• 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.

• 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.

• 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.

• 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.

• 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.

• Journal of Sasang Constitutional Medicine
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• v.23 no.1
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• pp.132-138
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• 2011

1. Objectives: This case study reports a Taeumin patient with Gastro-esophageal reflux disease who had suffered from chest pain, heartburn, acid regurgitation and dyspepsia who improved after Yeoldahanso-tang(Reduohanshao-tang) medication. 2. Methods: This patient had started treatment with Yeoldahanso-tang(Reduohanshao-tang), three times per day for three months and assessed the changes of the main symptoms such as chest pain, heartburn and acid regurgitation from baseline to post-treatment using a questionnaire with visual analogue scale(VAS). Electrogastrography(EGG) was also performed for assessment of gastric function from baseline to post-treatment. 3. Results: After the treatment, symptoms of GERD such as chest pain, heartburn, and acid regurgitation are almost disappeared. The patient don't need to take the proton pump inhibitor therapy. There was significant increase of % bradygastria parameters in fed EEG after treatment with Yeoldahansotang(Reduohanshao-tang). And significant increase of the power ratio after treatment was shown (20.5), compared with initial EGG(0.0). 4. Conclusions: This results show Yeoldahanso-tang(Reduohanshao-tang) can be used to treat GERD with Dry-heat symptom of Taeumin. This results suggest that Sasang Constitutional treatment for GERD patients who has a chronic condition with highly recurrence rate, might be a candidate for a therapeutic agent. Also effects of Yeoldahanso-tang(Reduohanshaotang) on GERD need further studies such as clinical trials.

• Archives of Pharmacal Research
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• v.21 no.3
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• pp.241-247
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• 1998

This study was designed to determine biochemical and pharmacological properties of a newly synthesized benzimidazole derivative, 2-amino-4, 5-dihydropyrido [1, 2-a] thiazolo [5, 4-g] benzimidazole (YJA20379-5) in vitro and in vivo. In the leaky membrane vesicles of pig gastric mucosa, YJA20379-5 inhibited the $K^+$-stimulated $H^+$, $K^+$-ATPase activity in a concentration- and time-dependent manner, with $IC_{50}$ values being $43{\mu}\textrm{M}$ and $43{\mu}\textrm{M}$ at pH 6.4 and 7.4, respectively. YJA20379-5, given intraduodenally, had a potent inhibitory effect on the gastric acid secretion in pylorus-ligated rats. The $ED_{50}$ value for acid secretion was 15.4 mg/kg. YJA20379-5, administered orally, also suppressed gastric damages induced by water-immersion stress, indomethacin and ethanol, and duodenal damage induced by mepirizole in rats; the $ED_{50}$ values were 17.6, 4.7, 3.0 and 18.7 mg/kg, respectively. Furthermore, repeated oral administration of YJA20379-5 accelerated the spontaneous healing of acetic acid-induced gastric ulcers in rats. It is concluded that the a-ntisecretory activity of YJA20379-5 appears to be associated with inhibition of $H^+$, $K^+$-ATPase, while its antigastric and antiduodenal lesion activities are primarily related to the antisecretory effect.

• Journal of Ginseng Research
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• v.34 no.2
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• pp.122-131
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• 2010

This clinical study was performed to evaluate whether supplementation of proton pump inhibitor (PPI)-based triple therapy with Korean red ginseng can enhance Helicobacter pylori (H. pylori) eradication and reduce levels of halitosis-associated volatile sulfur compounds (VSCs) in the stomach. Seventy-six patients were randomized into an eradication regimen-only group (n=45) or an eradication regimen plus 10 weeks of Korean red ginseng supplementation group (n=31). The eradication regimen consisted of PPI b.i.d., clarithromycin 500 mg b.i.d., and amoxicillin 1 g b.i.d.. for seven days. Korean red ginseng supplementation commenced on the last day of the eradication regimen. $^{13}C$-urea breath test and halimeter measurements were performed prior to protocol repetition. By intention-to-treat analysis, the H. pylori eradication rate in the Korean red ginseng group (77.4%, 24 of 31) was higher than that in the control group (45.0%, 26 of 45). However, by per protocol analysis, the eradication rate in the Korean red ginseng group was significantly higher than that in the control group (92.3%, 24/26 vs. 69.4%, 26/38; p<0.05). H. pylori infection was significantly associated with increased VSC levels. However, VSC levels decreased significantly in the Korean red ginseng group (p<0.05). In conclusion, supplementation of triple therapy with Korean red ginseng increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of this substance in combating H. pylori infection.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.24
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• pp.10957-10960
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• 2015

Background: The CYP2C19 genotype has been found to be an important factor for peptic ulcer healing and H. pylori eradication, influencing the efficacy of proton pump inhibitors (PPIs) and the pathogenesis of gastric cancer. The aim of this study was to investigate clinical correlations of the CYP2C19 genotype in patients with gastritis, peptic ulcer disease (PUD), peptic ulcer bleeding (PUB) and gastric cancer in Thailand. Materials and Methods: Clinical information, endoscopic findings and H. pylori infection status of patients were assessed between May 2012 and November 2014 in Thammasat University Hospital, Thailand. Upper GI endoscopy was performed for all patients. Five milliliters of blood were collected for H. pylori serological diagnosis and CYP2C19 study. CYP2C19 genotypes were determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism analysis (RFLP) and classified as rapid metabolizer (RM), intermediate metabolizer (IM) or poor metabolizer (PM). Results: A total of 202 patients were enrolled including 114 with gastritis, 36 with PUD, 50 with PUB and 2 with gastric cancer. Prevalence of CYP2C19 genotype was 82/202 (40.6%) in RM, 99/202 (49%) in IM and 21/202 (10.4%) in PM. Overall H. pylori infection was 138/202 patients (68.3%). H. pylori infection was demonstrated in 72% in RM genotype, 69.7% in IM genotype and 47.6% in PM genotype. Both gastric cancer patients had the IM genotype. In PUB patients, the prevalence of genotype RM (56%) was highest followed by IM (32%) and PM(12%). Furthermore, the prevalence of genotype RM in PUB was significantly greater than gastritis patients (56% vs 36%: p=0.016; OR=2.3, 95%CI=1.1-4.7). Conclusions: CYP2C19 genotype IM was the most common genotype whereas genotype RM was the most common in PUB patients. All gastric cancer patients had genotype IM. The CYP2C19 genotype RM might be play role in development of PUD and PUB. Further study in different population is necessary to verify clinical usefulness of CYP2C19 genotyping in development of these upper GI diseases.