• 대한한방내과학회지
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• 제40권4호
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• pp.697-708
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• 2019

Objective: The aim of this study was to introduce gastric dysmotility as a common cause in patients with concurrent functional dyspepsia and chronic atrophic gastritis. Method: Dyspeptic symptoms, the Rydoraku score, gastric motility (electrogastrography, bowel sound analysis), gastric mucosa (gastroendoscopy), and blood and blood chemistry were all evaluated. For the treatment method, Pyengwi-san (solution) and Banwhasashim-tang (extract) were used as herbal drugs. Both ST36 electrical stimulation and simple immersion stimulation of CV11, 12, and 13 in the abdomen were applied. Results: Dyspeptic symptoms including indigestion, headache, and insomnia were all relieved. Gastric myoelectrical activity and gastric pyloric function were additionally improved. The condition of the gastric mucosa was changed from atrophic to erosive. Other side-effects of the treatment were not noted. Conclusion: The traditional Korean treatment showed effectiveness in the relief of dyspeptic symptoms and mucosal improvement of chronic atrophic gastritis. Gastric dysmotility is a common cause of the condition being concurrent with both functional dyspepsia and chronic atrophic gastritis without Helicobacter pylori infection.

• 동의생리병리학회지
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• 제31권5호
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• pp.255-263
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• 2017

This article is for understanding relations between the classifications of gastritis and syndrome differentiation types of Korean Medicine through research on syndrome differentiations of clinically applied gastritis and literature of Korean Medicine. Clinical papers were searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI) from 1995 to 2015. Conclusions are as follows. First, disease mechanism of chronic gastritis are qi stagnation, damp stagnation, heat obstruction, blood stasis obstruction, yin damage, damage to collaterals with healthy qi deficiency and pathogenic qi. And qi movement stagnation is shown through the status of chronic gastritis. Second, chronic superficial gastritis belongs to qi aspect syndrome and mainly pathogen excess syndrome. And the key mechanisms are congestion and disharmony of stomach qi sometimes combined with liver depression, food accumulation and dampness-heat. Third, chronic atrophic gastritis belongs to qi-blood syndrome and deficiency-excess complex syndrome with the root of spleen qi deficiency and stomach yin deficiency and the tip of blood stasis, qi stagnation. And key mechanism is damage to collaterals with healthy qi deficiency and toxin-blood stasis. Forth, pathogen excess syndromes are shown at the early stage of chronic gastritis and healthy qi deficiency syndromes after the middle stage. Qi deficiency is shown at the beginning of the disease and yin deficiency at the late stage. And qi deficiency is related with superficial gastritis and yin deficiency with atrophic gastritis.

• 한국임상수의학회지
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• 제33권5호
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• pp.286-289
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• 2016

Two dogs (Case 1: Poodle, 4 years old, spayed female; Case 2: Bulldog, 3 years old, intact female) were referred to us for treatment of vomiting; Case 1 had a history of acute vomiting that started 1 day prior to presentation, and Case 2 had a history of chronic vomiting that started 2 years prior to presentation. The vomiting did not respond to medication in the local animal hospital. Results from abdominal ultrasound examinations showed that case 1 had gastric wall thickening, and case 2 had no remarkable findings. For both cases, we performed gastrointestinal endoscopic examinations, and several biopsy samples were obtained from different gastric areas. On the basis of the results of histopathological examinations, both dogs were diagnosed with atrophic gastritis concurrent with a Helicobacter infection. Clinical signs improved after antibiotic therapy. This case report describes the clinical, endoscopic, and histopathological findings of atrophic gastritis concurrent with a Helicobacter infection.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2999-3001
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• 2015

