• Title/Summary/Keyword: ulcers

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Various Diagnostic Methods for Helicobacter pylori Infection (헬리코박터 파일로리 감염의 다양한 진단법)

  • Han Jo Jeon;Hyuk Soon Choi
    • The Korean Journal of Medicine
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    • v.99 no.2
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    • pp.104-110
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    • 2024
  • Helicobacter pylori (H. pylori) is a bacterium that colonizes the human stomach, leading to various gastrointestinal diseases including gastritis, peptic ulcers, and gastric cancer. There is no gold standard test that relies entirely on one method in H. pylori diagnosis. We must be aware of the pros and cons of various testing methods to perform an appropriate test according to the situation. Accurate diagnosis and eradication therapy are essential for disease management. Diagnostic methods include invasive techniques like tissue biopsy and rapid urease test, as well as non-invasive tests such as urea breath test, serology test, and stool antigen test. Each method has its advantages and limitations, requiring careful consideration in clinical practice. Understanding these diagnostic tools is crucial for effective H. pylori management and prevention of associated complications.

Current status and clinical outcome of endoscopic hemostatic powder in gastrointestinal bleeding: a retrospective multicenter study

  • Zie Hae Lim;Seung In Seo;Dae-Seong Myung;Seung Han Kim;Han Hee Lee;Selen Kim;Bo-In Lee
    • Clinical Endoscopy
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    • v.57 no.5
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    • pp.620-627
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    • 2024
  • Background/Aims: Few multicenter studies have investigated the efficacy of hemostatic powders in gastrointestinal (GI) bleeding. We aimed to investigate the clinical outcomes of hemostatic powder therapy and the independent factors affecting rebleeding rates. Methods: We retrospectively recruited patients who underwent a new hemostatic adhesive powder (UI-EWD; Next-Biomedical) treatment for upper and lower GI bleeding between January 1, 2020 and March 1, 2023. We collected patients' medical records and bleeding lesions. The primary outcomes were clinical and technical success rates, and the secondary outcomes were early and delayed bleeding rates refractory bleeding rate, mortality rate, and factors affecting early rebleeding rates. Results: This study enrolled 135 patients (age: 67.7±13.6 years, male: 74.1%) from five hospitals. Indications for UI-EWD were peptic ulcers (51.1%), post-procedure-related bleeding (23.0%), and tumor bleeding (19.3%). The clinical and technical success rates were both 97%. The early, delayed, and refractory rebleeding rates were 19.3%, 11.1%, and 12.8%, respectively. Initially elevated blood urea nitrogen (BUN) levels (p=0.014) and Forrest classification IA or IB compared with IIA or IIB (p=0.036) were factors affecting early rebleeding. Conclusions: UI-EWD showed high clinical and technical success rates; however, rebleeding after UI-EWD therapy in patients with initially high BUN levels and active bleeding, according to the Forrest classification, should be considered.

The Effects of Sea Cucumber as an Anti-gastritis, Anti-gastric Ulcer, and Anti-Helicobater (해삼의 항위염, 항위궤양 및 항헬리코박터 효과)

  • Oh, Hong-Geun;Moon, Dae-In;Kim, Jung-Hoon;Kang, Young-Rye;Park, Jung-Woo;Seo, Min-Young;Park, Sang-Hoon;Kang, Yang-Gyu;Choe, Chung-Hyeon;Park, In-Sun;Kim, Ju;Yu, Kang-Yeol;Seol, Eu-Ddeum;Kim, Ok-Jin;Lee, Hak-Yong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.5
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    • pp.605-611
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    • 2012
  • Sea cucumber, $Stichopus$ $japonicus$, is used not only as an outstanding tonic food but also as a traditional medicine for the treatment of asthma, hypertension, rheumatism, anemia, and sinus congestion. The purpose of this study was to examine sea cucumber as an anti-gastritis and anti-gastric ulcer in HCl-ethanol-induced gastric and $H.$ $pylori$-infected animal models. Thirty 7-week-old SD rats and Mongolian gerbils were divided into normal (Nor, n=6), control (Con, 60% HCl-ethanol+water, n=6), groupI (DSCI, 60% HCl-ethanol+sea cucumber 30 mg/kg, n=6), groupII (DSCII, 60% HCl-ethanol+sea cucumber 100 mg/kg, n=6), and group III (DSCIII, 60% HCl-ethanol+sea cucumber 300 mg/kg, n=6). Sea cucumber significantly suppressed gastric lesions and ulcers in the 60% HCl-ethanol-induced gastric model. Especially, 100 mg/kg of sea cucumber showed significantly inhibitory effects. In histopathological analysis of the $H.$ $pylori$ model, we found that sea cucumber augmented the eradication rates of $H.$ $pylori$ and attenuated gastric ulcer formation. Our results suggest that sea cucumber has inhibitory effects on gastritis and gastric ulcers. In addition, sea cucumber can be applied for the treatment of $H.$ $pylori$.

