A randomized controlled trial assessing Korea red ginseng treatment of Helicobacter pylori-associated chronic gastritis / 대한내과학회지

BACKGROUND: As Korea red ginseng has been reported to show a significant protective effect against H. pylori-induced cytotoxicity and DNA damage in vitro, we designed a study to assess the efficacy of red ginseng treatment in patients with H. pylori-associated chronic gastritis. METHODS: A total of 84 patients with H. pylori-associated chronic gastritis were recruited and randomly divided into two groups. During the trial, 34 patients out of 42 patients in the placebo control group and 36 patients out of 42 patients in the red ginseng group completed the protocol. The patients received a one week triple therapy for the eradication of H. pylori and then received either placebo capsules that were composed of flour for the placebo group or red ginseng capsules for the treatment group, which were administered for 10 weeks. An endoscopic examination of gastritis with a visual analogue scale, a test for detection of H. pylori, immunohistochemistry of 8-OHdG, the 8-OHdG immunohistochemical staining for assessing oxidative DNA damage and TUNEL staining for apoptosis were performed, respectively. RESULTS: H. pylori eradication rates were augmented in the red ginseng group as compared to the placebo group (91.7% in the red ginseng group and 79.4% in the placebo group), but there was no statistical significance (p=0.147). For an analysis of gastritis based on Updated Sydney System, the red ginseng group showed significant improvement in neutrophil infiltrations (p=0.008) and intestinal metaplasia (p=0.005). An attenuation of 8-OHdG immunohistostaining after treatment was seen more frequently in the red ginseng group (p<0.001). An attenuation of DNA damage and apoptosis was seen for the red ginseng group as compared to the placebo group (p<0.001). CONCLUSIONS: Supplementary administration of red ginseng augmented eradication rates of H. pylori, attenuated gastric inflammation, and reduced oxidative DNA damage and apoptosis, suggesting the clinical usefulness of red ginseng.

A Case of a Retained Surgical Sponge Diagnosed by Colonoscopy / 대한소화기내시경학회지

Gossypibomas, retained surgical sponges are prone to creat adhesions and to encapsulate, or to provoke an exudative response, with or without accompanying bacterial infection. Often a process of transmural migration can occur and we experienced a case which was diagnosed by colonoscopy. A 24 year-old female patient who had a history of Cesarean section 4 months ago came to the hospital with a complaint of intermittent right lower quadrant pain. A thread of surgical sponge was found by colonoscopy from ascending colon to cecum. At laparotomy, a transmurally migrating surgical sponge through the colonic fistula at the cecal base with surrounding abscess cavity was found. Adding a case report, the fate of intraperitoneal forgotten surgical sponges is reviewed.

Prevalence of HBV Genotypes in Korean Patients with Chronic Hepatitis B / 대한간학회지

BACKGROUND/AIMS: Hepatitis B virus (HBV) genotypes have distinct geographic distributions. The possibility of pathogenic differences among HBV genotypes has been suggested. We investigated the prevalence of HBV genotypes in Korea and the association between distinct genotypes and clinical outcomes. METHODS: Using a PCR-RFLP and sequencing, HBV genotypes were determined in 136 patients with chronic type B hepatitis. RESULTS: The genotype C was detected in 131 patients (96.3%), and other 5 patients (3.7%) had genotype B. There were no significant differences in sex, age, disease duration, ALT level, HBeAg/anti-HBe status, or HBeAg loss between genotype B and C patients. CONCLUSIONS: These results suggest that almost all patients with chronic hepatitis B are infected with genotype C. Genotypes do not influence the outcome of chronic hepatitis B patients in Korea.

Assessment of Right Ventricular Function in Patients with Chronic Obstructive Pulmonary Disease Using Echocardiographic Tei Index / 결핵

