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( Yunju Jo ),( Eunkyoung Park ),( Sang Bong Ahn ),( Young Kwan Jo ),( Byungkwan Son ),( Seong Hwan Kim ),( Young Sook Park ),( Hyo Jeong Kim ) 대한소화기학회 2015 Gut and Liver Vol.9 No.5
Background/Aims: Proton pump inhibitors (PPIs) act by irreversibly binding to the H+-K+-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H+-ATPase in osteoclasts. Methods: We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H+-K+-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period. Results: Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridino-line (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age ≥60 years was an independent predictor for the changes in serum calcium and urine DPD. Conclusions: In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H+-ATPase in osteoclasts. (Gut Liver 2015;9:607-614)
최신 연구 소개 : 기능성 소화불량 환자에서 Amitriptyline의 효과
조윤주 ( Yunju Jo ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.4
기능성 위장질환에서 항우울제 등은 흔히 처방되는 약제이지만, 기능성 소화불량증(functiona dyspepsia, FD)에서는 이러한 약제들의 치료 효과에 대한 임상적 근거가 부족하다. 이번 연구에서는 FD 환자에서 증상, 위배출능, 식이에 의한 포만감 등에 대한 항우울제 치료 효과에 대해 평가하였다. 1 2006년 10월부터 2012년 10월까지 환자가 등록되었으며, Rome criteria II에 합당한 FD 환자를 대상으로, 8개의 북아메리카 다기관에서 진행되어 총 292명의 환자가 등록되었다. 등록된 환자는 무작위 배정되어 위약, 50 mg amitriptyline, 10 mg escitalopram을 각각 10주 동안 복용하였다. 약제의 투약 방법은 야간 취침 전 1회 복용이었다. 이 연구의 일차 유효성 평가항목은 지난 10주 투약 기간 동안 적어도 50% 증상의 완화(self report, yes/no) 였으며, 첫 2주의 결과는 제외하였다. 이차 유효성 평가 항목은 10주 투약 전후 의 위배출시간, 유동식 부하 포만감 검사(nutrient drink test) 에서 maximal tolerated volume, 삶의 질의 변화였다. 이번 연구 결과, 여성이 FD 환자의 75%, 백인이 86%를 차지하였으며 14%에서 Helicobacter pylori 항체가 양성이었다. 등록된 FD 환자의 70%는 dysmotiltiy-like FD였으며, 30%는 ulcer-like FD였다. Dysmotility-like FD 환자 204명 중, 22% (44명)에서 위배출능이 지연되었고, 57% (116명)에서 비정상적인 조기 포만감을 보였다. 292명 중 75%에서 12 주 투약을 완료하였으며, 각각 placebo, amitriptyline, escitalopram 77%, 80%, 67%에서 투약이 완료되었다. Intent-to treat 분석에서, 증상의 호전을 보인 정도는 위약군의 40%, escitalopram군의 38%, amitriptyline군에서 53%였으며 이는 유의한 차이를 보였다(p=0.05). 특히 ulcer-like FD 환자 에서, 위약군이나 escitalopram에 비하여(각각 39%, 27%) amitriptyline 투약군에서 67% 호전을 보였고, 이는 위약군에 비해 amitriptyline 투약군에서 교차비 3.1 (95% 신뢰구간: 1.1-9.0) 이상의 증상 호전을 보였다. 그러나 amitriptyline이나 escitalopram 어느 군에서도 투약 전후로 위배출 기능이나 maximal tolerated volume, 삶의 질의 유의한 차이를 관찰할 수 없었다. 이 연구의 결론은 다음과 같다. FD에서는 tricyclic antidepressants (TCAs) 계열인 amitriptyline이 증상 호전에 유의한 효과를 가지고 있으며, selective serotonin reuptake inhibitors (SSRIs) 계열에 포함되는 escitalopram에서는 그 러한 효과를 확인하지 못했다. 이러한 TCA 항우울제는 ulcer- like FD에서 통증 조절에 더 효과적이며, 지연된 위배출기능을 호전시키지는 못했다. Effect of Amitriptyline and Escitalopram on Functional Dyspepsia: A Multicenter, Randomized Controlled Study (Gastroenterology 2015;149:340-349.e2)
Gastric Emptying in Migraine: A Comparison With Functional Dyspepsia
( Yeon Hwa Yu ),( Yunju Jo ),( Jun Young Jung ),( Byung Kun Kim ),( Ju Won Seok ) 대한소화기기능성질환·운동학회 2012 Journal of Neurogastroenterology and Motility (JNM Vol.18 No.4
Background/Aims Gastric stasis in migraineurs remains controversial. The aim of this study is to investigate gastric emptying (GE) time, and any associations between GE parameters and dyspeptic symptoms among patients with functional dyspepsia (FD) and migraine without any gastrointestinal symptoms during the interictal period. Methods We enrolled 27 migraine patients, 32 FD patients and 12 healthy people as controls, and performed GE scintigraphy as gastric function test. Gastrointestinal symptoms were evaluated in the FD and migraine. Results The age-adjusted mean gastric half-emptying time in FD (125.51 ± 52.55 minutes) patients was longer than in migraineurs (100.82 ± 23.94 minutes, P = 0.035) and controls (95.25 ± 23.29 minutes, P = 0.021). The percentage of gastric retention was higher in FD than in migraine. However, migraineurs did not show an obvious delayed gastric emptying or an increase of gastric retention when compared to the normal controls. The association between each dyspeptic symptom and GE parameters was not significant, but postprandial fullness and early satiety showed a tendency of delayed GE. In migraineurs, GE time did not show significant association with nausea and vomiting during interictal periods. Conclusions Delayed GE does not appear to be a mechanism that patients with FD and migraine have in common. Migraineurs without dyspepsia during interictal period had normal GE, and further study for association with FD should be investigated. (J Neurogastroenterol Motil 2012,18:412-418)
Frankincense ameliorates endometriosis via inducing apoptosis and reducing adhesion
Min Kyoung Cho,Jung-Sook Jin,Yunju Jo,Jung Ho Han,Su Shin,Sung-Jin Bae,Dongryeol Ryu,Jongkil Joo,Jang-Kyung Park,Ki-Tae Ha 한국한의학연구원 2023 Integrative Medicine Research Vol.12 No.2
Background: Frankincense, a resin derived from trees of the Boswellia genus, has been used as an incense and a type of herbal medicine for treating inflammatory diseases such arthritis, chronic bowel illness, and asthma. While endometriosis is a well-known inflammatory gynecological illness caused by the ectopic attachment and development of uterine tissue over the menstrual cycle, the impact of frankincense on this illness is poorly understood. The purpose of this study was to explore the effects of frankincense on endometriosis. Methods: We used a network pharmacological assessment, in vitro and in vivo investigations with a human endometriotic cell line as well as a syngeneic uterine transfer mouse model. High-performance liquid chromatographic analysis was used to compare water-extracted frankincense (Fr) to its reference compounds and validate the sample. Results: A network pharmacological analysis suggested a positive effect of Fr on endometriosis. Fr relieved endometriosis by reducing ectopic endometrial adherence and development, according to both in vivo and in vitro models. We suggested that the ER stress/p53-apoptosis and chemokine-migration/adhesion pathways underlie Fr's anti-endometriotic action using RNA sequencing and bioinformatic analysis. Conclusion: This study revealed the potential effect of Fr on endometriosis using an experimental investigation. Fr may have the potential to be an effective and safe treatment for endometriosis.