Kim, Hoi-Young;Son, Hyun-Soo;Lim, Sung-Woo;Nam, Hyo-Ik
The Journal of Internal Korean Medicine
/
v.28
no.2
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pp.209-216
/
2007
Background & Objective : The herbal medicine JGT has been used for the treatment of functional dyspepsia, generally categorized as a gastric disease. However, its effect and mechanism are not yet well known. Therefore, the effects of JGT on gastric emptying in rats was investigated to know its effectiveness and mechanism. Methods : Gastric emptying effect was measured by the number of glass beads expelled from the stomach within an hour after glass beads and test drugs were administered. In another series of experiments to evaluate the mechanisms of JGT under delayed conditions, the rats were treated with atropine sulfate Results : Intragastric administration of JGT significantly increased gastric emptying of glass beads Under the gastric emptying delayed with atropine sulfate, JGT insignificantly increased gastric emptying of glass beads. Conclusions : These suggest that JGT has a significant effect to stimulate gastric emptying. Results are indicative of JGT as an especially effective remedy for dysmotility-like functional dyspepsia with impaired reservoir function such as gastric adaptive relaxation.
Moon, Jong Wun;Lee, Chung Wun;Seo, Young Deok;Yun, Sang Hyeok;Kim, Yong Keun;Won, Woo Jae
The Korean Journal of Nuclear Medicine Technology
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v.17
no.2
/
pp.31-36
/
2013
Purpose: Measure gastric emptying time (GET: Gastric Emptying Time) is a non-invasive and quantitative evaluation methods, mainly by endoscopic or radiological examination confirmed no mechanical obstruction in patients with symptoms of congestion is checked. Such tests are not common gastric emptying time measured esophageal cancer patients (who underwent esophagectomy) patients after surgery for gastric emptying time was measured test. And the period of time for more than one year after the gastric emptying time measurement was performed. By comparing the two kinds of tests in the chest cavity after surgery as the evaluation of gastrointestinal function tests evaluate the usefulness of GET, and will evaluate the characteristics of the image. Materials and Methods: 93 patients who underwent esophagectomy with gastric emptying time measurement of subject tests immediately after surgery and after 1 year or longer were twice. Preparation of the patient before the test is more than 12 hours of overnight fasting is important, in addition to the medicine or to stop smoking, and diabetes insulin injections should be early in the morning is ideal to test. Generally labeled with $^{99m}Tc-DTPA$ resin which is used to make steamed egg, seaweed and fermented milk with a high viscosity after eating, three hours in the standing position was measured. Evaluation of gastric emptying curves on the way intragastric radioactivity level by 50% the time (half-time [T1/2]) was calculated, based on the half-life was divided into three steps: over 180 minutes was defined as delayed gastric emptying, within 180minutes was defined as intermediate gastric emptying and when all the radioisotopes were dumped into the jejunum as soon as swallowed, was defined as rapid gastric emptying. Results: Gastric emptying time of a typical images stomach of antrum and fundus additional images appear stronger over time move on to the small intestine. but esophageal cancer who underwent esophagectomy side of the thoracic cavity showed a strong image. Immediately after surgery, the half-time (T1/2) of rapid gastric emptying appeared to 12.9%, intermediate gastric emptying appeared to 52.7%, delay gastric emptying appeared to 34.4%. After more than a year the results of the half-life after surgery, 67% of rapid gastric emptying to intermediate gastric emptying was changed, 69% of delay gastric emptying to intermediate gastric emptying changed. Intermediate gastric emptying worse in patients rapid gastric emptying and the delay gastric emptying is 24% in the case. Conclusion: Esophagectomy for esophageal cancer who underwent half-time measurement test (T1/2) rapid gastric emptying and delay gastric emptying are the result of the comparison over time, changes were observed intermediate gastric emptying. Mainly seeing of gastric emptying time measurement in the esophagus instead of thoracic cavity to check the evaluation of gastrointestinal function can be useful even means. And segmentation criteria and narrow time interval of checking if more accurate information and analysis of the clinical diagnosis and evaluation seems to be done.
A gamma camera coupled to a computer was used in 20 normal volunteers after ingestion of the mixture of $^{99m}Tc-DTPA$ and milk in order to determine gastric emptyng time (GET) and to evaluate the effect of metoclopramide, a dopamine antagonist that stimulates gastric motility, to gastric emptying. The normal value for biological gastric emptying half time was found to be $63{\pm}7$ minutes, and the gastric emptying was monoexponential fashion, at least for the first 60 minutes. Among the 20 volunteers, nine were repeated the test after injection of metoclopramide, which has significantly reduced the value of GET to $31{\pm}3$ minutes (p<0.01). GET test using $^{99m}Tc-DTPA$ is very useful in gastric function evaluation, especially in follow-up check of the functional change.
