Purpose: This clinical study was conducted to evaluate the predictive value of tumor markers for recurrence and the clinical significance of false positive findings after curative gastrectomy in patients with gastric cancer. Materials and Methods: Two hundred ninety patients with gastric cancer who underwent gastrectomy with curative intent were evaluated retrospectively. We analyzed the correlations between changes in tumor markers (CEA, CA 19-9, AFP, and CA-125) and clinicopathologic data, and basis for changes in tumor markers without recurrence during the follow-up period. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of tumor markers for recurrence were 75.0%, 64.6%, 23.1%, 94.8%, and 65.9% respectively. Among 36 patients with recurrences, 10 patients (27.8%) had elevated tumor markers prior to positive findings on imaging studies, while 13 patients (36.1%) had concomitant elevation in tumor markers. At least 1 of the 4 tumor markers increased in 90 of 290 patients during the follow-up period; however, there was no evidence of tumor recurrence. Twenty patients had persistently elevated tumor markers, while the tumor marker levels in 70 patients returned to normal level within $9.08\pm7.2$ months. The patients with pulmonary disease, hepatobiliary disease, diabetes, hypertension, or herbal medication users had elevated tumor markers more frequently than patients without disease (P<0.001). Conclusion: Although detecting recurrence of gastric cancer with tumor markers may be useful, false positive findings of tumor markers are common, so surgeons should consider other chronic benign diseases and medical conditions when tumor markers increase without evidence of recurrence.
Backgrounds & Methods : Asthma is considered to be chronic inflammatory disease characterized by airway hyperresponsiveness and pulmonary eosinophilia. Recently, there has been many researches about asthma. IBS(Irritable Bowel Syndrome), PUD(peptic Ulcer disease) and GERD(gastroesophageal reflux disease) are the most common diseases of the gastrointestinal tract. Recent studies suggest that IBS, PUD and GERD are associated with bronchial hyper-responsiveness and bronchial asthma might be more prevalent in IBS and GERD patients than in control subjects. In addition, there are many comments about the interrelationship between the gastrointestinal problem and asthma in the oriental medical books. Actually, many oriental medical doctors don$^{\circ}$Øt consider the gastrointestinal condition when they deal with the asthmatic patients these days. So, we assessed the prevalence of gastrointestinal symptoms and histories in a cohort of patients with asthmatic symptoms. We evaluated 128 outpatients with asthmatic symptoms(60 males and 68 females, aged 13-75). All subjects enrolled completed the GSRS(Gastrointestinal Symptom Rating Scale). GSRS is an interview based rating scale consisting of 15 items for assessment of gastrointestinal symptoms in IBS and PUD developed by Jan Svedlund. Results : The limit of total score of GSRS in asthmatic patients is zero to 30. The number of patients with no GI symptoms is 66(51.5%). The number of patients with GSRS>5 is 62(48.4%), GSRS>10 is 24(18.8%), GSRS>15 is 8(6.25%). The number of patients with history of gastritis is 54(42.2%), gastric ulcer is 13(10.2%), gastroptosis is 8(6.25%), IBS is 6(4.68%), others is 6(4.68%). Conclusions : This study suggests that patients with bronchial asthma have an significant prevalence of gastrointestinal symptoms. Additional studies are needed to find the mechanism of the association between gastrointestinal symptoms and asthma.
The purpose of this study was to evaluate the significance of higher than normal mean corpuscular volume (MCV) and lower than normal mean corpuscular hemoglobin concentration (MCHC) in 20 patients. The hemoglobin (Hb), red blood cell indices (MCV, MCH, MCHC,), red cell distribution width (RDW), serum ferritin, serum iron (Fe) and total iron binding capacity (TIBC) were measured and the transferrin saturation were calculated. 18 (90.0%) cases were categorized as chronic diseases. Chronic renal failure, malignancy, and bleeding were all related to the cases. The mean values of hemoglobin was $9.5{\pm}2.14g/dL$; the MCV was $29.0{\pm}2.8fL$; the MCH was $30.9{\pm}1.0pg$; the MCHC was $31.2{\pm}0.5%$; the RDW was $17.0{\pm}3.6%$; serum Fe was $39{\pm}21{\mu}g/dL$; the TIBC was $219.7{\pm}108.8{\mu}g/dL$; transferrin saturation was $19.2{\pm}9.9%$ and ferritin was $445.5{\pm}499.6{\mu}g/L$ in the patients. The WHO criteria for hemoglobin of patients confirms anemia in 18 of the 20 (90.0%) cases. Anemia of chronic disease was shown in 11 (73.3%) cases; acute gastric ulcer with hemorrhage in 1 (6.7%) case; iron deficiency anemia in 1 (6.7%) case; 2 patients (13.3%) were of normal cases. There were changes in the baseline Hb level results of the 19 (95.0%) cases while no change was shown in 1 case. As a result, diseases associated with anemia and bleeding where the MCV is higher than the normal range and MCHC is lower than normal range are considered relevant findings.
