Journal of gastroenterology
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Randomized Controlled Trial Clinical Trial
Bezafibrate treatment: a new medical approach for PBC patients?
A new medical approach to primary biliary cirrhosis (PBC) has been desired. We investigated the feasibility of using combination ursodeoxycholic acid (UDCA)-bezafibrate therapy in patients with PBC nonresponsive to UDCA monotherapy. ⋯ UDCA at 600 mg/day plus bezafibrate at 400 mg/day may be considered as a new therapeutic option for patients with PBC.
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Review Case Reports
Novel germline mutation of the PTEN gene in a Japanese family with Cowden disease.
We report a novel germline mutation of the PTEN gene in a Japanese family with Cowden disease. A 46-year-old Japanese man and his mother were diagnosed as having Cowden disease. ⋯ The single-strand conformation polymorphism (SSCP) analysis showed an abnormal band on exon 7 of their PTEN gene. Direct sequence analysis of exon 7 detected a TAAA insertion to codon 221, producing a stop codon (c.663ins TAAA).
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The somatostatin analogue octreotide was effective in controlling systemic effects related to multiple liver metastases from a gastrinoma. A 61-year-old man underwent distal gastrectomy for gastrinoma in the duodenum, because a curative resection was not feasible due to metastases found in paraaortic lymph nodes during operation. ⋯ Although chemotherapy with dimethyltrizenoimidazole carboxamide was not effective, subcutaneous administration of octreotide was effective in controlling the growth of the liver metastases and in stabilizing serum gastrin. The patient now receives subcutaneous injections of octreotide, at 200 microg a day, twice a week, as an outpatient.
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Although Japan's contributions to several biomedical fields have already been reported, little is known about Japan's contribution to gastroenterology and hepatology. ⋯ Japan's share of articles in this field was 10.6%, ranking third in the world, following the United States (35.1%) and the United Kingdom (11.5%). Japan's share of articles went up significantly as a whole (P = 0.01), while the share for RCTs showed no significant change ( P = 0.57) during this period of time. CONCLUSIONS; Japan's contribution to the field of gastroenterology and hepatology is, in general, acceptable compared with that of other counties, but the contribution for RCTs not satisfactory.
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This study investigated the influence of feeding on gastric acid suppression in Helicobacter pylori-positive patients treated with intravenous infusions of proton pump inhibitors (PPIs) or with H2-receptor antagonists (H2-RAs) after bleeding from a gastric ulcer. ⋯ Gastric acid suppression during the administration of an H2-RA or a PPI soon after the cessation of gastric bleeding was scarcely affected by feeding. It may well be that H. pylori-positive patients with bleeding gastric ulcer can resume a regular diet and return to work soon after bleeding ceases.