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Effect of DA-9701 on gastric emptying in a mouse model: Assessment by ^(13)C-octanoic acid breath test

World Journal of Gastroenterology 2013年第27期19卷 4380-4385页

作者： Chul-Hyun Lim Myung-Gyu Choi Hyeyeon Park myong ki baeg Jae Myung Park Department of Internal Medicine The Catholic University of Korea College of Medicine

AIM:To evaluate the effects of DA-9701 on the gastric emptying of a solid meal using the 13C-octanoic acid breath test in a mouse model. METHODS:Male C57BL/6 mice aged > 8 wk and with body weights of 20-25 g were used in this study. The solid test meal consisted of 200 mg of egg yolk labeled with 1.5 L/g 13C-octanoic acid. The mice were placed in a 130 mL chamber flushed with air at a flow speed of 200 mL/min. Breath samples were collected for 6 h. The half-emptying time and lag phase were calculated using a modified power exponential model. To assess the reproducibility of the 13C-octanoic acid breath test, the breath test was performed two times at intervals of one week in ten mice without drug treatment. To assess the gastrokinetic effects of DA-9701, the breath test was performed three times in another twelve mice, with a randomized crossover sequence of three drug treatments:DA-9701 3 mg/kg, erythromycin 6 mg/kg, or saline. Each breath test was performed at an interval of one week. RESULTS:Repeatedly measured half gastric emptying time of ten mice without drug treatment showed 0.856 of the intraclass correlation coefficient for the half gastric emptying time (P = 0.004). The mean cumulative excretion curve for the 13C-octanoic acid breath test showed accelerated gastric emptying after DA-9701 treatment compared with the saline control (P = 0.028). The median half gastric emptying time after the DA-9701 treatment was significantly shorter than after the saline treatment [122.4 min (109.0-137.9 min) vs 134.5 min (128.4-167.0 min), respectively; P = 0.028] and similar to that after the erythromycin treatment [123.3 min (112.9-138.2 min)]. The lag phase, which was defined as the period taken to empty 15% of a meal, was significantly shorter after the DA-9701 treatment than after the saline treatment [48.1 min (44.6-57.1 min) vs 52.6 min (49.45-57.4 min), respectively; P = 0.049]. CONCLUSION:The novel prokinetic agent DA-9701 accelerated gastric emptying, assessed with repeated measurements in the same mouse usin

关键词： DA-9701 Gastric emptying Prokinetic agent Breath test Functional dyspepsia

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Increased liver markers are associated with higher risk of type 2 diabetes

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World Journal of Gastroenterology 2015年第24期21卷 7478-7487页

作者： Sun-Hye Ko myong ki baeg Kyung-Do Han Seung-Hyun Ko Yu-Bae Ahn Division of Endocrinology and Metabolism Department of Internal Medicine College of Medicine The Catholic University of Korea Division of Gastroenterology Department of Internal Medicine College of Medicine The Catholic University of Korea Department of Biostatistics College of Medicine The Catholic University of Korea

AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age were analyzed from the fifth Korean National Health and Nutrition Examination Survey(2010-2011). The associations of serum liver markers such as aspartate aminotransferase(AST), alanine aminotransferase(ALT), AST/ALT, and gamma-glutamyltransferase(GGT) with T2 DM and IFG were analyzed using logistic regression models. Participants were divided into sex-specific quartiles on the basis of liver markers.RESULTS: The prevalence of T2 DM and IFG were 11.3% and 18.3%. Increasing quartiles of ALT and GGT were positively and AST/ALT were negatively correlated with T2 DM and IFG. Analysis of the liver marker combinations showed that if any two or more markers were in the highest risk quartile, the risks of both T2 DM and IFG increased significantly. The risk was greatest when the highest ALT and GGT and lowest AST/ALT quartile were combined, with the riskof T2 DM at 3.21(95%CI: 1.829-5.622, P < 0.001) in men and 4.60(95%CI: 3.217-6.582, P < 0.001) in women. Men and women with the highest AST and ALT and lowest AST/ALT quartile had a 1.99 and 2.40 times increased risk of IFG.CONCLUSION: Higher levels of GGT and ALT and lower AST/ALT within the physiological range are independent, additive risk factors of T2 DM and IFG.

