• Radiation Oncology Journal
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• v.17 no.4
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• pp.314-320
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• 1999

Purpose : Paclitaxel is a chemotherapeutic agent with potent microtubule stabilizing activity that arrests cells in $G_2$-M phase. Because $G_2$ and M are the most radiosensitive phase of the cell cycle, paclitaxel has potential role as a cell-cycle specific radiosensitizer. This study was peformed to see the effects of paclitaxel on the radiation-induced damage of gastric mucosa of the rat. Materials and Methods : The rats were divided into the three groups i.e., paclitaxel alone group, radiation alone group and, a combination of paclitaxel and radiation in combined group. A single intraperitoneal infusion of paclitaxel (10 mg/kg) was done in paclitaxel alone group. In radiation alone group, a single fraction of irradiation (8 Gy, x-ray) to the whole abdomen and, a combination of a single fraction of irradiation (8 Gy, x-ray) to the whole abdomen was given 24 hrs after paclitaxel infusion In combined group of paclitaxel and radiation. The incidence of mitosis and apoptosis as well as histologic changes of the gastric mucosa were evaluated at 6 hrs, 24 hrs, 3 days and 5 days after treatment. Results : The number of the mitosis was not increased by paclitaxel infusion. The incidence of the apoptosis was similar from 6 hrs to 3 days after paclitaxel infusion and was decreased at 5 days. Paclitaxel induced minimal glandular dilatation and cellular atypia of gastric mucosa at 24 hrs and 3 days. In irradiation group, the incidence of apoptosis was $6.0\%$ in 6 hrs and $1.25\%$ in 24 hrs after irradiation and minimal glandular dilatation and cellular atypia were noted throughout the experimental period. The incidence of apoptosis in the combined group of paclitaxel and irradiation ($4.5\%$) was significantly higher than irradiation alone group ($1.25\%$) at 3 days (p<0.05). Conclusion : Paclitaxel had no mitotic on mitotic arrest in gastric mucosa of the rat. Increased number of apoptosis in combined paclitaxel and irradiation group suggested the additive effects of paclitaxel on irradiation.

• Current Research on Agriculture and Life Sciences
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• v.1
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• pp.201-214
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• 1983

A study was undertaken on rats in order to clarify the gastric mucosal, morphologic response to oral and subcutaneous administration of acetylsalicylic acid(aspirin). Aspirin was administered orally (oral group) and subcutaneously (subcutaneous group) at does rate of 60 mg per kg of body weight per day to 40 normal rats. On the 1st, 3rd, 7th, and 15th day of administration, in addition to clinical observation, 5 rats each from the both groups were sacrificed and examined macroscopically, histologically and electron-microscopically for the morphological changes of gastric mucosal cells with the following results. Although the clinical, macroscopic and histological changes were not significant, marked ultrastructural changes were observed. Parietal and chief cells were affected most severely by the administration of aspirin ; parietal cells showed increase in the number of SER and intracellular canaliculi, where-as in chief cells fragmentation, luminal dilatation, decrease in the number and structural abnormalities of RER were seen. Relatively mild changes were observed in mucous, mucous neck and basal-granulated cells. Although the degree of changes was milder than those of oral group, the similar changes were also observed in the subcutaneous group. From these results, it would be concluded that aspirin injury of gastric mucosa is effected not only by the direct injury to the mucosa but also indirectly by the blood concentration of aspirin.

• Journal of Gastric Cancer
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• v.19 no.3
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• pp.290-300
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• 2019

Purpose: The optimal method for intracorporeal esophagojejunostomy remains unclear because a purse-string suture for fixing the anvil into the esophagus is difficult to perform with a laparoscopic approach. Therefore, this study aimed to evaluate our novel technique to fix the anvil into the esophagus. Materials and Methods: This retrospective study included 202 patients who were treated at our institution with an intracorporeal circular esophagojejunostomy in a laparoscopy-assisted total gastrectomy with a Roux-en-Y reconstruction (166 cases) or a laparoscopy-assisted proximal gastrectomy with jejunal interposition (36 cases). After incising 3/4 of the esophageal wall, a hand-sewn purse-string suture was placed on the esophagus. Next, the anvil head of a circular stapler was introduced into the esophagus. Finally, the circular esophagojejunostomy was performed laparoscopically. The clinical characteristics and surgical outcomes were evaluated and compared with those of other methods. Results: The average operation time was 200.3 minutes. The average hand-sewn purse-string suturing time was 6.4 minutes. The overall incidence of postoperative complications (Clavien-Dindo classification grade ${\geq}II$) was 26%. The number of patients with an anastomotic leakage and stenosis at the esophagojejunostomy site were 4 (2.0%) and 12 (6.0%), respectively. All patients with stenosis were successfully treated by endoscopic balloon dilatation. There was no mortality. Regarding the materials and devices for anvil fixation, only 1 absorbable thread was needed. Conclusions: Our procedure for hand-sewn purse-string suturing with the double ligation method is simple and safe.

