Peptic ulcer bleeding is a common complication of peptic ulcer disease and the most common cause of upper gastrointestinal bleeding. Despite advances in drug usage and endoscopic modalities, no significant improvement is observed in the mortality rate of bleeding ulcers. The purpose of this review is to discuss various endoscopic hemostatic methods to treat peptic ulcer bleeding. Endoscopic hemostatic techniques can be classified into injection, mechanical, electrocoagulation, hemostatic powder, and endoscopic Doppler-guided hemostatic therapies (the last mentioned being a newly developed technique). Endoscopic hemostasis can be performed as mono or combination therapy using the aforementioned methods. Endoscopic hemostasis is the most important treatment for patients with peptic ulcer bleeding. Endoscopists should consider the treatment approach for peptic ulcer bleeding based on patient characteristics, the size and shape of the lesion, the endoscopist's expertise, and the resources and circumstances at each hospital. Follow-up studies are needed to evaluate the efficacy of newly developed hemostatic powder therapy and endoscopic Doppler-guided hemostasis.
Studies on diagnosis and treatment of tumor . abscess . ulcer in intestinal carbuncle were carried out. The result of studies were summerized as follows: 1. By Nai-Gyung carbuncle-tumor arose from disharmony between nutrient and defensive because of cold, abscess arose from fever victory between cold and fever, ulcer arose from decreasing function of Bi-Kam year. By latter literature Bi-Kam year could be interpreted that spleen stomach was invaded evil influence from unattainable vital force of the earth. 2. Sites of intestinal carbuncle were large intestine, small intestine, intestinal inside or outside between large and small intestine, Intestinal carbuncle was common name of a disease about large intestinal carbuncle, small intestinal carbuncle, pelvic intestinal carbuncle, shrink leg intestinal carbuncle etc.. Pain appeared Chunchu-Hyul in large intestinal carbuncle, and Gwanweon-Hyul in small intestinal carbuncle. 3. On abdominal diagnosis tumor had indistinct pain of Gwanweon Chunchu, edema and heary feeling in low abdomen, no excessive pain by hand press and intestinal boiling sound. In abscess pain descended from right side of low abdomen to huckle, and there was rejection against press, feeling about fever,water sound with flank movement. In ulcer hand approach was difficult since excessive pain diffuse to whole abdomen, and perforating ulcer sometimes caused a serious symptom of umbilical pus. 4. On fecal and urinary diagnosis in tumor urine was yellowish red pollakiuria like gonorrhoea and occasional constipation. In abscess uncomfortable rough pain short red early urine like gonorrhoea appeared during urination, and constipation with stinging pain appeared during defecation. In ulcer red rough pyuria appeared, and stinging and pain with puruloid blood appeared during defecation. 5. On treatment in tumor Daiwhang-Tang Daisenggi-Tang Dangui-Jun by dissipation method, calming down method, interior reliance maturation method, in abscess Mokdan-San Euiiin-Tang Jeokduiin-Tang by the method of water repelling pus discharge, acute breaking, in ulcer Takridanggui-Tang Paljin-Tang Bojungikki-Tang were each used by the method of interior reliance, virulence astriction, supplement vital force and blood, supplement spleen stomach. 6. On treatment patient may have to be careful of excessive moving and suprising anxiety. Abuse of acupuncture and moxibustion made patient worse, misuse of analgesics purgative intestinal irrigation etc. could provoke difficult diagnosis and perforation. So you must treat after exact diagnosis. 7. Prognosis of ease tumor ease abscess ease ulcer and ease astriction was good. If the intestinal carbuncle were not to promote to abscess and ulcer for a long time, its prognosis was bad and it could metastasize to cancer because of dark purple with hardness. So tumor abscess ulcer in intestinal carbuncle may be significant of precancerous lesion.
The effect of ginseng on gastric ulcer and gastric acid secretion was investigated in pylorus-ligated rats. Methods: Sprague-Dawley strain rats were used after 24 hours fast. Pylorus-ligation was performed under light ether anaesthesia, then gastric mucosal damage was evoked in conscious pylorus-ligated rats by the administration of subcutaneous (s.c.) indomethancin (20mg/kg), s.c. histamine (150mg/kg) or by pylorus-ligation (Shay ulcer). Ginseng was given by intragastric (i.g.) or intraperitoneal (i.p.) route simultaneously with the ulcerogens. Rats were killed after 3h (indomethacin) and histamine models) or after 18h (Shay ulcer), when the gastric secretory responses, the number and severity of gastric mucosal lesions and mucosal mucus content deetermined. the effect of i.p. ginseng on basal gastric acid secretion and on gastric acide secretion in indomethacin (20mg/kg, s.c.)-treated rats was also investigated in urethane anesthetized rats. Gastric acid secretion was measured by flushing of the gastric lumen with saline every 15min through an oesophageal cannula. Results: In conscious pylorus-ligated rats, i.g. ginseng(12.5-50mg/$m\ell$; 50-200mg/kg) protected against gastric mucosal lesions evoked by s.c. indomethacin or s.c. histanmine in the d3-h pylorus-lighted rat, withoutmodifying gastric acid secretory responses. Ginseng given i.p. (150 or 200mg/kg) did not reduce the gastric lesions produced by histamine or by ligating the pylorus (Shay ulcer) Ginseng given orally in 50mg/$m\ell$ (200mg/kg) increased gastric mucus secretion in saline- and indomethacin-treated conscious pylorus-ligated rats. In anaesthetized rats ginseng (50 or 200mg/kg) did not modify basal gastric acid secretion or gastric acid secretion in the indomethacin-treated rats. Conclusions: ginseng given orally exerts gastroprotective effects in the rat stomach. Such anti-ulcer effect does not involve changes in gastric acid secretory responses. In addition, ginseng possesses stimulatory effect on gastric mucus secretion, which could be one mechanism by which the compound exerts its antiulcer effect. Our data are in favor for a beneficial effect for topically applied ginseng on the gastric mucosa.
