Postischemia myocardial injury in coronary artery bypass patients (PP6)

PURPOSE

To investigate the reperfusion injury of the myocardium in patients undergoing elective coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB), we monitored the blood levels of troponin I (TNI), white blood cells, oxygen radicals, malondialdehyde, and myeloperoxidase seeking to define the relationship between the CABG-induced systemic inflammation and myocardial injury.

MATERIALS AND METHODS

We selected 10 patients undergoing primary CABG with CPB at moderate hypothermia and cardioplegic arrest concomitant with intermittent warm blood cardioplegia. We compared all data with their own baseline values to study the reperfusion injury. After release of the aortic clamp, blood was drawn from the coronary sinus, via a catheter placed through the right atrium. We measured plasma levels of inflammatory mediators, such as malondialdehyde, myeloperoxidase, oxygen radicals, and the myocardium injury parameter of TNI.

RESULTS

Patients showed no difference concerning aortic clamp time. TNI increased significantly at 1, 15, and 30 minutes after the onset of reperfusion. Blood levels of white blood cells, oxygen radicals, malondialdehyde, and myeloperoxidase also increased significantly with reperfusion time.

CONCLUSIONS

Reperfusion of ischemic myocardium induced increased TNI, which may be related to the systemic inflammatory responses induced by ischemia and reperfusion of the myocardium among patients undergoing elective coronary bypass surgery.

Transcatheter closure of patent foramen ovale with the Spider patent foramen ovale occluder: a prospective, single-center trial

BACKGROUND

Transcatheter closure of patent foramen ovale (PFO) is a promising alternative to surgical closure or anticoagulation therapy to prevent paradoxical embolic events in patients with PFO. Several different devices have been used for transcatheter PFO closure. The aim of the present study was to evaluate the safety and feasibility for closure of PFO with a new PFO occluder, the Spider PFO occluder.

METHODS

The device was implanted in the PFO patients under fluoroscopy and transthoracic echocardiography (TTE) using a 10 French delivery sheath employing a femoral vein approach. Aspirin was administered at 100 mg/d for six months after occlusion. The clinical and echocardiographic follow-up of patients were performed at the 24th hour, 1st month, 3rd month, 6th month, and 12th month after occlusion, and yearly thereafter.

RESULTS

The device was implanted successfully in all 55 patients. No major complications occurred during the perioperative period, such as thromboembolism, occluder dislodgement, infection or myocardial infarction. No residual shunt of the atrial level was shown by transesophageal echocardiography, and no latent arrhythmia or cerebral vessel events occurred in any cases during follow-up ((35 +/- 9) months, range 6 - 51 months).

CONCLUSION

Transcatheter closure of a PFO with the Spider PFO occluder is a safe and effective therapeutic option for the secondary prevention of presumed paradoxical embolism. However, randomized trials comparing this device with other devices and therapies have to be performed.

Strontium borate glass: potential biomaterial for bone regeneration

Boron plays important roles in many life processes including embryogenesis, bone growth and maintenance, immune function and psychomotor skills. Thus, the delivery of boron by the degradation of borate glass is of special interest in biomedical applications. However, the cytotoxicity of borate glass which arises with the rapid release of boron has to be carefully considered. In this study, it was found that the incorporation of strontium into borate glass can not only moderate the rapid release of boron, but also induce the adhesion of osteoblast-like cells, SaOS-2, thus significantly increasing the cyto-compatibility of borate glass. The formation of multilayers of apatite with porous structure indicates that complete degradation is optimistic, and the spread of SaOS-2 covered by apatite to form a sandwich structure may induce bone-like tissue formation at earlier stages. Therefore, such novel strontium-incorporated borosilicate may act as a new generation of biomaterial for bone regeneration, which not only renders boron as a nutritious element for bone health, but also delivers strontium to stimulate formation of new bones.

Effect of V2O5 on the properties of mullite ceramics synthesized from high-aluminum fly ash and bauxite

In this communication, high-strength mullite ceramics was prepared from bauxite and high-aluminum fly ash that is a by-product of coal combustion in thermal power plants. The effects of the doping V(2)O(5) on the bulk density, apparent porosity, bending strength and microstructure of mullite ceramics were studied in detail. It was indicated that 5-10 mol% V(2)O(5) reduced the sintering temperature by 50 degrees C. The apparent porosity and water absorption of the mullite ceramics decreased with increasing V(2)O(5) content. Mullite ceramics with bending strength as high as 108 MPa were obtained at 1500 degrees C with the addition of 10 mol% V(2)O(5). X-ray diffraction analysis suggested that the prepared ceramics was mainly in phase of mullite, and scanning electron microscope images confirmed that it mostly existed in the shape of a long parallelepiped. This research may provide a new method in utilizing the vast resources of fly-ash waste from power plants in the production of low-cost mullite-based engineering materials.

