Although dysphagia in patients with acute leukemia is usually related to reflux esophagitis, infectious esophagitis, chemotherapy1) and leukemic infiltration2), acute esophageal stricture resulting from chemotherapy in the patient with leukemia is very rare. A 40-year-old man with acute myelogenous leukemia was admitted for operation of esophageal stricture which was developed within 1 month of chemotherapy. An esophagectomy and esophagogastrostomy with pyloroplasty was carried out. Histology showed mucosal infiltration of mononuclear cells and transmural fibrosis involving submucosa and the muscle layer.
Adult ; Deglutition Disorders ; Drug Therapy ; Esophageal Stenosis* ; Esophagectomy ; Esophagitis ; Esophagitis, Peptic ; Fibrosis ; Humans ; Induction Chemotherapy* ; Leukemia ; Leukemia, Myeloid, Acute

BACKGROUNDChai Lai Prescription is a Chinese herbal compound which is used to sooth the liver, strengthen the spleen and harmonize the stomach for descending adverse Qi. We initiated the study to investigate its mechanism of treating in vitro rabbit reflux esophagitis models.

METHODSAdult male Japanese white rabbits, weighing 1.8-2.2 kg, were divided into five groups of three each, which were: normal control group (Krebs buffer, pH7.4), esophagitis model group (Krebs buffer, pH5.8), esophagitis model proup+low-dose Chinese herbal medicine protection group (0.6 mg × ml(-1)× kg(-1)), esophagitis model group+moderate-dose Chinese herbal medicine protection group (6 mg × ml(-1)× kg(-1)), esophagitis model group+high-dose Chinese herbal medicine protection group (60 mg × ml(-1)×kg(-1)). The RT-PCR method was used to test the influence of Chai Lai Prescription on IL-1 and IL-6 in in vitro rabbit models of esophagitis. We treated the in vitro models with different doses of Chinese herbal medicine.

RESULTSEsophageal mucosa were filled with various liquids. IL-6 and IL-1β mRNA expression was increased in rabbit esophageal mucosa stimulated with acid. Chinese herbal medicine significantly reduced the levels of IL-6 and IL-1β mRNA expression in the in vitro cultured rabbit esophageal mucosa. Using Chinese herbal medicine to treat in vitro models of RE, we found that the IL-6 and IL-1β mRNA expression levels went down, near to or lower than the normal control levels, compared with the group treated with acidified buffer solution.

CONCLUSIONSChai Lai Prescription lowered the IL-1β and IL-6 cytokine mRNA levels and protected the esophageal mucosa in the in vitro models of reflux esophagitis, suggesting that the traditional Chinese herbal compound may be able to treat reflux esophagitis by inhibiting the its inflammatory mediators.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Esophagitis, Peptic ; drug therapy ; metabolism ; Interleukin-1beta ; genetics ; Interleukin-6 ; genetics ; Male ; Rabbits

OBJECTIVETo observe the therapeutic efficacy of Jiangni Hewei Decoction (JHD) in treating reflux esophagitis (RE).

METHODSSeventy-five RE patients conformed with the inclusive criteria were randomly divided into the treated group (45 patients) and the control group (30 patients). Patients in the treated group received JHD orally, one dose per day, while those in the control group received Omeprazole, 20 mg once per day. The therapeutic course was 8 weeks. The efficacy on clinical symptoms, RE grades and scores determined by gastroscope were evaluated.

RESULTSPatients' symptoms were obviously improved after treatment of JHD and Omeprazole. The cured rate and the total effective rate in the treatedgroup were 37.8% (17 cases) and 84.5%, respectively, while in the control group were 36.7% (11 cases) and 83.3% respectively. The symptomatic score and the total score in both groups after treatment were obviously lowered (P < 0.01). Gastroscopic examination showed that the patients in the two groups with RE of 0 grade were significantly increased and no patients with RE of III grade. The healing rate and the total effective rate were 48.9% (22 cases) and 91.1% respectively in the treated group, and the corresponding numbers in the control group were 46.7% (14 cases) and 93.3% respectively. Significant difference was found in comparison of the gastroscopic figures in the same group before and after treatment (P < 0.01). The therapeutic effect of JHD on RE was similar to that of Omeprazole in aspects of improving clinical symptoms such as heartburn, acid regurgitation, chest pain, etc., and in curing oesophageal mucous inflammation (under gastroscope) and esophagitis. But the recurrence in the JHD group was obviously lower than that in the control group in 12 weeks after withdrawal of treatment (P < 0.05). Besides, no adverse reaction happened in the JHD group.

