bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Gastric Non‐Hodgkin's Lymphoma Patients: Parallels with Helicobacter pylori
Authors: Thorburn Christine , Rodriguez Larissa , Parsonnet Julie 
Published: February 2007

ABSTRACTBackground.The incidence of gastric non‐Hodgkin's lymphoma (NHL) is increasing in the United States. However, little is known about the etiology of the disease. Some studies have shown an association between gastric NHL and Helicobacter pylori. No study has specifically delineated demographic features that distinguish gastric NHL patients from nongastric NHL patients. Materials and Methods.To obtain information about the differences between gastric and nongastric NHL patients, we conducted a hospital chart review study. We examined charts of all 25 cases of primary gastric NHL, as well as charts of 75 randomly selected nongastric NHL patients as controls. All patients were seen in the Division of Oncology at Stanford University Medical Center from 1972 to 1991. Demographic information was tabulated, and differences between the cases and controls were noted. The identified risk factors were determined by both univariate and logistic regression analyses. Results.There was no difference between gastric NHL cases and nongastric controls with respect to age, gender, race, and family history of any cancer. However, in logistical regression, persons with gastric NHL were more likely than those with other forms of NHL to be born outside the United States (odds ratio = 12.8; 95% confidence interval = 2.9–56.0) and also to have a family history of stomach cancer (odds ratio = 18.4; 95% confidence interval 2.1–160.1). Conclusions.Gastric NHL is more likely than NHL at other sites to occur in persons with a family history of gastric cancer or in those born in developing countries. This epidemiological pattern supports the identified role of H. pylori in the development of gastric lymphoma.
Effectiveness of Quadruple Therapy Using Lansoprazole, Instead of Omeprazole, in Curing Helicobacter pylori Infection
Authors: de Boer Wink A. , van Etten Ruud J. X. M. , Lai J. Y. L. , Schneeberger Peter M. , van De Wouw Branka A. M. , Driessen Willem M. M. 
Published: February 2007

ABSTRACT Background.Omeprazole enhances the efficacy of bismuth‐based triple therapy. It is unknown whether the same is true for other proton pump inhibitors. Lansoprazole has superior anti‐Helicobacter activity in vitro and possibly also in vivo; therefore we investigated quadruple therapy with lansoprazole. Materials and Methods.In two studies performed in separate hospitals, a total of 67 Helicobacter pylori–positive patients were treated with 7‐day quadruple therapy (lansoprazole, colloidal bismuth subcitrate, tetracycline, and metronidazole) after 3 days of lansoprazole pretreatment. Testing for cure was done by endoscopy in study 1 and by breath test in study 2. Results.Cure rates per protocol were 31 of 31 (100%) in study 1 and 30 of 32 (94%) in study 2. Intention‐to‐treat cure rates were 31 of 35 (89%) in study 1 and 30 of 32 (94%) in study 2. Cured overall were 32 of 34 with a metronidazole sensitive strain and 3 of 3 with a metronidazole‐resistant strain. Data on side effects were collected from 51 patients. Twelve (21%) had no side effects, 27 (53%) had mild side effects, 10 (20%) had moderate side effects, but only 2 (4%) had severe side effects. Side effects, never were the reason that a patient stopped taking the medication. Conclusions.The results with lansoprazole‐quadruple therapy are comparable to the historic control group treated with omeprazole‐quadruple therapy. The cure rate is very high, and although mild to moderate side effects occured in many patients, everybody finished the treatment regime.
Twenty‐Minute Fasting Version of the US 13C‐Urea Breath Test for the Diagnosis of H. pylori Infection
Authors: Malaty Hoda M. , El‐Zimaity Hala M. T. , Genta Robert M. , Klein Peter D. , Graham David Y. 
Published: February 2007

