소화성궤양과 위암에서 Helicobacter pylori 의 검출빈도

성자원(Ja Won Sung),육은주(Eun Ju Yook),임의혁(Euyi Hyeog Im),김병호(Byeong Ho Kim),이기천(Ki Cheon Lee),허승식(Seoung Sik Heo),정현용(Hyun Yong Jeong),이헌영(Heun Young Lee),김영건(Young Kun Kim) 대한내과학회 1993 대한내과학회지 Vol.45 No.1

N/A Background: It is clear that gastric colonization by H. pylori is extremely common among patients with peptic ulcer, particularly when this involves the duodenal mucosa. The precise frequency of H, pylori in various gastroduodenal conditions varies somehow, but there is unanimity in confirming a strong association among H. pylori, chronic gastritis, and ulceration. Furthermore atrophic gastritis has been reported to be a precursor lesion for gastric cancer. So we estimated the prevalences of H. pylori infection, and serum gastric level in peptic ulcer and gastric cancer. Methods: The specimens were obtained by endoscopic biopsy of the gastric antrum from 40 patients with duodenal ulcer, 38 patients with gastric ulcer and 47 patients with gastric cancer. The urease activity was analyzed for 24 hours on the basis of Campylobacter-like organism test(CLO test). A change in color of the urea broth from yellow-gold to pink-red was interpreted as a positive result. Results: 1) The prevalence of H. pylori infection was significantly higher in duodenal ulcer (75.0%) than in gastric ulcer (52.6%) and in gastric cancer (38.3%, p<0.05). 2) The mean age of positive groups of CLO test among total 125 cases was significantly younger (49 years) than the negative groups (63 years, p<0.05), In each diseases, gastric cancer and duodenal ulcer were also significantly younger in the positive groups than the negative groups(p<0.05). But there was no significant difference between two groups in gastric ulcer. 3) Duodenal ulcer patients with positive CLO test had significantly the lower gastrin level when compared to patients with negative CLO test (p<0.05). In contrst, patients with gastric cancer or gastric ulcer with positive CLO test had trend of higher gastrin level when compared to patients with negative CLO teat. Conclusions: There is a strong association between H, pylori and duodenal ulcer, The influence of H. pylori infection on serum gastrin may be different between gastric disease and duodenal ulcer.

Diversity of the Gastric Microbiota in Thoroughbred Racehorses Having Gastric Ulcer

( Hee-jin Dong ),( Hungwui Ho ),( Hyeshin Hwang ),( Yongbaek Kim ),( Janet Han ),( Inhyung Lee ),( Seongbeom Cho ) 한국미생물 · 생명공학회 2016 Journal of microbiology and biotechnology Vol.26 No.4

Equine gastric ulcer syndrome is one of the most frequently reported diseases in thoroughbred racehorses. Although several risk factors for the development of gastric ulcers have been widely studied, investigation of microbiological factors has been limited. In this study, the presence of Helicobacter spp. and the gastric microbial communities of thoroughbred racehorses having mild to severe gastric ulcers were investigated. Although Helicobacter spp. were not detected using culture and PCR techniques from 52 gastric biopsies and 52 fecal samples, the genomic sequences of H. pylori and H. ganmani were detected using nextgeneration sequencing techniques from 2 out of 10 representative gastric samples. The gastric microbiota of horses was mainly composed of Firmicutes (50.0%), Proteobacteria (18.7%), Bacteroidetes (14.4%), and Actinobacteria (9.7%), but the proportion of each phylum varied among samples. There was no major difference in microbial composition among samples having mild to severe gastric ulcers. Using phylogenetic analysis, three distinct clusters were observed, and one cluster differed from the other two clusters in the frequency of feeding, amount of water consumption, and type of bedding. To the best of our knowledge, this is the first study to investigate the gastric microbiota of thoroughbred racehorses having gastric ulcer and to evaluate the microbial diversity in relation to the severity of gastric ulcer and management factors. This study is important for further exploration of the gastric microbiota in racehorses and is ultimately applicable to improving animal and human health.

