• Journal of Gastric Cancer
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• 제9권4호
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• pp.207-214
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• 2009

목적: 위체부에 발생하는 조기위암에 대해 원위부 위아전 절제술(SDG)이 표준 술식으로 시행되나 술 후 기능장애와 합병증이 있으며, 이런 단점을 최소화하기 위해 내시경적점막절제술을 하지만 림프절의 전이여부를 알 수 없는 단점이 있다. 위의 절제 범위를 줄이고 유문을 보존하고, 림프절의 절제가 가능한 위구획절제술(SG)에 대해 그 유용성을 평가하고자 한다. 대상 및 방법: 2004년 1월부터 2007년 7월까지 본원에서 위체부의 조기위암 환자 중 41명에서 SG를 하였고, 40명에서는 SDG를 하였다. 의무기록 및 전화를 이용한 설문을 이용하여 수술 후 6개월과 12개월의 영양상태와 술 후 합병증에 대해 두 군을 비교하였다. 결과: 영양상태의 변화(혈색소, 혈장단백, 혈장알부민, 혈장콜레스테롤, P>0.05)와 체중의 변화에서 유의한 차이는 보이지 않았다. SG군에서 SDG군에 비하여 내시경 시 잔여음식물(P<0.05)이 많았으나, 상복부 불편감이나 식사 시조기 팽만감에는 큰 차이가 없었다(P>0.05). 식도염은 두군에서 비슷한 발생률을 보였고(P>0.05), 담즙 역류는 SG군과 SDG군에서 각 한 명만 관찰이 되었다. 결론: SG군에서는 유문이 보존되므로 담즙 역류로 인한식도염, 위염의 발생 감소와, 위절제범위의 감소와 유문보존으로 인한 영양학적인 장점을 기대하였으나, 현재까지의 결과는 두 군에서 큰 차이를 발견할 수 없었다. SG의 장점과 단점을 알기 위해서는 더 오랜 기간의 경과관찰과 연구가 필요할 것으로 생각한다.

• 대한본초학회지
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• 제27권1호
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• pp.51-58
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• 2012

Objectives : This study was performed to investigate effect of evodiae fructus on acute reflux esophigitis rat induced by pylorus and forestomach ligation operation. Methods : Twenty-four laboratory rats were divided four groups and each group had six rats ; normal intact group, acute reflux esophagitis (RE) control group, two experiment RE group treated extract of evodiae fructus 600 mg/kg (EEF600) and 300 mg/kg (EEF300). All rats was fasted for 18 hr but free water, we induced RE by pylorus and forestomach ligation operation. Intact group and RE control group rats were orally administered a distilled water and two experiment groups were orally administed with EEF 600 mg/5ml/kg and 300 mg/5ml/kg. One hour after, rats were anesthetized, intact group was cut the abdomen open and sutured with 2.0 silk thread. RE control group and EEF group were cut the abdomen open, ligated pyloric canal and forestomach with 2.0 silk thread and sutured. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, disectted a esophagus and stomach. The stomach was washed a 1 ml PBS and the esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. Results : The esophagic tissue damage percentage of reflux esophagitis rat was increased compared to that of normal intact group. But esophagic damage percentage of EEF 600 were significantly decreased compared to that of RE control group. But there was no difference on gastric juice pH between control RE, alpha-tocopherol administration rat group and EEF administration rat group. In esophagus of RE control rat, gastric damage occurred severely and injury percentage of mucosa were increased, but EEF 600 mucous inflammatory damage percentage was significantly compared to that of RE control group. Proinflammatory cytokines such as TNF-alpha, IL-1beta and IL-6 in serum on RE control group were markedly grew than those of intact rat, those of vechicle group treated with EEF 600 and EEF 300 were remarkably decreased compared to production of proinflammatory cytokine of RE control group. In microscopic observation, intact group rat had no hyperemia, mucous injury and exclusion, ulcer and edema. But it could showed mucosa damages, submucosa edema and ulcer in RE control. However, administration of EEF 600 and EEF 300 made esophagus have less inflammation and injury by gastric acid. Conclusions : The results suggest that antiinflammatory Effect of EEF could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

• 대한본초학회지
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• 제30권4호
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• pp.37-44
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• 2015