ABSTRACT Background.In large‐scale multi‐center clinical trials, the US 13C‐urea breath test (UBT) has proven to have a sensitivity and specificity of approximately 95%. Ingestion of a meal to delay gastric emptying has advantages of increasing the level of signal as well as prolonging the duration of significantly increased 13C excretion, at the expense of requiring 40 to 60 minutes to complete the test. Our aim was to explore the utility of the 13C‐UBT with a total duration of 30 minutes or less. Methods. After a baseline breath sample was obtained, 125 mg of 13C‐urea was given in 100 ml of water, and additional breath samples were taken after 20 and 30 minutes. The results of the UBT were compared to histological assessment, culture, and the rapid urease test. 13C‐UBTs were carried out on normal volunteers who underwent gastroscopy during which six mucosal biopsies were taken. Three biopsies were for histological evaluation (Genta stain), two for culture, and one was for agar gel rapid urease testing. The UBT was conducted 2 to 3 days either before or after the endoscopic procedure. Results.The cutoff value for a positive UBT was enrichment of 2.4Δ%0 (delta over baseline). Of the 66 tests, 51%0 were Helicobacter pylori‐positive. There were no false positive UBTs and only two false negative UBTs at 20 minutes (sensitivity, 96%; specificity, 100%). At 30 minutes, one other UBT was false negative (gray zone of 2.36%0.) (sensitivity, 94%; specificity, 100%). Conclusion. These results suggest that omission of the meal and shortening the duration of the US 13C‐UBT to 20 minutes still may maintain excellent specificity and sensitivity of the test.
The Role of Ranitidine Bismuth Citrate in Significantly Reducing the Emergence of Helicobacter pylori Strains Resistant to Antibiotics
Authors: McLaren Alistair , Donnelly Christine , McDowell Sylvia , Williamson Russell 
Published: February 2007

Background.This study was carried out to investigate the clinical observation that the emergence of antibiotic resistance can be reduced in Helicobacter pylori if agents are administered in combination with bismuth salts.Materials and Methods.Two H. pylori clinical isolates were grown on chocolate Columbia agar containing either ranitidine bismuth citrate (RBC) at one‐half lethal concentration (8 μg/ml) or no drug control for 22 subcultures. After 1, 5, 8, 14, 17, and 22 subcultures, the emergence of antibiotic resistance to metronidazole, clarithromycin, and streptomycin was calculated and statistically analyzed.Results.Acquisition of resistance to metronidazole was reduced significantly for both strains (p = .007 and 0.014) and for one strain against clarithromycin (p = .037). However, spontaneous emergence of resistance to streptomycin was not altered significantly. In an analysis of the effect of long‐term exposure of the isolates to RBC, susceptibility to bismuth was unaltered in one strain and had risen by only twofold in the other at experiment termination.Conclusion.RBC significantly decreased resistance acquisition in an inherently sensitive strain and also decreased resistance emergence in a strain that readily became metronidazole‐resistant.
Effects of Smoking on Cure ofHelicobacter pyloriInfection and Duodenal Uulcer Recurrence in Patients Treated with Clarithromycin and Omeprazole
Authors: Bardhan Karna D. , Graham David Y. , Hunt Richard H. , O’morain Colm A. 
Published: February 2007

Background.Smoking may affect adversely the cure rate forHelicobacter pyloriinfection in patients treated with amoxicillin and omeprazole. Therapy with clarithromycin and omeprazole was tested for its effectiveness in the treatment ofH. pyloriinfection in smokers and nonsmokers.Materials and Methods.Patients with verified duodenal ulcer andH. pyloriinfection received clarithromycin 500 mg tid, in combination with omeprazole 40 mg/day, for 2 weeks, followed by omeprazole (20 or 40 mg daily) for 2 additional weeks according to a randomized, double‐blind, multicenter design. Patients were analyzed by their smoking status for the cure ofH. pyloriinfection, ulcer healing, and prevention of duodenal ulcer recurrence.Results.After treatment with clarithromycin and omeprazole,H. pyloriinfection was cured in 71% of the smokers and in 77% of the nonsmokers (evaluated 4–6 weeks after treatment). Overall ulcer healing was 95%, and overall ulcer recurrence was 19%. ForH. pylori–negative patients, ulcer recurrence was 12% in both smokers and nonsmokers. None of these values was significantly different when smokers were compared to nonsmokers.Conclusions.Therapy with clarithromycin and omeprazole is effective for cure ofH. pyloriinfection in smokers and nonsmokers. Smoking has no effect on duodenal ulcer healing or duodenal ulcer recurrence for patients treated with this regimen.
Hematoxylin and Eosin Staining of Gastric Tissue for the Detection of Helicobacter pylori
Authors: Fallone Carlo A. , Loo Vivian G. , Lough John , Barkun Alan N. 
Published: February 2007

Background.Gold standard methods of detection of Helicobacter pylori are expensive, difficult to perform, or not widely available. The purpose of this study was to assess hematoxylin and eosin staining of antral tissue, a relatively inexpensive and widely available method of H. pylori detection.Materials and Methods.The hematoxylin and eosin stain was assessed as a method of H. pylori detection, with 2 × 2 table analysis using culture as the gold standard in 133 gastric biopsy specimens obtained from patients both before and following attempted eradication.Results.Performance of the stain was good among untreated patients as well as among patients having previously undergone an eradication treatment, with an overall accuracy of 92% (95% confidence intervals: 86–96), sensitivity of 93% (87–97), and specificity of 87% (69–96).Conclusion.The hematoxylin and eosin stain is an inexpensive method of H. pylori detection but with test performance characteristics inferior to Giemsa, Genta, or silver stains.
Promotion of Ulcerative Duodenitis in Young Ferrets by Oral Immunization with Helicobacter mustelae and Muramyl Dipeptide
Authors: Whary Mark T. , Palley Lori S. , Batchelder Margaret , Murphy James C. , Yan Lili , Taylor Nancy S. , Fox James G. 
Published: February 2007

