• Title/Summary/Keyword: Small-bowel

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A Case of Pancreatic Neuroendocrine Tumor Accompanied by a Cystic Change in Early Stage

  • Sang Soo Bae;Eun Jeong Kim;Dong Wook Lee;Ho Gak Kim;Jimin Han
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.50-54
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    • 2017
  • Pancreatic neuroendocrine tumors are rare pancreatic neoplasms comprising 1-2% of all pancreatic tumors and typically present high attenuating mass on arterial and venous phase images, due to their rich capillary network. A 70-year-old South Korean female visited our hospital presenting with jaundice and dark urine color. She had received an operation for treatment of small bowel perforation seven years ago. On physical examination, icteric sclera was observed but otherwise unremarkable. Laboratory tests were abnormal liver function test and suspected obstructive jaundice. Computed tomography revealed 4 cm sized cystic mass lesion with homogeneous low attenuation in the head of pancreas and distal common bile duct was compressed by the mass. During review of past medical records, we found that the mass was observed and measured about 1.7 cm seven years ago. To resolve obstructive jaundice, pylorus preserving pancreaticoduodenectomy was performed and diagnosed with well differentiated pancreatic neuroendocrine carcinoma with intermediate grade.

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Migrated Pancreaticojejunal Stent Forming a Stent-Stone Complex in the Jejunum with Resultant Small Bowel Obstruction: A Case Report (췌공장 스텐트의 공장으로의 이동으로 발생한 스텐트-돌 복합체 형성과 이로 인한 소장폐색: 증례 보고)

  • Jiwon Kim;Young Han Kim;Byung-Hee Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.2
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    • pp.512-517
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    • 2023
  • Transanastomotic pancreatic duct stent placement during reconstruction following pancreaticoduodenectomy is widely performed to prevent postoperative pancreatic fistulas and duct stenosis. However, stent-related complications, such as stent occlusion and migration, may occur. Here, we report a rare case of a migrated pancreatic duct plastic stent. After pylorus-preserving pancreaticoduodenectomy, the stent migrated to the jejunum and served as a nidus of the stent-stone complex, which developed jejunal obstruction. The stent-stone complex was removed by explorative laparotomy.

Effects of Alginic Acid, Cellulose and Pectin Level on Bowel Function in Rats (알긴산과 셀룰로오스 및 펙틴 수준이 흰쥐의 대장기능에 미치는 영향)

