Pattern of vessel involvement in cerebral atherosclerosis. A comparative study between a Japanese and Minnesota population.
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Biomedical subjects
Publications and source records attributed to K Kimoto.
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BACKGROUND/AIMS: There have been few reliable published studies permitting assessment of therapeutic regimens for Helicobacter pylori infection in gastric ulcer (GU) patients. The aim of the present study was to evaluate the efficacy of omeprazole-based dual and triple therapy regimens, both including clarithromycin, for the cure of H. pylori infection in active GU and duodenal ulcer (DU) patients. The study was conducted in Japan, a country in which GU is more prevalent than DU. METHODS: Two hundred and thirty-four consecutive peptic ulcer patients (GU: n = 124; DU: n = 103; GDU: n = 7) suffering from H. pylori infection were randomly treated with either omeprazole 20 mg b.i.d. + amoxicillin 500 mg q.i.d. + clarithromycin 400 mg b.i.d. (OAC) or with omeprazole 20 mg b.i.d. + clarithromycin 400 mg b.i.d. (OC) for 14 days. H. pylori infection was evaluated by histology and culture from antral and corpus biopsies 6 weeks after completing antimicrobial therapy. RESULTS: Follow-up data were available in 202 patients. The cure rates of H. pylori infection in GU patients were 83.9% (47/56) with OAC and 59. 2% (29/49) with OC. Corresponding rates in DU patients were 91.5% (43/47) and 70.5% (31/44), respectively. The cure rates with OAC were significantly higher than those with OC (p < 0.001, chi2 test). The cure rates in GU patients were lower than those in DU patients for both regimens, but these differences were not statistically significant. Side effects were generally mild and did not interfere with compliance. One patient in the OAC group and 2 patients in the OC group complained of severe side effects that led to therapy discontinuation. CONCLUSIONS: Triple therapy with omeprazole, amoxicillin and clarithromycin is a safe and effective regimen for the cure of H. pylori infection in GU patients as well as in DU patients. We recommend this triple regimen as a first-line treatment in all patients with peptic ulcers associated with H. pylori infection in Japan.
Histological examinations of the intracerebral and retinal arteries were preformed in patients who had cerebrovascular disease and in those cases who did nott. Fibrinoid degeneration, fibrous nodule, and splitting, which are most frequently found in putamen, thalamus and pons, are thought to be the main changes in cerebral hemorrhage and infarction. Fibrous and fibro-hyalinoid thickenings of the retinal arteries were found mainly in the neighboring region of the optic disk, which reflects the changes of the intracerebral arteries. Hyalinoid thickening was found in the ora serrata, which does not reflect the changes of the intracerebral arteries. Our results suggest that patients with these retinal artery changes in the region near the optic disk if moderate to severe have an increased risk of having or incurring cerebral hemorrhage and infarction, but the arterial changes in the ora serrata do not always indicate risk of cerebral hemorrhage and infarction.
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