Background: This study aimed to evaluate upper gastrointestinal polyps detected during esophago-gastroduodenoscopy tests. Materials and Methods: We conducted a retrospective analysis on data regarding 55,987 upper gastrointestinal endoscopy tests performed at the endoscopy unit of Istanbul Education and Research Hospital between January 2006 and June 2012. Results: A total of 66 upper gastrointestinal polyps from 59 patients were analyzed. The most common clinical symptom was dyspepsia, observed in 41 cases (69.5%). The localizations of the polyps were as follows: 29 in the antrum (43.9%), 15 in the corpus (22.7%), 11 in the cardia (16.7%), 3 in the fundus (4.54%), 3 in the second portion of the duodenum (4.54%), 2 in the bulbus (3.03%) and 3 in the lower end of the esophagus (4.54%). Histopathological types of polyps included hyperplastic polyps (44) (66.7%), faveolar hyperplasia (8) (12.1%), fundic gland polyps (4) (6.06%), squamous cell polyps (4) (6.06%), hamartomatous polyps (3) (4.54%), and pyloric gland adenoma (3) (4.54%). Histopathological analysis of the gastric mucosa showed chronic atrophic gastritis in 30 cases (50.84%), HP infection in 33 cases (55.9%) and intestinal metaplasia in 19 cases (32.20%). In 3 cases with multiple polyps, adenocarcinoma was detected in hyperplastic polyps. Conclusions: Among polypoid lesions of the upper gastrointestinal tract, the most common histological type is hyperplastic polyps. Generally, HP infection is associated with chronic atrophic gastritis and intestinal metaplasia. The incidence of adenocarcinoma tends to be higher in patients with multiple hyperplastic polyps.

• Journal of Gastric Cancer
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• 제2권2호
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• pp.73-80
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• 2002

In spite the fact that H. pylori infection might be the causative organisms of acute and chronic gastritis, peptic ulcer diseases and the definition as the class I carcinogen by WHO IARC, still debates exist about the relationship between H. pylori and gastric carcinogenesis. Epidemiological and animal studies demonstrated a link between gastric cancer and chronic infection with H, pylori, but the exact mechanism responsible for the development of gastric cancer in H. pylori-infected patients still remain obscure. In order to declare the clear association, definate evidences like that decrement in the incidence of gastric cancer after the eradication of H. pylori in designated area compared to noneradicated region or the blockade of specific mechanism acting on the carcinogenesis by H. pylori infection. The other way is to identify the upregulating oncogenes or downregulating tumor suppressor genes specifically invovled in H. pylori-associated carcinogenesis. For that, we established the animal models using C57BL/6 mice strain. Already gastric carcinogenesis was developed in Mongolian gerbils infected with H. pylori, but there has been no development of gastric cancer in mice model infected with H. pylori after long-term evaluation. Significant changes such as atrophic gastritis were observed in mice model. However, we could observe the development of mucosal carcinoma in the stomach of transgenic mice featuring the loss of TGF-beta sig naling by the expressions of dominant negative forms of type II receptor specifically in the stomach. Moreover, the incidence of gastric adenocarcinoma was significantly increased in group administered with both MNU and H. pylori infection than MNU alone, signifying that H. pylori promoted the gastric carcinogenesis and there might be host susceptibility genes in H. pylori-associated gastric carcinogenesis. Based on the assumption that chronic, uncontrolled inflammation might predispose to carcinogenesis, there have been several evidences showing chronic atrophic gastritis predisposed to gastric carcinogenesis in H. pylori infection. Although definite outcome of chemoprevention was not drawn after the longterm administration of anti-inflammatory drug in H. pylori infection, the actual incidence of atrophic gastritis and molecular evidence of chemoprevention could be obtained. Selective COX-2 inhibitor was effective in decreasing the development of gastric carcinogenesis provoked by H. pylori infection and carcinogen like in chemoprevention of colon carcinogenesis.

• Journal of Gastric Cancer
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• 제7권1호
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• pp.38-41
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• 2007

악성빈혈을 동반한 자가면역성 만성 위축성 위염은 위암의 전구 병변으로 알려져 있다. 저자들은 악성빈혈에 동반된 위암 1예를 경험하였기에 보고한다. 40세 여자환자가 어지럼증과 공복 시 속쓰림으로 시행한 혈액검사상 혈색소 4.2 g/dl으로 측정되었다. 상부위장관 내시경상에서는 위 고위 체부의 편평 융기성 병변이 관찰되었고 조직검사상 위선암으로 보고되었다. 위전절제술을 시행하였고 병리조직 검사상 병변은 고위 체부 전벽에 점막하층(SM2)까지 침범한 조기위암이었으며, 검사된 림프절 44개 중에 전이된 림프절은 없었다. 악성빈혈 환자에서 위축성 위염이 동반된 경우 위암의 호발연령이 되면 위암의 발생 가능성이 있으므로 상부위장관 내시경의 주기적인 시행이 중요하리라 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5199-5205
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• 2013

