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Background: US and European guidelines recommend budesonide for the treatment of mild-to-moderate active ileocolic Crohn's disease (CD). However, budesonide has not been approved, and mesalazine is widely used as first-line treatment in Japan. The objective of this study was to evaluate the efficacy and safety of budesonide in patients with mild-to-moderate active CD in Japan. Methods: In this phase 3 noninferiority study (NCT01514240), 112 patients with a baseline Crohn's Disease Activity Index (CDAI) score of 180-400 were randomized to budesonide or mesalazine for 8 weeks. Assessments included remission rate (CDAI score ≤150) at weeks 2, 4, and 8, change in CDAI score, health-related quality of life (measured using the Inflammatory Bowel Disease Questionnaire [IBDQ]), and tolerability. Results: The remission rate at week 8 was numerically higher in the budesonide group (30.4%) than in the mesalazine group (25.0%), and the noninferiority of budesonide to mesalazine was shown. The mean total CDAI score decreased to a greater extent with budesonide than with mesalazine. Mean IBDQ scores improved from baseline to weeks 2, 4, 8, and 10 in both groups; improvements were numerically higher with budesonide than with mesalazine. No safety concerns were found. Conclusion: Budesonide is comparably effective to mesalazine in the treatment of Japanese patients with mild-to-moderate active CD.

We give a combinatorial formula for the Betti numbers which ap­pear in a minimal free resolution of the Stanley-Reisner ring k[􀀁(P)]= A/ h('P) of the boundary complex 􀀁(P) of an odd-dimensional cyclic polytope P over a field k. A corollary to the formula is that the Betti number sequence of k[􀀁(P)] is unimodal and does not depend on the base field k.

Let Δ be a simplicial complex of dimension d - 1 on the vertex set V and write Ei for the number of "minimal" subsets er C V with U(er) = i + 1 and er

We study the Betti numbers which appear in a minimal free res­olution of the Stanley-Reisner ring k[􀀃] = A/ft:. of a simplicial com­plex 􀀃 over a field k. It is known that the second Betti number of k[􀀃] is independent of the base field k. We show that, when the ideal ft:. is generated by square-free monomials of degree two, the third and fourth Betti numbers are also independent of k. On the other hand, we prove that, if the goemetric realization of􀀃 is homeomorphic to either the 3-sphere or the 3-ball, then all the Betti numbers of k[􀀃] are independent of the base field k.

Let P( v, d) be a stacked d-polytope with v vertices, .6.(P( v, d)) the boundary complex of P( v, d), and k[.6.(P( v, d))] = A/ IA(P(v,d)) the Stanley-Reisner ring of .6.(P( v, d)) over a field k. We comﾂｭpute the Betti numbers which appear in a minimal free resolution of k[.6.(P(v,d))] over A, and show that every Betti number depends only on v and d and is independent of the base field k.

We study the Betti numbers which appear in a minimal free res­olution of the Stanley-Reisner ring k[.6.] of a Buchsbaum complex .6. and find a characterization of Buchsbaum complexes .6. for which a minimal free resolution of k[.6.] is linear.

The clinical significance of Helicobacter pylori antibody titer has been controversial, and the association between the extent of gastric atrophy or acid secretion and H. pylori antibody concentration has not been elucidated.Serum pepsinogen, H. pylori antibody concentration, and fasting gastric pH (as an indicator of acid secretion) were measured in 231 patients undergoing upper gastrointestinal endoscopy. "Atrophic" pepsinogen was defined as pepsinogen-I70 ng/mL and pepsinogen-I/II ratio3. Other levels of pepsinogen were defined as "normal". Fasting gastric pH was analyzed in subjects stratified by pepsinogen level and by H. pylori antibody concentration.Helicobacter pylori antibody concentration showed no significant relationship with fasting gastric pH when all subjects were analyzed together. In H. pylori-seronegative subjects, fasting gastric pH was within the normal range, irrespective of the extent of mucosal atrophy. In H. pylori-seropositive subjects, H. pylori antibody concentration was positively correlated with fasting gastric pH in subjects with "normal" pepsinogen, but inversely correlated in those with "atrophic" pepsinogen. Particularly in subjects with low H. pylori antibody concentration and atrophic mucosa, a group reportedly at high risk of noncardia cancer, the most impaired acid secretion was shown among subjects with atrophic mucosa. The relationship between acid secretion and H. pylori antibody concentration differs depending on the presence of mucosal atrophy. Our findings provide a possible rationalization for measuring both serum pepsinogen levels and H. pylori antibody concentration in gastric cancer screening.