• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.7 no.1
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• pp.87-91
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• 2004

Herein, the case of a 5-year-old boy with cytomegalovirus-induced Menetrier's disease, with peripheral eosinophilia, presenting with abdominal pain and vomiting, followed by generalized edema, is reported. The initial laboratory findings, hypoalbuminemia and peripheral eosinophilia were noted, with no evidence of renal, hepatic, cardiac or allergic diseases. Gastrofiberscopy was performed under the suspicion of eosinophilic gastroenteritis with protein losing gastropathy. The gastrofiberscopy showed the characteristic features of giant hypertrophy of the gastric rugae, with large quantities of adherent gelatinous material on the gastric fundus and body. The histological findings revealed foveolar hyperplasia, compatible with Menetrier's disease, with massive eosinophilic infiltrations. The presence of cytomegalovirus infection was identified by serology and confirmed by urine PCR. His symptoms, gastrofiberscopic findings and peripheral eosinophilia resolved spontaneously, and he has remained well for 10 months.

• Advances in Traditional Medicine
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• v.7 no.4
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• pp.357-362
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• 2007

Cytochrome P450 2C19 (CYP2C19) is a clinically important enzyme involved in the metabolism of therapeutic drugs, including (S)-mephenytoin, omeprazole, proguanil, and diazepam. Individuals are characterized as either extensive metabolizers (EM) or poor metabolizers (PM) on the basis of CYP2C19 enzyme activity. The PM phenotype occurs in 2-5% of Caucasians, but in 18-23% of Asians. To clarify the association between CYP2C19 polymorphisms and gastric cancer in Koreans, we investigated CYP2C19 genotypes ($CYP2C19^*1,\;{^*2},\;and\;^*3$) in 109 patients with gastric cancer and 211 controls. Normal ($CYP2C19^*1$) and defective alleles were detected with polymerase chain reaction/restriction enzyme analysis. CYP2C19 has three hereditary genotypes: homozygous EM, with high enzymatic activity; heterozygous EM, with moderate enzymatic activity; and PM, with no enzyme activity. We found that CYP2C19 heterozygous EM is more closely associated with gastric cancer than is homozygous EM. Because the CYP2C19 genotype varies in Koreans, a genotyping test is desirable to prevent gastropathy recurrence in patients before their doses of omeprazole are reduced during maintenance therapy.

• The Journal of Internal Korean Medicine
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• v.31 no.2
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• pp.212-223
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• 2010

Objectives : The aims of this study were to evaluate whether gastric contractility could be measured by bowel sound of rats, and whether gastrointestinal side effect of any herbal restoratives would be related with their inhibition of gastric contraction. Methods : Streptozotocin (STZ)-induced diabetic rats were used as a gastric hypocontraction model. At the time of 6 weeks after induction of diabetes, 2mL of normal saline (NS) and 2mL of extract solution each containing 125mg/kg of Bojoongikki-tang (BJ), Sipjeondaebo-tang (SJ), Youngkaechulgam-tang (YG) were given to Normal (NR) and diabetic rats (DR), respectively. Bowel sound was recorded for 30 minute in fasting, and 120 minute of their administration. Gastric motility index was serially calculated with the ratio of accumulated potentials of post-administration/fasting state every 10 minutes. Results : Gastric contractility between NR and DR could be significantly distinguished by bowel sound auscultation. BJ had a decreasing effect, SJ had a bidirectional effect, and YG had an increasing effect on gastric contractility measured by bowel sound auscultation. Conclusions : BJ showed the possibility of inhibitory effects on gastric contraction. So, before administration, a gastric motility test should be recommended to prevent possible side effects in patients with gastric hypocontractility.

