• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.46-52
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• 2016

Background: The use of acid suppressive agents became a standard therapy in an intensive care unit (ICU) to prevent stress related gastrointestinal mucosal damage. However, the risk of infectious diseases has been concerned. Objective: The study was to determine the differences between histamine 2 receptor antagonists (H2RA) and proton pump inhibitors (PPI) in incidence of nosocomial pneumonia and pseudomembranous colitis (PMC) by Clostridium difficile with patients in ICU. Methods: This is a retrospective comparative study including patients admitted to the ICU who were at least 18 years of age and stayed for more than 48hrs from August 1, 2014 to January 31, 2015. The propensity score analysis and propensity matched multivariable logistic regression were used in analyzing data to control for confounders. Results: A total of 155 patients were assessed. H2RA were prescribed in 110 (53.9%) and PPI were in 45 (22.1%). Nosocomial pneumonia developed in 37 (23.9%); 25 (22.7%) were on H2RA and 12 (26.7%) were on PPI. The unadjusted incidence of nosocomial pneumonia was slightly higher in the patients with PPI (odds ratio (OR) 1.24; 95% confidence interval (CI): 0.54-2.71) compared to them with H2A. After adjusting with propensity score, the adjusted OR with PPI was 1.35 (95% CI: 0.44-4.11). The propensity score matched analyses showed similar results. Conclusion: The uses of PPI and H2RA as a stress ulcer prophylaxis agent showed similarity in the incidence of nosocomial pneumonia and PMC.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.3
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• pp.243-250
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• 2020

Purpose: Gastric delta cells (D-cells), which are somatostatin-secreting cells, are the main paracrine inhibitor of acid secretion. The number of D-cells was studied in children presenting with upper gastrointestinal (UGI) disease. Methods: We retrospectively investigated the number of D-cells in the gastric body and antrum through immunofluorescence examinations according to symptoms, endoscopic findings, and Helicobacter pylori infection in 75 children who visited Hanyang University Hospital Pediatrics. Results: The mean patient age was 12.2±3.3 years. The male-to-female ratio was 1:1.4. The mean D-cell number per high-power field in the antrum and body was 20.5 and 12 in children with substernal pain, 18.3 and 10.3 in vomiting, 22.3 and 6 in diarrhea, and 9.3 and 6 in abdominal pain, respectively (p>0.05). According to endoscopic findings, the mean D-cell number in the antrum and body was 14.3 and 6 with gastritis, 14 and 9.3 with reflux esophagitis, 16.7 and 8.7 with duodeno-gastric reflux, 19.3 and 12.7 with gastric ulcer, 16 and 13.7 with duodenitis, and 12.3 and 4 with duodenal ulcer, respectively (p>0.05). The D-cell number in the gastric body was 2.7 and 8.7 in children with current H. pylori infection and non-infected children, respectively (p=0.01), while those in the antrum were 15.5 and 14, respectively, with no statistical significance. Conclusion: The D-cell number was lower in the gastric body of children with current H. pylori infection. Further studies concerning peptide-secreting cells with a control group would provide information about the pathogenic pathways of UGI disorder.

• 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.

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1084-1092
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• 2018

Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

• The Journal of Korean Medicine
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• v.25 no.4
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• pp.61-78
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• 2004

Objective : This study was undertaken to determine whether Gamibaegi-eum (BGU) in vitro and in vivo exerts a beneficial effect against cell injury induced by reactive oxygen species (ROS) in the human intestine. Methods : Effects of BGU in vitro on cell injury were examined using Caco-2 cells, cultured human intestinal cell line. Exposure of cells to H₂O₂ induced increases in the loss of cell viability in a time and dose-dependent fashion. Results : BGU prevented H₂O₂-induced cell death and its effect was dose-dependent over a concentration range of 0.05­1%. H₂O₂-induced cell death was prevented by catalase, the hydrogen peroxide scavenger enzyme, and deferoxamine, the iron chelator. However, the potent antioxidant DPPD did not affect H₂O₂-induced cell death. H₂O₂ increased lipid peroxidation, which was inhibited by BGU and DPPD. H₂O₂ caused DNA damage in a dose-dependent manner, which was prevented by BGU, catalase, and deferoxamine, but not DPPD. BGU restored ATP depletion induced by H₂O₂. BGU inhibited generation of superoxide and H₂O₂ and scavenged directly H₂O₂. Oral administration of mepirizole in vivo at a dose of 200mg/kg resulted in ulcer lesions in the stomach and the proximal duodenum. Pretreatment of BGU(0.1%/kg, orally) and catalase (800Units/kg, i.v.) significantly decreased the size of ulcers. Mepirizole increased lipid peroxidation in the mucosa of the duodenum, suggesting an involvement of ROS. Pretreatment of BGU and catalase significantly inhibited lipid peroxidation induced by mepirizole. Morphological studies showed that mepirizole treatment causes duodenal injury and its effect is prevented by BGU. Conclusion : These results indicate that BGU exerts a protective effect against cell injury in vitro and in vivo through antioxidant action. The present study suggests that BGU may playa therapeutic role in the treatment of human gastrointestinal diseases mediated by ROS.

