• 대한핵의학회지
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• 제29권3호
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• pp.313-318
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• 1995

통상적인 Tc-99m DISIDA 스캔도중 우연하게 위장역류가 발견되는 경우가 있는데 이의 임상적 의의를 알아보고자 1991년 12월부터 1995년 6월까지 충남대학교병원에서 통상적인 Tc-99m DISIDA 스캔을 시행한 1,553명의 환자들중 우연하게 위장부위로 방사능역류를 보인 36명의 환자들을 대상으로 후향적으로 이러한 환자들의 검사당시 임상상을 알아보았다. 1) 연구기간동안 시행한 Tc-99m DISIDA 스캔상 위장 역류는 2.3%에서 발견되었다. 2) 위장역류를 보인 대상환자중 위장관 및 담도계에 수술을 받은 과거 병력이 있는 경우는 19% 이었으며 역류가 없었던 환자들에서보다 의미있게 많았다(p<0.01). 3) 역류가 발견되는 시점은 Tc-99m DISIDA 정맥주사 후 30분에서 60분 사이가 50%로 가장 많았으며 60분에서 90분 사이가 23% 이었다. 4) 위장 역류를 보인 환자중 87%에서 위내시경 검사상 위염, 위궤양, 십이지장궤양, 위암등의 병변을 보였다. 이상에서 저자들은 Tc-99m DISIDA 스캔상 위-십이지장 역류를 보이는 경우는 역류가 없는 경우보다 위장관이나 담도계에 수술을 받은 병력이 있는 경우가 의미있게 많았으며 이들 중 상당수가 위-십이지장에 질환을 가지고 있음을 알 수 있었다.

• Journal of Gastric Cancer
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• 제20권1호
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• pp.72-80
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• 2020

Purpose: Proximal gastrectomy (PG) is a function-preserving surgery in cases of proximally located early-stage gastric cancer. Because gastroesophageal reflux is a major pitfall of this operation, we devised a modified esophagogastrostomy (EG) anastomosis to fix the distal part of the posterior esophageal wall to the proximal part of the anterior stomach wall to produce an anti-reflux mechanism; we named this the SPADE operation. This study aimed to show demonstrate the clinical outcomes of the SPADE operation and compare them to those of previous PG cases. Materials and Methods: Case details of 56 patients who underwent PG between January 2012 and March 2018 were retrospectively reviewed: 30 underwent conventional esophagogastrostomy (CEG) anastomosis using a circular stapler, while 26 underwent the SPADE operation. Early postoperative clinical outcome-related reflux symptoms, endoscopic findings, and postoperative complications were compared in this case-control study. Results: Follow-up endoscopy showed more frequent reflux esophagitis cases in the CEG group than in the SPADE group (30% vs. 15.3%, P=0.19). Similarly, bile reflux (26.7% vs. 7.7%, P=0.08) and residual food (P=0.01) cases occurred more frequently in the CEG group than in the SPADE group. In the CEG group, 13 patients (43.3%) had mild reflux symptoms, while 3 patients (10%) had severe reflux symptoms. In the SPADE group, 3 patients (11.5%) had mild reflux symptoms, while 1 had severe reflux symptoms (absolute difference, 31.8%; 95% confidence interval, 1.11-29.64; P=0.01). Conclusions: A novel modified EG, the SPADE operation, has the potential to decrease gastroesophageal reflux following a PG.

• 대한한방내과학회지
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• 제41권6호
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• pp.1162-1171
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• 2020

Objectives: The aim of this study was to determine the therapeutic effects of a traditional Korean treatment on the symptom improvement and loss of bile juice in cases of functional dyspepsia of gastric dysmotility complicated by bile juice reflux. Methods: Dyspeptic symptoms, gastric motility (electrogastrography and bowel sound analysis), and gastric mucosa (gastroendoscopy) were evaluated. The treatment consisted of Banwhasashim-tang (extract) used as a herbal drug. Both ST36 electrical stimulation and simple immersion stimulation of CV11, 12, and 13 in the abdomen were also applied. Results: Dyspeptic symptoms, including a foreign body sensation in the throat, indigestion, and upper abdominal pain, were all relieved by the treatment and gastric myoelectrical activity and gastric pyloric function were improved. Bile juice disappeared from the gastric mucosa. Conclusion: The traditional Korean treatment was effective at relieving dyspeptic symptoms and bile juice reflux by improving the pyloric sphincter function.

• 대한한방내과학회지
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• 제37권4호
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• pp.669-677
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• 2016

Reflux esophagitis is a common disease in developed nations. We describe the case of a female patient with endoscopic reflux esophagitis complicated by gastric dysmotility. Both electrogastrography and enterotachography were performed to detect gastric myoelectrical activity and pyloric sphincter function and evaluate gastric motility. The patient was treated only with herbal medications and general acupuncture, with electrical stimulation of the ST.36 (Zusanli) point, in addition to moxibustion therapy. After each primary and secondary treatment, the therapeutic effect was immediately evaluated. At the final follow-up 5 mon after the end of the secondary treatment, the patient’s general condition was assessed, in addition to the mucosa of the esophagus. At follow up, all the patients’ symptoms had disappeared, and the mucosa of the esophagus had returned to normal. We attributed these therapeutic effects to improved gastric dysmotility. To confirm the usefulness of this treatment method, studies of larger numbers of patients with reflux esophagitis treated with Korean traditional medicine are needed.

