• Title/Summary/Keyword: duodenal ulcer

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Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases (각기 다른 유문-십이지장의 기질적 병변 3증례에 대한 장음 측정 보고 : 장음의 주주파수를 중심으로)

  • Yoon, Sang-hyub
    • The Journal of Internal Korean Medicine
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    • v.36 no.3
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    • pp.276-283
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    • 2015
  • Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

A Case of Aggravated Hyperplastic Gastric Polyps after Treatment with Long-term Proton Pump Inhibitors (양성자 펌프 억제제 투여로 악화된 과증식 위용종 1예)

  • Kim, Ho Tae;Park, Jong Wan;Eom, Seok Hyeon;Kwak, Tae Yeung;Hwang, Hong Suk;Kim, Yeung Sung;Kwak, Dong Hyup;Kim, Jung Hee
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.141-144
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    • 2013
  • Hyperplastic gastric polyps (HPPs) are the most common type of gastric polyps. They are assumed to be caused by chronic inflammation and regenerative proliferation, although this has not been clearly investigated yet. Many studies suggested the development of fundic gland polyps and carcinoid during long-term proton pump inhibitor (PPI) therapy, but the relationship between PPIs and HPPs is still unclear. We encountered a patient who showed aggravation of HPPs after long-term use of PPIs. A 58-year-old male patient with liver cirrhosis visited our hospital because of hematemesis. We started PPI medication after confirming esophageal variceal bleeding and duodenal ulcer with blood clot in its base via emergency endoscopy. He took PPIs for three years because of an intractable duodenal ulcer. There was a marked increase in the size of the pre-existing polyps and in the development of new polyps. We presumed that the PPIs caused the aggravation of the HPPs, so we stopped their administration. After five months, the HPPs shrank and the polyps were partially degraded. More prospective studies are needed to investigate the relationship between HPPs and PPIs.

Antigastric and Antiulcerative Action of a New Proton Pump Inhibitor (IY-81233) (새로운 프로톤 펌프 억제제, IY-81233의 항위염과 항궤양작용)

  • Kim, Seung-Hee;Kim, Jeen;Kang, Seog-Youn;Lee, Song-Deuk;Hong, Sung-Gul;Kim, Dong-Yeun;Moon, A-Ree
    • Biomolecules & Therapeutics
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    • v.4 no.3
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    • pp.285-290
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    • 1996
  • This study was designed to determine the effect of newly synthesized antiulcer agent, 5-pyrrolyl-6-halo-2-(pyridyl-2-methylthio)benzimidazole derivatives (IY-81233), on various experimental ulcers and on the secretion of prostaglandin $E_2(PGE_2)$ into the gastric lumen of rat. IY-81233 was previously reported to have a strong inhibitory effect on $H^+/K^$-ATPase and on gastric acid secretion in rats. Oral administration of IY-81233 at concentrations of 0.2, 2.0, and 20 mg/kg inhibited gastric lesions and duodenal ulcer induced by indomethacin, HCI-ethanol, water-immersion stress, cysteamine, and acetic acid in a dose dependent manner. Their IC$IC_{50}$ values were 3.4, 1.4, 0.8, 1.3, and 1.2 mg/kg, respectively. These results indicate that IY-81233 is a potent antiulcer agent although it is slightly less potent than omeprazole in healing of gastritis and ulcers. The secretion of $PGE_2$ into gastric lumen was also investigated in relation to the cytoprotective effect by IY-81233 in rats. The $PGE_2$ level was not changed significantly by an oral administration of IY-81233, suggesting that IY-81233 has little effect on the gastric protection. Therefore, it can be concluded that IY-81233 exerts prominent antiulcer activity by suppressing gastric acid secretion via an inhibition of a proton pump and not by protecting the gastrointestinal mucosa against various ulcerative stimuli.

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Evaluation of Clinical Use by Comparative Efficacy and Safety Study of Fine Granvles for Upper Gastrointestinal Disorders Including Symptoms (상부 소화관 질환증상에 대한 제산.소화효소제와 생약제를 함유한 복합제제 세립의 유용성)

  • 전형식;김주현;황일순;추현광;박현철;정숙향
    • YAKHAK HOEJI
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    • v.37 no.2
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    • pp.172-181
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    • 1993
  • The purpose of this study was to evaluate the clinical efficacy and safety of NRM which was newly developed as a combination product containing antacids, digestive enzyme and herbal drugs, and OTA powder, called OHTA'S ISAN on the morret, for the treatment of various symptoms in upper gastrointestinal diseases. 63 patients were recruited, 36 as a treated group with NRM and 27 as a controlled one with OTA. Patients were randomly allocated to receive either NRM or OTA t.i.d. for treatment of upper G-1 symptoms and undergone endoscopic, symptomatic and clinical laboratory assessments before and after 2 weeks. The results were as follows; 1. The general improvement rates of subjective symptoms in upper G-1 diseases were observed in 100%(32/32) for NRM and in 92%(23/25) for OTA. 2. The overall effective rates in terms of the symptoms and endoscopic findings were 88.9%(32/36) for NRM and 85.2%(23/27) ,or OTA respectively. 3. In NRM group, no significant side effects by NRM were observed except a mild and transient vomiting in one patient, but in OTA group treatment was discontinued due to nousea in one patient, However, there were no clinically significant changes detected in the laboratory parameters. According to the result of this trial, it is cocluded that NRM was safe and effective and (but not statistically significant) was superior to OTA in the treatment of gastrointestinal diseases caused by gastritis, gastric and duodenal ulcer, functional gastrointestinal disorder, non-ulcer dyspepsia etc.

