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  • 1
    Electronic Resource
    Electronic Resource
    Distribution of Distinct vacA, cagA and iceA Alleles in Helicobacter pylori in Hong Kong (2001)
    Oxford, UK : Blackwell Science Ltd
    Helicobacter 6 (2001), S. 0 
    Details
    ISSN: 1523-5378
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: There is a substantial genetic heterogeneity among Helicobacter pylori strains, and certain genotypes have been suggested to be associated with the virulence of this pathogen. The aim of this study was to investigate the distribution of H. pylori vacA, cagA and iceA genotypes and their association with duodenal ulcer disease in Hong Kong.〈section xml:id="abs1-3"〉〈title type="main"〉Materials and Methods.Gastric biopsies of 72 H. pylori infected patients were analyzed by specific polymerase chain reactions.〈section xml:id="abs1-4"〉〈title type="main"〉Results.Of the 72 cases, 69 (95.8%) had vacA signal sequence s1c strains, and three (4.2%) had s1a strains. vacA middle region sequences, m1b and m2, were detected in 23 (31.9%) and 46 (63.9%), respectively. Six (8.3%) cases contained multiple vacA subtypes. vacA s2 allele was only observed in three (4.3%) cases, which were also infected with s1c subtype. cagA was present in 64 (88.9%) of 72 patients, and iceA1 subtype was detected in 46 (63.9%) cases. Neither cagA nor vacA and iceA were associated with duodenal ulcer disease.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusion.The distribution of vacA, cagA and iceA alleles in H. pylori strains in Hong Kong is similar to that in east Asia. There is a difference in the distribution of genotypes between strains in Hong Kong and those in mainland China, although strains in the two regions exhibit a very close relation. The association of these virulence genes and duodenal ulcer disease needs reappraisal, particularly under geographic considerations.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-5378.2001.00040.x
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  • 2
    Electronic Resource
    Electronic Resource
    Pathogenetic role ofHelicobacter pylori in duodenal ulcer disease (1991)
    Springer
    Digestive diseases and sciences 36 (1991), S. 424-430 
    Details
    ISSN: 1573-2568
    Keywords: Helicobacter pylori ; duodenal ulcer ; relapse
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The pathogenesis of duodenal ulcer disease is multifactorial and the contribution ofHelicobacter pylori in relation to the other factors to the release of duodenal ulcer is unknown. To investigate this, we studied 147 patients with endoscopically proven healed ulcers. These patients were randomized to receive either placebo, misoprostol 200 μg or misoprostol 300 μg four times daily, and clinical, personal, physiological and endoscopic characteristics were obtained prospectively. Endoscopy was performed at the active phase of the ulcer and when the ulcer healed. Biopsies were taken from the antrum to assess histologically for: (1) the activity of gastritis as assessed by the degree of polymorph infiltration, (2) the degree of chronic inflammation by the degree of chronic inflammatory cells infiltration and degree of mucosal degeneration, and (3) bacteriologically for the presence ofH. pylori. The severity of the gastritis and the bacterial density were graded independently by two pathologists. The patients were assessed at two-month intervals for 12 months or until the ulcer relapsed. The results demonstrated that the relapse rates of duodenal ulcer were similar in the three treatment groups. The relapse rate was higher in the group with higher density of the bacteria (P〈0.05). The degree of gastritis did not affect the relapse rate of duodenal ulcer in either the placebo or misoprostol group or in all patients combined. Stepwise logistic regression analysis identified that increased duodenal inflammation, male sex, early-onset disease, andH. pylori adversely affected relapse of the ulcer. We conclude that multiple factors affect the relapse of duodenal ulcer andH. pylori is one of them.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01298869
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  • 3
    Electronic Resource
    Electronic Resource
    Is reduced release of gastrin the mechanism of ulcer healing after gastroenterostomy? (1977)
    Springer
    Digestive diseases and sciences 22 (1977), S. 397-401 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Until recently in this unit gastroenterostomy was the operation of choice for patients with duodenal ulcer whose maximal acid output (MAO) is less than 30 mmol/hr. Ulceration (jejunal) has recurred in only 2.1%. Unlike partial gastrectomy, which has a peak incidence of ulcer recurrence in the first two years, the incidence of ulcer recurrence remains constant throughout the years after gastroenterostomy. In looking for the explanation of this low recurrence rate we have studied the effect of the operation upon serum gastrin responses to standardized test meals 3 weeks and 26 weeks after operation in 9 patients. Nine normal subjects acted as controls. Six months after operation the responses were significantly lowered, a fall in the serum levels of gastrin at 30, 45, 60, and 90 min after meals suggesting that gastroenterostomy reduces both the gastric and intestinal phases of acid secretion. The mean integrated gastrin response (IGR) throughout the postprandial 90 min is also significantly lower 6 months after surgery. The overall mean reduction was 31.1%.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01071884