위궤양환자에서 Rebamipide의 자유산소유리기제거에 의한 궤양치료효과

박수헌(Soo Heon Park),정운태(Woon Tae Jung),서정한(Jung Han Suh),정명희(Myung Hee Chung),정인식(In Sik Chung),이용찬(Yong Chan Lee),박인서(In Suh Park),송근암(Guen Am Song),양웅석(Ung Suk Yang),유종선(Jong Sun Rew),윤종만(Chong Mann 대한소화기학회 1997 대한소화기학회지 Vol.29 No.5

N/A Background/Aims: Helicobacter pylori has been shown to be an important pathogen of gastric disorder including gastritis and gastric ulcer. One of the potential toxic factors involving gastric mucosal cell injury is reactive oxidants, which are released from activated neutrophils. Rebamipide had been reported to promote mucus synthesis, mucosal prostaglandin content, and rapid ulcer healing, It has recently been reported to inhibit the production of oxygen derived free radicals from stimulated neutrophils. We conducted this study to evaluate the effects of rebamipide on gastric ulcer healing and reactive oxygen metabolite production. Methods: In this multicenter study conducted in Korea, combination treatment of rebamipide and ranitidine was compared with ranitidine alone in 108 patients with gastric ulcer patients. Pre- and post-treatment endoscopic findings and concentration of reactive oxygen metabolite produced were used to evaluate efficacy. The efficacy of rebamipide and ranitidine versus ranitidine was evaluated using endoscopy results, and tissue lipid peroxides by thiobarbituric acid and myeloperoxide concentration. Results: The percentage of ulcer size reduction was significantly higher with rebamipide and ranitidine group than with placebo and ranitidine group(size reduction: 71.5% vs 58.3% P=0.04556). The myeloperoxidase activities at ulcer margin in rebamipide and ranitidine group patients were 96.7+-13.4 unit/mg protein in baseline and 53.8+9.9 unit/mg protein in follow up (P=0.0065). The myeloperoxidase activities at ulcer margin in placebo and ranitidine group patients were 90.2+9.1 unit/mg protein in baseline and 63.1+6.7 unit/mg protein in follow up (P=0.0668). The thiobarbituric acid activities at ulcer margin in rebamipide and ranitidine group patients were 34.7+5.3 nmol of MDA/mg protein in baseline and 24.1W3.1 nmol of MDA/mg protein in follow up. The thiobarbituric acid activities at ulcer margin in placebo and ranitidine group patients were 14.8+1.5 nmol of MDA/mg protein in baseline and 24.3+2.7 nmol of MDA/mg protein in follow up (P=0.0059). The thiobarbituric acid activities at ulcer margin in H. pylori positive and negative patients were 28.1+2.1 nmol of MDA/mg protein and 25.3+4.7 nmol of MDA/mg protein, respectively. The myeloperoxidase activities at ulcer margin in H. pylori positive and negative patients were 79.9+5.3 unit/mg protein and 40.4+25.3 unit/mg protein, respectively (P=0.0001). The cumulative relapse rate was examined starting at 24 week after ulcer treatment. The rate was lower in rebamipide and ranitidine group patients, but insignificantly(19.2% vs 27.3%, P=0.0857). Conclusions: These results suggest that rebamipide promote gastric ulcer healing by decreasing reactive oxygen metabolite production in patients with gastric ulcer. (Korean J Gastroenterol 1997;29:569-578)

한국인의 소화성 궤양에 대한 임상적 고찰

이동필(Dong Pil Lee),정영태(Yeong Tae Jeong),이재복(Jae Bok Lee),고우석(Woo Suk Ko),이선희(Sun Hee Lee),신영민(Young Min Shin),송근암(Geun Am Song),조몽(Mong Cho),양웅석(Ung Suk Yang),문한규(Han Kyu Moon) 대한내과학회 1995 대한내과학회지 Vol.48 No.6

