Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Healing-promoting actions of KU-1257 (N-ethyl-N'-[3-[3-(piperidinomethyl)phenoxy]propyl]urea, CAS 120958-90-9) were investigated in chronic gastric and duodenal ulcer models induced by acetic acid in rats and the effects were compared with those of famotidine and roxatidine acetate by gross or histological evaluation. KU-1257 markedly promoted the well-balanced healing of gastric ulcer at oral doses of 10-50 mg/kg x 2/day, as evidenced by the reduction of ulcer, regeneration of mucosa and proliferation of connective tissue. KU-1257 caused an increase in gastric mucus secretion in the regenerated mucosa around the gastric ulcers. Famotidine and roxatidine acetate failed to promote the healing of gastric ulcers even at 100 mg/kg x 2/day p.o. KU-1257 also significantly accelerated the healing of acetic acid-induced duodenal ulcers as well as famotidine and roxatidine acetate. These results indicate that KU-1257 is characterized by a potent promoting action on the healing of chronic ulcers, suggesting that the increase in gastric mucus secretion might be associated with the antiulcer actions of KU-1257 in part.
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PMID:Healing-promoting action of the new histamine H2-receptor antagonist N-ethyl-N'-[3-[3-(piperidinomethyl)phenoxy]propyl]urea with dual action on chronic gastric and duodenal ulcers induced by acetic acid in rats. 809 34

The in vitro effect of urea and hydrolysis of urea by urease on mucus H+ permeability is reported here. The effective DHCl values indicate a strong pH dependence for H+ diffusion in both water and mucus layers, with no apparent trend at concentrations between 1 and 50 mM urea. However, the estimated DHCl at near-neutral and alkaline pH are 4- to 10-fold lower through mucus than through aqueous films. Moreover, the pKa values of HCO3- and NH3 (generated by urease action on urea) had a profound effect on measured DHCl. These in vitro studies suggest that a high local concentration of NH3 and HCO3- within the mucus layer, generated by the action of Helicobacter pylori urease on endogenous intragastric urea, could greatly accelerate proton flux to the surface epithelium by operation of a buffer shuttle. This results in enhanced H+ permeability, particularly at pKa values of HCO3- and NH3, and in extreme circumstances it may result in gastric ulcer formation.
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PMID:An in vitro study of enhanced H+ diffusion by urease action on urea. Implications for Helicobacter pylori-associated peptic ulceration. 826 22

We analyzed 321 consecutive episodes of community-based acute upper gastrointestinal bleeding admitted to the Hadassah University Hospital in Jerusalem during 1988-91. Of these 71% were in males aged 56.2 +/- 1.2 years (mean +/- SE) and 29% were in females (67.9 +/- 1.7 years, P < 0.001). The main diagnoses were duodenal ulcer (39.5%), gastric ulcer (16.9%), esophageal varices (10.0%), erosive gastritis (8.2%) and esophagitis (7.5%). The distribution of these diagnoses differed significantly between the genders (P = 0.0003). In males the prevalence of duodenal ulcer and of esophageal varices was higher, and that of gastric ulcer and esophagitis lower, than in females. Gastric ulcer patients were oldest, were the least likely to have received anti-ulcer medications prior to admission, and had the highest levels of urea and the lowest levels of hemoglobin on admission. Use of nonsteroidal anti-inflammatory drugs increased significantly with age and was reported in 35% of the cases (aspirin in doses < 1.0 g/day in 21%, nonsalicylate anti-inflammatory agents in 11%, aspirin plus other anti-inflammatory drugs in 3%). Use of systemic corticosteroids was reported in 4%. The most distinctive features of the population with acute upper gastrointestinal bleeding in the present study compared to other series were the significantly higher proportion of duodenal ulcers and the lower proportion of Mallory-Weiss tears.
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PMID:Acute upper gastrointestinal bleeding in Jerusalem 1988-91: causes, characteristics and relation to nonsteroidal anti-inflammatory drugs. 831 97