Surgical Treatment for Chronic Peptic Ulcer with Gastric Outlet Obstruction (만성 소화성 궤양에 합병된 위출구 폐색의 수술적 치료)

  • Lee, Jei Hee;Yang, Shi Joon;Jeon, Young Woong;Park, Sei Hyeog;Kim, Jong Heung;Park, Jong Min
    • Journal of Gastric Cancer
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    • v.8 no.3
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    • pp.160-165
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    • 2008
  • Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

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Preventive Effect of LS-RUG-com-a Mixture of Rubus crataegifolius, Ulmus macrocarpa, and Gardenia jasminoides-on Gastric Disorders in Animal Models (산딸기, 유백피, 치자 추출물의 임상용 복합제제의 동물 실험모델에서의 위 질환 억제활성)

  • Young Ik Lee;Ahtesham Hussain;Md Aziz Abdur Rahman;Ho Yong Sohn;Hye Jung Yoon;Jin Sook Cho
    • Journal of Life Science
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    • v.33 no.11
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    • pp.923-935
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    • 2023
  • Rubus crataegifolius (RC), Ulmus macrocarpa (UM), and Gardenia jasminoides (GJ) are well-known folk medicines in Asia used to treat various gastrointestinal disturbances. The present study evaluated the gastroprotective effect of LS-RUG-com, a mixture of commercially prepared powders of RC, UM, and GJ with a ratio of 3:1:2(w/w/w) against HCl/ethanol-induced gastritis, indomethacin-induced ulcers, and esophageal reflux-induced esophageal mucosal damage and Helicobacter pylori infections. In addition, TNF-α and IL-1β expressions were also determined and measured in esophageal tissue. As to HCl/ethanol-induced gastritis, the LS-RUG-com treatment at a dose of 150 mg/kg showed a remarkable anti-gastritis effect. Regarding indomethacin-induced gastric ulcers, the LS-RUG-com treatment had a significant anti-gastric ulcer effect. Furthermore, in the gastroesophageal reflux disease (GERD) model experiment, the LS-RUG-com treatment resulted in the histological recovery of stomach damage and mucosal injuries. Furthermore, the LS-RUG-com treatment led to an increase in gastric content pH, an increase in mucus protection, and a decrease in gastric pepsin output with a significant decrease in TNF-α and IL-1β. As to the Helicobacter pylori infected animal model, LS-RUG-com had a notable inhibitory effect on Helicobacter growth. The use of RC, UM, or GJ in isolation or the LS-RUG-com treatment as whole had good effects in terms of anti-oxidation, anti-neutralization, gastric acid secretion inhibition, and anti-lipid peroxidation, which supported the use of natural products as systemic gastric protective agents. Our results suggest that the LS-RUG-com might be a significant systemic gastroprotective agent that could be utilized for the treatment and/or protection from gastric disturbances and related damage.

A Study on Antiulcer Effects of Opuntia dillenii Haw. on Stomach Ulcer Induced by Water-immersion Stress in Rats (랫드의 스트레스성 위궤양에 대한 Opuntia dillenii Haw.(선인장)의 항궤양작용에 관한 연구)

  • 이후장;이용욱;김정현
    • Journal of Food Hygiene and Safety
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    • v.13 no.1
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    • pp.53-61
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    • 1998
  • This study was performed to investigate the antiulcer effects of Opuntia dillenii Haw. on the stomach ulcer induced by restraint and water-immersion stress in rats. For this experiment, 48 male Sprague-Dawley strain were used. The experimental groups were divided into four: a control (C) and 3 Opuntia dillenii Haw. treatment groups (E-1, E-2, E-3). Each dose of Opuntia dillenii Haw. was 30 mg/kg bw (E-1), 60 mgfKg bw (E-2) and 120 mg/kg bw (E-3). The rats were allocated to each group by 12 and observed for 4 weeks. The results were as following: 1. The stomach surface pH in each group showed no significant difference, but the values of Opuntia dillenii Haw. treatment groups were higher than the value of the control group. 2. The gastric wall mucus was increased in all Opuntia dillenii Haw. treatment groups compared with the control group. Especially in E-1 difference was higher (p<0.05) and in E-2 difference was significantly higher (p<0.01). 3. At shear rate 11.25, 45.0, 90.0, $225\;sec^{-1}$, whole blood viscosity and plasma viscosity were measured. Most of the values of Opuntia dillenii Haw. treatment groups were low compared with that of the control group. At shear rate 90.0, $225\;sec^{-1}$ the values of whole blood viscosity in E-1 were significantly low (p<0.05) and at shear rate 11.25, $45.0\;sec^{-1}$, more significant (p<0.01). At shear rate 11.25, 45.0, 90.0, $225\;sec^{-1}$ the values of whole blood viscosity in E-2 were significantly low (p<0.01). At shear rate $90.0\;sec^{-1}$ the value of plasma viscosity in E-1 was significantly low (p<0.05) and at shear rate 90.0, $225\;sec^{-1}$ the values of plasma viscosity in E-2 we resignificantly low (p<0.01). 4. Less severe ulcers were obsered in Opuntia dillenii Haw. treatment groups than in the control group. Especially E-1 groups tissues had only slight ulcers and necrosis of tissue was not observed in this group. From the results of this study, it can be concluded that the oral administratio-n of Opuntia dillenii Haw. results in protection of stomach ulcer by stimulating the secretion of gastric mucus and improving the gastric mucosal microcirculation.