Background/Aim: The Hippo signaling pathway is a newly discovered and conserved signaling cascade, which regulates organ size control by governing cell proliferation and apoptosis. This study aimed to investigate its effects in human gastric cancer. Methods: Tumor tissues (n=60), adjacent non-tumor tissues (n=60) and normal tissues (n=60) were obtained from the same patients with primary gastric cancer (GC). In addition, 70 samples of chronic atrophic gastritis (CAG) tissues were obtained from patients with intestinal metaplasia (IM) by endoscopic biopsy. Hippo signaling molecules, including Mst1, Lats1, YAP1, TAZ, TEAD1, Oct4 and CDX2, were determined by quantitative polymerase chain reaction (qPCR). Protein expression of Mst1, Lats1, YAP1, TEAD1 and CDX2 was assessed by immunohistochemistry and Western blotting. Results: Mst1, Lats1 and Oct4 mRNA expression showed an increasing tendency from GC tissues to normal gastric tissues, while the mRNA expression of YAP1, TAZ and TEAD1 was up-regulated (all P<0.01). Mst1 and Lats1 protein expression presented a similar trend with their mRNA expression. In addition, YAP1 and TEAD1 protein expression in GC was significantly higher than in the other groups (all P<0.01). CDX2 mRNA and protein expression in the CAG group were higher than in the other groups (all P<0.01). In GC, mRNA expression of Mst1, Lats1, Oct4, YAP1, TAZ, TEAD1 and CDX2 had a close correlation with lymphatic metastasis and tumor TNM stage (all P<0.01). Furthermore, protein expression of Mst1, Lats1, YAP1, TAZ, TEAD1 and CDX2 had a close correlation between each other (P<0.05). Conclusion: The Hippo signaling pathway is involved in the development, progression and metastasis of human gastric cancer. Therefore, manipulation of Hippo signaling molecules may be a potential therapeutic strategy for gastric cancer.

• 대한핵의학회지
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• 제39권6호
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• pp.456-463
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• 2005

목적: FDG PET에서 위(stomach)에 보이는 다양한 FDG 섭취 양상들이 임상적으로 어떠한 의미가 있는지 알아보고 유의한 병변의 특징적 양상을 밝혀 내어 좀 더 정확한 PET 판독을 유도하여 임상적 처치에 도움이 되고자 하였다. 대상 및 방법: 2003년 6월에서 2004년 8월까지, 15개월 동안 FDG PET과 위 내시경을 모두 시행한 위 절제술을 받지 않은 피검자들 중에서 두 검사간 간격이 1주일 이내인 총 38명을 대상으로 하여 후향적으로 연구하였다. PET 영상의 분석은 섭취 정도의 측면에서 시각적 섭취 정도와 max.SUV를 사용하였고, 섭취 모양의 측면에서 국소적, 미만성, 비대칭성의 섭취 양상을 인자로 분석하였다. 내시경 소견은 악성 병변, 염증성 병변, 비염증성 병변, 정상 소견으로 분류하였고, 염증성 병변은 다시 궤양, 위염(만성위염, 기타위염)으로 분류하였다. 통계적 분석은 t-test와 Mann Whitney test를 이용하였다. 결과: 악성 병변의 경우 시각적 섭취 정도에서 grade 4,5, max.SUV $7.95{\pm}4.38$로 높은 섭취 정도를 보였으며, 섭취 양상은 국소적 섭취 양상이었다. 이러한 기준에 따른 결과는 다른 병변들과 유의한 차이를 보였다. 염증성 병변, 비염증성 병변, 정상 소견에서는 시각적 섭취 정도가 grade$1{\sim}5$까지 다양하게 분포하였으며, 섭취 양상도 국소적, 미만성, 비대칭적인 다양한 양상이었다. 이러한 양성 염증성 병변, 비염증성 병변, 정상 소견 병변들 간에는 섭취 정도와 양상의 인자들 사이에 유의한 차이를 보이지 않았다. 결론: 위의 악성 병변은 양성 병변에 비해 높은 FDG 섭취 정도를 보이고 섭취 양상에 있어서는 대개가 국소적 섭취 양상이었다. 그러나 위의 양성 병변과 정상에서는 다양한 정도의 섭취 정도와 섭취 양상을 보여 주었고, 각 병변들간에 또는 정상의 생리적 섭취와 구별할 수 있는 소견은 제시하기 어려웠다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권sup1호
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• pp.83-92
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• 2008

