• 대한한방내과학회지
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• 제34권2호
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• pp.165-177
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• 2013

Objectives : The object of this study was to observe the protective effects of 8 types of individual herbal components of Yijintang-gamibang, on the reflux esophagitis (RE) in rats as compared with omeprazole. Methods : Each 100 mg/kg individual herbal component was orally pretreated, at 1 hr before and 6 hrs after pylorus and forestomach ligation, the changes on the esophageal lesion areas, gastric volumes, acid and pepsin outputs, antioxidant effects, esophageal total hexose and sialic acid contents were observed with changes on the esophageal histopathology. The results were compared with an omeprazole 10 mg/kg treated group. Results : Pylorus and forestomach ligation-induced RE were inhibited by treatment of all 8 herbal components and omeprazole except for Pinella Rhizoma and Massa Meicata Fermentata, in order of Atractylodis Rhizoma, Citri Pericarpium, omeprazole, Glycyrrhizae Radix, Hordei Fructus Germiniatus, Holelen and Citri Pericarpium, as compared with RE control. Pinella Rhizoma and Massa Meicata Fermentata did not show any favorable protective effects against RE nor antioxidant effects in the present study. Conclusions : The main active herbal components showing favorable protective effects on RE of Yijintang-gamibang mediated by antioxidant effects, were Atractylodis Rhizoma, Citri Pericarpium, Glycyrrhizae Radix, Hordei Fructus Germiniatus, Holelen and Citri Pericarpium. Furthermore Atractylodis Rhizoma and Citri Pericarpium showed more favorable protective effects as compared with omeprazole, therefore, it is expected that Atractylodis Rhizoma and Citri Pericarpium have potential as new alternatives or safe therapeutics against RE.

• 대한본초학회지
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• 제31권5호
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• pp.85-92
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• 2016

Objectives： This study is experimental comparison of brown rice (BR) and germinated brown rice (GBR) on upper gastrointestinal diseases animal models.Methods： The ICR mice were divided randomly into four groups of six animals each (Normal mice, gastritis mice, gastritis mice treated with BR, gastritis mice treated with 48h GBR). Gastritis was induced by administration of 0.5 mL 150 mM HCl-60% ethanol. Six-week-old male Sprague-Dawley (SD) rats were randomly divided into 7 groups after 1 week adaptation. (Normal rat, reflux esophagitis (RE) rat, RE rat treated with BR, RE rat treated with 24,30,36,48h GBR). Reflux esophagitis was induced by ligation with a 2-0 silk thread both the pylorus and the transitional junction between the forestomach and the corpus in SD rats.Results： HCl/ethanol-induced gastric mucosal injury mice were ameliorated mucosal damage upon histological evaluation by treatment of 48h GBR than BR. Optical changes such as hyperemia and multiple erosions were observed in the rats with RE and damage to the normal rats was not apparent. The oral administration of GBR significantly diminished against gross mucosal damage in a germination time-dependent manner. Also, the administration of GBR suppressed the biomarker of oxidative stress, reactive oxygen species (ROS) and produces peroxynitrite (ONOO-) in serum. However, the administration of GBR could not affect to the pH level secreted from stomach when compared with Control group.Conclusions： These findings suggest that GBR could have improving effects on upper gastrointestinal diseases in a germination time-dependent manner.

• 대한한의학회지
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• 제42권4호
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• pp.150-163
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• 2021

Objectives: The purpose of this study was to confirm the effects of Liriope platyphylla extract on relieving Gastroesophageal reflux disease (GERD) through regulation of acid secretion. Methods: 8-week-old ICR mice were divided into untreated control group (Ctrl), GERD elecitation group (GERDE), Omeprazole administrate group before GERD elicitation (OMA), and Liriope platyphylla extract administrate group before GERD elicitation (LPA). After inducing GERD, gross observation and histological examination were performed and ATP6V1B1 (ATPase H+ Transporting V1 Subunit B1), GRPR (Gastrin-releasing peptide receptor), COX-1 (Cyclooxygenase 1), 8-OHdG (8-hydroxy-2'-deoxyguanosine), Cathelicidin, p-JNK (phospho c-Jun N-terminal kinase) were observed to confirm the damage defense effect of the esophageal mucosa, acid secretion regulation, antioxidant, anti-inflammatory, mucosal protection, and apoptosis regulation Results: OMA and LPA showed lower levels of damage compared to GERDE in gross observation and histological examination. ATP6V1B1, GRPR, and 8-OHdG showed lower positive reactions in OMA and LPA than in GERDE. COX-1 were less positive in GERDE and OMA than in Ctrl, but showed higher secretion in LPA than in Ctrl. Cathelicidin showed a decreased positive reaction in GERDE, OMA and LPA compared to Ctrl, but the decrease in positive reaction was smaller in OMA and LPA compared to GERDE. p-JNK showed increased positive reaction in GERDE, OMA and LPA than in Ctrl, but the increase in the positive reaction was smaller in the OMA and LPA compared to GERDE. Conclusions: The effects of Liriope platyphylla extract on esophageal mucosal damage protection, acid secretion regulation, antioxidant, anti-inflammatory, mucosal protection and apoptosis regulation were confirmed.

