PubMed Health⌕ Search

Biomedical subjects

C M Jan

Publications and source records attributed to C M Jan.

At least 19 recordsLinked to original sources
PubMed2001

Prospective study of Helicobacter pylori eradication therapy in stage I(E) high-grade mucosa-associated lymphoid tissue lymphoma of the stomach.

PURPOSE: High-grade mucosa-associated lymphoid tissue (MALT) lymphomas of the stomach are generally believed to be Helicobacter pylori-independent, autonomously growing tumors. However, anecdotal cases of regression of high-grade lymphomas after the cure of H pylori infection had been described. The present prospective study was conducted to evaluate the effect of anti-H pylori therapy in stage I(E) high-grade gastric MALT lymphomas. PATIENTS AND METHODS: Sixteen patients with H pylori infection and stage I(E) gastric high-grade MALT lymphoma consented to a brief antibiotic therapy as first-line treatment from June 1995 through April 2000. Then, patients underwent intensive endoscopic follow-up examinations (+/- endoscopic ultrasonography) with biopsy to evaluate tumor response. Patients with significant improvement of gross lesions that accompanied regression of large cells were followed up without additional treatment. Patients without significant improvement were immediately referred to systemic chemotherapy. RESULTS: Eradication of H pylori was achieved in 15 patients and was accompanied by rapid gross tumor regression and disappearance of large cells in 10. All 10 of these patients with early response had subsequent complete histologic remission of lymphoma. The complete remission rate was 62.5% (95% confidence interval, 35.8% to 89.1%). The response rate was not affected by the tumor grading (proportion of large blast cells within the tumor) but was adversely affected by the depth of tumor invasion. At a median follow-up of 43.5 months (range, 21.1 to 67.4 months), all 10 of these patients remained lymphoma-free. The median duration of complete response was 31.2 months (range, 14.4 to 49.1 months). CONCLUSION: These results suggest that high-grade transformation is not necessarily associated with the loss of H pylori dependence in early-stage MALT lymphomas of the stomach.

Adult↗
PubMed2001

Comparison of MALT and non-MALT primary large cell lymphoma of the stomach: does histologic evidence of MALT affect chemotherapy response?

BACKGROUND: Although the clinicopathologic features of low grade gastric MALToma (lymphoma of mucosa-associated lymphoid tissue) recently have been well delineated, the significance of identifying histologic evidence of MALT origin in a primary high grade gastric lymphoma is less clear. The authors sought to address this issue and, in particular, to clarify if MALT and non-MALT primary large cell gastric lymphoma might have a different response to systemic chemotherapy. METHODS: The authors reviewed the pathologic specimens of all patients who had a diagnosis of primary large cell lymphoma of the stomach and who had been treated primarily by systemic chemotherapy in our institutions January 1, 1988-December 31, 1998. The patients were divided into two groups by experienced hematopathologists, based on the presence or absence of histologic features suggestive of MALToma, including typical lymphoepithelial lesions and infiltration of characteristic centrocyte-like cells. Disease staging was done according to the AJCC/UICC system with Musshoff modification. The median number of gastric biopsies for each patient was 7 (range, 1-21). RESULTS: Seventeen patients with and 26 patients without histologic evidence of MALToma were identified. Clinical features were similar between the two groups except that a greater proportion of patients without evidence of MALToma had elevated levels of serum lactate dehydrogenase (50% vs. 12%, P = 0.01). The median duration of follow-up for the 43 patients was 46.5 months (range, 17-124 mos). All patients received standard systemic chemotherapy including anthracyclines or anthracenedione. The response rate was 88.2% for patients with evidence of MALToma and 57.7% for those without (P = 0.03). The 5-year overall survival rate was 80.5% for patients with evidence of MALToma and 48.9% for those without (P = 0.02). Multivariate analysis indicated that response to chemotherapy, disease stage (Stage I and II-1 vs. Stage II-2, III, and IV), and the presence of MALToma features were independent prognostic factors for overall survival. CONCLUSION: The results of this relatively small study series suggested that the presence of histologic features of MALToma in patients with primary large cell gastric lymphoma might have been associated with a better response to systemic chemotherapy and a better prognosis. Further studies to consolidate this conclusion are necessary.