Background.The purpose of this study was to determine whether oral immunization of ferret kits with a whole‐cell sonicate of Helicobacter mustelae lysate (Hml) and the adjuvant muramyl dipeptide (MDP) would reduce the incidence of natural colonization with H. mustelae and the extent of Helicobacter‐associated gastritis by enhancing the host mucosal immune response.Materials and Methods.Between the ages of 4 and 11 weeks, 44 ferret kits were gavaged with Hml and various doses of MDP. The extent of gastritis and duodenitis and the immune response to H. mustelae were evaluated.Results.All kits became colonized naturally with H. mustelae and the majority developed mild to severe gastritis and duodenitis. Kits that received Hml with MDP developed significantly greater inflammation of the gastric antrum and duodenum, as compared to kits vaccinated with Hml alone. Vaccination with Hml and 50 μg of MDP was associated with severe lesions in the proximal duodenum characterized by accumulation of mononuclear inflammatory cells, mucosal erosion, and ulceration. Although serum antibody specific for H. mustelae in 4‐week‐old kits was approximately 50% of adult levels, a finding attributable to passively acquired maternal antibody, both systemic and mucosal antibody levels became depressed over time despite oral vaccination. The humoral immune response was sufficiently low to prevent detection of any significant dose effect of MDP on antibody levels among experimental groups.Conclusions.Oral vaccination of young ferrets with Hml and 50 μg MDP increased the risk of Helicobacter‐associated mucosal ulceration in the proximal duodenum, which was associated with low humoral (but significant cell‐mediated) immune responses to H. mustelae. In retrospect, the frequency of vaccination may have suppressed the systemic humoral immune response, thereby promoting mucosal damage by H. mustelae. The 50‐μg dose of MDP enhanced the cell‐mediated immune response, which indirectly contributed to development of severe lesions. The increased frequency of mucosal damage associated with this vaccination regimen enhances the value of the ferret model for studying duodenal ulceration secondary to Helicobacter infection.
Effect of Fasting Subjects’ Posture on 13C‐Urea Breath Test for Detection of Helicobacter pylori Infection
Authors: Miwa Hiroto , Murai Toshio , Ohkura Ryuichi , Kawabe Masato , Tanaka Hiroshi , Ogihara Tatsuo , Watanabe Sumio , Sato Nobuhiro 
Published: February 2007

Background.Although many factors that may affect the 13C‐urea value have been verified, no literature is available regarding the effect of the posture of the patient on the shape of the Δ13C excretion curve. In an effort to contribute to the development of a simple and standard procedure for the 13C‐urea breath test, we investigated whether either the posture of the patient during the procedure or the mouthwash after dosing affects the shape of the Δ13C excretion curve.Materials and Methods.Seventy‐two Helicobacter pylori–infected subjects were divided into four groups according to the position during procedure and the mouthwash after dosing: group A, in the supine position with mouthwash; group B, in the sitting position with mouthwash; group C, changed position by rolling with mouthwash; and group D, changed position (as did group C) without mouthwash. Absolute values of Δ13C at each sampling point were compared in the four groups.Results.Δ13C values in group A gradually increased until the 15‐minute point; those in group B were almost stable from 5 to 30 minutes, and those in group C peaked at the 5‐minute point, then decreased until 30 minutes, the values becoming similar at the 20‐minute point. Significant differences were seen between groups A, B, C, and D at the 5‐ and 10‐minute points.Conclusion.These results suggest that posture and mouthwash affect Δ13C value at the 5‐ and 10‐minute points. Sampling at 20 (maybe 15 or 30) minutes for fasting patients in a sitting position is considered to be appropriate for detection of H. pylori infection in a standard two‐sampling‐point 13C‐urea breath test.
The Efficacy and Safety of One‐Week Triple Therapy with Lansoprazole, Clarithromycin, and Metronidazole for the Treatment ofHelicobacter pyloriInfection in Japanese Patients
Authors: Takimoto Takuya , Satoh Kiichi , Taniguchi Yushi , Saifuku Koji , Kihira Ken , Seki Masaru , Yoshida Yukio , Ido Kenichi , Kimura Ken 
Published: February 2007