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Clinical Manifestations of the Lung Involvement in Behçet's Syndrome (Behçet 증후군에서 폐침범의 임상양상에 관한 고찰)

  • Park, Kwang Joo;Park, Seung Ho;Kim, Sang Jin;Kim, Hyung Jung;Chang, Joon;Ahn, Chul Min;Kim, Sung Kyu;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.763-773
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    • 1996
  • Background : Behçet's syndrome is a chronic multisystemic disease affecting many organs such as skin, mucosa, eye, joint, central nervous system and blood vessels. Lung involvement occurs in 5% of Behçet's syndrome and is thought to be due to the pulmonary vasculitis leading to thromboembolism, aneurysm and arteriobronchial fistula. Pulmonary vasculitis in Behçet's syndrome is a unique clinical feature, differing from other vasculitis affecting the lung and is one of the major causes of death. Therefore, we examined the incidence, the clinical features, the radioloic findings and the clinical courses of the lung involvement in Behçet's syndrome. Methods: We retrospectively reviewed the medical records and radiologic studies of 10 cases of the lung involvement in Behçet's syndrome diagnosed at Yongdong Severance Hospital and Severance Hospital from 1986 to 1995. We analysed the clinical features, the radiological findings, the treatment modalities and the clinical courses. Results: 1) The incidence of the lung involvement in Behçet's syndrome was 2%(10/487). The male to female ratio was 8 : 2 and the mean age was 34 years. The presenting symptom was hemoptysis in 5 of 10 cases, and massive hemoptysis was noted in 2 cases. Other pulmonary symptoms were cough(6/10), dyspnea(4/10), and chest pain(2/10). Other manifestations were oral ulcers(10/10), genital ulcers(9/10), skin lesions(7/10), and eye lesions(6/10). 2) The laboratory findings were nonspecific. The posteroanterior views of chest radiographies showed multiple infiltrates(6/10), nodular or mass-like opacities(4/10), or normal findings(2/10). The chest CT scans showed multifocal consolidations(6/8), and aneurysms of the pulmonary aneries(4/8). The pulmonary angiographies were performed in 3 cases, and showed pulmonary artery aneurysms in 2 cases. The ventilation-perfusion scans in 2 cases of normal chest x-ray showed multiple mismatched findings. 3) The patients were treated with combination therapy consisting of corticosteroids, cyclophosphamide, and colchicine or anticoagulant agents. Surgical resection was performed in one case with a huge aneurysm. 4) We have followed up nine of ten cases. Three cases are well-being with medical therapy, two cases are severely disabled now and four cases died due to massive hemoptysis, massive pulmonary embolism, or sepsis. Conclusion : Pulmonary vasculitis is a main feature of the lung involvement of Behçet's syndrome, causing hemorrhage, aneurysmal formation, and/or thromboemboism. The lung involvement of Behçet's syndrome is uncommon but is one of the most serious prognostic factors of the disease. Therefore, an aggressive diagnostic work-up for early detection and proper treatment are recommended to improve the clinical course and the survival.

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A Study on Wound Healing Factors in Diabetic Foot Ulcer Patients (당뇨발 궤양을 가진 환자에서의 창상치유인자에 대한 조사)