关键词： Type 2 diabetes mellitus Liver markers Impaired fasting glucose Gamma-glutamyl transferase Aspartate aminotransferase Alanine aminotransferase

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Helicobacter pylori infection is not associated with nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2016年第8期22卷 2592-2600页

作者： myong ki baeg Seung Kew Yoon Sun-Hye Ko Yong-Sun Noh In-Seok Lee Myung-Gyu Choi Department of Internal Medicine The Catholic University of Korea College of Medicine

AIM: To determine whether Helicobacter pylori(H. pylori) infection confers a higher risk of Nonalcoholic fatty liver disease(NAFLD).METHODS: Healthy people who underwent health screening were analyzed retrospectively. Inclusion criteria were age ≥ 20 years, history of H. pylori infection, and recorded insulin level. Participants were classified as H. pylori positive or negative according to 13 C urea breath tests. NAFLD was defined using the hepatic steatosis index(HSI) and NAFLD liver fat score(NAFLD-LFS). Those with an HSI > 36 or NAFLD-LFS >-0.640 were considered to have NAFLD. Multivariable logistic regression was performed to identify risk factors for NAFLD.RESULTS: Three thousand six hundred and sixtythree people were analyzed and 1636(44.7%) were H. pylori positive. H. pylori infection was associated with older age, male gender, hypertension, higher body mass index, and a dyslipidemic profile. HSI differed significantly between H. pylori positive and negative subjects(median 33.2, interquartile range(IQR) 30.0-36.2 for H. pylori-positive vs median 32.6, IQR 29.8-36.0 for negative participants, P = 0.005), but NAFLD-LSF did not [median-1.7, IQR-2.4--0.7 vs median-1.8, IQR-2.4-(-0.7), respectively, P = 0.122]. The percentage of people with NAFLD did not differbetween infected and uninfected groups: HIS, 26.9% vs 27.1%, P = 0.173; NAFLD-LFS, 23.5% vs 23.1%, P = 0.778. H. pylori infection was not a risk factor, but C-reactive protein concentration and smoking were significant risk factors for NAFLD.CONCLUSION: H. pylori infection is not a risk factor for NAFLD as indicated by HSI or NAFLD-LFS. Prospective, large-scale studies involving liver biopsies should be considered.

关键词： Helicobacter pylori Nonalcoholic fatty liver disease Hepatic steatosis index Nonalcoholic fatty live

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A case of a duodenal duplication cyst presenting as melena

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World Journal of Gastroenterology 2013年第38期19卷 6490-6493页

作者： Seung Yeon Ko Sun Hye Ko Sungeun Ha Mi Sung kim Hyang Mi Shin myong ki baeg Department of General Surgery College of MedicineThe Catholic University of Korea Department of Internal Medicine College of MedicineThe Catholic University of Korea Department of Pathology College of MedicineThe Catholic University of Korea

Duodenal duplication cysts are benign rare congenital anomalies reported mainly in the pediatric population,but seldom in adults.Symptoms depend on the type and location and can present as abdominal pain,distension,dysphagia or dyspepsia.They have been reported to be responsible for duodenal obstruction,pancreatitis and,in rare cases,gastrointestinal bleeding.We present a case of a duodenal duplication cyst in a 43-year-old man presenting as melena.Initial gastroduodenoscopy and colonoscopy did not reveal any bleeding focus.However,the patient began passing melena after 3 d,with an acute decrease in hemoglobin levels.Subsequent studies revealed a duplication cyst in the second portion of the duodenum which was surgically resected.Histology revealed a duodenal duplication cyst consisting of intestinal mucosa.There was no further bleeding and the patient recovered completely.In rare cases,duodenal duplication cysts might cause gastrointestinal bleeding and should be included in the differential diagnosis.

关键词： Gastrointestinal hemorrhage Duodenum Duplication

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Case of inappropriate ADH syndrome:Hyponatremia due to polyethylene glycol bowel preparation

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World Journal of Gastroenterology 2014年第34期20卷 12350-12354页

作者： Sun-Hye Ko Chul-Hyun Lim Jae-Young kim Seung Hun Kang myong ki baeg Hyun Jin Oh Division of Endocrinology and Metabolism Department of Internal MedicineCollege of MedicineThe Catholic UniversitySeoul 137-701South Korea Division of Gastroenterology Department of Internal MedicineCollege of MedicineThe Catholic University of KoreaSeoul 137-701South Korea

Colonoscopic screening has been reported to reduce deaths from colorectal cancer.Adequate bowel preparation is essential for this and safety is an important issue in choosing the methods.Polyethylene glycol(PEG)is regarded as a safe method for cleansing,especially compared with oral sodium phosphate.Here,we present a case of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone(ADH)syndrome after PEG precolonoscopic cleansing resulting in generalized tonic-clonic seizures.A 62-year-old women had ingested PEG for precolonoscopic bowel cleansing.While waiting for the colonoscopy,she developed a stuporous mentality and generalized tonic-clonic seizures,which did not correlate with brain magnetic resonance imaging.Her serum sodium level was 113 mEq per liter and laboratory analyses were consistent with inappropriate ADH syndrome.Her thyroid and adrenal functions were normal.There were no malignancies,infections,respiratory disorders or central nervous disorders and she had no history of taking either diuretics or other medications,which might have caused inappropriate ADH syndrome.She was treated with 3%hypertonic saline and showed a complete neurological recovery as her sodium levels recovered.Follow-up visits showed the patient to have a normal sodium level without neurologic deficits.This case shows that inappropriate ADH syndrome can be caused by PEG preparation,which implies that physicians have to be aware of the possible side effects of this colonic cleansing approach and mindful of the possible ensuing symptoms.

