• Journal of Gastric Cancer
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• 제21권3호
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• pp.298-307
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• 2021

Purpose: Delayed gastric emptying usually manifests as gastric food retention. This study aimed to evaluate the incidence of gastric food retention after distal gastrectomy with gastrojejunostomy in gastric cancer patients and identify the risk factors for its development. Materials and Methods: We retrospectively enrolled 245 patients who underwent distal gastrectomy with gastrojejunostomy for gastric cancer at Boramae Medical Center between March 2017 and December 2019. We analyzed the presence of gastric food residue via computed tomography (CT) scans at 3 and 12 months postoperatively and analyzed the risk factors that may influence the development of gastric food retention. Results: CT scans were performed on 235 patients at 3 months and on 217 patients at 12 months postoperatively. In the group that received closure of Petersen's space, the incidence of gastric food retention was significantly low as per the 3- and 12-month postoperative follow-up CT scans (P=0.028 and 0.003, respectively). In addition, hypertension was related to gastric food retention as per the 12-month postoperative follow-up CT scans (P=0.011). No other factors were related to the development of gastric food retention. In the multivariate analysis, non-closure of Petersen's space (hazard ratio [HR], 2.54; 95% confidence interval [CI], 1.20-5.38; P=0.010) was the only significant risk factor for gastric food retention at 3 months postoperatively, while non-closure of Petersen's space (HR, 2.81; 95% CI, 1.40-5.64; P=0.004) and hypertension (HR, 2.30; 95% CI, 1.14-4.63; P=0.020) were both significant risk factors for gastric food retention at 12 months postoperatively. Conclusions: Closure of Petersen's space has an effect on decrease the incidence of gastric food retention after distal gastrectomy with gastrojejunostomy in gastric cancer patients.

• 대한핵의학회지
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• 제23권1호
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• pp.41-48
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• 1989

$^{99m}Tc-Pertechnetate\;(TcO_4^-)$ is concentrated by the stomach after intravenous injection, allowing the detection of ectopic gastric mucosa. It has been used to develop a noninvasive test of gastric secretion. However the cellular site of concentration is still controversial, that is whether mucin-secreting epithelial cell or acid-secreting parietal cell. This study is planned to investigate the effects of cimetidine and gastric acidity on the retention of $TcO_4^-$ in the gastric wall of the rat. Also we further attempted to clarify the uptake and secreting cell of $TcO_4^-$ in the gastric mucosa. One hundred rats were divided into two groups, preliminary (40 rats) and main examination group (60 rats). Preliminary examination group was composed of fasting group (20 rats) for the detection of the time for reaching stable $TcO_4^-$ retention ratio in gastric wall and post-prandial group (20 rats) for the detection of the time for reaching the maximal gastric acidity. Main examination group was composed of fasting group (30 rats), which was subdivided into control group (10 rats), cimetidine group (10rats), $Mylanta^{(R)}$ group (10 rats) and post?prandial group (30 rats), which was subaivided into 90 min group (10 rats), 90 min cimetidine group (10 rats), and 120 min group (10 rats). Retention ratio (%) of $TcO_4$ in the gastric wall and the pH of the gastric contents were measured in the extracted stomach of the six groups. Gastric wall retention ratio of $TcO_4^-$ was calculated by the gastric wall radioactivity (cpm) divided by total gastric radioactivity (cpm) at 30 mins after intravenous injection of 0.4 mCi of $TcO_4^-$. The results were as follows: 1) The time required for reaching stable $TcO_4$ retention ratio and the lowest gastric PH were 30 min and 90 min, respectively. 2) In the fasting group, the gastric wall retention ratio of $TcO_4^-$ was significantly increased in the cimetidine group, compared with the control group (P < 0.01). However there was no significant difference between the control and $Mylanta^{(R)}$ group 3) The $TcO_4^-$ retention ratios of 90 min and 120 min groups were lower than that of the fasting control group (p < 0.05), either. After administration of cimetidine, the retention ratio was significantly increased in 90 min group (p < 0.01). 4) While $TcO_4^-$ retention ratio and gastric pH were well correlated in the post-prandial 120 min group (r=0.7112, p<0.05), in the post-prandial 90 min and 90 min cimetidine groups correlated poorly. However, there was no correlation in the three fasting groups at all. Referring the above results, we infer that $TcO_4^-$ is secreted into the gastric lumen by both parietal and non-parietal cells, with dominant non-parietal $TcO_4^-$ secretion in the fasting state and dominant parietal $TcO_4^-$ secretion in the stimulated state.

