• Asian-Australasian Journal of Animal Sciences
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• v.2 no.3
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• pp.489-490
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• 1989

• Journal of Gastric Cancer
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• v.12 no.4
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• pp.237-242
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• 2012

Purpose: Despite the great advances in laparoscopic techniques, most active general surgeons do not apply laparoscopic surgery in the treatment of duodenal ulcer perforation when facing a real-life emergency. Therefore, our study was designed to evaluate the feasibility of laparoscopic surgery in duodenal ulcer perforation, and provide a step-by-step protocol with tips and recommendations for less experienced surgeons. Materials and Methods: Between March, 2011 and May, 2012, 21 patients presenting with duodenal ulcer perforation underwent laparoscopic primary repair with omentopexy. There were no contraindications to perform laparoscopic surgery, and the choice of primary repair was decided according to the size of the perforation. The procedure for laparoscopic primary repair with omentopexy consisted of peritoneal lavage, primary suture, and omentopexy using a knot pusher. Results: During the operation, no conversion to open surgery or intra-operative events occurred. The median operation time was 45.0 minutes (20~80 minutes). Median day of commencement of a soft diet was day 6 (4~17 days). After surgery, the median hospital stay was 8.0 days (5~27 days). Postoperative complications occurred in one patient, which included a minor leakage. This complication was resolved by conservative management. Conclusions: Although our study was carried out on a small number of patients at a single institution, we conclude that laparoscopic primary repair can be an effective surgical method in the treatment of duodenal ulcer perforation. We believe that the detailed explanation of our procedure will help beginners to perform laparoscopic primary repair more easily.

• Asian-Australasian Journal of Animal Sciences
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• v.14 no.7
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• pp.960-965
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• 2001

The effects of different feeding ratios of concentrate (C) and roughage (R) on balance of long chain fatty acids and microbial fatty acids in the rumen of sheep were investigated. The diets were divided into 8:2 (concentrate feeding), 4:6 (middle mixture) and 0:10 (roughage feeding) ratios (C:R). Duodenal digesta was collected through 24 hours after feeding. Biohydrogenation rate, total duodenal flow of fatty acids and microbial fatty acids were measured. Total duodenal flow of fatty acids was significantly (p<0.05) increased with increasing concentrate. Total duodenal flow of fatty acid was greater than intake of fatty acid in all diets. In comparison with intake of each fatty acid, duodenal flow of stearic acid ($C_{18:0}$) remarkably increased in all diets. Biohydrogenation rate for total C18 unsaturated fatty acids in the rumen tended to increase (p<0.10) when sheep were fed the middle mixture. In particular, biohydrogenation rate of linoleic acid ($C_{18:2}$) and linolenic acid ($C_{18:3}$) with the middle mixture were highest (p<0.05) compared with other diets. Duodenal flow of protozoal fatty acids was significantly (p<0.05) increased with the increased supply of concentrate. That of bacterial fatty acids was significantly (p<0.05) increased with both concentrate diets compared with the roughage feeding diet. $C_{18:0}$ occupied the greater part of both protozoal and bacterial fatty acids in all treatments. Results indicated that biohydrogenation of free unsaturated fatty acids was actively carried out when the middle mixture diet was supplied, and that microbial uptake and synthesis of fatty acids were accelerated by adding the supply of concentrate.

• Parasites, Hosts and Diseases
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• v.30 no.3
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• pp.231-234
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• 1992

A 58-year-old chronic alcoholism patient, who complained of epigastric discomfort, nausea, and frequent loose stool was diagnosed as strongyloidiasis accompanied by duodenal ulcer. The symptoms first appeared two years ago and aggravated during the recent 3 months, and he lost 4 kg of his body weight. Stool examination revealed rhabditoid nematode larvae, which were confirmed as those of Strongyloides stercoralis after cultivation of them to alariform larvae. At duodenoscopy, duodenal ulcer was found. The patient was treated with albendagole (200 mg, bid, for 14 days) for stronglyloidiasis and with colloidal bismuth sulfate(240 mg, bid, for 6 weeks) for duodenal ulcer. After the medication, the symptoms of loose stool and epigastric discomfort were much improved and he was discharged with no clinical problems. This is an interesting case which suggests that S. stercoralis infection could be related with ulceration of the duodenal mucosa.

• Journal of Gastric Cancer
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• v.17 no.4
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• pp.354-362
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• 2017

Purpose: Laparoscopic gastrectomy is accepted as a standard treatment for patients with early gastric cancer in Korea, Japan, and China. However, duodenal stump leakage remains a fatal complication after gastrectomy. We conducted a prospective phase II study to evaluate the safety of the new technique of laparoscopic reinforcement suture (LARS) on the duodenal stump. Materials and Methods: The estimated number of patients required for this study was 100 for a period of 18 months. Inclusion criteria were histologically proven gastric adenocarcinoma treated with laparoscopic distal or total gastrectomy and Billroth II or Roux-en-Y reconstruction. The primary endpoint was the incidence of duodenal stump leakage within the first 30 postoperative days. The secondary endpoints were early postoperative outcomes until discharge. Results: One hundred patients were enrolled between February 2016 and March 2017. The study groups consisted of 65 male and 35 female patients with a mean age (years) of 62.3. Of these, 63 (63%) patients had comorbidities. The mean number of retrieved lymph nodes was 38. The mean operation time was 145 minutes including 7.8 minutes of mean LARS time. There was no occurrence of duodenal stump leakage. Thirteen complications occurred, with one case of reoperation for splenic artery rupture and one case of mortality. Conclusions: Based on the results of this prospective phase II study, LARS can be safely performed in a short operation period without development of duodenal stump leakage. A future randomized prospective controlled trial is required to confirm the surgical benefit of LARS compared to non-LARS.

