In vitro and in vivo anti-Helicobacter pylori activities of FEMY-R7 composed of fucoidan and evening primrose extract / 한국실험동물학회지

Effects of FEMY-R7, composed of fucoidan and evening primrose extract, on the bacterial growth and intragastric infection of Helicobacter pylori as well as gastric secretion were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1x10(8) CFU/mL) was incubated with a serially-diluted FEMY-R7 for 3 days. As a result, FEMY-R7 fully inhibited the bacterial growth at 100 microg/mL, which was determined to be a minimal inhibitory concentration. In addition, 6-hour incubation with H. pylori, FEMY-R7 inhibited urease activity in a concentration-dependent manner, showing a median inhibitory concentration of 1,500 microg/mL. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (5x10(9) CFU/mouse) 3 times at 2-day intervals, and simultaneously, orally treated twice a day with 10, 30 or 100 mg/kg FEMY-R7 for 7 days. In Campylobcter-like organism-detection test and bacterial identification, FEMY-R7 exerted a high bacteria-eliminating capacity at 30-100 mg/kg, comparably to 30 mg/kg pantoprazole. In contrast to a strong antacid activity of pantoprazole in a pylorus-ligation study, FEMY-R7 did not significantly affect gastric pH, free HCl, and total acidity, although it significantly decreased fluid volume at a low dose (10 mg/kg). The results indicate that FEMY-R7 eliminate H. pylori from gastric mucosa by directly killing the bacteria and preventing their adhesion and invasion, rather than by inhibiting gastric secretion or mucosal damage.

Anti-Helicobacter pylori effects of IgY from egg york of immunized hens / 한국실험동물학회지

Effects of egg york containing IgY specific for Helicobacter pylori on the bacterial growth and intragastric infection were investigated in comparison with a proton-pump inhibitor pantoprazole. For in vitro anti-bacterial activity test, H. pylori (1x108 CFU/mL) was incubated with a serially diluted IgY for 3 days. As a result, IgY fully inhibited the bacterial growth at 16 mg/mL, which was determined to a minimal inhibitory concentration. In vivo elimination study, male C57BL/6 mice were infected with the bacteria by intragastric inoculation (1x108 CFU/mouse) 3 times at 2-day intervals, and 2 weeks later, orally treated twice a day with 50, 100, 200 or 500 mg/kg IgY for 18 days. After the final administration, biopsy sample of the gastric mucosa was assayed for the bacterial identification via urease, oxidase, catalase, nitrate reduction and H2S tests in addition to microscopic examination for mucosal inflammation. In CLO kit test, 75, 50, 12.5 and 12.5% of the animals revealed positive reaction following treatment with 50, 100, 200 and 500 mg/kg IgY, respectively, resulting in a superior efficacy at 200 mg/kg than 30 mg/kg pantoprazole that displayed 75% elimination. The CLO test results were confirmed by bacterial identification. Microscopic examination revealed that H. pylori infection caused severe gastric mucosal inflammation, which were not observed in the CLO-negative mice following treatment with IgY or pantoprazole. Taken together, IgY inhibited the growth of H. pylori, and improved gastritis and villi injuries by eliminating the bacteria from the stomach. The results indicate that IgY could be a good candidate overcoming tolerance of antibiotics for the treatment of H. pylori-mediated gastric ulcers.

Changes in the Prevalence of Biopsy-proven Helicobacter pylori Infection in Korean Children with Functional RecurrentAbdominal Pain Over the Last 18 Years / 대한소아소화기영양학회지

PURPOSE: The aim of this study was to evaluate observed changes in the prevalence of biopsy-proven Helicobacter pylori infection in Korean children with functional recurrent abdominal pain during the past 18 years. METHODS: Between July 1991 and December 2008, 1,194 children with functional recurrent abdominal pain (499 males and 695 females) 9.2+/-3.1 years of age were included. Upper gastrointestinal endoscopies were performed in all patients. H. pylori infection was assessed by the CLO test. Changes in the prevalence of the endoscopic diagnosis of H. pylori infection during 18 years were analyzed. RESULTS: The prevalence of H. pylori infection between 1991 and 1993, 1994 and 1996, 1997 and 1999, 2000 and 2002, 2003 and 2005, and 2006 and 2008 were 25.1% (56/223), 23.1% (45/195), 19.3% (28/145), 16.1% (39/242), 11.3% (24/213), and 10.8% (19/176), respectively; these serial decreases in the prevalence over 18 years were statistically significant (p<0.001). Regardless of gender and age, the prevalence of H. pylori infection decreased. This decrease was inversely related to socioeconomic improvement as represented by the per capita gross national income growth of Korea. CONCLUSION: The prevalence of H. pylori infection has decreased significantly for the past 18 years in Korean children. This decrease might be caused by an improvement in socioeconomic status.

