• Safety and Health at Work
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• 제8권4호
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• pp.327-328
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• 2017

Despite provision of drinking water as the most common method of occupational heat stress prevention, there remains confusion in hydration messaging to workers. During work site interactions in a hot and humid climate, workers commonly report being informed to consume tepid fluids to accelerate rehydration. When questioned on the evidence supporting such advice, workers typically cite that fluid absorption is delayed by ingestion of chilled beverages. Presumably, delayed absorption would be a product of fluid delivery from the gut to the intestines, otherwise known as gastric emptying. Regulation of gastric emptying is multifactorial, with gastric volume and beverage energy density the primary factors. If gastric emptying is temperature dependent, the impact of cooling is modest in both magnitude and duration (${\leq}5$ minutes) due to the warming of fluids upon ingestion, particularly where workers have elevated core temperature. Given that chilled beverages are most preferred by workers, and result in greater consumption than warm fluids during and following physical activity, the resultant increased consumption of chilled fluids would promote gastric emptying through superior gastric volume. Hence, advising workers to avoid cool/cold fluids during rehydration appears to be a misinterpretation of the research. More appropriate messaging to workers would include the thermal benefits of cool/cold fluid consumption in hot and humid conditions, thereby promoting autonomy to trial chilled beverages and determine personal preference. In doing so, temperature-based palatability would be maximized and increase the likelihood of workers maintaining or restoring hydration status during and after their work shift.

• Journal of Gastric Cancer
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• 제12권4호
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• pp.223-231
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• 2012

Purpose: Clinical staging of gastric cancer appears to be important more and more for tailored therapy. This study aimed to verify the accuracy of clinical T staging in a low-volume institute. Materials and Methods: We retrospectively reviewed prospectively collected data of gastric cancer patients who underwent resection. A total of 268 patients of gastric cancer were enrolled from March 2004 to June 2012. These demographics, tumor characteristics, and clinical stages were analyzed for identification of diagnostic value of clinical T staging. Results: The predictive values for pT1 of endoscopy and computed tomography were 90.0% and 89.4%, respectively. In detail, the predictive values of endoscopy for pT1a, pT1b, and pT2 or more were 87%, 58.5%, and 90.6%, respectively. The predictive values of computed tomography for pT1a, pT1b, and pT2 or more were 68.8%, 73.9%, and 84.4%, respectively. The factors leading to underestimation of pT2 or more lesions by gastroscopy were the middle third location, the size greater than 2 cm, and younger age. Those for overestimation of pT1 lesion by computed tomography were male, age more than 70 years, elevated type, and size greater than 3 cm. Conclusions: Diagnostic accuracy of early gastric cancer was 90%, which is comparable to those of high volume center. In patients with early gastric cancer, limited gastrectomy or minimal invasive surgery can be safely introduced at a low volume center also. However, the surgeon of low-volume institute should consider the accuracy of clinical staging before extending the indication of limited treatment.

• Journal of Gastric Cancer
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• 제22권1호
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• pp.35-46
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• 2022

Background: The correlation between hospital volume and postoperative outcomes has led to the centralization of complex procedures in several countries. However, the results reported in relation to gastric cancer (GC) are contradictory. This study aimed to analyze GC surgical volumes and 30-day postoperative mortality in Italy and to provide a simulation for modeling centralization of GC resections based on district case volumes. Methods: A national registry was used to identify all GC resections, record mortality rates, and track the national in-border GC resection health travel. Hospitals were grouped according to caseload. Centralization of all GC procedures performed within the same district was modeled. The outcome measures were a minimal volume of 25 GC resections/year and the 30-day postoperative mortality. Results: In 2018, 5,873 GC resections were performed in 498 Italian hospitals (mean resections per hospital per year: 11.8); the postoperative mortality rate (5.51%) was tracked from 2016-2018. GC resection health travel ranged from 2% to 50.5%, with a significant (P<0.001) difference between northern and central/southern Italy. The mean mortality rate was 7.7% in hospitals performing one to 3 GC resections per year, compared with 4.7% in those with >17 GC resections/year (P≤0.01). Most Italian districts achieved 25 procedures/year after centralization; however, 66.3% of GC cases in southern Italy vs. 42.2% in central and 52.7% in the northern regions (P<0.001) required reallocation. Conclusion: Postoperative mortality after GC resection correlated with hospital volume. Despite health travel, most Italian districts can reach a high-volume threshold, but discrepancies in mortality rates are alarming.Trial RegistrationResearch Registry Identifierresearchregistry6869

