• The Korean Journal of Physiology and Pharmacology
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• v.5 no.3
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• pp.279-285
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• 2001

Although only a minority of the infected individuals develops atrophic gastritis and the malignancy, factors governing clinical outcomes subsequent to Helicobacter pylori (H. pylori) infection have not yet been defined. H. pylori infection is characterized by extensive infiltration of neutrophils. Myeloperoxidase (MPO) in neutrophils amplifies the oxidative potential of hydrogen peroxides that induce gastric mucosal damage, thus MPO is suspected to play a role in H. pylori-induced gastric injury. Therefore, we explored the association of host MPO genetic polymorphism with atrophic gastritis upon H. pylori infection. Biopsy specimens taken from the gastric mucosa were examined histologically in 87 patients. The PCR-RFLP assay was used to characterize MPO genotypes. The distributions of MPO genotypes were MPO (G/G) 82% and MPO (G/A) 18%. None of MPO (A/A) genotype was observed. A strong positive correlation between the levels of neutrophil infiltration and gastric atrophy found only in MPO (G/G) but not in MPO (G/A) genotype. These results suggest that MPO genotype is a critical determinant in the pathogenesis of atrophic gastritis subsequent to H. pylori infection. Further works need to clarify the functional relevance of MPO genetic polymorphisms on gastric cell injury.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.1
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• pp.23-28
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• 2012

Purpose: Interest in peptic ulcer in children has been relatively low because the disease is rarer in children than in adults and there were restrictions in the application of endoscopy to children, but the recent development of pediatric endoscopy is activating research on pediatric peptic ulcer. Thus, this study compared the $H.$ $pylori$ infection rate and clinical and endoscopic findings among pediatric patients diagnosed with peptic ulcer. Methods: We analyzed retrospectively 58 pediatric patients for whom whether to be infected with $H.$ $pylori$ was confirmed selected out of pediatric patients diagnosed with gastric ulcer or duodenal ulcer through upper gastrointestinal endoscopy at the Department of Pediatrics of Gachon University Gil Hospital during the period from January 2002 to December 2007. A case was considered $H.$ $pylori$ positive if $H.$ $pylori$ was detected in the Giemsa stain of tissue or the results of UBT (urea breath test) and CLO (rapid urease test) were both positive. Results: Of the pediatric patients, 37 were infected with $H.$ $pylori$ and 21 were not. The $H.$ $pylori$ infection rate increased with aging and the result was statistically significant ($p$<0.05). However, $H.$ $pylori$ infection was not in a statistically significant correlation with sex, chief complaint, and gastroduodenal ulcer ($p$>0.05). Conclusion: $H.$ $pylori$ infection increased with aging, but was not significantly correlated with gastroduodenal ulcer. Further research may need to examine prospectively the relation between $H.$ $pylori$ and gastroduodenal ulcer in the Incheon area.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.17-22
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• 2000

Purpose: This study was conducted to evaluate the association between H. pylori infection and socioeconomic status and to determine the current prevalence of H. pylori infection in Korean adolescents. Methods: A structured questionnaire was sent to the children's parents to obtain demographic information on the parents and environmental information. Of the 532 questionnaires sent out, 375 (70.5%; 170 girls and 205 boys) were returned. Their ages ranged from 10 to 15 years (mean, 12.9 years). After collecting blood samples, we measured serum IgG antibody to H. pylori using ELISA method. The association of risk factors such as age, sex, socioeconomic class, type of house, and crowding index with H. pylori infection were analyzed by multiple regression analysis. Socioeconomic status was estimated from the parents' education and occupation using a modified Hollingshead index. Results: The prevalence rate of H. pylori infection was 16.8% (63/375). It increased with age (10.3% at 10~11 years, 15.9% at 12~13 years, and 20.7% at 14~15 years). The H. pylori infection was inversely related to the socioeconomic class (6.3% for the upper class, 16.0% for the middle class, and 20.0% for the lower calss). Crowding condition and type of house did not affect significantly on seroprevalence of H. pylori infection. After logistic regression, we found that the odds ratio for age was 2.2 (95% confidence interval 0.9~5.4), and for socioeconomic status, 3.6 (95% confidence interval 0.5~28.9). Conclusion: The prevalence of H. pylori infection in Korean adolescents was 16.8%. It related inversely to socioeconomic status but was not statistically significant. Socioeconomic status based on parents' education and occupation seemed to affect more on H. pylori seroprevalence than crowding or type of house did.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.2
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• pp.170-178
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• 2004