N/A Objectives: Although the peptic ulcer is a benign disease, it has relatively high incidence and recurrence rate in Koreans. It is important to understanding the current characteristics of peptic ulcer disease because that helps us to diagnose and treat and expect the exact prognosis of peptic ulcer disease. Methods: The clinical observation of the peptic ulcer was done retrospectively using medical records and protocl in 893 peptic ulcer patients who were diagnosed with gastroduodenoscopy at eight medical school hospitals in Korea during recent 10 years, Results: In 893 peptic ulcer patients, gastric ulcers were 499(55.9%) cases, duodenal ulcers were 319(35.7%) cases, and combined gastric and duodenal ulcers were 75(8.5%) cases. The incidence of duodenal ulcer was higher before forties and lower after forties than that of gastric ulcer. Among the peptic ulcer patients, males were 645/893 cases(72.2%) and females were 248/893 cases(29.8%) and the ratio of males and females was 2.6:1. The seasonal incidence of peptic ulcer was not remarkable except slightly lower in the fall. There was no special difference in the incidence of peptic ulcer between the alcoholics and nonalcolics. Regard in blood types, peptic ulcer was more common in the blood type O group than others. The location of gastric ulcer showed as 54.7% in body, 25.6% in angle, 19.7% in antrum. The location of duodenal ulcer showed as 57.5% in the anterior wall of bulb, 28.0% in lesser curvature, 11.4% in posterior wall and 3.0% in greater curvature. The single ulcer was noted 68.6% in gastric ulcer, 80.2% in duodenal ulcer. The complication rate was 38.2% in peptic ulcer and the bleeding was the most common with 73.6% of total complications(gastric ulcer 54.5%, duodenal ulcer 46.7%) followed by perforation(19.6%) and pyloric obstruction(6.4%). The recurrence rate of peptic ulcer was 51.6%(54.5% in gastric ulcer, 46.7% in duodenal ulcer). Conclusion: We analized the peptic ulcer disease in 893 patients using medical records and protocol. We report the characteristics of current peptic ulcer disease in koreans.