Helicobacter pylori is the causative agent of chronic gastritis and has a role in the pathogenesis of peptic ulcer diseases, and gastric cancer. There have been reports suggesting a close link between these gastroduodenal disorders and a state of vitamin C deficiency. In this paper, the past, present and future perspectives on H. pylori infection and vitamin C will be discussed under the following view points. Since the ecological niche of H. pylori is the mucus layer and intercellular junctions of the gastric epithelium, the various kinds of host inflammatory cells motivated by the local and systemic immune responses cannot eliminate the microorganisms. When the invading foreign body is not removed, despite full activation of defense mechanisms, adverse consequences of the immune responses develop on the host gastric mucosa. The reasons for the body vitamin C depletion could be explained as follows; 1) the increased vitamin C consumption by increased oxygen free radical production through the prolonged hypersensitivity reactions in the gastric mucosa, 2) the increased vitamin C oxidation by the nitrite which is formed from nitrate reduction by the intragastric bacteria proliferated in the hypochlorhydric gastric cavity, 3) the strong ${\gamma}$-glutamyltranspeptidase activity of H. pylori which depletes the glutathiones in gastric mucosa. Depletion of glutathiones in the stomach favors irreversible oxidative destruction of ascorbic acid. Both persistent inflammatory burdens in the stomach by H. pylori and resultant vitamin C depletions synergistically and uninhibitedly might aggravate the hypothetical sequence of gastric carcinogenesis: atrophic gastritis${\rightarrow}$intestinal metaplasia${\rightarrow}$dysplasia${\rightarrow}$gastric adenocarcinoma. High intake of vitamin C could reverse the hypothetical sequence of the gastric carcinogenesis via direct and indirect effects on H. pylori and host-parasite relationships.

• Journal of Gastric Cancer
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• 제5권3호
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• pp.158-162
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• 2005

목적: 위암환자의 임상적 특성과 수술 전 혈중 pepsinogen I/II 비율의 결과를 비교 분석하여 위암 발생과 혈중 pepsinogen의 변화와의 관련성 및 혈중 pepsinogen의 위암 진단의 이용 가능성 여부를 밝히는 것이 본 연구의 목적이다. 대상 및 방법: 분당차병원에서 절제술을 받은 103명의 위선암 환자를 대상으로 수술 전 혈중 pepsinogen I과 II를 측정하고, 이 결과를 종양의 임상 및 조직학적 요소와 비교 분석하였다. 결과: Pepsinogen I/II 비율의 평균치는 mucinous type, 종양 주위에 위축이 있는 경우 및 종양이 큰 경우에 감소하였으며 종양주위에 위축이 있는 환자에서도 종양이 클수록 의미 있게 감소하였다. 암세포가 고분화를 보이는 환자가 인환세포암 환자에 비하여 pep I/II이 의미 있게 감소하였으나 종양의 위치,침윤도, 림프절 전이 여부 및 Lauren분류에 따른 종양의 아형은 pep I/II의 변화와 의미 있는 관련을 보이지 않았다. 결론: 본 연구의 결과는 혈중 pepsinogen과 점막위축 정도와의 연관성은 증명하였지만 이 결과만으로 pepsinogen과 위암의 전암 병소의 연관성이나 일차점진의 유용성을 논하기는 부족하다고 생각된다.