• Title/Summary/Keyword: peptic ulcer disease

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The Influence of Comorbidities on Reoperations Following Primary Surgery of Lumbar Degenerative Diseases : A Nationwide Population-Based Retrospective Cohort Study from 2009-2016

  • Park, Hyung-Ki;Park, Su-Yeon;Lee, Poong-Hhoon;Park, Hye-Ran;Park, Sukh-Que;Cho, Sung-Jin;Chang, Jae-Chil
    • Journal of Korean Neurosurgical Society
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    • v.63 no.6
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    • pp.730-737
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    • 2020
  • Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.

Helicobacter pylori vacA d1 Genotype Predicts Risk of Gastric Adenocarcinoma and Peptic Ulcers in Northwestern Iran

  • Basiri, Zeinab;Safaralizadeh, Reza;Bonyadi, Morteza Jabbarpour;Somi, Mohammad Hossein;Mahdavi, Majid;Latifi-Navid, Saeid
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1575-1579
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    • 2014
  • Background: There is a close relationship between Helicobacter pylori (H pylori)-specific factors and different gastroduodenal diseases. The present study aimed to investigate the prevalence of vacA d1, d2 genotypes in the H pylori isolates from patients with gastric adenocarcinoma, peptic ulcer disease (PUD) and gastritis in East Azerbaijan region, where the incidence of gastric cancer (GC) is high. Strains isolated from this area are likely to be of European ancestry. Materials and Methods: In this study, genotyping of the vacA d region of 115 isolates obtained from patients with different gastrodoudenal diseases was accomplished by PCR methods. In addition to PCR amplification of H pylori 16S rDNA, rapid urease tests or histological examination were used to confirm the presence of H pylori in biopsy specimens. Data were collected and analyzed using SPSS version 19. Results: Of the total of 83 H pylori isolates, 36 (43.4%) contained the d1 allele and 47 (56.6%) were subtype d2. The results of the multiple linear/logistic regression analysis showed high correlation between allele d1 and gastric adenocarcinoma or PUD. Conclusions: This study suggests that the H pylori vacA d1 genotype helps predict risk for gastric adenocarcinoma and PUD in East Azerbaijan, Iran.

Gastric mucosal immune response of Helicobacter pylori-infected children (Helicobacter pylori 감염 소아에서 위점막 면역반응)

  • Yom, Hye Won;Seo, Jeong Wan
    • Clinical and Experimental Pediatrics
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    • v.51 no.5
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    • pp.492-499
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    • 2008
  • Purpose : Helicobacter pylori infection is one of the most common gastrointestinal infections worldwide; it almost invariably causes chronic gastritis. Pediatric studies may provide important insights into the mucosal immune response of H. pylori-infection, as children are not submitted to environmental factors such as alcohol, tobacco and anti-inflammatory medication. The aim of the present study was to investigate the mucosal immune response against H. pylori in clinically well-defined groups: H. pylori-positive (divided into peptic ulcer disease and gastritis) and H. pylori-negative control. Methods : Antral biopsies were obtained from 45 children undergoing an upper GI endoscopy for dyspeptic symptoms. T cells (CD3+, CD4+, CD8+) and B cells (CD20+) were analyzed by quantitative immunohistochemistry. The correlation of lymphocyte subsets of gastric mucosa with histology was evaluated. Results : T cells (CD3+, CD4+, CD8+) and B cells (CD20+) were significantly increased in the lamina propria of H. pylori-positive group (P<0.01). CD8+ T cells were significantly increased in the lamina propria of the H. pylori-positive peptic ulcer disease (P<0.01). Within the epithelium, only CD4+ T cells were significantly increased in the H. pylori-positive group (P<0.01). Gastric histological parameters had a closer correlation with lymphocytes in the lamina propria than intraepithelial lymphocytes. Conclusion : This study suggests that both T cells and B cells in the lamina propria play important roles in the local immune response of H. pylori-infected children. Furthermore, it remains to be elucidated whether CD8+ T cells in the lamina propria may contribute to peptic ulcer formation in H. pylori-infected children.

The Effect of Rebamipide on Cellular Release of Leukotriene $B_4$ by Helicobacter Pylori (Helicobacter pylori에 의해 호중구 및 위점막 세포로부터 유도되는 Leukotriene $B_4$의 생성에 미치는 Rebamipide의 영향)

