| Role of free radical scavengers in the management of refractory duodenal ulceration. A new approach. | |
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MedLine Citation:
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PMID: 8277768 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This prospective randomized double blind study examined the influence of free radical scavengers on the healing and recurrence of refractory duodenal ulceration. To this end, allopurinol (50 mg, four times a day) -a hydroxyl radical scavenger and an inhibitor of xanthine oxidase, the enzyme which forms superoxide radicals--and dimethyl sulfoxide (DMSO, 500 mg, four times a day)--a hydroxyl radical scavenger--were administered orally. Three hundred and sixty-three consecutive patients with duodenal ulceration that did not heal despite 3 months of treatment with cimetidine, who were cigarette smokers and social drinkers, were randomized to receive 800 mg cimetidine twice a day alone or with either allopurinol or DMSO. In 315 patients who were evaluable for efficacy analysis, the healing rate at 8 weeks was, for cimetidine alone, 60%; for cimetidine with DMSO, 100%; and for cimetidine with allopurinol, 100%. The healing efficacy of cimetidine was therefore significantly (P < 0.01) heightened by DMSO and allopurinol. The patients whose ulcers healed were instituted on maintenance treatment for 1 year and received 800 mg cimetidine at bedtime alone or with either DMSO or allopurinol. In 218 patients who were evaluable for efficacy analysis, the cumulative relapse rate at 1 year was, for cimetidine alone, 29%; for cimetidine with DMSO, 8%; and for cimetidine with allopurinol, 7% DMSO with cimetidine and allopurinol with cimetidine were, therefore, superior to cimetidine alone (P < 0.01) in preventing ulcer relapse. The results suggest that oxygen-derived free radicals are implicated in the mechanism of refractory duodenal ulceration and that scavenging these radicals stimulates healing and reduces recurrence of the ulceration. |
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Authors:
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A S Salim |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of surgical research Volume: 56 ISSN: 0022-4804 ISO Abbreviation: J. Surg. Res. Publication Date: 1994 Jan |
Date Detail:
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Created Date: 1994-02-04 Completed Date: 1994-02-04 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0376340 Medline TA: J Surg Res Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 45-52 Citation Subset: IM |
Affiliation:
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University Department of Surgery, Medical City, Baghdad, Iraq. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Alcohol Drinking Allopurinol / administration & dosage, therapeutic use* Cimetidine / administration & dosage, therapeutic use Dimethyl Sulfoxide / administration & dosage, therapeutic use* Double-Blind Method Drug Therapy, Combination Duodenal Ulcer / drug therapy* Female Free Radical Scavengers* Humans Hydroxyl Radical / metabolism Male Middle Aged Prospective Studies Recurrence Smoking Xanthine Oxidase / antagonists & inhibitors |
| Chemical | |
Reg. No./Substance:
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0/Free Radical Scavengers; 315-30-0/Allopurinol; 3352-57-6/Hydroxyl Radical; 51481-61-9/Cimetidine; 67-68-5/Dimethyl Sulfoxide; EC 1.17.3.2/Xanthine Oxidase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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