Two Taiwanese siblings with dyschromatosis universalis hereditaria

Two Taiwanese siblings presented with clinical and histological findings of dyschromatosis universalis hereditaria, which is an uncommon hereditary skin disease. A 26-year-old Taiwanese man had developed diffuse hyperpigmentation with hypopigmented spots over his whole body from the age of 4 years. His 34-year-old brother had also developed a similar skin pigmentary defect from about the same age. Histological examination of the hyperpigmented lesions found an increase in melanin in the basal layer, pigmentary incontinence, and some melanophages in the upper dermis but no increase in the number of melanocytes. The unique clinical, histological, and genetic features of this condition are outlined.

Silver structure environments in ion-exchanged silicate glasses studied by X-ray absorption fine structure

X-ray absorption fine structure (XAFS) technique was used to analyze structural geometry of Ag atoms introduced into soda-lime silicate glass and soda aluminosilicate glass by ion-exchange method. The results show that Ag+ ion in soda aluminosilicate glass takes a coordination number of 1.6 with a Ag-O distance of 2.20 A when the ion-exchange ratio x is smaller than 0.47 and of 2.28 A when x is larger than 0.47. The introduced Ag+ ions are stabilized at the non-bridge oxygen (NBO) sites when x is lower than 0.47. The Na+ ions in AlO4 (O4 represents the bridging oxygen) sites are exchanged by Ag+ ions after all Na+ in NBO sites are replaced. The disorder of Ag-O coordination increases gradually with increasing x from 0.24 to 0.47 in soda aluminosilicate glass and increases dramatically when x is larger than 0.47. Ag+ ions takes a coordination number of 1.6 in the ion-exchanged soda-lime silicate glass and of 1.3 after subsequently thermal treatment with the same Ag-O distance of 2.14 A. Debye-Waller factor (DWF) of Ag-O coordination in soda aluminosilicate glass is higher than that in soda-lime silicate glass. Small Ag cluster has a reduced interatomic distance and a larger DWF. Ag nanoparticle in sample Ag-7 is in a state of tensile stress.

DITOP: drug-induced toxicity related protein database

MOTIVATION

Drug-induced toxicity related proteins (DITRPs) are proteins that mediate adverse drug reactions (ADRs) or toxicities through their binding to drugs or reactive metabolites. Collection of these proteins facilitates better understanding of the molecular mechanisms of drug-induced toxicity and the rational drug discovery. Drug-induced toxicity related protein database (DITOP) is such a database that is intending to provide comprehensive information of DITRPs. Currently, DITOP contains 1501 records, covering 618 distinct literature-reported DITRPs, 529 drugs/ligands and 418 distinct toxicity terms. These proteins were confirmed experimentally to interact with drugs or their reactive metabolites, thus directly or indirectly cause adverse effects or toxicities. Five major types of drug-induced toxicities or ADRs are included in DITOP, which are the idiosyncratic adverse drug reactions, the dose-dependent toxicities, the drug-drug interactions, the immune-mediated adverse drug effects (IMADEs) and the toxicities caused by genetic susceptibility. Molecular mechanisms underlying the toxicity and cross-links to related resources are also provided while available. Moreover, a series of user-friendly interfaces were designed for flexible retrieval of DITRPs-related information. The DITOP can be accessed freely at http://bioinf.xmu.edu.cn/databases/ADR/index.html.

SUPPLEMENTARY INFORMATION

Supplementary data are available at Bioinformatics online.

Post-translational modification of delta antigen of hepatitis D virus

The hepatitis delta virus (HDV) genome has only one open reading frame, which encodes the viral small delta antigen. After RNA editing, the same open reading frame is extended 19 amino acids at the carboxyl terminus and encodes the large delta antigen. These two viral proteins escort the HDV genome through different cellular compartments for the complicated phases of replication, transcription and, eventually, the formation of progeny virions. To orchestrate these events, the delta antigens have to take distinct cues to traffic to the right compartments and make correct molecular contacts. In eukaryotes, post-translational modification (PTM) is a major mechanism of dictating the multiple functions of a single protein. Multiple PTMs, including phosphorylation, isoprenylation, acetylation, and methylation, have been identified on hepatitis delta antigens. In this chapter we review these PTMs and discuss their functions in regulating and coordinating the life cycle of HDV.