  • 이형자
    • Journal of Nutrition and Health
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    • v.30 no.5
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    • pp.465-477
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    • 1997
  • The purpose of this article is to know the effects on bowel function of the kind of fiber and the amount of fiber in SD-rats. To do this experiment, we select of $\alpha$-cellulose as n insoluble cellulose source and alginic acid and pectin as soluble cellulose source. The rats diets contained callolose camcentrations of 1.0%, 3.6%, 6.0% and 10.0%. After that, we raised the SD-rats for 4weeks and measured the amount of food intake, body weight, the food effciency ratio, the length of liver and stomach the weight of the intestines, the transit time through the intestines, pH in feces, and the amount of bile acid and Ca, Mg, pp. 1) The amount of food intake was 15.75-31.00g/day. It was highest in the 10.0% cellulose group and the lowest in the 3.6% and 6.0% alginic acid group (p<0.05). The body weights of rats were 277.50-349.809. It was highest in the 1.0% pectin group and lowest in the 3.6% alginic acid group, 6.0% cellulose group, and 10.0% pectin group. It had differences according to the content fiber and the kind of dietary(p<0.01). The food efficiency ratio was (p<0.01). The higher the content of dietary fiber, the lower the calory and the food efficiency ratio. 2) Transit time was 446.0-775.0 minutes and it showed signidicant ifferences according to the content and kind of dietary fiber(p<0.01). It was long in the 1.0% cellulose group and 1.0% pectin group but short in the 10.0% alginic acid group. As the content of dietary fiber increased, the transit time through the intestines was shortened. The length of small intestine was 101.03-120.40cm and there were no difference cegardloss of the content and kind of fiber. The length of the large intestine was 20.92-25.42cm and there were significant differences according to the content and kind of the fiber. High-fiber diets resulted in increases in the length of the large intestine. 3) The weight of the liver was 8.68-10.96g and there were no differences according to the content and kind of fiber. The weight of stomach was 1.28-1.74g and there were no differences resulting from the kind of dietary fiber, but it was highest in the 10.0% alginic acid group. The weight of the small intestine was 5.52-8.04g with no difference resulting from to the kind of fiber. It was highest in the 10.0% the alginic acid group and lowest in the 1.0% alginic acid group(p<0.05). The weight of large intestine was 2.50-3.30g with no differences related to the kind of dietary fiber. It was heaviest in the 6.0% and 10.0% alginic acid groups and in the 10.0% pectin group with differences related to the content of fiber(p<0.05). 4) The pH of the feces was 5.82-6.86 according to the kind of dietary fiber, alginic acid group was high at 6.66, the cellulose group was 6.26. but the pectin group was low at 6.30. There were difference according to the content of fiber, but no consistency. The content of bile acid was 6.25-34.77umol per 1g of dry feces. According to the kind of dietary fiber, the alginic acid group was low at 12.91umol, cellulose group was 18.64umol and, the pectin group was the highest at 27.78umol(p<0.001). Based on the content of dietary fiber, alginic acid group was low at 1.0%, but high at 3.6% pectin group(p<0.001). 5) The amount of feces was 1.00-5.10g/day. The weight of rat feces was 2.23g/day in the alginic acid goup, 2.75g/day in the cellulose group, and 1.82g/day in the pectin group. According to the content of fiber, cellulose group was high at 10.0% but alginic acid group was 1.0%, and there were significant difference according to the dietary fiber. The more the content of fiber, the more increase the content of feces in alginic acid, cellulose and pectin group. The content of Ca in the feces was 80.10-207.82mg/1g of dry feces. In the dietary fiber, alginic acid group was 193.08mg, cellulose group was 87.5mg, pectin group was 138.16mg. In the content of fiber, alginic acid group was high at 1.0% and 3.6% but low at 10.0% of Pectin group. The content of Mg was 19.15-44.72mg/1g of dry feces. According to the kind of dietary fiber, alginic acid group was 35.33mg, cellulose group was 23.60mg, and pectin was 36.93mg. According to the content of fiber, pectin group was high at 1.0% and low at 10.0% of cellulose group. The content of P was 1.65-4.65mg/1g of dry feces. According to the kind of dietary fiber, alginic acid group 2.23mg/g dry feces, cellulose group was 2.29mg/g, pectin group wa 4.08mg/g dry feces. In the content of fiber, pectin group was high at 6.0% and low at 6.0% alginic acid group, but there were significant difference among the analysis value. The conetnt of Ca and MG was higher in soluble alginic acid group and pectin group than in insoluble cellulose group. The high the content of the dietary fiber, the lower the food efficiency ratio and the short the transit time through intestine with the increase of the length of large intestin as well as the higher level of the stomach, the small intestine and the large intestine. According to the content of the dietary fiber, the amount of the feces, Ca, Mg and P was increased but the length the small intestin, the weight of liver, pH of the feces and the amount of bile acid showed no differences and consistency.

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A Case of Jejunal Diverticulitis with Perforation Combined with Intussusception Caused by Inflammatory Fibroid Polyp (천공을 동반한 공장게실염과 염증성 섬유양 용종으로 인한 장중첩증이 동반된 1예)

  • Choi, Jae-Won;Kim, Kook-Hyun;Lee, Ji-Eun;Kim, Jun-Hwan;Jang, Byung-Ik;Kim, Tae-Nyeun;Chung, Moon-Kwan;Kim, Jae-Whang
    • Journal of Yeungnam Medical Science
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    • v.22 no.1
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    • pp.113-118
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    • 2005
  • Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.

