• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.276-283
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• 2015

Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.21 no.2
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• pp.85-96
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• 1988

Purification and some properties of alkaline proteinases in the pyloric caeca of skipjack, Katsuwonus vagans, were investigated. Four alkaline proteinases, temporarily designated proteinases I, II, III and IV, were identified from the tissue extract of the pyloric caeca by ammonium sulfate fractionation, DEAE-Sephadex A-50 chromatography, and Sephadex G-100 and G-200 gel filtration. Result of disc-polyacrylamide gel electrophoretic analysis showed that the purified proteinases II and III were homogenous with the yields of $1.5\%\;and\;1.2\%$, and those specific activities were increased to 33 to 37 fold over that of the crude enzyme solution, respectively. Molecular weight of the proteinases II and III determined by sephadex G-100 gel filtration were 28,500 and 24,200, respectively. The optimum conditions for the caseinolytic activity of the two enzymes were pH 9.6 and $48^{\circ}C$. The reaction rates of the two alkaline proteinases were constant to the reaction time to 80 min in the reaction mixture of $3.4{\mu}g/ml$ of enzyme concentration and $2\%$ casein solution. The Km values against casein substrate determined by the method of Lineweaver-Burk were $0.56\%$ for proteinase II and $0.30\%$ for proteinase II. The proteinases II and III were inactivated under the presence of $Ag^+,\;Hg^{2+},\;Ni{2+},\;Fe^{2+},\;and\;Cu^{2+}$, and but activated by $Mn^{2+}\;and\;Ca^{2+}$ and markedly inhibited by the soybean trypsin inhibitor and N-p-toluenesulfonyl-L-lysine chloromethyl ketone. Therefore, the proteinases II and III were found to be a group of serine proteases and assured to be trypsin-like proteinases.

• Advances in pediatric surgery
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• v.11 no.1
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• pp.27-33
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• 2005

Infantile hypertrophic pyloric stenosis (HPS) is a relatively common entity. A number of studies for the postoperative feeding schedule has been studied to allow for earlier hospital discharge and improve cost-effectiveness in the treatment of HPS. The purpose of this study was to compare 3 feeding-methods and to evaluate the usefulness of ad lib feeding for HPS. The authors retrospectively reviewed the records of 116 patients who underwent pyloromyotomy for HPS from 1995 to 2004. Three cases were excluded because of the duodenal perforation during pyloromyotomy. Three feeding-methods were defined as: Conventional feeding (>10 hours nothing by mouth and incremental feeding every 2 hours, C), Early feeding(for 4 to 8 hours nothing by mouth and incremental feeding every 2 hours, E), and Ad lib feeding (for 4 hours nothing by mouth and ad lib feeding, A). Time to normal feeing in C, E and A were $51{\pm}24$, $34{\pm}12$ and $24{\pm}6$ hours, respectively. Hospital-stay in C, E and A were $72{\pm}17$, $55{\pm}13$ and $43{\pm}12$ hours, respectively. There were statistically significant differences according to the method of feeding. Frequency of postoperative emesis in C, E and A were 38 %, 47 % and 53 %, but was not significant statistically. Ad lib feeding decreased time to normal feeding and hospital stay, and did not increase postoperative emesis. We conclude that ad lib feeding is recommended for patient with pyloromyotomy in HPS.

• Korean Journal of Veterinary Research
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• v.33 no.3
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• pp.369-379
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• 1993

The regional distribution and the relative frequencies of endocrine cells were studied in nine portions of the blue fox GI tract, and the distribution pattern and cell types of the pancreatic endocrine cells were also studied in the pancreas by immunohistochemical method. Six kinds of immunoreactive cells were identified in the GI tract, and four kinds of immunoreactive cells were also identified in the pancreas. Although numerous 5-HT- and somatostatin-immunoreactive cells were seen throughtout the GI tract, somatostatin-immunoreactive cells were a few in the intestine. Very numerous Gas/CCK-immunoreactive cells were restricted generally in the pyloric region and duodenum. Numerous glucagon-immunoreactive cells were found in the stomach except the pyloric region, and generally a few in the intestine. Moderate number of BPP-immunoreactive cells were found in the stomach except the pyloric region, and a few in the large intestine. Numerous porcine CG-immunoreactive cells were restricted to the cardiac and fundic region. In the pancreas, four types of pancreatic endocrine cells-somatostatin-, glucagon-, BPP- and insuline-immunoreactive-were identified in the pancreatic islet and exocrine portion. These results suggest that the regional distribution, the relative frequencies and cell types of the GEP endocrine cells in the GI tract and pancreas varies considerably among the species.

