• 제목/요약/키워드: Vagotomy

검색결과 33건 처리시간 0.017초

소아에서의 합병성 위십이지장 궤양 (A Clinical Analysis of Complicated Gastroduodenal Ulcer in Children)

  • 정광용;정연준;김찬영;양두현;김재천
    • Advances in pediatric surgery
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    • 제10권1호
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    • pp.22-30
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    • 2004
  • A total of 30 cases of the peptic ulcer in children, who underwent operations from January 1981 to December 1995 because of complications at Department of the Surgery, Chonbuk National University Medical School, is reviewed. Twenty-three were males (76.7%), 7 females (23.3%) and male was preponderant at 3.3:1. There were 25 cases (83.3%) age 10 to 15 years, 3(10.0%) between 2 and 9 years, and 2 (6.7%) below 2. The ulcer was located at duodenum in 27(90.0%), and at stomach in 3 cases (10.0%). Complications were perforation in 19 cases (63.3%), pyloric obstruction in 9 (30.0%) and bleeding in 2 (6.7%). For perforation, truncal vagotomy with pyloroplasty was done in 11 cases, truncal vagotomy with hemigastrectomy and gastrojejunostomy in 6, and simple closure in 2 cases. For obstruction, truncal vagotomy with hemigastrectomy and gastrojejunostomy was done in 5, and truncal vagotomy and pyloroplasty in 3 cases. For bleeding lesions, truncal vagotomy and pyloroplasty was performed in 2 cases. Ten postoperative complications developed in 9 patients: adhesive ileus in 5, recurrence in 2, pneumonia 2, and wound seroma 1 case. One patient developed a primary duodenal perforation and another a recurrent obstruction. Both of patients had symptoms for more than 3 years and were treated with truncal vagotomy and pyloroplasty for the primary operations. Hospital stay was 11.5 days for the patient with perforated ulcer, 11.0 days for the patient with pyloric obstruction, and 14.5 days for the child with bleeding. Average hospital period was 11.6 days. To reduce recurrences after operation, extensive procedure such as distal gastrectomy with vagotomy at the first operation should be considered in case with severe complication or with patients who have been symptomatic for long periods.

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Sympathectomy 및 Vagotomy에 따른 자율신경계 변화의 관찰을 위한 HRV 스펙트럼 분석 (HRV spectrum analysis to observe the changes in ANS caused by sympathectomy and vagotomy)

  • 여형석;임재중;박환태
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1997년도 추계학술대회
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    • pp.443-446
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    • 1997
  • HRV(heart rate variability) is the time series data of R-R interval time duration based on ECGs. Power spectral analysis of HRV has recently been used to define the activity of ANS(autonomic nervous system). In this study, 14 rats were divided into two groups, sympathectomy and vagotomy. During the experiments, ECGs of rats were collected three times at each experimental conditions or the duration of 5 minutes, where sampling frequency was set at 2KHz. After the application of the Berger's Serires algorithm to ECG raw data, power spectrum of HRV was obtained via FFT. Results showed that HF/LF were increased or the sympathectomy group and decreased or the vagotomy group. It implies that the variations in HF/LF components could be used or the ANS function classification.

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내측 편도핵의 위산분비 촉진작용에서 미주신경의 역할 (Effect of Vagotomy on Gastric Acid Secretory Response to Medial Amygdolid Stimulation)

  • 김명석;조양혁;윤신희;한상준;이덕주;김정진
    • The Korean Journal of Physiology
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    • 제23권2호
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    • pp.393-399
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    • 1989
  • Sixty-seven conscious rats prepared with chronic gastric fistula were studied to examine the effect of vagotomy on gastric secretory responses to medial amygdaloid stimulation. Gastric acid output was significantly increased by electrical stimulation of the medial amygdaloid nucleus, and the increases in acid secretion were completely eliminated by vagotomy. However, in rats subjected to stimulation of the medial amygdaloid nucleus plus vagotomy, acid output was almost same as that in only vagotomized rats. And vagotomy itself decreased the acid secretion significantly. These results indicate that the influence of electrical stimulaton of the medial amygdaloid nucleus on acid secretion is carried largely via vagus nerves. And also, without electrical stimulation of medial amygdaloid nucleus, acid secretion is controlled by way of vagus in rats. Plasma gastrin concentrations were measured following stimulation of the medial amygdaloid nucleus. Plasma levels of gastrin were not significantly altered by stimulation of the medial amygdaloid nucleus with or without vagotomy. It is therefore inferred from the above results that the facilitatory influence of the medial amygdaloid nucleus on the gastric acid secretion is mediated chiefly via vagal activity and that gastrin is not responsible for the increase in acid secretion in this process.

