• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8281-8285
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• 2016

Background: Helicobacter pylori is a cause of chronic gastritis, peptic ulcer disease, and gastric malignancy, infection being a serious health problem in Thailand. Recently, clarithromycin resistant H. pylori strains represent the main cause of treatment failure. Therefore this study aimed to determine the prevalence and pattern of H. pylori resistance to clarithromycin in Suranaree University of Technology Hospital, Suranree University of Technology, Nakhon Ratchasima, Northeastern Thailand, Nakhon Ratchasima province, northeast of Thailand. Materials and Methods: This hospital-based cross-sectional study was carried out between June 2014 and February 2015 with 300 infected patients interviewed and from whom gastric mucosa specimens were collected and proven positive by histology. The gastric mucosa specimens were tested for H. pylori and clarithromycin resistance by 23S ribosomal RNA point mutations analysis using real-time polymerase chain reactions. Correlation of eradication rates with patterns of mutation were analyzed by chi-square test. Results: Of 300 infected patients, the majority were aged between 47-61 years (31.6%), female (52.3%), with monthly income between 10,000-15,000 Baht (57%), and had a history of alcohol drinking (59.3%). Patient symptoms were abdominal pain (48.6%), followed by iron deficiency anemia (35.3%). Papaya salad consumption (40.3%) was a possible risk factor for H. pylori infection. The prevalence of H. pylori strains resistant to clarithromycin was 76.2%. Among clarithromycin-resistant strains tested, all were due to the A2144G point mutation in the 23S rRNA gene. Among mutations group, wild type genotype, mutant strain mixed wild type and mutant genotype were 23.8%, 35.7% and 40.5% respectively. With the clarithromycin-based triple therapy regimen, the efficacy decreased by 70% for H. pylori eradication (P<0.01). Conclusions: Recent results indicate a high rate of H. pylori resistance to clarithromycin. Mixed of wild type and mutant genotype is the most common mutant genotype in Nakhon Ratchasima province, therefore the use of clarithromycin-based triple therapy an not advisable as an empiric first-line regimen for H. pylori eradication in northeast region of Thailand.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.167-171
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• 2009

목적: 정상인과 위암 환자의 혈중 Pepsinogen (PG)농도를 비교 분석하여 선별검사로서 이용가능성 및 위암의 임상 조직학적 요소와의 상관 관계를 알아보고자 하였다. 대상 및 방법: 2008년 11월부터 2009년 5월까지 대구가톨릭대학병원에서 내시경상 특이소견이 없는 정상인과 위선암 환자의 수술 전 혈중 PG농도를 측정하였다. 위암진단의 선별검사로서의 이용가능성을 알아 보기 위해 receiver operator characteristics (ROC) curves를 이용하여 가장 유용한 검사법을 선별하였고, 위암 조직과의 상관관계를 알아보기 위해 특정 기준치에 따라 임상 조직학적 요소를 비교 분석하였다. 결과:선별검사로서 혈중 PG I/II 비율이 가장 유용하였고, 기준치에 따른 민감도, 특이도는 81.8%, 82%로 나타났다. 임상 조직학적 요소 중 Lauren분류에 따른 종양의 아형(P=0.003), TNM 병기의 T 병기(P=0.001), 및 종양주위의 만성 위축성 위염(P=0.036)을 동반한 위선암이 특정기준치(cut off point)값에 의미 있는 관련을 보였다. 결론: 본 연구는 정상 대조군의 수가 적어 선별검사로서 혈중 PG측정의 유용성을 논하기에는 부족하나, 위암의 선별검사로서 이용 가능성 및 임상 조직학적 요소와 의미 있는 관련을 보여 차후 추가연구가 필요할 것으로 생각한다.

• Asian Pacific Journal of Cancer Prevention
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• 제17권3호
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• pp.979-984
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• 2016

