• The Journal of Internal Korean Medicine
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• v.30 no.1
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• pp.191-199
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• 2009

Objectives : The aim of this study was to evaluate the therapeutic effect of acupuncture and herbal medicine in patients who had hvpoactivity of the gastric vagus nerve and pyloric valve disturbance simultaneously with function dyspepsia by bowel sounds analysis. Methods : Bowel sounds of 10 patients (male 1, female 9) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed before and after treatment. Hypoactivity of the gastric vagus nerve was considered if % BS was <6%. and pyloric valve disturbance was accepted if DF ratio (e.g.. postprandial DF/fasting DF) was <1. Electroacupuncture at Zusanli (ST36, 3Hz, 30 minutes) and manual acupuncture at other meridian points were applied daily for 2 weeks. Herbal medicine, Pyengwi-san. was administered to all patients (100cc, 3 times/day). Results : DF ratio significantly increased from $0.93\pm0.06$ to $1.06\pm0.04$ after treatment for 2 weeks (p=0.005). 9 of 10 patients were improved to DF ratio>1. %BS also increased from $2.97\pm1.17%$ to $4.49\pm4.27%$. not significantly. 3 patients showed a remarkable elevation, and their %BS reached >6% of normal value. Conclusions : Combined effect of electroacupuncture at Zusanli (ST36), manual acupuncture. and Pyengwi-san was shown effective in the improvement of pyloric valve disturbance more than hypoactivity of gastric vagus nerve on patients with functional dyspepsia.

• Journal of Gastric Cancer
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• v.8 no.1
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• pp.20-26
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• 2008

Purpose: Pylorus-preserving gastrectomy (PPG), which retains pyloric ring and gastric function, has been accepted as a function-preserving procedure for early gastric cancer for the prevention of postgastrectomy syndrome. This study was compared laparoscopy-assisted pylorus-preerving gastrectomy (LAPPG) with laparoscopy-assisted distal gastrectomy with Billroth-I reconstruction (LADGB I). Materials and Methods: Between November 2006 and September 2007, 39 patients with early gastric cancer underwent laparoscopy-assisted gastrectomy in the Department of Surgery at Korea Cancer Center Hospital. 9 of these patients underwent LAPPG and 18 underwent LADGBI. When LAPPG was underwent, we preserved the pyloric branch, hepatic branch, and celiac branch of the vagus nerve, the infrapyloric artery, and the right gastric artery and performed D1+$\beta$ lymphadenectomy to the exclusion of suprapyloric lymph node dissection. The distal stomach was resected while retaining a $2.5{\sim}3.0\;cm$ pyloric cuff and maintaining a $3.0{\sim}4.0\;cm$ distal margin for the resection. Results: The mean age for patients who underwent LAPPG and LADGBI were $59.9{\pm}9.4$ year-old and $64.1{\pm}10.0$ year-old, respectively. The sex ratio was 1.3 : 1.0 (male 5, female 4) in the LAPPG group and 2.6 : 1.0 (male 13, female 5) in the LADGBI group. Mean total number of dissected lymph nodes ($28.3{\pm}11.9$ versus $28.1{\pm}8.9$), operation time ($269.0{\pm}34.4$ versus $236.3{\pm}39.6$ minutes), estimated blood loss ($191.1{\pm}85.7$ versus $218.3{\pm}150.6\;ml$), time to first flatus ($3.6{\pm}0.9$ versus $3.5{\pm}0.8$ days), time to start of diet ($5.1{\pm}0.9$ versus $5.1{\pm}1.7$ days), and postoperative hospital stay ($10.1{\pm}4.0$ versus $9.2{\pm}3.0$ days) were not found significant differences (P>0.05). The postoperative complications were 1 patient with gastric stasis and 1 patient with wound seroma in LAPPG group and 1 patient with left lateral segment infarct of liver in the LADGB I group. Conclusion: Patients treated by LAPPG showed a comparable quality of surgical operation compared with those treated by LADGBI. LAPPG has an important role in the surgical management of early gastric cancer in terms of quality of postoperative life. Randomized controlled studies should be undertaken to analyze the optimal survival and long-term outcomes of this operative procedure.

• The Journal of Internal Korean Medicine
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• v.29 no.3
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• pp.621-628
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• 2008

Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.

• Korean Journal of Ichthyology
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• v.10 no.1
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• pp.115-127
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• 1998

The digestive tract of the rockfish, Sebastes schlegeli composed of pharynx, esophagus, stomach, intestine, anus and ten or eleven pyloric caeca. Pyloric caeca is blind sac of banana shape, and that is originated from pyloric portion of the stomach. The relative length of gut(RLG), that is length of digestive tract to standard length, is about 1.56(n=10). Esophageal muscularis consists of thin outer layer of longitudinal muscle and thick inner layer of circular muscle. Mucosal epithelium consists of columnar epithelium with short microvilli and contains numerous mucous secretory cell. The mucosal folds of the stomach are regular, and the muscularis consists of longitudinal, oblique and circular muscle layer. The chief cell of the gastric gland have a tubular mitochondria, endoplasmic reticula and numerous secretory granules in electron-dense. However, parietal cell contains small mitochondria, endoplasmic reticula and vacuoles in low electron density. Mucosal epithelium of the pyloric caeca and intestine composed of columnar epithelium, goblet cell, rodlet cell and dark cell. Columnar absorptive cell in the pyloric caeca and intestine contains well developed mitochondria, endoplasmic reticula, vesiculated granules in high electron density, pinocytotic vesicles and multivesicular body. Rodlet cell have a well developed cytoplasmic capsule and the endoplasmic reticula in the cytoplasm. Dark cell showing a high electron density in the cytoplasm and contains well developed mitochondria. Columnar epithelium of the intestine have a well developed intercellular junction and the microvilli which contains actin filament originated from the cytoplasm. Mucosal epithelium of the intestine have a longer microvilli and more abundant goblet cells than in the pyloric caeca.