Morphometric estimation of acid output in duodenal ulcer associated with Helicobacter pylori infection.
OBJECTIVE
to determine the changes in acid output before and after eradication therapy in patients with duodenal ulcer associated with Helicobacter pylori infection.


METHODS
the subjects of this prospective study were 16 patients with acute duodenal ulcer at endoscopy and H. pylori infection determined by rapid urease test and histology. They were randomly assigned to receive treatment with pantoprazole 40 mg b.i.d., clarithromycin 500 mg b.i.d. and amoxicillin 1 g b.i.d. during 7 or 14 days. Endoscopic examination and biopsy were repeated 4 weeks after treatment ended. The changes in acid output before and after treatment were calculated by the morphometric quantification of parietal cell canaliculi from the gastric corpus. To this end 20 parietal cells from the medial glandular zone were selected and canalicular index was calculated, before and after eradication therapy, with a morphometric method based on automatic analysis of histological images.


RESULTS
canalicular index was 26.4 +/- 1.4 (mean +/- standard error of the mean) before treatment, and 20.5 +/- 1 (p < 0.01) after therapy.


CONCLUSIONS
morphometric analysis showed a decrease in acid output in patients with duodenal ulcer associated with H. pylori infection 4 weeks after eradication therapy with clarithromycin, amoxicillin and pantoprazole.
Rodríguez Téllez
M
M
Servicio de Aparato Digestivo, Hospital Universitario "Virgen Macarena", Sevilla, España. mrodrigueztellez@meditex.es
Valenzuela Barranco
M
M
Caballero Plasencia
A
A
Martín Ruiz
J
J
López-Andrade
A
A
Carmona Soria
I
I
Herrerías Gutiérrez
J
J
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D005744:Gastric Acid / Q000378:metabolism*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D009853:Omeprazole / Q000031:analogs & derivatives; D000077402:Pantoprazole; D010295:Parietal Cells, Gastric / Q000378:metabolism / Q000648:ultrastructure; D010406:Penicillins / Q000627:therapeutic use; D013454:Sulfoxides / Q000627:therapeutic use
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D010406:Penicillins; D013454:Sulfoxides; D000658:Amoxicillin; D000077402:Pantoprazole; D017291:Clarithromycin; D009853:Omeprazole