Purpose: Helicobacter pylori (H. pylori) infection has been known to be vital in the pathogenesis of duodenal ulcer disease in children as well as in adults. But the relationship between H. pylori infection and the histopathologic findings of the duodenum has not been explained obviously in children yet. So the aim of this study is to determine whether duodenitis and/or gastric metaplasia in the duodenum increases the risk of duodenal ulcer disease in children infected by H. pylori. Methods: From October 2001 to April 2004 gastric and duodenal biopsies were performed in 177 children who visited Department of Pediatrics, Gil Hospital, Gachon Medical School. Biopsy sections were stained with hematoxylin and eosin and also with Giemsa for identification of H. pylori. The grades of duodenitis and gastric metaplasia were classified from 0 to 3 and from 0 to 4, respectively. Results: The incidence of H. pylori infection was 54% in total patients. Amongst 163 children with duodenitis there was a lack of correlation between H. pylori infection and the grade of duodenitis. Amongst 11 patients with duodenal ucler, only 4 children were infected by H. pylori. And amongst 5 patients with gastric metaplasia, H. pylori and duodenal ulcer were detected in 2 and 3 children, respectively. The occurrence of duodenal ulcer and gastric metaplasia were increased significantly in proportion to the grade of duodenitis (p<0.0001 and p=0.0365, respectively). Conclusion: As opposed to the results of previously reported articles, there were lacks of correlation between H. pylori infection and duodenitis, duodenal ulcer, and gastric metaplasia. So further study hould be done to clarify the effect of H. pylori on the duodenal histopathology in children infected by H. pylori.

• Korean Journal of Clinical Laboratory Science
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• v.39 no.3
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• pp.271-276
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• 2007

Helicobacter pylori (H. pylori) infection is common in korea and high incidence at gastric ulcer and duodenal ulcer. $^{14}C-urea$ breath test ($^{14}C-UBT$) is regarded as a highly reliable and non-invasive method for the diagnosis of H. pylori infection. The purpose of this study was to evaluate the diagnositc performance of a new and rapid $^{14}C-UBT$, which was equipped with Geiger-Muller counter and compared the results with those obtained by gastroduodenoscopic biopsies (GBx). One hundred sixty-eight patients (M : F = 118 : 50) underwent $^{14}C-UBT$, rapid urease test (CLO test), and GBx. The results of $^{14}C-UBT$ were classified as positive (>50 cpm), borderline (25$^{14}C-UBT$ or CLO test results with GBx as a glod standard. In the assessment of the presence of H. pylori infection, the $^{14}C-UBT$ global performance yielded positive predictive value, negative predictive value and accuracy of 93.3% and 83.3%, respectively. However, the CLO test had performance yielded positive predictive value, negative predictive value and accuracy of 76.9%, 50.0%, respectively. In this study $^{14}C-UBT$ is a highly accurate, simple and non-invasive method or the diagnosis of follow up H. pylori infection.

• Journal of Oral Medicine and Pain
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• v.35 no.2
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• pp.101-110
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• 2010

Helicobacter pylori(H. pylori) is bacterial infection, with more than half of the world population infected and oral cavity is considered second reservoir of H. pylori infection. The purpose of this study was to evaluate role of oral cavity in H. pylori infection by comparison of the mode H. pylori infection in oral cavity and stomach. We recruited 100 subjects without systemic disease including gastrointestinal disease. Samples in oral cavity taken on gingival sulcus fluid(GSF) of lower left central incisor and 1st molar, area of buccal mucosa, dorsum of the tongue, palatal and saliva. We analyzed by Nested polymerase chain reaction(PCR) for oral infection and Urea Breath Test(UBT) for gastric infection. The results were as follows : 1. Among these 100 subjects, 36(36%) were positive by Nested PCR and 33(33%) were positive by UBT(p>0.05). 2. In detection rate of H. pylori in sites taken sample, 11(11%), 8(8%), 9(9%), 3(3%), 9(9%), 7(7%) were positive on GSF of lower left central incisor and 1st molar, area of buccal mucosa, dorsum of the tongue, palatal and saliva, respectively. Statical significance was observed in samples of GSF of lower left central incisor and area of dorsum of the tongue(p<0.05). 3. In comparison of the mode of H. pylori infection in oral cavity and stomach by analytic method, positive in oral cavity and stomach was 10(10%), negative in oral cavity and positive in stomach was 23(23%), positive in oral cavity and negative in stomach was 26(26%) and negative in oral cavity and stomach was 41(41%)(p>0.05). Conclusively, we can guess that oral H. pylori is not associated with gastric H. pylori infection and normal flora.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.97-103
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• 2007

Purpose : Lewis antigen has been known to have a role in the attachment of H. pylori to the gastric mucosa, but its expression pattern in children with H. pylori infection is still unclear. The recently described blood group antigen-binding adhesin BabA is known to mediate adherence of H. pylori to Lewis B receptors on gastric epithelium. We investigated the expression of Lewis antigen in gastric mucosa of Korean children with H. pylori infection. Methods : The expression of Lewis A ($Le^a$), B ($Le^b$), X ($Le^x$), and Y ($Le^y$) was evaluated by immunohistochemistry in H. pylori positive biopsy specimens from 35 children (antral gastritis in 30, peptic ulcer in 5) and in H. pylori negative specimens from 19 children. PCR assays for cagA and babA2 gene of H. pylori were performed. Results : We confirmed the expression of $Le^a$ in 60%, $Le^b$ in 97%, $Le^x$ in 100%, and $Le^y$ in 100% of the superficial epithelium of the 35 H. pylori positive children. In H. pylori negative patients, $Le^a$, $Le^b$, $Le^x$, and $Le^y$ expression was 52%, 100%, 89%, and 100%, respectively. The cagA gene was detected in 65% and babA2 gene in 25% of 35 patients. No differences in neutrophil activity and chronic inflammation were found according to the presence of cagA and babA2 genes in H. pylori. Conclusion : $Le^b$, $Le^x$ and $Le^y$ antigen were highly expressed in gastric mucosa of Korean children, but they were not associated with the status of H. pylori infection and the positivity of babA2 gene. Further studies for other mucosal receptors and toxins are needed to define the immune responses to H. pylori infection in gastric mucosa of Korean children.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5691-5694
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• 2012