The role of surgical intervention in patients with diabetic gastroparesis is unclear. We report a case of a 37-year-old man with a history of recurrent episodes of vomiting and long-standing type 2 diabetes mellitus. Esophagogastroduodenoscopy did not reveal any findings of reflux esophagitis or obstructive lesions. A gastric emptying time scan showed prolonged gastric emptying half-time (344 minutes) indicating delayed gastric emptying. Laboratory tests revealed elevated fasting serum glucose and glycosylated hemoglobin (HbA1c, 12.9%) and normal fasting C-peptide and insulin levels. We performed Roux-en-Y reconstruction after subtotal gastrectomy to treat gastroparesis and improve glycemic control, and the patient showed complete resolution of gastrointestinal symptoms postoperatively. Barium swallow test and gastric emptying time scan performed at follow-up revealed regular progression of barium and normal gastric emptying. Three months postoperatively, his fasting serum glucose level was within normal limits without the administration of insulin or oral antidiabetic drugs with a reduced HbA1c level (6.9%). Long-limb Roux-en-Y reconstruction after subtotal gastrectomy may be useful to treat severe diabetic gastroparesis by improving gastric emptying and glycemic control.
Kim, Keum-ji;Jeon, Hye-jin;Ko, Seok-jae;Park, Jae-woo
The Journal of Internal Korean Medicine
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v.41
no.6
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pp.1030-1051
/
2020
Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.
Background & Objective : The herbal medicine Sojukgunbihwan granule has been used for the treatment of functional dyspepsia, generally categorized as a gastric dysmotility disease. However, its mechanisms are not yet well known. Therefore, the effects of Sojukgunbihwan granules on gastric motility in rats was investigated. Methods : The myoelectrical activity of the gastric smooth muscle was recorded by a bipolar electrode placed at the gastric antrum of rats. The contractile waves were measured for 30 minutes before and after intragastric administration of each solution(normal saline, Pyungwisan 40mg/kg, Sojukgunbihwan granules 60mg/kg) and expressed as the motility index. Gastric emptying was measured by the number of glass beads expelled from the stomach(containing one hundred 1mm glass beads) within an hour after glass beads and test drugs(normal saline, Pyungwisan 40mg/kg, Pyungwisan 120mg/kg, Sojukgunbihwan granules 60mg/kg, Sojukgunbihwan granules 180mg/kg) were administered. In another series of experiments to evaluate the mechanisms of Sojukgunbihwan granules under delayed conditions, the rats were treated with atropine sulfate(1 mg/kg, s.c.), cisplatin(10mg/kg, i.p.), and NAME($N^G$-nitro-L-arginine methyl ester, 75mg/kg, s.c.) respectively. Results : Intragastric administration of Sojukgunbihwan granules increased the myoelectrical activity significantly, gastric motility index rose 25%, and gastric emptying of glass beads was significantly enhanced over a period of 60minutes. Under the delayed gastric emptying induced by atropine sulfate, cisplatin, and NAME, Sojukgunbihwan granules aggravated gastric emptying in the atropine sulfate($5.71{\pm}3.45\;vs\;3.71{\pm}4.42$) and cisplatin($13.86{\pm}3.53\;vs\;5.14{\pm}5.05$, p<0.01) treated groups, but enhanced gastric emptying in the NAME treated group($5.00{\pm}3.21\;vs\;11.71{\pm}5.65$, p<0.05). Conclusions : Results suggest that Sojukgunbihwan granules stimulate gastric motility through cholinergic and 5-hydroxytryptamine 3 receptors. Results are indicative of Sojukgunbihwan as an especially effective remedy in dysmotility-like functional dyspepsia with impaired reservoir functions such as gastric adaptive relaxation.