• Journal of Gastric Cancer
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• v.8 no.3
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• pp.160-165
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• 2008

Purpose: With the introduction of H. pylori eradication and proton pump inhibitor, the operative treatments for the acute or chronic complications of peptic ulcer, such as perforation, bleeding and stricture, have decreased. Also owing to the development of non-operative treatment such as interventional endoscopic treatment, the surgical approach to the acute complications, like perforation and bleeding, has diminished. The non-operative treatments for the stricture and obstruction of chronic peptic ulcer in part related to discontinuation of medication have not been satisfactory. We analyzed the clinical outcomes of the patients who underwent operative treatment for outlet obstruction with peptic ulcer. Materials of Methods: From January 1994 to December 2007, we reviewed 31 patients who had been operated on at the National Medical Center for peptic ulcer obstruction. We excluded the cases of adhesive obstructions that were caused by a former ulcer operation and also the cases of obstructions found during emergency operations for treating perforation and bleeding. We classified the surgical treatment group into the bypass operation group and the surgical resection group. We evaluated the effects of the operations by the Visick score. The recurrences were confirmed only by the endoscopic observation of peptic ulcer. Results: The number of patients in the bypass operation group was 6 (19.4%) and that of resection group was 25 (80.6%). The mean age was 57.5 (25~81) years. The number of male patients was 29 (93.5%) and the number of females was 2 (6.5%). The mean symptom duration was 29.6 months. There were 19 smokers (61.3%), 6 NSAID users (19.4%) and 7 H. pylori positive patients (22.6%). Two patients underwent endoscopic balloon dilatation with no success. The locations of lesion were the stomach, the duodenum and both in 9, 20 and 2 cases, respectively. There were operative complications in 13 cases (41.9%), recurrent ulcers in 2 cases (6.5%), and reoperations in 4 cases. The mean Visick score was 1.8 (1~4). There were no statistically significant clinicopathologic differences between the bypass operation group and the resection group. The two groups had 1 case each of recurrence. Although the bypass group had a greater complication rate (83.3%) than the resection group (32%), this was not statistically meaningful (P=0.175). The mean Visick score was 3.0 in the bypass group and 1.6 in the resection group, so the resection group was better (P=0.001). Conclusion: For a case of chronic peptic ulcer with outlet obstruction, even though it has been reported that endoscopic balloon dilatation worked well, surgery is still regarded as an important treatment. If you consider the patients' satisfaction and the difficulty of diagnosing malignant ulcers, surgical resection should be recommended more often than a bypass operation.

• Journal of Yeungnam Medical Science
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• v.31 no.1
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• pp.56-60
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• 2014

Hepatic portal venous gas (HPVG) is a rare radiographic finding associated with severe intra-abdominal disease and fatal outcome. Most cases of HPVG are historically related to mesenteric ischemia accompanied by bowel necrosis. The current spread of computed tomography scan promotes not only the early detection of related severe diseases but also the identification of other causes of HPVG. It has been reported in many non-fatal conditions, such as inflammatory bowel disease, intra-abdominal abscess, bowel obstruction, paralytic ileus, endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, and gastric dilatation. Among these, paralytic ileus is a very rare condition, with no case yet reported in South Korea. Reported herein is a case of HPVG in paralytic ileus, which was treated well internally and was promptly resolved.