Objectives : The present study was designed to evaluate the anti-inflammatory and anti-oxidative stress activities through regulation of Nrf2-mediated genes by Rhei rhizoma and Glycyrrhiza rhizoma combined extract (RGE) in reflux esophagitis.Methods : The antioxidant activity of RGE in vitro was measured in terms of radical scavenging capacity such as DPPH and ABTS. RGE was administered at 350 mg/kg body weight prior to induction of reflux esophagitis. Reflux esophagitis was induced that tied the pylorus and the transitional junction between the forestomach and the corpus in Sprague-Dawley rats.Results : RGE scavenged DPPH and ABTS effectively and IC₅₀of RGE each were 4.9 μg/ml and 45.6 μg/ml. Our results show that RGE administration markedly ameliorated mucosal damage upon histological evaluation. In serum and esophagus tissue, RGE significantly suppressed the oxidative stress biomarkers. Reflux esophagitis induced rats exhibited down-regulation of antioxidant-related proteins in the esophagus; however, the levels with treatment of RGE were significantly higher than those of vehicle reflux esophagitis rats. RGE treatment caused significant reductions in activation of NF-κB transcription factor. Thus, RGE significantly exhibited potent anti-inflammatory activities by suppressing the protein expression levels of pro-inflammatory proteins such as COX-2 and iNOS and inflammatory cytokines such as TNF-αin the esophagus tissue.Conclusions : Reflux esophagitis caused considerable levels of oxidative stress in the esophageal mucosa and the administration of RGE reduced the esophageal mucosa damage through the regulation of Nrf2 and NF-κB pathways. Our findings can considered as supplementary therapy in the prevention or treatment of reflux esophagitis.

• 대한한방내과학회지
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• 제37권3호
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• pp.495-507
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• 2016

Objectives: This study was designed to investigate the effects of Jwa Kum-Whan (JKW) on reflux esophagitis in rats.Methods: Forty rats were divided into five groups: a sham group (with no medication and only treated with ventrotoby); a group with reflux esophagitis (RE); a pantoprazole group (treated with 30 mg/kg pantoprazole per day for two weeks); a JKW280 group (treated with 280 mg/kg JKW per day for two weeks); and a JKW560 group (treated with 560 mg/kg JKW per day for 2 weeks). All rats fasted for 24 hrs and then were induced with RE by the oral administration of indomethacin and by a pylorus and forestomach ligation operation. After 8 hrs, the rats were sacrificed. We measured body weight, gastric juice pH, gastric volume, antioxidant activity, and cytokine and made a histologic examination of the esophagus and the stomach.Results: The weights of the rats in each group were not significantly different. The gastric juice pH significantly increased in the JKW560 group and the pantoprazole group compared with the RE group. Gastric volume significantly decreased in the JKW560 group compared with the RE group and the pantoprazole group. SOD activities significantly increased in the JKW280 and JKW560 groups compared with the RE group. Catalase activities significantly increased in the pantoprazole group and the JKW560 group compared with the RE group. TNF-α significantly decreased in the JKW280 and JKW560 groups compared with the RE group. IL-6 significantly decreased in the pantoprazole group and the JKW280 and JKW560 groups compared with the RE group. Histologic examination of the esophagus and the stomach showed significant improvements in the pantoprazole, JKW280, and JKW560 groups compared with the RE group.Conclusion: Based on these results, it is concluded that JKW can prevent reflux esophagitis.

• 대한한방내과학회지
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• 제42권1호
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• pp.11-24
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• 2021

Objective: Chronic reflux esophagitis (CRE), characterized by esophageal mucosa ulcer, is caused by continuous backflow of gastric acid and consequent inflammation due to unstable gastroesophageal sphincter. The aim of the present study was to clarify the effect of an Arecae Semen and Coptidis Rhizoma mixture (AC-mix) on CRE. Methods: CRE was surgically induced in SD rats with three experimental groups used: normal; CRE control; and CRE treatment (200 mg/kg AC-mix). Blood and esophageal tissue were collected after two weeks of drug administration. The anti-oxidant activity of the AC-mix was measured by total polyphenol and total flavonoid contents as well as by radical scavenging activity with protein levels evaluated using western blotting. Results: CRE damage to the esophageal mucosa was significantly reduced in the AC-mix group as compared with the controls, and administration of the AC-mix was seen to inhibit NF-κBp65 activity. Consequently, the inactivation of NF-κBp65 significantly inhibited inflammatory mediators such as COX-2 and iNOS. Moreover, the anti-oxidant enzyme HO-1 significantly increased through activation of the Nrf2-Keap1 pathway. Matrix metalloproteinase-2 (MMP-2), which can break down collagen from the basement membrane and extracellular matrix, was decreased following AC-mix treatment, and elevated levels of MMP-2 were regulated by its tissue inhibitor. Conclusions: These results show that AC-mix can alleviate esophageal mucosa ulcer though inhibition of the NF-κBp65 inflammatory pathway and enhancement of the anti-oxidant Nrf2-Keap1 pathway.

