• Title/Summary/Keyword: proton pump

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Laryngopharyngeal Reflux Disease: Diagnosis and Treatment in 2021 (인후두 역류 질환: 진단 및 치료)

  • Kang, Jeong Wook;Eun, Young-Gyu
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.2
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    • pp.56-63
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    • 2021
  • Laryngopharyngeal reflux disease (LPRD) is an inflammatory condition of the upper aerodigestive tract mucosa induced by reflux content from stomach. Some of vocal cord diseases are associated with laryngopharyngeal reflux. Because of the pathophysiological features, proton pump inhibitor shows therapeutic effect on some vocal cord diseases. As like that, the gastric reflux contents can make macroscopic or microscopic morphological changes in the upper aerodigestive tract mucosa. Although the pathophysiology of LPRD is relatively clear, clinical diagnosis is still difficult. The diagnosis of LPRD includes objective tests such as 24-hours multichannel intraluminal impedance-pH metry and subjective tests such as questionnaire method. However, the objective verification of reflux is difficult due to invasiveness of the method, and the questionnaire methods have limitations because many symptoms are not specific for LPRD. Moreover, most methods are not fully standardized until now. Despite these limitations, many researchers are struggling to standardize diagnosis and treatment of LPRD, and there are several new achievements recently. Therefore, the purpose of this article is to review the recent literature on the clinical presentation, diagnosis, and treatment of LPRD, and to systematize our knowledge.

Effectiveness of Acupuncture for Laryngopharyngeal Reflux Disease: A Systematic Review and Meta-Analysis

  • Jihun Oh;Jaewoo Yang;Jungmin Yang;Minsoo Kang;Sukyoung Kim;Minjun Lee;Jinwoong Lim
    • Journal of Acupuncture Research
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    • v.40 no.3
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    • pp.188-200
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    • 2023
  • Laryngopharyngeal reflux (LPR) disease is a condition in which the stomach contents return to the larynx and pharynx via the esophagus, causing mucosal injury. While conventional treatments, such as proton pump inhibitors, have limitations, acupuncture has been shown to reduce LPR symptoms. However, its effectiveness has not been systematically assessed. This study aimed to systematically evaluate the effectiveness of acupuncture in treating LPR. We review 10 electronic databases with a consistent search strategy, and 2 independent reviewers screened the articles based on the inclusion and exclusion criteria. This study selected and analyzed 7 randomized controlled trials after the screening to assess primary outcomes, including reflux symptom index and reflux finding score, and secondary outcomes, including upper and lower esophageal sphincter pressure. The results revealed the statistically significant effectiveness of acupuncture in combination with conventional treatment in reducing LPR symptoms compared with conventional treatment alone. The most commonly used acupuncture points were CV22, ST36, and LR3. However, the meta-analysis demonstrated low reliability, as assessed using the GRADE Tool. Further research is needed to improve the evidence and draw clear conclusions regarding the clinical use of acupuncture for treating LPR.

STAT3 and SHP-1: Toward Effective Management of Gastric Cancer

  • Moon Kyung Joo
    • Journal of Digestive Cancer Research
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    • v.6 no.1
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    • pp.6-10
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    • 2018
  • The importance of signal transducer and activator of transcription 3 (STAT3) signaling in gastric carcinogenesis was firmly evaluated in the previous studies. Fully activated STAT3 induces various target genes involving tumor invasion and epithelial-mesenchymal transition (EMT), and mediates interaction between cancer cells and microenvironmental immune cells. Thus, suppression of STAT3 activity is an important issue for inhibition of gastric carcinogenesis and invasion. Unfortunately, data from clinical studies of direct inhibitor targeting STAT3 have been disappointing. SH2-containing protein tyrosine phosphatase 1 (SHP-1) effectively dephosphorylates and inhibits STAT3 activity, which has not been extensively studied gastric cancer research field. However, by summarizing recent data, it is evident that protein and gene expression of SHP-1 are minimal in gastric cancer cells, and induction of SHP-1 effectively downregulates phosphorylated STAT3 and inhibits cellular invasion in gastric cancer cells. Several SHP-1 inducers have been investigated in the experimental studies, including proton pump inhibitor, arsenic trioxide, and other natural compounds. Taken together, we suggest that modulation of SHP-1/STAT3 signaling axis may present a new way for treatment of gastric cancer, and development of effective SHP-1 inducer may be an important task in the future search field of gastric cancer.