• Journal of Yeungnam Medical Science
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• v.23 no.2
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• pp.247-251
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• 2006

Bezoars are collections or concretions of indigestible foreign material that accumulate and coalesce in the gastrointestinal tract; they usually occur in patients who have undergone gastric surgery and have delayed gastric emptying. Treatment options include dissolution with enzymes, endoscopic fragmentation with removal or aspiration, and surgery. Recently, the efficacy of nasogastric lavage or endoscopic infusion of Coca-Cola for the dissolution of phytobezoar have been reported. We report a case of phytobezoar successfully treated by oral administration and endoscopic injection of Coca-Cola. A 62-year-old woman was referred to Yeungnam University Hospital for epigastric pain. Upper gastrointestinal endoscopy revealed one very large, dark-greenish, solid bezoar in the stomach with gastric ulcer and duodenal bulb deformity. We performed endoscopic injection of Coca-Cola into the bezoar. The patient was instructed to drink four liters of Coca-Cola per day. At endoscopy two days later, the phytobezoar was easily broken into pieces. At endoscopy on the $11^{th}$ day of admission, the phytobezoar was decreased in size and removed by endoscopic fragmentation with a polypectomy snare. At follow up endoscopy after 13 days, the bezoar was completely dissolved.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.53-57
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• 2011

Purpose: Pyoderma gangrenosum is a rare inflammatory, reactive dermatosis marked by painful cutaneous ulcer. The causes of pyoderma gangrenosum remain unclear. Gastrointestinal, hematological, rheumatological, and immmune disorders may be associated with pyoderma gangrenosum. The appearance of this disease may range from mild skin ulcers to life-threatening conditions. Generalized multiple ulcerative pyoderma gangrenosum is very rare. Here we report our experience with a case of multiple ulcerative pyoderma gangrenosum accompanied by ulcerative colitis. Methods: A 67-year-old man had cutaneous ulcers at multiple sites including the scalp, face, chest, abdomen, hands, and buttocks. He also developed gastrointestinal symptoms such as intermittent dyspepsia and bloody excrement. Debridement and irritation aggravated the disease progress. We gave a diagnosis of pyoderma gangrenosum with ulcerative colitis based on the clinical appearance and biopsy. The patient was treated with systemic intravenous steroid therapies and careful wound cares. Ulcers of the scalp and buttocks were treated with split thickness skin grafts. Results: Most of the multiple cutaneous ulcers were treated by systemic intravenous steroid therapies and wound cares. The rest of the ulcers were treated with skin grafts. Systemic intravenous steroid therapy was used to treat the ulcerative colitis. Conclusion: Generalized multiple ulcerative pyoderma gangrenosum is very rare. Without making an accurate diagnosis, hasty surgical treatments could aggravate the progression of the disease. Additionally, care should be taken to systemically treat underlying disease as well as administrating local treatments for the skin lesions. Intravenous systemic steroid therapy and skin grafts are useful treatments for generalized pyoderma gangrenosum.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.2
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• pp.103-111
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• 2003