Adult↗
PubMed2001

Diagnosis of Helicobacter pylori infection by stool antigen test in southern Taiwan.

Helicobacter pylori (H. pylori) has been found to be associated with various gastrointestinal diseases. Confirmation of H. pylori infection includes invasive and non-invasive methods. There has been increasing interest in noninvasive tests recently. However, the geographical differences among H. pylori strains have been emphasized recently and the H. pylori strain in Taiwan showed a high cagA positive result and different vacA subtype when compared with those of Western countries. The aim of this study is to access and compare the reliability and the diagnostic accuracy of the stool H. pylori antigen tests by spectrophotometry and by the visual method, especially in Southern Taiwan. Thirty-two patients (18 men and 14 women; age range: 23-91 y/o, mean: 50.5 y/o) who underwent gastroendoscopy at Kaohsiung Medical University Hospital were enrolled in this study. H. pylori infection status was confirmed by culture or two positive test results on CLO test, histology and 13C-urea breath test (13C-UBT). The exclusion criteria included previous gastrointestinal tract surgery, use of antibiotics, proton pump inhibitor or compounds containing bismuth within 1 month of the study. Among them, 14 patients were with duodenal ulcer (DU), 4 with gastric ulcer (GU), 12 with non-ulcer dyspepsia, and 2 with GU and DU. Those patients had their stool collected for ELISA tests of H. pylori stool antigen (HpSA). The HpSA tests were positive in 16 of 18 patients diagnosed as H. pylori positive, and negative in 13 of 14 patients as H. pylori negative. The sensitivity and specificity were 88.9% and 92.9% respectively. The positive and negative predictive values were 94.1% and 86.7% respectively. The concordance of HpSA accessed by spectrophotometry and visual method is 100%, which makes this test even easier and cheaper. We concluded that stool HpSA test is a noninvasive, accurate, reliable, rapid and easy way to diagnose H. pylori infection in Southern Taiwan, either by spectrophotometry or by visual assessment.

Adult↗
PubMed2000

The association between Helicobacter pylori infection and functional dyspepsia in patients with irritable bowel syndrome.

OBJECTIVE: Irritable bowel syndrome (IBS) is associated with an exaggerated response to a variety of physiological and nonphysiological gastrointestinal stimuli. Many patients with IBS also have functional dyspepsia. Our aim was to examine the hypothesis that Helicobacter pylori (H. pylori) infection may predispose IBS patients to functional dyspepsia. METHODS: In 69 IBS patients, dyspeptic symptoms, H. pylori status, and sociodemographic and psychological variables (perceived stress, trait anxiety, and depression) were assessed. Sociodemographic and psychological variables were also evaluated in 52 control subjects. RESULTS: Mean scores for perceived stress (17.1 +/- 6.0 vs 14.9 +/- 6.0, p = 0.05), trait anxiety (45.6 +/- 9.1 vs 41.1 +/- 7.8, p = 0.004) and depression (9.9 +/- 8.4 vs 5.0 +/- 5.5, p = 0.0002) were higher in IBS patients than in controls. In all, 33 of the 69 patients (47.8%) had H. pylori infection, and this was associated with relevant symptoms of epigastric pain (odds ratio [OR] = 6.77, 95% confidence interval [CI] 1.89-24.3) and postprandial upper abdominal fullness (OR = 4.23, 95% CI 1.38-13.2). H. pylori infection and female gender were independent predictors of the presence of relevant dyspepsia (OR = 8.31, 95% CI 2.35-29.5 and 6.06, 95% CI 1.71-21.5, respectively). Symptom intensity was associated with the level of perceived stress (total relevant symptom number > or =3 vs <3, OR = 1.16 per point on a 40-point perceived stress scale, 95% CI 1.01-1.34). CONCLUSIONS: In IBS patients, the presence of dyspepsia is associated with H. pylori infection, female gender, and perceived stress.