• 대한한의학회지
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• 제40권2호
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• pp.17-34
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• 2019

Objectives: This study was carried out to observe and compare the effects of Pinellia ternata, Zingiber officinale and Sobanhatang on the reflux esophagitis induced by gastric fundus and pylorus ligation in mice with esomeprazole. Methods: Antioxidant effects were measured by DPPH radical scavenging activity at four different concentration of 0.125, 0.25, 0.5 and $1.0mg/102{\mu}{\ell}$. Zingiber officinale water extract(ZE), Pinellia ternata water extract(PE) and Sobanhatang water extract(SBE) and esomeprazole were treated orally for 14 days before gatric fundus and pylorus ligation. In the histochemistry, changes in suface mucous cells, muscle tissue and connective tissue in gastro esophageal junction(GEJ) and mast cell on the esophageal mucosa were observed. The change of Hemo oxygenase(HO)-1, ghrelin, gastrin and substance P in gastric body tissue were measured by immunohistochemistry. Results: DPPH radical scavenging activity exhibited concentration dependently increases in ZE, PE, SBE. ZE was significantly higher at all concentrations than PE. The gastric surface mucous cells were more in the treated group than in the reflux esophagitis elicited group(GE) in the order of PE, SBE, ZE and esomeprazole treateded group(PT, SBT, ZT, ET). Lower esophageal sphincter muscle damage and intercellular space in the GEJ were less in the treated group than GE. In the esophageal mucosa, the mast cell distribution and the migration of inflammatory cells were lower in the treateded troup than GE in order to ZT, SBT, PT and ET. The antioxidative enzyme, HO-1 was more in the order of ZT, SBT, control group, PT, ET than in GE. ZT was significantly higher than the other groups and SBT was significantly higher than ET. Ghrelin was found to be higher in ZT, ET, SBT and PT than in GE, and ZT was significantly higher than all other groups except ET. Gastrin showed the highest positivity in GE, and was lower in the order of ET, ZT, SBT, PT, and control group. Substance P was the highest in GE, and was lower in the order of ET, ZT, SBT, PT and control group, and PT were significantly lower than ET. Conclusion: ZT, PT and SBT showed superior antioxidative, anti-inflammatory and mucosal protective effects on mouse reflux esophagitis as compared with ET. In particular, ZE was more effective in antioxidant and gastric motility enhancement, while PE was more effective in mucosal protection and anti-inflammatory effects. Sobanhatang is expected to be effective treatment because it has advantages of both drugs and reduces toxicity.

• 대한본초학회지
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• 제34권2호
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• pp.15-23
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• 2019

Objective : Reflux esophagitis (RE) is a disease that caused gastric acid reflux and inflammation due to unstable gastroesophageal sphincter, as increasing worldwide respectively. This study was conducted to evaluate the effect of Evodiae Fructus (EF) extract on chronic reflux esophagitis in rats. Methods : The EF was measured antioxidant activity, such as total polyphenol and total flavonoid contents, 1, 1-diphenyl-2-picrylhydrazyl (DPPH) and 2, 2'-azinobis-3-ethyl-enzothiazoline-6-sulfonic acid (ABTS) radical scavenging activity. Rats were divided into 3 groups; Nor (normal group), Con (chronic acid reflux esophagitis rats treatment with water), EF (chronic acid reflux esophagitis rat treatment with EF 200 mg/kg body weight group). A surgically-induced chronic acid reflux esophagitis (CARE) model was established in SD rats, and treated with water or EF 200 mg/kg body weight for 14 consecutive days. Results : Administration of EF to rats of induction of chronic acid reflux esophagitis was found to reduce esophagus tissues injury. Reactive oxygen species (ROS) and produces peroxynitrite ($ONOO^-$) levels of esophagus tissues were significantly decreased in EF compared to Con group. As results of esophagus protein analyses, EF effectively reduce inflammatory-related factors ($NF-{\kappa}Bp65$, $p-I{\kappa}B{\alpha}$, iNOS, $TNF-{\alpha}$, IL-6), and increase anti-oxidant enzyme (Nrf2, HO-1, SOD, catalase, GPx-1/2). Conclusions : These results suggest that EF administration comfirmed that decreased esophagus tissues injury, oxidantive stress, anti-inflammation effect, and increased anti-oxidant effect. Therefore, EF was the potential to be used as a natural therapeutic drug.