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  • 4
    Electronic Resource
    Electronic Resource
    Factors influencing healing of duodenal ulcer (1985)
    Springer
    Digestive diseases and sciences 30 (1985), S. 45-51 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To study the efficacy of a single bedtime dose of H2-receptor antagonist in the healing of duodenal ulcer, a 12-week randomized double-blind controlled trial of oxmetidine, which is equipotent to cimetidine and has a similar duration of action, was performed in 80 patients. Oxmetidine, 600 mg bedtime, resulted in significantly more complete healing than placebo at weeks 2, 4, 6, 8, 10, and 12 as assessed endoscopically. At weeks 4 and 6, 72.5% and 85%, respectively, of ulcers were completely healed by oxmetidine, and 36.8% and 41.7%, respectively, by placebo. Of 45 prospectively obtained patient characteristics, high pentagastrin-stimulated maximal acid output and large ulcer diameter significantly affected healing adversely. These results indicate that duodenal ulcer healing may be achieved by reducing the nocturnal acid secretion alone.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01318370
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  • 5
    Electronic Resource
    Electronic Resource
    Persistence ofCampylobacter pyloridis despite healing of duodenal ulcer and improvement of accompanying duodenitis and gastritis (1987)
    Springer
    Digestive diseases and sciences 32 (1987), S. 1255-1260 
    Details
    ISSN: 1573-2568
    Keywords: duodenal ulcer ; campylobacter ; duodenitis ; gastritis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Campylobacter pyloridis has been associated with antral gastritis and duodenal ulcer. To study the pathogenetic role of these organisms in duodenal ulcer, endoscopic biopsies, two from the first part of duodenum, four from antrum, and four from body and fundus, were taken before and after four weeks of cimetidine treatment (1.2 g/day) from 67 patients with active duodenal ulcer. The biopsies were examined for the presence and severity of any inflammation by two independent pathologists in the absence of any clinical information and for the occurrence and density ofCampylobacter pyloridis by culture and Warthin-Starry stain. Before treatment, inflammation was present in 71.1, 100, and 25.8%, while the organisms were present in 34.3, 91.0, and 79.1% of the duodenal, antral, and fundal biopsies, respectively. With complete healing of duodenal ulcer, inflammation was present in 48.9, 98.2, and 30.2%, while the organisms were present in 25, 76.7, and 63.3% of the respective mucosae. With ulcer healing, duodenitis became significantly milder (P〈0.05). With improvement of gastritis and duodenitis, there was no significant change in the occurrence and density ofCampylobacter pyloridis. These findings indicate that healing of duodenal ulcer is not influenced by the presence ofCampylobacter pyloridis, which is frequently found in the gastroduodenal mucosa of patients with duodenal ulcer, but does not appear to be associated with mucosal inflammation except in the antrum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01296375
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  • 6
    Electronic Resource
    Electronic Resource
    Rapid gastric emptying in duodenal ulcer patients (1982)
    Springer
    Digestive diseases and sciences 27 (1982), S. 598-604 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Isosmotic liquid peptone meals adjusted to pH 7, 3, and 1.5 were instilled on separate days into the stomachs of 8 duodenal ulcer patients and 7 healthy controls. Using a marker-dilution method, duodenal acid load (DAL) was measured as the amount of unbuffered hydrogen ions delivered to the duodenum per unit time. Gastric emptying was measured as the total volume of gastric contents, including meal plus gastric secretion, passing through the pylorus per unit time (VPP). Mean pentagastrin-stimulated acid output was not significantly different between the two groups. However, after all three test meals, mean DAL was significantly greater in duodenal ulcer than in normal subjects in both hours of the test, and VPP was significantly greater in ulcer than in normal subjects in the first 40 min. In both groups, following peptone meals of pH 7 and 3, the volume of gastric contents delivered through the pylorus decreased as the amount of free hydrogen ions entering the duodenum increased, but a given load of acid was less effective in slowing emptying in duodenal ulcer patients than in controls. These studies indicate that duodenal ulcer patients empty liquid meals more rapidly than do normal subjects, independent of the initial pH of the meals, and that, in addition, acid inhibition of gastric emptying is defective in duodenal ulcer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01297215
