Inter-individual pharmacokinetic variation of H2-receptor antagonist is related to genetic polymorphism of CYP2C19. We investigated the frequency of CYP2C19 genetic polymorphism and the treatment duration of cimetidine by CYP2C19 genotypes in functional dyspeptic patients without definite causes who were treated with cimetidine in Korea. One hundred subjects with functional dyspepsia participated in this study from March 1, 2010 to June 30, 2011. They were tested by upper gastrointestinal endoscopy and treated for their dyspepsia with cimetidine. The single nucleotide polymorphisms (SNPs) of CYP2C19 were genotyped using the Seeplex CYP2C19 ACE Genotyping system. There were no significant differences in the demographic, clinical, or laboratory findings among the CYP2C19 subgroups which are wild type homozygote (W/W), heterozygote (W/V), and variant homozygote (V/V). The frequencies of CYP2C19 subgroups were 33 (33%) in W/W, 49 (49%) in W/V, and 18 (18%) in V/V, respectively. The mean duration of cimetidine treatment (in weeks) was the shortest in the V/V among the CYP2C19 genotypes (W/W: $5.1{\pm}1.5$, W/V: $4.0{\pm}1.7$, V/V: $2.1{\pm}0.7$; p<0.001). This study can also act as a basis for further investigation to identify the underlying genetic, epigenetic, or environmental factors in CYP2C19 enzyme activity.
Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.
Objectives : Functional dyspepsia (FD) is one of the most common gastrointestinal diseases. Nevertheless, there are many unknown mechanisms of autonomic functioning in FD patients. This study was designed to investigate the relationship between FD and biosignals from heart rate variability (HRV) and Yangdorak diagnosis. Methods : 32 patients (22 female, 10 male; mean age 40) and 32 healthy volunteers (21 female, 11 malemean; age 38) participated in this study. First gastrointestinal symptoms rating scale (GSRS) was assessed by questionnaires in both groups to evaluate the types of gastrointestinal symptoms. Second, HRV and Yangdorak diagnosis were measured in both groups. Results : 1. The FD group in this study mainly had the complaint of 'bloating' symptoms. 2. There was statistically no significant difference between Yangdorak (total average and 24 acupoints) and HRV values except logarithmic low-frequency band (lnLF) and total power (TP) in frequency domain. 3. There was statistically no significant relationship between HRV and Yangdorak in either group. However, most Yangdorak values were positively related with some HRV values (low-frequency, low-frequency/high-frequency ratio and high-frequency, etc) in the control group. Conclusions : FD patients had relatively lesser sympathetic domain than healthy subjects, indicated by decreased lnLF and TP. Particularly, there were positive relationships and significant differences between Yangdorak and HRV in young healthy subjects. This suggests that biosignals from HRV may be a useful method that can differentiate FD from healthy state in those of young age.
Background: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even when asymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most common gastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress are frequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asian countries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depression on Thai FD patients. Materials and Methods: This cross-sectional study was conducted in a tertiary care center in Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome III criteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The Hospital Anxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was defined as positive with H. pylori culture, positive rapid urease test or positive histology. Results: Three hundred FD patients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patients with PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety and depression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depression were significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and 29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9, respectively). Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patients and more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of Thai FD patients and prevent the development of gastric cancer.
