• The Korean Journal of Physiology and Pharmacology
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• 제23권5호
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• pp.419-426
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• 2019

Mosapride accelerates gastric emptying by acting on 5-hydroxytryptamine type 4 ($5-HT_4$) receptor and is frequently used in the treatment of gastrointestinal (GI) disorders requiring gastroprokinetic efficacy. We tested the effect of mosapride on 5-hydroxytryptamine type 3 ($5-HT_3$) receptor currents because the $5-HT_3$ receptors are also known to be expressed in the GI system and have an important role in the regulation of GI functions. Using the whole-cell voltage clamp method, we compared the currents of the $5-HT_3$ receptors when 5-HT was applied alone or was co-applied with mosapride in cultured NCB-20 cells known to express $5-HT_3$ receptors. The $5-HT_3$ receptor current amplitudes were inhibited by mosapride in a concentration-dependent manner. Mosapride blocked the peak currents evoked by the application of 5-HT in a competitive manner because the $EC_{50}$ shifted to the right without changing the maximal effect. The rise slopes of $5-HT_3$ receptor currents were decreased by mosapride. Pre-application of mosapride before co-application, augmented the inhibitory effect of mosapride, which suggests a closed channel blocking mechanism. Mosapride also blocked the opened $5-HT_3$ receptor because it inhibited the $5-HT_3$ receptor current in the middle of the application of 5-HT. It accelerated desensitization of the $5-HT_3$ receptor but did not change the recovery process from the receptor desensitization. There were no voltage-, or use-dependency in its blocking effects. These results suggest that mosapride inhibited the $5-HT_3$ receptor through a competitive blocking mechanism probably by binding to the receptor in closed state, which could be involved in the pharmacological effects of mosapride to treat GI disorders.

• 대한한방소아과학회지
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• 제33권4호
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• pp.1-25
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• 2019

Objectives The purpose of this study is to analyze the trends of Chinese clinical research in the last 5 years of Chinese herbal medicine treatment for anorexia in children, and to find ways to utilize the diagnostic criteria and herbal medicine treatment for children who have anorexia in Korea. Methods The authors searched literatures using China National Knowledge Infrastructure published from January 1, 2015 to June 18, 2019. Selected literatures were collected in order of recent publication year. And then, demographic data, duration of illness, intervention, treatment period, outcome, and adverse events were analyzed. In addition, the diagnostic criteria for anorexia in children are categorized and presented in chart. Results A total of 50 papers were included in the analysis of this study. In the selected studies, the most commonly used diagnostic criteria for anorexia in children were ${\ll}$Zhu Futang Practice of Pediatrics${\gg}$ in Western medicine and ${\ll}$Diagnostic and therapeutic criteria for TCM syndromes${\gg}$ in traditional Chinese medicine. As a result, in all the studies reporting total efficacy, the total effective rate of the treatment group treated with herbal medicine was significantly higher than that of the control group. Also, appetite recovery rate and weight gain were significantly higher, gastric emptying time and appetite recovery time were significantly shorter in the treatment group. Conclusions Herbal medicine treatment can help improve anorexia in children. In Korea, diagnostic criteria for anorexia in children should be established. In addition, criteria should be established to evaluate the effectiveness of herbal medicine treatment.

• 한국간담췌외과학회지
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• 제27권1호
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• pp.76-86
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• 2023

Backgrounds/Aims: The aim of this study was to describe short- and long-term outcomes of patients who underwent pancreatoduodenectomy (PD) at a typical United Kingdom hepatopancreatobiliary unit. Methods: A retrospective analysis of all PD patients with histologically-confirmed pancreatic ductal adenocarcinoma (PDAC), ampullary adenocarcinoma (AA), or distal cholangiocarcinoma (CC) from September 1st, 2006 to May 31st, 2015 was carried out. The following information was obtained: demographics, comorbidities, preoperative investigations, neoadjuvant treatment, operative details, postoperative management, complications, adjuvant treatment, five-year recurrence, and five-year survival. Effects of selected preoperative variables on short- and long-term outcomes were investigated. Results: Of 271 included patients, 57.9% had PDAC, 25.8% had AA, and 16.2% had CC. In total, 67.9% experienced morbidity and 17.3% developed a Clavien-Dindo grade ≥ III complication. The 90-day mortality was 3.3%. Clinically-relevant postoperative pancreatic fistula, bile leak, gastrojejunal leak, postpancreatectomy haemorrhage and delayed gastric emptying affected 8.1%, 4.1%, 0.0%, 9.2%, and 19.9% of patients, respectively. American Society of Anesthesiologists grade III-VI correlated with overall morbidity (p = 0.002) and major morbidity (p = 0.009), but not 90-day mortality or five-year survival. The same pattern was observed in patients with a preoperative serum bilirubin > 29 µmol/L and/or a neutrophil/lymphocyte ratio > 3.1. Five-year cancer recurrence and five-year survival were 68.3% and 22.5%, respectively. PDAC patients had higher five-year recurrence but lower five-year survival rates (both p = 0.001). Conclusions: In our series, the majority of patients experienced a complication. However, few patients experienced major morbidity. Surgical risk factors did not affect five-year survival.