Adult↗
PubMed2000

Simplified 13C-urea breath test for the diagnosis of Helicobacter pylori infection--the availability of without fasting and without test meal.

The conventional 13C-urea breath test (13C-UBT) for detecting Helicobacter pylori infection was performed during fasting state and with a test meal to delay gastric emptying during the test. For the convenience of propagating this test, we assessed the availability of non-fast and without test meal in 13C-UBT for the diagnosis of H. pylori infection. One hundred and five consecutive patients who received endoscopic examination were studied. All of them received endoscopic biopsy for urease test, culture and histopathology to determine whether there was a presence of H. pylori infection. Each patient received four separate 13C-UBT under the following four testing conditions. Test I) fasting state with test meal (100 ml fresh milk), Test II) non-fast (taking usual food) but with test meal, Test III) fasting state without test meal, and Test IV) non-fast and without test meal. The excess delta 13CO2 values were calculated via the breathed samples that were collected at 15 minutes after ingestion of 13C-urea. There were 61 H. pylori positive and 44 negative patients in this study, with an excess delta 13CO2 values 3.0, 4.0, 3.5 and 4.0 as a cut-off value in the four tests respectively, according to the ROC curve. The results of test I, a conventional procedure, had a good correlation with the gold standard. The sensitivity and specificity were 100% and 95% respectively. The alternative procedures in other tests also have high sensitivity and specificity at 15-minute detecting time. The sensitivity of the tests II, III and IV at 15-minute detecting times were 98%, 98% and 100%, and the specificities of those were 95%, 98% and 95% respectively. We therefore suggest that fasting and test meal possibly be omitted when the cut-off value is 4.0 per mil in the simplified 13C-UBT (non-fast and without test meal, and detection at 15 minutes after ingestion of 13C-urea) which is a simple and available procedure for clinical diagnosis of H. pylori infection.

Adult↗
PubMed1999

Endoscopic hydrogen peroxide spray may facilitate localization of the bleeding site in acute upper gastrointestinal bleeding.

BACKGROUND AND STUDY AIMS: A major problem encountered in the emergency endoscopic management of acute upper gastrointestinal (UGI) bleeding is poor localization of the bleeding site, which can be obscured by blood or clots. Traditional attempts to overcome this problem have been by physical methods, which have usually proved unsatisfactory. The aim of this prospective study was to show that hydrogen peroxide can be used as a dissolution agent, resulting in an alteration of the characteristics of blood clots and allowing a clearer visual field. PATIENTS AND METHODS: Twenty patients with acute UGI bleeding (13 male, seven female) were included in the study. The suspected site of bleeding was initially sprayed with 200 ml of saline and then with 25-175 ml of 3 % H2O2. Pictures of the visual field were taken before and after irrigation with both saline and H2O2. These pictures were evaluated by three gastroenterologists and scored using the following visual clearance scoring system: -3, marked worsening of visual field; -2, moderate worsening; -1, slight worsening; 0, no change; +1, slight improvement; +2, moderate improvement; + 3, marked improvement. In cases of active oozing or spurting, after initial hemostasis was achieved the bleeding point was injected with pure ethanol or cauterized with a heater probe. In order to assess the safety of 3 % H2O2 endoscopic biopsies of the antrum and the duodenal bulb were performed before and 30 minutes after its use and examined by a pathologist. RESULTS: There was a significant improvement in the mean visual clearance score after irrigation with H2O2 compared to irrigation with saline alone (2.13 vs. 0.43, P<0.001). During endoscopic examination there were 19 patients with active oozing from the ulcer base covered by an adherent blood clot; 12 of these (63.1%) achieved initial hemostasis after H2O2 spraying. Eleven of 18 (61.1 %) patients complained of a mild epigastric burning sensation during H2O2 irrigation. There was no clinically significant change in the histology of the antrum and the duodenal bulb after H2O2 therapy. CONCLUSIONS: We concluded that H2O2 is a safe and effective way to clear the visual field, facilitating the localization of the bleeding site during emergency endoscopy for acute UGI bleeding, with only mild side effects. In some cases H2O2 therapy can also induce temporary hemostasis. We recommended the use of hydrogen peroxide to improve endoscopic visualization, especially in cases where an adherent blood clot covers the suspected bleeding site.