CONCLUSIONJHD showed favorable therapeutic efficacy in treating RE.

Adult ; Aged ; Drugs, Chinese Herbal ; therapeutic use ; Esophagitis, Peptic ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

OBJECTIVETo study the effects of tongjiang granule (TJG) on reflux esophagitis (RE) in rats.

METHODSTwo rat models of RE were established respectively by cardioplasty + pyloric ligation + Roux-en-Y gastro-jejunum anastomosis and by placed a fixed steel ring into the gastric cardia, and the model rats were treated with various dosages of TJG or cisapride by gastric perfusion.

RESULTSRat models were established successfully by both methods. The score of pathological changes of esophagus mucosa in the model rats, made by either method, after high-dosage TJG treatment was lower than that in the model rats (P < 0.05), but equal to that in the cisapride treated model rats. High and moderate dosages of TJG were shown by transmission electron microscope to have effects of alleviating heckle cells and inflammatory reaction. They could reduce the level of gastric acid, more significant in high and moderate dosage groups (P < 0.05), while cisapride couldn't.

CONCLUSIONTJG is effective in treating experimental RE in rats to a certain extent.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Esophagitis, Peptic ; drug therapy ; pathology ; Esophagus ; drug effects ; pathology ; Female ; Male ; Phytotherapy ; Powders ; Random Allocation ; Rats ; Rats, Sprague-Dawley

BACKGROUND/AIMS: Reflux esophagitis is a recurring condition for which many patients require maintenance therapy. This comparative, randomized multicenter study was designed to evaluate the effect of long-term maintenance treatment comparing proton pump inhibitor, rabeprazole and H2 receptor antagonist, ranitidine. METHODS: Eighty four patients with healed reflux esophagitis confirmed by endoscopy were randomly allocated to receive maintenance treatment with either rabeprazole 10 mg once daily or ranitidine 300 mg once daily for 32 weeks. Patients were seen every 8 weeks or at symptomatic relapse. RESULTS: Of 84 initially treated patients, 73 entered the maintenance study. The percentage of asymptomatic patients after 90-day and 210-day treatment were 97% and 81.5%, for rabeprazole and 74.3% and 62.3%, for ranitidine, respectively. After 32 weeks, the relapse rates of esophagitis were 21.3% in the rabeprazole group and 62.9% in the ranitidine group (RR: 0.405, 95% CI: 0.215-0.766). CONCLUSIONS: Maintenance treatment with rabeprazole (10 mg once daily) is superior to ranitidine (300 mg once daily) in keeping the patients with reflux esophagitis in remission over a 32 week period.
2-Pyridinylmethylsulfinylbenzimidazoles ; Adult ; Anti-Ulcer Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Esophagitis, Peptic/*drug therapy ; Female ; Humans ; Male ; Middle Aged ; Omeprazole/*analogs & derivatives/therapeutic use ; Ranitidine/*therapeutic use

No abstract available.
Endoscopy, Digestive System ; Esophagitis, Peptic/diagnosis/*drug therapy ; Humans ; Male ; Middle Aged ; Proton Pump Inhibitors/*therapeutic use ; Severity of Illness Index ; Sucralfate/therapeutic use

Herpes simplex esophagitis has been recognized with increased frequency as an opportunistic infection in immunosuppressed or debilitated patients. However, it is also documented as self-limited esophagitis in apparently healthy patients. We report two cases of herpetic esophagitis diagnosed by biopsies. One case was noted in an immunocompetent patient having gastric peptic ulcer who had clinical improvement with symptomatic treatment. And the other was noted in an immunosuppressed patient having chemotherapy for gastric carcinoma who had resolution of symptoms with acyclovir therapy. Histologically, esophageal mucosa exhibited erosion and inflammatory cellular exudate with intranuclear eosinophilic inclusions in the epithelial cells. These were confirmed by the PCR and immunohistochemical stain for herpes simplex virus using a biopsy material.
Acyclovir ; Biopsy ; Drug Therapy ; Eosinophils ; Epithelial Cells ; Esophagitis* ; Exudates and Transudates ; Herpes Simplex* ; Humans ; Mucous Membrane ; Opportunistic Infections ; Peptic Ulcer ; Polymerase Chain Reaction ; Simplexvirus

OBJECTIVETo observe the effect of pungent dispersion bitter purgation method (PDBPM) on the esophageal mucosal intercellular space of reflux esophagitis (RE) model rats.