  • Lee, Jung-Jin;Han, Bok-Gee;Ro, Jai-Youl;Rhee, Kwang-Ho;Youn, Hee-Shang;Kim, Mal-Nam;Chung, Myung-Hee
    • The Korean Journal of Physiology and Pharmacology
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    • v.1 no.6
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    • pp.825-830
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    • 1997
  • Leukotrienes(LTs) are hewn to act as a mediator provoking tissue response in inflammation. This finding implicates that LTs also play important roles in the pathogenesis of H, pylori-induced gastritis and gastric ulceration. Rebamipide is being currently used as a therapeutics for gastritis and peptic ulcer, but their mechanisms of action have not been known clearly yet. One possibility is that their therapeutic effects are ascribed to interfering with the H. pylori-induced release of LTs from neutrophils and gastric mucosal cells. In the present study, this possibility was tested using $LTB_4$ as the test material in human neutrophils and Kato III cells(gastric adenoma cells as a substitute for gastric mucosal cells). The release of $LTB_4$ from both neutrophils and Kato III cells was time and H. pylori-dose dependent. The maximum release of $LTB_4$ was induced by neutrophils and Kato III cells when these cells incubated with H. pylori $(4.8{\times}10^8\;cells/ml$ for 30min. But in the presence of rebamipide the release of $LTB_4$ from these cells was suppressed in dose dependent manners. The release was completely suppressed at 1.0 mM of rebamipide in neutrophils and 2.0 mM of this drug in Kato III cells, respectively. We also obtained the results that the release of $LTB_4$ was induced by A23187$(Ca^{2+}\;ionophore)$ and the A23187-induced release was also inhibited by rebamipide. It seems that the machanism of action of rebamipide is through its interaction with the level of intracellular $Ca^{2+}$. In view of the roles of $LTB_4$ in inflammatory reaction and the roles of H. pylori in gastritis and peptic ulcer, the effects of this drug observed in this study may contribute to their therapeutic action in these gastric disorders.

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The Diagnostic Significances of Serum Carcinoembryonic Antigen in Gastrointestinal Tract Cancers (위장종양(胃腸腫瘍)에 있어서 혈청(血淸) Carcinoembryonic Antigen의 진단적(診斷的) 의의(意義)에 관(關)한 연구(硏究))

  • Kim, Jong-Tae;Won, Kyung-Hee;Kim, Yul-Ja;Lee, Chong-Suk;Lee, Hak-Choong
    • The Korean Journal of Nuclear Medicine
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    • v.17 no.1
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    • pp.1-10
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    • 1983
  • Carcinoembryonic antigen (CEA) levels were measured in the serum of 35 normal control subjects and 179 cases of various benign and malignant gastrointestinal diseases. Malignant gastrointestinal tumors include 69 cases of stomach cancer, 24 cases of hepatoma and 33 cases of colorectal cancer. Benign gastrointestinal diseases include 29 cases of peptic ulcer and 24 cases of liver cirrhosis. The results were as followings: 1) Mean serum CEA level in normal control subjects was $6.9{\pm}3.3ng/ml$ and there was; no difference in mean serum CEA level between age and sex difference. 2) In malignant gastrointestinal tumors, mean serum CEA level in colorectal cancer, hepatoma and stomach cancer, were $54.3{\pm}88.9ng/ml,\;62.1{\pm}99.7ng/ml$ respectively. Serum CEA level showed positive rate of 67% in colorectal cancer, 63% in hepatoma and 62% in stomach cancer. There was no difference in mean levels and positivity of serum CEA between these 3 malignant tumor groups. 3) Positivity of serum CEA was 61% in malignant gastrointestinal tumor group in spite of 37% in benign gastrointestinal disease group. In both mean level and positivity of serum CEA, stomach cancer was much higher than peptic ulcer. But there was no difference in mean level and positivity of serum CEA level between hepatoma and liver cirrhosis. 4) In hepatoma serum CEA level showed positive rate of 62.5% and alpha-feto protein showed a rate of 58.3%. 5) Mean serum CEA levels in patients with cancer in rectal, cecal, sigmoid colon, ascending: colon and descending colon were $73.7{\pm}106.7ng/ml,\;69{\pm}84.8ng/ml$, $15.7{\pm}9.1ng/ml,\;7.5{\pm}10.6ng/ml$ and 4.0ng/ml respectively. Positive rate of serum CEA showed 86% in sigmoid. colon cancer, 68% in rectal cancer and 66% in cecal cancer. 6) In considering of histological background, there was no correlation between the degree of differentiation of tumor cell and the serum CEA level in colorectal cancer. According to Duke's classification, the mean serum levels of CEA were $8.8{\pm}11.4ng/ml$ in group A, $15.3{\pm}16.0ng/ml$ in group B and $68.5{\pm}101.5ng/ml$ in group C respectively. Positivity-of serum CEA in group A, Band C were 40%, 50% & 69% respectively. So there was significant correlation between the degree of elevation of serum CEA and tumor extension.