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FTIR spectroscopy of the two-photon product of sensory rhodopsin I

  • Sasaki, Jun;Kannaka, Masato;Kandori, Hideki;Tokunaga, Fumio
    • Journal of Photoscience
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    • v.9 no.2
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    • pp.534-536
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    • 2002
  • A halophilic archaeon, Halobacterium salinarum, exhibits phototactic behaviors, by which the organism is guided to red-orange light and evades shorter wavelengths of light. The phototaxis is mediated by two retinal proteins, sensory rhodopsin I and II (SRI and SRII), whose structures are analogous to the cognate protein bacteriorhodopsin, a light-driven proton pump. SRI mediates both attractant and repellent swimming behaviors to orange light and near- UV light, respectively. The two different signaling through the single photoreceptor have been ascribed to the presence of two active structures of SRI (S$\_$373/ and P$\_$520), which are produced upon orange light illumination of SRI and upon subsequent near-UV illumination of S$\_$373/, respectively. In the present study, we have measured the difference FTIR spectra of S$\_$373/ and P$\_$520/ states. In P$\_$520/, the isomeric structure of the chromophore is assignable to all-trans, and the Schiff base of the chromophore is protonated with concomitant deprotonation of Asp76, a combination which allows for the formation of a salt bridge between them. It was suggested that the way of interaction between the Schiff base and the counterion, which is different among SRI$\_$587/, S$\_$373/ and P$\_$520/ and which has been shown to drive the conformational changes in the cognate protein, bacteriorhodopsin, is the key to controlling conformational changes for the attractant and the repellent signaling by SRI.

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Protective Effects of BJS-mix001, in Indomethacin induced Gastric Damages in Rats (BJS-Mix001이 Indomethacin 유발 랫트 위점막 손상에 미치는 영향)

  • Lim, So-Yeon;Byun, Joon-Seok;Kim, Dae-Jun;Kwak, Min-A
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.2
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    • pp.181-188
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    • 2012
  • The object of this study was to observe the gatro protective effects of BJS-mix001, a mixed herbal formula consisted of 4 herbal drugs Pinelliae Rhizoma : Coptidis Rhizoma : Massa Medicata Fermentata : Ostreae Testa = 1 : 1 : 1 : 1 (g/g) mixtures, which were main component of oriental medicine for treating various digestive diseases, in indomethacin induced gastric damages in rats. Three different dosages of BJS-mix001 (200, 100 and 50 mg/kg) were once orally administered 30 min before indomethacin treatment. Six hrs after indomethacin treatment, changes on the gross lesion scores, fundic histopathology, MPO activity and anti oxidant activities were observed. The results were compared with omeprazole, antioxidant and proton pump inhibitor 10 mg/kg and DA-9601, a standardized extract of the herb Artemisia asiatica 100 mg/kg treated group, respectively. As results of all three different dosages of BJS-mix001 in the indomethacin induced gastric damaged rats, significant decreased gastric damages were detected as compared with the indomethacin treated control rats. BJS-mix001 also strengthened the antioxidative defense systems - decreased the level of lipid peroxidation and catalase activity but increased the level of superoxide dismutase and glutathione contents. BJS-mix001 showed similar gastro protective effects as compared with equal dosage of DA-9601, and BJS-mix001 50 mg/kg showed slighter effects as compared with omeprazole 10 mg/kg, in the present study. The results obtained in this study suggest that BJS-mix001 showed favorable effects in the indomethacin induced gastric damages mediated by strengthening of the antioxidative defense systems.