• Asian-Australasian Journal of Animal Sciences
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• v.2 no.3
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• pp.361-363
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• 1989

• Asian-Australasian Journal of Animal Sciences
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• v.2 no.3
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• pp.394-395
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• 1989

• Asian-Australasian Journal of Animal Sciences
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• v.33 no.1
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• pp.91-99
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• 2020

Objective: This study investigated the effects of oral administration of rumen-protected L-tryptophan (RPL-T) on duodenal starch digestion and gastrointestinal hormones (GIH) secretions using Hanwoo beef steers as the animal models. Methods: Four steers (423±24 kg) fitted with ruminal and duodenal cannulas were employed in a crossover design replicated twice. Treatments were control (basal diet) and RPL-T (basal diet+191.1 mg/kg body weight [BW]) group. Blood and duodenal samples were collected to measure serum GIH levels and pancreatic α-amylase activity at day 0, 1, 3, and 5 (-30, 30, 90, 150, and 210 min) of the study. Samples from each segment of the gastrointestinal tract were collected via ruminal and duodenal cannulas and were used to determine soluble protein and the starch digestion rate at days 6 (-30, 180, 360, and 540 min) and 8 (-30, 90, 270, and 450 min) of the experiment. Results: No significant difference in ruminal pH, NH₃-N, and total volatile fatty acid including the levels of acetate, propionate, butyrate, isobutyrate, valerate, isovalerate, and the acetate-to-propionate ratio was observed between groups (p>0.05). Crude protein uptake was higher and feces starch content was lower in RPL-T group than the control group (p<0.05). The D-glucose contents of feces in RPL-T group decreased at day 5 compared to those in the control group (p<0.05), however, no change was found at day 0, 1, or 3 compared to the control group (p>0.05). Serum cholecystokinin (CCK), melatonin, duodenal pancreatic α-amylase activity, and starch digestion were significantly higher in RPL-T group than the control group (p<0.05). Conclusion: Taken together, oral administration of RPL-T at the rate of 191.1 mg/kg BW consistently increased CCK concentration, pancreatic α-amylase activity in duodenal fluids, and starch digestion rate in the small intestine and thus found to be beneficial.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.157-162
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• 2013

Purpose: Abdominal trauma rarely causes injuries involving duodenum. But, it is associated with higher rate of the complication and mortality than other abdominal injuries. There are many options for the management of duodenal injuries. Herein we are to review our experiences and find out the risk factors related to the morbidity and the mortality in traumatic duodenal injuries. Methods: The medical records of total 25 patients who managed by surgical managements and survive more than 48 hours were conducted from January 2006 to December 2012. The clinical characteristics, treatments, and outcomes are reviewed. Results: Among 25 patients, most of them (n=17, 68.0%) were managed by the pyloric exclusion and the gastrojejunostomy. The $3^{rd}$ portion is the most injured site (n=15, 60.0%), and the majority exhibited grade 2 severity (n=14, 56.0%). Most of patients had blunt abdominal traumas (n=23, 92.0%) so that many of them (n=14, 56.0%) had other combined abdominal injuries. The mean ISS is $11.5{\pm}6.2$. The surgery related mortality rate was 28.0%. There was no statistical significance between each factors and the mortality except leakage (p=0.012). But, we could find some trends about traumatic duodenal injuries in this study. The mortality rates of them who older than 55 years were higher than others. And, all 3 patients who delayed the operation more than 24 hours after the trauma had some complications or died. Also, the patients who had the $2^{nd}$ portion injury, grade 3 injury, or combined abdominal injury were less survived. Conclusion: Duodenal injury is related to high rate of morbidity(47.8%) and mortality(28.0%). Age, portion of injury, OIS grade, ISS>15, combined intra-abdominal operation, and trauma to operation time over 24 hrs have some trend with attribution to mortality. Especially leakage of duodenal injury is related to mortality.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6305-6310
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• 2012

Objectives: This study aimed to demonstrate the tyrosine phosphorylation motif (TPM) and 3' region structure of the Helicobacter pylori CagA gene as well as its SHP-2 binding activity in AGS cells and relation to gastric carcinogenesis. Methods: Sixteen clinical isolate H. pylori strains from eight duodenal ulcer and eight gastric adenocarcinoma patients were studied for CagA repeat sequence EPIYA motifs, C-terminal structure, and western blot analysis of CagA protein expression, translocation, and SHP-2 binding in AGS cells. Results: Except for strain 547, all strains from the gastric adenocarcinoma patients were positive for CagA by PCR and had three EPIYA copy motifs. Western blotting showed that all strains were positive for CagA protein expression (100%), CagA protein translocation (100%), and SHP-2 binding (100%). CagA protein expression was significantly higher in the gastric adenocarcinoma patients than in the duodenal ulcer patients (P=0.0023). CagA protein translocation and SHP-2 binding in the gastric adenocarcinoma patients were higher than those in the duodenal ulcer patients, but no significant differences were found between the two groups (P=0.59, P=0.21, respectively). Conclusions: The TPMs and 3' region structures of the H. pylori CagA gene in the duodenal ulcer and gastric adenocarcinoma patients have no significant differences.