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A Case of Gastric Wall Hematoma and Ischemic Necrosis After Endoscopic Biopsy (상부 위장관 내시경조직검사 후 위벽에 발생한 출혈을 동반한 혈종 및 점막 괴사 1예)

  • Kim, You-Min;Lee, Jin-Sung;Kim, Dong-Hee;Sung, Young-Ho;Choi, Sun-Taek;Kim, Hyun-Tae;Lee, Hyun-Wook;Kim, Keung-Ok
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.159-164
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    • 2010
  • Hematoma of gastric wall is very rare, and occasionally associated with coagulopathy, trauma, peptic ulcer disease, and therapeutic endoscopy. Ischemic gastric necrosis is also rare because of the abundant anastomotic supply to the stomach, and it is usually associated with surgery and disruption of the major vessels. Endoscopic submucosal injection of hypertonic saline-epinephrine (HS-E) is a safe, cost-effective, and widely used therapy for hemostasis but it may cause tissue necrosis and perforation. We describe a case of gastric wall hematoma with oozing bleeding after endoscopic gastric mucosa biopsy in 71-year old woman with chronic renal failure and angina pectoris undergoing anti-platelet medication. We injected a small dose of HS-E (7ml) for controlling oozing bleeding. Two days later, endoscopy showed huge ulcer with necrotic tissue at the site of previously hematoma. Therefore we should pay particular attention for hematoma and mucosal necrosis when performing endoscopic procedure in a patients with high bleeding and atherosclerotic risk.

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The Effect of Omeprazole and Lansoprazole on the Susceptibility of Helicobacter pylori to Antimicrobial Agents (오메프라졸과 란소프라졸의 혼합으로 인한 헤리코박터파이로리에 대한 항생제의 감수성 변화)

  • Bang, Sung Hye;Lee, Suk Hyang;Suh, Ok Kyung;Shin, Hyun Taek;Cho, Kyung Joo;Rhie, Ho Gun
    • Korean Journal of Clinical Pharmacy
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    • v.7 no.1
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    • pp.40-44
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    • 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.

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Detection of Helicobacter pylori in Saliva of Patient with Oral Lichen Planus (구강 편평태선 환자의 타액에서 Helicobacter pylori의 검출)

  • Ryu, Ji-Won;Kang, Seung-Woo;Yoon, Chang-Lyuk;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.33 no.3
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    • pp.241-246
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    • 2008
  • 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.

Pharmacological properties of the reversible inhibitor of the gastric $H^+/K^+$ ATPase, AU-164

  • Kim, Hyo-Jung;Yum, Eul-Kgun;Choi, Jong-Kwon;Cheon, Hyae-Gyeong
    • Biomolecules & Therapeutics
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    • v.5 no.3
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    • pp.228-232
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    • 1997
  • AU-164 was synthesized as a reversible gastric $H^+/K^+$ ATPase inhibitor, and its effects were tested in various systems. AU-164 inhibited rabbit gastric $H^+/K^+$ ATPase with an $IC_{50}$/ of 9 $\mu$M. On the other hand, AU-164 was a weak inhibitor for dog kidney $Na^+/K^+$ ATPasc, indicating the selectivity for gastric $H^+/K^+$ ATPase. The reversible property of the AU-164-induced inhibition of $H^+/K^+$ ATPase was confirmed by filtering the inhibition mixture through Sephadex G-25M column. In vivo basal acid secretion was also inhibited by AU-164 under the pylorus ligation of Sprague-Dawley rats. In addition, AU-164 protected dose dependently gastric lesion induced by ethanol in rats. The $ED_{50}$ value of 62 mg/kg p.o was estimated. These results suggest that AU-164 is a potent, selective and reversible gastric $H^+/K^+$ ATPase inhibitor, and that AU-164 has a potential use for the clinical therapeutics of peptic ulcer disease.

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A study on the correlation of Chiljung(七情) with chronic recurrent abdominal pain in children (소아의 만성 반복성 복통과 칠정(七情)과의 관계에 대한 문헌적 고찰)

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Lee, Seoung-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.1
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    • pp.139-152
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    • 2004
  • Objective: The aim of this study was to find about relation between Chiljung(七情) and chronic recurrent abdominal pain in children. Methods: It was surveyed the oriental medical book concerning Chiljung(七情) and western medical book concerning Chronic recurrent abdominal pain. Results: Chronic recurrent abdominal pain which is common disorder in children is mostly functional abdominal pain due to stress. The Stress can be defined as spiritual factor which lead to imbalance of body homeostasis in medicine. In oriental medicine, it is considered as Chiljung(七情) disorder. The gastrointestinal disease due to stress are peptic ulcer, chronic gastritis, irritable bowel syndrome, chronic abdominal pain, vomitting etc. In oriental medicine pathology mechanism, it is considered as discord with liver and spleen, depression of spleen-energy. It comes within the category of depression. Children with chronic recurrent abdominal pain is dependent on parents and they have an introspective nature, compulsive idea which is intolerable for failure.

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