The incidence rate of stomach cancer in Bali, Indonesia, is estimated to be strikingly lower than that in Japan. We conducted an on-site ecological study to investigate the association between the stomach cancer incidence and Helicobacter pylori (H. pylori) infection. Recruiting 291 healthy persons (136 men and 155 women) from the general population in Bali, Indonesia, we conducted a urea breath test (UBT) to examine H. pylori infection, along with a pepsinogen test to detect chronic atrophic gastritis and urine analysis to estimate sodium and potassium excretion. UBT positivities were 9% (2-15, 95% confidence interval) for men and 7% (1-12) for women, and positive cases for H. pylori IgG antibodies were 1% (0-3) for men and 3% (0-5) for women, significantly lower than the respective values in Japan. Positive pepsinogen tests in Bali were 0% (0-0) for men and 1% (0-4) for women, also significantly lower than the Japanese figures. Computed values for daily salt excretion were $13.3{\pm}4.1g$ (mean${\pm}$SD) for men and $11.1{\pm}3.1g$ for women, as high as corresponding Japanese consumption values. Moreover, the estimated potassium excretion was $3.2{\pm}0.7g$ for men and $2.8{\pm}0.6g$ for women in Bali, significantly higher than the figures in Japan. There were no associations across genetic polymorphisms of IL-beta, TNF-alpha, and PTPN11 with UBT positivity. The low incidence of stomach cancer in Bali may thus mainly be due to the rare H. pylori infection. Namely, the bacterium infection seems to be a critical factor for gastric cancer rather than host or other environmental factors.

• Journal of Chest Surgery
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• 제22권1호
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• pp.134-140
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• 1989

A clinical evaluation was made on total 207 cases of corrosive esophageal stricture after ingestion of various corrosive substances and 173 cases of neoplasms in the esophagus and the cardia. The various complications associated with esophageal corrosion were observed on 28 cases [13.5%] in a total of 207 cases. Pathoanatomic findings of complication may be classified to the five category as follow; [1] stenosis in the pharynx due to adhesion of the epiglottis, [2] esophagobronchial fistula, [3] esophageal perforation with bougienation, [4] necrotic rupture of the esophagus and the stomach, and [5] so-called chronic corrosive gastritis. The comparative studies were done on a total of 165 cases of the various procedures of esophagoplasty to the reconstruction of the esophagus, which consists of antethoracal esophagoplasty with jejunum, retrosternal esophagoplasty with jejunum, retrosternal esophagoplasty with right colon, and retrosternal esophagoplasty with left colon. There is no hard and fast rule in selection of jejunum, right colon or left colon as the transplanting bowel and an operative method either antethoracal or retrosternal approach. When there was no possibility of the complication and no any defect of the anatomical states, one stage retrosternal esophagoplasty using right colon was better in various points of view. The 173 patients of the neoplasm of the esophagus consist of 28 cases of benign tumors and 145 cases of malignant tumors in the esophagus and cardia. 28 cases of benign tumors in the esophagus received the surgical treatment and they obtained with excellent results postoperatively. Of the 145 patients of esophageal carcinoma who received surgical managements, 101 cases [69.6%] were found to be operable and 44 cases [30.3%] were inoperable. Due to the various level of carcinoma in the esophagus, the following different surgical procedure was properly used case by case to get the best results in each case. Esophageal carcinoma in the upper and middle third segment received the total esophagectomy and the reconstruction of the esophagus using right colon by substernal procedure. Esophageal carcinoma in the lower third segment received an esophagojejunostomy in the mediastinum after the resection of lower third segment of the esophagus. Carcinoma in the esophago cardia and the stomach received also an esophagojejunostomy after the resection of the lower third segment of the esophagus and subtotal gastrectomy. For the 44 patients with inoperable carcinoma, the several palliative surgical managements such as gastrostomy or jejunostomy for feeding and esophagojejunostomy for bypass of the lower esophagus and the stomach were properly performed case by case for their maximum improvement.

• Asian Pacific Journal of Cancer Prevention
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• 제16권13호
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• pp.5199-5203
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• 2015

Background: Helicobacter pylori (H.pylori) is associated with chronic gastritis, peptic ulcers, gastric adenocarcinomas and mucosa associated tissue lymphomas. Cytotoxin associated gene A (CagA) is one of the virulence factors of H.pylori. It is hypothesized that reactive oxygen species (ROS) play roles in H.pylori associated disease especially in development of gastric adenocarcinoma. Individuals infected with H.pylori bearing CagA produce more ROS than others. 8-hydroxydeoxyguanosine (8OHdG) is an in vitro marker of DNA damage and oxidative stress. The aim of this study was to investigate the relationship between 8OHdG level, H.pylori infection and CagA and alterations of serum 8OHdG level after H.pylori eradication. Materials and Methods: Patients admitted with dyspeptic complaints and upper gastrointestinal endoscopy were assessed. H.pylori was determined from histopathology of specimens. Serum 8OHdG levels of three groups (H.pylori negative, H. pylori positive CagA negative and H.pylori positive CagA positive) were compared. Patients with H.pylori infection received eradication therapy. Serum 8OHdG levels pretreatment and posttreatment were also compared. Results: In total, 129 patients (M/F, 57/72) were enrolled in the study. Serum 8OHdG level of H.pylori negative, H. pylori positive CagA negative and H.pylori positive CagA positive groups were significantly different ($5.77{\pm}1.35ng/ml$, $5.43{\pm}1.14ng/ml$ and $7.57{\pm}1.25ng/ml$ respectively, p=0.05). Furthermore, eradication therapy reduced serum 8OHdG level ($6.10{\pm}1.54ng/ml$ vs $5.55{\pm}1.23ng/ml$, p=0.05). Conclusions: Individuals infected with H.pylori bearing CagA strains have the highest serum 8OHdG level and eradication therapy decreases the serum 8OHdG level. To the best of our knowledge this is the first study that evaluated the effect of CagA virulence factor on serum 8OHdG level and the effect of eradication therapy on serum 8OHdG levels together. Eradication of CagA bearing H.pylori may prevent gastric adenocarcinoma by decreasing ROS. 8OHdG level may thus be a good marker for prevention from gastric adenocarcinoma.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.2363-2367
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• 2012

