Reviewer's report 
 The diagnostic value of endoscopy and Helicobacter pylori tests for peptic ulcer patients in late Title: 
post-treatment setting 
 1  26 August 2004 Version: Date: 
 Deng-Chyang Wu Reviewer: 
Reviewer's report: 
This paper focused on comparison of different methods to detect H. pylori, especially assessing the 
post-treatment status in symptomatic patients and tried to evaluate the endoscopic and histologic changes after H. pylori eradication. 
Major Compulsory Revisions: 
1. In page 4, the patient group was observed at 4 weeks, and thereafter one year and 5 years after treatment (127, 107 and 81 patients, respectively). That means 7 patients received post-treatment Hp evaluation after 1 year or 5 years. So, what is the definition of successful eradication? As time 
past, Hp could be re-infected or recrudesced during 5-year period. Of course, the aim of this paper 
focuses on detecting Hp with different methods. But detecting scanty Hp at 4 weeks and large amount Hp after 1 year with different methods and compared their accuracy, not a good way to do this. 
2. Since recent proton pump inhibitor use leads to false negative UBT result. It’s necessary that 
author describe the percentage of patients underwent Hp exams during proton pump inhibitor use and the duration of cessation of proton pump inhibitor use and evaluation of residual Hp infection. 3. In page 6, since the specimens from the antrum and corpus mucosa used for imprinting the 
cytology slides were the same with those used for culture, how do you explain the obvious difference 
between the cytology (24% positive) and culture (100% positive) results in UBT(+) cases? 
4. The aim of this paper is to compare invasive and non-invasive methods for the detection of Hp in late post-treatment patients. Unfortunately, these can not be showed clearly in the result section and 
table 1. Please adjust this problem. 
5. In page 10 line 12, since the histologic finding of Hp completely correlated with the result of 13C-UBT, it was irrelevant with following sentence “Thus, endoscopy and gastric mucosal biopsy remain the best available methods…”. 
6. In discussion section, our readers can’t easily find the crucial answer from the endpoint of this 
paper. Moreover, further discussion was relatively irrelevant to the result, though the author tried to address that the visual evaluation of mucosa did not well correlate with Hp infection. 7. In page 5, author diagnosed GU and DU, different with traditional definition? Could you explain 
this and provide reference? 
8. In page 5, the author performed E-test for clarithromycin, not for amoxicillin and metronidazole 
which were main antibiotics used to treat these patients in this study (as shown in Line 5 Page 4). 
9. In page 7. the endoscopic finding of these 34 patients were 6 patients with duodenal mucosa 
erosion and 4 peptic ulcer in line 9. However, in line 16, the author showed 6 patients with gastric 
mucosa erosions. 
Generally speaking, the result, discussion and conclusion part can not meet the aim of this paper. 
Secondly, this study lacks a good study design. 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Acceptable Quality of written English: 
 No Statistical review: 
Reviewer's report 
 The diagnostic value of endoscopy and Helicobacter pylori tests for peptic ulcer patients in late Title: 
post-treatment setting 
 1  26 August 2004 Version: Date: 
 Deng-Chyang Wu Reviewer: 
Reviewer's report: 
This paper focused on comparison of different methods to detect H. pylori, especially assessing the 
post-treatment status in symptomatic patients and tried to evaluate the endoscopic and histologic changes after H. pylori eradication. 
Major Compulsory Revisions: 
1. In page 4, the patient group was observed at 4 weeks, and thereafter one year and 5 years after treatment (127, 107 and 81 patients, respectively). That means 7 patients received post-treatment Hp evaluation after 1 year or 5 years. So, what is the definition of successful eradication? As time 
past, Hp could be re-infected or recrudesced during 5-year period. Of course, the aim of this paper 
focuses on detecting Hp with different methods. But detecting scanty Hp at 4 weeks and large amount Hp after 1 year with different methods and compared their accuracy, not a good way to do this. 
2. Since recent proton pump inhibitor use leads to false negative UBT result. It’s necessary that 
author describe the percentage of patients underwent Hp exams during proton pump inhibitor use and the duration of cessation of proton pump inhibitor use and evaluation of residual Hp infection. 3. In page 6, since the specimens from the antrum and corpus mucosa used for imprinting the 
cytology slides were the same with those used for culture, how do you explain the obvious difference 
between the cytology (24% positive) and culture (100% positive) results in UBT(+) cases? 