Purpose: This study was undertaken to evaluate the gastroduodenal pathology and Helicobacter pylori infection in children with upper gastrointestinal symptoms. Methods: One hundred and seven pediatric patients with upper gastrointestinal symptoms were undergone endoscopy at the Gyeongsang National University Hospital from June 1990 to April 1991. Histopathologic examination was done by H & E staining of gastric antral biopsy specimen and gastritis was defined according to the Sydney System. Tissue H. pylori status was evaluated with the urease test using Christensen's urea broth and H & E or Warthin-Starry silver staining of gastric antral biopsy specimen. IgG Immunoblotting were also performed to detect specific anti-H. pylori antibody in these patients. Results: The reasons for endoscopy were recurrent abdominal pain, acute abdominal pain, sallow face, hunger pain, and frequent nausea. Variable degrees of gastric mucosal hyperemia were found in most of the patients. Gastric hemorrhagic spots, gastric ulcer, duodenal ulcer, duodenal erosion, and hemorrhagic duodenitis were rare endoscopic findings. Histologic chronic gastritis was found in 88% of 107 patients. Histologic chronic duodenitis was observed in all 99 patients whose tissue were available. Gastric tissue H. pylori was positive in 57% of 107 patients by one of the ureasetest, H & E staining and Warthin-Starry silver staining. However, gastric tissue H. pylori detection rate was lower in the younger age groups. Anti-H. pylori IgG antibodies were detectable in 96% of 107 patients. Conclusion: Chronic gastroduodenitis and anti-H. pylori IgG antibody were ubiquitous in children with upper gastrointestinal symptoms.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.176-182
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• 2006

Purpose: The aim of this study was to investigate the spectrum of gastrointestinal mucosal lesions in the children presenting with short-term abdominal pain. Methods: Thirty one children with short term abdominal pain for less than 1 month from January 1995 to May 2004 who were examined using gastrointestinal (GI) endoscopy were reviewed retrospectively. Children presenting with acute abdominal pain unrelated to proper GI were excluded from this study. Results: Male patients were 16 and female were 15. Three patients were 1~5 years old, 15 were 6~10 years old, and 13 were 11~15 years old. The duration of the abdominal pain was less than 7 days in 23 patients, 10 days in 1, 20 days in 2, and 30 days in 4. The major accompanying symptoms were vomiting (15), diarrhea (4), melena (1), hematemesis (1), and fever (2). Using endoscopy, 6 patients were found to have hemorrhagic gastritis, 5 nodular gastritis, 4 duodenal ulcer, 3 gastric ulcer, 3 reflux esophagitis, 2 nodular duodenitis, 2 superficial gastritis, 2 erosive hemorrhagic duodenitis, 2 ulcerative colitis, 1 duodenogastric reflux, and 1 esophageal polyp. Helicobacter pylori (H. pylori) infection was positive in 10 patients. The age and sex ratio, duration of abdominal pain, site of abdominal pain, and duration of abdominal pain between H. pylori- positive and negative children were different. However, only the site of abdominal pain (epigastric) showed statistical significance. All symptoms improved with medication for the GI mucosal lesions noted by the endoscopic findings. Conclusion: The author suggests that GI endoscopy be one of the important first steps in examinations to find out diverse GI mucosal lesions in the patients with short-term abdominal pain. Additionally, the examinations for H. pylori infection are important for these patients, also.

• The Korea Journal of Herbology
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• v.34 no.6
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• pp.57-62
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• 2019

Objective : Gastritis is a major complication of gastrointestinal disease. Lonicera japonica is used in folk medicine to treat different diseases such as exopathogenic wind-heat, epidemic febrile diseases, sores, carbuncles and some infectious diseases. Therefore, this study examined the effects of Lonicera japonica water extract (LJE) on HCl/ethano-linduced acute gastric ulceration and anti-oxidants properties. Methods : LC-ESI-IT-TOF MS was employed for rapid identification of major compound from LJE. The antioxidant activities were evaluated through total polyphenol and flavonoid contents and radical scavenging assays and superoxide dismutase (SOD)-like activity. SD rats were randomly divided into five different groups including the normal group, ulcer group, positive group (20 kg/mg of omeprazole, ip), and experimental groups (100 kg/mg and 500 kg/mg of LJE, ip). Results : 4,5-Dicaffeoyl quinic acid, loganic acid, secologanic acid, sweroside, loganin, vogeloside were identified based on the detection of the molecular ion with those of literature data. The LJE was possessed free radical scavenging activities such as DPPH (IC₅₀=189.7 ㎍/㎖), ABTS (IC₅₀=164.5 ㎍/㎖), and SOD-like activity (IC₅₀=405.02 ㎍/㎖). Macroscopic and histological analyses showed LJE treated group were significantly reduced to an extent that it allowed leukocytes penetration of the gastric walls compared with the ulcer group. In addition, an ulcer inhibition rate and prostaglandin E₂ levels were increased in rats treated with LJE. Conclusion : The present study has demonstrated the antioxidantive and gastroprotective effect of LJE, these findings suggested that LJE has the potential for use in treatment of gastric disorders.