Prediction of n-octanol/water partition coefficients for polychlorinated dibenzo-p-dioxins using a general regression neural network

A general regression neural network was used for the first time to study quantitative structure and property relationships of organic pollutants to correlate and predict n-octanol/water partition coefficients of polychlorinated dibenzo- p -dioxins from their topological molecular descriptors. In total, 42 polychlorinated dibenzo- p -dioxins and dibenzo- p -dioxins were available for this study-42 polychlorinated dibenzo- p -dioxins and dibenzo- p -dioxins in the training data set and 41 polychlorinated dibenzo- p -dioxins in the test data set. Partial least squares regression, back propagation network and general regression neural network models were trained using the training data set, and the accuracy of the models obtained were examined by the use of leave-one-out cross-validation. For prediction of the n-octanol/water partition coefficient, the best method is the general regression neural network. With the test data set, the correlation coefficient, root mean square error and mean absolute relative error for the general regression neural network model are 0.9276, 0.22 and 2.79%, respectively. For describing the structure of polychlorinated dibenzo- p -dioxins, the topological molecular descriptors outperform the mobile order and disorder thermodynamic method.

The nucleolar phosphoprotein B23 interacts with hepatitis delta antigens and modulates the hepatitis delta virus RNA replication

Hepatitis delta virus (HDV) encodes two isoforms of delta antigens (HDAgs). The small form of HDAg is required for HDV RNA replication, while the large form of HDAg inhibits the viral replication and is required for virion assembly. In this study, we found that the expression of B23, a nucleolar phosphoprotein involved in disparate functions including nuclear transport, cellular proliferation, and ribosome biogenesis, is up-regulated by these two HDAgs. Using in vivo and in vitro experimental approaches, we have demonstrated that both isoforms of HDAg can interact with B23 and their interaction domains were identified as the NH(2)-terminal fragment of each molecule encompassing the nuclear localization signal but not the coiled-coil region of HDAg. Sucrose gradient centrifugation analysis indicated that the majority of small HDAg, but a lesser amount of the large HDAg, co-sedimented with B23 and nucleolin in the large nuclear complex. Transient transfection experiments also indicated that introducing exogenous full-length B23, but not a mutated B23 defective in HDAg binding, enhanced HDV RNA replication. All together, our results reveal that HDAg has two distinct effects on nucleolar B23, up-regulation of its gene expression and the complex formation, which in turn regulates HDV RNA replication. Therefore, this work demonstrates the important role of nucleolar protein in regulating the HDV RNA replication through the complex formation with the key positive regulator being small HDAg.

A method for the fabrication of low-noise carbon fiber nanoelectrodes

A new and facile method has been developed for the fabrication of low-noise carbon fiber microelectrodes (CFMEs) and carbon fiber nanoelectrodes (CFNEs). The carbon fiber was flame-fuse sealed in the tip of the glass capillary. The CFMEs were made by cutting the protruding carbon fiber to the desired length, and the CFNEs were achieved by etching the protruding carbon on the flame to form a nanometer-scale tip. The tip of CFNEs can be controlled within the range from 100 to 300 nm. Thus, no epoxy wax was involved in the CFMEs and CFNEs. The experimental results of inspecting CFMEs and CFNEs by scanning electron microscopy demonstrated that the surface of the electrodes and the glass/fiber interface are very smooth. Therefore, the noise caused by the glass/fiber of these electrodes is much lower than that of the electrodes fabricated conventionlly. The electrodes were characterized by ferricyanide, catecholamine (dopamine,DA), norepinephrine (NE), and epinephrine (E)) and 5-hydroxytryptamine (5-HT) neurotransmitters using CV, LSV, DPV, and FSCV. The results showed that the CFMEs and CFNEs have very excellent electrochemical behavior and high sensitivity. The CV and DPV detection limits of DA, NE, and E are 7.6 x 10(-8), 7.0 x 10(-8), and 5.0 x 10(-8) mol/L, and the DPV detection limits of DA, NE, and E are 4.0 x 10(-8), 1.0 x 10(-7), and 2.2 x 10(-7) mol/L, respectively. This experiment offers a new and facile method for the fabrication of CFMEs and CFNEs of very high sensitivity and low noise.