BACKGROUND: Advanced chronic obstructive pulmonary disease is characterized by progressive pulmonary hypertension leading to right heart dysfunction, which plays a important role in clinical evaluation but remains difficult and challenging to quantify. The noninvasive doppler echocardiographic value referred to as the Tei index has been suggested as a simple, reproducible and reliable parameter of the right ventricular function. The purpose of this was to assess the right ventricular function in patients with chronic obstructive pulmonary disease using the Tei index and to evaluate its relationship with the pulmonary functional status. METHODS: The study population comprised of 26 patients with chronic obstructive pulmonary disease and 10 normal control subjects. The Tei index was obtained by dividing the sum of the isovolumetric contraction and the relaxation tines by the ejection time using a pulsed-wave doppler. It was compared with the other available Doppler echocardiographic parameters of systolic or diastolic and with the pulmonary function of the patients. RESULTS: The Tei indices of the patients with COPD were significantly higher than those of normal subjects (0.45±0.17 vs. 0.27±0.03, p<0.01). The isovolumetric contraction time/ejection time(0.32±0.08 vs. 0.25±0.05, p<0.05), the isovolumetric relaxation time/ejection time(0.29±0.16 vs. 0.15±0.08, p<0.05) and the preejection period/ejection time (0.46±0.10 vs. 0.38±0.06, p<0.05) were prolonged and the ejection time (255.2±32.6 vs. 314.2±16.5 msec, p<0.05) was significantly shortened in patients with COPD compared to normal subjects. The tei indices were inversely correlated with the FEV1(r=-0.46, p=<0.05) and were prolonged significantly in patients with a severe obstructive ventilatory dysfunction(less than 35% of predicted FEV1) compared to those with a mild and moderate ventilatory dysfunction. The tei indices showed an inverse correlation with the ejection time (r=-0.469), the isovolumetric contraction time/ejection time(r=0.453), the isovolumetric relaxation time/ejection time(r=0.896) and the preejection period/ejection time(r=0.480). CONCLUSION: The tei index appeared to be a useful noninvasive means of evaluating the right ventricular function. It revealed a significant correlation with the pulmonary function in patients with COPD.

A case of allogeneic bone marrow transplantation in Gaucher's disease type III and recovery of enzyme activity documented by Fluorescence-Activated Cell Sorter (FACS) analysis / 대한내과학회지

Gaucher's disease (GD) is the most common inherited lysosomal storage disease, manifested by generalized accumulation of glucocerebroside in macrophages of the reticuloendothelial system due to a deficient lysosomal beta-glucocerebrosidase (GC). It is inherited by an autosomal recessive pattern in which three clinical phenotypes have been described based on the presence and severity of neurologic involvement. GD is treated possible by GC enzyme replacement therapy, allogeneic bone marrow transplantation (BMT), and gene therapy. We here report the exprience of successful allogeneic BMT in a 16-year-old female patient with GD type III which was demostrated markedly increased Gaucher cells in bone marrow and absence of GC activity in peripheral blood monocytes by FACS using 5'- pentafluorobenzoylaminofluorescein-di-beta-D-glucoside (PFBFDGlu) as substrate. Donor marrow engraftment was confirmed by chromosome analysis using microsatellite and by bone marrow examination. Assay of GC activity using FACS revealed normal level of enzyme activity. She remains alive and well after 12 months of BMT.

Expression of phospholiapse C isozymes in human lung cancer tissues / 결핵

BACKGROUND: Phospholipase C (PLC) plays an important role in cellular signal transduction and is thought to be critical in cellular growth, differentiation and transformation of certain malignancies. Two second messengers produced from the enzymatic action of PLC are diacylglycerol(DAG) and lnositol 1, 4, 5-trisphosphate(IP3). These two second messengers are important in down stream signal activation of protein kinase C and intracelluar calcium elevation. In addition, functional domains of the PLC isozymes, such as Src homology 2(SH2) domain, Src homology 3(SH3) domain, and pleckstrin homology(PH) domain play crucial roles in protein translocation, lipid membrane modification and intracellular memrane trafficking which occur during various mitogenic processes. We have previously reported the presence of PLC-γ1, γ2, β1, β3, and δ1 isozymes in normal human lung tissue and tyrosine-kinase-independent activation of phospholipase C-γisozymes by tau protein and AHNAK. We had also found that the expression of AHNAK protein was markedly increased in various histologic types of lung cancer tissues as compared to the normal lungs. However, the report concerning expression of various PLC isozymes in lung cancers and other lung diseases is lacking. Therefore, in this study we examined the expression of PLC isozymes in the paired surgical specimens taken from lung cancer patients. METHODS: Surgically resected lung cancer tissue samples taken from thirty seven patients and their paired normal control lungs from the same patients. The expression of various PLC isozymes were studied. Western bolt analysis of the tissue extracts for the PLC isozymes and immunohistochemistry was performed on typical samples for localization of the isozyme. RESULTS: In 16 of 18 squamous cell carcinomas, the expression of PLC-γ1 was increased. PLC-γ1 was also found to be increased in all of 15 adenocarcinoma patients. In most of the non-small cell lung cancer tissues we had examined, expression of PLC-δ1 was decreased. However, the expression of PLC-δ1 was markedly increased in 3 adenocarcinomas and 3 squamous carcinomas. Although the numbers were small, in all 4 cases of small cell lung cancer tissues, the expression of PLC-δ1 was nearly absent. CONCLUSION: We found increased expression of PLC-γ1 isozyme in lung cancer tissues. Results of this study, taken together with our earlier findings of AHNAK protein-a putative PLD-γ, activator-over-expression, and the changes observed in PLC-δ1 in primary human lung cancers may provide a possible insight into the derranged calcium-inositol signaling pathways leading to the lung malignancies.