• 대한한의학회지
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• 제35권4호
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• pp.110-115
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• 2014

Objectives: A 54-year-old advanced gastric cancer patient developed severe fluid retention after docetaxel chemotherapy, at cumulative dose of $930mg/m^2$, with no improvement using diuretics or prophylactic glucocorticoids. Consequently, he changed chemotherapy regimen from docetaxel to paclitaxel. After he treated with herbal decoction Bangkihwangki-tang (BHT), which is widely used to treat several symptoms including edema in traditional Korean medicine, docetaxel-induced fluid retention (DIFR) was significantly improved along with associated symptoms, such as peripheral edema, pleural and pericardial effusion, pain, scleroderma, and hypoesthesia. As the symptoms were relieved, his performance status and ambulatory ability were improved. During herbal treatment, he continued chemotherapy without any problems and didn't show any adverse events related to herbal medicine. Although there is possibility of natural improvement progress after withdrawal of docetaxel, he showed shorter recovery period and significant improvement despite of severity of initial symptoms.

• Journal of Nutrition and Health
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• 제28권4호
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• pp.291-297
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• 1995

This study aimed to verify the nutritional and curative effects of protein hydroysate in rats model with gastric ulcer induced by restraint and water-immersion stress. Sprague-Dawley, famale rats weighing approximtely 200g were forced in 5$\times$5$\times$15cm plexiglas cage. The restraint and water immersion stress was carried at 20$\pm$2$^{\circ}C$ for 8-hours. After stress 4 kinds of diets(10% casein, 20% casein, 10% casein hydrolysate, 20% casein hydrolysate) were given for 5 days. In the gastric ulcer rats model, the growth, gastric emptying rate, trypsin activity in gastrointestinal content, plasma total protein, albumin, $\alpha$-amino-N, UUN, creatinine and hydroxyproline of the urine and nitrogen retention were analyzed for nutritional effects of dietary nitrogen levels(10%, 20%) and sources (casein, casein hydrolysate). The results were as follows ; In gastric ulcer rats model, severeness of ulcer, plasma protein, gastric emptying rate, nitrogen retention rate were not different between 20% casein-fed group and 20% casein hydrolysatefed group. But 10% casein hydrolysate-fed group had more curative group. The casein hydrolysate diet-fed group was lower trysin activity in small intestianl content than the casein-fed group, at both casein level(10%, 20%). Finally at 20% levels, there was no difference between casein and casein hydrolysate diet, but 10% level, casein hydrolysate diet was more curative of ulcer than casein diet in gastric ulcer rat model. The results of this study provide useful information concerning diet therapy for the patients with gastrointestinal diseases and the field of enteral diet materials.

• Journal of Pharmaceutical Investigation
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• 제38권1호
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• pp.51-55
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• 2008

To develop a novel metformin HCl-loaded GR type tablet, various tablets were compressed with poly acrylic acid (PAA) and hydroxypropylmethyl cellulose (HPMC) using a wet granulation, and their physical properties such as swelling rate, hardness and dissolution were then investigated. Among the formulae tested in this study, the tablet prepared with PAA 971 and 974 as disintegrants showed fastest dissolution rate and swelling rate. Furthermore, the tablets prepared with PAA and HPMC improved the swelling rate, hardness and dissolution compared to those prepared with only HPMC. Our results suggested that the tablets prepared with PAA 971, 974 and HPMC might be a potential candidate for gastric retention type tablets.

• Journal of Nutrition and Health
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• 제27권7호
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• pp.699-708
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• 1994

This study aimed to verify the nutritional and curative effects of protein hydrolysate in rats with cysteamine-induced duodenal uncer. Duodenal ulcer rat model was established by intraperitoneal injections of cysteamine. Sprague-Dawley, female rats weighing approximately 200g were intraperitoneally injected twice cysteamine(13mg/100g BW) at intervals of 3h per day. This procedure was repeated 3$\times$at intervals of 3d. Animals fed on 10% casein diet for infection periods. After last injection, 4 kinds of diets(10% casein, 20% casein, 10% casein hydrolysate, 20% casein hydrolysate) were given. Gastric montility, trypsin activity in gastrointestinal content, retention rate of nitrogen, plasma total protein, albumin, amino-N, urinary urea nitrogen, creatinine and hydroxyproline were analyzed for nutritional effects of dietary nitrogen levels(10%, 20%) and sources(casein, casein hydrolysate). In duodenal ulcer rat model, there was no differences between 20% casein diet and 20% casein hydrolysate in the view of severeness of ulcer, gastric emptying rate, serum total protein, serum albumin, plasma $\alpha$-amino-N, UUN, creatinine excretion, GFR, nitrogen retention. On the other hand, rats on 10% casein hydrolysate diet group had more curative effect of the ulcer, higher plasma albumin concentration and nitrogen retention than 10% casein diet group. The casein hydrolysate diet group was lower trypsin activity in small intestinal content than the casein diet group, at both nitrogen levels(10%, 20%). The results suggest that protein hydrolysate be applied in diet therapy for the patients with gastrointestinal ulcer.