Antigastritic and Antiulcer action of Effective Compounds from Propolis Extract (Propolis 유효성분의 항위염 및 항위궤양 작용)

  • 김은주;정춘식;정기화
    • Biomolecules & Therapeutics
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    • v.7 no.4
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    • pp.362-370
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    • 1999
  • Propolis, a natural resinous compound collected from honey bees, contains many biochemical constituents(wax, flavonoids, phenolic compounds, etc.) and has been used in traditional medicines as early as 300 B.C. It was been demonstrated that ethanol, acetylsalicylic acid, ischemia reperfusion, non-steroidal antiin-flammatory drugs and stress induce gastric lesions by promoting the generation of reactive oxygen metabolites. Therefore, some drugs that are capable of scavenging or inhibiting the generation of reactive oxygen radicals might be expected to prevent the gastric mucosal injury. The aim of this study was 1) to examine the antiulcer effect of propolis, 2) to investigate the mechanism of action by determining gastric acid secretion, lipid per-oxidation, mucus content and proton pump ($H^+$/$K^+$-ATPase) activity on gastric mucus in varios experimental models, and finally, 3) to isolate and identify the pure compounds that exert antiulcer activity. Step 2-1 and 2-3 sub-sub fraction shoed a significant reduction of severity of gastirc damage at the dose of 25 mg/kg in various experimental models. We isolated 4 sub-sub-sub fractions by flash column chromatography of Step 2-1 sub-sub fraction and one sub-sub-sub fraction by recrystalization of Step 2-3 sub-sub fraction. The protective effects of propolis sub-sub-sub fraction manifested sifnificant effects in HCl-ethanol induced gastric erosion model and aspirin induced gastric ulcer model. These results showed that the gastric mucosal protective effect of propolis might result from the increase of mucus secretion, free radical scavenging effect as well as the reduction of acid secretion in accordance with the reduction of $H^+$/$K^+$-ATPase activitv. Three compounds were isolated and identified from sub-sub fraction of propolis which showed antiulcer effects. Subsequently, these compounds were identified as a flavonoid, namely, 2-acetoxy-5,7,-dihydroxy-flavanone, galangin and chrysin.

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Analysis of Healthcare Personnel's Clinical Beliefs and Knowledge behind Overutilization of Stress Ulcer Prophylaxis in Hospitalized Patients (스트레스성 위장궤양 예방치료제 처방남용에 대한 의료전문가의 인식과 지식 분석)

  • Noh, Yoojin;Lee, Jae Myeong;Shin, Sooyoung
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.4
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    • pp.264-272
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    • 2015
  • Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.

Surgical treatment of laryngeal contact granuloma (후두 접촉성 육아종의 수술적 치료)

  • Yoo, Byung Joon;Zheng, Tao;Lee, Dong Won;Song, Chang Myeon;Ji, Yong Bae;Tae, Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.23-27
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    • 2017
  • Background and Objectives: Gastric acid reflux is known to be the most important cause of contact granuloma. Therefore, anti-gastric acid reflux medication has been used as the first line treatment although there are other treatment methods such as surgery or steroid injections. Actually, the role of surgery in the treatment of contact granuloma has not been established clearly. The purpose of this study was to evaluate the effectiveness of surgical treatment for contact granuloma. Materials and Methods: We retrospectively reviewed the medical records of 14 patients who were diagnosed with contact granuloma and treated with surgery from 2011 to July 2016 at Hanyang University hospital. Results: Of 14 patients, 9 (64.3%) were male and 5 (27.4%) were female. The mean age was 53.8 (${\pm}6.1$) years. The main symptoms were voice change followed by globus, dyspnea, and asymptomatic. Mean Reflux Finding Score (RFS) before surgery was 13.5 and mead Reflux Symptom Index (RSI) was 10.4. The causes of surgery were inadequate response to proton pump inhibitor (PPI) in 4 cases, airway obstruction with large granuloma in 8 cases, and differential diagnosis in 2 cases. Of 14 patients, recurrence occurred in 8 (53.3%) patients after surgery. In 8 recurrent cases, 5 patients showed complete remission and 3 patients showed partial remission with PPI medication. Conclusion: The role of surgery in the treatment of contact granuloma might be limited due to high recurrence rate.