• Advances in pediatric surgery
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• v.20 no.2
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• pp.43-47
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• 2014

Purpose: Hypertrophic pyloric stenosis (HPS) is known to be one of the most common cause of surgery for infants and pyloromyotomy was considered to the standard treatment. There has been an ongoing debate about whether laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) is the best option for treating HPS. The aim of this study is to evaluate safety and effectiveness of LP by comparing the clinical results of both surgical strategies performed by single surgeon. Methods: Between January 2000 and December 2013, 60 patients who underwent pyloromyotomy at Asan Medical Center performed by a surgeon were followed: open-supraumbilical incision (n=36) and LP (n=24). The parameters included sex, age and body weight at operation. Clinical outcomes included operation time, time to full feeding, postoperative hospital stay, and postoperative complications. Results: There were no significant differences in characteristics, postoperative hospital stay between the two groups. Time to full feeding was shorter in LP (OP 24.5 hours vs. LP 19.8 hours; p=0.063). In contrast, the mean operation time was longer in LP (OP 37.5 minutes vs. LP 43.5 minutes; p=0.072). Complications such as perforation of mucosal layer (OP 1 vs. LP 0) and wound problems (OP 2 vs. LP 0) were found to be not worse in laparoscopic group as compared with open group. Conclusion: There has no difference both laparoscopic and open-supraumbilical incision in terms of postoperative hospital stay, time to full feeds and frequency of complications.

• The Korean Journal of Zoology
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• v.37 no.4
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• pp.478-487
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• 1994

The developmental changes of three enteroendocrine cells, i.e. gastrln, somatostatin and serotonin, of gastric and small intestinal mucosa in pre- and postnatal rat were examined by peroxidase-antiperoxidase (PAP) method. In the course of development, gastrin cells were obsenred in the pyloric gland region and the whole part of small intestine, while somstostatin and serotonin cells in the whole gastric gland region and small intestine. More entroendocrine cells were detected in the pyloric gland region and duodenum than in the other portion. In the stomach, gastrin, somatostatin and serotonin ceils were first obsenred in the pyloric Bland region on 17, 19 and 19 days of gestation respectively. The small intestinal gastrin and serotonin cells were first appeared in the duodenum and iriunum on 17 and 15 days of gestation respectively, and somatostBtin cells in duodenum on 17 days of gestation. The number of cells examined from the stomach were increased from fetal to weanling period and showed a decrease during adult period: the notable increase was shown at the end of suckling period or at early weanling period. The cells of the small intestine increased from fetal to suckling period, especially, these cells markedly increased at the end of fetal period or at early suckling period, and decreased from weanling period. The shape of these cells was oval or fusiform during fetal period. In the stomach, most of gastrin cells turned out to be oval and open-type from suckling period, while the remaining two tripes of cells were oval and open- or closed-type. In the small intestine, 311%Ves of cells examined were changed to fusiform and open-type from the end of fetal period. Three types of cell were distributed over the stratified epithelium on 15 and 17 days of gestation. In the stomach, these cells were distributed lower gastric pit and gland from the following fetal period, and were detected mainly on the upper part of gland from suckling period, and then obsenred on the whole part of gland. In the small intestine, most of cells distributed over only between epithelium of villi on 19 days of gestation, increased in number on the crypt from following fetal period, and also observed abundantly in the crypt at adult period.

• Korean Journal of Veterinary Research
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• v.33 no.4
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• pp.579-589
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• 1993

The regional distribution and the relative frequencies of endocrine cells were studied in nine portions of the blue fox GI tract, and the distribution pattern and cell types of the pancreativc endocrine cells were also studied in the pancreas by immunohistochemical method. Six kinds of immunoreactive cells were identified in the GI tract, and four kinds of immunoreactive cells were also identified in the pancreas. Although numerous 5-HT- and somatostatin-immunoreactive cells were seen throughout the GI tract, somatostatin- immunoreactive cells were a few in the intestine. Very numerous Gas/CCK-immunoreactive cells were restricted generally in the pyloric region and duodenum. Numerous glucagon-immunoreactive cells were found in the stomach except the pyloric region, and generally a few in the intestine. Moderate number of BPP-immunoreactive cells were found in the stomach except the pyloric region, and a few in the large intestine. Numerous porcine CG-immunoreactive cells were restricted to the cardiac and fundic region. In the pancreas, four types of pancreatic endocrine cells- somatostatin-, glucagon-, BPP- and insulin-immunoreactive- were identified in the pancreatic islet and exocrine portion. These results suggest that the regional distribution, the relative frequencies and cell types of the GEP endocrine cells in the GI tract and pancreas varies considerably among the species.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.3
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• pp.265-272
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• 2021