Relationship of Helicobacter pylori Infection with Appetite

BACKGROUND: It has been reported that H.pylori causes changes in fundic leptin levels and plasma levels of ghrelin, and that eradication of H.pylori infection can increase appetite. There is also a report that showed changes of appetite between before and after eradication of H.pylori in peritoneal dialysis patients. Our study investigated the degree of appetite between H.pylori negative group and H.pylori positive group in adults. METHODS: The subjects included those without appetite- related diseases. We carried out gastroscopy and then performed CLO test in subjects who had no gastric lesions. We interviewed the study subjects about appetite related behavior (three items: desire to eat, hunger before meal, deliciousness) using visual analogue scale. We examined the appetite related behavior between CLO (??) group and CLO (+) group. RESULTS: The difference of age, sex, height, weight, body mass index, alcohol con sumption, blood pressure, hemoglobin, fasting blood sugar, AST, ALT, GGT between CLO (??) group and CLO (+) group were not statistically significant. The difference of appetite related behavior (three items) between CLO (??) group and CLO (+) group was not statistically significant. CONCLUSION: The degree of appetite between CLO (??) group and CLO (+) group was not different.

Evaluation of Asan Helicobacter Test for Diagnosis of Helicobacter pylori Infection / 대한임상미생물학회지

BACKGROUND: Helicobacter pylori is the single most common pathogen that causes chronic bacterial infection in human. The authors designed a new type of urease detection method (Asan Helicobacter test) that can be used for rapid early detection of H. pylori as well as a transport medium. This medium has a strong acidity with a minimal concentration of urea for the purpose of the detection of H. pylori. The current study was to evaluate the bacteriological and clinical usefulness of this medium. METHOD: 252 antral biopsies from patients underwent upper gastrointestinal endoscopies in Inha University Hospital were inserted Asan Helicobacter Test and CLO test. 37 antral biopsies from patients underwent upper gastrointestinal endoscopies in Konyang University Hospital were inserted Asan Helicobacter Test. Biopsies were cultured on nonselective media only. RESULT: The sensitivity and specificity of the Asan Helicobacter test were comparable with the CLO test (88.0% and 94.0%, respectively), and the results agreed in 99.2% of 252 cases with the CLO test. With this transport medium, all 23 specimens that showed positive reaction among 37 patients yielded satisfactory isolation of H. pylori. CONCLUSION: These findings suggest that the reagent in the kit inhibit the growth of microbial contaminant due to low pH and do not suppresses growth of H. pylori due to low concentration of urea. This kit may be used as a transport medium as well as a rapid urease test for H. pylori.

The Diagnostic Usefulness of Endoscopic Findings and Detection Rates of CLO and HpKit Test for Helicobacter pylori Infection in Children

PURPOSE: We performed this study to evaluate the diagnostic usefulness of endoscopic finding of nodular gastritis, CLO and HpKit test for H. pylori infection in children. METHODS: Gastroduodenal endoscopy and mucosal biopsy were performed on 212 children who visited our hospital between Jul. 1999 and May 2000 due to abdominal pain. We performed CLO and HpKit test for H. pylori with the time interval of 15, 30 minutes, 1, 2, 3, 24, 48, 72, 96, 120 and 144 hours. Histological examination of H. pylori was made by H-E or Alcian yellow stain with biopsy specimens. Sensitivity, specificity, positive predictive and negative predictive value of nodular gastritis, CLO and HpKit test were calculated from the analysis of above data. RESULTS: Sensitivity and specificity of 3 hour-CLO test was 68.4% and 100% respectively. Sensitivity and specificity of 3 hour-HpKit test was 65.8% and 100% respectively. No significant difference in sensitivity and specificity was found between in 3 hour-CLO and HpKit test(P>0.05). Sensitivity of CLO test increased as time lapsed, but corresponding specificity did not decrease as time lapsed(sensitivity and specificity at 144 hours : 89.5% and 94.8% respectively). However, sensitivity of HpKit test increased as time lapsed, but specificity markedly decreased. Sensitivity and specificity of the nodular gastritis was 78.9% and 93.7% respectively. CONCLUSION: Both CLO and HpKit test have relatively low sensitivity and specificity for the detection of H. pylori in 3 hours of testing in children. The endoscopic finding of nodular gastritis is another good standard in the diagnosis of H. pylori infection in children.

