• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.24
• /
• pp.10957-10960
• /
• 2015

Background: The CYP2C19 genotype has been found to be an important factor for peptic ulcer healing and H. pylori eradication, influencing the efficacy of proton pump inhibitors (PPIs) and the pathogenesis of gastric cancer. The aim of this study was to investigate clinical correlations of the CYP2C19 genotype in patients with gastritis, peptic ulcer disease (PUD), peptic ulcer bleeding (PUB) and gastric cancer in Thailand. Materials and Methods: Clinical information, endoscopic findings and H. pylori infection status of patients were assessed between May 2012 and November 2014 in Thammasat University Hospital, Thailand. Upper GI endoscopy was performed for all patients. Five milliliters of blood were collected for H. pylori serological diagnosis and CYP2C19 study. CYP2C19 genotypes were determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis (RFLP) and classified as rapid metabolizer (RM), intermediate metabolizer (IM) or poor metabolizer (PM). Results: A total of 202 patients were enrolled including 114 with gastritis, 36 with PUD, 50 with PUB and 2 with gastric cancer. Prevalence of CYP2C19 genotype was 82/202 (40.6%) in RM, 99/202 (49%) in IM and 21/202 (10.4%) in PM. Overall H. pylori infection was 138/202 patients (68.3%). H. pylori infection was demonstrated in 72% in RM genotype, 69.7% in IM genotype and 47.6% in PM genotype. Both gastric cancer patients had the IM genotype. In PUB patients, the prevalence of genotype RM (56%) was highest followed by IM (32%) and PM(12%). Furthermore, the prevalence of genotype RM in PUB was significantly greater than gastritis patients (56% vs 36%: p=0.016; OR=2.3, 95%CI=1.1-4.7). Conclusions: CYP2C19 genotype IM was the most common genotype whereas genotype RM was the most common in PUB patients. All gastric cancer patients had genotype IM. The CYP2C19 genotype RM might be play role in development of PUD and PUB. Further study in different population is necessary to verify clinical usefulness of CYP2C19 genotyping in development of these upper GI diseases.

• Journal of Nutrition and Health
• /
• v.2 no.2
• /
• pp.79-85
• /
• 1969

A serious case of the stomach ulcer was cured completely through a dietery treatment. The patient was listed as one of worse cases by the doctors. The patient refused to accept doctors' advises to have al surgical operation and sticked to his idea of dietetics. The doctors openly expressed their scepticism to a successful out come of a dietery treatment. However, it has been a success. A special ulcer diet menu prepared for the patient was based on those principles as follow: 1. Ulcer diet contained high protein (70g/day) and high energy (2,000cal/day). 2. To maintain a minimum degree of pressure on digestive process of the stomach, several small meals more than three times a day were served. Fat was avoided except that contained in milk and small amount of butter on toast. 3. To help to neutralize acid of the stomach, ample amount of milk was served. 4. Irritating food and beverage were prohibited. It was concluded that milk was one of the best diet for a peptic ulcer patient, for it could neutralize acid of the stomach as well as could provide ample amount of high protein which expedite healing craters formed by the stomach or duodenal ulcer. It was reported that most of unsucessful peptic ulcer cases of the local patients could be attributed to their failure in observance of an ulcer diet during their dietery treatment period, particularly their unfriendly attitude toward a milk diet.

• The Journal of the Convergence on Culture Technology
• /
• v.6 no.4
• /
• pp.289-294
• /
• 2020

Peptic ulcer disease is a gastrointestinal disorder caused by Helicobacter pylori infection and the use of nonsteroid anti-inflammatory drugs. While many studies have been conducted to find the risk factors of peptic ulcers, there are no studies on the suggestion of peptic ulcer prediction models for Koreans. Therefore, the purpose of this study is to implement peptic ulcer prediction model using machine learning based on demographic information, obesity information, blood information, and nutritional information for middle-aged and elderly people. For model building, wrapper-based variable selection method and naive Bayes algorithm were used. The classification accuracy of the female prediction model was the area under the receiver operating characteristics curve (AUC) of 0.712, and males showed an AUC of 0.674, which is lower than that of females. These results can be used for prediction and prevention of peptic ulcers in the middle and elderly people.

• YAKHAK HOEJI
• /
• v.44 no.1
• /
• pp.16-21
• /
• 2000

Peptic ulcer is involved with Helicobacter pylori infection and antibiotic regimens are primary treatments. An optimal therapeutic regimen for eradication of Helicobacter pylori remains uncertain due to variable efficacy. The objectives of this study were to evaluate the efficacy of omeprazole based antibiotic regimens in bacterial eradication, healing of peptic ulcer and to identify factors affecting efficacy. Seventy-seven patients were enrolled in the prospective, open-trial from November 1997 to Setember 1998. H. pylori infection was identified with endoscopy, H. pylori stain and rapid urease test. The first group (OAC7) received omeprazole 20 mg twice daily for 4 weeks which were the same schedule for all, amoxicillin and clarithromycin 500 mg three times daily for 1 week; the second group (OAC14), for 2 weeks on the same regimen as the first; and the last group (OACD) has taken bismuth in addition to the OAC7 regimen for 1 week. Eradication of H. pylori and healing of peptic ulcer were evaluated with endoscopy and tests for H. pylori before and after treatments. There were no significant differences in eradication rates; 77% in OAC7, 76% in OAC14, 81% in OACD (p=0.935) and healing rates; 82% in OAC7, 71% in OAC14, 95% in OACD (p=0.179), respectively. Compliance had an relationship with eradication rates significantly among regimens (p=0.049). Twenty three cases (29%) complained of the minor side effects. In conclusion, OAC7 was better in convenience of dosing schedule and showed fewer side effects with shorter duration and lower cost while There were no significant differences in efficacy among regimens.

