• 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 Gastric Cancer
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• v.9 no.4
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• pp.172-176
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• 2009

Purpose: The rapid urease test is a rapid and reliable method for diagnosing Helicobacter pylori infection. However it requires gastric mucosal biopsies during endoscopy, and the test is not covered by national health insurance for patients with gastric cancer. So, we introduced an alternative method for a rapid urease test using back-table gastric mucosal biopsies from gastrectomy specimen. Materials and Methods: Ninety gastric cancer patients underwent an anti H. pylori IgG ELISA test and gastrectomy. Just after gastrectomy, two gastric mucosal biopsies from the prepyloric antrum and lower body of the gastrectomy specimen were taken from the back table in the operative room, and these were fixed immediately with the rapid urease test kit, and the color change was monitored for up to 24 hours. In this study, H. pylori infection was defined as positive when the serology or rapid urease test showed positive results. Results: The positive rate of the rapid urease test and serology was 91.1% and 77.8%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of the rapid urease test and serology were 94.3 and 80.5%, 100 and 100%, 100 and 100%, and 37.5 and 15%, respectively. The accuracy of the rapid urease test was higher than that of serology (94.4 vs. 81.1%, respectively). The rapid urease test showed a higher rate of detecting H. pylori infection than that of serology (McNemar's test, P=0.019). Conclusion: The result of the rapid urease test using back-table gastric mucosal biopsies from a gastrectomy specimen is comparable to the reference data of the conventional rapid urease test using gastric mucosal endoscopic biopsies. Therefore, it can be an alternative diagnostic method for H. pylori infection.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3391-3394
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• 2016

Background: Helicobacter pylori is now recognized as a causative factor of chronic gastritis, gastroduodenal ulcers, gastric cancer and mucosa-associated lymphatic tissue lymphoma. Toll-like receptors are important bacterial receptors in gastric epithelial cell signaling transduction and play critical roles in gastric carcinogenesis. Materials and Methods: A total of 400 patients undergoing esophagogastroduodenoscopy for investigation of chronic abdominal pain were genotyped for single-nucleotide polymorphisms (SNPs) in TLR1 (rs4833095) using TagMan SNPs genotyping assay by real-time PCR hybridization. Relationships with susceptibility to H. pylori infection and pre-malignant gastric mucosa morphological patterns, classified by magnifying NBI endoscopy, were investigated. Results: The percentages of TLR1 rs4833095, CC homozygous, CT heterozygous and TT homozygous cases were 34, 46.5 and 19%, respectively. CC showed statistical differences between H. pylori positive and negative cases (P<0.001). CT and TT correlated with type 1 and type 2 gastric mucosal morphological patterns (P <0.01) whereas CC correlated with types 3 and 4 (P<0.01). Conclusions: This study demonstrated good correlation of TLR1 rs4833095 genotype with severity of inflammation in H. pylori infected gastric mucosa according to gastric mucosal morphologic patterns with magnifying NBI endoscopy.

• The Korean Journal of Gastroenterology
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• v.72 no.6
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• pp.286-294
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• 2018

Background/Aims: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. Methods: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. Results: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. Conclusions: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.

• The Korean Journal of Food And Nutrition
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• v.29 no.1
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• pp.73-78
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• 2016

