[Protective effects of teprenone and gefarnate against taurocholate/hydrochloric acid-induced acute gastric mucosal lesions in rats].

To evaluate the effects of teprenone on acute gastritis, its inhibitory effects on gastric mucosal damage were compared to that of gefarnate in taurocholate/hydrochloric acid-induced acute gastric mucosal lesions in rats. After oral administration of 160 mM taurocholic acid and 250 mM hydrochloric acid, hemorrhage and erosion were macroscopically observed in the gastric mucosal surface layer. Edema in the submucosal tissue and decreased PAS staining in the mucosa were histomorphologically observed. Concerning macroscopic findings, pretreatment with teprenone at a dose of 50 mg/kg or more significantly reduced pathological changes in the mucosa of the fundic glandular area. However, gefarnate slightly inhibited these changes in at a dose of 50 mg/kg and significantly inhibited them at a dose of 200 mg/kg. With regards to histomorphological findings in the fundic glandular area, teprenone slightly inhibited erosion at a dose of 50 mg/kg, and it significantly and slightly inhibited the decrease in PAS staining in this area at doses of 50 and 200 mg/kg, respectively. Gefarnate at doses of 50 and 200 mg/kg showed significant inhibition of decreased PAS staining in the fundic glandular area. In the pyloric mucosa, decreased PAS staining was slightly inhibited by teprenone at both doses but not by gefarnate at either dose. The differences between teprenone and gefarnate observed in this model appear to be due to their differences in mucus production ability. These results suggest that teprenone was more effective than gefarnate for the treatment of gastritis.

A new method for evaluating gastric ulcer healing by endoscopic ultrasonography.

We observed the quantitative estimation of the transmural changes associated with gastric ulcer healing by using endoscopic ultrasonography (EUS). It was possible to diagnose the depth of ulcer by EUS. Forty-eight patients were divided into three treatment groups. Group A (n = 16) was treated with 800 mg cimetidine daily, group B (n = 22) with 20 mg omeprazole daily, and group C (n = 10) with 400 mg cimetidine + 300 mg gefarnate daily. EUS was performed before and after 2, 4, and 8 weeks of treatment. The groups were compared from the viewpoints of endoscopic findings and contraction rate of the length and the cross-sectional area of the ulcer in EUS pictures. The best healing of both the endoscopic and EUS findings was seen in group B. By estimating the changes inside the ulcer, EUS may provide useful information for choice of anti-ulcer agents.

A comparison of alprazolam, gefarnate and their combination in treatment of peptic ulcer patients--an application of life table analysis.

One hundred and thirty-nine patients with endoscopically confirmed peptic ulcers (gastric and duodenal) entered a double blind comparative evaluation of alprazolam (1.2 mg/day), gefarnate (300 mg/day) and their combination in treatment of peptic ulcer. Healing of ulcers was confirmed by endoscopic examinations. For evaluation of the treatment effect, the "life table" method was applied to the analysis of the data. The results revealed that ulcer healing with the combination was faster by two weeks than that with alprazolam or gefarnate alone. The difference did not reach the statistical significance in all the subjects who fulfilled the entry criteria. There was, however, a statistical difference between treatments in the patients having manifest psychic symptoms such as anxiety, insomnia and depressive mood (p less than 0.05 by generalized Kruskal-Wallis test and p less than 0.1 by Logrank test). The rate of patients who had psychic symptoms before entry and had not been cured of ulcers at the 4th week of treatment was 61% on the combination treatment as compared to 96% on the gefarnate treatment and 93% on the alprazolam treatment.