• Journal of Gastric Cancer
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• 제13권2호
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• pp.79-85
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• 2013

There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.

• The Korean Journal of Physiology and Pharmacology
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• 제5권4호
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• pp.315-321
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• 2001

This study was aimed to evaluate the effects of quercetin and desferrioxamine on the development of the reflux esophagitis induced surgically, on gastric secretion and on lipid peroxidation which is a marker of oxidative stress. Omeprazole was used as a positive control drug. Omeprazole significantly and dose-dependently prevented the development of reflux esophagitis, but quercetin or desferrioxamine prevented only at high dose. Omeprazole significantly and dose-dependently inhibited the gastric acid secretion (gastric volume, pH and acid output), but quercetin or desferrioxamine did not inhibit. Malonyldialdehyde content, the end product of lipid peroxidation, increased significantly after the induction of reflux esophagitis. Omeprazole prevented lipid peroxidation. Quercetin and desferrioxamine inhibited the lipid peroxidation independent of their actions on gastric secretion. This result indicates that omeprazole confirmed preventing effect of rat reflux esophagitis, but quercetin and desferrioxamine inhibited esophagitis by reduction of lipid peroxidation irrespective of gastric acid secretion.

• The Korean Journal of Physiology and Pharmacology
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• 제13권4호
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• pp.295-300
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• 2009

It was evaluated the inhibitory action of quercetin-3-O-${\beta}$-D-glucuronopyranoside (QGC) on reflux esophagitis and gastritis in rats. QGC was isolated from the herba of Rumex Aquaticus. Reflux esophagitis or gastritis was induced surgically or by administering indomethacin, respectively. Oral QGC decreased ulcer index, injury area, gastric volume, and acid output and increased gastric pH as compared with quercetin. Furthermore, QGC significantly decreased gastric lesion sizes induced by exposing the gastric mucosa to indomethacin. Malondialdehyde levels were found to increase significantly after inducing reflux esophagitis, and were reduced by QGC, but not by quercetin or omeprazole. These results show that QGC can inhibit reflux esophagitis and gastritis in rats.

• Journal of Gastric Cancer
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• 제20권3호
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• pp.337-343
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• 2020

Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.

• Journal of Gastric Cancer
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• 제14권4호
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• pp.229-237
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• 2014

Purpose: Laparoscopic distal gastrectomy (LDG) is a well-established procedure for the treatment of early gastric cancer. Several reconstruction methods can be adopted after LDG according to tumor characteristics and surgeon preference. This study aimed to compare the remnant gastric functions after different reconstructions. Materials and Methods: In total, 221 patients who underwent LDG between March 2005 and October 2013 were reviewed retrospectively. The patients were classified into four groups based on the reconstructive procedure: Billroth I (BI) anastomosis, Billroth II (BII) with Braun anastomosis, Roux-en-Y (RY) reconstruction, or uncut RY reconstruction. Patient demographics, surgical outcomes, and postoperative endoscopic findings were reviewed and compared among groups. Results: Endoscopic evaluations at $11.8{\pm}3.8$ months postoperatively showed less frequent gastritis and bile reflux in the remnant stomach in the RY group compared to the BI and BII groups. There was no significant difference in the gastric residue among the BI, BII, and RY groups. The incidence of gastritis and bile reflux in the uncut RY group was similar to that in the RY group, while residual gastric content in the uncut RY group was significantly smaller and less frequently observed than that in the RY group (5.8% versus 35.3%, P=0.010). Conclusions: RY and uncut RY reconstructions are equally superior to BI and BII with Braun anastomoses in terms of gastritis and bile reflux in the remnant stomach. Furthermore, uncut RY reconstruction showed improved stasis compared to conventional RY gastrojejunostomy. Uncut RY reconstruction can be a favorable reconstructive procedure after LDG.

• 동의생리병리학회지
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• 제24권6호
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• pp.970-975
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• 2010

Because Lonicerae Flos has effects of antiinflammatory and antioxidant, we studied an effect of Lonicerae Flos on reflux esophagitis (RE) through those effects. Rats were treated with three different dosages of LF (500, 250 and 125 mg/kg) orally for 14 days before pylorus and forestomach ligation. Six hrs after pylorus and forestomach ligation, we dissected a stomach and examined a stomach volume, gastric acid output, pepsin release in the stomach, total hexose, sialic acid in stomach tissue and histamine contents of sera. The results were compared with an ${\alpha}$-tocopherol (once orally, 1hr before operation, 30 mg/kg) treated group in which the effects on RE were already confirmed. Lonicerae Flos extract (LE) reduced gastric volumes compared to RE control. This indicate that LE protect a stomach mucosa by depressing of gastric acid release and corresponse with a reducing histamine content of serum. And LE decreasd a volume of pepsin in stomach compraed to RE control, LE increased contents of total hexose and sialic acid based on esophageal and gastric mucus. This indicated that an increased mucus by LE protected inflammation of esophagus mucosa and gastric mucosa induced by gastric acid. So, LE suppressed a gasric acid by decreasing a pepsin release in stomach, suppressed an injury of esophagus inducted by gastric acid with increasing esophageal mucus and a minimum dose of LE to RE was 250 mg/kg. The results suggest that antioxidant effects of LF could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.