• 약학회지
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• 제37권5호
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• pp.511-519
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• 1993

The short and variabke transit of drug throught GI tracj and the inter-and intra-subject variations of the transit restrict the sustained drug absorption after oral adminstration. These restrictions may be solved by retaining the dosage forms in the stomach. Then the dosage form will act as a platform which releases the drug slowly and makes the GI absorption occur for a long time. In this study, as the platforms, PVP hydrogels were synthesized by chemical and y-irradiation method in the cylindrical test tube. The chemical method means the synthesis of the hydrogel by heating the mixed solution of N-vinyl-2-pyrrolidone [monomer], acrylated albumin [crosslinking agent], 2, 2'-agobis(2-methylpropionitrile) [initiator] and proxyphylline [drug] at $65^{\circ}C$ for 5 hr. The $\gamma$-irradiation method means the synthesis of the hydrogel by irradiation with $^{60}$ Co $\gamma$-ray of the mixed solution of the monomer, acrylated albumin, and flurbiprofen [drug] at room temperature with total 0.2 Mrad for 3 hr. Our intention is to design the hydrogel tablet (diameter : 1.20 cm, thickness : 0.60 cm) which swells in the gastric fluid after oral administration to such a size that passing through the pylorus could be inhibited during the period of drug release. After releasing drug, the hydrogel should be degraded by the enzymeatic digestion in the stomach, or by hydrolysis and eventually solubilized. Thus, in votro tests were performed to examine the factors that affect swelling and drug release from the PVP hydrogels. Experimental results show that the hydrogels swell to a size larger than the diameter of the pylorus(l.3$\pm$0.7 cm) and the hydrogel prepared by the chemical method is digested by pepsin. But the hydrogel prepared by the $\gamma$-irradiation method was not digested by the pepsin and just collapsed with time. Thus, the swelling of the hydrogel synthesized by $\gamma$-irradiation was independent albumin acrylation time and pepsin concentration. But drug content and radiation dose affected the swelling and drug release kinetics of the hydrogel. Drug release from the hydrigels was prolonged up to about 24 hr. Therefore, it was concluded that by adjusting these factors, the albumin-crosslinked PVP hydrogel synthesized by $\gamma$-irradiation method is expected to be retained in the stomach for up to 60hr and be a potential platform of drugs for long-term GI absorption.

• 대한본초학회지
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• 제34권6호
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• pp.45-55
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• 2019

Objective : Diabetic gastroparesis is a complication that is defined as delayed gastric emptying and upper gastrointestinal symptoms and often occurs in long-standing diabetic patients. Bojungikgi-tang (BJT) is a traditional oriental herbal formula that has long been used for the treatment of digestive disorders. The purpose of this study was to investigate the effects of BJT on streptozotocin (STZ)-induced diabetic gastroparesis rat model. Methods : Sprague-Dawley (SD) male rats (250-270g) were divided into 13 groups including normal group, STZ-induced diabetic control group, BJT diet (7 various concentrations), and insulin-, glibenclamide-, metformin-treated group were used for the experiments for the comparison. Diabetic gastroparesis was induced by intraperitoneal injection of STZ. The water intake, food intake, body weights and fasting blood glucose levels were measured. After 4 weeks the animals were sacrificed and gastrin, leptin, insulin, hemoglobin A1C (HbA1c), lactate, lactate dehydrogenase (LDH), bilirubin, creatinine, albumin and lipid levels were evaluated. Results : Intraperitoneal injection of BJT for 4 weeks resulted in increased levels of gastrin in blood and decreased leptin and lactate concentration in STZ-induced diabetic gastroparesis rat model. BJT did not affect insulin, fasting glucose, HbA1c, and lipid levels in STZ-induced diabetic gastroparesis rat model. Conclusion : These results indicated that BJT would have protect effect on diabetic gastroparesis through the improvement effect of gastric motility and fatigue syndrome in STZ-induced diabetic rats. This study shows that BJT might be effective for treatment of diabetes and its complications such as gastroparesis.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.115-121
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• 2012

