• Journal of Gastric Cancer
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• 제19권1호
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• pp.49-61
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• 2019

Purpose: The perigastric vagus nerve may play an important role in preserving function after gastrectomy, and intraoperative neurophysiologic tests might represent a feasible method of evaluating the vagus nerve. The purpose of this study is to assess the feasibility of neurophysiologic evaluations of the function and viability of perigastric vagus nerve branches during gastrectomy. Materials and Methods: Thirteen patients (1 open total gastrectomy, 1 laparoscopic total gastrectomy, and 11 laparoscopic distal gastrectomy) were prospectively enrolled. The hepatic and celiac branches of the vagus nerve were exposed, and grabbing type stimulation electrodes were applied as follows: 10-30 mA intensity, 4 trains, $1,000{\mu}s/train$, and $5{\times}$frequency. Visible myocontractile movement and electrical signals were monitored via needle probes before and after gastrectomy. Gastrointestinal symptoms were evaluated preoperatively and postoperatively at 3 weeks and 3 months, respectively. Results: Responses were observed after stimulating the celiac branch in 10, 9, 10, and 6 patients in the antrum, pylorus, duodenum, and proximal jejunum, respectively. Ten patients responded to hepatic branch stimulation at the duodenum. After vagus-preserving distal gastrectomy, 2 patients lost responses to the celiac branch at the duodenum and jejunum (1 each), and 1 patient lost response to the hepatic branch at the duodenum. Significant procedure-related complications and meaningful postoperative diarrhea were not observed. Conclusions: Intraoperative neurophysiologic testing seems to be a feasible methodology for monitoring the perigastric vagus nerves. Innervation of the duodenum via the celiac branch and postoperative preservation of the function of the vagus nerves were confirmed in most patients.

• Archives of Pharmacal Research
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• 제28권3호
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• pp.364-369
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• 2005

HPMC (Hydroxypropyl methylcellulose) was chemically modified, using maleic anhydrides, to obtain pH-sensitive HPMCAM (Hydroxypropyl methylcellulose acetate maleate) polymers for use as novel duodenum-specific coating agents. The pharmaceutical properties of HPMCAM, such as film forming, acid values, pH-sensitive values, water vapor permeability, tensile strength and Tg, were investigated, and found to show good film forming properties. The pH­sensitive values were 3.0 to 3.7. In vitro results demonstrate that HPMCAM could completely suppress drug release within 2h in a simulated gastric fluid (pH 1.2) and rapidly release the drug in a simulated pathological duodenal fluid (pH 3.4). These results indicate that HPMCAM might be a useful material for a duodenum-specific drug delivery system.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.484-492
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• 2019

Few surgeons have adopted pancreaticoduodenectomy (PD) for the treatment of advanced gastric cancer (AGC) invading the pancreas or duodenum because it remains controversial whether its prognostic benefits outweigh the high morbidity rates in such advanced cases. However, recent technical advances have revived diverse surgical procedures in minimally invasive approaches. Inspired by this trend, laparoscopic PD procedures have been performed for AGC in our institute since 2014. We recently performed a laparoscopic Whipple's operation in a case of cT4b gastric cancer with invasion of the pancreatic head and duodenum.

• 대한방사선치료학회지
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• 제26권1호
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• pp.51-57
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• 2014

목 적 : 췌장암의 경우 십이지장에 부여되는 선량 분포가 중요하게 다뤄진다. 십이지장의 경우는 호흡에 따라 변화가 발생된다. 이에 본 논문에서는 본원에 설치된 CT-on rail System을 이용하여 환자의 Kilovoltage Cone-Beam CT 촬영하여 십이지장의 위치 변화를 파악하고 체적 당 부여받는 선량의 변화를 파악하고자 한다. 대상 및 방법 : 3 명의 환자를 대상으로 CT-on rail System을 이용하여 KVCBCT를 획득하고 SYNGO Software를 이용하여 최초의 치료계획 영상과 비교 십이지장의 위치 변화를 파악하였다. 획득한 영상을 치료계획장치인 Pinnacle로 전송하여 변화된 위치에서 치료 용적에 포함되는 십이지장의 체적 변화를 파악하고 같은 선량에서 발생되는 체적의 변화를 분석하였다. 결 과 : 위치 변화 분석에서 좌우(Left-Right Direction) 방향에서 1.2cm, 1.0cm 머리 다리(Craniocaudal Direction) 방향에서는 0cm, 0.8cm 전후(Anterior-Posterior Direction) 방향에서는 0.1cm, 1.0cm의 변화를 나타내었다. 체적의 변화는 환자 1의 경우는 최초 치료계획에 비해 체적이 최대 약 460%, 최소 120% 증가하였고 환자 2는 최대 490%, 최소 160% 증가하였다. 반면 환자 3은 최대 150% 증가하였으나 최소 값에서는 약 30% 감소함을 나타내었다. 호흡의 변화에 따라 가장 많은 변화를 나타낸 환자 1의 경우는 최초의 치료계획과 비교하였을 시 초기 선량에서는 변화가 크게 나타나지 않았지만 선량이 증가함에 따라서 $V_{10}$에서는 118%, $V_{20}$ 117%, $V_{30}$ 400%, $V_{40}$ 480%의 체적 변화가 발생됨을 알 수 있었다. 결 론 : 현재 3D-CRT를 이용한 방사선 치료 시 4D-CT를 이용한 모의치료를 통해 환자의 호흡에 따른 십이지장의 위치 변화에 대해 파악하고 정확한 치료계획용적의 설정을 통해 호흡에 따른 십이지장의 체적 변화를 예측하고 이에 맞는 적합한 치료 계획을 세워 십이지장에 부여될 수 있는 선량을 최소화 시켜야 할 필요성이 있다고 사료된다.