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New Technique of Intracorporeal Anastomosis and Transvaginal Specimen Extraction for Laparoscopic Sigmoid Colectomy

  • Wang, Zheng;Zhang, Xing-Mao;Zhou, Hai-Tao;Liang, Jian-Wei;Zhou, Zhi-Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6733-6736
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    • 2014
  • Background: Despite the growing acceptance of laparoscopic colon surgery, an abdominal incision is needed to remove the specimen and perform an anastomosis. Recently, natural orifice specimen extraction (NOSE) and intracorporeal anastomosis have been proposed to minimize abdominal wall trauma and improve the quality of laparoscopic colon resections Objective: To evaluate the feasibility and safety of a new approach combining intracorporeal delta-shaped anastomosis and transvaginal specimen extraction for totally laparoscopic sigmoid colectomy. Materials and Methods: Mobilization of bowel and dissection of lymph nodes were performed laparoscopically. After both proximal and distal incisal edges about 10.0 cm distance from sigmoid neoplasm were transected with an Endoscopic Linear Cutter-Straight, a small incision about 1.0 cm was created on the each colon wall of the contralateral side of the mesentery. Then anvils of an Endoscopic Linear Cutter-Straight were inserted into each colon through the small incisions, and incision and anastomosis between the walls of each colon were performed with a linear stapler. A V-shaped anastomosis was made on the wall and the remnant openings was reclosed with the Endoscopic Linear Cutter-Straight. The culdotomy was enlarged with laparoscopic ultrasound dissector. Transvaginal extraction of specimens was accomplished through a wound protector. Results: Surgery was performed for 11 patients with sigmoid cancer. No intraoperative complications or conversions occurred. The mean operating time was 132 min. All the patients were treated laparoscopically without any postoperative complications. Conclusions: The procedures of intracorporeal delta-shaped anastomosis and transvaginal specimen extraction are safe and oncologically acceptable for selected colon cancer cases.

Synthesis and Properties of 5-Aminosalicyl-L-Aspartic Acid and 5-Aminosalicyl-L-glutamic Acid as Colon-Specific Prodrugs of 5-Aminosalicylic Acid (5-아미노살리실산의 결장표적성 프로드럭 : 5-아미노살리실-L-글루타민산과 5-아미노살리실-L-아스파틸산의 합성 및 성상)

  • Jung, Yun-Jin;Lee, Jeoung-Soo;Kim, Hak-Hyun;Kim, Young-Mi;Kim, Dae-Duk;Han, Suk-Kyu
    • YAKHAK HOEJI
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    • v.42 no.1
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    • pp.5-11
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    • 1998
  • 5-Aminosalicyl-L-aspartic acid (5-ASA-Asp) and 5-aminosalicyl-L-glutamic acid (5-ASA-Glu) were synthesized as new colon-specific prodrugs of 5-aminosalicylic acid (5-ASA), their apparent partition coefficients, and the extent of conversion in the homogenates of tissue and contents of various G.I. Tract segments of rats were evaluated. These prodrugs were stable in the homogenate of tissue and contents of stomach, proximal small intestine (PSI) or distal small intestine (DSI). Release of 5-ASA from 5-ASA-Asp after incubation with the cecal and colonic contents for 8hrs at $37^{\circ}C$ was 18%, and 8%, respectively. No significant conversion of prodrug was observed in the cecal and colonic contents of rats pretreated with kanamycin sulfate, which indicated that microbial enzymes were responsible for the cleavage of these prodrugs.

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An Experimental Study on the Effectiveness of Microwave Hyperthermia Combined with Radiation on the Small and Large Intestine in rats (흰쥐의 장조직에 X-선 조사와 마이크로파 온열요법의 효과에 관한 실험적 연구)