Purpose: Severe pancreaticoduodenal injuries are relatively uncommon, but may result in high morbidity and mortality, especially when management is not optimal, and determining the appropriate treatment is often difficult. The objective of this study was to review our experience and to evaluate the role of a pancreaticoduodenectomy (PD) in treatment of pancreaticoduodenal injuries. Methods: We performed a retrospective review of 16 patients who underwent an emergency PD at our hospital for severe pancreaticoduodenal injury from 1990 to 2011. Demographic data, clinical manifestations, mechanism and severity of the injury, associated injuries, postoperative complications and outcomes were reviewed. Results: The mean age of the 16 patients was $45{\pm}12years$ ($mean{\pm}standard$ deviation), and 15(93.8%) patients were male. All patients underwent an explorative laparotomy after a diagnosis using abdominal computed tomography. Almost all patients were classified as AAST grade higher than III. Thirteen(83.3%) of the 16 patients presented with blunt injuries; none presented with a penetrating injury. Only one(6.3%) patients had a combined major vascular injury. Fifteen patients underwent a standard Whipple's operation, and 1 patient underwent a pylorus-preserving pancreaticoduodenectomy. Two of the 16 patients required an initial damage-control procedure; then, a PD was performed. The most common associated injured organs were the small bowel mesentery(12, 75%) and the liver(7, 43.8%). Complications were intraabdominal abscess(50%), delayed gastric emptying(37.5%), postoperative pancreatic fistula(31.5%), and postoperative hemorrhage (12.5%). No mortalities occurred after the PD. Conclusion: Although the postoperative morbidity rate is relatively higher, an emergency PD can be perform safely without mortality for severe pancreaticoduodenal injuries. Therefore, an emergency PD should be considered as a life-saving procedure applicable to patients with unreconstructable pancreaticoduodenal injuries, provided that is performed by an experienced hepatobiliary surgeon and the patient is hemodynamically stable.

• 한국자원식물학회지
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• 제24권1호
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• pp.61-68
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• 2011

참다래 동결건조물을 2.5%, 5% 농도로 사료와 혼합하여 실험동물에 투여하고 실험 5일간 loperamide(2 mg/kg/day, s.c.)로 변비를 유도하여 참다래의 변비치료 및 예방 효과를 측정하였다. Lopermide를 단독 투여한 군은 정상대조군과 비교하여 변의 개수 및 중량이 유의적으로 감소하였으며 원위 결장 내 변 잔류의 증가 및 cecocolonic segment의 무게가 증가하였다. 참다래 동결건조물 및 loperamide를 투여한 군은 loperamide를 단독 투여한 군과 비교하여 변의 개수 및 중량이 유의적으로 증가하였으며 원위 결장 내 잔류 변 및 cecocolonic segment의 무게도 감소하였다. 이러한 결과는 참다래가 in vivo에서 변비 개선 효과가 있음을 보여준다. 변의 수분 함량에서도 loperamide로 변비를 유발시킨 군에서 감소하는 경향을 보였고 참다래 동결건조물 투여군에서 농도 의존적으로 증가하는 것을 확인 할 수 있었다. 조직학적 검사에서도 참다래 동결건조물 투여군의 원위 대장관에서 crypt cell내 점액의 증가와 장관내 분변의 점액질의 증가도 관찰되었다. In vitro 실험결과, 회장 적출 절편에서 참다래 동결건조물(2.5 mg/ml)을 전 처리 시 loperamide에 의한 장력과 진폭 억제가 부분적으로 차단되었으며 이러한 결과는 참다래 동결건조물의 변비 개선효과가 장의 운동성 촉진과 대장관 내 점액분비 증가에 의한 대장관 내용물의 이동성증가와 관련이 있음을 시사한다.

• Advances in pediatric surgery
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• 제16권1호
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• pp.11-17
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• 2010