Objectives : This study was aimed to investigated the effect of Yijin-tang on gastric motility and its mechanism of action in normal intact and partial pyloric obstructed rats. Methods : Gastric emptying was measured by the number of glass beads expelled from the stomach (containing one hundred of glass beads. ${\phi}1mm$) in 1 hour or 2 hours after glass beads and test drugs (normal saline. Yijin-tang 90mg/kg. Yijin-tang 270mg/kg) administration in normal intact and partial pyloric obstructed rats. In another series of experiments to evaluate the mechanism of Yijin-tang 270mg/kg under delayed conditions, normal intact rats were treated with atropine sulfate (1mg/kg,s.c.), cisplatin (10mg/kg,i.p.), quinpirole HCI (0.3mg/kg,i.p.) and NAME (NG-nitro-L-arginine methyl ester. 75mg/ kg,s.c.), respectively. Partial pyloric obstructed rats were modified by wrapping the nonabsorbable rubber ring (D :6mm, W:4mm, T: 1mm) around the 1st portion of the duodenum for 8 weeks. The myoelectrical activity of the gastric smooth muscle was recorded by a bipolar electrode placed at the abdominal surface in normal intact and partial pyloric obstructed rats. The gastric myoelectrical activity was measured for 30 minutes before and after orogastric administration of each solution (normal saline, Yijin-tang 270mg/kg) and expressed as dominant frequency, percent of normogastria and power ratio. Results : Yijin-tang improved gastric emptying more than normal saline in normal intact(p<0.001) and partial pyloric obstructed rats(p=0.002). Under the delayed gastric emptying induced by atropine sulfate, cisplatin, quinpirole HCI and NAME. Yijin-tang enhanced gastric emptying significantly in the cisplatin treated group(p<0.001). but didn't in other treated groups. Administration of Yijin-tang 270mg/kg has no significant effect on the myoelectrical activity of the gastric smooth muscle in both normal intact rats and partial pyloric obstructed rats. Conclusions : Yijin-tang seems to stimulate the gastric motility through suppressing the 5HT3 receptor and promoting the antroduodenal flow. We expect that Yijin-tang would be effective especially in dysmotility-like functional dyspepsia with partial pyloric obstruction or the side effects of cisplatin such as nausea, vomiting, abdominal discomfort, and delay of gastric emptying.
Kim, Jin-A;Lim, Seung-Han;Moon, Seong-Keun;Lee, Sang-Yeol
Korean Journal of Psychosomatic Medicine
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v.9
no.1
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pp.49-57
/
2001
Objectives : This study was designed to investigate the relationship between gastric emptying, psychopathology(especially anxiety and depression), and various factors that can mediate stress and response, such as coping style, social support and level of perceived stress. Methods : A total 30 patients who complained of the non-ulcer dyspepsia and did not have any abnormal finding on the gastroduodenal endoscopic examination, 24 hour ambulatory esophageal manometry and conventional gastroesophageal manometry were tested with gastric emptying that would be a functional examination of stomach. The correlations between the gastric emptying and psychological vaiable such as quantity of perceived stress, Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), Spielberger Stait-Trait Anxiety Inventory(STAI), Ways of Coping Checklist and Interpersonal Support Evaluation List were evaluated. Results : 1) The mean and standard deviation of the time for half of the meal to empty(T50%) was $118.50{\pm}23.64$ minute which showed no gastric stasis in terms of gastric emptying test. 2) There were significant positive correlations between T50% and the state anxiety, T50% and thedepression. 3) There was no significant correlation between T50% and the quantity of perceived stress, T50% and mediating factors(coping style and social support). Conclusion : These results suggested that psychopathology, especially emotional components such as depression and anxiety, could affect on the current physiological functional gastric activity(gastric emptying), but quantity of perceive stress and mediating factors of stress and response such as coping style and social support could not affected on the functional gastric activity. These results showed that psychological interventions should considered in management of the patients with functional dyspepia.
Abnormal gastric emptying time of dog by alien substance, neoplasm, pyloric antrum hyperplasia, stomach surgery, electrolyte imbalance, stomach-dilated torsion is clinically important as a digestive disease. Therefore study aims to provide basic data on the clinical usefulness of gastric emptying time test which uses radiopaque Kolomark developed in Korea rather than using the existing BIPS for the dog. 9 beagles were used for this experiment and their average weight was about 10.3kg with 2.5 year-old average age. For the test, fast for 12 hours was made without chemical sedation, and just before the test, 1 capsule of Kolomark was fed with 25% of daily feed amount, and we took photographs at ventrodorsal and right lateral position after 2, 4, 8 and 12 hours. As for interested reading area, we observed entire stomach from cardia to stomach pyloric part, and as for analysis method, we counted Kolomarks remained in the stomach per time and judged only P value below 0.05 to be meaningful by using Friedman Test. After feeding Kolomark through oral cavity, it took average 7.55 hours for the Kolomark to have escaped from the stomach to small intestine. In this study of gastrointestinal tract passing time after feeding matured dog, we used Kolomark and expect that it could be a basic data for normal gastrokinetic time.
Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes alter therapy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy.
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