  • Gu, Ja Hea;Han, Seung-Kyu;Chang, Hyun;Lee, Byoung Il;Kim, Woo Kyung
    • Archives of Plastic Surgery
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    • v.34 no.5
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    • pp.543-550
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    • 2007
  • Purpose: Diabetic foot ulcer is a representative disease of chronic would with multiple defects of wound healing factors. Many nutrition factors have been known to be essential for wound healing, but objective data are lacking. The purpose of this study is to determine those factors essential for wound healing, and to find out which of those factors are lacking in diabetic foot ulcer patients through this pilot study. Methods: We studied 100 patients who visited our clinic from March 2005 to February 2006 for treatment of diabetic foot ulcers with a duration of more than 6 weeks. We checked serum levels of protein, albumin, vitamin A, C, E, iron, magnesium, zinc, copper and hemoglobin by drawing 23cc blood after 8 hours of fasting. Protein, albumin, iron, magnesium levels were measured by colorimetry; hemoglobin levels were measured by auto analysis. Vitamin levels were measured by high performance liquid chromatography (HPLC), copper and zinc levels were measured by Inductively coupled plasma (ICP). They were compared with normal values. The patients were divided by transcutaneous oxygen pressure levels, age and sex to study the effects of these parameters. Results: 76% and 61% of patients had within-normal range serum protein and albumin levels, respectively. Among vitamins, only the level of vitamin C was low in 55% of the patients. Levels of vitamin A, E were normal or high in 93% and 100% of patients. As for trace elements, levels of iron and zinc were low in 63% and 60% of patients, but levels of magnesium and copper were usually normal or high. Levels of vitamin C, iron and zinc were lower in the low-transcutaneous oxygen pressure group. There were no definite differences according to age and sex. Conclusion: Serum levels of Hb, vitamin C, iron, zinc were low in most diabetic foot ulcer patients. The deficit was very severe in the low-transcutaneous oxygen pressure group.

Immuno-stimulating and Antitumor Effects on Mouse Sarcoma 180 by Crude Polysaccharides Extracted from Fruiting Body of Hericium erinaceus (노루궁뎅이(Hericium erinaceus) 자실체 추출 조다당류의 생쥐 Sarcoma 180에 대한 면역증강 및 항암 효과)

  • Choi, Yon-Il;Lee, Jae-Seong;Lee, U-Youn;Lee, Tae-Soo
    • Journal of Life Science
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    • v.20 no.4
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    • pp.623-631
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    • 2010
  • Hericium erinaceus, an edible and medicinal mushroom belonging to the Basidiomycota family, has been used for curing gastric ulcers and stomach cancers in human beings and is also known to have good inhibitory effects on sarcoma 180 and Ehrlich carcinoma in mice. Neutral saline soluble (0.9% NaCl), hot water soluble and methanol soluble substances (hereinafter referred to as Fr. NaCl, Fr. HW and Fr. MeOH, respectively) were extracted from the fruiting body of the mushroom. In in vitro cytotoxicity tests, crude polysaccharides were not cytotoxic against cell lines such as Sarcoma 180, HepG2, HT-29 and NIH3T3 at concentrations of $10{\sim}2,000\;{\mu}g/ml$. Intraperitoneal injection with crude polysaccharides exhibited a life prolongation effect of 29.1~54.1% in mice previously inoculated with Sarcoma 180. Fr. Na increased the numbers of spleen cells by 2.9 fold at a concentration of $50\;{\mu}g/ml$ compared with the control. Fr. Na improved the immuno-potentiating activity of B lymphocytes by increasing alkaline phosphatase activity by 5.5 fold compared with the control at a concentration of $200\;{\mu}g/ml$. Fr. NaCl increased the numbers of peritoneal exudate cells and circulating leukocytes by 4 and 2.3 folds at a concentration of 50 mg/kg, respectively. Therefore, the crude polysaccharides extracted from the fruiting body of H. erinaceus could improve antitumor activities in mice.

Effect of Fruit Extract of Prunus mume on the Scavenging Activity of Reactive Oxygen Species and Melanin Production in B16F1 Cells (매실추출물이 활성산소종 소거효과와 B16F1 세포에서 멜라닌 생성에 미치는 영향)

  • Park, Hyeong-Joon;Kim, Moon-Moo;Oh, Yung-Hee
    • Journal of Life Science
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    • v.22 no.7
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    • pp.936-942
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    • 2012
  • Prunus mume has been traditionally used as a medicinal food in Korea, Japan, and China. In particular, this fruit has been reported to have beneficial biological effects on gastritis and gastric ulcers. However, its action in relation to skin whitening has remained unclear. Accordingly, the effects of fruit extract of P. mume related to antioxidation and skin whitening were examined in this study. First, using the MTT assay, it was observed that fruit extract of P. mume below 0.1% has no cytotoxicity in B16-F1 cells as a result of cell viability. Second, the direct scavenging effects and the reducing power of the fruit extract of P. mume were evaluated in vitro on DPPH radicals, hydrogen peroxide, and superoxide. It exhibited high reducing power and scavenging activity on the aforementioned reactive oxygen species. Furthermore, we found that its protective effect against genomic DNA damage related to oxidative stress was increased in a dose-dependent manner. In addition, the fruit extract of P. mume had an inhibitory effect on melanin production induced by L-dopa. In addition, it reduced the expression level of NRF-2, SOD-1, and SOD-2 related to antioxidation in western blot analysis. These results suggest that fruit extract of P. mume could exert a whitening effect through inhibition of melanin production by its antioxidant effect.