Adult↗
PubMed1999

The hemodynamic changes of gastroduodenal regional blood flow after Helicobacter pylori eradication in patients with duodenal ulcer scar.

Duodenal ulcer (DU) is frequently accompanied by Helicobacter pylori (Hp) infection and associated with the imbalance of aggressive factors and defensive factors. To investigate the possible relationship between Hp and regional gastric blood flow, 26 endoscopically proved DU (scar stage) and Hp infection patients were included and received triple therapy (colloid bismuth subcitrate 120 mg qid for 4 weeks, amoxicillin 500 mg qid for 2 weeks and metronidazole 250 mg tid for 2 weeks). Regional gastroduodenal blood flow (RGDF) was measured at DU scar area and antrum lesser curvature site by laser Doppler flowmetry during endoscopic examination, before and one month after triple therapy. In 22 patients with Hp eradication the RGDF was significantly elevated at antrum lesser site after triple therapy (p < 0.05) but there was no difference at DU scar area. However, in 4 patients without Hp eradication no difference of RGDF in these two points was found. Therefore, Hp appears to have direct effects on gastric microcirculation.

Adult↗
PubMed1998

Quantification of Helicobacter pylori infection: Simple and rapid 13C-urea breath test in Taiwan.

The 13C-urea breath test (13C-UBT) is a non-invasive method for detecting Helicobacter pylori. This study was performed to determine the cutoff value and evaluate the sensitivity and specificity of 13C-UBT in Taiwan. 13C-Urea (100 mg of 99% 13C-labeled urea) was dissolved in 50 ml sterile water for the test. The test meal for delaying gastric emptying was 100 ml fresh milk. Patients fasted for at least 6h. A baseline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients ingested the 13C-urea. The test was evaluated in 352 patients after routine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. pylori. According to the receiver operating characteristic (ROC) curves, we chose values of 2.8 and 4.2 excess delta 13CO2 per mil as the cut-off values for 15 and 30 min, respectively, post 13C-urea. The sensitivity and specificity of 13C-UBT were 99% and 93% at 15 min, and 98% and 93% at 30 min post 13C-urea, respectively. The 13C-UBT breath test is an efficient non-invasive method of high sensitivity and high specificity for detecting H. pylori infection. We suggest that the use of fresh milk as the test meal and the detection of excess delta 13CO2 15 min after the ingestion of 13C-urea are suitable for the clinical use of 13C-UBT. This test is simple and rapid.

Adolescent↗
PubMed1996

High seroprevalence of IgG against Helicobacter pylori among endoscopists in Taiwan.

A prospective survey to investigate the seroprevalence of IgG against Helicobacter pylori among endoscopists in Taiwan was conducted by analyzing blood samples of 70 study subjects and 64 nonendoscopist physicians with quantitative ELISA. Personal information and the practices of infection control related to gastroscopy examination were obtained by a self-administered questionnaire. Significant differences were detected in the IgG prevalence between study and control subjects (80.0% vs 51.6%; P < 0.05). The serum level of antibody in endoscopists (385.2 +/- 36.1 unit/ml) was significantly higher than that of nonedoscopists (211.8 +/- 33.0 unit/ml; P = 0.018). Endoscopists performing 30 or more sessions of gastroscopy per week had higher seroprevalence than those performing less than 30 sessions (90.9% vs 70.3%; P = 0.0126). In conclusion, endoscopists in Taiwan had a high prevalence of H. pylori infection. The cause might be related to the frequency of gastroscopies performed.

