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Vonoprazan is a novel potassium-competitive acid blocker (P-CAB) recently approved for Helicobacter pylori eradication therapy in Japan.To compare PPI- and P-CAP-containing triple therapy and vonoprazan-based triple therapy.Two hundred ninety-five initial subjects received a PPI-containing triple therapy; the next 125 subjects received vonoprazan-containing triple therapy. Two sequential groups received 7-day eradication regimens consisting of amoxicillin 750 mg, clarithromycin 200 mg both twice a day with standard dose PPI or vonoprazan (20 mg) each twice daily. H. pylori eradication was confirmed by a 13C-UBT. Clarithromycin susceptibility was evaluated by 23S rRNA PCR.Population cure rates with clarithromycin susceptible strains were 89.6 versus 100 % for PPI and vonoprazan therapies, respectively. Cure rates with resistant strains were 40.2 % with PPI therapy versus 76.1 % with vonoprazan triple therapy. There was no difference in side effects.Although 7-day P-CAB triple therapy was superior to 7-day PPI triple therapy, neither was highly effective, or can be recommended, in the presence of clarithromycin-resistant infections.

心筋梗塞後の心機能低下は突然死の危険因子である.また心筋梗塞後突然死には再分極過程の異常が関与する.そこで心室筋不応期不均一性を表す指標であるmicrovolt T wave alternans (以下TWA) と心筋梗塞後の心機能の関係を検討した.【方法】対象は心筋梗塞患者163人で, 男/女=141/22, 平均年齢62±10歳である.心筋梗塞発症急性期と慢性期 (3～6カ月) に心臓力テーテル検査を施行し, 慢性期に行われたTWA検査の結果と比較した.【結果】163例中TWA陽1生37例 (22.7%) , 陰性103例 (63, 2%) , 判定不能11例 (6.7%) , 評価不能12例 (7.4%) であった.陽性群は陰性群に比べ, 慢性期の左室駆出率が低く (46±12vs54±11%, p

Fulminant type 1 diabetes is characterized by abrupt onset of loss of pancreas β-cell function with low initial HbA1c levels and absence of autoantibodies to islet antigens (1). Initial histological examinations revealed the absence of insulitis, and it was thought that the autoimmune process did not mediate this type of diabetes. However, with an accumulation of cases, possible involvement of an immune response to islet antigens has come to light. CD8+ lymphocytes infiltrating the pancreatic islets were seen in a patient who died of fulminant type 1 diabetes (2), and peripheral GAD-reactive interferon-γ-producing CD4+ lymphocytes were detected in another case of fulminant type 1 diabetes (3). Thus, T-cell-mediated autoimmunity may be involved. HLA analyses also indicate that an autoimmune process similar to that in autoimmune type …