• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.268-272
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• 2006

Purpose : The reinfection rate of H. pylori reported before $^{13}C$-urea breath test($^{13}C$-UBT) era was higher than that of the post $^{13}C$-UBT era. Children are usually reluctant to receive invasive endoscopic evaluation for the reinfection of H. pylori, particularly when they are asymptomatic. The aim of the study is to discover the reinfection rate by different diagnostic tests, and to find out what causes the difference. Methods : Children confirmed to be eradicated from H. pylori were included in the study. Reinfection was evaluated by endoscopic biopsy based tests(n=34, mean age $11.5{\pm}3.7$ years) and/or a $^{13}C$-UBT(n=38, mean age $10.0{\pm}3.6$ years) at the time of 18 months after eradication. At first visit, H. pylori infection had been diagnosed by positive results from a rapid urease test, Giemsa stain and Warthin-Starry stain and/or a positive culture. Eradication was defined as negative results from all above tests 1-3 months after eradication therapy. Results : Reinfection rate by endoscopic biopsy based tests was 35.3 percent(12/34). All patients had abdominal symptoms(P=0.000). Reinfection rate was 13.2 percent(5/38) by a $^{13}C$-UBT. Reinfection rate was higher in children with abdominal symptoms(P=0.008). There was no evidence that reinfection rate depended on the sex(P=0.694), age(P=0.827), diseases(peptic ulcers vs gastritis, P=0.730) and eradication regimen(P=0.087). Conclusion : Helocibacter pylori reinfection rate in Korean children was 13.2 percent per 18 months by a non-invasive test or $^{13}C$-UBT. Accurate determinations of the reinfection rate in children is affected by the compliance of the diagnostic tests. Non-invasive tests should be considered to investigate the reinfection rate in children.

• Proceedings of the Microbiological Society of Korea Conference
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• 2002.10a
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• pp.180-182
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• 2002

Substantial genomic diversity has been expected among clinical isolates of H. pylori. We have suggested that the two complete H. pylori genomes already sequenced may be insufficient for providing a discriminatory tool for typing clinical isolates as well as an insight into the genomic diversity, which enable to establish strategy for control of H. pylori infection. In this study, we determine the nucleotide sequence of the entire genome of Korean strain 51 and compare it with two reported genomic sequences to suggest validity for extensive genomic sequencing of H. pylori. The genome of H. pylori 51 consists of a circular chromosome with a size of 1,591,297 bp, which is corresponding to $95.4\%\;and\;96.8\%$ of the 26695 and J99 chromosome length, respectively. We predict that there are 1,454 open reading frames (ORFs) in 51, representing $91.4\%\;and\;97.2\%$ of the reported numbers of ORF of 26695 and J99, respectively. In contrast to 26695 and J99 that have 123 and 65 strain-specific genes, respectively, of the 1,454 genes, only 39 genes are unique to 51. Differences in genomic organization between 51 and each foreign strain were greater than between 2 foreign strains in pair wise entire sequence alignments by BLASTN. Particularly, the extent of genomic rearrangement observed between 51 and 26695 is higher than between 51 and J99. Multiple sequence alignment of orthologous genes among 3 strains showed that 51 is genetically closer to 26695 rather than J99. Phylogenetic analysis of nonsynonymous and synonymous mutation indicated J99 has the longest branch length in the unrooted phylogenetic tree, suggesting that J99 has higher mutation rate than the other 2 strains.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.2
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• pp.103-109
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• 2008

Purpose: Children with esophagitis express a variety of nonspecific symptoms and signs depending on their age, and diagnosis is limited because gastrointestinal endoscopy (GFS) and biopsy are difficult to perform. The aim of this study was to examine the prevalence of esophagitis in children with upper abdominal pain, to determine the necessity of esophageal biopsy, and to evaluate the associated risk factors. Methods: We reviewed 266 pediatric patients with upper abdominal pain who underwent history-taking, physical examination, and GFS with esophageal and gastric biopsies between January 2006 and December 2007. Esophagitis was confirmed on biopsy. We analyzed the risk factors for histologic esophagitis and the necessity of esophageal biopsy. Results: The prevalence of esophagitis was 19.9% (53/266 patients). The sensitivity and specificity of endoscopic diagnosis were 41.5% and 77%. Of 53 patients with histologic esophagitis, reflux esophagitis was seen in 50 patients, eosinophilic esophagitis was seen in 2 patients, and esophageal candidiasis was seen in 1 patient. Vomiting was a significant factor in patients under 8 yr of age (p<0.05). H. pylori infection was documented in 41.5% of patients with histologic esophagitis, compared with 58.5% of patients not infected with H. pylori (p<0.05). The possibility of histologic esophagitis was higher in patients with H. pylori infection (OR 2.5, 95% CI 1.2544 to 4.8286) and in those who visited in the spring (OR 2.5, 95% CI 1.2544 to 4.8286). Conclusion: We believe esophageal tissue biopsy should be performed in pediatric patients with upper gastrointestinal symptoms who are undergoing GFS and stomach tissue biopsy, especially preschoolers and H. pylori-infected children in the spring.