The Effect of Omeprazole and Lansoprazole on the Susceptibility of Helicobacter pylori to Antimicrobial Agents (오메프라졸과 란소프라졸의 혼합으로 인한 헤리코박터파이로리에 대한 항생제의 감수성 변화)

  • Bang, Sung Hye;Lee, Suk Hyang;Suh, Ok Kyung;Shin, Hyun Taek;Cho, Kyung Joo;Rhie, Ho Gun
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.40-44
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    • 1997
  • Helicobacter pylori(HP) has been implicated as the cause of acute and chronic gastritis, peptic ulcer, and gastric carcinoma. To date the most successful treatment in eradicating HP is known to be the combination of two or more antibiotics with an anti-ulcer drug. In this study, in vitro antimicrobial activity against two was assessed, when proton pump inhibitors (PPIs), omeprazole and lansoprazole, were added to antibiotics at different concentrations. The assays in the absence of PPIs gave minimum inhibitory concentration(MIC) value of 0.63 mg/l for amoxicillin, 4 mg/l for tetracycline, 0.08 mg/l for clarithromycin and 0.16 mg/l for azithromycin. At the concentrations of 125 mg/l, 25 mg/1 and 0.5 mg/l of omeprazole, and the concentrations of 31.25 mg/l, 6.25 mg/l and 1 mg/l of lansoprazole, the MICs of clarithromycin and azithromycin were reduced by $50\%$. Also, lansoprazole at the highest concentration 31.25 mg/l reduced the MIC of amoxicillin by $50\%$, and omeprazole at the highest concentration of 125 mg/l reduced the MIC of tetracycline by $50\%$. In conclusion, the in vitro combination of PPIs and antibiotics led to improvement in the MIC of antibiotics against HP associated gastric disease.

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A Comparative Study of Sepiae Os, Arcae Concha, Ostreae Concha and Esomeprazole in a Mouse Model of Reflux Esophagitis (역류성 식도염 생쥐 모델에서 해표초, 와릉자, 모려와 Esomeprazole의 치료효과에 대한 비교 연구)

  • Song, Chang-Hun;Baek, Tae-Hyun
    • The Journal of Korean Medicine
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    • v.39 no.2
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    • pp.92-105
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    • 2018
  • Objectives: This aim of this study is to compare the reflux esophagitis improvement effects of Sepiae Os, Arcae Concha, Ostreae Concha, and Proton Pump Inhibitor(esomeprazole) through rat experiments. Methods: NO production inhibitory effect was measured by NO production amount and iNOS mRNA expression level in cell lines. iNOS, $TNF-{\alpha}$ and $p-I{\kappa}B$, and serotonin were compared using immunohistochemistry at the rat reflux esophagitis. Reflux esophagitis connection external form, lower esophageal sphincter, and gap were observed and an esophageal inflammatory indicator, IL-6 activity was also evaluated by immunohistochemistry. Results: NO production and iNOS mRNA expression was showed concentration dependent decrease in cell lines treated with Sepiae OS, Arcae Concha, and Ostreae Concha at the experiments of cell lines. In the suppression of iNOS and $p-I{\kappa}B$ at the rat reflux esophagitis, Sepiae Os treat group(SOT) and Ostreae Concha treat group(OCT) were more effective. In the increase of serotonin at the rat reflux esophagitis, ACT, MT and OCT were more effective. Damage of lower esophageal sphincter, and gap between esophageal keratin and mucosa were observed less at the SOT, ACT, OCT. In the suppression of IL-6 at the rat reflux esophagitis, SOT and OCT were more effective than GE and, SOT was more effective than MT significantly. Conclusions: The anti-inflammatory effect was the best in the SOT and lower esophageal sphincter muscle contraction was the best in the ACT at the rat reflux esophagitis. Sepiae OS was more effective than esomeprazole in the suppression of iNOS, $TNF-{\alpha}$, and IL-6.