Objective: To investigate the association between the connexin 37 C1019T polymorphism and Helicobacter pylori infection in patients with gastric cancer. Methods: 388 patients with gastric cancer (GC), 204 with chronic superficial gastritis (CSG) were studied. H. pylori was detected by gastric mucosal biopsies biopsy dyeing method. Connexin 37 gene polymorphism 1019 site genotypes were determined by gene sequencing technology. Genotypes and alleles frequencies were compared. Results: (1) Connexin37 gene 1019 site distribution frequency (CC type, TC type, TT type) in the CSG group was 18.1%, 45.1% and 36.8%; in the stomach cancer group it was 35.1%, 45.9% and 19.%, conforming to the Hardy-Weinberg euilibrium. (2) In comparison with CSG group, the frequency of Connexin37 C allele was higher in the gastric cancer group (58.0% vs 40.7%, OR = 2.01, 95%CI = 1.58-2.57, P < 0.01). The prevalence of gastric cancer risk was significantly increased in the carriers of C allele (CC+TC) than in TT homozygote (OR = 2.47, 5%CI = 1.68- 3.610. (3) Gastric cancer patients complicated with Hp infection 211 cases, gastric cancer group of the male patients with HP positive patients with 187 cases, 40 cases of female patients with negative patients, 24 cases were HP positive, negative in 137 cases, control group male patients, 28 cases were Hp positive, negative in 95 patients, female patients with Hp positive 6 cases, 75 cases were negative. On hierarchical analysis, the male group OR value was 15.9 (95%CI to 9.22-27.3), and the female OR was 2.19 (95%CI 0.88-5.59), indicating a greater contribution in males (P <0.01). After elimination of gender effects, positive HP and gastric cancer were closely related (OR 8.82, 95% CI: 5.45-14.3). (4) The distribution frequency of C allele in patients with Hp infection was much higher than that in Hp negative cases in the GC group (64.5% vs 47.0%, OR = 2.05, 95%CI = 1.54-2.74, P < 0.01). Compared with TT homozygotes, (CC+TC) genotype prevalence of gastric cancer risk increased significantly (OR = 2.96, 5%CI = 1.76-2.99 ). Conclusion: The T allele in the connexin37 gene might not only be associated with gastric cancer but also with H. pylori infection.

• 생명과학회지
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• 제10권6호
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• pp.630-639
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• 2000

The gastric pathogen Helicobacter pylori(H. pylori) establishes long-term chronic infection that can lead to atrophic gastritis, intestinal metaplasia, and gastric cancer. H. pylori, which express cytotoxic genes is now recohnized as a cause of peptic ulcer and is also a major risk factor for the development of gastric adenocarcinoma. We performed this study 1) to assess the detection rate of H. pylori according to direct investigation of bacteria of gastric biopsy specimen and two serologic tests of GAP test and Helico blot 2.0 system in the symptomatic and non-symptomatic group 2) to evaluate and compare the efficacy of two serologic tests of GAP test and Helico blot 2.0 system for the diagnosis of H. pylori infection. Forty-nine patients were positive for H pylori infection based on direct investigation of bacteria by histology. The detection rates of H. pylori infection based on direct investigation of bacteria by histology. The detection rates of H. phlori were significantly lower in gastric cancer than in other gastroduodenal disease(p<0.05). The concordance of two serologic tests of GAP test and Helico blot 2.0 system is poor. There was no statistically significant difference between the expression rate of CagA and VacA in the symptomatic and non-symptomatic group. Although Helico blot 2.0 system may not displace GAP test, it was a very sensitive serologic test for the diagnosis of H. pylori infection and it was used to detect IgG antibodies to H. pylori-specific antigens, including CagA, VacA and the various urease subunit. Our data suggest that further investigation is needed to determine whether or not the serologic expression of cytotoxic gene may be clinical usefulness of diagnostic methods in the gastroduodenal disease.