Association between Helicobacter pylori and Colorectal Neoplasm

PURPOSE: Helicobacter pylori infection has been reported as a major factor of chronic gastritis, peptic ulcer, gastric lymphoma, and stomach cancer. In some uncontrolled studies, a high seroprevalence of H. pylori infection unexpectedly has been found in patients with colorectal cancer. The purpose of this study was to investigate the prevalence of H. pylori infection in patients with colorectal neoplasm. METHODS: 93 colonic tissue samples were collected during the colonoscopic biopsy. The specimens included polyp, cancer, and normal colonic mucosa. The CLO testTM kit (Delta West Ltd., Bentley, Western Australia) was used for detection of H. pylori. The SAS program (USA) was used for the Fisher's exact test. RESULTS: H. pylori infection was detected 11 (11.8%) of total 93 specimens, 7 (25.7%) of 27 in cancers and 3 (6.9%) of 43 in polyps. Significantly higher H. pylori infection was detected in the colorectal cancers than non-cancer lesions (p=0.012) and polyps (p=0.038). CONCLUSIONS: These results suggest a statistically significant association between H. pylori and colorectal neoplasm. The mechanism underlying this association needs to be investigated.

Can the C-14 Urea Breath Test Reflect the Extent and Degree of Ongoing Helicobacter pylori Infection? / 대한핵의학회잡지

PURPOSE: The C-14 urea breath test (C-14 UBT) is the most specific noninvasive method to detect Helicobacter (H) pylori infection. We investigated if the C-14 UBT can reflect the presence and degree of H. pylori detected by gastroduodenoscopic biopsies (GBx). MATERIALS AND METHODS: One hundred fifty patients (M:F=83:67, age 48.6+/-11.2 yrs) underwent C-14 UBT, rapid urease test (CLO test) and GBx on the same day. For the C-14 UBT, a single breath sample was collected at 10 minutes after ingestion of C-14 urea (137 KBq) capsule and counting was done in a liquid scintillation counter for 1 minute, and the results were classified as positive ( 200 dpm), intermediate (50~199 dpm) or negative (<50 dpm). The results of CLO tests were classified as positive or negative according to color change. The results of GBx on giemsa stain were graded 0 (normal) to 4 (diffuse) according to the distribution of H. pylori by the Wyatt method. We compared C-14 UBT results with GBx grade as a gold standard. RESULTS: In the assessment of the presence of H. pylori infection, the C-14 UBT global performance yielded sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 92.5%, 88.4%, 97.1%, 88.4% and 91.3%, respectively. However, the CLO test had sensitivity, specificity, PPV, NPV and accuracy of 83.2%, 81.4%, 91.8%, 81.4% and 82.7%, respectively. The quantitative values of the C-14 UBT were 45+/-27 dpm in grade 0, 707+/-584 dpm in grade 1, 1558+/-584 dpm in grade 2, 1851+/-604 dpm in grade 3, and 2719+/-892 dpm in grade 4. A significant correlation (r=0.848, p<0.01) was found between C-14 UBT and the grade of distribution of H. pylori infection on GBx with giemsa stain. CONCLUSION: We conclude that the C-14 UBT is a highly accurate, simple and noninvasive method for the diagnosis of ongoing H. pylori infection and reflects the degree of bacterial distribution.

