A prospective randomized trial of lafutidine vs rabeprazole on post-ESD gastric ulcers.

AIM: To compare the effects of rabeprazole and lafutidine on post-endoscopic submucosal dissection (ESD) gastric ulcers. METHODS: Patients with gastric tumors indicated for ESD were prospectively studied. After ESD, all patients were treated with intravenous omeprazole for the first 3 d. Patients were then randomly assigned to oral lafutidine or rabeprazole. Ulcer size, ulcer size reduction rate, and ulcer stage were evaluated 4 wk later. Occurrence of complication was monitored throughout the 4-wk period. RESULTS: Sixty five patients were enrolled in the study, and 60 patients were subjected to the final analysis. In the lafutidine group (30 lesions in 29 patients), initial and 4-wk post-ESD ulcer sizes were 33.3 ± 9.2 and 10.5 ± 4.8 mm, respectively. In the rabeprazole group (34 lesions in 31 patients), the values were 34.7 ± 11.3 and 11.8 ± 6.7 mm, respectively. Ulcer size reduction rates in lafutidine and rabeprazole groups were 32.3% and 33.5%, respectively (P = 0.974). Ulcer stage 4 wk post-ESD did not differ significantly between the two groups (P = 0.868). Two cases in the rabeprazole group and no cases in the lafutidine group developed ulcer bleeding during the oral dose period, although the difference of bleeding rate between the two groups was not statistically significant (P = 0.157). CONCLUSION: Lafutidine and rabeprazole have equivalent therapeutic effects on post-ESD gastric ulcers.

Magnetic resonance imaging in case of cortical apex syndrome caused by varicella zoster virus.

We present a case of orbital apex syndrome that developed after a re-activation of varicella zoster virus. The magnetic resonance imaging showed signs of a diffuse inflammation of the ipsilateral orbital cavity, external ocular muscles and optic nerve. Pattern visually evoked cortical potentials were non-recordable by stimulating the affected eye.

Effect of chronic hyperglycemia on intraocular pressure in patients with diabetes.

PURPOSE: To investigate the effect of chronic hyperglycemia on intraocular pressure (IOP) in patients with diabetes. DESIGN: Cross-sectional study. METHODS: We prospectively measured the IOP by Goldmann applanation tonometry in patients with diabetes with mild hyperglycemia (glycosylated hemoglobin A1c (HbA1c) < or = 6.5%), moderate hyperglycemia (6.5% < HbA1c < 8.0), and severe hyperglycemia (HbA1c > or = 8.0%). None of the patients with diabetes had diabetic retinopathy, secondary glaucoma, ocular or laser therapy, or history of glaucoma. The HbA1c level determined within three months of the IOP measurement was used. Statistical analysis was performed by Mann-Whitney U test. P < .05 was considered significant. RESULTS: The mean IOP in the mild group (n = 58) was 15.5 +/- 2.5 mm Hg, which was statistically significantly lower than that of the severe group (16.6 +/- 2.4 mm Hg; P = .013; n = 60). CONCLUSIONS: Chronic hyperglycemia is associated with increased IOP in patients with diabetes.

Macular and retinal nerve fiber layer thickness in Japanese measured by Stratus optical coherence tomography.

The purpose of this study was to determine the thickness of the macula and the retinal nerve fiber layer (RNFL) in Japanese subjects by Stratus optical coherence tomography (OCT), and to compare the findings with the normative data of subjects from the United States of America (USA). Sixty-one eyes from 31 healthy subjects were used for the measurement of the macular thickness, and 60 eyes from 30 healthy subjects were used for the RNFL thickness measurements. The values obtained from the Japanese subjects were compared with the corresponding values in healthy subjects from the USA. The superior, nasal, temporal, and inferior macular sectors and the mean and inferior areas of the RNFL in the Japanese subjects were significantly thicker than the corresponding areas of normal subjects in the USA (272 +/- 13 vs 255 +/- 17 mum, 274 +/- 12 vs 267 +/- 16 mum, 262 +/- 12 vs 251 +/- 13 mum, 268 +/- 13 vs 260 +/- 15 mum; p < 0.0001, 104 +/- 11 vs 100 +/- 12 mum, 134 +/- 20 vs. 126 +/- 18 mum; p = 0.0167, 0.0047, respectively). In conclusion, the significantly thicker macular regions and RNFL in the Japanese indicate not only that there are racial differences in retinal thicknesses but also that the normative values provided by the Stratus OCT should not be used for different races.