Effects of lansoprazole plus amoxycillin on the cure of Helicobacter pylori infection in Japanese peptic ulcer patients.

AIM: The effect of lansoprazole plus amoxycillin on curing Helicobacter pylori infection and peptic ulcer recurrence was evaluated. METHOD: The study group was composed of 68 patients with gastric ulcers and 51 with duodenal ulcers, all were H. pylori-positive. The participants were assigned at random to the lansoprazole alone group (lansoprazole 30 mg o.m. for 6 or 8 weeks) or the lansoprazole plus amoxycillin group (lansoprazole alone regimen plus amoxycillin at 500 mg q.d.s. concomitantly for the first 2 weeks). Healed patients were not given maintenance treatment with acid secretion inhibitors. The cure rate for H. pylori infection and the ulcer recurrence rate after 1 year were investigated. RESULT: The cure rate for H. pylori infection was 4.2% in patients receiving lansoprazole alone and 38.5% in patients receiving lansoprazole plus amoxycillin (P < 0.01) for gastric ulcers, and 0% in patients receiving lansoprazole alone and 61.9% in patients receiving lansoprazole plus amoxycillin (P < 0.001) for duodenal ulcers. The recurrence rate was 42.3% in patients receiving lansoprazole alone and 28.6% in patients receiving lansoprazole plus amoxycillin for gastric ulcers, and 66.7% for patients receiving lansoprazole alone and 11.1% for patients receiving lansoprazole plus amoxycillin (P < 0.001) for duodenal ulcers. None of the patients with gastric or duodenal ulcers cured of H. pylori infection had a recurrence. CONCLUSION: Concomitant use of lansoprazole and amoxycillin increased the curative effects on H. pylori infection. However, the cure rates with this regimen remained inadequate.

Synthesis of N-acetylglucosaminides of unconjugated and conjugated bile acids.

3-N-Acetylglucosaminides of unconjugated, glycine- and taurine-conjugated bile acids have been synthesized. Bile acids appropriately protected were condensed with acetochloroglucosamine through the 3 alpha-hydroxyl group by means of the Koenigs-Knorr reaction using cadmium carbonate as a catalyst. Subsequent borohydride reduction and/or alkaline hydrolysis provided desired 3-N-acetylglucosaminides of unconjugated bile acids. Glycine-conjugates were obtained from N-acetylglucosaminides of unconjugated bile acids and ethyl glycinate by the carbodiimide method. The preparation of N-acetylglucosaminides of taurine-conjugates was attained by the Koenigs-Knorr reaction of bile acid p-nitrophenyl esters followed by condensation with taurine. 7-N-Acetylglucosaminides of ursodeoxycholates were prepared in a similar fashion. The convenient synthesis of 3-N-acetylglucosaminides of unconjugated bile acids is also described.

Inclusion complexes of Fe(III) tetrakis(4-sulfonatophenyl)porphyrin with cyclodextrins in aqueous solutions.

In aqueous solutions, inclusion complexation of Fe(III) tetrakis(4-sulfonatophenyl)porphyrin (FeTSPP) with alpha-cyclodextrin (alpha-CD), beta-CD, gamma-CD, and heptakis(2,3,6-tri-O-methyl)-beta-CD (TM-beta-CD) has been examined by means of absorption and induced circular dichroism spectroscopy. FeTSPP has been found to form inclusion complexes with beta-CD, gamma-CD, and TM-beta-CD in pH 3.2 buffers. At pH 10.1, where FeTSPP self-associates to form an oxo-bridged dimer, FeTSPP also forms inclusion complexes with alpha-CD, beta-CD, gamma-CD, and TM-beta-CD. The stoichiometries of the CD-FeTSPP inclusion complexes are 1:1, except for TM-beta-CD in pH 10.1 buffers where its 1:1 inclusion complex associates with TM-beta-CD to form a 2:1 inclusion complex at high TM-beta-CD concentrations. Equilibrium constants of FeTSPP for the formation of the 1:1 inclusion complexes have been evaluated for beta-CD, gamma-CD, and TM-beta-CD. Induced circular dichroism spectra of FeTSPP in alpha-CD and beta-CD solutions exhibit a signal pattern (a negative sign) that is different from those in acidic and basic solutions containing gamma-CD and that in basic solution containing TM-beta-CD, suggesting different inclusion modes towards FeTSPP.

Role of Helicobacter pylori in chronic gastritis: a prospective study.

We conducted a prospective study to evaluate the relationship between Helicobacter pylori infection and chronic gastritis in a Japanese population. H. pylori was found in 67% of patients positive for mononuclear cell (MN cell) infiltration and in 75.8% of patients positive for polymorphonuclear cell (PMN cell) infiltration, whereas H. pylori was found in 14.2% of patients without MN cell infiltration and in 33.2% of patients without PMN cell infiltration. The frequency of MN and PMN cell infiltration in H. pylori-positive patients was significantly higher than that in H. pylori-negative patients. The frequency of H. pylori infection did not differ in those with atrophic gastritis from those without, whereas the frequency of intestinal metaplasia became significantly higher in those with moderate and severe atrophy. There was no significant difference between serum pepsinogen I (PG I) levels in H. pylori-positive and -negative patients. However serum PG II levels were significantly increased in H. pylori-positive patients aged 40-69 years. The serum PG I-II ratio was significantly lower in H. pylori-positive patients aged 40-59 years. These results suggest that H. pylori infection in the gastric mucosa plays an important role in the pathogenesis of chronic and atrophic gastritis and in the development of intestinal metaplasia.