Sequential Therapy for Helicobacter pylori Infection in Korea: Systematic Review and Meta-Analysis

BACKGROUND/AIMS: Sequential therapy (ST) for Helicobacter pylori infection in countries other than Korea has shown higher eradication rates than triple therapy (TT). The aim of this study was to evaluate the efficacy of ST in Korea by performing a meta-analysis. METHODS: We performed a comprehensive literature search on the efficacy of ST as a first-line therapy. The odds ratios (ORs) of eradicating H. pylori infection after ST compared with TT were pooled. Pooled estimates of the eradication rates of ST and TT were also calculated. RESULTS: A total of six studies provided data on 1,759 adult patients. The ORs for the intention to treat (ITT) and the per-protocol (PP) eradication rate were 1.761 (95% confidence interval [CI], 1.403 to 2.209) and 1.966 (95% CI, 1.489 to 2.595). Pooled estimates of the ITT and PP eradication rate were 79.4% (95% CI, 76.3% to 82.2%) and 86.4% (95% CI, 83.5% to 88.8%), respectively, for the ST group, and 68.2% (95% CI, 62.1% to 73.8%) and 78.9% (95% CI, 68.9% to 81.7%), respectively, for the TT group. CONCLUSIONS: Although ST presented a higher eradication rate than TT in Korea, the pooled eradication rates were lower than expected. Further studies are needed to validate ST as a first-line treatment for H. pylori in Korea.

Recent Trends of Helicobacter pylori Eradication Therapy in Korea

Helicobacter pylori infection is one of the most common gastrointestinal infectious diseases in Korea and is related to diseases such as gastritis, peptic ulcer disease, marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type, and gastric adenocarcinoma. The eradication of H. pylori infection requires combinations of antibiotics and acid suppressants. Triple therapy has been considered as the first-line therapy for a long time. However, its eradication rate is declining and we need more effective strategies. Quadruple therapy including acid suppressants, bismuth, and other two antibiotics is a main rescue therapy after first-line therapy failure in Korea. In this review, we describe new therapeutic regimens and new trends of H. pylori eradication in Korea.

Recent Trends of Helicobacter pylori Eradication Therapy in Korea

Helicobacter pylori infection is one of the most common gastrointestinal infectious diseases in Korea and is related to diseases such as gastritis, peptic ulcer disease, marginal zone B cell lymphoma of mucosa-associated lymphoid tissue type, and gastric adenocarcinoma. The eradication of H. pylori infection requires combinations of antibiotics and acid suppressants. Triple therapy has been considered as the first-line therapy for a long time. However, its eradication rate is declining and we need more effective strategies. Quadruple therapy including acid suppressants, bismuth, and other two antibiotics is a main rescue therapy after first-line therapy failure in Korea. In this review, we describe new therapeutic regimens and new trends of H. pylori eradication in Korea.

The Number of Endothelial Progenitor Cells is Decreased in Patients With Non-Dipper Hypertension

BACKGROUND AND OBJECTIVES: Circulating endothelial progenitor cells (EPCs) play a key role in the maintenance of endothelial homeostasis and promote vascular repair. A reduced number of EPCs and the functional activity have been associated with several cardiovascular risk factors. However, the relationship between the number of EPCs and circadian rhythm of the blood pressure (BP) remains unclear. The purpose of the present study was to evaluate the relationship between the circadian rhythm of the BP and EPCs in patients with essential hypertension. SUBJECTS AND METHODS: A total of 45 patients with essential hypertension who were newly identified by outpatient BP measurements, underwent 24-hour ambulatory BP monitoring. Among the 45 patients with essential hypertension, 20 were classified as dippers (12 men and 8 women; mean age 48+/-14 years) and 25 as non-dippers (14 men and 11 women; mean age 52+/-18 years). The EPC count was isolated from the peripheral bloodstream and quantified by flow cytometry. RESULTS: The baseline clinical characteristics were similar between the dipper and non-dipper hypertensive patients. The circulating EPCs were statistically reduced in the non-dipper patients as compared to the dippers (104+/-60 vs. 66+/-47 EPCs per 106 mononuclear cells, p=0.027). The circulating EPC level correlated positively with the circadian changes in the systolic and diastolic BP (r=0.435, p=0.003, and r=0.310, p=0.038, respectively). CONCLUSION: The present study demonstrated that the EPC count was reduced in the peripheral bloodstream in non-dipper hypertensive patients.

A Case of Lupus-Related Hepatitis Mimicking Autoimmune Hepatitis / 대한내과학회지

Patients with systemic lupus erythematosus (SLE) have a 25% to 50% incidence of abnormal findings on liver function tests. The main causes of abnormal liver function in patients with SLE are viral hepatitis, drug-induced toxic hepatitis, and fatty liver. However, hepatic involvement due to the pathogenic process of SLE is rare. In such conditions, lupus-related hepatitis must be distinguished from autoimmune hepatitis, which is a type of primary liver disease characterized by similar clinical manifestations and autoimmune profiles. Relationships between hepatic involvement of SLE and autoimmune hepatitis remain to be elucidated. We report a case of lupus-related hepatitis mimicking autoimmune hepatitis.