• Journal of Ginseng Research
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• v.33 no.4
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• pp.367-377
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• 2009

Halitosis is a generally accepted marker of diseases in the oral cavity and of systemic and gastrointestinal disorders. Based on these authors' previous findings (that (1) there is a close association between H. pylori infection and halitosis; (2) Korea red ginseng may suppress the colonization of H. pylori, fight H. pylori-induced cytotoxicity, and impose significant anti-inflammatory actions in patients with chronic gastritis; and (3) H. pylori infection is linked with the generation of significant levels of volatile sulfur compounds (VSCs), and the levels of VSCs correlate significantly with H. pylori-associated mucosal damages), in the current study, the authors documented the molecular mechanisms of Korea red ginseng's efficacy in ameliorating halitosis. When the RAW 264.7 cells were treated with the $H_2S$ releasing compound NaHS, the mRNA expression of cystathionine ${\gamma}$-lyase (CSE), IL-6, COX-2, and iNOS were more significantly induced compared with the vehicle-treated group. The cytoskeletal components of ezrin's and moesin's mRNA expressions were elevated by NaHS treatment accompanied by the activation of MAPK, p38, and ERK. Korea red ginseng pretreatment reduced both the NaHS-induced CSE expression and the proinflammatory genes (e.g., IL-6, COX-2, and iNOS) in a concentration-dependent manner. The ERM expression and the phosphorylation of p38 were also significantly reduced by Korea-red-ginseng pretreatment. Overall, Korea red ginseng pretreatment imposed significant anti-inflammatory effects through the downregulation of the NaHS-triggered proinflammatory gene expression, CSE, and ERM mRNA expression. Korea red ginseng could thus be said to be a key remedy of halitosis and to be effective in relieving gastric inflammation.

• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.335-346
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• 2011

The aim of this study is to compare the differences of influencing factors and subjective digestive symptoms among upper gastrointestinal disease groups. Subjects of this study are the results of Helicobactor Pylori test, gastrofibroscopic findings, and the electronic data of medical questionnaires on individuals at the age of 20 to 79 who visited a Health Promotion Center in Seoul from October, 2003 to October, 2004. 2,708 cases are analysed for final with $x^2$ test and ANOVA test. The sociodemographic factors of sex, age and occupation, the living habits factors of smoking and drinking, the pathophysiological factor of H. pylori infection, and the psychological factor of stress show statistically significant differences among groups. The digestive symptoms of "the feeling of something remained in the stomach", "the burning feeling right after eating or at the empty state of stomach" and "the frequent reflux of watery acid from the stomach" show statistically significant differences among groups. This study provides meaningful data in finding distinctive features of each disease and will be applied as basic materials to the development of intervention methods for health promotion relating to the upper gastrointestinal diseases.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.2
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• pp.105-110
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• 2012

Gastric ulcers are rare in children and are typically seen in cases of Helicobacter pylori (H. pylori) infection, non-steroidal anti-inflammatory drugs (NSAIDs) use, and critical illnesses such as sepsis. The risk of a bleeding ulcer due to use of NSAIDs is dependent on the dose, duration, and the individual NSAIDs, but the bleeding may occur soon after the initiation of NSAID therapy. An experience is described of a 16-month-old infant with a bleeding gastric ulcer after taking the usual dosage of ibuprofen for 3 days. The infant was also successfully treated with endoscopic hemostasis. Even a small amount of ibuprofen may be associated with bleeding gastric ulcers in infant.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2333-2340
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• 2015

Background: Due to the strong inhibitory effects of $PPAR{\gamma}$ gene on the growth of cancer cells, the role of Pro12Ala polymorphism in $PPAR{\gamma}$ gene has been extensively investigated in cancer recently. However, the results were inconsistent according to cancer type. The aim of this study was to comprehensively evaluate the $PPAR{\gamma}$ Pro12Ala polymorphism and gastric cancer susceptibility. Materials and Methods: Search strategies were conducted in Pubmed, Medline (Ovid), Chinese biomedical database (CBM), China national knowledge infrastructure (CNKI), VIP, and Wanfang database, covering all publications, with the last search up to November 01, 2014. The strength of association between $PPAR{\gamma}$ Pro12Ala polymorphism and gastric cancer risk was assessed by OR with 95%CI. Results: A total of 546 cases and 827 controls in 5 case-control studies were included in this meta-analysis. The results indicated that the variant G allele carriers (CG+GG) had a 2.31 times higher risk for gastric cancer when compared with the homozygote CC (odds ratio (OR)=2.31, 95% confidence interval (CI)=1.67-3.21 for CG+GG vs. CC). In the subgroup analysis by ethnicity, significantly elevated risks were both found in Asians (OR=2.56, 95% CI=1.42-4.64) and Caucasians (OR=2.20, 95% CI=1.48-3.25). Similarly, in the subgroup analysis by H. pylori status, a significantly increased risk was identified in H. pylori (+) populations (OR=3.68, 95%CI=2.07-6.52), but not in H. pylori(-) populations (OR=1.17, 95%CI=0.58-2.39). Conclusions: This pooled analysis suggested that the $PPAR{\gamma}$ Pro12Ala polymorphism could be an independent predictive risk factor for gastric cancer especially in H. pylori infected populations in Asians and Caucasians. Nevertheless, prospectively designed cohort studies are needed to further investigate gene-gene and gene-environment interactions to confirm the combined effects of $PPAR{\gamma}$ Pro12Ala polymorphisms and H. pylori infection on gastric cancer risk.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.1
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• pp.20-27
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• 2018

