• Biomolecules & Therapeutics
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• v.20 no.2
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• pp.239-244
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• 2012

This study examined the inhibitory effects of 4-guanidinobutyric acid (4GBA), an alkaloid, against gastric lesions by assessing the inhibition of Helicobacter pylori (H. pylori) and gastric cancer cells. Acute and chronic gastritis were also observed using HCl/ethanol (EtOH) and indomethacin-induced gastric lesion models, respectively. 4GBA inhibited the growth of H. pylori in a dose dependent manner, and showed acid-neutralizing capacity. In the pylorus ligated rats, 4GBA decreased the volume of gastric secretion and gastric acid output slightly, and increased the pH. 4GBA at a dose of 100 mg/kg reduced the size of HCl/EtOH-induced gastric lesions (70.8%) and indomethacin-induced gastric lesions (38.8%). The antigastritic action of 4GBA might be associated with the acid-neutralizing capacity, anti-H. pylori action, and decreased volume of gastric secretion. These results suggest that 4GBA might be useful in the treatment and/or protection of gastritis.

• The Journal of Korean Medicine
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• v.28 no.2 s.70
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• pp.166-184
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• 2007

Objectives : This study was conducted to investigate the effects of Daegeum-eumja, Igwi-tang, and Sihosogan-san on gastric mucosal lesions induced by alcohol, indomethacin, and burn-stress in mice. Methods : Experimental mice were divided into six groups. The normal group (NOR) did not receive any treatment to elicit gastropathy. In the control group (GE), gastropathy was elicited by alcohol, indomethacin, and stress. In the misoprostol group (MS), misoprostol was administered after gastropathy was elicited by alcohol, indomethacin, and stress. In the Daegeum-eumja group (DG), Daegeum-eumja was administered after gastropathy was elicited by alcohol, indomethacin, and stress. In the Igwi-tang group (IW), Igwi-tang was administered after gastropathy was elicited by alcohol, indomethacin, and stress. In the Sihosogan-san group (SH), Sihosogan-san was administered after gastropathy waselicited by alcohol, indomethacin, and stress. The effects on gastric mucosal lesions were evaluated by the morphological change of gastric mucosa, the anti-oxidant effect, HSP 70, $NF-{\kappa}B$ p65, $I{\kappa}B$, COX-1, PNA, BrdU, and iNOS. Results : Hemorrhage erosion, HSP70, and $NF-{\kappa}B$ in the DG, IW and SH groups decreased more than that of the control. The $I{\kappa}B$, COX-1, PNA, BrdU, and iNOS in the DG, IW, and SH groups increased more than that of the control. DG showed the most effect against gastric mucosal lesions induced by alcohol; IW against gastric mucosal lesions induced by indomethacin; and SH against gastric mucosal lesions induced by burn-stress. Conclusions: Daegeum-eumja, Igwi-tang, and Sihosogan-san extracts have excellent effects on gastric mucosal lesions induced by alcohol, indomethacin, and burn-stress, respectively.

• The Journal of Korean Medicine
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• v.26 no.3 s.63
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• pp.215-227
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• 2005

Objectives : This study was carried out to investigate the effects of Pyungjintang on indomethacin-induced gastric mucosal lesions of mire. Methods : Experimental mice were classified into not-treated group (NOR group), gastro-inflammation elicitated group (CON group), misoprostol-administered group after gastro-inflammation elicitation (MA group), and Pyungjintang-administered group after gastro-inflammation elicitation (PA group). This study examined the morphological change, distribution of mast cells, mucus surface cells, neutral mucus secreting cells, acid mucus secreting cells, PNA reaction, angiogenesis (MIP-2), COX-1, Hsp70, NF-kB p50, COX-2IL-12B, ICAM-1, BrdU and apoptotic cells of gastric mucosa. Results : 1. The scars of diapedesis, dilatation of right gastric artery and the hemorrhagic erosions of gastric mucosa were reduced in the MA and PA groups. 2. Gastric perforation was observed in the gastro-inflammation elicitated group, but not in the MA and PA groups. 3. The COX-1 positive cellsl, cell proliferation of gastric mucosa, neutral mucus secreting ce31s, acid mucus secreting cells and PNA positive reaction of surface mucus cells were increased in the MA and PA groups. 4. The distribution of apoptotic cells, mast cells, MIP-2, Hsp70, NF-kB p50, COX-2, IL-l2B and ICAM-1 were decreased in the MA and PA groups. Conclusions : Pyungjintang had excellent effects on indomethacin-induced gastric mucosal lesions in mice.