• The Korean Journal of Pharmacology
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• v.8 no.1
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• pp.77-87
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• 1972

Korean rheum (Rheum undulatum Linne) as one of the botanical crude drugs which belong to polygonaceae family has been extensively applied in Chinese medicine during the last decades. It has been particularly used in cathartic and gastric tonic among the folk remedies. There are, however, a few reports with regard to the pharmacological effects on the motility of intestines of several animals. The authors hereby paid attention to this point of view and made experiment to examine the relationship between the alcohol extract of Korean rhei rhizoma and the motility of the isolated rabbit intestine, making the use of several drugs related to the motility of intestine such as acetylcholine, pilocarpine, atropine, papaverine, serotonin, and barium chloride. The movement of the isolated rabbit intestine in Tyrode's solution was recorded with the electric kymograph according to the Magnus method. The results of the experiment are as follows. 1. The motility of the isolated rabbit intestine represents the tendency of gradual dilatation in proportion to the concentration of R-A $10^{-4}$, $5{\times}10^{-4}$, and $10^{-3}$. 2. R-A $5{\times}10^{-4}$ does not seem to have the significant effect with acetylcholine, pilocarpine and atropine on motility of the isolated rabbit intestine strip. 3. R-A $5{\times}10^{-4}$ significantly blocks the contractile effect caused by serotonin $10^{-6}$ on motility of the isolated rabbit intestine strip. 4. R-A $5{\times}10^{-4}$ significantly blocks the contractile effect caused by barium chloride $10^{-4}$ on motility of the isolated rabbit intestine strip. 5. R-A $5{\times}10^{-4}$ significantly synergizes the dilatative effect caused by papaverine $10^{-6}$.

• Advances in pediatric surgery
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• v.13 no.2
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• pp.105-111
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• 2007

We reviewed the records of 25 patients who were re-operated upon after primary repair of esophageal atresia with or without fistula at the Department of Pediatric Surgery, Seoul National University Children's Hospital, from January 1997 to March 2007. Types of the esophageal atresia anomalies were Gross type A in 5 patients, C in 18, and E in 2. The indications for re-operation were anastomosis stricture (n = 14), tracheo-bronchial remnant (n = 4), persistent anastomosis leakage (n = 3), recurrent tracheo-esophageal fistula (n = 2) and esophageal web (n = 2). The interval between primary and secondary surgery was from 48 days to 26 years 5 months (mean: 2 years and 4 months). Four patients required a third operation. The interval between the second and third operation was between 1 year 1 month and 3 year 10 month (mean: 2 years 5 months). Mean follow up period after last operation was 35 months (1 years-8 years 6 months). The secondary surgery was end-to-end esophageal anastomosis in 15, esophagoplasty in 5, gastric tube replacement in 5. After secondary operation, 6 patients had anastomosis stricture (4 patients were relieved of the symptoms by balloon dilatation, 2 patients underwent tertiary operation). Five patients had leakage (sealed on conservative management in all). Two patients had recurrent tracheo-esophagel fistula (1 patient received chemical cauterization and 1 patient underwent tertiary operation). Currently, only one patient has feeding problems. There were no mortalities. Secondary esophageal surgery after primary surgery for esophageal atresia was effective and safe, should be positively considered when complications do not respond to nonoperative therapy.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.2
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• pp.157-160
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• 2018

Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

• Journal of Gastric Cancer
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• v.5 no.4 s.20
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• pp.246-251
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• 2005

Purpose: Benign anastomotic stricture after an esophagojejunostomy using EEA stapler following a radical total gastrectomy is one of the most serious complications. The purpose of this study is to evaluate the incidence risk factors, and treatment associated with benign stricture. Materials and Methods: From March 1998 to February 2001, 436 patients underwent an esophagojejunostomy with Roux-en-Y anastomosis using an EEA stapler followed by an endoscopy. Thirty three of the 436 patients(5.5%) developed an anastomotic stricture; included 24 of the 33 patients had a benign stricture. Nine patients with a malignant stricture were excluded. Results: The median age of the 436 patients was 57 years $(23{\sim}85\;years)$. Two hundred ninety two patients were male, and 144 patients were female. The median time to diagnosing the stricture was 1.5 months $(0.5{\sim}6months)$. There was no statistical significance in any of the risk factors, including the diameter of the stapling device, the status of adjuvant treatment, the status of reflux esophagitis, and a clinical history of diabetes and hypertension. The strictured patients were treated with balloon dilatation, one to three times, with symptom relief. Conclusion: There were no statistically significant risk factors. However, further study of the vascularity of anastomoses and benign strictures needs to be considered. In the anastomotic strictured patients endoscopic balloon dilatation appeared to be the first line of treatment.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.1-5
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• 2006

Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)