Backgrounds & Objectives: Banhasasimtang granule(BHSST) has been used for the treatment of functional dyspepsia regarded as one of the gastric dysmotility disease. but its mechanisms of action are not well known yet: So we investigated the effects of BHSST on gastric emptying and its mechanisms of action in rats. Methods: Gastric emptying was measured by glass beads(1mm in diameter) expelled from the stomach for 60 min after administration of normal saline(NS) or BHSST 31mg/kg or 93mg/kg in rats. And by the same method gastric emptying was measured after administration of NS or BHSST 93mg/kg in rats treated with atropine sulfate(1mg/kg, s.c.), quinpirol HCI(0.3mg/kg, i.p.), NAME(NG-nitro-L-arginine methyl ester, 75mg/kg, s.c.) or cisplatin(10mg/kg, i.p.) to make delayed gastric emptying. Results: BHSST 93mg/kg improved gastric emptying more than NS or BHSST 31mg/kg(p=0.016). Under the delayed gastric emptying, BHSST 93mg/kg improved gastric emptying in the group treated with NAME$(5.00{\pm}3.101\;vs\;9.00{\pm}3.51,\;p\;=0.046)$, but aggravated it With atropine sulfate$(5.71{\pm}3.45\;vs\;2.57{\pm}1.62,\;p\;=0.050)$ and cisplatin$(12.7{\pm}2.29\;vs\;8.57{\pm}5.06,\;p\;=0.072)$. Conclusions: BHSST improves the gastric emptying through cholinergic and 5-hydroxytryptamine 3 receptors. Especially it is effective to improve gastric emptying delayed by NAME. So we expect that it would be effective in functional dyspepsia with impaired reservoir functions such as gastric adaptive relaxation.
Backgrounds & Objectives : Yukgunjatanggranule (YGJT) ha been used for the treatment of functional dyspepsia, regarded as one of the gastric dysmotility diseases, but its mechanisms of cation are not yet well known, We investigated the effects of YGJT on gastric emptying and its mechanisms of action in rats. Methods : Gastric emptying was measured by glass beads (1mm in diameter) expelled from the stomach for 1 hour and 2 hours after administration ofnormal saline (NS) or YGJT 41.6mg/kg or 124.8mg/kg in rats. By the same method, gastric emptying was measured only for 2 hours after administration of NS of YGJT 124.8mg/kg in rats treated with atropine sulfate (1mg/kg, s.c), quinpirole HCl(0.3mg/kg, i.p.), NAME (NG-nitro-L-arginine methyl ester, 75mg/kg, s.c.) or cisplatin (10mg/kg, i.p.) to delay gastric emptying. Results : YGJT 124.8mg/kg improved gastric emptying more than NS or YGJT 41.6mg/kg (p=0.046). Under delayed gastric emptying, YGJT 124.8mg/kg improved gastric emptying in the group treated with cisplatin ($3.1{\pm}1.3$ vs. $6.6{\pm}3.1$, p=0.015), quinpirole HCl ($4.7{\pm}2.8$ vs. $5.5{\pm}5.6$, p=0.874) and NAME ($2.2{\pm}1.4$ vs. $4.7{\pm}6.0$, p=0.414), but aggravated it with atropine sulfate ($1.8{\pm}0.9$vs. $1.7{\pm}1.0$, p=0.957). Conclusions : YGJT improves gastric emptying through the cholinergic pathwas, and shows some effect against the toxicity of cisplatin. Therefore, we expect that it would be effective in relieving gastrointestinal symptoms in functional dyspepsia patients and cisplatin-treated patients.
Baglan Peren H.;Bozdayi Gulendam;Ozkan Muhip;Ahmed Kamruddin;Bozdayi A. Mithat;Ozden Ali
Journal of Microbiology
/
v.44
no.4
/
pp.409-416
/
2006
Clarithromycin resistance in Helicobacter pylori is a principal cause of failure of eradication therapies, and its prevalence varies geographically. The IceA gene is a virulence factor associated with clinical outcomes. The objective of this study was to determine the current state of clarithromycin resistance prevalence, and to investigate the role of iceA genotypes in 87 Turkish adult patients (65 with functional dyspepsia and 22 with duodenal ulcer). A2143G and A2144G point mutations were tested by PCR-RFLP for clarithromycin resistance. Among the patients in the study, 28 patients were tested by agar dilution as well. Allelic variants of the iceA gene were identified by PCR. A total of 24 (27.6%) strains evidenced one of the mutations, either A2143G or A2144G. IceA1 was found to be positive in 28 of the strains (32.2 %), iceA2 was positive in 12 (13.8 %) and, both iceA1 and iceA2 were positive in 22 (25.3 %) strains. In conclusion, we discovered no relationships between iceA genotypes and functional dyspepsia or duodenal ulcer, nor between clarithromycin resistance and iceA genotypes. clarithromycin resistance appears to be more prevalent in Turkish patients.