• Journal of Oriental Physiology
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• v.14 no.2 s.20
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• pp.1-9
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• 1999

Ethanol induces compoundhemorrhagic gastric lesions and causes a dose-dependent decrease in the concentration of endogenous nonprotein sulfhydryls in rat gastric mucosa. Sulfhydryl-containing drugs protect rats from ethanol - induced gastric lesions. Based on this findings, we investigated the involvement of sulfhydryl compounds in the antioxidant effects of Puerariae radix, a traditional herbal medicine, against ethanol - induced gastric lesions in the absence and presence of iodoacetamide(IDA. sulfhydryl blocking agent) in rats. respectively. Because of the known role of sulfhydryls in gastric cytoprotection, its role in gastric antioxidation was of intrest. In vitro, Puerariae radix extract(PRE) reduced linoleic acid autooxidation and exert DPPH radical scavenging effect. In vivo. PRE increased antioxidants(SOD, catalase. GSH) and reduced lipid peroxide level in ethanol-induced gastric mucosal lesions. But treatment with PRE plus IDA significantly inhibit the antioxidant effects such as SOD and GSH but did not affect catalase levels. These results suggest that Puerariae radix may play roles in the gastric cytoprotection through antioxidant effects and increase of SOD activity and GSH level are dependent of endogenous sulfhydryls.

• Journal of Gastric Cancer
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• v.1 no.3
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• pp.136-143
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• 2001

Purpose: The prognosis for gastric cancer with peritoneal seeding is very poor, and the role of surgical intervention is limited. We evaluated the effect of radical removal of primary and metastatic lesions on survival in gastric cancer with peritoneal seeding. Materials and Methods: From May 1989 to March 1999 at Kosin University Gospel Hospital, 115 patients revealed gastric cancer with peritoneal seeding but without liver or lung metastasis and without follow-up loss. The study group included 86 patients who underwent surgery for radical removal of primary gastric and metastatic peritoneal lesions. The control group included 29 patients who experienced incomplete removal of primary or metastatic lesions. Both groups received intraoperative intraperitoneal chemotherapy using mytomycin or cisplatin, and 25 patients underwent postoperative intravenous chemotherapy. Results: The median survival times in the study and the control groups were 13 months and 4 months, respectively (p<0.0001). The 1-year, 2-year, and 5-year survival rates were, respectively, $50.6\%,\;18.1\%$, and $11.3\%$ in the study group and $14.8\%,\;3.7\%$ and $0\%$ in the control group (p<0.0001). In the study group, neither postoperative intravenous chemotherapy nor microscopic invasion of the resection margin had any effect on survival, but intraoperative intraperitoneal chemotherapy and degree of peri-toneal seeding, especially the amount of peritoneal seeding, had an effect on survival. In the control group, neither intraperitoneal nor intravenous chemotherapy had any effect on survival, but resection of the primary gastric lesion improved survival. Conclusion: Radical removal of primary gastric and metastatic peritoneal lesions improved the survival rate for gastric cancer with peritoneal seeding. However, a randomized prospective study is needed to correctly evaluate the effect of intraperitoneal or intravenous chemotherapy.