Background.The aim of this study was to evaluate the efficacy and tolerability of 1‐week, low‐dose triple therapy with lansoprazole, clarithromycin, and metronidazole (LCM) for the cure ofH. pyloriinfection and to establish the adequate dosage of a new triple therapy for Japanese patients.Materials and Methods.One hundred fourH. pylori–positive Japanese patients were assigned alternatively to one of two groups: one to receive either 30 mg lansoprazole once in the morning, 200 mg clarithromycin twice daily, and 250 mg metronidazole twice daily for 1 week (LCM1; n = 52); the other to receive 30 mg lansoprazole once in the morning, 200 mg clarithromycin twice daily, and 500 mg metronidazole twice daily for 1 week (LCM2; n = 52).H. pyloriinfection was assessed by smear, culture, and histological assessment (Giemsa stain) performed before and 4 weeks after cessation of the therapy.Results.The overall cure rates ofH. pyloriinfection were 92.3% (48 of 52; 95% confidence interval (CI), 85% to 100%) in LCM1 and 92.3% (48 of 52; 95% CI, 85% to 100%) in LCM2. The cure rates in the patients without prior treatment were 95.7% (44 of 46; 95% CI, 89%–100%) in LCM1 and 95.7% (45 of 47; 95% CI, 89%–100%) in LCM2. Minor side effects were observed in 7.7% of LCM1 and 9.6% of LCM2, respectively.Conclusion.The LCM1 regimen consisting of 30 mg lansoprazole once daily, 200 mg clarithromycin twice daily, and 250 mg metronidazole twice daily (the regular doses in ordinary use in Japan) is a highly effective and safe regimen for Japanese patients. LCM1 as a new triple therapy is a promising regimen for the first‐line treatment ofH. pyloriinfection in Japanese patients.
Omeprazole‐Based Dual and Triple Therapy for the Treatment ofHelicobacter pyloriInfection in Peptic Ulcer Disease: A Randomized Trial
Authors: Pieramico Oreste , Zanetti Mario V. , Innerhofer Matthias , Malfertheiner Peter 
Published: February 2007

Objectives.It was our goal to evaluate the efficacy and safety and patient compliance with omeprazole‐based dual and triple therapy for eradication ofHelicobacter pyloriin peptic ulcer disease.Materials and Methods.One hundred seventy‐five consecutive patients withH. pyloriinfection and associated active peptic ulcer were included.H. pyloriinfection was assessed by rapid urease test and histological analysis. Patients were randomized among three treatments: group 1 (56 patients): omeprazole, 20 mg bid, and amoxicillin, 1 gm bid, for 2 weeks; group 2 (61 patients): omeprazole, 20 mg bid, plus amoxicillin, 1 gm bid, and metronidazole, 500 mg bid, for 1 week; and group 3 (58 patients): omeprazole, 20 mg bid, plus amoxicillin, 1 gm bid, and clarithromycin, 500 mg bid, for 1 week. Ulcer healing and cure of infection were evaluated at 4 to 6 weeks after cessation of therapy. Eradication rate was calculated per‐protocol and by an intention‐to‐treat analysis.Results.At posttreatment endoscopy, duodenal ulcer was healed in 98.3% of patients. Eleven patients (6%) were lost to follow‐up.H. pyloriinfection was treated successfully in 55% (95% confidence interval [CI] = 41%–69%) of patients of group 1; 86% (95% CI = 77%–95%) of group 2 (p< .001 vs. group 1); and 93% (95% CI = 85%–100%) of group 3 (p< .001 vs. group 1). On intention‐to‐treat analysis, eradication was 52%, 80%, and 86% in groups 1, 2, and 3, respectively. A good compliance was observed in more than 90% of patients of all groups. Side effects were reported by 7% of patients in group 1, 9% in group 2, and 11% in group 3. None of the patients stopped therapy because of side effects.Conclusions.Dual‐therapy omeprazole‐amoxicillin for 2 weeks is associated with significantly lower eradication rate than is 1‐week omeprazole‐based triple therapies. Triple therapy is well‐tolerated and produces side effects similar to those of dual therapy. The highest cure rate ofH. pyloriinfection was achieved with triple therapy of omeprazole, amoxicillin, and clarithromycin for 1 week.
Shelf Life of Unbuffered Rapid Urease Test
Authors: Ng Fook‐Hong , Wong Siu‐Yin , Chang Chee‐My 
Published: February 2007