Adult↗
PubMed1996

Computed tomography, endoscopic ultrasonography and intraoperative assessment in TN staging of gastric carcinoma.

In a prospective study from November 1989 to December 1993, the accuracy of computed tomography (CT), endoscopic ultrasonography (EUS) and intraoperative surgical assessment were compared for the evaluation of the depth of invasion (T category) and involvement of lymph nodes (N category) in patients with gastric carcinoma. Sixty-nine consecutive patients who received preoperative CT and EUS underwent subsequent surgery. CT and EUS results were compared with histopathologic staging of tumor invasion depth and regional lymph node metastasis (pT and pN categories). T categories were staged correctly in 42% of the cases by CT, 71% by EUS and 55% by intraoperative surgical assessment. CT correctly staged 49% of N1 and N2 lymph nodes compared with 65% for EUS and 45% for intraoperative surgical assessment. CT was more accurate for advanced cancer but had a tendency to understage the T and N categories. EUS was more accurate for serosal cancer and displayed a tendency to overstage T categories and understage N categories. Intraoperative surgical assessment overstaged early T stages, understaged the T4 stage and had a tendency to overstage N categories. CT and intraoperative surgical assessment of T and N categories were of limited value in the staging of gastric carcinoma compared to EUS. EUS is a valuable form of assessment to evaluate gastric cancer staging before surgery.

Adenocarcinoma↗
PubMed1996

Clinicopathologic study of gastric carcinoma with duodenal invasion.

Clinicopathologic features of 319 patients who underwent gastrectomy for adenocarcinoma of stomach were studied whether disease involved duodenum or not. Thirty-eight patients (11.9%) had duodenum invasion. Gastric carcinoma with duodenal invasion was most often Borrmann III or Borrmann IV (65.8%) type, with pylorous invasion by endoscopy (39.5%), large tumor size (73.7% > or = 5cm), lymph node metastasis (78.9%), serosal invasion (97.4%) and the incidence of the resection line not being free was high (13.2%). Duodenal invasion was most often (55.3%) direct through the deep layer or through lymphatics or venules. We need to pay more attention to finding duodenum invasion. More than 3 cm width of duodenal resection is recommended if duodenum invasion is suspected.

Adenocarcinoma↗
PubMed1995

Utility of Argyrophilic nucleolar organizer regions (AgNOR) in differentiating malignant from benign of colorectal tumors.

BACKGROUND: Argyrophilic nucleolar organizer regions (AgNOR) can reflect the activity of cellular proliferation. The purpose of this study is to evaluate the potential value of AgNOR in differentiating benign from malignant colon epithelial neoplasms, and to determine the correlation between the nucleus AgNOR and the grade of colonic adenocarcinomas. METHODS: In this study, AgNOR technique was applied to 61 paraffin embedded sections of colorectal tissue including normal mucosa (n = 10), adenomatous polyp (n = 16), and adenocarcinoma (n = 35). RESULTS: The mean +/- standard error (SE) numbers of AgNOR dots per nucleus of normal mucosa, adenomatous polyp, and adenocarcinoma were 2.17 +/- 0.07 (n = 10) 3.89 +/- 0.10 (n = 16) and 5.52 +/- 0.10 (n = 35), respectively (p < 0.00001). In addition, the mean numbers of AgNOR dots per nucleus of well differentiated (WD) adenocarcinoma (n = 14), moderately differentiated (MD) adenocarcinoma (n = 11) and poorly differentiated (PD) adenocarcinoma (n = 10) were 5.20 +/- 0.12, 5.81 +/- 0.20, 5.67 +/- 0.15, respectively. MD and PD tumor had significantly higher AgNOR count than that of WD tumor (p < 0.05). However, there was no significant difference between MD and PD colorectal adenocarcinoma. CONCLUSION: AgNOR method is a simple, rapid method in diagnosis of colorectal tumors, and it provides a useful adjunct to histopathology in the diagnosis of colorectal tumors.