A 12-year-old castrated male Shih-tzu dog presented with vomiting, anorexia, and weight loss. The patient's medical history and hematological, radiographic, ultrasonographic, and endoscopic findings were used for diagnosis. The patient's medical history showed that he was being treated for chronic kidney disease since a few weeks. The serum biochemical analysis showed moderate azotemia. However, abdominal radiographic and ultrasonographic findings showed the presence of a mass in the pylorus area of the stomach. On gastrointestinal endoscopic examination, the proliferative mass was found in the pyloric antrum. The histopathological results of the endoscopic biopsy specimen indicated that it was strongly suspected a gastric adenoma; therefore, we surgically excised the pyloric outflow region via a Y-U pyloroplasty. The histopathological examination of the surgically excised specimen also indicated that the mass was a gastric adenoma. After surgical treatment, the patient's condition improved gradually, and the clinical symptoms diminished in approximately 3 weeks after surgery. The patient's condition was well controlled until recently, i.e., 18 months after surgery. This case report describes the clinical findings, imaging characteristics, endoscopic findings, and histopathological features of a gastric adenoma in the pyloric outflow tract of a dog.
Three hundred sixty-two(male 131, female 231) elderly aged over 65 in Chungb- uk area were interviewed to determine the disease states and drug usage patterns. The prebalence of disease was 78% and women reported more chronic diseases(83%) than men(71%). Elderly who live with spouse and have an occupation have a lower rate of disease. Average number of diseases of the elderly was $1.8\pm{1.1}$, and women$(2.1\pm{1.3)}$ have significantly higher average number of diseases than that of men$(1.4\pm{0.7)}$. Also the elderly in urban areas$(2.1\pm{1.4)}$ have significantly higher number of diseases than that of the elderly in rural areas$(1.6\pm{0.9)}$. Arthritis, hypertension, cardiovascular and gastric diseases were the most frequently listed chronic diseases in order for both men and women. Anemia and fracture of bone were relatively higher in women than in men. Particularly, the arthritis of the urban elderly have a rate of 1.5 times higher than that of the rural elderly. Fifty-two percent of the elderly were currently using drugs ; among drug users 71.2% used prescription drugs and 20.5% used nonprescription drugs. The average number taken per person was 2.1$\pm$1.4 and there was no sex or age difference. However, the elderly in rural areas $(2.7\pm{1.7)}$ consumed a significantly higher number of drugs than those in urban areas$(1.7\pm{0.7)}$. The average number of prescripti- on drugs taken was 2.0$\pm$1.4 while the average of nonprescription drugs taken was $(1.3\pm{0.6)}$. Analgesics and antihypertensive drugs were most commonly used. Vitamin and analgesics were the most frequently used self-prescribed drugs. It was noted that potential adverse drug interaction by concominant drug consumption for arthritis and antihypensive drug, abuse of digestants and antiacid without treatment of the underlying disease, and misuse of quick-acting bowel medications were problematic for the elderly. In addition drugs used for the elderly have some adverse effect on the digestive system. The types and composition of drugs used by the elderly were identified and presented. Medication compliance was poor and 13.5% reported adverse reactions such as edema, heartburn, nausea, and difficulty with eating. Seventeen percent of the elderly obtained drugs arranged by those other than medical staff. Also, even among those elderly who obtained drugs prescribed by a doctor, 69.1% of subjects had not receive instruction about potential adverse reactions. These results suggest that nutritional problems related to drug usage might exist and so dietitians, either individually or as members of health teams, need to have a better understanding of drug-nutrient interaction and closer supervision, and drug information/education service should therefore be provided to prevent or minimize adverse drug reaction in elderly users of medication.
Lee, Jin A;Park, Hae-Jin;Kim, Soo Hyun;Kim, Min Ju;Kim, Kyeong Jo;Shin, Mi-Rae;Roh, Seong-Soo
The Korea Journal of Herbology
/
v.34
no.2
/
pp.15-23
/
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.
Bang, Sung Hye;Lee, Suk Hyang;Suh, Ok Kyung;Shin, Hyun Taek;Cho, Kyung Joo;Rhie, Ho Gun
Korean Journal of Clinical Pharmacy
/
v.7
no.1
/
pp.40-44
/
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.