Propolis possesses antimicrobial, anti-inflammatory, anaesthetic and immunostimulating activities. The aim of this study was to evaluated chemical composition and in vitro anti-Helicobacter pylori activity of eight propolis ethanolic extracts form different region in Korea. The chemical composition of eight Korean propolis was investicated by absorption spectrophotomety and UHPLC. Total penolic and total flavonoids content ranged between $21{\pm}1.5$ and $31{\pm}1.8$ gallic acid g/100 g and $7.2{\pm}0.9$ and $24.4{\pm}1.9$ quercetin g/100 g, respectively. The p-coumaric acid as standard components content ranged between $0.29{\pm}0.00$ and $2.34{\pm}0.02mg/g$ using UHPLC. Cinnamic acid content between $0.43{\pm}0.00$ and $1.33{\pm}0.01mg/g$. 80% ethanolic extract of propolis against H. pylori was evaluated by using the disc diffusion method. Ethanol was used as a control. Mean diameters of H. pylori growth inhibition using $10{\mu}g/mL$, $50{\mu}g/mL$ or $100{\mu}g/mL$ ethanol propolis per disc were 0, ranging from 0.9 to 2.1 mm and from 1.9 to 3.5 mm, respectively. In conclusion, variation in the chemical composition of Korean propolis were mainly due to the difference in the preferred regional plants visited by honeybees. Also Korean propolis possesses considerable antibacterial activity against H. pylori. There was not confirmed a correlation between the chemical composion contens and anti-H. pylori effect. The potential of propolis in the prevention or treatment of H. pylori infection is worth further extensive evaluation.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.79-92
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• 2003

Objectives: To investigate the reinfection rate of Helicobacter pylori and the factors related to reinfection of H. pylori, 86 persons were examined in April 2000 after 1 year follow-up period and 77 persons were examined in October 2001 after two and a half-year follow-up period in Gyeongju-si, Gyeongsangbuk-do, Korea. Methods: The subjects were confirmed as H. pylori negative by urea breath test(UBT), and asked to answer the questionnaire regarding demographic characteristics, dyspepsia symptoms, health-related behaviors and family history. Results: The reinfection rate on the first year of the eradication of H. pylori was 15.6%, when the 77 subjects have finished follow-up observation for one year. In the urea breath test performed after two and a half year, 13 out of 77 were positive, with the reinfection rate of 16.9%. Age, sex, socio-economical status, educational level and family history were not associated with the reinfection, while there was significant association between the reinfection and postprandial fullness and epigastric bloating in subjective dyspepsia that the subjects who were determined to be negative in the urea breath test for the following year. The treatment compliance and drinking were significant variables in univariate analysis. Meanwhile, the cases in which the dyspepsia symptom scores for the recent year were 2 to 3 points served as the only statistically significant variable in multiple logistic regression analysis, with the odds ratio of 4.5. The cases in which salt intake during meals was exceeded were 8.7 in the odds ratio, but statistically insignificant. Conclusions: Conclusively, the first-year reinfection rate was 15.6%, and the second-year reinfection rate was 16.9%. Thecomplaints of subjective dyspeptic symptoms and the treatment compliance, as the basis for predicting the H. pylori reinfection in communities, can be used as the basis to screen the subjects for follow-up examination to find out H. pylori infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.15 no.2
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• pp.85-90
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• 2012

Purpose: Commercial enzyme-linked immunosorbent assay (ELISA) kits have been considered less reliable for children than for adults. The aim of this study was to compare four ELISA kits and in-house immunoblotting based on the analysis of anti-H. pylori-IgG antibody reactivity. Methods: A total of 399 serum samples were collected at the GNU Hospital during 1998-1999. All sera were tested using ELISA and immunoblotting. Statistically significant differences were determined by the $x^2$ test. Results: The overall seropositivity rates using GAP IgG, Genedia IgG, HM-CAP, Pyloriset EIA-G, and immunoblotting were 13.0%, 25.1%, 18.3%, 15.8%, and 62.9%, respectively. Immunoblotting showed a higher seropositivity rate than did all four ELISA kits in all age groups. Genedia IgG had the highest seropositivity among the ELISA kits. The seropositivity rate for children aged 13 to 18 months was lowest, and that of children aged 15 years was highest (90.0%). The seropositivity rate for children aged 7 months to 5 years was significantly lower than that for children aged 6 to 15 years among the four ELISA kits (p<0.0001) and immunoblotting (p=0.02). Conclusion: Immunoblotting is the most sensitive test for detection of anti-Helicobacter pylori IgG antibodies among the serological tests in this study. These results emphasize the need for standardization when commercial ELISA tests are used in different nations or in young age groups. Immunoblotting could be a suitable noninvasive assay for serodiagnosis and seroepidemiologic study of H. pylori infection in Korean children.

