No abstract available.
Conscious Sedation* ; Endoscopy*

No abstract available.
Helicobacter pylori* ; Helicobacter*

No abstract available.
Chilaiditi Syndrome*

The development and introduction into clinical practice of proton pump inhibitors (PPIs) have influenced the management of acid-peptic disorders dramatically. PPIs inhibit the gastric hydrogen/potassium adenosine triphosphatase selectively and irreversibly which is the final step in acid secretion. PPIs are currently the most effective form of therapy in acid-peptic diseases. All PPIs are potent, effective and generally safe, but little different in equivalent doses. PPIs undergo hepatic metabolism by cytochrome P450 (CYP) system. Polymorphism of CYP2C19 influences the pharmacokinetics and pharmacodynamics of PPIs. Doses and dosing schemes of PPIs based on CYP2C19 genotype status is expected to increase the efficacy in clinical outcome. The major indication of PPIs are acid-related diseases such as peptic ulcers and their complications, gastroesophageal reflux diseases, Zollinger-Ellison syndrome and eradication of Helicobacter pylori with antibiotics and dyspepsia. The potency and cost-effectiveness of PPIs have extended their clinical uses. However, their widespread and long-term use may limit the therapeutic benefit between efficacy and clinical problems such as acid rebound hypersecretion, enhanced oxyntic gastritis, problems with carcinoids in rodents and long-term concern for gastric cancer development. Further studies are needed to minimize the side effects and to maximize the therapeutic effects of PPIs.
Animals ; Anti-Ulcer Agents/*therapeutic use ; Gastroesophageal Reflux/*drug therapy ; Helicobacter Infections/*drug therapy ; Humans ; Peptic Ulcer/*drug therapy ; Proton Pumps/*antagonists & inhibitors

Non-Helicobacter pylori, non-NSAID peptic ulcer disease, termed idiopathic peptic ulcer disease (IPUD), is being increasingly recognized. Current data suggest that the relative proportion of patients with IPUD among those with peptic ulcers has been increasing for the past decade in both the West and East, while the prevalence of H. pylori ulcers has decreased. Potential causative or risk factors of IPUD include cigarette smoking, genetic predisposition, psychological factors, infections other than H. pylori, non-NSAID drugs or toxins, systemic inflammatory disease, and local mucosal defects. Diagnosis is made after confident exclusion of H. pylori infection by at least two different standard tests and accurate exclusion of unrecognized or surreptitious NSAID use by careful history taking and serologic assay. IPUD is characterized by higher complication and recurrence rates than other forms of peptic ulcer disease and has become a main cause of refractory ulcer disease. Maintenance therapy using proton pump inhibitors may be required at higher doses and for longer durations than in H. pylori- or NSAID-associated peptic ulcer diseases. Well-designed nationwide epidemiologic studies are required to fully elucidate this emerging condition.
Diagnosis ; Genetic Predisposition to Disease ; Humans ; Peptic Ulcer* ; Prevalence ; Proton Pump Inhibitors ; Psychology ; Recurrence ; Risk Factors ; Smoking ; Ulcer

No abstract available.
Humans ; Pepsinogen A*

Anatomy of the pancreaticobiliary ductal system is so variable that one should think of its normal anatomy as nonexistent. But exact location of the termination of the common bile duct in important to the biliary surgeon when performing transduodenal exploration of the common bile duct, to the physician and radiologist when diagnosing pancreaticobilijary disease by ERCP. We report a case of Lnomalous termination of the common bile duct into thii. duadenal bulb diagnosed by ERCP and operative cholangiogram.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct*

BACKGROUND/AIMS: Phase IIb clinical study of Stillen(TM), a novel cytoprotectant, for gastritis showed 180 mg of Stillen, t.i.d. for 2 weeks results in a significant increase of cure rate when compared with a placebo group. It is reported that antioxidative effect and strengthening the endogenous cytoprotective molecules of the gastric mucosa play a pivotal role for cytoprotective action of Stillen(TM). The aim of this phase III multicenter, double-blind comparative study was to assess the efficacy of Stillen(TM) for the treatment of erosive gastritis. METHODS: Five hundred and twelve patients with erosive gastritis were enrolled and divided into three groups. Each group received 180 mg or 360 mg of Stillen(TM) or 600 mg of cetraxate (Neuer(TM)) t.i.d. for 2 weeks, respectively and a follow-up endoscopic examination for evaluation. RESULTS: Patients treated with 180 mg and 360 mg of Stillen(TM) had a significantly improved endoscopic cure rate of gastritis (55.6% and 57.5%, respectively) compared with patients treated with 600 mg of cetraxate (35.5%, p<0.001). Endoscopic improvement rate was also significantly higher in 180 mg group (67.3%) and 360 mg group (65.0%) of Stillen(TM) treated patients than cetraxate treated group (46.4%, p<0.001). During the study, both Stillen(TM) and cetraxate were well tolerated. CONCLUSIONS: These results clearly demonstrate that Stillen(TM) is an efficacious, safe, and well-tolerated treatment for gastritis.
Follow-Up Studies ; Gastric Mucosa ; Gastritis* ; Humans

Advance in fiberoptic endoscopy have improved diagnostic capabilities and management in patients with gastric polyps and increased experience with endoscopic polypectomy offers the most simple and safe method in removal of gastric polyps. Sixty six endoscopic gastric polypectomies was performed in 59 patients who visited Chonnam National University Hospital from 1980 to 1989 The results obtained were as follows. 1) The most patients were in the seventh decade followed by fifth, fourth decade. The ratio of male to female was 1: 1.95. 2) The common clinical symptoms with which patients presented were epigastric discomfort (54. 2%), epigastric pain (44.1%), indigestion (16.9%), nausea and vomiting (13.6%) and hematemesis (3.4%). The associated diseases of gastric polyp were chronic superficial gastritis (28.8%), chronic atrophic gastritis (13.6%), benign gastric ulcer, gastric caecer, cancer of ampulla of Vater. 3) The number of patients with single gastric polyp wa 47 (79.7%), and that of multiple gastric polyps was 12 (20.3%). The most common location of gastric polyps was gastric antrum (66.6%) follawed by gastric body (27.3%) and gastric fundus (6.1%). 4) The removed polyps were mostly 1.0 cm to 2.0 cm in size and in the gross findings by Yamadas classification, type IV (48.5%) was most common. 5) Histogical examinations revealed that 49.6% of remoyed polyps were hyperplastic polys and 18. 7% of those were adenomatous polyps. Only one case of adenomatous polyp had contaied focally malignant change of mucosa. 6) Almost all cases were in the absenee of significant complications, but three patients showed bleeding at the site of polypectomy, which controlled by conservative means.
Adenomatous Polyps ; Ampulla of Vater ; Classification ; Dyspepsia ; Endoscopy ; Female ; Gastric Fundus ; Gastritis ; Gastritis, Atrophic ; Hematemesis ; Hemorrhage ; Humans ; Jeollanam-do ; Male ; Mucous Membrane ; Nausea ; Polyps ; Pyloric Antrum ; Stomach Ulcer ; Vomiting

No abstract available.
Esophageal Achalasia ; Esophageal Spasm, Diffuse ; Humans