Noh, Hye-Ji;Koh, Hong Bum;Kim, Hee-Kyoung;Cho, Hyang Hyun;Lee, Jeongmin
Nutrition Research and Practice
/
v.11
no.1
/
pp.11-16
/
2017
BACKGROUND/OBJECTIVES: Helicobacter pylori (H. pylori) colonization of the stomach mucosa and duodenum is the major cause of acute and chronic gastroduodenal pathology in humans. Efforts to find effective anti-bacterial strategies against H. pylori for the non-antibiotic control of H. pylori infection are urgently required. In this study, we used whey to prepare glycomacropeptide (GMP), from which sialic acid (G-SA) was enzymatically isolated. We investigated the anti-bacterial effects of G-SA against H. pylori in vitro and in an H. pylori-infected murine model. MATERIALS/METHODS: The anti-bacterial activity of G-SA was measured in vitro using the macrodilution method, and interleukin-8 (IL-8) production was measured in H. pylori and AGS cell co-cultures by ELISA. For in vivo study, G-SA 5 g/kg body weight (bw)/day and H. pylori were administered to mice three times over one week. After one week, G-SA 5 g/kg bw/day alone was administered every day for one week. Tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$), IL-$1{\beta}$, IL-6, and IL-10 levels were measured by ELISA to determine the anti-inflammatory effects of G-SA. In addition, real-time PCR was performed to measure the genetic expression of cytotoxin-associated gene A (cagA). RESULTS: G-SA inhibited the growth of H. pylori and suppressed IL-8 production in H. pylori and in AGS cell co-cultures in vitro. In the in vivo assay, administration of G-SA reduced levels of IL-$1{\beta}$ and IL-6 pro-inflammatory cytokines whereas IL-10 level increased. Also, G-SA suppressed the expression of cagA in the stomach of H. pylori-infected mice. CONCLUSION: G-SA possesses anti-H. pylori activity as well as an anti-H. pylori-induced gastric inflammatory effect in an experimental H. pylori-infected murine model. G-SA has potential as an alternative to antibiotics for the prevention of H. pylori infection and H. pylori-induced gastric disease prevention.
Lichen planus is a common, chronic inflammatory disease of the skin and mucous membrane for which no precise causes have been confirmed. But it is often connected with infections. Helicobacter pylori(H. pylori) among various bacteria has been associated with the cause of gastritis, peptic ulcer and gastric cancer. Considering the similarities of histological features between gastric ulcer and oral ulcers, it is resonable to assume that H. pylori might also be involved in the development oral mucosal ulceration. So we employed this study to investigate the possible involvement of H. pylori in the aetiology of erosive oral lichen planus. We analyzed detection rate of H. pylori in saliva of patients with erosive oral lichen planus by nested PCR. As a result, it revealed a significant difference statistically by showing positivity in 16 to 21(76.2%) saliva samples of patients group and in 11 of 44(25%) saliva samples of control group(P>0.001). We were able to suppose that H. pylori in saliva can be related to cause of erosive oral lichen planus.
Banhasasim-tang is a well-known traditional Korean herbal formula and has been used clinically for the treatment of gastric disease, including acute and chronic gastritis, diarrhea and gastric ulcers in Korea. In this study, an ultra-performance liquid chromatography-electrospray ionization-mass spectrometer method was developed for the quantitative determination of the 13 marker constituents, homogentisic acid (1), 3,4-dihydroxybenzaldehyde (2), spinosin (3), liquiritin (4), baicalin (5), ginsenoside Rg1 (6), liquiritigenin (7), wogonoside (8), ginsenoside Rb1 (9), baicalein (10), glycyrrhizin (11), wogonin (12), and 6-gingerol (13) in Banhasasim-tang decoction. Separation of the compounds 1-13 was using an UPLC BEH $C_{18}$ ($100{\times}2.1mm$, $1.7{\mu}m$) column and column oven temperature was maintained at $45^{\circ}C$. The mobile phase consisted of 0.1% (v/v) formic acid in water (A) and acetonitrile (B) by gradient elution. The injection volume and flow rate were $2.0{\mu}L$ and 0.3 mL/min, respectively. Calibration curves of the compounds 1-13 were showed with $r^2$ values ${\geq}0.9908$. The limit of detection and limit of quantification values of the compounds 1-13 were 0.04-1.11 ng/mL and 0.13-3.33 ng/mL, respectively. Among the these compounds, the compounds 1-3 were not detected, while the compounds 4-13 were detected in the ranges of $3.20-107,062.98{\mu}g/g$ in Banhasasim-tang sample.
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