• The Journal of Internal Korean Medicine
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• v.25 no.3
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• pp.497-507
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• 2004

This study was carried out to investigate the effects of Ikwitang extract on indomethacin-induced gastric mucosal lesions in mice. Experimental groups were classified into a non-treated group(NM group), a non-administered group(CON group), the Misoprostol-administered group(MI group) and the Ikwitang-extract-administered group(IW group). This study examined the morphological change, distribution of mast cells, mucous surface cells, acid mucose secreted cells, and apoptic cells, BrdU, COX-1, Hsp70, $NF-{\kappa}B\;p50$, PKC, COX-2 and IL-12B of gastric mucosa. Results : The results of this study were as follows: 1. In the Misoprostol-administered group and the Ikwitang-extract-administered group, the hemorrhagic erosion of gastric mucous and infiltrated mast cells decreased. 2. Mucous surface cells and acid mucose secreted cells abserved in the Misoprostol-administered group and the Ikwitang-extract administered group. 3. The distribution of apoptic cells, Hsp70, $NF-{\kappa}B\;p50$, PKC, COX-2, and IL-12B increased in the Control group, but decreased in the Misoprostol-administered group and Ikwitang-extract-administered group. 4. Cells proliferation of gastric mucosa and the COX-l positive cells decreased in the Control group, but increased in the Misoprostol-administered group and the Ikwitang-extract -administered group. The above results suggest the lkwitang extract had beneficial effects on indomethacin induced gastric mucosal lesions.

• Journal of Gastric Cancer
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• v.1 no.3
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• pp.150-154
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• 2001

Purpose: Multiple early gastric cancers were found in $6.9\∼11.7\%$ of patients with early gastric cancer. The goal of this study was to clarify the clinicopathologic features of and to investigate treatment strategy for multiple early gastric cancer. Materials and Methods: Of 967 patients with an gastric adenocarcinoma who were treated by surgical resection during the period of $1993\∼1998$ at the Department of Surgery, Korea University College of Medicine, 267 patients had early gastric cancer. A retrospective analysis of the clinicopathologic differences between the main and the accessory lesions in multiple early gastric cancer was carried out. A comparative analysis was also conducted between solitary early gastric cancer and multiple early gastric cancer. Results: Of 267 patients with early gastric cancer, multiple early gastric cancers were found in 12 patients ($4.5\%$), including 10 men and 2 women. Eleven patients with multiple early gastric cancer had one accessory lesion and 1 patient had 2 accessory lesions. Of the 13 accessory lesions, 7 ($53.8\%$) were located in the same region as the main lesion. The most frequent combination of macroscopic types for the main lesion and the accessory lesion were depressed and depressed types (6 cases, $46.1\%$). The most frequent histologic type of main lesion was a well differentiated adenocarcinoma in 7 ($58.3\%$) of the 12 cases; the accessory lesion was also well differentiated in 4 of those 7 cases. Of the 13 accessory lesions, 4 ($30.8\%$) had been overlooked preoperatively; most of them were located in the lower third of the stomach and were IIb or IIc type and measured less than 1 cm in diameter. Lymph node metastasis was detected in 1 patient ($8.3\%$). The clinicopathologic features of multiple early gastric cancer were not different from those of solitary early gastric cancer. Conclusion: In multiple early gastric cancer, the main and the accessory lesions showed similar differentiation, and lymph node metastasis was less frequent than in solitary early gastric cancer. Therefore, limited procedures, including endoscopic mucosal resection, may be indicated if each lesion of the multiple early gastric cancer fits the criteria for treatment strategy.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.2
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• pp.326-337
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• 2003

In order to evaluate the prevention effect of Sunkiwhajung-tang (SWT) which has been used as a traditional prescription for the treatment of digestive disease in Korea on the gastric ulcer induced by indomethacin in rats, the changes of number and size of ulcerative lesions, parietal, chief, Grimelius and Serotonin-positive cells in the peri-ulcerative tissues were detected with histological examinations of ulcerative and peri-ulcerative lesions after oral injections of SWT extracts (125, 250 and 500 mg/kg, respectively). SWT prevented to a great extent the expected indomethacin-induced elevation in hemorrhagic ulcerative lesions, the number and size of ulcerative lesions, and the number of parietal cell, chief cell, Grimelius-positive cells and Serotonin-positive cells in the peri-ulcerative lesions in a dose dependent manner. These results provide a story evidence that SWT produced an protective effect on gastric ulcer induced by indomethacin. Determination of the specific mechanisms involved in the protective effect of SWT on the gastric ulcer will require additional study.

