Byung Won Hur

7188 The role of hla class ii gene dqb1 in the development of duodenal ulcer disease in helicobacter pyloriinfected patients.

Objects: We evaluated the HLA DQ to examine the host genetic factors that increase the risk of duodenal ulcer among H. pylori -infected persons. Methods: Consecutive patients who were diagnosed duodenal ulcer by endoscopic examinations and control who had normal endoscopic findings were studied. H. pylori infection status was confirmed by CLO test and 13C-urea breath test in all patients with duodenal ulcer. HLA DQ alleles were determined by PCR using SSOP(sequence specific oligonucleotide probes). Results: Allele frequency of HLA DQA1 was not significant different between the H. pylori (+) duodenal ulcer patients and controles. In addition, the allele frequency of HLA DQB1*04 was significantly lower in the H. pylori (+) duodenal ulcer patients than in controls. Conclusion: The HLA DQB1 allele may contribute to protective role for H. pylori associated duodenal ulcer, whereas the absence of DQB1*04 may be a host genetic risk foctor for H. pylori associated duodenal ulcer.

4715 Significance of pretreatment δ13co2as predictor of success for h. pylorieradication - comparison of the efficacy of oac 7, 10, 14 days regimen.

Backgrounds and Aims: Recently, several studies have shown that a high δ 13 CO 2 value in 13C-urea breath test(13C-UBT), representing increased bacterial density of Helicobacter pylori (H. pylori), is associated with a significant reduction in the eradication rate of H. pylori. And also, efficacy of triple therapy with omeprazole, amoxicillin, and clarithromycin (OAC) varies among different geographic regions and patient populations. We assessed the efficacy of the OAC regimen according to the treatment duration (7, 10 or 14 days) using 13C-UBT in Korea, and studied the significance of pre-treatment δ 13 CO 2 as predictor of success for H. pylori eradication. Method: 387 H. pylori positive patients (224 male and 163 female; mean age of 50.2 years, range of 18-86) with peptic ulcer were randomly assigned to a OAC (omeprazole 20mg b.d., amoxycillin 1.0g b.d. and clarithromycin 500mg b.d.) 7, 10 or 14 days regimen. Eradication of H. pylori infection was assessed by 13C-UBT 4 weeks after completion of therapy. Patients with taking drugs, which affect the result of 13C-UBT, within a month preceding the study, and those with poor compliance ( 13 CO 2 for the three groups (53.9±31.3 ¢¶ , 41.5±27.8 ¢¶ , 44.7±27.5 ¢¶ ). The eradication rates of H. pylori according to the pre-treatment δ 13 CO 2 in each group are shown in the following table. Conclusions: Overall eradication rate of H. pylori was highest in OAC 14 regimen in Korean patients. And pretreatment δ 13 CO 2 value may be considered as a factor that predicts failure of treatment for H. pylori.

Dose the Gabexate mesilate (FOY) protect against ERCP-related pancreatic damage?

Backgrou nds and Aim: Recent studies have been reported that prophylact ic treatment with 19 of Gabexate mesi late (GM) is effective in preventing ERCP-related pancreatic damage. However, there are some debates for its low cost-effectiveness in application of Ig of GM in all patients undergoing ERCP. Furthermore, it has not been established whether the effect of GM in preventing ERCPrelated pancreatic damage is dosedependent. The aim of this study was to evaluate the effectiveness of low dose of GM for preventing ERCP-related pancreatic damage. Methods: Th is study was performed prospectively with consec utive 102 patients (68 for GM group, 34 for placebo group) who were sched uled for ERCP due to various reasons . Infusion of GM (500 mg) was started 30 minutes before ERCP and continued for 12 hours afterward. The control group was given normal saline alone as same methods. The serum amylase and lipase were measured before ERCP and 4, 8, and 24 hours after ERCP . Hyperenz ymemi a was defined as elevation of serum amylase and/or lipase above upper norma l limit within 24 hours after ERCP. The ERCP-related pancreatiti s was defined as abdominal pain with elevation of serum amylase and/or lipase more than 3 times the upper norma l limit. Incidence of hypcren zymemia and pancreatitis, and mean changes of serum amylase and lipase levels were analyzed between two groups according to the various parameters, such as difficulty of duct cannulation, visualization of pancreatic duct, performance of therapeut ic procedures and total procedure time. Resu lts: The overall incidence of ERCP-related hyperenzymemia was not statis tically reduced by GM treatment (45.6% in GM group, 55.9% in con trol group) . Overall incidence of acute pancreatitis was low (1.0%) in our series. and did not affect by GM treatment. Difficulty of duct cannulation, visualization of pancreatic duct, performa nce of therapeutic procedures and total procedure time were associated with increased incidence of hyperenzyme mia. However, GM treatment did not reduce hyperenzymemia under the various conditio ns. Concl usion: Prophylactic treatment with 500 mg of GM has no advantage for the prevention of ERCP-related pancreatic damage. This suggests that the effec t of prophylactic treatment with GM is dose-dependent. Conside ring cost-effectiveness. further randomized studies are needed in determining the selective indications for prophylactic treatment with expensive high dose of GM.