关键词： Inappropriate antidiuretic hormone syndrome Colono

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Hematologic diseases: High risk of Clostridium difficile associated diarrhea

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World Journal of Gastroenterology 2014年第21期20卷 6602-6607页

作者： Tae-Geun Gweon Myung-Gyu Choi myong ki baeg Chul-Hyun Lim Jae Myung Park In Seok Lee Sang Woo kim Dong-Gun Lee Yeon Joon Park Jong Wook Lee Division of Gastroenterology Department of Internal MedicineSeoul St Mary’s hospitalThe Catholic University of KoreaCollege of MedicineSeoul 137-701South Korea Division of Infectious Diseases Department of Internal MedicineSeoul St Mary’s hospitalThe Catholic University of KoreaCollege of MedicineSeoul 137-701South Korea Department of Laboratory Medicine Seoul St Mary’s hospitalThe Catholic University of KoreaCollege of MedicineSeoul 137-701South Korea Division of Hematologic Diseases Department of Internal MedicineSeoul St Mary’s hospitalThe Catholic University of KoreaCollege of MedicineSeoul 137-701South Korea

AIM:To investigate the incidence and clinical outcome of Clostridium difficile(C.difficile)associated diarrhea(CDAD)in patients with hematologic disease.METHODS:We retrospectively reviewed the medical records of patients who underwent C.difficile testing in a tertiary hospital in 2011.The incidence and risk factors for CDAD and its clinical course including recurrence and mortality were assessed in patients with hematologic disease and compared with those in patients with nonhematologic disease.RESULTS:About 320 patients were diagnosed with CDAD(144 patients with hematologic disease;176with nonhematologic disease).The incidence of CDAD in patients with hematologic disease was estimated to be 36.7 cases/10000 patient hospital days,which was higher than the 5.4 cases/10000 patient hospital days in patients with nonhematologic disease.Recurrence of CDAD was more frequent in patients with hematologic disease compared to those with nonhematologic disease(18.8%vs 8.5%,P<0.01),which was associated with higher re-use of causative antibiotics for CDAD.Mortality due to CDAD did not differ between the two groups.Multivariate analysis showed that intravenous immunoglobulin was the only significant factor associated with a lower rate of recurrence of CDAD in patients with hematologic disease.CONCLUSION:The incidence and recurrence of CDAD was higher in patients with hematologic disease than in those with nonhematologic disease.

关键词： Clostridium difficile associated diarrhea Incidenc

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Long-term pretreatment with proton pump inhibitor and Helicobacter pylori eradication rates

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World Journal of Gastroenterology 2014年第4期20卷 1061-1066页

作者： Seung Bae Yoon Jae Myung Park Jong-Yul Lee myong ki baeg Chul-Hyun Lim Jin Soo kim Yu Kyung Cho In Seok Lee Sang Woo kim Myung-Gyu Choi Division of Gastroenterology Department of Internal Medicine College of Medicine The Catholic University of Korea

AIM:To investigate whether proton pump inhibitor(PPI)pretreatment influences Helicobacter pylori eradication rate.METHODS:We retrospectively reviewed H.pylori-infected patients who were treated with a standard triple regimen(PPI,amoxicillin 1 g,and clarithromycin 500mg,all twice daily for 7 d).The diagnosis of H.pylori infection and its eradication was assessed with the rapid urease test,histological examination by silver staining,or the13C-urea breath test.We divided the patients into two groups:one received the standard eradication regimen without PPI pretreatment(Group A),and the other received PPI pretreatment(Group B).The patients in Group B were reclassified into three groups based on the duration of PPI pretreatment:Group B-Ⅰ(3-14 d),Group B-Ⅱ(15-55 d),and Group B-Ⅲ(≥56 d).RESULTS:A total of 1090 patients were analyzed and the overall eradication rate was 80.9%.The cure rate in Group B(81.2%,420/517)was not significantly different from that in Group A(79.2%,454/573).The eradication rates in Group B-Ⅰ,B-Ⅱand B-Ⅲwere80.1%(117/146),81.8%(224/274)and 81.4%(79/97),respectively.CONCLUSION:PPI pretreatment did not affect H.pylori eradication rate,regardless of the medication period.

关键词： Proton pump inhibitor Helicobacter pylori Urea bre

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