The role played by Helicobacter pylori in the pathogenesis of peptic ulcer disease (PUD) is discussed, and the epidemiology, identification, diagnosis, eradication, and treatment of H. pylori infection are reviewed. Isolation of H. pylori from up to 100% of patients with duodenal ulcer and 80% of patients with gastric ulcer establishes a strong association between H. pylori and idiopathic PUD, although other factors also may be essential for the development of PUD. Invasive procedures for diagnosis of H. pylori infection include upper endoscopy and biopsy of gastroduodenal tissues followed by culture or the rapid urea test; noninvasive tests include the urea breath tests and serology. Although H. pylori is susceptible to a number of antimicrobials, eradication (as opposed to suppression) of this organism has been a major challenge. The most important predictive factor for clinical and microbiological efficacy is the pretreatment susceptibility of H. pylori to nitroimidazoles. Triple therapy with bismuth, metronidazole, and either amoxicillin or tetracycline has resulted in better clinical and microbiological outcomes than either monotherapy or dual therapy. Possible adverse effects of this regimen include nausea, vomiting, taste disturbance, and diarrhea. Anti-H. pylori therapy should be reserved for those patients who have recurrent symptomatic or intractable PUD. Currently, the regimen of choice includes bismuth, metronidazole, and either amoxicillin or tetracycline given for at least two weeks.
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PMID:Helicobacter pylori and peptic ulcer disease. 842 32

Duodenal ulcer recurrence and gastritis are reduced with successful Helicobacter pylori treatment. To identify the patient factor influencing H. pylori eradication, we prospectively evaluated 96 consecutive patients undergoing a single 2-wk course of bismuth, tetracycline, and metronidazole therapy. At the time of initial esophagogastroduodenoscopy with biopsies, each patient had a profile obtained which included demographic information, gastrointestinal pathology, and H. pylori status of the spouse. Elimination of H. pylori was confirmed by repeat esophagogastroduodenoscopy with biopsies 4 wk after the completion of therapy and serial urea breath tests. Eradication at 4 wk was successful in 80 of 96 (83%) patients. On multivariate analysis, H. pylori elimination was associated with advanced age (p = 0.002) and a greater amount of chronic inflammation on baseline antral biopsy (p = 0.024). Eradication was inversely associated with the presence of a gastric ulcer (p = 0.008) and lack of medication compliance (p = 0.030). Successful eradication reduced the severity of both acute and chronic antral mucosal inflammation. Household income, gender, ethnic group, smoking, alcohol intake, and H. pylori status of the spouse did not differ between the eradicated and noneradicated groups. We conclude that it will be important to control for influential patient factors in future studies of H. pylori treatment regimens.
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PMID:Patient factors affecting Helicobacter pylori eradication with triple therapy. 847 Jun 29

The in vitro effect of ammonium bicarbonate buffer on mucus H+ permeability is reported here. The diffusional resistance of mucus and water was demonstrated to be dependent on buffer concentration, and the contrast between the two types of layers was most pronounced for low buffer concentration near neutrality. Moreover, the pKa values of HCO3- and NH3 had a profound effect on measured DHCl. These in vitro studies suggest that a potentially damaging high local concentration of NH3 and HCO3- within the mucus layer generated by the action of Helicobacter pylori urease on endogenous intragastric urea could greatly accelerate proton flux to the surface epithelium by operation of a buffer shuttle. This results in enhanced H+ permeability, particularly at pKa values of HCO3- and NH3, and that in extreme circumstances this may result in gastric ulcer formation.
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PMID:Enhanced H+ diffusion by NH4+/HCO3-: implications for Helicobacter-pylori-associated peptic ulceration. 851 85

Many diagnostic methods have been developed and used for detecting Helicobacter pylori to evaluate the success of treatment of H. pylori infection. We investigated and compared the suitability of the rapid urease test (RUT), polymerase chain reaction (PCR), 13C-urea breath test (13C-UBT), and serology with culture for evaluating cure of H. pylori infection. Forty-seven H. pylori-positive gastric ulcer patients received dual therapy of lansoprazole (30 mg u.i.d.) and clarithromycin (200 mg b.i.d.). Four weeks after the completion of treatment, RUT, PCR, 13C-UBT, and culture were performed and the negative rates of these tests were compared. Anti-H. pylori IgG antibodies were measured by enzyme-linked immunosorbent assay (ELISA) before and 4 weeks after completion of the treatment to evaluate changes of titers during the treatment. The negative rate of RUT (55%) was significantly greater than that of culture (27%). Significant declines in titers were seen in the patients who had negative culture results, while the decline in the titer was not significant in the patients who had positive results. PCR assay and 13C-UBT were suitable for the evaluation of H. pylori eradication, but RUT was not suitable, because of its sensitivity. By monitoring anti-H. pylori IgG antibody titers, therapeutic failure can be detected early after completion of treatment.
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PMID:Validity of various diagnostic tests to evaluate cure of Helicobacter pylori infection. 868 May 35