• 대한한의학방제학회지
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• 제31권4호
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• pp.389-413
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• 2023

Objectives : This study aimed to review the current trends in experimental studies on the use of natural products for treatment of gastroesophageal reflux disease (GERD). Methods : Experimental studies assessing the efficacy of natural products against GERD were searched on PubMed. Articles were selected based on predefined inclusion and exclusion criteria and then analyzed for experimental methods, interventions, and result analysis techniques. Results : A total 37 studies were included in this review. Predominantly, in vivo experiments were conducted to induce GERD through surgery, involving the ligation of the pylorus and the transitional junction between the corpus and the forestomach using 7-week-old male Sprague-Dawley rats. The acute induction model, sacrificing animals after a single administration following GERD induction, was mainly used.The utilization of cell experiments was relatively infrequent, with a focus on assessing antioxidant and anti-inflammatory effects via the treatment of the RAW 264.7 cell line with lipopolysaccharides treatment. Glycyrrhizae Radix et Rhizoma, Pinelliae Tuber, Ginseng Radix and Zingiberis Rhizoma were used as single ingredients, and herbal formula, STW-5 (iberogast), Rikkunshito (六君子湯), Banhasasim-tang (半夏瀉心湯), and Hewei Jiangni granule (和胃降逆湯) were used. Outcome analysis methods encompassed Macroscopic evaluation, esophageal function assessment, blood biomarker analysis, histological examination, protein analysis, gene expression analysis, and gastric juice analysis. Proton pump inhibitors were predominantly employed as positive controls. Conclusions : This study revealed the current trends in non-clinical research evaluating natural products for GERD. Based on the results of this study, we expect that non-clinical research on clinically effective natural products will be revitalized.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.438-450
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• 2019

Purpose: Although linear-shaped gastroduodenostomy (LSGD) was reported to be a feasible and reliable method of Billroth I anastomosis in patients undergoing totally laparoscopic distal gastrectomy (TLDG), the feasibility of LSGD for patients undergoing totally robotic distal gastrectomy (TRDG) has not been determined. This study compared the feasibility of LSGD in patients undergoing TRDG and TLDG. Materials and Methods: All c: onsecutive patients who underwent LSGD after distal gastrectomy for gastric cancer between January 2009 and December 2017 were analyzed retrospectively. Propensity score matching (PSM) analysis was performed to reduce the selection bias between TRDG and TLDG. Short-term outcomes, functional outcomes, learning curve, and risk factors for postoperative complications were analyzed. Results: This analysis included 414 patients, of whom 275 underwent laparoscopy and 139 underwent robotic surgery. PSM analysis showed that operation time was significantly longer (163.5 vs. 132.1 minutes, P<0.001) and postoperative hospital stay significantly shorter (6.2 vs. 7.5 days, P<0.003) in patients who underwent TRDG than in patients who underwent TLDG. Operation time was the independent risk factor for LSGD after intracorporeal gastroduodenostomy. Cumulative sum analysis showed no definitive turning point in the TRDG learning curve. Long-term endoscopic findings revealed similar results in the two groups, but bile reflux at 5 years showed significantly better improvement in the TLDG group than in the TRDG group (P=0.016). Conclusions: LSGD is feasible in TRDG, with short-term and long-term outcomes comparable to that in TLDG. LSGD may be a good option for intracorporeal Billroth I anastomosis in patients undergoing TRDG.

• 대한본초학회지
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• 제35권4호
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• pp.25-36
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• 2020

Objective : Reflux esophagitis is a disease caused by the reflux of gastric acid and inflammation due to unstable gastroesophageal sphincter. The aim of the present study was to clarify the effect of Phellodendri Cortex (PC) on chronic reflux esophagitis (CRE) in rats. Methods : The anti-oxidant activity of PC was measured by total polyphenol, total flavonoid contents, 1, 1-diphenyl-2-picrylhydrazyl (DPPH), and 2, 2'-azinobis-3-ethyl-enzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity. A CRE was established surgically in SD rats. And then CRE rats were treated with water or PC 200 mg/kg body weight for 14 days. Besides, the anti-oxidant and inflammatory protein levels were evaluated using western blotting. Results : PC reduced esophagus tissues injury. The total polyphenol (36.05 ± 0.25 mg/g) and total flavonoid (72.90 ± 0.61 mg/g) of PC showed a high content. PC strongly reduced radical scavenging activities (DPPH IC₅₀ 43.58 ± 1.54 ㎍/㎖; ABTS IC₅₀ 36.75 ± 0.35 ㎍/㎖). Moreover, reactive oxygen species (ROS) and peroxynitrite (ONOO^-) levels in serum, the protein expression of inducible nitric oxide synthases (iNOS) were significantly reduced. In addition, the protein expression of NADPH oxidases related to oxidative stress were significantly reduced in PC compared to CRE control. PC effectively reduced inflammatory factors including, TNF-α, and IL-6 via NF-κBp65 inactivation through the inhibition of p-IκBα and increased anti-oxidant enzyme such as HO-1, SOD, catalase, and GPx-1/2 via Nrf2 activation. Conclusions : Taken together, these results show that PC can alleviate the esophageal mucosal ulcer though the inhibition of NF-κB inflammatory and the enhancement of Nrf2 anti-oxidant pathway.