CoMFA-based prediction of agonist affinities at recombinant wild type versus serine to alanine point mutated D2 dopamine receptors

Agonist affinity changes dramatically as a result of serine to alanine mutations (S193A, S194A, and S197A) within the fifth transmembrane region of D2 dopamine receptors and other receptors for monoamine neurotransmitters. However, agonist 2D-structure does not predict which drugs will be sensitive to which point mutations. Modeling drug-receptor interactions at the 3D level offers considerably more promise in this regard. In particular, a comparison of the same test set of agonists across receptors differing minimally (point mutations) offers promise to enhance the understanding of the structural bases for drug-receptor interactions. We have previously shown that comparative molecular field analysis (CoMFA) can be applied to comparisons of affinity at recombinant D1 and D2 dopamine receptors for the same set of agonists, a differential QSAR. Here, we predicted agonist K(L) for the same set of agonists at wild type D2 vs S193A, S194A, and S197A receptors using CoMFA. Each model used bromocriptine as the template. ln(1/K(L)) values for the low-affinity agonist binding conformation at recombinant wild type and mutant D2 dopamine receptors stably expressed in C6 glioma cells were used as the target property for the CoMFA of the 16 aligned agonist structures. The resulting CoMFA models yielded cross-validated R(2) (q(2)) values ranging from 0.835 to 0.864 and simple R(2) values ranging from 0.999 to 1.000. Predictions of test compound affinities at WT and each mutant receptor were close to measured affinity values. This finding confirmed the predictive ability of the models and their differences from one another. The results strongly support the idea that CoMFA models of the same training set of compounds applied to WT vs mutant receptors can accurately predict differences in drug affinity at each. Furthermore, in a "proof of principle", two different templates were used to derive the CoMFA model for the WT and S193A mutant receptors. Pergolide was chosen as an alternate template because it showed a significant increase in affinity as a result of the S193A mutation. In this instance both the bromocriptine- and pergolide-based CoMFA models were similar to one another but different from those for the WT receptor using bromocriptine- or pergolide- as templates. The pergolide-based S193A model was more strikingly different from that of the WT receptor than was the bromocriptine-based S193A model. This suggests that a "dual-template" approach to differential CoMFA may have special value in elucidating key differences across related receptor types and in determining important elements of the drug-receptor interaction.

High-throughput single-molecule DNA screening based on electrophoresis

In electrophoresis, the migration velocity is used for sizing DNA and proteins or for distinguishing molecules based on charge and hydrodynamic radius. Many protein and DNA assays relevant to disease diagnosis are based on such separations. However, standard protocols are not only slow (minutes to hours) but also insensitive (many molecules in a detectable band). We successfully demonstrated a high-throughput imaging approach that allows determination of the individual electrophoretic mobilities of many molecules at a time. Each measurement only requires a few milliseconds to complete. This opens up the possibility of screening single copies of DNA or proteins within single biological cells for disease markers without performing polymerase chain reaction or other biological amplification. The purpose is not to separate the DNA molecules but to identify each one on the basis of the measured electrophoretic mobility. We developed three different procedures to measure the individual molecular mobilities. The results correlate well with capillary electrophoresis (CE) experiments for the same samples (2-49 kb dsDNA) under identical separation conditions. The implication is that any electrophoresis protocols from slab gels to CE should be adaptable to single-molecule screening for disease diagnosis.

Effect of ice water ingestion on asthmatic children after exercise challenge

Both exercise and ice water ingestion are known to be trigger factors for an asthma attack in ethnic Chinese asthmatic children. The purpose of this study was to investigate whether ice water ingestion further deteriorates pulmonary function of asthmatic children after exercise. Thirty Chinese asthmatic children underwent exercise challenge by ergocyclometer for 6 minutes and then were further challenged by immediate ingestion of ice water (200 ml, 0-4 degrees C), warm water (200 ml, 37 degrees C) or no ingestion on three different days in one week. Each patient completed the three different water ingestion tests after exercise challenge. The FEV1, FEF25-75%, and PEF tests were performed at baseline and again at 5, 15, 30, 60, 90 minutes after exercise plus water ingestion challenge. After the spirometric test at 90 minutes, 3 puffs (0.6 mg) of hexoprenaline from a metered dose inhaler were given and then a further spirometric test was performed 15 minutes later. The FEV1 and PEF were significantly decreased after exercise plus the 3 different water ingestion challenge except for the FEV1 in the patients who ingested nothing (p = 0.051) and PEF in the patients who ingested warm water (p = 0.163). FEF25-75% of the three tests was not significantly decreased. Exercise-induced asthma (EIA) developed in about two thirds of the 30 patients, regardless of whether ice water, warm water or nothing at all was ingested after exercise challenge. There was no statistically significant difference in spirometric data among the 3 different water tests at various time points. The mean percentage increase of FEV1, FEF25-75% and PEF after bronchodilator therapy were all the lowest in the ice water test, and the greatest in the warm water test. A statistically significant difference was found between ice water and warm water tests for FEV1 and PEF (p = 0.0293 and p = 0.0308 respectively). In conclusion, about two thirds of the asthmatic children in this series had EIA. Those who ingested warm water after exercise had a better bronchodilator response than those who ingested ice water.