  • Ahn, Kyung-Sook;Lee, Kyung-Ja;Rhee, Chung-Sik
    • Radiation Oncology Journal
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    • v.5 no.2
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    • pp.83-95
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    • 1987
  • The synergistic effect of combining radiation therapy and hyperthermia kills significantly more cells than using either modality alone. The reason for enhanced cell killing from the combined treatment is that the two modalities are complementary. For histopathological exmination, 102 rats were divided into 4 groups as hyperthermia, radiation, hyperthermia combined with radiation and normal control groups. The effect of prior irradiation (6-15 Gy of X-ray) on the response of small and large bowel of rats to $40^{\circ}C-44^{\circ}C$ (for 30 minutes) microwave (2450 MHz) hyperthermia was investigated. The musculature of the small and large intestine remained intact and the circumference of the histological sections were not significantly altered by the heated at $43^{\circ}C$ for 30 minutes. Thermal enhancement ratios of normal tissue is 1.0 Thermal enhancement ratio was not increased in combination therapy by evaluation of histopathologic changes in small and large intestine.

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Enterotoxigenic Bacteroides fragilis-Associated Diseases and Detection (Enterotoxigenic Bacteroides fragilis에 의한 질환과 검출)

  • Gwon, Sun-Yeong;Jang, In-Ho;Rhee, Ki-Jong
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.161-167
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    • 2015
  • These commensal intestinal bacteria can enhance the immune system and aid in nutrient absorption but can also act as opportunistic pathogens. Among these intestinal bacteria, the anaerobic Bacteroides fragilis are divided into enterotoxigenic B. fragilis (ETBF) which secrete the B. fragilis toxin (BFT) and non-enterotoxigenic B. fragilis (NTBF) which do not secrete BFT. ETBF can cause diarrhea and colitis in both humans and livestock but can also be found in asymptomatic individuals. ETBF is predominantly found in patients with inflammatory diarrheal diseases and traveller's diarrhea. Several clinical studies have also reported an increased prevalence of ETBF in human patients with inflammatory bowel disease (IBD), colitis and colorectal cancer. In small animal models (C57BL/6 wild-type mice, germ-free mice, multiple intestinal neoplasia (Min) mice, rabbits and Mongolian gerbils), ETBF have been found to initiate and/or aggravate IBD, colitis and colorectal cancer. BFT induces E-cadherin cleavage in intestinal epithelial cells resulting in loss of epithelial cell integrity. Subsequent activation of the ${\beta}$-catenin pathway leads to increased cellular proliferation. In addition, ETBF causes acute and chronic colitis in wild-type mice as well as enhances tumorigenesis in Min mice via activation of the Stat3/Th17 pathway. Currently, ETBF can be detected using a BFT toxin bioassay and by PCR. Advances in molecular biological techniques such as real-time PCR have allowed both researchers as well as clinicians to rapidly detect ETBF in clinical samples. The emergence of more sensitive techniques will likely advance molecular insight into the role of ETBF in colitis and cancer.

'Study on Oui-Ga-Sil( 胃家實 )' (위가실(胃家實)에 관(關)한 연구(硏究))