• Journal of Gastric Cancer
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• 제1권4호
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• pp.210-214
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• 2001

Purpose: The aim of this study was to evaluate the shortterm outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to $86.0\%$ and $87.6\%$ of the recent original body weight in the jejunal interposition (JI) group and to $90.8\%,\;87.0\%$, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the JI group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the JI group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the JI group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the JI group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in $7.1\%$ of the patients in the JI group and in $3.5\%$ in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy.

• Journal of Chest Surgery
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• 제53권4호
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• pp.233-241
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• 2020

Vagal damage and subsequent pyloric denervation inevitably occur during esophagectomy, potentially leading to delayed gastric emptying (DGE). The choice of an optimal pyloric procedure to overcome DGE is important, as such procedures can lead to prolonged surgery, shortening of the conduit, disruption of the blood supply, and gastric dumping/bile reflux. This study investigated various pyloric methods and analyzed comparative studies in order to determine the optimal pyloric procedure. Surgical procedures for the pylorus include pyloromyotomy, pyloroplasty, or digital fracture. Botulinum toxin injection, endoscopic balloon dilatation, and erythromycin are non-surgical procedures. The scope, technique, and effects of these procedures are changing due to advances in minimally invasive surgery and postoperative interventions. Some comparative studies have shown that pyloric procedures are helpful for DGE, while others have argued that it is difficult to reach an objective conclusion because of the variety of definitions of DGE and evaluation methods. In conclusion, recent advances in interventional technology and minimally invasive surgery have led to questions regarding the practice of pyloric procedures. However, many clinicians still perform them and they are at least somewhat effective. To provide guidance on the optimal pyloric procedure, DGE should first be defined clearly, and a large-scale study with an objective evaluation method will then be required.

• Journal of Gastric Cancer
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• 제18권4호
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• pp.328-338
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• 2018

The incidence of gastroesophageal junction adenocarcinoma (GEJAC) in Western countries has increased in recent decades, in addition to a rise in the incidence of esophageal adenocarcinoma (EAC). Gastroesophageal reflux disease (GERD), obesity, smoking, alcohol consumption, and low Helicobacter pylori (HP) infection rate have been nominated as risk factors for such cancers. Among these risk factors, the increased prevalence of GERD and obesity and the decreased prevalence of HP infection are of special interest owing to the currently increasing prevalence of GEJAC in Western countries. Although similar trends in the prevalence of GERD, obesity, and HP infection are observed in Asian countries after a time lag from Western countries, it is still uncertain if the prevalence of GEJAC in Asian countries is increasing, especially in Korea. The incidence of GERD in Korea is currently increasing; it was below 3% in the 1990s. The incidence of obesity in the Korean population is increasing owing to the adoption of westernized lifestyles, including food preferences, and the HP infection rate in Korea is known to be decreasing. Therefore, based on logical extrapolation of observations of Western countries, the incidence of GEJAC will increase in Korea. However, the proportion of GEJAC among other upper gastrointestinal malignancies in Korea appears to be currently unchanged compared with that in the 1990s. Presently, there is a lack of epidemiologic studies on this issue in this region; therefore, more studies are needed to clarify the characteristics of these tumors and to improve clinical outcomes for patients with these tumors.

• Journal of Gastric Cancer
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• 제7권3호
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• pp.139-145
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• 2007

목적: Uncut Roux-en-Y gastrojejunostomy는 잔위로의 담즙 역류와 Roux stasis 증후군을 예방하는 데 효과적인 것으로 알려져 있다. 이에 원위부위절제술 후 전복강경하 uncut Roux-en-Y 위공장문합술(TLuRYGJ)의 임상적 유용성을 알아보고자 본 연구를 시행하게 되었다. 대상 및 방법: 본원에서 TLuRYGJ를 시행 받은 19영의 환자들과 같은 기간에 전복강경하 Billroth I 위절제술(TLB-I)을 시행 받은 11명의 환자들의 수술 후 6개월째 조사한 Visick 분류, 식습관, 위절제후증후군과 관련된 위장관 증상, 내시경 검사 소견 등을 비교, 분석하였다. 결과: 수술 후 6개월째에 조사한 위절제후증후군과 관련한 위장관 증상과 Visick 분류에서는 별다른 차이가 없었으나 TLuRYGJ 군 환자들 중 담즙 역류성 위염의 증상을 호소했던 환자는 한 명도 없었고 투약을 요하는 위 지연배출의 증상을 호소했던 환자가 한 명(5.3%)있었다. 수술 후 6개월째 위 내시경 검사 소견에서 TLuRYGJ 군에서 TLB-I군에 비해 담즙 역류성 잔위염이 더 적은 소견을 보였다. 결론: TLuRYGJ는 담즙 역류성 위염과 Roux stasis 증후군을 예방하는 데 효과적이었다.