Early and late long-term effects of vasectomy on Zn, Cd, and Cu levels in prostatic fluid and serum

AIM

To evaluate the early and late long-term effects of vasectomy on the serum and prostatic fluid trace elements.

METHODS

In 37 vasectomized and 25 non-vasectomized (control) men, the Zn, Cd and Cu levels in the serum and prostatic fluid were measured by means of inductively coupled plasma-atomic emission spectroscopy (ICP-AES).

RESULTS

No significant difference was found in the prostatic Zn, Cd and Cu levels between the vasectomized and control group. The Zn level in the serum were significantly lower in the vasectomized men than in the controls (11.04 and 13.54 umol/L, respectively; P < 0.05), while the serum Cd and Cu levels were not significantly different between the two groups.

CONCLUSION

Vasectomy may decrease the serum, but not the prostatic Zn levels. Its pathophysiological significance is worthy of further investigation.

Effects of cancer therapy on dental and maxillofacial development in children: report of case

Malignant lymphoma is one of the most common hematological diseases of children. The prognosis is fairly good with multimodal cancer therapy. We reported a boy with Burkitt's lymphoma in the nasal cavity who received chemotherapy and irradiation of the head and neck area at four years of age. During seven years of follow-up, we studied the developmental effects of cancer therapy, including general growth, maxillofacial bones, and dentition. Compared with boys of matching age, the development of his entire body and maxillofacial bones was delayed. In the irradiated areas, the roots of teeth were short or poorly developed and the root apices showed premature closure. After the patient was in remission from the tumor in his early childhood, the long-term effects of cancer therapy on dental and maxillofacial development are worth our further evaluation and follow-up.

One- and two-photon-induced fluorescence from recombinant green fluorescent protein

The fluorescence spectral properties of recombinant green fluorescent protein (rGFP) were examined with one- and two-photon excitations using femtosecond pulses from a Ti:sapphire laser. Intensity-dependent properties of the two-photon-induced fluorescence from rGFP excited by an 800-nm, 100-fs laser beam were reported, and the two-photon excitation cross section of rGFP was measured at 800 nm as about 160 x 10(-50) cm(4)s/photon. The possible excited-state proton transfer between two electronic states at about 400 nm in protonated (RH) species and 478 nm in deprotonated (R(-)) species in rGFP was confirmed by fluorescence and fluorescence excitation anisotropy spectra. A subelectronic state (or vibronic progression) at about 420 nm in RH species was identified, which was relatively stable and not involved in the excited state proton transfer in rGFP upon irradiation.

Steroid hormones and bone

Steroid hormones have an important impact on bone. The mechanism of steroid action on bone cells is through an interaction with specific receptor proteins in the target cells. Steroid receptors are a class of molecules that function as both signal transducers and transcription factors. The receptors each have similar functional domains that are responsible for discrete functions. The mechanism of receptor action is mediated by both genomic and nongenomic pathways. It is believed that in genomic pathway the steroid passes through the cell membrane by passive diffusion and binds to the receptor within the nucleus. Steroids have direct action on osteoblasts via receptor, and the effects of steroids on osteoclastic bone resorption are mediated through osteoblasts which release soluble factors by the action of hormone-receptor binding. However, in addition to indirect effects on osteoclasts, the question whether steroid hormones could exert direct action on osteoclasts as well has not to be answered and findings to date are controversial. It is not doubt that understanding the precise molecular mechanism of steroid action on bone resorption will develop new approaches for the diagnosis and treatment of disease associated with osteoclastic bone resorption.