It has been shown that bilateral decrease of point H4,5,6 in Ryodoraku test is related with gastric dysmotility. This suggested that the system of Kyung-Rak related with anatomical gastric disease may not be the Stomach Meridian, in the view that the system of Kyung-Rak is similar to that of Ryodoraku, and which was not consistent with classical contents of Kyung-Rak principle. Therefore, this paper was done to investigate whether bilateral decrease of point H4,5,6 is a general sign of common gastric disease in Ryodoraku test and to study its relation between Kyung-Rak principle and autonomic nervous system as a mediator explaining Ryodoraku response. As shown in the results of this study, different electrical response of Ryodoraku between patients with dyspepsia of gastric dysmotility and gastric ulcer revealed discrepancy of location indicating anatomical stomach between Kyung-Rak principle and Ryodoraku and instability of explanation of autonomic nerve theory to Ryodoraku. Thus, it presented the possibility that artificial application of Kyung-Rak principle against Ryodoraku may destroy its originality in the clinical field. To correctly use Ryodoraku in the diagnosis or evaluation of disease, Ryodoraku test should be used according to Nakatani's suggestion and clinical indication of which is limited to the diseases complicated with dysfunction of the autonomic nervous system.
Park, Jae-Heung;Jang, Kyung-Jun;Kim, Cheol-Hong;Lee, Yoo-Hwan;Lee, Soo-Jung;Kim, Bum-Hoi;Yoon, Hyun-Min
대한약침학회지
/
제17권3호
/
pp.40-49
/
2014
Objectives: The gastric ulcer is a common disorder of the stomach and duodenum. The basic physiopathology of a gastric ulcer results from an imbalance between some endogenous aggressive and cytoprotective factors. This study examined whether Ganoderma lucidum pharmacopuncture (GLP) would provide protection against acute gastric ulcers in rats. Methods: Sprague-Dawley rats were divided randomly into 4 groups of 8 rats each: normal, control, normal saline (NP) and GLP groups. The experimental acute gastric ulcer was induced by using an EtOH/HCl solution and the normal group received the same amount of normal saline instead of ethanol. The NP and the GLP groups were treated once with injections of saline and GLP, respectively. Two local acupoints were used: CV12 (中脘) which is the alarm point of the Stomach Meridian, and ST36 (足三里), which is the sea point of the Stomach Meridian. The stomachs from the rats in each group were collected and analyzed for gross appearance and histology. Also, immunohistochemistry staining for BAX, Bcl-2 and TGF-${\beta}1$ was performed. Results: Histological observations of the gastric lesions in the control group showed comparatively extensive damage of the gastric mucosa and necrotic lesions had penetrated deeply into the mucosa. The lesions were long, hemorrhagic, and confined to the glandular portions. The lesions were measured microscopically by using the clear depth of penetration into the gastric mucosal surface. The length and the width of the ulcer were measured and the inhibition percentage was calculated. Wound healing of the acute gastric ulcer was promoted by using GLP, and significant alterations of indices in gastric mucosa were observed. Such protection was shown by gross appearance, histology and immunohistochemistry staining for BAX, Bcl-2 and TGF-${\beta}1$. Conclusion: These results suggest that GLP administered at CV12 and ST36 can provide significant protection to the gastric mucosa against an ethanol-induced acute gastric ulcer.
Stomach ulcer is the sickness with high frequency of occurrence at the digestive organs and is usually induced by a disproportion of an aggressive factor and a defense factor. To find the medicines having comparative effect to $Stillen^{(R)}$ currently on sale, we screened SHI-7004 and carried out following experiments; Effects of HCl-EtOH induced gastric lesions measuring test, Acid-Neutralizing Capacity, DPPH antioxidation activity, effect of stomach glands secrection. We can suggest that this herbal medicines could be a promising drug for the treatment of gastrc ulcers.