胃癌 및 胃潰瘍에서 나타나는 異形成의 形態學的 比較檢索

黃奎興,郭精植,李東久 慶北大學校 醫科大學 1985 慶北醫大誌 Vol.26 No.4

胃癌發生의 形態學的 前段階라고 알려진 異形成이 胃癌 및 胃潰瘍에서 어떠한 頻度와 分布를 가지는지를 分析하여 胃癌組織發生의 一端 및 胃潰瘍과 癌과의 關係를 究明하고자 外科的으로 切除한 胃癌 107例와 胃潰瘍 84例를 組織構築的으로 檢索한 結果를 要約하면 다음과 같다. 胃內 部位別로 癌이나 潰瘍 모두 小彎의 中央部에 가장 흔하였으며 幽門部에서는 癌의 頻度가 더 높았다. 胃潰瘍은 84.6%가 4㎝미만이었으나 4㎝以上도 15.4%가 있었고 깊이는 潰瘍이 클수록 깊어지는 傾向이었다. 胃癌은 63.6%가 6㎝ 以上이었으며 潰瘍形成은 4㎝미만이 33.3%, 4∼6㎝사이가 55.6%, 6㎝以上이 70.6%로서 癌가 커질수록 潰瘍形成이 많았다. 胃癌과 胃潰瘍 周邊粘膜에는 病巢에서 조금 떨어진 곳에 慢性萎縮性胃炎과 腸上皮化生이 흔히 觀察되었으며 異形成은 주로 病巢에 隣接하여 나타났고 幽門部에 더 넓게 分布하고 있었다. 異形成同伴率은 胃潰瘍이 2㎝ 미만에서 64.4%, 2∼4㎝사이는 69.2%, 4㎝以上은 92.3%였으며 胃癌은 4㎝미만이 83.3%, 4∼6㎝사이가 88.9%, 6㎝以上은 97.1%로서 全體的으로 胃潰瘍에서 보다 胃癌에서 훨씬 많이 異形成을 同伴하고 있었으나 모든 胃癌이 異形性을 가지지는 않았고 胃潰瘍에서도 높은 頻度의 異形成을 나타내었다. 以上의 成績으로 보아 胃癌은 形態學的으로 반드시 異形成의 과정을 거친다고 할 수는 없지만 異形成은 胃癌을 誘發하는데 하나의 可能性있는 病變으로 생각된다. 따라서 異形成을 同伴하는 胃潰瘍은 다른 조건이 부합되면 胃癌으로 進行될 수도 있다고 推定된다. This study was designed to examine the histogenesis of gastric cancer and the relationship between gastric cancer and chronic gastric ulcer. The frequency and distribution of dysplasia known for precancerous lesion were analyzed by investigating 107 cases of gastric cancer and 84 cases of ulcer topographically. The results obtained were as follows: The gartric cancer and ulcer tended to occur most frequently in middle third of lesser curvature as far as the regional distribution was concerned. The ulcer tended to be deeper in proportion to its size. The ulcer of less than 4㎝ was 84.6% ; that of more than 4㎝ 15.4%, while the cancer of more than 6㎝ was 63.6%. The ulcer formation in cancer was more frequent in proportion to the size of cancer lesions: the rates of ulcer formation were 33.3% in less than 4㎝, 55.6% in those of 4-6㎝ and 70.6% in those of more than 6㎝. The atrophic gastritis and intestinal metaplasia were frequently observed in the surrounding mucosa near the gastric cancer and ulcer. Dysplasia which was more widely distributed in the pyloric region occurred adjacent to the lesions, As far as the dysplasia-accompanying rate was concerned, the ulcer of less than 2㎝ was 64.4%; that of 2-4㎝ 69.2%; that of more than 4㎝ 92.3%. And the cancer of less than 4㎝ was 83.3%; that of 4-6 88.9%; that of more than 6㎝ 97.1%. The dysplasia was more frequently noted in the cancer than in the ulcer. However, it was not always to accompany dysplasia in gastric cancers. In conclusion, it seemed that the gastric cancer didn't necessarily pass through the process of dysplasia pathologically. Yet the dysplasia seemed to become the potential lesion in developing cancer. Therefore it was assumed that the ulcer accompanying dysplasia might developed into the cancer.

한국인의 위궤양 및 십이지장궤양 환자에서 Helicobacter pylori 감염 빈도

장명국(Myoung Kuk Jang),김학양(Hak Yang Kim),조병동(Byung Dong Cho),장웅기(Woong Ki Jang),김동준(Dong Jun Kim),김용범(Yong Bum Kim),박충기(Choong Kee Park),신형식(Hyung Sik Shin),유재영(Jae Young You) 대한내과학회 1997 대한내과학회지 Vol.52 No.4

N/A Objectives: Peptic ulcer is the major condition that affect numerous individuals every year. In 1983, Warren and Marshall presented the evidence that H. pylori was associated with gastritis and peptic ulcer. Thereafter, K. pylori infection is thought to be a important factor in the pathogenesis of gastric and duodenal ulcer. In western studies, about 58% to 100% of patients with peptic ulcer disease were infected with H. pylori. But in Korea, there is no study about the prevalence of H. pylori infection in peptic ulcer disease despite of its high prevalence and importance. The aim of this study was to investigate the prevalence of H. pylori infection in case of gastric and duodenal ulcer disease in Korea. Methods - We surveyed the prevalence of H. pylori infection of 1031 patients, who were diagnosed as gastric or duodenal ulcer by gastrofiberoscopy. H. pylori infection was evaluated with Rapid Urease Test(CLO test) and/or histology by Wright-Giemsa staining. Results: 1) Peptic ulcer was more frequently developed in males than females, as the frequency of peptic ulcer was 77% in males, and 23% in females. But in view of the prevalence of H. pylori infection, there was no significant difference between males and females, 73% in males and 71% in females. 2) Gastric ulcer was most common in sixth decade(29.8%), but the prevalence of H. pylori infection was peak in fourth(76%), and fifth decade (73%). 3) Duodenal ulcer was most common in fourth decade(26.3%), but the prevalence of H. pylori infection was peak in teenagers(93%) and third decade(87%). 4) The patients who had both gastric ulcer and duodenal ulcer concurrently were most common in sixth decade(27.9%), but the prevalence of H, pylori infection was peak in third decade(100%). Conclusion: We concluded that the majority of peptic ulcer patients in Korea had H. pylori infection. Particularly, young aged patients had higher H. pylori infection rate than old aged.