Adenocarcinoma↗
PubMed1995

Does Helicobacter pylori infection play a role in the pathogenesis of non-ulcer dyspepsia--a study of gastric emptying time.

UNLABELLED: To investigate the relationship between gastric motility and Helicobacter pylori infection in patients with non-ulcer dyspepsia, 28 patients and 10 asymptomatic healthy persons underwent gastroduodenal endoscope examinations and scintigraphic test of solid phase gastric emptying time using Chinese fried rice as a test meal. Clinical symptoms were also recorded using questionnaires for scoring. Half emptying times for ingested food (t1/2) between H. pylori infected (190.86 +/- 112.53 minutes) and uninfected patients (227.69 +/- 179.29 minutes) were not different statistically. Seven of the 15 patients with H. pylori infection (46.6%) had delayed gastric emptying time (t1/2 > 197.7 minutes), compared to 4 out of 13 without infection (30.07%) (p > 0.05). There was also no association between the status of H. pylori infection and severity of clinical symptoms (total symptoms scores: H. pylori positive: 10.07 +/- 3.84; H. pylori negative: 7.62 +/- 2.25) (p > 0.05). Seven patients from whom H. pylori was found to have been eradicated using triple therapy (colloid bismuth subcitrate 120 mg q i d, tetracycline 500 mg q i d and metronidazole 250 mg q i d for 14 days) did not show significant changes in gastric emptying time (before: 171.14 +/- 128.13; after: 158.57 +/- 182.49 minutes) but showed improvement in total symptoms scores (before: 9.28 +/- 3.85; after: 3.85 +/- 4.22) (p = 0.0277). CONCLUSIONS: infection by H. pylori in patients with non-ulcer dyspepsia did not influence solid phase of gastric emptying time and was not associated with clinical symptoms. Eradication of H. pylori infection relieved the clinical symptoms of the patients with non-ulcer dyspepsia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Evaluation of the severity of Helicobacter pylori infection with urease test: its correlation with histopathology and bacterial density.

In 69 patients, the severity of Helicobactor pylori (H. pylori) infection was evaluated by bacterial density of tissue implants and inflammatory responses by histology. The specimens were taken from gastric angle and antrum (greater and lesser curvature sides) by gastroduodenal endoscopy. In urease test, the severity was measured in 3 grades according to color change of the agar: those change are within 30 minutes (grade 3), 30 minutes to 3 hours (grade 2), and 3 to 6 hours (grade 1), respectively; while the grade 0 indicated no color change occurring 6 hours after tissue inoculation. The severity of infection was assessed according to the bacterial density under high power microscopic fields (Gram's stain). Grade 0 indicated no bacterium seen; grade 1, only 1 to 10 bacteria at all fields; grade 2, 1 to 3 bacteria in each high power field; and grade 3 was 4 bacteria or more on average in each high power field. The degree of inflammatory response was evaluated by inflammatory cell infiltration (H & E stain) and classified into grade 0, 1 and 2, which indicated the inflammatory cell infiltration below 50%, between 50% and 75%, and above 75%, respectively. There are no positive relationships among urease test reaction time, bacterial density grading and degrees of inflammatory cell infiltration. Clinically, the reaction time of urease test cannot reflect the severity of H. pylori infection semi-quantitatively, either in terms of bacterial density or cellular inflammatory response.

Adult↗
PubMed1994

Reappraisal of gastroduodenal lesions after transcatheter arterial chemoembolization of liver neoplasms--selective versus superselective method.