Formulations of controlled atmosphere agents for packaged foods

Four food grade additives-sodium ascorbate, sodium bicarbonate, sodium carbonate-10-hydrate, and ferrous sulfate-7-hydrate-were selected as the basic ingredients to formulate the controlled atmosphere agents which could effectively remove oxygen and release carbon dioxide. The mathematical models giving the relationships between the formulations and the responses (oxygen and carbon dioxide contents) were developed using response surface methodology (RSM). Within 8-24 h, the oxygen and carbon dioxide contents of all tested formulations could reach constant levels, in the ranges of 2-9% and 0-41%, respectively. These formulations were considered to be effective, safe, and easy to prepare and could be applied to wide varieties of food products.

Successful pregnancy after treatment of deep adenomyosis with cytoreductive surgery and subsequent gonadotropin-releasing hormone agonist: a case report

Adenomyosis is a common pathologic finding significantly related to the menstrual and reproductive characteristics of women. Although noted during younger reproductive years, it usually presents in women over 35 years of age. For those with a strong desire to preserve fertility, there is presently no uniform agreement on the most appropriate therapeutic methods to manage the condition. Herein, we present a case of long-term secondary infertility with successful pregnancy after treatment of deep adenomyosis with cytoreductive surgery and a subsequent six-month course of gonadotropin-releasing hormone agonist (GnRHa) therapy. For those who want to conceive, early combined GnRHa therapy immediately following cytoreductive surgery and a delay of four to six months before attempting to fall pregnant is advisable. This is because adenomyosis tends to recur rapidly and the myometrium can be significantly disrupted during surgery. The major obstetric complications, such as uterine atony, rupture or placenta accreta, do not increase with adenomyosis during pregnancy. Although two events of threatened abortion and one of preterm labor were encountered during the pregnancy course, a healthy 2,900-g female was delivered by low transverse cesarean section at term. A cesarean section was performed because of previous large cytoreductive surgery. In contrast to GnRHa therapy alone, we report an effective alternative to hysterectomy in order to maintain fertility and achieve successful pregnancy.

New one-week, low-dose triple therapy for the treatment of duodenal ulcer with Helicobacter pylori infection

BACKGROUND

Antimicrobial therapy is the recommended treatment for duodenal ulcer associated with Helicobacter pylori infection. The eradication of bismuth-based triple therapy with bismuth subcitrate, metronidazole and amoxicillin is limited by low compliance, drug resistance and side-effects. Two-week proton pump inhibitor (PPI)-based triple therapy has a higher eradication rate but is costly. This study was designed to compare the efficacy, patient compliance and cost of short-term PPI-based triple therapy with those of bismuth-based triple therapy.

METHODS

Ninety patients with active duodenal ulcer disease and H pylori infection, proven with the 13C-urea breath test and CLO test (Campylobacter-like organism test) were treated randomly in three therapeutic groups: Group A, DeNol 120 mg, amoxicillin 500 mg and metronidazole 250 mg four times a day orally for 14 days; Group B, omeprazole 20 mg plus clarithromycin 500 mg twice a day and amoxicillin 500 mg four times a day for 14 days; Group C, omeprazole 20 mg, clarithromycin 250 mg and metronidazole 500 mg twice a day for seven days. Nizatidine 150 mg twice a day was given continuously following the end of anti-H pylori therapy for each group. Two months later, endoscopy, the CLO test and 13C-urea breath test were repeated to assess the eradication rate of H pylori and the ulcer-healing rate. Drug tolerance was evaluated by patients themselves by daily recording of any side-effects.

RESULTS

Eighty-four patients completed the entire course of therapy and evaluation for H pylori infection. The H pylori eradication rates in Groups A, B and C were 75% (21/28), 93% (26/28) and 89% (25/28), respectively (p = 0.466). The ulcer healing rate was 86% (24/28) in Group A and 89% (25/28) in Groups B and C (p = 0.764). A total of 74 patients (88%) were free from symptoms at the end of the triple therapy. Symptom relief was faster in patients with PPI-based triple therapy (Groups B and C) (days 3 and 4) than for patients with bismuth-based triple therapy (day 5). The cost of Group C therapy was lower than that for Groups A and B. There were no major side-effects in any of the patients.

CONCLUSIONS

One-week triple therapy with omeprazole, clarithromycin and metronidazole is highly effected for the eradication of H pylori. A therapeutic regime of one week's duration with lower cost, good compliance and mild side-effects may offer a good choice for treatment of duodenal ulcer associated with H pylori infection in clinical practice.