• The Journal of Internal Korean Medicine
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• v.29 no.1
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• pp.67-79
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• 2008

Backgrounds & Objectives : The aims of this study were to observe how morphology was changed and whether gastric motility was impaired in streptozotocin(STZ)-induced diabetic rats(DR), and whether Yijin-tang(YJT) was able to restore their impaired gastric motility. Methods : We investigated the change of body weight, feed intake and blood glucose between normal rats (NR) and DR for 12 weeks after induction of diabetes. At the time of 12 weeks after induction of diabetes, gastric surface area, gastric slow wave and gastric emptying rate were measured. Results : Decreased body weight, increased feed intake and increased gastric surface area were observed in DR, compared with NR. The percentage of normogastria decreased but that of bradygastria increased in DR, compared with NR. YJT 90mg/kg had no effect on the correction of gastric slow wave. YJT 90mg/kg and 270mg/kg had a significant effect on improvement of gastric emptying, more than normal saline (NS) in both NR and DR but the gastric emptying rate of DR was significantly lower than that of NR when YJT 90mg/kg and YJT 270mg/kg were administered. Conclusions : We can expect that administration of YJT would be effective on the improvement of gastric emptying and upper gastrointestinal symptoms as a juvantia.

• Gut and Liver
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• v.12 no.6
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• pp.704-713
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• 2018

Background/Aims: Gastric varices (GVs) are a major cause of upper gastrointestinal bleeding in patients with liver cirrhosis. The current treatments of choice are balloon-occluded retrograde transvenous obliteration (BRTO) and the placement of a transjugular intrahepatic portosystemic shunt (TIPS). We aimed to compare the efficacy and outcomes of these two methods for the management of GV bleeding. Methods: This retrospective study included consecutive patients who received BRTO (n=157) or TIPS (n=19) to control GV bleeding from January 2005 to December 2014 at a single tertiary hospital in Korea. The overall survival (OS), immediate bleeding control rate, rebleeding rate and complication rate were compared between patients in the BRTO and TIPS groups. Results: Patients in the BRTO group showed higher immediate bleeding control rates (p=0.059, odds ratio [OR]=4.72) and lower cumulative rebleeding rates (logrank p=0.060) than those in the TIPS group, although the difference failed to reach statistical significance. There were no significant differences in the rates of complications, including pleural effusion, aggravation of esophageal varices, portal hypertensive gastropathy, and portosystemic encephalopathy, although the rate of the progression of ascites was significantly higher in the BRTO group (p=0.02, OR=7.93). After adjusting for several confounding factors using a multivariate Cox analysis, the BRTO group had a significantly longer OS (adjusted hazard ratio [aHR]=0.44, p=0.01) and a longer rebleeding-free survival (aHR=0.34, p=0.001) than the TIPS group. Conclusions: BRTO provides better bleeding control, rebleeding-free survival, and OS than TIPS for patients with GV bleeding.

• Journal of Gastric Cancer
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• v.5 no.3 s.19
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• pp.191-199
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• 2005

Background: Though infections of Helicobacter pylori (H. pylori) are closely associated with activation of host angiogenesis, the underlying mechanisms, as well as the strategy for its prevention, have not been identified. Here, we investigated a causal role of H. pylori infection in angiogenesis of gastric mucosa and a potent inhibitory effect of a gastric proton pump inhibitor (PPI) on the gastropathy. Materials and Methods: A comparative analysis of CD 34 expression in tissues obtained from 20 H. pylori-associated gastritis and 18 H. pylori-negative gastritis patients was performed. Expression of $HIF-1{\alpha}$ and VEGF were tested by using RT-PCR. To evaluate the direct effect of H. pylori infection on differentiation of endothelial HUVEC cells, we carried out an in vitro angiogenesis assay. Results: H. pyfori-associated gastritis tissues showed significantly higher density of $CD34^+$ blood vessels than did H. pylori-negative gastritis tissues, and the levels were well correlated with expressions of $HIF-1{\alpha}$. Conditioned media from H. pylori-infected gastric mucosal cells stimulated a tubular formation of HUVEC cells. We also found a significant inhibitory effect of PPI, an agent frequently used for H. pylori eradication, on H. pylori-induced angiogenesis. This drug effectively inhibited the phosphorylation of MAP kinase ERK1/2, which is a principal signal for H. pylori-induced angiogenesis. Conclusion: The fact that PPls can down-regulate H. pylori-induced angiogenesis suggest that anti-angiogenic treatment using PPI may be a preventive approach for H. pylori-associated carcinogenesis.