• Clinical and Experimental Pediatrics
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• v.45 no.3
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• pp.339-345
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• 2002

Purpose : The purpose of this study was to evaluate the clinical usefulness of chest high-resolution computed tomography(HRCT) in patients with chronic coughs or persistent wheezing with normal chest X-ray finding. Methods : We reviewed the charts, chest X-rays, and HRCT findings of patients with chronic coughs or persistent wheezing of less than 2 years of age. The records were sourced from the Department of Pediatrics, Inha University Hospital covering the period from July, 1999 to June, 2000. Chronic cough was defined as a cough which was prolonged for more than 3 weeks. Results : The sample consisted of 24 patients(male 15 and female 9, mean age $4.7{\pm}3.8$ months old). Among them, 16 patients showed normal findings(66.7%) and 8 patients showed abnormal (33.3%) in simple chest X-rays. Among 16 patients who had the normal chest X-rays, 13 patients showed abnormal chest HRCT findings(81.3%) such as air space consolidation of the dependent portion(62.5%), bronchiolitis obliterans(12.5%), and bronchopulmonary dysplasia(6.3%). Conclusion : We suggest that the chest HRCT is a useful diagnostic tool in the evaluation of patients with chronic cough or persistent wheezing with normal chest X-ray, especially below 2 years of age.

• 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.

• Journal of Acupuncture Research
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• v.30 no.2
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• pp.31-41
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• 2013

Objectives : This study was to evaluate inhibitory effects of Naegwan-acupuncture($PC_6$) on acute RE(reflux esophigitis) rat induced by pylorus and forestomach ligation operation. Methods : Twenty seven SD rats were divided three groups (intact normal rat; RE control rat; RE control rat respectively stimulated by Naegwan point($PC_6$)). All rats was fasted for 18 h but free water, we induced RE by pylorus and forestomach ligation operation. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, dissected a esophagus and stomach. The stomach was washed a 1 ml PBS to research gastric volume, pH, acidity and mucin release of gastric juice, esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. The proinflammatory cytokine and chemokine including IFN-${\gamma}$, TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and MCP-1 were analyzed by ELISA kit. Results : 1. Significantly, death rate of $PC_6$ acupuncture rat group was decreased compared to that of RE control group. 2. Gastric Volume, gastric injury and esophageal mucosa demage were decreased significantly, too. 3. Compared with RE, all of the proinflammatory cytokine and chemokine analyzed in serum of $PC_6$ were decreased remarkably. Especially, there were significant meanings TNF-${\alpha}$, IL-6 and MCP-1 in serum of $PC_6$ were decreased. Conclusion : The results suggest that antiinflammatory and protecting effects of PC6 could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

• Journal of Physiology & Pathology in Korean Medicine
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• v.30 no.4
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• pp.257-265
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• 2016

The aim of this study was to investigate the effects of Ulmi Pumilae cortex extracts on acute reflux esophagitis rats induced by pylorus and forestomach ligation operation. 40 rats were divided into five groups; Normal group, Sham group, Control group, T1 group and T2 group. 4 groups has a laparotomy after controled 2weeks and sham group, T1 group, T2 group has ligation in stomach. After laparotomy, all group`s body weight, gastric volume, gastric juice PH, SOD activities, catalase activities, lipid peroxidation, total glutathione, the effects on esophageal and stomach mucosa damage were checked. There was significant statistical differences between control group and Ulmi Pumilae cortex extracts adminitration groups(T1 and T2 group) in terms of gastric volume decreasing. Also, adminitration groups has significant effect than control group in decreasing mucosa damage. SOD(superoxide dismutase) and catalase activities has a significant statistical differences between control group and T2 group not in T1 group. These results suggest that the medication of Ulmi Pumilae cortex extracts is effective for the treatment of acute reflux esophagitis in terms of decerasing gastric volume and mucosa damage. Especially, the results were shown to be more positive in High-dose administration group (T2 group) than in Low-dose administration group (T1 group) in SOD and catalase activities.

• The Journal of Internal Korean Medicine
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• v.32 no.1
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• pp.75-86
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• 2011

Objectives : This study investigated oriental diagnosis and treatment of reflex esophagitis (RE) such as syndrome differentiation and herbal medicine by reviewing Chinese journals. Methods : A journal search was performed using China National Knowledge Infrastructure (CNKI) from January 2006 to December 2010. The keywords were the various combinations of 'reflex esophagitis', 'Chinese medicine', 'syndrome differentiation', and 'herbal medicine'. All types of journal entries that explained or referred to herbal medicines and definite syndrome differentiations were included. The Types of the journals were randomized clinical trials (RCT), reviews, essays, case series and reports. Vague syndrome differentiations and experimental studies were excluded. Selected journals were extracted and summarized by two researchers independently. Results : 47 Chinese entries were finally selected. 61% of them were case-control trials that had non-randomized, active controlled clinical trials. 36 kinds of syndrome differentiations about RE were investigated. We summarized and divided them into 10 syndrome differentiation groups. 肝胃不和(syndrome of liver qi invading the stomach) in syndrome differentiation, 和胃降逆 (harmonize the stomach and direct qi downward) in method of treatment, and Jwa kum-whan (左金丸) were cited with high frequency in RE. Conclusions : We find that many kinds of syndrome differentiation groups and herbal medicines for reflex esophagitis are used in China, compared with Korea. Further studies will be required about oriental syndrome differentiation and treatment of this disease.

