Simultaneous analysis of mucosal and submucosal hemodynamics using infrared electronic endoscopy: effects of intraluminal acid on ulcer scars

Combination therapy of ecabet sodium and cimetidine compared with cimetidine alone for gastric ulcer: prospective randomized multicenter study

BACKGROUND AND AIM

Little is known about the clinical efficacy of co-therapy of ecabet sodium, a mucoprotective agent, and a histamine H2-receptor antagonist. The aim of the present study was to assess its additive benefit in combination with cimetidine for gastric ulcer.

METHODS

In this prospective randomized study, after gastric ulcer was confirmed by endoscopy, 200 patients in 47 hospitals received either ecabet sodium 1 g b.i.d and cimetidine 400 mg b.i.d. (EC), or cimetidine 400 mg b.i.d. alone (C) for 8 weeks. Healing was examined by endoscopy at 4 and 8 weeks.

RESULTS

Of the intention-to-treat (ITT) population (EC, 103; C, 97), 181 patients comprised the per protocol (PP) analysis (EC, 93; C, 88). At 4 weeks, healing rates were significantly higher in the EC group (60%) than in the C group (36%) ( p < 0.01). At 8 weeks, those by the ITT and PP analyses were 82% (EC) versus 58% (C), and 90% (EC) versus 64% (C), respectively ( p < 0.01 and p < 0.001). Symptom relief rates (EC vs C) at 2, 4 and 8 weeks were 73%versus 47% ( p < 0.01), 89%versus 66% ( p < 0.001), and 97%versus 73% ( p < 0.001), respectively. Significant additive effects of ecabet sodium were observed in patients aged 60 years or older, with solitary and medium to large ulcer, and without smoking or drinking habits. No adverse effects were critical.

CONCLUSION

Ecabet sodium significantly augmented gastric ulcer healing and symptom relief by cimetidine, especially in the elderly.

Effectiveness of the near-infrared electronic endoscope for diagnosis of the depth of involvement of gastric cancers

BACKGROUND

Near-infrared light penetrates deeply into tissue but is not visible with a conventional endoscope. We developed a new infrared electronic endoscope system and evaluated its usefulness for assessing the depth of involvement of gastric cancers.

METHODS

A total of 61 patients with depressed or ulcerated gastric cancers underwent infrared endoscopy after intravenous injection of indocyanine green.

RESULTS

Intramucosal cancers were observed as tumors with or without a homogeneous tumor stain, whereas submucosal or deeper cancers were observed as tumors with an inhomogeneous stain or with pooling of the dye. Histologic examination showed staining properties of gastric cancers were significantly correlated with the characteristics of the vascular bed. The accuracy for depth of cancer invasion was 89% for mucosal cancers and 89% for submucosal or deeper cancers.

CONCLUSION

Our new infrared electronic endoscope system was useful for distinguishing mucosal cancers from submucosal or deeper cancers either with or without ulcerative changes.