Cell-type Specific Activation of MAPKs in the Progression of Gastric Ulcer in Rats

유리,권영삼,오태호,김태환,박상준 한국임상수의학회 2013 한국임상수의학회지 Vol.30 No.5

Mitogen-activated protein kinases (MAPKs) are a family of central signaling molecules that respond to numerous stimuli and are known to participate in processes of cell survival and death. However, it is not clear on data for cell-type specific activation of MAPKs in the progression of gastric ulcer. In the present study, we assessed how MAPKs localized at various cell types during the progression of gastric ulcer induced by ibuprofen. Gastric ulcer was induced by the repeated treatment of 200 mg/kg ibuprofen with 8 hrs interval in a day. Animals were sacrificed at 24 hrs, 48 hrs, and 72 hrs after oral treatment of ibuprofen and gastric tissues were subjected to immunohistochemical and immunoblotting evaluation. Immunoreactivity of phospho-extracellular signal-regulated kinase (p-ERK) was mainly expressed at the proliferating zone of gastric mucosa in control rats. But, these signals for p-ERK were highly shifted from cells of proliferating zone to parietal cells of the basal regions 24 hrs after treatment of ibuprofen. p-ERK signal was strongly expressed in epithelial cells adjacent to ulcer margin and new capillary and infiltrated inflammatory cells within granulation tissue of the ulcer base above 48 hrs after treatment of ibuprofen. While, phospho-c-Jun NH2 terminal kinase (p-JNK) was mainly localized to the nuclei of the surface epithelial cells and the glandular epithelial cells in early gastric injury. Also, p-JNK was often observed as a scattered pattern in different regions of gastric mucosa with early gastric injury. Gradually, signal of p-JNK was strongly stained in infiltrated inflammatory cells and fibroblasts within severe ulcer base. Phospho-p38 (p-p38) MAPK was observed as scattered pattern within connective tissues of gastric mucosa. Especially, p-p38 MAPK showed strong signal in infiltrated macrophages within ulcer base. These results show that each MAPK has a specific role in various cell types during the progression of gastric ulcer.

Comparative effect of silkworm powder from 3 Bombyx mori varieties on ethanol-induced gastric injury in rat model

( Da-young Lee ),( Jae-min Cho ),( Sun-mi Yun ),( Kyung-sook Hong ),( Sang-deok Ji ),( Jong-gon Son ),( Eun-hee Kim ) 한국잠사학회 2017 International Journal of Industrial Entomology Vol.35 No.1

Gastric ulcer is a clinical symptom characterized by inflammation of the gastric mucosa. Stress and alcohol consumption have been identified as the major cause of gastric ulcer. However, the effects of silkworms on ethanol-induced gastric ulcer have not been studied yet. The mature silkworms that are difficult to eat have become easier to ingest due to recent technological development to make steaming and freeze-drying mature silkworm larval powder (SMSP). In this study, we investigated whether three silkworm varieties, Baekokjam, Golden-silk and Yeonnokjam could alleviate ethanol-induced gastric mucosal damage in vivo . Sprague-Dawley rats pretreated with 3 SMSPs (0.1 or 1 g/kg BW) or normal diet (AIN- 76A) were exposed to absolute ethanol (3 g/kg BW, 3 h) by oral gavage. Morphological examination included ulcer index as a measurement of hemorrhages and hematoxylin and eosin staining was performed to analyze the severity of gastric ulcer. Results of macroscopic examination suggested that all 3 SMSPs pretreatment significantly protected gastric mucosa against ethanol-induced damage. Microscopic observations demonstrated significant mucosal erosion and inflammation in ethanol-treated rats, which was abrogated in rats pretreated with 3 SMSPs. In addition, pretreatment with all 3 SMSPs showed significant decreases the expression of pro-inflammatory mediators, IL-6 and cyclooxygenase-2. Among SMSP from 3 varieties of silkworm, preadministration of 1 g/kg Baekokjam SMSP showed the most effective protective effect against ethanol-induced gastric ulcer. These results suggest that Baekokjam SMSP can be a potential gastroprotective agent against ethanol-induced gastric ulcer.