Ectopic expression of CDX2 in the stomach is closely associated with chronic Helicobacter pylori (H. pylori) infection and intestinal metaplasia. Whether CDX2 has tumor suppression or tumorigenesis potential remains to be elucidated. In this study, we investigated the association between the CDX2 G543C polymorphism (silent mutation) and the risk for H. pylori-induced gastric atrophy and cancer as well as H. pylori infection, using 454 Japanese subjects undergoing a health checkup and 202 gastric cancer patients. The frequency of the minor allele was the same as previously reported in China, but different from that reported in England. CDX2 G543C was not associated with risk of H. pylori infection, gastric atrophy, or gastric cancer, although the point estimate for non-cardiac differentiated gastric cancer as compared to controls with gastric atrophy was 2.22 (95%CI=0.17-29.4). In conclusion, our results indicate that the CDX2 G543C polymorphism is unlikely to affect the H. pylori infection-gastric atrophy-gastric cancer sequence.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.10-17
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• 2001

Purpose: We measured anti-H. pylori IgG in Korean elementary school children living in Shinchon area of Seoul, Korea to evaluate the influence of environmental living standards on H. pylori infection. Methods: IgG antibodies to H. pylori were measured in plasma using a commercial ELISA kit (GAP IgG Helicobacter pylori, Bio-Rad Laboratories Inc., Hercules, CA, USA). Information on environmental status such as place of birth, parental income, type of housing, number of persons in the household, parents' occupation, family history of peptic ulcer disease and gastric cancer was obtained. Statistical analysis was done by Chi-square and logistic regression test using SPSS $7.0^{TM}$ for Windows. Results: Study subjects consisted of 571 children, and the age distribution ranged from 6.0 to 13.6 years with a mean of $9.6{\pm}1.8$ years. Male-to-female ratio was 1.1:1. The seropositive rates of H. pylori infection ranged from 10.4% in children aged 6 years to 30.9% in 12 year-old group, overall 16.8%. The prevalence of H. pylori infection progressively increased with age, but there was no significant difference in seropositive rates among children in different age groups (p=0.06). Seropositive rates of anti-H. pylori IgG on the basis of gender, place of birth, parental income, type of housing, parents' occupation, family history of peptic ulcer disease and gastric cancer showed no statistically significant difference. Interestingly, however, seropositive rate of anti-H. pylori IgG showed statistical significance in relation to number of persons in the household (p=0.003; Odds ratio 1.50 by logistic regression test). Conclusion: These results suggest that number of persons in the household is the most important factor among environmental living standards, and that risk of H. pylori infection increases by increment of 1.5 times as the number of persons in the household increases by one.

• Preventive Nutrition and Food Science
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• v.8 no.1
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• pp.70-74
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• 2003

This study investigated the relationship of Helicobacter pylori (H. pylori) infection to iron-deficiency anemia in high school girls. Four hundred and fourty-five subjects resided in Ulsan City in Korea were evaluated by questionnaire or blood analysis for serum indicators of iron status, daily nutrient intakes, symptoms of anemia, and H. pylori IgG antibody status. In H. pylori infected subjects, total energy intake of was 1534.14±350.81 kcal (73.0% of the Korean RDA), the iron intake of subjects was 11.38±3.90 mg (71.1% of Korean RDA) and calcium intake was 467.63±175.96 mg (58.3% of the Korean RDA). Carbohydrate (p < 0.05), vitamin A (p < 0.05), vitamin C (p < 0.01) intakes were significantly lower in infected subjects than in non-infected subjects. The prevalence of anemia (hemoglobin (Hb) < 12 g/dL.) in H. pylori infected subjects was 22.7% as compared to 14.7% in non-infected subjects. The mean serum ferritin of infected subjects (21.71±21.50 ng/mL) was significantly lower than in non-infected subjects (p < 0.05) (as was the mean Hb concentration (12.54±1.51 g/dL) and hematocrit (37.99±3.64%)). Total iron binding capacity (TIBC) of H. pylori infected subjects (449.09±78.23 ㎍/dL) was significantly higher than that of non-infected subjects (432.99＋76.15 ㎍/dL) (P < 0.05). The levels of iron, red blood cell (RBC) and transferrin saturation were similar in infected and non-infected subjects. Two symptoms of anemia, 'pale face (p < 0.01)' and 'decreased ability to concentrate (p < 0.005)', were significantly higher in H. pylori infected subjects than in non-infected subjects. High school girls are known to be more vulnerable to iron deficiency than other age groups, and this research demonstrates that infection with H. pylori increases their risk of iron-deficiency anemia.