• Journal of Gastric Cancer
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• v.1 no.1
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• pp.55-59
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• 2001

Purpose: Several studies of an endoscopic mucosal resection(EMR) have been reported, but reports about benign protruding lesions that arise at the scar of EMR for early gastric cancer (EGC) or a gastric adenoma are rare. The purpose of this study was to elucidate endoscopic and histological characteristics of benign protruding lesions which arise at the scar of an EMR for EGC and a gastric flat adenoma. Materials and Methods: In 101 lesions (73 gastric flat adenomas and 28 EGCs) from 96 patients, 16 lesions developed new protruding lesions that arose at the scar of the EMR. We retrospectively analyzed the endoscopic findings of initial and protruding lesions, and several other clinical factors (H. pylori infection, eradication therapy, and proton pump inhibitor (PPI) or H2-blocker use). Results: 1. The mean duration until detection of the protruding lesion was 8.9 months ($1.5\∼27$). Protruding lesions arose at the scar of the EMR in 1 of 28 EGCs ($3.6\%$) and from 15 of 73 gastric flat adenomas ($20.5\%$). All of the patients were men. 2. With respect to the endoscopic findings, the shapes of the protruding lesions were as follows: 10 Yamada (Y) I, 4 Y-II, 1 Y-III, and 1 flat lesion. Histological examination of the protruding lesions revealed regenerating hyperplasia in 5 lesions, intestinal metaplasia in 5, and both in 6. 3. The incidence of these lesions was higher in cases of tubular adenomas with focal high-grade dysplasia than in cases of tubular adenomas without dysplasia (p<0.05). 4. The incidence of H. pylori infection was higher in patients ($81.7\%$) who developed a protruding lesion than in those ($51.8\%$) who did not develop (p=0.029); also, the incidence of use of PPI was higher in those patients (p=0.045). However, eradication therapy for H. pylori and duration of use of PPI or H2-blocker showed no difference between groups. Conclusions: It may be possible that the potential hyperplasia that may reside in normal mucosa surrounding EGC or a gastric adenoma might awaken during the healing process of the EMR ulcer and develop to benign protruding lesions. And, H. pylori and PPI might also be related to the development of the protruding lesions.

• Journal of Gastric Cancer
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• v.23 no.4
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• pp.512-522
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• 2023

Purpose: Dental floss clip (DFC) traction-assisted endoscopic submucosal dissection (ESD) is widely performed owing to its simplicity. This study aimed to clarify the appropriate indications for the DFC traction method in early gastric cancer when ESD is performed by less-experienced endoscopists. Methods and Methods: We retrospectively analyzed 1,014 consecutive patients who had undergone gastric ESD performed by less-experienced endoscopists between January 2015 and December 2020. Gastric ESD was performed without DFC in all cases before December 2017 [DFC (-) group, 376 cases], and ESD was performed with DFC in all cases after January 2018 [DFC (+) group, 436 cases]. The procedure time and rates of en bloc resection, complete resection, and adverse events of the groups were compared. Results: The procedure time did not differ significantly between the 2 groups. However, when comparing lesions >20 mm, the procedure time in the DFC (+) group was significantly shorter than that in the DFC (-) group (95±46 vs. 75±31, P<0.01). The procedure time for lesions located in the greater curvature of the upper or middle stomach and lesions >20 mm located in the lesser curvature side of the stomach in the DFC (+) group was significantly shorter than that in the DFC (-) group. Conclusions: The indications for DFC during gastric ESD by less-experienced endoscopists include lesions located in the greater curvature of the upper or middle stomach, and lesions >20 mm located in the lesser curvature of the stomach.