• Journal of Gastric Cancer
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• 제6권1호
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• pp.47-51
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• 2006

위에서 생기는 점막하 종양은 내시경적 조직검사로는 그 기원을 알기 어려운 경우가 많다. 이러한 점막하 종양 중, 슈반 세포(Schwann cell)로부터 분화하여 생기는 종양을 신경초종(Schwannoma)이라고 하며, 위에서 생기는 전체 종양의 0.2%를 차지한다고 알려져 있다. 이 증례는 2개월 전부터 시작된 다량의 흑색변과 빈혈을 주소로 내원한 57세 여자 환자에 대한 보고이다. 복부 컴퓨터 단층 촬영 및 상부 위장관 내시경에서 위 분문에서 3 cm정도 아래부터 위각 직상부까지 위체부 소만을 대부분 차지하는 약 8 cm 이상의 돌출된 종양이 관찰되었고, 수 차례에 걸친 내시경적 조직검사를 시행하였으나 괴사조직과 육아종성 조직, 만성 위염 소견만 반복해서 나왔다. 출혈을 동반한 진행성 위암, 림프종 등을 생각하여 정확한 진단 및 출혈에 대한 치료를 위해 수술을 시행하였다. 술 후 조직검사에서 전반적으로 소엽상 형태(lobulating pattern)로 주변에 림프구 침윤(lymphocyte cuffing)이 있었고 책상핵(palisading nuclei), 방추세포(spindle-cell) 등이 보였다. C-kit, CD34, SMA 모두 음성이었으며 S-100 양성으로 신경초종으로 진단되었다.

• 생명과학회지
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• 제22권12호
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• pp.1729-1739
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• 2012

발효 한약의 안전성과 유효성을 평가하기 위하여 CNKI, PubMed, 국내 한의학 저널에서 2000년부터 2011년까지 이루어진 관련 연구를 검색하였다. 발효 한약에 대한 유효성을 검증하기 위한 11개의 무작위 대조군 임상 연구로 국내에서는 면역 기능과 심혈관 기능에 대한 연구가 있었고, 중국에서는 만성 천표성 위염을 비롯한 각종 질환에 대한 임상 연구가 이루어졌다. 그 외의 국가에서는 식도암이나 국소 면역 반응에 대하여 검증하였다. 결과, 발효 한약은 특정 질환에 있어 명백한 효과를 보이고 있으며 부작용 또한 발견되지 않았다. 따라서 발효 한약에 대한 지속적인 관심과 연구가 필요할 것으로 사료된다.

• 생명과학회지
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• 제20권5호
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• pp.760-767
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• 2010

지질, 단백질 및 DNA의 산화적 손상이 관절염, 간염, 위염, 대장염 및 치주 질환과 같은 만성 염증뿐만 아니라 암 전이에 관련되어 있다고 알려져 있다. 이러한 질환의 발생을 예방하기 위하여 독성이 없는 천연 화합물을 개발하는 것이 최근의 주요 연구 관심 대상이다. 산화적 스트레스와 관련 있는 DPPH radical, hydrogen peroxide, hydroxyl radical 및 과산화수소와 같은 활성산소에 대한 흑마늘(ABGE)의 소거능력이 연구되었다. 뿐만 아니라 TBARS assay를 이용하여 본 연구에서 사용된 산화방법으로 Fenton반응에 의하여 hydroxyl radical에 노출된 세포에서 ABGE의 항산화 효과도 조사되었다. ABGE는 활성산소종 중에서 특히 과산화수소에 대한 항산화 효능이 우수하였고 hydroxyl radical에 노출된 genomic DNA의 산화에 대한 보호 효과도 관찰되었다. 살아있는 세포에 대한 산화적 스트레스도 ABGE의 존재 하에서 억제되었다. 뿐만 아니라, 암전이와 관련 있는 MMP-2 및 MMP-9의 활성과 발현에 대한 ABGE의 효과를 gelatin zymography 및 western blot을 이용하여 조사하였다. ABGE는 PMA로 자극한 사람 섬유아육종세포로부터 분비된 MMP-2 및 MMP-9의 활성과 발현을 동시에 억제 하였으므로 암을 억제 할 수 있는 하나의 생리활성물질로 개발 될 수 있으리라 판단된다.