Usefulness of Giemsa Staining and Campylobacter-Like Organism (CLO) Test Following Helicobacter pylori Eradication Therapy / 대한소화기내시경학회지

BACKGROUND/AIMS: Follow-up studies with low sensitivity and specificity make it difficult to predict precisely long-term effect of H. pylori eradication therapy. The aim of this prospective study was to evaluate the usefulness of Giemsa staining and CLO test following eradication therapy. METHODS: In this study, H. pylori eradication therapy was done in 99 consecutive peptic ulcer patients and followed at 1, 6, and 12 months. Follow-up diagnosis was performed by Giemsa staining and CLO test using 6 specimens taken from the gastric antrum and midbody. Eradication was considered if the results of the two tests were negative. RESULTS: Overall the results of 63 (64%) patients among 99 patients who followed more than 6 months did not changed including 9 persistent positive, and 54 negative. However, the result of 36 patients changed to 21 positive and 15 negative conversion after 6 months. The estimated sensitivity, specificity, positive predictive value, negative predictive value of the Giemsa staining and CLO test, using PCR and culture as 'gold standard', were 67%, 85%, 82%, 70%, respectively. CONCLUSIONS: Sensitivity and specificity of Giemsa staining and CLO test following eradication therapy are lower than other reports. It is suggested that the large, multicenter prospective study is necessary to prove diagnostic accuracy of those follow-up studies.

Home-made Rapid Urease Test for Detection of Helicobacter pylori Infection / 대한임상미생물학회지

BACKGROUND: The rapid urease test has been widely used for detection of Helicobacter pylori infection because it is easy, simple and rapid result. The CLO test and PyloriTek test observe color changes after the gastric biopsy specimens are inerted into the test kits. Because H. pylori is not evenly distributed in the gastric mucosa, grinding or mincing of gastric specimens prior to culture enhances isolation rate of H. pylori. Therefore, we evaluated the effects of rubbing the gastric biopsy specimens onto the urea soaked filter paper in this home-made rapid urease test. METHODS: Forty-three patients referred for upper gastrointestinal tract endoscopy were evaluated for H. pylori infection. The home-made rapid urease test was prepared by soaking a piece of Whatman No. 2 filter paper in 2% urea agar. We compared the results of the home -made rapid urease test with histologic examination, gram stain, CLO test and culture. RESULTS: Of forty-three patients, 28 were found to be H. pylori-positive either by gram stain or by culture. The sensitivity and specificity of CLO test, based on the results of gram stain and culture were 85.7% and 92.9%. The sensitivity and specificity of home -made rapid urease test, based on the results of gram stain and culture were 92.9% and 92.9%. CONCLUSIONS: The home-made rapid urease test is faster and shows a high sensitivity and specificity.

Prevalence and risk factors of Helicobacter pylori infection in general population

BACKGROUND: It was reported that Helicobacter pylori causes duodenal ulcer and chronic active gastritis, but is still controversial on the relationship with gastric cancer. H. pylori is still clinically significant despite improvements in microbiologic, pathologic and therapeutic aspects. The purpose of this study is to evaluate the prevalance of H. pylori infection according to age and sex, the risk factors of H. pylori infection and the relationship with upper gastrointestinal symptoms. METHODS: The subjects were 409 people who underwent esophagogastroscopy and CLO test from Feb. to Jun. in 1997 at Health Promotion Center, Pundang CHA General Hospital. Six types of upper gastrointestinal symptoms and demographic characterastics were surveged by questionnaire. The relationship with H. pylori infection according to age, sex, education, smoking,alcohol, coffee, stress and exercise was evaluated. And, the frequencies of H. pylori according to the presence of symptoms and the six different symptoms(indigestion, frequent belching, dyspepsia, nausea/vomiting, distension, anorexia) were anallyzed by Chi-square test. RESULTS: CLO test was positive for 264(64.5%) in total, 156(65.3%) in females. not different significantly in each group. The frequency of CLO test positive was 53.5%(under 30 years old), 64%(thirties), 67.9%(fifties), 48%(over 60years old). H. pylori infection increased slightly as age increased, but deacreased in over sixties. The frequency of H. pylori infection according to sex, education, smoking, alchol, coffee, stress, and exercise was not different significantly. 174(60.2%) of 284 symptomatic subjects(who had more than one symptom) was positive by CLO test and 93(74.4%) of 125 asymptomatic subjects was positive. The frequency of H. pylori infection according to six symptoms was not different significantly. The sensitivity, specificity, false negative rate, false positive rate, positive predictive value and negative predictive value of CLO test to pathologic report were 77.4%, 81.3%, 22.6%, 18.7%, 93.2%, 52% respectively. CONCLUSIONS: The prevalence of H. pylori infection was 64.5% and showed no difference by sex. H. pylori infection infection increased slightly as age increased. Education, smoking, alcohol, coffee, stress, exercise were not considered as risk factors. The relationship of upper gastrointestinal symptoms and H. pylori infection infection was not significant biostatiscally.

