The Relationship of the Helicobacter pylori Virulence Factor Gene Subtype in Gastric Adenocarcinoma

PURPOSE: The H. pylori cagA gene, vacA gene and iceA gene are considered to be important virurence factors that have been implicated in the development of gastric adenocarcinoma. It was reported that the presence of IS605 elements may be responsible for rearrangements and lead to partial or total deletions of the cag pathogenicity island (PAI) and the virulence of cag PAI may be changed. However, different results regarding the association between these virulence factors and clinical disease have been reported from different geographic regions. This study evaluated the relationship between H. pylori virulence factors such as cagA, vacA, iceA, IS605 and gastric adenocarcinoma. MATERIALS AND METHODS: H. pylori isolates were obtained from 54 infected patients (24 cases of gastric adenocarcinoma, 30 cases of control). H. pylori isolates were identified by PCR with ureC gene and 16S rRNA. PCR was performed to examine cagA, vacA, iceA and IS605 genotypes. RESULTS: Significant difference was found in the negative rates of cagA between gastric adenocarcinoma group and control (62.5% vs. 33.3% P=0.033). No significant difference was found in the prevalence of iceA, vacA between gastric adenocar cinoma and control. The genotype of cagA+ vacA s1-m1 iceA1 was predominant in H. pylori isolates irrespective of the clinical outcome. IS605 in PAI was not found in gastric adenocarcinoma gruop and control. The positive rates of IS605 in genome were 33.3% in gastric adenocarcinoma group and 36.7% in control (P>0.05). In gastric carcinoma, the positive rate of cagA+/IS605- was lower than in control (12.5% vs. 40.0%, P=0.025) and the positive rate of cagA-/IS605- was higher than in control (54.2% vs. 23.3%, P=0.02). CONCLUSION: H. pylori virulence factors had not related significantly with gastric adenocarcinoma. Further study is needed to examine the specificity of H. pylori strains.

Effectiveness of Flumazenil against Midazolam as Premedication for Upper Gastrointestinal Endoscopy / 대한소화기내시경학회지

BACKGROUND/AIMS: Midazolam is utilized as a premedication for uppoer gastrointestinal endoscopy. Midazolam has a more rapid onset of reaction than that of diazepam and its duration is shorter. But the Consciousness of premedicated patients has not been regained sooner. The Purpose of this study was to examine the effectiveness of flumazenil against midazolam as premedication for upper gastrointesinal endoscopy. METHODS: Sixty patients underwent upper gastrointestinal endoscopy. These patients were divided to three groups: Group I included twenty patients without premedication; Group II Included twenty patients with premedication of midazolam and then were not given an antisedative agent excluign of normal saline; and Group III included the others with midazolam and flumazenil as an antisedative agent. RESULTS: There was no change in vital signs after midazolam and flumazenil as an antisedative agent. RESULTS: There was no change in vital signs after midazolam injection, compared with presedation value. Modified Steward Coma Scale showed a significant increase after flumazenil injection as an antagonist of midazolam. The assessment of the endoscopist and the comfort of patients were satisfactory. When the 40 patients were asked about their willingness to undergo the same procedure in the future, thirty-four patients responded favorably. CONCLUSION: Midazolam was safe and effective for sedation for upper gastrointestinal endoscopy. There was rapid regaining of consciousness with flumazenil indection after midazolam, so the use of flumazenil against midazolam injection also appeared to be effective.

Combination chemotherapy with 5-fluorouracil and cisplatin for advanced gastric cancer / 대한내과학회지

No abstract available.

The Effect of Enalapril in the Patients with the Chronic Severe Congestive Heart Failure

ACE inhibitiors have been recently used to treat the chronic congestive heart failure after the use of the antihypertensive agents.The enalapril was added to the chronic congestive heart failure patients unresponded to diuretics and digoxin. The echocardiography, serum chemical examinations, ECG, chest X-ray and clinical manifestations were done to the 47 patients with chronic severe congestive heart failure unresponded to diuretics and digoxin before and 2 months after the addition of enalapril between Feb. 1991 and Nov. 1991 in Dong-A Univerity Hospital. The results were followed : 1) The dyspnea, the hepatomegaly, the engorged jugular vein, cough, edema, palpitation, chest discomfort, and the tachycardia were improved 2 months after the treatment of enalapril. 2) The cardiomegaly and lung edema on the chest PA, and the elevated GOT, GPT and serum creatinine were improved 2 months after the treatment of enalapril. 3) Left ventricular end systolic dimension, fractional shortening, left ventricular end diastolic volume, and ejection time on the ECHO were significantly increased after 2 months of the treatment of enalapril. ACE inhibitor, enalapril revealed the effectiveness of the treatment to the patients with the severe congestive heart failure, and we should try to study the mortality rates to decrease compared with the control groups without the treatment of enalapril.