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  • 7
    Electronic Resource
    Electronic Resource
    Cholinergic inhibition and release of gastrin following insulin injection in duodenal ulcer before operation and after complete and incomplete vagotomy (1977)
    Springer
    Digestive diseases and sciences 22 (1977), S. 214-222 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In 50 duodenal ulcer patients acid and gastrin secretory responses were determined in the fasting state and after insulin hypoglycemia. Completeness of vagotomy was assessed by multiple criteria. In all three groups of patients studied, ie, the unoperated, the incomplete and the complete vagotomy groups, an initial gastrin inhibition was observed, the inhibition being minimal, moderate, and exaggerated, respectively. This inhibitory phase was followed by a significant rise in gastrin in the unoperated and the incomplete vagotomy groups, the rise being significantly higher in the latter. This rise was insignificant in those with complete vagotomy. The evidence suggests the presence of both an inhibitory and a releasing mechanism for gastrin release. The ratio of basal serum gastrin to postinsulin gastrin separates complete and incomplete vagotomy without overlap.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01072279
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  • 8
    Electronic Resource
    Electronic Resource
    Prostaglandin E1 (Misoprostol) overcomes the adverse effect of chronic cigarette smoking on duodenal ulcer healing (1986)
    Springer
    Digestive diseases and sciences 31 (1986), S. 68S 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Chronic cigarette smoking adversely affects duodenal ulcer healing despite treatment by potent gastric acid-reducing agents. Prostaglandins of the E series possess antisecretory and cytoprotective properties and theoretically offer advantages over existing therapeutic agents. A double-blind randomized study was performed to compare complete duodenal ulcer healing as assessed by endoscopies every two weeks for up to 12 weeks. Two hundred twenty-nine patients were randomized to receive misoprostol, an orally stable synthetic derivative of prostaglandin E1, in 200-μg or 300-μg qid dosages, or placebo. Life-table analysis showed that (1) both regimens of misoprostol were significantly more effective than placebo, achieving healing rates of 61% and 71%, respectively, at four weeks, and (2) cigarette smoking significantly impaired healing by placebo but not by misoprostol. In fact, the time-healing curves of smokers and nonsmokers on the higher dose of misoprostol completely overlapped. Furthermore, delayed treatment and large ulcer diameter adversely affected healing by misoprostol in smokers, whereas in nonsmokers, high basal and maximal acid output were unfavorable. Misoprostol is recommended for the treatment of duodenal ulcer, particularly in chronic smokers early in a given period of symptoms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01309326
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  • 9
    Electronic Resource
    Electronic Resource
    Reducing meal-stimulated acid secretion versus reducing nocturnal acid secretion for healing of duodenal ulcer (1989)
    Springer
    Digestive diseases and sciences 34 (1989), S. 1494-1500 
    Details
    ISSN: 1573-2568
    Keywords: duodenal ulcer healing ; meal-time cimetidine ; bedtime cimetidine ; acid
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Both meal-stimulated and nocturnal acid secretions have been shown to be abnormally increased in patients with duodenal ulcer. The relative efficacy of an acid-reducing regimen aimed specifically at controlling postprandial acid secretion compared with one that controls nocturnal acid secretion is, however, not known. The endoscopic healing rates at weeks 2, 4, 6, 8, 10, and 12 of three cimetidine regimens with identical total daily dose—bedtime (1200 mg), mealtime (400 mg three times a day with meals), and reference (200 mg three times a day with meals and 600 mg at bedtime)—were compared in a randomized study on 141 patients with endoscopically proven duodenal ulcer. Evaluating endoscopists were blinded to patients' form and duration of treatment and their clinical progress; patients were unaware of the comparative design of the study. Life-table analysis for the 12 weeks of observation revealed that the mealtime regimen resulted in significantly (P〈0.05) better healing rates than either the bedtime or the reference regimen. The differences were accounted for largely by the significantly (P〈0.04) better healing rate at two weeks with the mealtime regimen (68%) than with either the bedtime (47%) or the reference (45%) regimen. These findings indicate that a regimen that aims at controlling meal-stimulated acid secretion achieves a faster healing rate than one that aims at controlling nocturnal acid secretion in the treatment of duodenal ulcer, and they suggest that postprandial acid secretion plays a greater role than nocturnal acid secretion in the pathophysiology of this condition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01537099
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