• The Journal of Internal Korean Medicine
• /
• v.22 no.2
• /
• pp.207-213
• /
• 2001

Objectives : In order to study the clinical efficiency of Dohwatang, based on Oriental Medical References, using experimental animals, we studied ulcers, gastric juice secretion, free acidity, total acidity, and the action of transport rates in the intestine. Methods : We used rats administered with the above herbs. Results : Dohwa-tang showed remarkable inhibitory effects on peptic ulcers, gastric juice secretion, free acidity, and total acidity in pyloricligated rat. It also showed remarkable inhibitory effects on the transportability in the large intestine of rats. But Dohwa-tang didn't show any remarkable difference on stressed rats. Conclusions : Dohwatang works better for chronic pyloristenosis-peptic ulcer and for diarrhea than acute stress ulcer.

• The Journal of Internal Korean Medicine
• /
• v.16 no.1
• /
• pp.33-39
• /
• 1995

A previous study suggested that there might be an association between use of herb medicine and peptic ulcer. The past history of patient with perforated duodenal ulcer was treated with herb medicine. We identified that the mucosa of stomach & duodenum were completed healed by herb medicine treatment on the gastro-endoscopy and the systom. Author report ths case with a brief review of literatures.

• Journal of Korean Academy of Nursing
• /
• v.21 no.2
• /
• pp.230-246
• /
• 1991

Pain is a subjective and multidemensional concept. Therefore the patient's expression of pain have been referedl to the best believable indicator of pain condition but the support data obtained from the patient considered cultural difference is a deficient condition in determinded on the precise nursing diagnosis. The purpose of this reasearch was to understand multiple pain reponses in cultural difference and sensitivity, to encourage communication between medical teams, and to provide the foundation data of on data of precise nursing assessment for the patient in pain. The research problem was to grasp pain express pattern of Korean peptic ulcer patients. The subjects were 20 peptic ulcer patients in medical unit or OPD of twp university hospitals in Seoul. Data were collected from September 7th to 22nd, 1990 by intensive interviews. Interviews were done by the researcher and all were tape - recorded. The Data analysis was done by Phenomenological method from Van Kaam. Validity assured by confirmation of the internal consistency of the statements and catigory by nursing collegue in educational and clinicions in medical care. From the emic data, 96 descriptive statements were organized in 18 theme cluster. The results of study were summerized as follows. 1. Pain Express Pattern cluster of Peptic Ulcer Patients were “Pain as clogging”, “shallow pain”, “pain as pressing”, “nauseating pain”, “pain as smarting”, “pain as pulling”, “pain as pricking”, “pain as bursting”, “wrenching pain”, “excising pain”, “uncontrollable pain for mind and body”, “awakening pain”, “pain as hollowing” and the other cluster. As above mentioned, Pain Express Pattern of Peptic Ulcer Patient appeared diversely in verbal and they were propered to Korean culture. Therefore they will provide for the foundation data of precise nursing assessment.

• Korean Journal of Psychosomatic Medicine
• /
• v.11 no.2
• /
• pp.149-158
• /
• 2003

Objectives: The authors studied the anxiety, depression and psychological characteristics of medical out-patients, which are diagnosed as peptic ulcer disorder and essential hypertension. We also examined the state of psychiatric consultation. Methods: The subjects were composed of 56 patients with peptic ulcer disorder, 44 patients with essential hypertension and 116 controls. STAI, BDI and SCL-90R was administered to all subjects. Chart review, telephone interview and Self report questionnaire of etiology and severity of illness, drug compliance and so forth were performed in disease groups. Results: Considerable depression was noticed in 39.3% among the patients with peptic ulcer disorder, 27.7% in hypertension and 12.1% in control group by BDI. State anxiety was noticed in 44.6% among the patients with peptic ulcer disorder, 54.5% in hypertension and 18.1% in control group by State anxiety. Trait anxiety was noticed in 42.9% among the patients with peptic ulcer disorder, 34.1% in hypertension and 25.8% in control group by Trait anxiety. The higher SOM, BDI, STAI, the lower drug compliance and rapport. Psychological problems are considered of the most important etiology in 48.2% of peptic ulcer group and 45.7% of hypertensive group. But psychiatric consultation is made only in 1.8% of peptic ulcer group and 2.3% of hypertensive group. Conclusions: Anxiety and depression are common phenomena in medical outpatients. In comparison with the normal control group, peptic ulcer group showed significantly higher trait anxiety and depression and hypertensive group higher state anxiety. These characteristics are related to the drug compliance and doctor-patient relationship. These results suggested the needs of active psychiatric consultation.

• Journal of Gastric Cancer
• /
• v.8 no.3
• /
• pp.160-165
• /
• 2008

Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.10
• /
• pp.5043-5046
• /
• 2012

The role of Helicobacter pylori status and serum zinc value in gastric disease patients and healthy controls were investigated. Cases used in this work were 45 gastric cancer patients, 44 with peptic ulcers, 52 suffering gastritis and 64 healthy controls, all diagnosed histologically with the controls undergoing medical checkups. Helicobacter pylori status and serum levels of Zn were determined by 13C-urea breath test and flame atomic absorption spectrophotometer, respectively. Our study showed that Helicobacter pylori infection has no change in gastritis, peptic ulcer and gastric cancer group, on the contrast, serum levels of Zn were significantly reduced in gastritis, peptic ulcer and gastric cancer group, compared with healthy controls, and the higher the Zn levels are, the more increased risk of gastric cancer. Helicobacter pylori infection is a cause of gastritis, peptic ulcers and even gastric cancer, while serum zinc level is an indicator of protection of gastric membranes against damage.