  • Han, Gyu-Eon;Ryu, Bong-Ha;Park, Dong-Won;Ryu, Gi-Won;Jang, In-Gyu
    • The Journal of Internal Korean Medicine
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    • v.10 no.1
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    • pp.65-80
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    • 1989
  • About Oui-Ga-Sil(胃家實) in order to considerate the contents recorded in Nai-Gyung Sang-Han-Lon and latter literature, definition, etiopathology, syndrome, differential diagnosis, therapy, Prognosis and prevention were classified. And the results were as follows: 1. Oui-Ga(胃家)was a term which indicated the whole digestive system such as stomach, small intestine, large intestine, rectum and anus. Sil(實)could be defined as the peculiar concept pertaining to the acute and last stage which was invaded to inside bowels because of abundance with evil influence. 2. Eliology of Oui-Ga-Sil was abunt gastric fever originally, injured mucus because of mistreatment, the invasion to inside of outside evil influence through meridian. Pathology was the opening and shutting appearance of gastric abundance with intestinal emptiness, and intestinal abundance with gastric emptiness, Oui-Ga-Sil could be occurred because of gastric abundant dryness and splenic humidifying capacity decrease. 3. Symptom of Oui-Ga-Sil was classified as for the sunlight outside syndrome and the inside abundant syndrome. The sunlight outside syndrome was body fever, sweating, no chilling, on the contrary hatred of fever. The chief complaint of inside abundant syndrome was daily fever, talking in delirium, hand and foot sweating, abdominal distention, difficult defection and those could be pertained to sunlight bowel syndrome. 4. Diagnostic views of Oui-Ga-Sil were that pulse was descending abundant large strong and smooth quick, a coated tongue was yellow, deep yellow, old yellow, thick, scorching dry rough or gray black. On abdominal diagnosis, pressing by hand, patient was conscious of pain, excessive pain, rejection against press, impossible press or intermittent abdominal pain and bowel cutting pain without press. 5. Differential diagnosis was that the sunlight of Nai-Gyung-Fever-Theory was outside desease making meridian the prime object, Baik-Ho-Tang syndrome was making figureless abundant fever the pivotal point. And important differential standard of splenic shrink syndrome was that a daily fever, an irritation with fever were not occurred. 6. Theory of Oui-Ga-Sil was that Seng-Gi-Tang classes had been used in attacking downward or making balance, and moxibustion on Jung-Wan, honey boiling induction theory had been also used. Attacking downward therapy was invigorating method to preserve mucus, and if mucus had been exausted with complicating emptiness prognosis had been appeared badly. 7. Preventing from Oui-Ga-Sil diet by rule, fitness to cold and warmth may be needed to prevent outside evil influence attack and inside evil influence occurrence. Prudence with being very busy, fatigue, wine and woman may be also needed not to be an injury to splanic and gastric spirit.

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A Study on the Collateral Vessel Pathology(絡脈病機) of Blood Disease(血證) in Onbyeong(溫病) with focus on Ju-Gaek-Gyo(主客交, guest-host minglement) and Dry Blood(乾血) (온병(溫病) 혈증(血證)의 낙맥병기(絡脈病機)에 대한 고찰 -주객교(主客交)와 건혈(乾血)을 중심으로-)

  • Kim, Dong-Hui;Jeong, Chang-Hyun;Jang, Woo-Chang;Lyu, Jeong-Ah;Baik, You-Sang
    • Journal of Korean Medical classics
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    • v.25 no.1
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    • pp.89-115
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    • 2012
  • Objective : Blood disease is common these days due to modern man's excessiveness in Yang heat (陽熱) and vulnerability of the Eum blood(陰血). This exposes them to warmheat/ dampness-heat diseases, where pathogenic heat easily penetrates the blood dimension(血分) creating stagnated blood(瘀血). Consequently, pathogenic symptoms in the collateral vessels increase, making it crucial to understand the pathogenic mechanism of the disease. Method : This paper examines the condition and region of the collateral vessel diseases(CVD) according to the blood diseases of Onbyeong, by analyzing each prescription's matching symptom. The disease in question in this paper is 'stagnated blood fixated in the collateral vessels'. Therefore diseases with stagnated blood in the Yang collaterals and Viscera collaterals or viscera themselves from the chapter of "On-Yeok-Ron(溫疫論)", and < Dry Blood-DaeWhangJaChungWhan(大黃蟅蟲丸) > chapter of "Geum-Gue-Yo-Rak(金匱要略)", were examined respectively. Result & Conclusion : The process of CVD according to the blood diseases of Onbyeong can be summarized as follows. First, bleeding in the Yang and Bowel collaterals, then stagnation in the Yang and Bowel collaterals, and finally stagnation in the viscera collaterals or Liver itself. The refractory nature of blood stagnation symptoms of the collateral vessels is mainly due to the characteristics of the collateral vessel itself. In structure, they are very narrow and small, situated at the most terminal part of the body where it is difficult for the Jeong Gi(精氣) to reach. Also, as they are symptomatic of degeneration of Jeong Gi, the root of the disease is very deep. Therefore to resolve blood stagnation in the cases of Ju-Gaek-Gyo and Dry Blood, general approaches using 'Gi communication(行氣)' or 'Blood vitalizing(活血)' medicinals will not suffice. Special medicinals such as crustacean and insects need to be appropriately applied.