Twenty-six patients with liver neoplasm receiving transcatheter arterial chemoembolization (TAE) therapy underwent gastroduodenal endoscopic examinations before and after TAE. The balloon was inflated in the common hepatic artery before chemoembolization if superselective cannulation beyond the gastroduodenal artery could not be done. Sixteen of the 26 patients (61.5%) showed new gastroduodenal lesions, with superficial gastritis in six, one or more erosions in nine, and hemorrhagic gastritis in five. The frequency of lesions detected was no different when the common hepatic artery was obstructed (60.0%) than when superselective embolization was done in more peripheral branch(es) (60.0%). No clinical events indicating upper gastrointestinal bleeding were noticed after TAE. The presence of esophageal and/or gastric varices and session(s) of TAE performed before did not affect the occurrence of gastroduodenal lesion(s). We conclude that TAE produces erosive gastroduodenal lesions that are detected by endoscopic examination but are clinically unimportant; balloon catheter occlusion of the common hepatic artery did not result in more frequent gastroduodenal complications than the ordinary superselective chemoembolization method.

Adult↗
PubMed1994

Long-term follow-up and serological study after triple therapy of Helicobacter pylori-associated duodenal ulcer.

OBJECTIVE: The purpose of this study was to monitor the change of IgG antibodies to Helicobacter pylori during the course of a long-term follow-up after the eradication of H. pylori, as well as to evaluate the efficacy of triple therapy in preventing the recurrence of duodenal ulcer (DU). METHODS: Twenty-three DU patients with positive H. pylori were studied; among those patients, 20 ulcers healed after initial treatment of triple therapy. Each patient received a follow-up endoscopy and biopsy examination every 3 months for 1 yr, or whenever the ulcer symptoms recurred. Serological tests for IgG antibodies were performed with a commercial ELISA. RESULTS: Of the 20 patients with healed ulcers, one dropped out of this study; the recurrence rate of DU at 1 yr was 5% (1/19). There was no recurrence of ulcer in 17 H. pylori-negative patients and only one recurrence out of two H. pylori-positive patients. After the eradication of H. pylori, the seroconversion rates of IgG were 5%, 21%, 42%, 76%, and 94% at 0, 3, 6, 9, and 12 months, respectively. After 6 months, 95% (18/19) of the patients in which H. pylori was eradicated had at least a one-grade fall in IgG titers (p < 0.001). One patient had a relapse of H. pylori which was accompanied with re-elevating IgG titers. CONCLUSIONS: We conclude that seroconversion, which usually occurs after 1 yr, indicates complete eradication of H. pylori. Furthermore, we suggest that the success of the eradication of H. pylori can be judged without endoscopic examination, 8 months after treatment by triple therapy, according to the fall of IgG titers or seroconversion. Re-elevating IgG titers may be a warning of the possibility of relapse or reinfection of H. pylori.

Anti-Ulcer Agents↗
PubMed1993

Eradication of Helicobacter pylori infection and the recurrence of duodenal ulcers.

The purpose of this study was to compare the performance of different regimens on Helicobacter pylori (H. pylori) eradication and duodenal ulcer recurrence. During a four-week period, 59 patients with duodenal ulcers who were positive for H. pylori infection were randomly treated with one of three regimens. Seventeen patients were treated with ranitidine, 19 with colloidal bismuth subcitrate (CBS), and 23 with triple therapy (CBS, tetracycline and metronidazole). Forty-six patients with healed ulcers after treatment received follow-up for six months without maintenance therapy. The recurrence rates of duodenal ulcers confirmed by endoscopy in these three groups were 64%, 33% and 0% at the third month, and 73%, 67% and 5% at the sixth month, respectively. In the ranitidine therapy group, H. pylori infection was still present at the final follow-up. In the CBS therapy group, H. pylori was suppressed initially, but recurred in all cases. In the triple therapy group, there was only one case in which H. pylori infection persisted and where ulcer recurrence occurred after 3.5 months. The remaining cases were all H. pylori negative and had no recurrence of duodenal ulcers during the six months of follow-up. Overall, 19/27 (70%) patients positive for H. pylori had a recurrence of duodenal ulcers, while none of the 19 patients who were negative for H. pylori had a recurrence of ulcers at the sixth month. This study shows that triple therapy is more effective than the other two regimens in the eradication of H. pylori and in reducing the recurrence of ulcers. H. pylori may play a role in the recurrence of the duodenal ulcer.

Adolescent↗