4. The aim of this paper is to compare invasive and non-invasive methods for the detection of Hp in late post-treatment patients. Unfortunately, these can not be showed clearly in the result section and 
table 1. Please adjust this problem. 
5. In page 10 line 12, since the histologic finding of Hp completely correlated with the result of 13C-UBT, it was irrelevant with following sentence “Thus, endoscopy and gastric mucosal biopsy remain the best available methods…”. 
6. In discussion section, our readers can’t easily find the crucial answer from the endpoint of this 
paper. Moreover, further discussion was relatively irrelevant to the result, though the author tried to address that the visual evaluation of mucosa did not well correlate with Hp infection. 7. In page 5, author diagnosed GU and DU, different with traditional definition? Could you explain 
this and provide reference? 
8. In page 5, the author performed E-test for clarithromycin, not for amoxicillin and metronidazole 
which were main antibiotics used to treat these patients in this study (as shown in Line 5 Page 4). 
9. In page 7. the endoscopic finding of these 34 patients were 6 patients with duodenal mucosa 
erosion and 4 peptic ulcer in line 9. However, in line 16, the author showed 6 patients with gastric 
mucosa erosions. 
Generally speaking, the result, discussion and conclusion part can not meet the aim of this paper. 
Secondly, this study lacks a good study design. 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Acceptable Quality of written English: 
 No Statistical review: 
Please review this paper.
user
Reviewer's report 
 The diagnostic value of endoscopy and Helicobacter pylori tests for peptic ulcer patients in late Title: 
post-treatment setting 
 1  26 August 2004 Version: Date: 
 Deng-Chyang Wu Reviewer: 
Reviewer's report: 
This paper focused on comparison of different methods to detect H. pylori, especially assessing the 
post-treatment status in symptomatic patients and tried to evaluate the endoscopic and histologic changes after H. pylori eradication. 
Major Compulsory Revisions: 
1. In page 4, the patient group was observed at 4 weeks, and thereafter one year and 5 years after treatment (127, 107 and 81 patients, respectively). That means 7 patients received post-treatment Hp evaluation after 1 year or 5 years. So, what is the definition of successful eradication? As time 
past, Hp could be re-infected or recrudesced during 5-year period. Of course, the aim of this paper 
focuses on detecting Hp with different methods. But detecting scanty Hp at 4 weeks and large amount Hp after 1 year with different methods and compared their accuracy, not a good way to do this. 
2. Since recent proton pump inhibitor use leads to false negative UBT result. It’s necessary that 
author describe the percentage of patients underwent Hp exams during proton pump inhibitor use and the duration of cessation of proton pump inhibitor use and evaluation of residual Hp infection. 3. In page 6, since the specimens from the antrum and corpus mucosa used for imprinting the 
cytology slides were the same with those used for culture, how do you explain the obvious difference 
between the cytology (24% positive) and culture (100% positive) results in UBT(+) cases? 
4. The aim of this paper is to compare invasive and non-invasive methods for the detection of Hp in late post-treatment patients. Unfortunately, these can not be showed clearly in the result section and 
table 1. Please adjust this problem. 
5. In page 10 line 12, since the histologic finding of Hp completely correlated with the result of 13C-UBT, it was irrelevant with following sentence “Thus, endoscopy and gastric mucosal biopsy remain the best available methods…”. 
6. In discussion section, our readers can’t easily find the crucial answer from the endpoint of this 
paper. Moreover, further discussion was relatively irrelevant to the result, though the author tried to address that the visual evaluation of mucosa did not well correlate with Hp infection. 7. In page 5, author diagnosed GU and DU, different with traditional definition? Could you explain 
this and provide reference? 
8. In page 5, the author performed E-test for clarithromycin, not for amoxicillin and metronidazole 
which were main antibiotics used to treat these patients in this study (as shown in Line 5 Page 4). 
9. In page 7. the endoscopic finding of these 34 patients were 6 patients with duodenal mucosa 
erosion and 4 peptic ulcer in line 9. However, in line 16, the author showed 6 patients with gastric 
mucosa erosions. 
Generally speaking, the result, discussion and conclusion part can not meet the aim of this paper. 
Secondly, this study lacks a good study design. 
 Unable to decide on acceptance or rejection until the authors have responded to the What next?: 
major compulsory revisions 
 An article whose findings are important to those with closely related research Level of interest: 
interests 
 Acceptable Quality of written English: 
 No Statistical review: 
assistant