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미주신경간절제술에 있어서 $^{99m}Tc-DISIDA$ 신티그램을 이용한 총수담관 및 Afferent loop의 평균지연시간 (The Mean Transit Time of the CBD and the Afferent Loop Using $^{99m}Tc-DISIDA$ Scintigram in Truncal Vagotomy)

  • 문태용;김동수
    • 대한핵의학회지
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    • 제22권2호
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    • pp.199-203
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    • 1988
  • The authors observed functional change of the CBD and the afferent loop with the transit time of $^{99m}Tc-DISIDA$ scintigram in patients treated by the surgical operation of gastric ulcers and cancer at Busan National University Hospital from June, 1987 to April, 1988. So authors estimated the time between the peak activity of the CBD and the afferent loop (TCA), the half transit time of the CBD activity (t 1/2 CBD) and the half transit time of the afferent loop activity (t 1/2 A-loop) in 9 patients undergone truncal vagotomy, who have no specific symptoms at 2 to 6 months after the operation, 5 patients undergone the operation without truncal vagotomy, and 7 persons as a control group. The results were as follows: I) In control group, the mean TCA, t 1/2 CBD and t 1/2 duodenum were $8.6{\pm}9.0$ min, $38.7{\pm}17.3$ min. and $28.6{\pm}10.9$ min, respectively. 2) In the operation group without truncal vagotomy, the mean TCA, t 1/2 CBD and t 1/2 A-loop were $10.0{\pm}7.1$ min. $48.2{\pm}22.3$ min. and $39.4{\pm}26.7$ min. respectively. 3) In the operation group with truncal vagotomy, the mean TCA, t 1/2 CBD and t 1/2 A-loop were $15.0{\pm}8.7$ min., $36.1{\pm}16.5$ min. and $42.6{\pm}24.4$ min, respectively. From the above results, we concluded that the transit time of the CBD and the afferent loop is not affected by truncal vagotomy.

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대사성 산증, 기도저항 변화 및 미주신경 절단이 구호흡 발생에 미치는 영향 (THE INFLUENCE OF METABOLIC ACIDOSIS, AIRWAY RESISTANCE AND VAGOTOMY ON THE DEVELOPMENT OF MOUTH BREATHING)

  • 손우성;양원식
    • 대한치과교정학회지
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    • 제20권1호
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    • pp.47-59
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    • 1990
  • Respiration is one of the most important functions which are carried out in stomatognathic system. When nasal orifice is obstructed or the resistance of upper airway is increased mouth breathing is initiated. Mouth breathing is regarded as an important etiologic factor of dentofacial anomalies. This experiment was performed to observe the influences of metabolic acidosis, tracheal resistance and vagotomy on mouth breathing. After rabbits were anesthetized with sodium pentobarbital, a pair of wire electrode was inserted into mylohyoid muscle, anterior belly of digastric muscle and dilator naris muscle to record EMG activity. Femoral vein and artery were cannulated for infusion of 0.3N HCl and collection of blood sample to determine the blood pH, and tracheal intubation was done to control airway resistance. Mouth breathing was induced by metabolic acidosis. Increase of the airway resistance through tracheal cannula intensified the activity of dilator naris, mylohyoid and digastric muscle. The higher the resistance, the larger the EMG amplitude. After bilateral vagotomy, respiratory volume and inspiatory time were increased and the activities of dilator naris, mylohyoid and digastric muscle were strengthened. It was concluded that the muscle activity related to mouth breathing was induced by metabolic acidosis and increase of tracheal tube resistance.

