Résumé
BACKGROUND: Helicobacter pylori (H. pylori) can now be eradicated in the majority of patients with 7 days of treatment with OAC (omeprazole+amoxicillin+clarithromycin) regimen. It is unclear if additional acid-suppressing treatment should be continued beyond 7 days in patients with active gastric or duodenal ulcers. METHODS: Ninety two patients with endoscopically proven active peptic ulcers who were H. pylori positive were randomized to receive either omeprazole 20 mg plus amoxicillin 1.0g plus clarithromycin 500mg ; twice daily for 1 week alone (OAC group) or same regimen followed by 3 weeks of omeprazole (OACP group). Endoscopy and UBT (urea breath test) were performed 8 weeks after the initiation of treatment. RESULTS: Forty four of forty five (97.8%) of OAC group and forty four of forty seven (93.6%) of OACP group were noted to have healed ulcer at week 8. CONCLUSION: In patients with H. pylori infection and peptic ulcers, one week of OAC therapy without further need for PPI may heal the ulcers. Following an l week course of H. pylori eradication therapy by OAC for peptic ulcers, further 3 weeks of acid-suppressing therapy with PPI was not proven to promote ulcer healing rate.
Sujets)
Humains , Amoxicilline , Clarithromycine , Ulcère duodénal , Endoscopie , Helicobacter pylori , Helicobacter , Oméprazole , Ulcère peptique , UlcèreRésumé
BACKGROUND/AIMS: Gastric carcinoma is the most common malignant neoplasm in Korea and is known to be associated with intestinal metaplasia (IM) of gastric epithelium, of which type III IM is suggested to play a special role in the carcinogenesis. This study is to evaluate the subtypes of IM and to measure each subtype in chronic gastritis. Methods: From October 1997 to September 1999, 321 patients with endoscopic chronic gastritis were evaluated the grade of chronic gastritis and IM by histologic and histochemical stain. RESULTS: Chronic inflammation and IM were remarkably severe in men and Helicobacter pylori (H. pylori) positivity was 69.4% in men and 65.2% in women. The frequency of IM was 50.1%, of which 65.4% was in men and 34.6% in women. The frequency of IM subtypes was 43.2%, 11.7% and 45.1% for type I, II and III respectively. Sixty percent of IM was noted in more than 50 years of age and ninety percent in more than 40 years of age. The frequency of type III IM was 61.6% in men and 38.4% in women. Sixty one percent of type III IM was noted in more than 50 years of age and ninety percent in more than 40 years of age. Interestingly, fifty three percent of type III IM was noted in men more than 40 years of age. The prevalence of H. pylori infection in type III IM was similar to in type I and II. The glandular atrophy in type III IM was remarkably severe than that in type I and II. Conclusions: The results of this study show that the proportion of type III IM in chronic gastiritis is remarkably high in Korean and age and sex distribution is similar to that of gastric carcinoma.
Sujets)
Femelle , Humains , Mâle , Atrophie , Carcinogenèse , Épithélium , Gastrite , Helicobacter pylori , Inflammation , Corée , Métaplasie , Prévalence , Répartition par sexeRésumé
BACKGROUND/AIMS: Colonic actinomycosis is a rare disease with clinical and radiographic findings that overlap those of other inflammatory and neoplastic conditions. We performed this study to analyze clinical manifestation, characteristic radiologic findings of 5 cases of abdominal actinomycosis, which was initially diagnosed as a colorectal cancer or periappendiceal abscess. METHODS: We analyzed chief complaint, predisposing factor, presence of leukocytosis and sulfur granule, involved site, presence of LN involvement and abdominal CT findings, retrospectively. RESULTS: The most common clinical manifestation was abdominal pain. In 3 cases, predisposing factors were identifiable, which were intrauterine contraceptive device (IUD), previous appendectomy, and diabetes mellitus (DM) respectively. Leukocytosis was noted in 4 cases (80%) and sulfur granule in all 5 cases. Sigmoid colon was the most common involved site (4 cases) followed by appendix and rectum. On computed tomography, inhomogeneous mass or severe inflammation along the bowel wall or serosa was noted. Explorations were performed in 4 cases. Preoperative diagnosis was a colorectal cancer in 3 cases and periappendiceal abscess in 1 case. CONCLUSIONS: Actinomycosis should be born in mind in the differential diagnosis of patients with IUD, previous appendectomy and DM, presenting leukocytosis and CT finding of inhomogeneous mass and relatively uncommon LN involvement to eliminate unnecessary explorations.