The activities of various types of antiulcer agents against Helicobacter pylori (formerly called Campylobacter pylon) strains were determined by an agar dilution method. Among the compounds tested, two benzimidazole proton pump inhibitors, lansoprazole (AG-1749) and omeprazole, were found to have significant activities against this organism. The activity of lansoprazole was comparable to that of bismuth citrate, with MICs ranging from 3.13 to 12.5 ,ug/ml, and fourfold more potent than that of omeprazole. A major metabolite and two acid-converted rearrangement products of lansoprazole also exhibited good activities comparable or superior to that of the parent compound. Exposure to lansoprazole of H. pylori growing in a liquid medium led to an extensive loss of viability without a reduction in culture turbidity and produced an aberrant bacterial morphology characterized by the irregular constriction of cells and the collapse of cell surface structures. The antibacterial activity of lansoprazole and its related compounds was selective against H. pylori; common aerobic and anaerobic bacteria and Campylobacterjejuni were not inhibited by 100 ,ug/ml.

Serum I-FABP measurement is a non-invasive method that is potentially useful for the efficient identification of patients with acute abdomen who are at risk of small bowel ischemia.

The presence of nodal micrometastases leads to a poor prognosis. The survival of patients with micrometastases was not different from that of patients with overt metastases. Therefore, patients with cytokeratin-positive cells in lateral lymph nodes should be regarded as having overt metastases.

The therapeutic effect of cefozopran (SCE-2787), a new semisynthetic parenteral cephalosporin, against experimental infections in mice was examined. Cefozopran was more effective than cefpiramide and was as effective as ceftazidime and cefpirome against acute respiratory tract infections caused by Kiebsiella pneumoniae DT-S. In the model of chronic respiratory tract infection caused by K. pneumoniae 27, cefozopran was as effective as ceftazidime. The therapeutic effect of cefozopran against urinary tract infections caused by Pseudomonas aeruginosa P9 was superior to that of cefpirome and was equal to those of ceftazidime and cefclidin. In addition, cefozopran was more effective than ceftazidime and was as effective as flomoxef in a thigh muscle infection caused by methicillin-sensitive Staphylococcus aureus 308A-1. Against thigh muscle infections caused by methicillin-resistant S. aureus N133, cefozopran was the most effective agent. The potent therapeutic effect of cefozopran in those experimental infections in mice suggests that it would be effective against respiratory tract, urinary tract, and soft tissue infections caused by a variety of gram-positive and gram-negative bacteria in humans.The search for new drugs effective as antibacterial agents requires the thorough evaluation of drugs not only in vitro but also in vivo (i.e., in the control and management of experimental infections). Systemic infections induced by an intraperitoneal injection of a bacterial suspension have been commonly used for the evaluation of new antibiotics. Such infections, however, are not always representative of infectious diseases in humans. It is therefore important to evaluate antibiotics by using animal models of infection which more closely mimic the actual situation in humans.This paper deals with the in vivo evaluation of cefozo- (Fig. 1), cefpirome, and cefclidin were prepared in the Research and Develop-* Corresponding author. ment Division of Takeda Chemical Industries, Ltd. Ceftazidime (Nippon Glaxo Co., Ltd., Tokyo, Japan), cefpiramide (Sumitomo Pharmaceuticals Co., Ltd., Osaka, Japan), and flomoxef (Shionogi & Co., Ltd., Osaka, Japan) were obtained commercially. MICs of each antibiotic were determined by an agar dilution method using an inoculum of ca.104 CFU and are shown in each table.Experimental infections and antibiotic treatment. (i) Respiratory tract infection. Acute respiratory tract infection caused by K pneumoniae DT-S was induced as described previously (19). Briefly, K pneumoniae DT-S was grown overnight at 37°C in brain heart infusion broth (Difco Laboratories, Detroit, Mich.), and cells were collected by centrifugation, washed with phosphate-buffered saline (Dulbecco formula [modified] without magnesium and calcium; Flow Laboratories, Inc., McLean, Va.), and suspended in the same buffered saline to give a suspension of ca. 109 CFU/ml. The bacterial suspension was placed in a nebulizer (Vaponefrin pocket nebulizer; USV Pharmaceutical Co., Tuckahoe, N.Y.) and aerosolized at a pressure of 1.2 kg/cm2 for ...

An 82-year-old woman underwent percutaneous endoscopic gastrostomy (PEG) 5 years after partial gastrectomy for cancer. Four months after PEG insertion, a colocutaneous fistula was noted at exchange of the PEG tube. Colocutaneous fistula is a rare and major complication of PEG with 10 reported cases to date. In eight of the 11 reported cases, including this case, fistulas appeared late (>6 weeks) after PEG insertion. This complication may heal after removal of the PEG alone, if the fistula has formed completely; otherwise a surgical approach is necessary for the treatment. Since five of the 11 reported patients had previously undergone abdominal surgery, prior abdominal surgery may increase the risk of a colonic injury after PEG. Open surgical gastrostomy is a wiser option when performing gastrostomy in patients with prior abdominal surgery.