• Journal of Microbiology and Biotechnology
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• 제25권7호
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• pp.1136-1145
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• 2015

The diverse microbial communities that colonize distinct segments of the gastrointestinal tract are intimately related to aspects of physiology and the pathology of human health. However, most recent studies have focused on the rectal or fecal microbiota, and the microbial signature of the duodenum is poorly studied. In this study, we compared the microbiota in duodenal and rectal samples to illustrate the characteristic microbial signatures of the duodenum in healthy adults. Nine healthy volunteers donated biopsies and luminal contents from the duodenum and rectum. To determine the composition and diversity of the microbiota, 454-pyrosequencing of bacterial 16S rRNA was performed and multiple bioinformatics analyses were applied. The α-diversity and phylogenetic diversity of the microbiota in the duodenal samples were higher than those of the rectal samples. There was higher biodiversity among the microbiota isolated from rectal biopsies than feces. Proteobacteria were more highly represented in the duodenum than in the rectum, both in the biopsies and in the luminal contents from the healthy volunteers (38.7% versus 12.5%, 33.2% versus 5.0%, respectively). Acinetobacter and Prevotella were dominant in the duodenum, whereas Bacteroides and Prevotella were dominant in the rectum. Additionally, the percentage of OTUs shared in biopsy groups was far higher than in the luminal group (43.0% versus 26.8%) and a greater number of genera was shared among the biopsies than the luminal contents. Duodenal samples demonstrated greater biological diversity and possessed a unique microbial signature compared with the rectum. The mucosa-associated microbiota was more relatively conserved than luminal samples.

• The Korean Journal of Physiology
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• 제5권2호
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• pp.55-62
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• 1971

In an attempt to better understand the effects of whole body X-irradiation on the levels of non-protein sulfhydryl (NP-SH), non-protein disulfide (NP-SS) and oxygen consumption rate $(QO_2)$ of the mouse duodenum, and to clarify the possible radioprotective action of reduced glutathione (GSH), a whole body X-irradiation of 1,000r was given to albino mouse either singularly or immediately after injecting GSH intraperitoneally to mouse 1 mg per gm of body weight. NP-SH was measured by Ellman's method, NP-SS was measured by the electrolytic reduction method described by Dohan and Woodward, and $(QO_2)$ by the Warburg's standard manometric method. The experiment was performed at 1, 6, 12 and 24 hours post-irradiation, and the comparison was made with the control. The results thus obtained are summarized as follows: 1) Comparing with the intrinsic NP-SH level of $3.31{\pm}0.27{\mu}\;mol/gm$ wet weight in the duodenum of the normal mouse, either whale body X-irradiation or injection of GSH alone produced no significant change in NP-SH from the normal. However, when GSH was injected prior to X-irradiation, markedly elevated NP-SH levels were observed throughout the entire experiment with the highest value of $4.70{\pm}0.10$ at 6 experimental hours. 2) The normal value of NP-SS in the mouse duodenum was $1.57{\pm}0.17{\mu}\;mol/gm$ wet weight, while in the group where injection of GSH and X-irradiation were combined, NP-SS increased to $2.36{\pm}0.33$ at 12 hours and $2.15{\pm}0.53$ at 24 hours, showing the intermediate value between the GSH injection group and X·irradiation group. 3) The normal value of $(QO_2)$ was $4.16{\pm}0.73{\mu}l\;O_2/hr./gm$ D.W., and no noticeable change was observed comparing with the GSH injection group. However, in the group where X·irradiation alone was given, $(QO_2)$ of the duodenum increased significantly throughout the entire experiment with the highest value of $6.35{\pm}1.07$ at 6 experimental hours. When GSH was injected before X-irradiation was given, the levels of $(QO_2)$ were in the middle of the GSH injection group and X-irradiation group. 4) The above results suggest that GSH may be effective as a radioprotector in terms of NP-SH, NP-SS and $(QO_2)$ of the mouse duodenum.