• 대한본초학회지
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• 제34권1호
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• pp.117-124
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• 2019

Objective : Chronic acid reflux esophagitis (CARE), one of gastroesophageal reflux disease (GERD) is increasing worldwide. Coptidis rhizoma extract (CRE) is a traditional herb that cures a variety of diseases. This study was conducted to evaluate the protective effect of CR on rats with chronic acid reflux esophagitis. Methods : The antioxidant activities were evaluated through radical scavenging assays using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothiazolin-6-sulfonic acid) (ABTS) radical scavenging assays. CARE was surgically induced in 5-week-old male SD rats by ligating the border between forestomach and glandular portion with a 2-0 silk tie and covering the duodenum using 18-Fr $N{\acute{e}}laton$ catheter. To evaluate the esophageal protective effect of CRE, rats were divided into 3 groups: Nor (normal rats), Veh (chronic acid reflux esophagitis induced rats), CR (chronic acid reflux esophagitis induced rats treated with CRE 200 mg/kg body weight). Results : The administration of CRE significantly prevented the mucosal injury of the esophagus tissue and histological findings improved the esophageal lesion. It has been shown that inflammation is prevented by the increase of antioxidant-related factors (Nrf-2, HO-1, SOD, catalase, and GPx-1/2) through the antioxidant pathway of esophageal tissue. The administration of CRE reduced the increase of serum peroxynitrite ($ONOO^-$) and markedly reduced the protein expression of inflammatory mediator such as $NF-{\kappa}Bp65$, $p-I{\kappa}B{\alpha}$, iNOS, and IL-6. Conclusions : Overall, these results suggest that CRE administration confirmed the protective effect of esophageal mucosa, suggesting that it is a potential treatment for chronic acid reflux esophagitis.

• 대한본초학회지
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• 제35권1호
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• pp.57-68
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• 2020

Objective : The aim of present study was to clarify the effect of Areca Semen and Toosendan Fructus Mixture (AT-mix) on chronic reflux esophagitis (CRE) in rats. Methods : The antioxidant activity of AT-mix was measured through DPPH and ABTS radical scavenging activities in vitro. CRE was induced in SD rats (5 weeks, male) by ligating the border forestomach and granular portion with 2-0 silk and the duodenum near the pyloric portion was covered with 2-mm wide piece of 18-Fr Nélaton catheter. And then rats were treated AT-mix 200 mg/kg one daily for 14 days. The anti-oxidant and inflammatory protein levels were evaluated using western blotting. Results : Gross lesion of esophageal mucosa after AT-mix treatment showed a superior enhancement compared with that of CRE control rats. AT-mix treatment strongly reduced both DPPH and ABTS radical scavenging activities (DPPH, IC₅₀ 8.15±0.14 ㎍/mL; ABTS, IC₅₀ 24.69±0.03 ㎍/mL, repspectively). Levels of the NADPH oxidase subunit including NOX4 and p22^phox increased in CRE control rats. Otherwise, AT-mix treatment significantly reduced. The activation of Nuclear factor-erythroid 2-related factor 2 (Nrf2) led to significantly the up-regulation of HO-1. The inhibition of IκBα phosphorylation led to NF-κB inactivation. Subsequently, NF-κB inactivation significantly induced the decrease of COX-2, iNOS, TNF-α, and IL-6 protein expressions. Conclusion : Taken together, these results suggest that AT-mix treatment can attenuate the esophageal mucosal ulcer though inhibiting NF-κB pathway and enhancing Nrf2/HO-1 pathway. Thus, the additional mechanism study about AT-mix would need for the development as a safe herbal therapy for CRE.