METHODSTotally 100 Wistar rats were randomly divided into the control group, the model group, the Western medicine group (WM), the Chinese medicine group (CM), 25 rats in each group. Rats in the control group only received switch operation. Rats in the rest three groups received modified partial cardia muscle incision combined pylorus ligation of external parts to prepare the RE rat model. Starting from the 3rd day after operation, WM mixture (Motilium 3. 2 mg/kg + Omeprazole Capsule 4.3 mg/kg + Hydrotalcite Tablet 161.4 mg/kg) was administered by gastrogavage to rats in the WM group. Rats in the CM group was administered by gastrogavage with Modified Banxia Xiexin Decoction (5.7 g/kg), 2.5 mL each time, twice daily for 14 consecutive days. Equal volume of normal saline was administered by gastrogavage to rats in the control group and the model group. On day 7 and 14, the lower esophagus pH value, general specimen of mucosa and histopathologic changes were observed. Intercellular spaces of esophageal epithelium were measured for a control study.

RESULTSCompared with the same group at day 7, the lower esophagus pH value increased at day 14 (P < 0.01); the naked eye integral of esophageal mucosa and intercellular spaces of esophageal epithelium also decreased at day 14 in the CM group and the WM group (P < 0.05). Compared with the control group at the same time point, the lower esophagus pH value decreased in the model group (P < 0.01). The naked eye integral of esophageal mucosa, and intercellular spaces of esophageal epithelium increased in the model group with increased intercellular spaces (P < 0.01). Compared with the model group at the same time point, the lower esophagus pH value increased and the naked eye integral of esophageal mucosa decreased in the CM group and the WM group at day 7 and 14 (P < 0.01). Intercellular spaces of esophageal epithelium of RE model rats at day 14 was lower in the CM group and the WM group than in the model group (P < 0.01). Compared with the WM group, the lower esophagus pH value decreased at day 7 in the CM group (P < 0.05); the naked eye integral of esophageal mucosa and intercellular spaces of esophageal epithelium decreased at day 14 in the CM group (P < 0.05).

CONCLUSIONSPDBPM had favorable treatment effect on RE model rats. The therapeutic effect was more obvious along with the therapeutic course went by. Its mechanism might be achieved through good repair effect on damaged mucosa, increasing the pressure of esophageal sphincter, and inhibiting gastric acid.

Animals ; Anti-Ulcer Agents ; pharmacology ; therapeutic use ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Esophagitis, Peptic ; drug therapy ; Extracellular Space ; Mouth Mucosa ; Omeprazole ; therapeutic use ; Rats ; Rats, Wistar

OBJECTIVETo screen and optimize the extraction of Dingxiangjiangqi granules.

METHODThe extraction route was screened by using pharmacodynamic experiment and the extraction conditions were optimized by orthogonal design and taking extract yield, content of naringin and tetrahydropalmatine as indexes.

RESULTThe pharmacodynamic result showed that aqueous extract had the best effect to cure the esophagitis of rats and the optimized extraction technique was adding 12 times water, extracting 0. 5 hour for 3 times.

CONCLUSIONThe optimum extraction was simple, reasonable, stable and useful for further development.

Animals ; Berberine Alkaloids ; analysis ; Drug Combinations ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Esophagitis, Peptic ; drug therapy ; pathology ; Esophagus ; drug effects ; pathology ; Flavanones ; analysis ; Male ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Syzygium ; chemistry ; Technology, Pharmaceutical ; methods

OBJECTIVETo study the mechanism of Tongjiang granule on treating GERD.

METHODThe rats in the model group received steel wire ring-cardiamyopexy. A steel wire ring was fixed firmly on cardia. The rats in the control group underwent the cardia-plasty plus pylori ligation plus stomach-empty intestine Roux-en-Y anastomosis. The rats were divided into six groups after operations at random, which were fed up respectively with Tongjiang granule of different dosage and perpulsid. No treatment groups were taken as control.

RESULTThe experiment showed that Tongjiang granule could lighten or cure RE in the pathology, decrease the hydrochloric acid in gastric juice, in the meantime, increase the motilin in the animal blood. This study indicated that the effect of Tongjiang granule group from experimental research was better than that of the control group (perpulsid).

CONCLUSIONThe effects of Tongjiang granule on treating GERD can be achieved by decreasing the hydrochloric acid in gastric juice, increasing the motilin in blood and promoting the gastric impetus in the animal experiment.

Animals ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Esophagitis, Peptic ; drug therapy ; physiopathology ; Esophagus ; pathology ; Female ; Gastric Acid ; metabolism ; Gastric Emptying ; drug effects ; Hydrochloric Acid ; metabolism ; Male ; Motilin ; blood ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley