• The Korea Journal of Herbology
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• v.35 no.4
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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.

• The Journal of Korean Medicine
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• v.40 no.2
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• pp.17-34
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• 2019

Objectives: This study was carried out to observe and compare the effects of Pinellia ternata, Zingiber officinale and Sobanhatang on the reflux esophagitis induced by gastric fundus and pylorus ligation in mice with esomeprazole. Methods: Antioxidant effects were measured by DPPH radical scavenging activity at four different concentration of 0.125, 0.25, 0.5 and $1.0mg/102{\mu}{\ell}$. Zingiber officinale water extract(ZE), Pinellia ternata water extract(PE) and Sobanhatang water extract(SBE) and esomeprazole were treated orally for 14 days before gatric fundus and pylorus ligation. In the histochemistry, changes in suface mucous cells, muscle tissue and connective tissue in gastro esophageal junction(GEJ) and mast cell on the esophageal mucosa were observed. The change of Hemo oxygenase(HO)-1, ghrelin, gastrin and substance P in gastric body tissue were measured by immunohistochemistry. Results: DPPH radical scavenging activity exhibited concentration dependently increases in ZE, PE, SBE. ZE was significantly higher at all concentrations than PE. The gastric surface mucous cells were more in the treated group than in the reflux esophagitis elicited group(GE) in the order of PE, SBE, ZE and esomeprazole treateded group(PT, SBT, ZT, ET). Lower esophageal sphincter muscle damage and intercellular space in the GEJ were less in the treated group than GE. In the esophageal mucosa, the mast cell distribution and the migration of inflammatory cells were lower in the treateded troup than GE in order to ZT, SBT, PT and ET. The antioxidative enzyme, HO-1 was more in the order of ZT, SBT, control group, PT, ET than in GE. ZT was significantly higher than the other groups and SBT was significantly higher than ET. Ghrelin was found to be higher in ZT, ET, SBT and PT than in GE, and ZT was significantly higher than all other groups except ET. Gastrin showed the highest positivity in GE, and was lower in the order of ET, ZT, SBT, PT, and control group. Substance P was the highest in GE, and was lower in the order of ET, ZT, SBT, PT and control group, and PT were significantly lower than ET. Conclusion: ZT, PT and SBT showed superior antioxidative, anti-inflammatory and mucosal protective effects on mouse reflux esophagitis as compared with ET. In particular, ZE was more effective in antioxidant and gastric motility enhancement, while PE was more effective in mucosal protection and anti-inflammatory effects. Sobanhatang is expected to be effective treatment because it has advantages of both drugs and reduces toxicity.

• Journal of Gastric Cancer
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• v.4 no.4
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• pp.252-256
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• 2004

Purpose: Anastomosis site stricture is a common complication after a total gastrectomy. End-to-end anastomosis (EEA) stapler devices are preferred to a hand-sewn esophagojejunostomy these days. However, stapling devices have been reported not to reduce the incidence of esophagojejunostomy site stricture considerably. Materials and Methods: From Sep. 1998 to Dec. 2000, at Korea Gastic Cancer Center, Seoul Paik Hospital, Inje University, we experienced 228 total gastrectomies in which EEA stapling devices had been used. We investigated the correlation of the stricture with the size of the EEA stapling device, the type of esophagojejunal reconstruction, reflux esophagitis, and duration of stricture development. Results: Among the 228 cases, as far as the patient's age was concerned, the 7th decade was the most common 64 cases, followed by the 5th decades. The Male-to-female ratio was 2.3：1. A loop esophagojejunostomy was used in 223 cases, and the Roux-en-Y method was used in 5 cases. The 32 patients with anastomosis site stricture were patients with loop esophagojejunal anastomosis. Anastomosis site stricture occurred in $14\%$ (32/228) of the total gastrectomy cases, in$15.9\%$ (11/69) of the total gastrectomies involving stapler devices with a 25-mm diameter, and in $13.2\%$ (21/159) of the total gastrectomies involving staper devices with a 28-mm diameter. There was no correlation between the incidence of stricture and EEA- stapling device size (P>0.05). Reflux esophagitis occurred in 56 of the 228 cases, with 7 of those 56 cases ($12.5\%$) and 25 of the remaining 172 cases ($14.5\%$) having strictures. There was no considerable difference in the stricture incidence rate according to the presence of reflux esophagitis (P>0.05). The onset of stricture development, occurred within 6 months in 16 cases, including 4 cases of reflux esophagitis, between 7 and 18 months in 14 cases, including 3 cases of reflux eshophagitis, and after 19 months in 2 cases. Conclusion: An esophagojejunostomy site stricture after a total gastrectomy was not correlated with the esophagojejunal reconstruction type, the size of the stapling device, or the presence of reflux esophagitis. General anastomosis technical factors (e.g., adequate blood supply, tension-free manner, adequate hemostasis) may be more important to prevent anastomosis site stricture after an esophagojejunostomy during a total gastrectomy.

• Journal of Physiology & Pathology in Korean Medicine
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• v.23 no.5
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• pp.1073-1079
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• 2009

The object of this study was to observe the protective effects of Yijin-tang-gamibang (YJGMB), Yijin-tang has been traditionally used as Korean medicine for treating various digestive diseases. The study showed that it is effective on reflux esophagitis induced by pylorus and forestomach ligation in rats. Three different dosages of Yijin-tang-gamibang extracts, 300, 150 and 75 mg/kg, were once orally administered 1 hour before pylorus ligation. 6 groups, each of 8 rats per group were used in the present study. The results were compared with Omeprazole, antioxidant and proton pump inhibitor, 30 mg/kg treated group. Yijin-tang-gamibang extracts 300 mg/kg were showed similar or slightly lower effects as compared with 30 mg/kg of omeprazole in the present study. Detail mechanism studies should be conduced in future with the efficacy tests of individual herbal composition of Yijin-tang-gamibang and the screening of the biological active compounds in herbs.

• The Journal of Internal Korean Medicine
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• v.34 no.2
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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.

• The Journal of Korean Medicine
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• v.31 no.5
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• pp.64-81
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• 2010

Objectives: The object of this study was to observe the suppressive effects of Yijintang-gamibang (YJGMB), Yijintang being traditionally used in the Korean Medicine for treating various digestive diseases, on the rat reflux esophagitis (RE) as compared with omeprazole, a well-known proton pump inhibitor. Methods: Three different dosages of YJGMB, 50, 100 and 200 mg/kg, were orally pretreated once a day for 28 days before pylorus and forestomach ligation. Seven groups of 8 rats each were used in the study. Six hrs after pylorus and forestomach ligation, changes to the stomach and esophagus lesion areas, gastric volumes, acid and pepsin outputs, invasive lesion percentages, fundic mucosa, esophageal submucosa and total thicknesses were measured by histomorphometry. The results were compared with omeprazole 10 and 30 mg/kg treated groups in which the effects on RE were already confirmed. Results: As results of pylorus and forestomach ligation, marked increases of esophageal and gastric mucosa lesion areas, gastric volumes, acid outputs, pepsin outputs were observed with histopathological changes of RE, such as hemorrhages, ulcerative lesions and edematous changes on the esophageal and fundic mucosa. However, these pylorus and forestomach ligation induced RE were dose-dependently inhibited by treatment of 50, 100 and 200 mg/kg of YJGMB. YJGMB 50 mg/kg showed similar suppressive effects as 30 mg/kg of omeprazole, but more favorable effects were observed as compared with omeprazole 10 mg/kg. Conclusion: The results suggest that YJGMB showed favorable suppressive effects on the RE induced by pylorus and forestomach ligation. It is therefore expected that YJGMB will show favorable effects on RE as corresponds to the suggestion of traditional Korean medicine. However, more detailed mechanism studies should be conducted in future with the screening of the biological active chemical compounds in herbs.

• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.3
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• pp.416-425
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• 2010

The object of this study was to observe the protective effects of Yijin-tang-gamibang (YJGMB), Yijin-tang has been traditionally used in the Korean Medicine for treating various digestive diseases. The study showed that it is effective on reflux esophagitis induced by pylorus and forestomach ligation in rats. Three different dosages of YJGMB extracts, 200, 100 and 50 mg/kg, were orally pretreated, once a day for 28 days before pylorus and forestomach ligation. Seven groups, each of 8 rats per group were used in the present study. The results were compared with omeprazole, antioxidant and proton pump inhibitor, 30 and 10 mg/kg treated group. YJGMB 200 mg/kg were showed similar protective effects as compared with 30 mg/kg of omeprazole but more favorable effects were observed in 200, 100 and 50 mg/kg of all YJGMB treated rats as compared with omeprazole 10 mg/kg in the present study. In addition, YJGMB 200 mg/kg were showed more favorable antioxidant effects as compared with 30 mg/kg of omeprazole in the present study. Detail mechanism studies should be conduced in future with the screening of the biological active chemical compounds in herbs.

• The Korea Journal of Herbology
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• v.31 no.5
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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.

• Korean Journal of Organic Agriculture
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• v.29 no.1
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• pp.85-96
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• 2021

Reflux esophagitis (RE) is a common gastrointestinal disease observed at all ages, which seriously affects the quality of life. In this study, we investigated the anti-inflammatory effects of Pomacea canaliculata extract (PCE) using the experimental RE rat model. RE was induced by a surgical procedure. The rats were randomly divided into 4 groups: normal group, RE group, PCE group (RE treated with PCE, 100 mg/kg), positive control group (RE treated with ranitidine, 40 mg/kg). We performed the histological examination and measured the expression of tight junction complex and inflammatory mediators using western blot analysis. The phenotypes of RE were attenuated by PCE treatment. PCE administration significantly reduced esophageal mucosal damage and protected tight junction confirmed by claudin-5. Furthermore, PCE treatment reduced inflammatory reaction by inhibiting the expression of COX-2 and TNF-α. PCE treatment, also, reduced translocation of NF-κB into nuclear and IκB-α phosphorylation at the same time. Our findings indicate that PCE has the potential as a novel therapeutic agent to inhibit RE by protecting mucosal damage and regulating inflammatory reactions mediated by NF-κB signaling.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1245-1254
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• 2021

Objectives: This study investigated the clinical characteristics and symptoms of patients with reflux esophagitis (RE) visiting a Korean medicine hospital. Methods: We retrospectively reviewed the medical records of patients with an RE diagnosis who visited a Korean medicine hospital from June 15, 2020, to April 15, 2021. We analyzed the clinical characteristics and the results of a symptoms questionnaire. Results: Our sample included 1,151 patients (711 females). The median age was 58 years; the most common age bracket was 60-69 years. A total of 837 patients (72.7%) presented with symptoms lasting more than one year, and 1,035 (89.9%) had been prescribed medications for more than three months before visiting a Korean medicine hospital. Belching (77.6%) and acid regurgitation (70.9%) were the most frequent symptoms, followed by epigastric pain (61.6%) and throat globus (58.5%). Throat globus was the most bothersome symptom, and 72.4% of the patients experienced the symptom on more than five days in the preceding two weeks. Patients with a longer symptom duration were older (p<0.01) and more likely to be overweight (p=0.03). Patients experiencing symptoms for more than five years were more likely to report throat globus (p=0.02), hoarseness (p<0.01), and coughing (p<0.01). Conclusions: Most RE patients visiting a Korean medicine hospital were females in their sixties with chronic and refractory RE. Atypical symptoms (belching, epigastric pain, and throat globus) were common. Throat globus was highly prevalent in severe cases, suggesting that it warrants attention when treating RE patients.