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가토(家兎)에서 xylazine의 혈압하강(血壓下降) 효과(效果)에 대한 yohimbine의 길항작용(拮抗作用) (Antagonism of xylazine-induced hypotensive effect by yohimbine in rabbits)

  • 신동호
    • 대한수의학회지
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    • 제30권3호
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    • pp.277-281
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    • 1990
  • Xylazine is commonly used for anesthesia in veterinary medicine and various adverse effects are developed. To examine if the severe hypotensive response associated with xylazine-induced anesthesia might be resulted from the stimulation of presynaptic alpha-2 adrenoceptors or the increase of vagal tone, effects of yohimbine, atropine and atropine with vagotomy on xylazine-induced severe and long-lasting hypotensive responses were investigated in rabbits. The results were summarized as follows: 1) Intravenously injected xylazine(1mg/kg)-induced hypotensive responses were inhibited by yohimbine(p<0.001). 2) Intravenously injected xylazine(1mg/kg)-induced hypotensive responses were not changed by atropine. 3) Intravenously administered xylazine(1mg/kg)-induced hypotensive responses are not changed by atropine with vagotomy. These results indicate that xylazine is thought to cause severe hypotensive response during anesthesia primarily by stimulating presynaptic alpha-2 adrenoceptors and other receptors or mechanisms may participate in the hgpotensive response of xylazine.

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흰쥐에서 내측 편도핵의 전기 자극에 의한 췌액 분비 증가 기전 (Mechanism of Pancreatic Secretory Response to Electrical Stimulation of Medial Amygdaloid Nucleus in Rats)

  • 윤신희;한상준;조양혁
    • The Korean Journal of Physiology
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    • 제23권2호
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    • pp.401-408
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    • 1989
  • This study was conducted to investigate whether an electrical stimulation of medial amygdaloid nucleus in rats increases pancreatic secretion. And an involvement of vagus nerve or plasma secretin in this process was also studied. In fasting rats anesthetized with urethane, a monopolar stainless steel electrode was stereotaxically inserted into the right medial amygdaloid nucleus. Pancreatic juice was collected for 20 minutes, during which physiological saline or 0.01 N HCI (0.18 ml/min) was perfused into the duodenum with or without bilateral subdiaphragmatic vagotomy. In the medial amygdaloid group, an electrical stimulation was continuously applied to the medial amygdaloid nucleus during the perfusion period. After collection of pancreatic juice, blood was drawn from the abdominal aorta for determination of the plasma secretin level. The results were as follows: 1) The electrical stimulaion of the medial amygdaloid nucleus did not influence the pancreatic secretion in response to intraduodenal saline perfusion. 2) The stimulation of the medial amygdaloid nucleus significantly increased the pancreatic secretory response (volume, bicarbonate output) to the intraduodenal 0.01 N HCI perfusion, and the increases were abolished by vagotomy. 3) The plasma secretin concentration after the intraduodenal 0.01 N HCI perfusion was higher than that after the saline perfusion. However, neither the electrical stimulation of the medial amygdaloid nucleus nor vagotomy affected the plasma secretin concentration during the intraduodenal perfusion with saline or 0.01 N HCI. It is, therefore, suggested that the medial amygdaloid nucleus facilitates the pancreatic secretion (volume, bicarbonate) elicited by intraduodenal HCI perfusion through the vagus nerve.

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정상 및 미주신경절단 흰쥐의 체중, 위액 분비량, 위의 형태변화에 대한 위 유문부 부분폐색과 재개통의 효과 (Effect of partial pyloric obstruction on body weight, gastric juice, gastric surface area and gastric edema in normal intact rats and/or vagotomized rats)

  • 선종기;윤상협
    • 대한한방내과학회지
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    • 제33권1호
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    • pp.26-38
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    • 2012
  • Objectives : The aim of this study was to investigate the effect of partial pyloric obstruction on body weight, gastric juice, gastric surface area and gastric edema in normal intact and/or vagotomized rats. Methods : Partial pyloric obstruction was performed by wrapping a non-absorbable rubber ring (D:6 mm, W:4 mm, T:1 mm) around the 1st portion of the duodenum. Vagotomy was performed by resecting the branches around the esophagogastric junction. Pre-post body weight differential, fasting gastric juice volume, gastric surface area and gastric edema were measured at 8 weeks and 20 weeks. For the effect of pyloric reperfusion the rubber ring was removed after 8 weeks and then an additional 12 weeks of observation was performed to the end of the 20-week experimental period. Results : In the initial 8 weeks observation, the effect of pylorus obstruction and/or vagotomy was significantly remarkable in the pylorus obstructed and vagotomized group; slowdown of weight gain, increase of fasting gastric juice volume, dilatation of gastric surface area and severe gastric edema were shown. In the remaining 12 weeks observation, the effect of reperfusion was significantly remarkable in the ring-removed antral dilated group; recovery of weight gain, decrease of gastric surface area and decrease of gastric edema were shown. However, gastric juice volume was not significantly different from the other group. Conclusions : Partial pyloric obstruction plays a aggravating role and the vagus nerve plays a protective role in body weight, gastric juice, gastric surface area, and gastric edema. Furthermore, pyloric valve dysfunction as an aggravating factor strengthened in defect of the vagus nerve. These results suggest that patients with both functional pyloric outlet obstruction and hypofunction of vagus nerve need to be diagnosed in good time and treated properly.