A new device Tunable Diode Laser Spectroscopy (LS) was developed for the analysis of isotope ratios of 13CO2/12CO2. Its applicability for breath tests was validated. The exhaled breath is collected in a 2 l aluminum bag, of which CO2 is separated by cryogenic system and introduced into LS. Repeat measurements (8 times) of two kinds of gases (delta 13C:-2.62 and - 1.14%) revealed 0.045% and 0.065% variation (IS.D.), from which precision of measurement was estimated as 0.2% (3S.D.). Seven healthy volunteers were given orally different dose of 13C-glycine (50 mg-200 mg in 5 subjects) and 13C-methacetin (30 mg and 150 mg in 2 subjects). One patient with gastric ulcer with helicobacter pylori (HP) infection was given 100 mg of 13C-urea. Serial breath samples (9-15) were taken and measured both by LS and mass spectrometer (MS) thereafter. Appreciable peaks were obtained at 30-50 min. after glycine and methacetin ingestions. The height of the peaks were dose dependent. Increased excretion of 13CO2 characteristics to HP infection was obtained in 13C-urea breath test. Measured values with LS were identical with those measured with MS (60 samples) with the range of difference within 0.2% (3S.D.). [Y (LS) = 1.02X (MS) + 0.55, r = 0.996] We conclude the LS is suitable for various 13C-breath tests.
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PMID:[Application of laser spectroscopy for 13C-breath tests]. 868 81

Helicobacter pylori infection is associated with peptic ulcer disease and chronic gastritis, and eradication of the microorganism markedly reduces the recurrence of peptic ulcer. However, a major problem is the choice of a treatment that is effective, has high eradication rate, and is well tolerated by patients. We evaluated the eradication of H. pylori infection in patients with chronic gastritis (CG), duodenal ulcer (DU), and gastric ulcer (GU) after two dual therapies (omeprazole with either amoxycillin or clarithromycin). Of 450 patients initially included in the study, 207 had CG, 187 DU and 56 GU, and all presented with H. pylori infection. Diagnosis was made from endoscope examination, biopsy samples, rapid urease test and 13C-urea breath test (UBT). H. pylori infection was considered to be present when two of the tests had positive results. All patients were randomized to one of two regimens: (A) omeprazole (20 mg b.i.d.) plus amoxycillin (750 mg t.i.d.) or (B) omeprazole (40 mg b.i.d.) plus clarithromycin (500 mg t.i.d.). The duration of each of the regimens was 2 weeks. Fifty-eight patients who showed H. pylori infection after the first treatment (27 with CG, 24 with DU, and 7 with GU) were allocated to a second therapy. H. pylori eradication was assessed by UBT, 6 weeks after the end of the therapies; positive values were those higher than 5 delta units. A second consecutive dual therapy of omeprazole plus an antibiotic (amoxycillin or clarithromycin) not used in the first therapy improved on the eradication rates obtained with the first regimen. The overall eradication rates were also higher, but no significant differences were found between amoxycillin and clarithromycin. The best results were obtained in those patients with GU.
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PMID:Significant increase in eradication rates of Helicobacter pylori infection with two consecutive dual therapies (omeprazole and amoxycillin or omeprazole and clarithromycin). A randomized study in 450 Spanish patients. 895 19

Helicobacter pylori (H. pylori) is the most common human gastrointestinal pathogen, infecting almost 50% of human population. By our present knowledge H. pylori is the cause of chronic active B type gastritis and the bacterium is accepted as a major pathogenetic factor of peptic ulcer disease. The prevalence of H. pylori positivity is about 95% in duodenal ulcer patients, in gastric ulcer patients 70-90% H. pylori positivity can be detected. The gastric mucosal barrier is weakened by the bacterial urease enzyme and vacoulating cytotoxin production. Special inflammatory and immunological processes as well H. pylori induced acid production increasing effects are also contributing to the pathogenesis of peptic ulcer disease. In the diagnosis of H. pylori the biopsy based invasive methods like histology and rapid urease test are offering the highest sensitivity and specificity. For controlling the eradication effect the most appropriate method is the isotope labelled urea breath test. In the lack of optimal H. pylori eradicating drug several combined therapeutical methods are available at present. Among the wide range of H. pylori eradicating regimens the macrolide or beta lactam antibiotics with nitromidazole and effective antisecretory drugs offer the highest eradication effect. In practice the low dose, short term administration of those compounds are most widely used presently.
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PMID:[Helicobacter pylori and ulcer disease]. 925 49


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