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The Study of Different Regimens Prescribed for the Treatment of Peptic Ulcer Disease in a Community Hospital (지역소재 종합병원에서 소화성궤양 환자의 약물요법 사용실태 분석)

  • Park, Young Mee;Oh, Jung Mi
    • Korean Journal of Clinical Pharmacy
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    • v.10 no.3
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    • pp.111-119
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    • 2000
  • The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.

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H. pylori-associated Iron-Deficiency Anemia (Helicobacter pylori 관련 철분 결핍 빈혈)

  • Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.129-138
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    • 2006
  • Lots of cases relating Helicobacter pylori infection to iron-deficiency anemia have been described in the literature and H. pylori infection has emerged as a cause of refractory iron-deficiency anemia which is unresponsive to oral iron therapy. H. pylori-associated iron-deficiency anemia can be treated by H. pylori eradication. It is not thought to be attributable to gastrointestinal blood loss, such as duodenal ulcer. The mechanism by which H. pylori infection contributes to iron-deficiency anemia remains unclear. However, four possible explanations can be posited for this relationship; occult blood loss secondary to chronic gastritis, reduced iron absorption due to hypo- or achlorhydria, increased iron consumption by H. pylori, and iron sequestration in gastric mucosa. H. pylori-associated iron-deficiency anemia seems to develop in populations at increased risk for iron depletion. When pubescent girls, including athletes, are found to have iron-deficiency anemia refractory to iron administration, they should be evaluated for H. pylori infection.

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Microscopic Identification of the Chinese Patent Medicine Jeong Wi Dan (한약 정위단의 현미 감정연구)

  • Park, Sang-Il;Whang, Myung-Seog;Cai, Shao Qing;Park, Jong-Hee
    • Korean Journal of Pharmacognosy
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    • v.29 no.1
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    • pp.40-43
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    • 1998
  • 'Jeong Wi Dan' is Chinese patent medicine. which is used for stomachic disorder, gastric and duodenal ulcer. This medicine is in the large of pills consisting 14 kinds of powdered crude drugs. For the identification of individual ingredients in such powdery mixtures, microscopic method may advantageously be used as it requires only a small amount of specimens. In this paper, effective of this method will be exemplified by the identification of the ingredients in Jeong We Dan which contains 14 powdered crude drug ingredients.

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Endoscopic Findings of Children with Henoch-Schonlein Purpura (소아 알레르기성 자반증의 위장관 내시경 소견)

  • Lee, Dong Hoon;Park, Chul Han;Park, Ji Min;Park, Geun Soo;Kim, Heung Sik;Kang, Chin Moo
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.572-575
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    • 2003
  • Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

Gastric Reflux on Routine Tc-99m DISIDA Hepatobiliary Scintigraphy (Tc-99m DISIDA 간담도 Scintigraphy상 우연히 발견된 위장역류의 임상적 의의)

  • Lee, Kang-Wook;Lee, Heon-Young
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.3
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    • pp.313-318
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    • 1995
  • Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid delivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISIDA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows : 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenoscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

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Antigenic Proteins of Helicobacter pylori of Potential Diagnostic Value

  • Khalilpour, Akbar;Santhanam, Amutha;Lee, Chun Wei;Saadatnia, Geita;Velusamy, Nagarajan;Osman, Sabariah;Mohamad, Ahmad Munir;Noordin, Rahmah
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1635-1642
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    • 2013
  • Helicobacter pylori antigen was prepared from an isolate from a patient with a duodenal ulcer. Serum samples were obtained from culture-positive H. pylori infected patients with duodenal ulcers, gastric ulcers and gastritis (n=30). As controls, three kinds of sera without detectable H. pylori IgG antibodies were used: 30 from healthy individuals without history of gastric disorders, 30 from patients who were seen in the endoscopy clinic but were H. pylori culture negative and 30 from people with other diseases. OFF-GEL electrophoresis, SDS-PAGE and Western blots of individual serum samples were used to identify protein bands with good sensitivity and specificity when probed with the above sera and HRP-conjugated anti-human IgG. Four H. pylori protein bands showed good (${\geq}$ 70%) sensitivity and high specificity (98-100%) towards anti-Helicobacter IgG antibody in culture-positive patients sera and control sera, respectively. The identities of the antigenic proteins were elucidated by mass spectrometry. The relative molecular weights and the identities of the proteins, based on MALDI TOF/TOF, were as follows: CagI (25 kDa), urease G accessory protein (25 kDa), UreB (63 kDa) and proline/pyrroline-5-carboxylate dehydrogenase (118 KDa). These identified proteins, singly and/or in combinations, may be useful for diagnosis of H. pylori infection in patients.