흰쥐의 위궤양 발생에 미치는 대상회전 제거 및 미주신경 절단의 영향 (Influence of cingulate cortical ablation and vagotomy upon gastric ulceration in rats)

  • 박형진;강숙희;조양혁;김철
    • The Korean Journal of Physiology
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    • 제11권1호
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    • pp.45-50
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    • 1977
  • This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric ulceration, and the pathway through which cingulate cortex exerts the effect. 56 female rats were divided equally into cingulate (cingulate cortical ablation), cingulate-vagal (cingulate cortical ablation and vagotomy), normal control and vagal (vagotomy) groups. Cingulate cortex was ablated through a slit-shaped opening (1 mm in width, 13 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from parietal and frontal bones on each side. Vagus nerves on both sides were transected around the distal end of the esophagus. In the normal control animals, surgical intervention ended with scalp incision. All rats were kept without restraint or food deprivation for 3 weeks after surgery. The stomach of each rat was inflated with 7 ml of physiological saline and then removed under deep anesthesia. The mucosal surface was examined under dissecting microscope for the location, shape and number of ulcers, and then enlarged photograph $(4{\times})$was taken. The incidence of ulcer in each group was counted and the number of ulceration as well as the total area of glandular mucosa were measured on the photograph. Results obtained were as follows: 1. The mean number of ulcer per stomach and the total area of ulcer exprssed as permillage of the total area of glandular mucosa were significantly higher in the cingulate group than the cingulate-vagal, the normal control and the vagal groups. There was no difference among the latter three groups. 2. The incidence of ulcer in the cingulate group was significantly higher than that in the .normal control group and was also higher, though not significantly, than those in the cingulate-vagal and the vagal groups. There was no difference among the normal control, the cingulate-vagal and the vagal groups. It is inferred from the above results that the cingulate cortex exerts an inhibitory influence upon gastric ulceration and that this influence is mediated by controlling the vagal activity.

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흰쥐에서 배측 봉선핵의 전기자극이 췌장의 외분비기능에 미치는 영향 (Exocrine Pancreatic Secretion in Response to Electrical Stimulation of Dorsal Raphe Nucleus in Rats)

  • 서상원;박형진
    • The Korean Journal of Physiology
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    • 제24권2호
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    • pp.403-411
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    • 1990
  • The present investigation was performed to see a possible influence of the dorsal raphe nucleus (DRN) on pancreatic exocrine secretion in anesthetized rats since the DRN had been known to exert a regulatory mechanism on sympathetic activity which was known to be very important for pancreatic exocrine secretion, particularly in rats. Twenty-nine Sprague-Dawley rats fasted for 24 hours were anesthetized by i.p. injection of 1 g/kg of urethane. The pancreatic duct was cannulated to collect pancreatic juice while bile juice was diverted into the jejunum. The duodenopyloric junction was tightly ligated. After surgery for collection of pancreatic exocrine secretion and recording of carotid blood pressure, a coaxial electrode was stereotaxically inserted in the DRN with a guide of a brain atlas. And then, electrical stimulus of biphasic square wave with 2 v, 2 msec, 40 Hz was applied on the electrode for 10 minutes. Pancreatic volume flow and protein output secreted in 10 min were measured. Either bilateral cervical vagotomy or spinal cord transection at the level of $C4{\sim}C5$ was performed 20 min prior to stimulation of the DRN. 1) Electrical stimulation of the DRN resulted in significant (p<0.05) increase in pancreatic volume flow and protein output. These stimulatory effects were not affected by cervical vagotomy but completely abolished by cervical cord transection. 2) Electrical stimulation of the DRN also resulted in significant (p<0.05) rise of blood pressure of the carotid artery. The hypertensive effect was not affected by cervical vagotomy but completely abolished by cervical cord transection. The results strongly suggest that the DRN, a part of the central serotonergic system, could exert a stimulatory influence on pancreatic exocrine secretion by increasing the sympathetic activity in anesthetized rats.

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