• Clinical and Experimental Pediatrics
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• 제46권5호
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• pp.454-458
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• 2003

목 적 : 신생아 로타바이러스 위장염의 빈도는 영유아와는 달리 계절적 유행 없이 일정하게 발생하며 임상 증상은 다양하여 무증상에서부터 구토, 설사 및 발열 드물게는 괴사성 장염과 출혈성 위장염 등을 나타낸다. 저자들은 건강한 만삭 신생아에서의 로타바이러스 원내 감염과 그 관련 요소에 대해 연구하였으며 본원에서 발생한 정상 신생아실의 만삭아에서 수유 및 분만 방법에 따른 증상의 빈도를 비교하여 이들의 연관성을 알아보고자 하였다. 방 법: 2001년 1월부터 6월까지 동국대학교병원에서 출생한 생후 7일 이내의 건강한 만삭 신생아 총 348명 중 증상을 보인 환아를 대상으로 시행한 변 rotazyme 검사에서 양성으로 확진된 환아 총 152례를 대상으로 연구하였으며 환아에 대한 각각의 항목은 병력지를 통하여 검토되었다. 환아 중 패혈증이나 뇌수막염, 요로 감염, 위식도 역류 및 황달 등이 있는 환아는 본 연구에서 제외되었다. 분만 방법은 정상 질식분만과 제왕절개술, 수유 방법은 모유와 분유로 구분해서 조사하였다. 분만 방법 및 수유 방법에 따른 로타바이러스 장염 신생아의 증상, 증상 기간에 대한 유의성을 통계적 Chi-square testd와 Fisher's exact test 및 Multiple logistic regression analysis로 검정하였으며 P<0.05인 경우를 유의 하다고 판정하였다. 결 과: 2001년 1월부터 6월까지 정상 만삭 출생아 중 입원 환아를 제외한 총 348명 중에서 로타바이러스 장염으로 확진 된 환아는 총 152명(43.7%)이었고, 그 중 남아는 95명(62.5%), 여아는 57명(37.5%)이었다. 체중이 2,500 g 이상이 149명(98.0%)이었고 모유 수유아는 97명(63.8%), 분유 수유아는 55명(36.2%)였고 분만 방법에서 정상 질식분만아는 22명(14.5%), 제왕절개아는 130명(85.5%)이었다. 증상은 미열이 51.3%로 가장 많았으며, 그 외 설사(40.8%), 복부 팽만(38.8%), 구토(35.5%) 등의 순 이었다. 증상 시작일이 생후 3-4일 이내인 경우가 134명(88.2%)이었으며 18명(11.8%)은 생후 5-7일째 증상이 나타났다. 증상 기간은 3일 이내인 경우가 120명(78.9%), 4-6일이 29명(19.1%), 7일 이상이 3명(2.0%)이었다. 모유 수유아에서 로타바이러스 장염의 증상의 빈도가 낮았고 분만 방법과 관련해서는 정상 질식 분만한 모유 수유아/분유 수유아에서 설사 11.1/84.6%, 수유 부진 22.2/69.2%, 체중 증가 지연 22.2/76.9%로 모유 수유아에서 증상 발현 빈도가 낮았고, 제왕절개분만 한 모유 수유아/분유 수유아에서는 정상 질식분만 한 환아에서와는 다르게 설사증상의 빈도는 차이가 없었으나 미열 45.5/66.7%, 복부 팽만 29.5/50.0%, 구토 31.8/60.9%, 체중 증가 지연 8.0/52.4%, 수유 부진 4.5/26.2%, 탈수 2.3/14.3%, 보챔 5.7/26.2%로 모유 수유아에서 증상의 빈도가 전반적으로 낮게 나타났으며 이는 통계적으로 유의성을 나타내었다(P<0.05). 결 론 : 로타바이러스 장염에 이환된 건강 만삭아의 분만 방법 및 수유 방법에 따른 로타바이러스 장염의 증상 차이에 대한 연구에서 모유 수유아에서 증상 발현빈도가 분유 수유아 보다 낮게 나타났다. 그러므로 모유 수유가 분유 수유보다 로타바이러스 장염의 증상을 완화시킬 수 있다고 생각된다.