Having examined the literatures on the terminologies. UlkyuK and Banui, the following results were obtained. 1. since Ul accompanies the symptom of dysphagia. it is thoughr ro indicate the disease and ailment in the larynx and pharynx. and the esphangus. 2. Kuyk is used in the contextof Kyuksak. Kyukjung. Bikyuk. Ulsakamnd Ulkyuk. and since it also includes the meaning of Ul. it is thought that disease and ailment in the esophagus. stomach and duodenum are included in this category. 3. Although Ul and Kyuk are differentiated. since they appear in conjunction with the other clinically. they can be refferred to as Ulkyuk. 4. Banui represents the phenomenon of vomiting. because it is oresent in a bad case of Ulkyuk. it can be seen to be included in Ulkyuk. Thus. Ulkyuk and Banui can be refferred to as one. 5.Although the name of an ailments in oriental medicine and that in the western medicine can not be in perfect match. Ulkyuk is refferred to as ailments in esophagus such as esophagitis. esophageal ulcer, esophageal deverticulum and esophageal cancer. while Banui is refferred to asailments in stomanch and duodenum such as stomach cancer. chtonic spasmic gastritis. it is reasonable to differentiate the two in general. As seen above, since the concept of the terminologies. Ulkyuk and Banui are somewhat different among Oriental medicine doctors. a consensus is needed to come up with terms that all can agree on.
This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric ulceration, and the pathway through which cingulate cortex exerts the effect. 56 female rats were divided equally into cingulate (cingulate cortical ablation), cingulate-vagal (cingulate cortical ablation and vagotomy), normal control and vagal (vagotomy) groups. Cingulate cortex was ablated through a slit-shaped opening (1 mm in width, 13 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from parietal and frontal bones on each side. Vagus nerves on both sides were transected around the distal end of the esophagus. In the normal control animals, surgical intervention ended with scalp incision. All rats were kept without restraint or food deprivation for 3 weeks after surgery. The stomach of each rat was inflated with 7 ml of physiological saline and then removed under deep anesthesia. The mucosal surface was examined under dissecting microscope for the location, shape and number of ulcers, and then enlarged photograph $(4{\times})$was taken. The incidence of ulcer in each group was counted and the number of ulceration as well as the total area of glandular mucosa were measured on the photograph. Results obtained were as follows: 1. The mean number of ulcer per stomach and the total area of ulcer exprssed as permillage of the total area of glandular mucosa were significantly higher in the cingulate group than the cingulate-vagal, the normal control and the vagal groups. There was no difference among the latter three groups. 2. The incidence of ulcer in the cingulate group was significantly higher than that in the .normal control group and was also higher, though not significantly, than those in the cingulate-vagal and the vagal groups. There was no difference among the normal control, the cingulate-vagal and the vagal groups. It is inferred from the above results that the cingulate cortex exerts an inhibitory influence upon gastric ulceration and that this influence is mediated by controlling the vagal activity.
Object : The purpose of this study is to arrange the literature about a acupuncture therapy on the gatroduodenal ulcer. Methods : We arrange twenty five kinds of literature about a acupuncture therapy on gastric pain coming within the category of the gatroduodenal ulcer. Results : The cause of gastric pain is disunion of liver and spleen caused by overeating, uncontrolled emotion. The gastric pain is accompanied by lack of appetite, nausea & vomiting, belching, constipation, abdominal discomfort and so on. Therapy methods of the gastric pain are tonifying the spleen, eliminating pathological coldness and alleviation of pain, draining the liver and replenish Ki. Acupuncture point at S36, P6, CV12, B20, B21, B18, B17 used frequently for the acupuncture therapy in the order of frequency of use. Conclusions : Meridians of Conception Vessel, Stomach, Spleen, Bladder and Liver used frequently for the acupuncture therapy. The meridian used for treatment of the gastroduodenal ulcer is related to it passing by a painful place in the body.
Doxycycline is frequently prescribed to treat urogenital infections or acne vulgaris. A 39-year-old man was prescribed doxycycline as a treatment for his skin infection. He took each tablet on an empty stomach in the morning, and just before going to bed with insufficient water. After taking the prescribed medication for approximately 3 weeks, he was diagnosed with esophageal ulcer. He had not experienced these symptoms before, and the drug label says that doxycycline rarely causes esophageal ulcer. After discontinuing the medication, the symptoms disappeared. Using the World Health Organization-Uppsala Monitoring Center criteria, the causality for doxycycline-induced esophageal ulcer was evaluated as "possible." Additionally, using the Naranjo scale and Korean causality assessment algorithm (Ver. 2), the causality was evaluated as "probable." Previous reports have stated that most patients who took doxycycline with insufficient water just before going to bed or in the supine position developed esophageal ulcer. Therefore, all patients taking doxycycline must be provided with detailed instructions about the appropriate administration methods.
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