Detection of Helicobacter pylori:A faster urease test can save resources

AIM: To investigate whether differences in the rapidity of a positive result for Helicobacter pylori can save res ources, by comparing two commercially available urease kits. METHODS: One hundred and eighty-five adults (130 outpatients, 55 inpatients) undergoing gastroscopy were entered prospectively. Patients were divided into two groups: Group 1 (if they were not on PPIs, antibiotics, H2A, bismuth or sucralfate for up to 14 d prior to the endoscopy) and Group 2 (if they were on, or had been on, any of the above medication in the previous 14 d). At endoscopy two sets of biopsies, taken in random order, were placed in the wells of the Campylobacter-like organism (CLO) test (Kimberly-Clark, Utah, USA) and the Quick test (Biohit Plc, Helsinki, Finland). Five additional gastric biopsies were taken for histology/Giemsa and immunohistochemical study. The two urease test slides were read at 2 min, 30 min, 2 h and 24 h. Sensitivity and specif icity at 24 h were determined. RESULTS: At 24 h, for all patients, there was no difference in sensitivity (100% vs 97.5%), specificity (99.3%), positive (97.5%) and negative predictive values (100% vs 99.3%) between the CLO and Quick tests, respectively. There was a positive result at 30 min in 17/41 (41.5%) CLO tests, and in 28/40 (70%) Quick tests, P = 0.05. Quick test enabled the prescription of eradication therapy before discharge in all 28/40 patients. Only 12 (30%) follow-up appointments were needed. If the CLO test had been used alone, only 17 (41.5%) prescriptions would have been possible prior to discharge and 24 (58%) follow-up appointments would be needed (P = 0.001). Of 2000 gastroscopies performed annually at our unit, a saving of 123 follow-up appointments (total: 8856 Euros or 11 808 USD) would be achieved if we switched to the Quick test. CONCLUSION: Direct comparison of locally available urease test kits is worthwhile, since the appropriate choice results in a significant saving of resources. Local costs and follow-up protocols will determine the magnitude of these savings.

Assessment of Balance and Vestibular Functions in Patients with Idiopathic Sudden Sensorineural Hearing Loss

This study investigated the relationship among the severity of hearing impairment,vestibular function and balance function in patients with idiopathic sudden sensorineural hearing loss（ISSNHL）.A total of 35 ISSNHL patients（including 21 patients with vertigo） were enrolled.All of the patients underwent audiometry,sensory organization test（SOT）,caloric test,cervical vestibular-evoked myogenic potential（cV EMP） test and ocular vestibular-evoked myogenic potential（o VEMP） test.Significant relationship was found between vertigo and hearing loss grade（P=0.009）,and between SOT VEST grade and hearing loss grade（P=0.001）.The abnormal rate of o VEMP test was the highest,followed by the abnormal rates of caloric and c VEMP tests,not only in patients with vertigo but also in those without vertigo.The vestibular end organs were more susceptible to damage in patients with vertigo（compared with patients without vertigo）.Significant relationship was found between presence of vertigo and SOT VEST grade（P=0.010）.We demonstrated that vestibular end organs may be impaired not only in patients with vertigo but also in patients without vertigo.The cochlear and vestibular impairment could be more serious in patients with vertigo than in those without vertigo.Vertigo does not necessarily bear a causal relationship with the impairment of the vestibular end organs.SOT VEST grade could be used to reflect the presence of vertigo state in the ISSNHL patients.Apart from audiometry,the function of peripheral vestibular end organs and balance function should be evaluated to comprehensively understand ISSNHL.Better assessment of the condition will help us in clinical diagnosis,treatment and prognosis evaluation of ISSNHL.

Actions of four organic acids in radix isatidis on endotoxin-neutralization investigated by kinetic turbidimetric assay

OBJECTIVE:To investigate anti-endotoxin action of four OAs reacted with endotoxin by the LAL assay with KTA.METHODS:Using a incubating kinetic tube reader and kinetic turbidimetric assay(KTA),the concentration-response time curve of endotoxin reacted with limulus amebocyte lysate(LAL) at 37℃ were obtained and the action of four organic acids(OAs) on it were investigated.The four OAs were benzoic acid,salicylic acid,syringic acid and 2-amino-benzoic acid from Radix isatidis.Meanwhile,the temperature variation caused by endotoxin with the four OAs was studied by the rabbit pyrogen test(RPT).RESULTS:It was showed that a low concentration(1 mg/mL) of the four OAs had a little effect of anti-endotoxin,and when the concentrations of the four OAs were 30 mg/mL,the endotoxin was neutralized completely.The relationships between the concentrations of endotoxin and the OAs were all linear with correlation coefficients of greater than 0.9995,indicating that the four OAs all had strong anti-endotoxin action,while syringic acid had the strongest action among the four OAs with IC50 of 12.84 mg/mL.CONCLUSION:The investigations of KTA agreed well with the results obtained by means of RPT.

Integration of Chemical Methods and Biomarkers for Assessment of Chlorimuron-Ethyl Bioavailability in Soil

Bioavailability is a critical factor for assessing the environmental risk of organic pollutants in soil. In this study, extractions with 3 different solvents, including 2 aqueous solutions, calcium chloride(CaCl_2) and a phosphate buffer solution(PBS), and a mixture of aqueous solution and organic solvent, a PBS-methanol(8:2,volume/volume) mixture(PBS-M), were performed to assess the bioavailability of chlorimuron-ethyl in soil in comparison to a battery of toxicity tests in wheat seedlings. The results indicated that the peroxidase(POD) activity in wheat leaves after 7 d of exposure was one of the sensitive biomarkers of chlorimuron-ethyl in soil.The extractability of chlorimuron-ethyl by all the 3 solvents decreased with exposure time, and the rate of decrease of the PBS-M extraction between 1 and 7 d of exposure was substantially higher than those of the aqueous solution extractions. Chlorimuron-ethyl gradually changed from a water-soluble form into a soil organic matter(SOM)-bound form in the soil. The PBS extraction correlated best with the POD activity in the leaves after 7 d of exposure.