• The Korean Journal of Physiology
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• 제11권1호
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• pp.27-32
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• 1977

Diospyros Kaki Thunberg is the species of persimmon tree that grows in Korea. Although its fresh or dried fruits are often served as a desert, it has little been known if persimmon tree has any specific pharmacological action. The leaves and branches of persimmon tree has long been used as folk remedies for palsy and frostbite in the southern part of Korea and it is also in use for the treatment of hiccup and nocturnal enuresis in chinese herbal medicine. Recently it was reported that an intravenous administration of Diospyros Kaki Thunberg ethanol extract (KTEE) into the animals lowered arterial blood pressure. Lee concluded from his study on the mechanism of depressor action of KTEE that at least a part of depressor response he observed was caused by acetylcholine-like action of KTEE. On the other hand little study has been made on the effect of KTEE on the motility of isolated animal intestines. Therefore the present study was undertaken to investigate effect of KTEE and the mechanism of its action on the motility of isolated rabbit duodenum. Ethanol extract of Diospyros Kaki Thunberg was prepared by boiling 1 kg of dried branches of persimmon tree in 1 liter of ethanol and the motility of isolated rabbit duodenum was recorded on physiograph by means of force transducer connected with Magnus apparatus. Doses of KTEE used were $5{\times}10^{-4}gm/ml,\;1{\times}10^{-3}gm/ml,\;and\;2{\times}10^{-3}gm/ml$. And the isolated duodenum was separately pretreated with acetylcholine $(5{\times}10^{-7}gm/ml)$, pilocarpine $(2.5{\times}10^{-6}gm/ml)$, histamine $(5{\times}10^{-6}gm/ml)$ and barium chloride $(2.5{\times}10^{-5}gm/ml)$ in order to find out interactions of these drugs with KTEE. The results obtained are as follows: 1. At doses of $5{\times}10^{-4}gm/ml,\;1{\times}10^{-3}gm/ml$ KTEE reduced contractions of isolated duodenum, while tonus as well as contaction of duodenum were depressed with $2{\times}10^{-3}gm/ml$ of KTEE. 2. Since the inhibitory effect of KTEE on the intestinal motility was not blocked by pretreatment with acetylcholine, pilocarpine, and barium chloride, it was strongly suggested that the inhibitory action of KTEE on intestinal motility is mainly Caused by its antihistamine effect. 3. It is also concluded that the principal substance of KTEE responsible for inhibition of intestinal motility may also have a vasodilating activity and would not be an acetylcholine-like substance in case it is same substance as that cause depressor responses.

• Asian-Australasian Journal of Animal Sciences
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• 제31권12호
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• pp.1963-1973
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• 2018

Objective: This study was conducted to evaluate the effect of dietary energy and lipase supplementation on growth performance, nutrient digestibility, serum profiles, intestinal morphology, small intestinal digestive enzyme activities, biochemical index of intestinal development and noxious gas emission in weaning pigs. Methods: A total of 240 weaning pigs ([Yorkshire${\times}$Landrace]${\times}$Duroc) with an average body weight (BW) of $7.3{\pm}0.12kg$ were used in this 28-d experiment. Weaning pigs were randomly allocated to 4 dietary treatments in a $2{\times}2$ factorial arrangement with 2 levels of energy (net energy = 2,470 kcal/kg for low energy diet and 2,545 kcal/kg for basal diet) and 2 levels of lipase (0 and 1.5 U/g of lipase) according to BW and sex. There were 6 replications (pens) per treatment and 10 pigs per pen (5 barrows and 5 gilts). Results: Weaning pigs fed the low energy diet had lower (p<0.05) gain-to-feed ratio (G:F) throughout the experiment, apparent digestibility of dry matter, nitrogen, ether extract, and gross energy during d 0 to 14, average daily gain during d 15 to 28, lipase activity in duodenum and ileum and protein/DNA in jejunum (p<0.05), respectively. Lipase supplementation had no effect on growth performance but affected apparent nutrient digestibility (p<0.05) on d 14 and enhanced lipase activity in the duodenum and ileum and protease activity in duodenum and jejunum of pigs (p<0.05) fed the low energy diet. Lipase reduced serum low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG), $NH_3$ production (p<0.05) from the feces. Conclusion: The low energy diet decreased G:F throughout the experiment and nutrient digestibility during d 0 to 14 as well as lipase activity in duodenum and ileum. Lipase supplementation increased nutrient digestibility during d 0 to 14 and exerted beneficial effects on lipase activity in duodenum and ileum as well as protease activity in duodenum and jejunum, while reduced serum LDL-C, TG and fecal $NH_3$.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.53-58
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• 2020

Duodenal injury following blunt abdominal trauma is a relatively unusual complication, and it may sometimes be difficult to distinguish a duodenal hematoma from duodenal perforation. According to recent reports, intramural hematomas typically resolve spontaneously with conservative treatment. Surgery, however, is occasionally necessary in some cases if the diagnosis is delayed, conservative therapy fails, or a high degree of suspicion of duodenal injury persists. We experienced a case of delayed manifestation of a duodenal intramural hematoma that was surgically treated.

• 한국임상수의학회지
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• 제5권2호
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• pp.101-106
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• 1988

A partial obstruction of small intestine was diagnosed by physical and radiographic examination in a dog which had signs of anorexia, vomiting, diarrhea and dehydration The dog was treated by surgical method. String-like foreign body was located from stomach to upper jejunum. Diffuse laceration, inflammation and perforation caused by foreign body were observed in intestine. Intestinal resection was carried out to remove the foreign body from upper duodenum to upper jejunum. The dog was convalesced successfully after operation.