Purpose: Minimal change esophagitis (MCE) is a reflux disease without mucosal breaks, known to be partially associated with abnormal gastric motor function. Electrogastrography (EGG) is commonly applied to assess gastric motor function in a noninvasive fashion. We aimed to determine the relationship between MCE and gastric myoelectrical activity (GME) recorded on EGG in children. Methods: We retrospectively assessed the records of 157 children without underlying disease who underwent both EGG and upper gastrointestinal endoscopy at Gachon University Gil Medical Center between January 2010 and June 2015. The children were stratified according to the appearance of the esophagus (normal vs. MCE). Between-group differences in EGG parameters and their correlation with each MCE finding were statistically analyzed. Results: Only the power ratio, one of the EGG parameters analyzed, differed significantly between the two groups (MCE, $1.68{\pm}3.37$ vs. normal, $0.76{\pm}1.06$; p<0.05), whereas the other parameters, such as dominant frequency, dominant power, and the ratio of abnormal rhythm, showed no differences. Among children with MCE, significant correlations were noted between erythema and power ratio (p<0.05), friability and postprandial dominant frequency (p<0.05), and edema and/or accentuation of mucosal folds and pre-prandial frequency (p<0.05). Helicobacter pylori infection correlated with postprandial arrhythmia (MCE, $33.59{\pm}15.52$ vs. normal, $28.10{\pm}17.23$; p<0.05). EGG parameters did not differ between children with normal esophagus and those with biopsy-proven chronic esophagitis. Conclusion: In children with MCE, gastric dysmotility may affect the development of MCE, manifesting as EGG abnormalities. H. pylori infection may also affect GME. However, larger prospective investigations are needed to confirm these findings.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3325-3328
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• 2012

Aim: To evaluate the association of glutathione S-transferases gene polymorphisms with the risk of gastric cancer, with reference to smoking and Helicobacter pylori infection. Methods: We conducted a 1:1 matched case-control study with 410 gastric cancer cases and 410 cancer-free controls. Polymorphisms of GSTM1, GSTT1 and GSTP1 were determined using PCR-CTPP. Results: The GSTM1 and GSTT1 null genotypes were significantly associated with the risk of gastric cancer after adjusting for potential confounding factors (OR=1.68, 95% CI=1.32-2.23 for null GSTM1, OR=1.73; 95% CI=1.24-2.13 for null GSTT1). The combination of null GSTM1 and null GSTT1 conferred an elevated risk (OR=2.54, 95% CI=1.55-3.39). However, no association was found for GSTP1 polymorphism The smoking modified the association of GSTM1 and GSTT1 null genotypes with the risk of gastric cancer. Conclusion: GSTM1 and GSTT1 null genotypes are associated with increased risk of gastric cancer, and smoking modifies the association.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.2069-2079
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• 2012

Background and Objective: A comprehensive overall review of gastric cancer (GC) risk and protective factors is a high priority, so we conducted the present study. Methods: Systematic searches in common medical electronic databases along with reference tracking were conducted to include all kinds of systematic reviews (SRs) about GC risk and protective factors. Two authors independently selected studies, extracted data, and evaluated the methodological qualities and the quality of evidence using R-AMSTAR and GRADE approaches. Results: Beta-carotene below 20 mg/day, fruit, vegetables, non-fermented soy-foods, whole-grain, and dairy product were GC protective factors, while beta-carotene 20 mg/day or above, pickled vegetables, fermented soy-foods, processed meat 30g/d or above, or salty foods, exposure to alcohol or smoking, occupational exposure to Pb, overweight and obesity, helicobacter pylori infection were GC risk factors. So we suggested screening and treating H. pylori infection, limiting the amount of food containing risk factors (processed meat consumption, beta-carotene, pickled vegetables, fermented soy-foods, salty foods, alcohol), stopping smoking, avoiding excessive weight gain, avoidance of Pb, and increasing the quantity of food containing protective components (fresh fruit and vegetables, non-fermented soy-foods, whole-grain, dairy products). Conclusions: The conclusions and recommendations of our study were limited by including SRs with poor methodological bases and low quality of evidence, so that more research applying checklists about assessing the methodological qualities and reporting are needed for the future.