As a disease that reduces quality of life, functional dyspepsia (FD) is associated with foods that may worsen its symptoms or cause it. The purpose of this study was to examine the nutritional status and dietary behaviors of FD patients. We investigated food intake, food intake frequency, and dietary habits of 45 FD subjects according to the Rome III Diagnosis Criteria. Average age and body mass index (BMI) were 47.7 years and $22.6kg/m^2$ (males: $23.4kg/m^2$, females: $22.1kg/m^2$), respectively. Average energy intake was 77% of Korean Dietary Reference Intake (KDRI), and it was less than that of the Korea National Health and Nutrition Examination Surveys (KNHANES). Other nutrient intake levels were similar to the KNHANES. Energy intake proportion of carbohydrates : protein : fat was 56 : 18 : 26, and the ratio of fat intake was higher than that of the KNHANES. Beans, laver, tomato, and yogurt were consumed very frequently. In the results of meal regularity, dietary behaviors and composition of diet were relatively good. It is likely that the patient controlled their diet by eating cautiously and by reducing alcohol drinking and smoking. Our results indicate that FD patients' nutritional status by consumption of nutrients was at a level of normal healthy people and that dietary habits were better than normal adults. However, their fat intake levels were somewhat higher than normal people. Therefore, further research is required to identify the relationship between dietary intakes and FD.
Objective: The aim of this case report is to report the effect of Korean medicine treatment, including Shihogayonggolmoryo-tang, on anxiety and abdominal pulsation in a patient diagnosed with functional dyspepsia. Method: The patient was treated with Shihogayonggolmoryo-tang, including acupuncture, moxibustion, and cupping therapy. Changes in symptoms were evaluated using a self-reported numerical rating scale (NRS) score every morning. The gastrointestinal symptom score (GIS) was checked on admission and discharge day. Results: After 6 days, the NRS scores for anxiety, abdominal pulsation, abdomen discomfort, and GIS all decreased. Conclusion: The results suggest that Shihogayonggolmoryo-tang with Korean medicine could be effective for treating anxiety, abdominal pulsation, and accompanying abdomen symptoms. However, further evaluation is needed to clarify the relationship between the treatment's effect and Shihogayonggolmoryo-tang.
Kim, Keumji;Jeon, Hye-jin;Ko, Seok-jae;Cha, Jae Myung;Park, Jae-Woo
The Journal of Internal Korean Medicine
/
v.42
no.6
/
pp.1285-1302
/
2021
Objectives: The aim of this study was to investigate the perception difference between Korean Medicine doctors, Western Medicine doctors, and functional dyspepsia (FD) patients on the 'Collaborative and Integrated Medicine (CIM)' for FD management. Methods: Between February and April 2021, 545 Korean Medicine doctors, 121 Western Medicine doctors, and 186 FD patients were invited to participate in this survey. A questionnaire was developed by both the Korean and Western Medicine doctors and consisted of questions about general perceptions of FD and perceptions of CIM for FD. Results: Responses from 424 Korean Medicine doctors, 113 Western Medicine doctors, and 153 FD patients were analyzed for the CIM of FD. Significant perceptional differences were noted between Korean Medicine doctors, Western Medicine doctors, and FD patients on the CIM for FD, including necessity, effectiveness, safety, cost, and reliability of CIM for the management of FD (p<0.001). The FD patients also more strongly supported the necessity of developing CIM for FD than did the Korean and Western Medicine doctors (p<0.001), and 87.6% of the FD patients strongly agreed or agreed with the use of CIM for FD. Conclusions: A significant perception difference was detected between Korean Medicine doctors, Western Medicine doctors, and FD patients regarding the use of CIM for FD. Patients with FD favored the necessity and were more willing to accept CIM for FD than were the doctors. Therefore, more efforts may be warranted for doctors to promote CIM for FD.
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