcer. Serum PGA levels were not affected by cagA.

Conclusions.

Our results indicate that cagA positivity may influence the circulating PGC levels, probably because it causes a higher grade of mucosal inflammation.
No Additional Value of Bismuth Subcitrate to Combination Omeprazole/Amoxicillin Therapy in the Eradication of Helicobacter pylori
Authors: Tan A.C.I.T.L. , Den Hartog G. , Meijer J.W.R. , Thies J.E. , De Vries R.A. , Mulder C.J.J.
Published: February 2007

Background.

We investigated whether addition of bismuth subcitrate (BSC, 4 × 120 mg) to a two week therapy scheme of omeprazole (OME, 2 × 40 mg)/amoxicillin (AMO, 4 × 500 mg) increases Helicobacter pylori eradication.

Materials and Methods.

Patients with dyspepsia underwent upper endoscopy. H. pylori positive patients were randomized to treatment A (OME/AMO, 83 patients) or treatment B (OME/AMO/BSC, 84 patients).

Results.

In 65 patients of group A (78%) H. pylori was eradicated as determined from the histological assessment (Sydney classification) of antrum and corpus biopsies. In comparison, in 68 patients of group B (81%) H. pylori was eradicated (p = NS between groups). H. pylori eradication in both groups was associated similarly with a decrease of inflammation and activity whereas atrophy and intestinal metaplasia were not affected. A positive association was revealed between the decrease of H. pylori score and the decrease of both inflammation and activity scores for antrum as well as corpus biopsies.

Conclusions.

Addition of BSC to OME/AMO does not increase H. pylori eradication in patients with dyspepsia. Eradication of H. pylori is associated with disappearance of epithelial damage (inflammation and activity) in antral and corpus mucosa.
Co‐Existing Gastric Cancer and Duodenal Ulcer Disease: Role of Helicobactor pylori Infection
Authors: Kim Hak Yang , Kim Yong Bum , Park Choong Kee , Yoo Jae Young , Graham David Y.
Published: February 2007

Background.

The association of gastric cancer and chronic duodenal ulcer disease is considered rare. In fact duodenal ulcer disease is believed to somehow “protect” against the development of gastric cancer. Helicobacter pylori infection is an important factor in the development of gastric cancer. No detailed investigation on the prevalence of H.pylori in coexistence of gastric cancer and duodenal ulcer disease has been performed. We evaluated the frequency of H. pylori infection in the patients with co‐existence of gastric cancer and duodenal ulcer disease.

Materials and Methods.

During the period March 1994 to February 1995, we collected data from 3,652 patients in whom esophagogastroduodenoscopy was done. During this period, when the cancerous or ulcerative lesions in stomach or duodenum were found, rapid urease tests were performed.

Results.

Six patients had concurrent gastric carcinoma and duodenal ulcer disease. Three of the cases had early gastric carcinoma; 2 had active duodenal ulcers and one had a duodenal ulcer scar; all 3 had positive rapid urease tests. The patients with early gastric cancer were younger than the individuals with advanced gastric cancer.

Conclusions.

The co‐existence of both diseases may be higher than reported from Western countries or from Peru which may either reflect the high prevalence of circulation of H.pylori ulcer and cancer strains in Korea and the co‐infection with both types of organism in some individuals.
Elevation of CSF Tumor Necrosis Factor α Levels in New Daily Persistent Headache and Treatment Refractory Chronic Migraine
Authors: Rozen Todd , Swidan Sahar Z.
Published: February 2007

Objective.—To determine if patients with new daily persistent headache (NDPH) have elevated levels of tumor necrosis factor α (TNF α) in the CSF.

Background.—NDPH is considered one of the most treatment resistant of all headache syndromes. This reflects a lack of understanding of its pathogenesis. As a certain percentage of NDPH patients have their headaches start after an infection, the possibility of a persistent state of systemic or CNS inflammation comes into question. TNF α is a proinflammatory cytokine involved in brain immune and inflammatory activities, as well as in pain initiation. The goal of this study was to look at TNF α levels in the CSF of NDPH patients, to determine if CNS inflammation may play some role in the pathogenesis of this condition.

Methods.—CSF TNF α levels were studied in 38 patients: 20 with NDPH and a control population of 16 patients with chronic migraine (CM), and 2 with post‐traumatic headache (PT).

Results.—CSF TNF α levels were elevated in 19 of 20 NDPH patients, 16 of 16 CM patients, and both PT patients. Serum TNF α levels were normal in most of the study subjects.

Conclusion.—An elevation of CSF TNF α levels was found in almost all NDPH patients and suggest a role for TNF α in the pathogenesis of this condition. Surprisingly, all CM and PT patients tested had elevated CSF TNF α levels. In most patients with elevated CSF levels, serum TNF α levels were normal. All of these syndromes may be manifestations of CNS inflammation. As most of the positive‐tested patients showed minimal to no improvement during aggressive inpatient treatment, persistent elevation of CSF TNF α levels may be one of the causes of treatment refractory CDH.
Resistance to Phenobarbital Extends to Phenytoin in a Rat Model of Temporal Lobe Epilepsy
Authors: Bethmann Kerstin , Brandt Claudia , Löscher Wolfgang
Published: February 2007

Summary:  Purpose: Most patients who are resistant to the first antiepileptic drug (AED) treatment are also resistant to a treatment with a second or third AED, indicating that patients who have an inadequate response to initial treatment with AEDs are likely to have refractory epilepsy. Animal models of refractory epilepsy are important tools to study mechanisms of AED resistance and develop new treatment strategies for counteracting resistance. We have recently described a rat model of temporal lobe epilepsy (TLE), in which spontaneous recurrent seizures (SRS) develop after a status epilepticus induced by sustained electrical stimulation of the basolateral amygdala. Prolonged treatment of epileptic rats with phenobarbital (PB) resulted in two subgroups, PB responders and PB nonresponders.

Methods: In the present study we examined if rats with PB‐resistant seizures are also resistant to phenytoin (PHT), using continuous EEG/video recording of spontaneous seizures.

Results: First, a new group of 15 epileptic rats was produced and selected by treatment with PB into responders (8 rats) and nonresponders (6 rats), respectively. During subsequent treatment with PHT, the doses of PHT had to be individually adjusted for each rat to avoid toxicity. Treatment with PHT led to complete seizure control in two animals and a >50% reduction of seizure frequency in three other rats, which were considered PHT responders. In nine of the remaining rats, PHT did not exert any clear anticonvulsant effect, so that these rats were considered nonresponders. Plasma levels of PHT did not differ significantly between responders and nonresponders. When comparing the PB and PHT nonresponder groups, five of the six PB‐resistant rats (83%) were also resistant to PHT, demonstrating that rats that have an inadequate response to initial treatment with PB are likely to be also resistant to treatment with a second AED.

Conclusions: The AED‐resistant rats of our model meet the definition of pharmacoresistance in animal models, that is, persistent seizure activity not responding to at least two AEDs at maximum tolerated doses. This new model of pharmacoresistant TLE may be useful in the targeted development of new therapies for refractory epilepsy.