• BMB Reports
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• v.40 no.2
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• pp.142-150
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• 2007

Epigenetic alterations, represented by aberrant DNA methylation, are deeply involved in human cancers. In gastric cancers, tumor-suppressor genes are inactivated more frequently by promoter methylation than by mutations. We recently showed that H. pylori infection, a potent gastric carcinogenic factor, induces methylation of specific genes in the gastric mucosae. When the methylation levels were analyzed in the gastric mucosae of healthy volunteers, cases with a single gastric cancer, and cases with multiple gastric cancers, who have increasing levels of risks for gastric cancers, there was a significant increasing trend in the methylation levels among the individuals without current H. pylori infection. This finding unequivocally showed the presence of an epigenetic field for cancerization. The degree of the field defect was measured more conveniently using methylation levels of marker genes than using those of tumor-suppressor genes. The presence of an epigenetic field for cancerization has been indicated for liver, colon, Barrett's esophageal, lung, breast, and renal cancers. Since decreased transcription is involved in the specificity of methylated genes, it is likely that specific genes are methylated according to carcinogenic factors. These findings emphasize the usefulness of DNA methylation as a marker for past exposure to carcinogens and future risk of cancer development.

• Microbiology and Biotechnology Letters
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• v.46 no.3
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• pp.261-268
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• 2018

Differences in host ethnicities and geographical distributions may influence the genetic variation and pathogenesis of Helicobacter pylori strains, particularly with respect to those with a high risk of gastric cancer and in Asian Enigma regions. We simultaneously identified H. pylori virulence-associated genes involved in inflammation and cell damage in Thai and Korean dyspeptic patients. The virulence-associated gene cagA, cagA genotypes (East Asian and Western type cagA), vacA genotypes (s- and m-), oipA, and sabA were detected in Thai and Korean dyspeptic patients by polymerase chain reaction (PCR), real-time PCR, and DNA sequence analysis. Comparisons between the two regions showed that cagA, East Asian type cagA, and vacA s1/m1 in Korean dyspeptic patients occurred at rates of 100%, 86.67%, and 88.89%, respectively (p < 0.05). The oipA- and sabA-positive samples were significantly more predominant in the Korean population (95.56%, 91.11%) than in the Thai population (32%, 34%). DNA sequence analysis revealed differences in the patterns of cytosine-thymine dinucleotide repeats of oipA and sabA among the two populations of dyspeptic patients. Our results indicate that the H. pylori strains detected in the two regions were divergent, and strains colonizing the Korean dyspeptic patients may be more virulent than those in the Thai population. Our data may help explain H. pylori pathogenesis in Asian Enigma areas with a low gastric cancer incidence. However, other factors involving H. pylori infection in these two regions should be further analyzed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.16 no.2
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• pp.123-126
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• 2013

$M\acute{e}n\acute{e}$trier's disease is a rare protein-losing gastropathy characterized by hypertrophic gastric fold, foveolar hyperplasia, and hypoproteinemia with resulting peripheral edema. It is clinically evident as nonspecific gastrointestinal symptoms, including abdominal discomfort, nausea and vomiting, abdominal pain, weight loss, diarrhea, and edema. Pediatric $M\acute{e}n\acute{e}$trier's disease usually has an insidious onset and progressive, chronic clinical course and it spontaneously resolves in weeks or months. The pathogenesis of $M\acute{e}n\acute{e}$trier's disease is not clearly understood. $M\acute{e}n\acute{e}$trier's disease is thought to be associated with some gastric infections. But the cause of $M\acute{e}n\acute{e}$trier's disease is unknown, an association with cytomegalovirus (CMV) and Helicobacter pylori has been suggested. In Korea, We present the first a case of pediatric $M\acute{e}n\acute{e}$trier's disease with positive evidence of CMV and H. pylori.