Prevalence of Helicobacter pylori infection in patients of peptic ulcer among Korean people

BACKGROUND: Helicobacter pylori infection is thought to be an important factor in the pathogenesis af gastric and duodenal ulcer. But in Korea, there are few studies on the prevalence of Helicobacter pylori infection in peptic ulcer patients and their relationship between the location of ulcers and Helicobacter pylori infection. The aim of this study was to investigate the prevalence af Helicobacter pylori infection of gastric and duodenal ulcer patients in Korea and the relationship between the location of ulcers and Helicobacter pylori infection. METHODS: We studied 476 consecutive patients with duodenal ulcers or benign gastric ulcer which were diagnased by gastrofiberscopy in Family Medicine of Hanil Hospital from January 1995 to December 1998. Helicobacter pylori infection was evaluated with rapid urease test ( CLO test) in 72.7% patients. RESULTS: The test rate of CLO test was not significantly different by sex, age and site of gastric ulcer lesions, but test rate in the gastric ulcer was significantly lower than in the duodenal ulcer. The prevalence of Helicobacter pylori infection diagnosed with CLO test was 90.1%. The prevalence cf Helicobacter pylori infection was not significantly different between rnales and females. Also it was also not significantly different according to age. 90.8% of those with gastric ulcer patients and 88.9% of the duodenal ulcer had Helicobacter pylori infection, but the difference was not significant. 94.6% of gastric ulcers located in only one area had Helicobacter pylori infection, compared to 83.6% of gastric ulcers which was located in multiple areas. The prevalence of Helicobacter pylori infection was significantly lower in patients who had lesions located in multiple areas. CONCLUSIONS: We condude that the majurity of peptic ulcer patients in Korea have Helicobacter pylori infection. Gastric uker located in multiple areas had significantly lower prevalence af Helicobacter pylori infection, which may suggest that gastric ulcers in multiple areas have other etiologic factors.

The Relationship of Helicobacter pylori Infection and Upper Gastrointestinal Diseases in Korean Adults

Helicobacter pylori infection is associated with various gastrointestinal disorders. It has been proved that those who are infected leads to gastritis in 100% and that there is no natural recovery. Therefore, treatment to cradicate the organism is essential to block the natural course of many disorders of the gastrointestinal tract, that may lead to gastric cancer which is the number one leading cause of death among cancer in Korea. The study was conducted in order to find out the prevalence of H. pylori infection in Inchon area and the relationship between H. pylori infection and its diverse pathology. The study involved 1,872 applicants screened for Helicobacter pylori infection by serology antibody test in the Health Promotion Center at Inha University Hospital in Inchon, Among them, 1,203(64.3%) were positive including 651 males(67.2%), and 524 females(61,0%). There was no significant statistical difference among age groups. In males of age group 40-49 years of age, and females of age group 50-59, H. pylori infection were most common. There were no differences among the H. pylori positive and negative group with respect to fatally history, past history, lob, lifestyle behavior (including smoking, drinking, and exercise), Epigastaic pain, diarrhea, rectal bleeding were more common and statistically different in H pylori positives compared to those of negatives. In the findings of upper gastrointestinal barium swallow, there were no differences between the two groups. H. pylori positive group showed more endoscopic findings compared to negative group, Out of the 1,239 total findings H pylori positive group showed 873 endoscopic findings as opposed to 366 in the negative group. Among the H pylori positive group, chronic superficial gastritis was most common with 338, followed by gastric crosion 134, duodenal ulcer 53. In the negative group, chronic superficial gastritis was also the most common with 160, followed by gastric crosion 79, and hiatal hernia 32 Gastric subepithelial hemorrhage(p<0.001), duodenal ulcer(p<0.022), intestinal metaplasia(p<0.024) were found to be significantly common in H pylori positive group compared to those of the negative group. Hiatal hernia(p<0.001) was found to be higher in the negative group. The sensitivity and specificity of CLO test performed during the endoscopy procedure were 79.9% and 100%, respectively. The sensitivity and specificity of endoscopic diopsy were 51.9% and 100%, respectively.