Background.Unbuffered rapid urease test (RUT) is an accurate and inexpensive method to detect Helicobacter pylori. However, the test is not always readily available because the reagents must be mixed freshly or stored at −20°C after mixing. From our experience, storage at 4°C for less than 6 days seemed to have no effect on the test’s accuracy. This prospective study was undertaken to evaluate the shelf life of our unbuffered RUT.Material and Methods.Forty‐five patients were studied. From all patients, two sets of antral biopsy (X2) and body biopsy (X1) were taken. One set was subjected to histological examination; the other set was placed into a single capped Eppendorff tube for RUT. The tube was examined for any color change at 1 and 5 minutes.Results.Twenty‐six patients (58%) were infected as defined by histological examination. The reagent was classified according to the storage time (group 1, ≤ 5 days; group 2, > 5 days). The mean storage times of group 1 (n = 24) and group 2 (n = 21) were 3.1 (1.7 SD) days and 7.7 (1.2 SD) days, respectively. At 1 and 5 minutes, the sensitivity of group 1 was consistently higher than that of group 2 (1 minute, 61% versus 38%; 5 minutes, 92% versus 62%), and no false‐positive result was observed in either group.Conclusion.RUT remains highly sensitive and specific when it was stored at 4°C for up to 5 days but should be discarded after that period.
Catalase and Superoxide Dismutase Secreted from Helicobacter pylori
Authors: Mori Mikiji , Suzuki Hidekazu , Suzuki Masayuki , Kai Akemi , Miura Soichiro , Ishii Hiromasa 
Published: February 2007

Background.Previously, we have reported that toxic oxidants produced by activated neutrophils play a pivotal role in the development of Helicobacter pylori–induced gastric mucosal damage. Microorganisms, however, are characterized by their ability to produce a variety of antioxidant enzymes. This study is designed to measure the oxygen radical scavenging enzymes, such as catalase and superoxide dismutase (SOD), and urease in the supernatant of H. pylori (NCTC11637) suspension.Materials and Methods. H. pylori was inoculated on a sheep blood agar plate and harvested. Bacterial suspensions (109 cfu/ml phosphate buffer) were washed twice and incubated at 37°C for 1, 2, 12, and 24 hours or were sonicated in ice. Their supernatants were obtained by centrifugation and filtration. SOD activity was measured spectrophotometrically by the cytochrome c method. Catalase activity was assayed by the fall in absorbance at 240 nm as H2O2 is degraded. Urease activity was determined by measuring the release of ammonia using Berthelot reaction.Results.Activities of both SOD and catalase were detected in the supernatants of 1‐hour microaerophilic incubation. Their activities were almost constant in 4‐, 12‐, and 24‐hour microaerobic incubation or sonication. Urease activity was increased dramatically in proportion to the period of microaerobic incubation.Conclusion.Although H. pylori possesses antioxidant as a constitutive compartment, the magnitude of its secretion was below the detectable level. It is not likely that SOD and catalase play a significant role for scavenging the oxidants from injured gastric mucosa, such as infiltrated leukocytes.
Ultrastructural Study of Antral G Cells in Patients with Duodenal Ulcer: Effect of Helicobacter pylori Eradication
Authors: Sugamata Masao , Ihara Tomomi , Todate Asahi , Sugamata Miho , Hirakawa Ryuichi , Yoshida Yukio , Yamanaka Takeo , Miyata Michio , Miura Myota 
Published: February 2007

Background.It is established now that Helicobacter pylori infection is associated with exaggerated gastrin release to meals and other stimuli and that the abnormal secretion of gastrin is reversed after successful treatment of the infection. By comparing morphology of G cells from the same patients before and after treatment, we were able to investigate the ultrastructural effect of cure of H. pylori on G cells.Methods.Gastric mucosal biopsy specimens were obtained from 10 patients with duodenal ulcer before and 3, 6, and 9 months after cure of H. pylori infection. Negative controls consisted of four healthy volunteers without H. pylori infection. G cells were evaluated by immunohistochemical and electron microscopy. Treatment with H2‐antagonists was continued for 6 months after cure of the H. pylori infection.Results.Ultrastructural studies of secretory granules of antral G cells in controls displayed a broad range of electron density ranging from dark with a full appearance to totally electron‐lucent with a “vacuolating” appearance. In duodenal ulcer patients before treatment, electron‐lucent vacuolating granules predominated. After elimination of H. pylori, G‐cell granules showed a marked increase in electron density close to that of controls.Conclusions.Our study showed that the density of granules of G cells is decreased in H. pylori–infected duodenal ulcer patients compared to that in H. pylori–negative controls and is consistent with enhanced gastrin release. Cure of H. pylori infection was associated with return to normal density of G‐cell granules.