• Journal of Pharmaceutical Investigation
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• 제23권3호
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• pp.145-153
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• 1993

Retaining a drug in the stomach by some means is sometimes necessary to extend the G1 absorption time of the drug more than 6-8 hrs. Hydrogel has often been examined for its feasibility as a dosage form, so called platform, that could be retained in the stomach due to its excellent swelling properties in the gastric fluid. In this study, polyvinylpyrrolidone (PVP) hydrogel crosslinked by albumin or acrylated albumin was synthesized in a tablet form and evaluated for its possibility as the platform. The synthesis of the hydrogel was performed by $^{60}Co\;{\gamma}-ray$ irradiation of N-vinyl-2-pyrrolidone (monomer) in the presence of a crosslinking agent: aqueous solution of albumin or acrylated albumin. Synthetic conditions such as radiation dose, dose rate and concentration of crosslinking agent were varied in order to optimize the swelling and mechanical properties of the hydrogels. Degree of swelling of albumin-crosslinked PVP (Al-PVP) was highly dependent on radiation dose, dose rate and albumin concentration: it was decreased as they increased. On the other hand, that of acrylated albumin-crosslinked PVP (Acryl-PVP) was almost independent on them except dose rate: it was decreased as the radiation dose rate increased. The compressive strength of the two hydrogels was decreased as the dose rate increased. Digestion of both PVP in artificial gastric fluid containing pepsin was delayed by the ${\gamma}-ray$ irradiation. In conclusion, Al-PVP and Acry-PVP with diverse swelling and mechanical properties could be obtained by controlling synthetic conditions, mainly the irradiation dose rate.

• 대한한방내과학회지
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• 제36권4호
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• pp.527-546
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• 2015

Objectives The purpose of this study was to investigate the correlation between gastric emptying measured by ultrasonography and Korean medical instruments of diagnosis and assessment in functional dyspepsia (FD) patients. Among the subgroups of FD, postprandial distress syndrome (PDS) is related to gastric motility disorder.Methods Ten patients with FD and particularly with PDS as well as 10 healthy controls were enrolled in the study from September to November 2015. The gastric emptying shown as the half-life of gastric volume (T_1/2) was measured by ultrasonography. The severities of spleen qi deficiency and dyspepsia symptoms were assessed by a spleen qi deficiency questionnaire (SQDQ) and the Nepean Dyspepsia Index-Korean version (NDI-K), respectively. In addition, a food retention questionnaire (FRQ), a damum questionnaire (DQ), a cold and heat questionnaire (CHQ), a deficiency and excess questionnaire (DEQ), and a visual analogue scale (VAS) of distention and fullness were completed by every participant.Results In comparison with the control group, the FD group showed significantly higher scores for the SQDQ, NDI-K, FRQ, DQ, DEQ, and VAS of distention and fullness. T_1/2 was also significantly higher in the FD group than in the control group. There were significant correlations between T_1/2 and the SQDQ score. However, there were no significant correlations between T1/2 and other questionnaire scores except for one item of the NDI-K.Conclusions According to these findings, it was determined that measuring gastric emptying using ultrasonography could be a quantitative indicator to diagnose spleen qi deficiency in FD patients.

• 대한한방내과학회지
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• 제41권6호
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• pp.1030-1051
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• 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.

• Journal of Pharmaceutical Investigation
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• 제39권1호
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• pp.7-12
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• 2009

A novel polymeric tablet of Tinidazole was formulated to treat Helicobacter pylori and Giardia lambria more efficiently, It was possible to reduce hepatotoxicity by controlling the release of Tinidazole after peroral administration. A gastric retentive formulation made of naturally occurring carbohydrate polymers and containing Tinidazole was tested in vitro for swelling and dissolution characteristics. Tinidazole tablets containing various concentration of either PEO or HPMC were prepared by the wet granulation method. In vitro release of Tinidazole at pH 1.2 and pH 6.8 buffer solutions was observed at $37^{\circ}C$ by using a KP dissolution method and an UV (313 nm) spectrophotometer. Compared to a commercial Tinidazole tablet, in vitro release of Tinidazole at both pH 1.2 and pH 6.8 buffer solutions significantly decreased as the concentration of PEO or HPMC in the tablet increased up. And the gastric retentive formulation hydrated and swelled back to about 50% of its original size in 30 min. Thus, it was possible to control the release of Tinidazole by changing the content of PEO or HPMC in the tablet, thereby manipulating the release rate and the retention of Tinidazole.