Purpose: Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques. We also analyzed the incidence of HPS in infants in the last 10 years in relation to the demographic trend of our province. Methods: We analyzed all the cases of HPS treated at our Unit between January 2010 and December 2019. The data were obtained from operating systems. Data about the demographic trends, in particular, the number of births and the population residing in the province of Verona from 2010 to 2019, were also retrieved. Results: During the study period, 60 patients were treated for HPS and met the inclusion criteria. Of these, 56 males and 4 females with an average age of 38±14 days at surgery were included. No differences were found in terms of the duration of surgery, post-operative complications, duration of hospitalization, and weight at the time of surgery. The only statistically significant data was the chlorine level in cases with and without post-operative vomiting (97±3.5 vs. 102±3.3 mmol/L, p<0.05). There was a lower incidence of HPS from 2014 to 2019; however, there was no significant evidence regarding the correlation between this and the reduced birth rate recorded in the province of Verona during the same period. Conclusion: Although laparoscopic pyloromyotomy is a highly complex procedure, it is a feasible alternative to the classic open technique.

• Journal of Yeungnam Medical Science
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• v.4 no.1
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• pp.33-42
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• 1987

Congenital origin intestinal obstruction are important disease due to required emergency operation. So accurate and rapid diagnosis is needed for decreased mortality and morbidity. Radiologist must detect to accurate obstruction site and also associated other congenital anomalies. And also embriological bases are very important role to the diagnosis of theses diseases. We were analysed radiologically and clinically 25 cases with congenital origin intestinal obstruction with review of literature. 1. Hypertrophic pyloric stenosis 6 cases, midgut malrotation 4 cases, congenital megacolon 8 case, imperforated anus 5 cases, ileal atresia 1 case and duodenal atresia 1 case. 2. Male and female radio were 16:9. Especially on hypertrophic pyloric stenosis, 5 cases were male infants. 3. All cases of hypertrophic pyloric stenosis represented string sign and also pyloric beak sign shoulder sign on UGI. 4. I case duodenal atresia showed double bubble sign on simple abdomen x-ray and ileal atresia showed mechanical small bowel obstruction sign with microcolon. 5. On midgut malrotation, cecum was located in right upper abdomen on 4 cases. And 2 cases were associated with Ladd's band. I case with volvulus and 1 case with mesenteric defect. 6. Involved site of all congenital megacolon were localized to rectosigmoid colon. 7. On 5 cases imperforated anus, 3 cases were low type and 2 case high type. Rectoperineal and rectourogenital fistula were demonstrated on 4 cases.

• Korean Journal of Veterinary Research
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• v.35 no.4
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• pp.793-807
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• 1995

This study was carried out to investigate the effects of diethyl maleate(DEM) on the carcinogenesis of forestomach and pyloric glandular stomach in rats caused by N-methyl-N'-nitro-N-nitrosoguanidine(MNNG). A total of 60 male 6-week-old Wistar rats were given twice intragastric injection of MMNG(200mg/kg BW), then were given diets containing 5% NaCl for 3 weeks until 4th week of the experiment. And then the animals of groups of 1 and 2 were placed on diets containing 0.2% DEM for 16 weeks until the end of 20 weeks of the experiment. On the other hand, the animals of groups of 3 and 4 were placed on basal diets for the same periods. The tissues of forestomach and liver of each group were frozen in liquid nitrogen and the activities of quinone reductase(QR) were determined by measurement of the dicoumarol-sensitive reduction of dichloro-indophenol by NADPH at 600nm. All rats were sacrificed at the end of 20 weeks of the experiment. Every animal was fasted for 24 hrs prior to sacrifice. The forestomach was fixed in 10% neutral phosphate buffered formalin for histology and the pyloric gland was fixed in sublimated formalin for immunohistochemistry of pepsinogen 1 altered pyloric gland(PAPG). The final body weight of the group given MNNG and treated with 5% NaCI and DEM was significantly decreased compared with that of the group 4(p<0.05). Food and water consumption rates were not significantly changed. The preneoplastic and neoplastic lesions of the forestomach given MNNG and treated with 5% NaCI and DEM were significantly increased compared to those of the group 4(p<0.0l). The incidence of PAPG in the groups treated with 0.2% DEM was significantly increased compared with that of the group 4(group 1:p<0.01, group 2:p<0.05). The activities of QR of forestomach in the groups treated with 0.2% DEM were significanitly increased compared with those of the group 4(p<0.001), but those of liver were not significant. These results indicate that DEM exert the enhancing effect of forestomach and glandular stomach carcinogenesis in rats pretreated with MNNG and NaCl.