Protective Effect of Platycodin D in the Acute Gastric Ulcer Induced by Ibuprofen in Rats

유리,신원호,김솔,손규희,곽동미,김상룡,류시윤,박상준 한국임상수의학회 2013 한국임상수의학회지 Vol.30 No.1

Acute gastric ulcer is caused by the unbalance between cell proliferation and apoptosis in gastric mucosa. Platycodin D (PD) has been reported to have a variety of pharmacological properties, including antioxidant and antiinflammatory effect. In the present study, we investigated the protective effect of PD on the basis of cell proliferation/apoptosis and cyclooxygenase-2 (COX-2) expression in the acute gastric ulcer induced by ibuprofen in Rats. Acute gastric damage was induced by the repeated treatment of ibuprofen (200 mg/kg) with 8 hrs interval in a day. PD was orally administrated at concentrations of 2.5 and 5 mg/kg every day for 5 days before the induction of acute gastric ulcer. Macroscopically, ibuprofen caused a significant increase in the number of lesions in the gastric mucosa. But pretreatment of PD significantly reduced ibuprofen-induced gastric lesion score and prevented excessive mucus depletion in gastric mucosa. Also, pretreatment of PD counteracted significantly Ki-67 decrease in the proliferating zone of gastric glandular portion and highly reduced or delayed apoptotic cells on TUNEL assay. In addition, COX-2 expression was increased in gastric mucosa bearing erosions or ulcers but pretreatment of PD reduced COX-2 expression in gastric lesions. These results show that pretreatment of PD has a protective effect against ibuprofen-induced gastric damage,not only by counteracting a decrease of cell proliferation, but also by inhibiting or delaying apoptosis via regulation of COX-2 within the gastric mucosa.

Protective Effect of 4-(3,4-Dihydroxyphenyl)-3-Buten-2-One from Phellinus linteus on Naproxen-Induced Gastric Antral Ulcers in Rats

( Jeong Hwan Kim ),( Hyun Ju Kwon ),( Byung Woo Kim ) 한국미생물 · 생명공학회 2016 Journal of microbiology and biotechnology Vol.26 No.5

The present study investigated the protective effect of naturally purified 4-(3,4- dihydroxyphenyl)-3-buten-2-one (DHP) from Phellinus linteus against naproxen-induced gastric antral ulcers in rats. To verify the protective effect of DHP on naproxen-induced gastric antral ulcers, various doses (1, 5, and 10 μg/kg) of DHP were pretreated for 3 days, and then gastric damage was caused by 80 mg/kg naproxen applied for 3 days. DHP prevented naproxen-induced gastric antral ulcers in a dose-dependent manner. In particular, 10 μg/kg DHP showed the best protective effect against naproxen-induced gastric antral ulcers. Moreover, DHP significantly attenuated the naproxen-induced lipid peroxide level in gastric mucosa and increased the activities of radical scavenging enzymes, such as superoxide dismutase, catalase, and glutathione peroxidase, in a dose-dependent manner. A histological examination clearly demonstrated that the gastric antral ulcer induced by naproxen nearly disappeared after the pretreatment of DHP. These results suggest that DHP can inhibit naproxen-induced gastric antral ulcers through prevention of lipid peroxidation and activation of radical scavenging enzymes.