Pancreatic tumors in children are relatively rare, and their prognosis differs from that in adults. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with pancreatic tumors. We retrospectively reviewed the medical records of children under 15 years of age with pancreatic tumors who were treated surgically at Asan Medical Center between January 1992 and November 2009. There were 16 patients, fourteen of whom were pathologically diagnosed with solid pseudopapillary tumor. The other two patients were diagnosed with pancreatoblastoma and acinar cell carcinoma, respectively. Six patients of the 16 patients (38 %) were male, and there was a male-to-female ratio of 1:1.6. The initial presentations were upper abdominal pain in eight patients (50 %), palpable abdominal mass in three, and vomiting in one. Four patients were diagnosed incidentally. Six patients' tumors were located in the pancreatic head, six in the pancreatic body, and four in the pancreatic tail, respectively. The surgical procedures performed included distal pancreatectomy (n=7, 44 %), median segmentectomy (n=3), enucleation (n=3), pancreaticoduodenectomy (n=2), and pylorus-preserving pancreaticoduodenectomy (n=1). Three patients underwent laparoscopic surgery. The median tumor size was 6.5 cm (1.8~20 cm). Early surgical complications included pancreatic fistula (n=4), bile leakage (n=1), and delayed gastric emptying (n=1). A late complication in one patient was diabetes. The median follow-up period was five years and four months, and all patients survived without recurrence. While pancreatic tumors in adults have a poor prognosis, pancreatic tumors of childhood are usually curative with complete resection and thus have a favorable prognosis.

• 혜화의학회지
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• 제18권1호
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• pp.19-28
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• 2009

Objectives: This study was conducted to help clinical studies for treating Functional Dyspepsia with acupuncture. We inspected tendency of studies of acupuncture treatment for functional dyspepsia and analyzed the assessing instrument for it by scrutinizing Pubmed recent publications. Materials and Methods: We inspected 8 theses and scrutinized their objectives, periods, participants, materials and methods, the instrument of assessment for the studies, and criteria and symptom score for questionaire, results and JADAD score. Results: 1. Most studies were published by oriental doctors except one which was published by an American doctor. More and more studies are being published in America and written in English recently. So it is considered that western doctors think that the acupuncture treatment is useful as unorthodox medicine for functional dyspepsia. 2. Among the 4 clinical studies, 2 studies were RCT and 1 study was not RCT and 1 study with vagueness. All 4 clinical studies were not double-blinded because they were about comparison between acupuncture treatment and medicine. 3. ST36, PC6, CV12, BL21 were chiefly used, and auricular point, ST40, SP6 were also used. Manual acupuncture were used in 2 studies, and low frequency pulse and electroacupuncture were used in other studies respectively. 4. 4 clinical studies used 0~3 points symptom score as the instrument of assessment. Additional assessments were on gastric emptying time, EGG and plasma level of motilin. All thesis were not verified of validity and reliability. 5. Among the 4 reviewed thesis, 2 theses were about acupuncture as one of the various treatment of functional dyspepsia, and the other 2 theses were about efficacy of acupuncture treatment. And the result generally showed effectivity of acupuncture treatment. Conclusion: Acupuncture treatment for functional dyspepsia is considered useful as in unorthodox medicine by western doctors, and it is necessary to provide objective instrument for assessing acupuncture treatment for functional dyspepsia.

• 문화기술의 융합
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• 제10권3호
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• pp.865-872
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• 2024

Loperamide에 의한 변비는 위 배출, 소장 및 대장 운동성을 감소시켰으며, 과채복합추출물(Fruit and vegetable complex extracts, FVCE)은 이러한 효과를 예방한다. 우리는 다음과 같은 실험에서 로페로마이드(3mg/kg, sc, 14일)로 유발된 변비 수컷 Sprague-Dawley 쥐에 대한 프락토올리고당 및 과채복합추출물의 효과를 조사하였다. 쥐를 무작위로 정상대조군 쥐(일반식이), 변비 쥐(일반식이 + 로페로마이드), 200mg FVCE(200mg/kg/day FVCE + 로페로마이드가 보충된 일반 식이)로 처리한 변비 쥐, 400mg FVCE로 처리한 변비 쥐(200mg/kg/day FVCE와 로페로마이드가 보충된 일반 식단)으로 시험군을 구성하였다. 대조군 쥐에 비해 로페로마이드로 처리된 쥐에서 대변 배설량이 적고 대변 수분 함량이 더 낮았다. FVCE을 경구투여 하면 분변배설량의 감소를 억제하고 로페로마이드로 처리된 쥐의 대변 수분 함량. 로페로마이드를 처리한 쥐에서는 대장선와세포의 점액 생성과 대변 및 점막표면의 점액 함량이 감소하였다. 그러나 FVCE 처리군에서는 대장선와세포의 뮤신 함량이 증가하였고, Aclain blue로 염색된 점액층은 로페로마이드 처리군에 비해 FVCE 처리군에서 유의적으로 두꺼워졌다. 쥐 회장에서 로페로마이드는 회장 운동성을 억제한다. 이러한 결과는 FVCE가 로페로마이드에 의한 대장 연동 운동 억제 완화에 효과적이며 FVCE추출물이 변비 예방에 효과적 일 수 있다는 것을 나타낸다.