• The Korea Journal of Herbology
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• v.31 no.1
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• pp.25-31
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• 2016

Objectives : The present study was conducted to evaluate protective effects of Combined Extract of young persimmon fruit and citrus peel (PCM) in Reflux Esophagitis(RE) rats.Methods : Twenty-four Sprague-Dawley (SD) rats were divided four groups and each group had six rats ; Normal group, RE control group, RE group treated PCM 50 ,100 mg/kg body weight group. Reflux esophagitis was induced that tied the pylorus and fundus in SD rats stomach. PCM was administered at 50, 100 mg/kg body weight 2 hrs prior to induction of RE. After 6 hrs, the effects of PCM treated rats were compared with those of normal and control rats. We have performed an analysis such as pH of stomach secretion, oxidative stress biomarkers in serum, and western blot.Results : The increased esophageal mucosa damage by RE was markedly improved by PCM treatment in a dose-dependent manner. Also, the administration of PCM decreased the elevated serum reactive oxygen species (ROS) and peroxynitrite (ONOO^-) in serum. The protein expressions of anti oxidant such as SOD, catalase, GPx exhibited down-regulation by PCM treatment in tissues. And, PCM effectively reduce inflammatory cytokines such as inflammation-related proteins cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), Tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) in RE rats. In addition, NFκB and p-IκBɑ were decreased in PCM-adiministrated RE rats. But there was no difference on stomach secretion pH between reflux esophagitis rats and PCM administration rat group.Conclusions : In conclusion, administration of PCM (50, 100 mg/kg body weight) made esophagus have less inflammation and injury by decreased NFκB path way. These findings suggest that PCM could have Improving effects on reflux esophagitis.

• Journal of Haehwa Medicine
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• v.22 no.1
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• pp.119-128
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• 2013

Objectives: Yijin-tang-gamibang has been used in the Korean Medicine for treating various digestive disease. This study was aimed to investigate the effects and safety of Yijin-tang-gamibang in reflux esophagitis through the analysis of articles. Method: A total of 9 articles about Yijin-tang-gamibang and reflux esophagitis were used to develop this article. Results: According to basic research and clinic research data, it is supported that Yijin-tang-gamibang was useful prescription in reflux esophagitis. Yijin-tang-gamibang has favorable protective effects on the reflux esophagitis induced by pylorus and forestomach ligation in rats. After treatment with Yijin-tang-gamibang, patients showed improvement in all symptoms associated with reflux esophagitis and functional dyspepsia, including general condition. And Yijin-tang-gamibang did not show any toxic effect in single oral dose toxicity test. Conclusion: The results of this study suggest that Yijin-tang-gamibang showed favorable protective effects on the reflux esophagitis. However, it proved insufficient to confirm its efficacy owing to lack of clinical studies of high quality. So, we need well designed studies to verify clinical efficacy of Yijin-tang-gamibang hereafter.

• 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.

• The Journal of Internal Korean Medicine
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• v.34 no.4
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• pp.362-374
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• 2013

Objectives : This study was carried out to investigate the inhibitory effect of Banhasasim-tang on early reflux esophagitis by control of gastric peristalsis and the lower esophageal sphincter in mice. Methods : Experimental mice were classified into three groups. The normal group were mice with no inflammation. The control group were mice with gastroesophageal reflux elicited by alcohol. The sample group were mice administered Banhasasim-tang after gastroesophageal reflux elicitation. We observed morphological change and production of ghrelin, substance P, and inducible nitric oxide synthase (iNOS) in gastroesophageal junction mucosa. In addition, we examined change of epithelial junction in esophageal mucosa and change of lower esophageal sphincter distribution. Results : The migration of inflammation-related cells in lamina propria of gastroesophageal junction decreased more in the sample group than in the control group. The positive reaction of ghrelin, substance P, and iNOS significantly decreased more in the sample group than in the control group (p<0.05). Injury of the epithelial junction in the esophageal mucosa and outer oblique layer in the lower esophageal sphincter were significantly mitigated by Banhasasim-tang administration in the sample group (p<0.05). Conclusions : According to the above results, it is supposed that Banhasasim-tang inhibits early reflux esophagitis by controlling not only gastric peristalsis and acid secretion through ghrelin, and substance P but also the lower esophageal sphincter through iNOS.

• The Journal of Internal Korean Medicine
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• v.37 no.6
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• pp.1030-1041
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• 2016

Objectives: This study investigated the administration of Jeungmiyijin-tang (JYT) to rats with reflux esophagitis (RE) induced by pylorus and forestomach ligation operations. Methods: Twenty laboratory rats were divided into three groups with 5~7 rats in each group. The control group consisted of rats with no inflammation (CON). The RE group had rats with gastroesophageal reflux elicited by pylorus and forestomach ligation operations. The JYT group had rats that were orally administered Jeungmiyijin-tang (1.5 ml/day/300 g) once a day for 14 days before reflux esophagitis was induced by the pylorus and forestomach ligation operations. Six hours after the operations, the rats were sacrificed, morphological changes were observed, and histological examinations were done in the stomach and esophagus lesion areas. If apoptosis was observed, the apoptotic cells in the esophagus lesion areas were counted. Results: The morphological and histochemical changes consisted of various injuries from hemorrhagic erosion in the RE group, while there were significantly fewer in the JYT group. The RE group marked increases of gastric mucosa erosion and infiltration of inflammatory cells in the submucosa, as well as cell division in the epithelial layer, the proliferation and degranulation of mast cells, and increases in the IL-$1{\beta}$, TNF-${\alpha}$, and MMP-9 expressions in the esophagus of the rats. The JYT group was inhibited above expression compared with the RE group. Apoptosis was statistically significantly decreased in the JYT group compared with the RE group. Conclusions: According to the above results, it appears that Jeungmiyijin-tang inhibits the expression of pro-inflammatory cytokines (TNF-${\alpha}$, IL-$1{\beta}$, and MMP-9) and apoptosis in the esophagus mucosa, thereby preventing esophageal mucosal damage from esophageal reflux.