• The Korean Journal of Physiology
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• 제11권2호
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• pp.67-71
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• 1977

This study was undertaken to investigate the effect of cingulate cortical ablation upon gastric secretion and its components in rats. 23 male rats were divided into the cingulate(N=9) and the operated control(N= 14) groups. Cingulate cortex was ablated through a slit-shaped opening(1 mm in width, 5 mm in length) which was made symmetrically on both sides of, and parallel to, the sagittal suture by removing a bone flap from frontal bone on each side. In the operated control group, the surgical procedure was ended by the removal of the bone flap. Under light ether anesthesia, experimental animals were placed in a restraining jacket of fine mesh wire and gastric juice was collected for 5 hours via a canula which had been inserted through the anterior abdominal wall into the antral portion of the lumen of the stomach. Volume of the gastric juice was measured, and total acid output and free acid output were titrated with 0.04 N NaOH solution by using phenolphthalein and Topfer's reagent at indicator, and chloride ion output was estimated by means of chloridometer. Results obtained were that volume, total acid output, free acid output and chloride ion output of the gastric juice were higher significantly in the cingulate group than in the operated control group. It is inferred from the above results that the cingulate cortex exerts a fascilitatory influence upon gastric secretion and acid output in rats.

• 동의생리병리학회지
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• 제30권4호
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• pp.257-265
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• 2016

The aim of this study was to investigate the effects of Ulmi Pumilae cortex extracts on acute reflux esophagitis rats induced by pylorus and forestomach ligation operation. 40 rats were divided into five groups; Normal group, Sham group, Control group, T1 group and T2 group. 4 groups has a laparotomy after controled 2weeks and sham group, T1 group, T2 group has ligation in stomach. After laparotomy, all group`s body weight, gastric volume, gastric juice PH, SOD activities, catalase activities, lipid peroxidation, total glutathione, the effects on esophageal and stomach mucosa damage were checked. There was significant statistical differences between control group and Ulmi Pumilae cortex extracts adminitration groups(T1 and T2 group) in terms of gastric volume decreasing. Also, adminitration groups has significant effect than control group in decreasing mucosa damage. SOD(superoxide dismutase) and catalase activities has a significant statistical differences between control group and T2 group not in T1 group. These results suggest that the medication of Ulmi Pumilae cortex extracts is effective for the treatment of acute reflux esophagitis in terms of decerasing gastric volume and mucosa damage. Especially, the results were shown to be more positive in High-dose administration group (T2 group) than in Low-dose administration group (T1 group) in SOD and catalase activities.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7401-7405
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• 2014

Background: Postoperative chemoradiotherapy is accepted as standard treatment for stage IB-IV, M0 gastric cancer. Radiotherapy (RT) planning of gastric cancer is important because of the low radiation tolerance of surrounding critical organs. The purpose of this study was to compare the dosimetric aspects of 2-dimensional (2D) and 3-dimensional (3D) treatment plans, with the twin aims of evaluating the adequacy of 2D planning fields on coverage of planning target volume (PTV) and 3D conformal plans for both covering PTV and reducing the normal tissue doses. Materials and Methods: Thirty-six patients with stage II-IV gastric adenocarcinoma were treated with adjuvant chemoradiotherapy using 3DRT. For each patient, a second 2D treatment plan was generated. The two techniques were compared for target volume coverage and dose to normal tissues using dose volume histogram (DVH) analysis. Results: 3DRT provides more adequate coverage of the target volume. Comparative DVHs for the left kidney and spinal cord demonstrate lower radiation doses with the 3D technique. Conclusions: 3DRT produced better dose distributions and reduced radiation doses to left kidney and spinal cord compared to the 2D technique. For this reason it can be predicted that 3DRT will result in better tumor control and less normal tissue complications.

• The Korean Journal of Physiology
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• 제23권1호
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• pp.119-127
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• 1989

This study was undertaken to investigate the effect of medial amygdala on the gastric acid secretion and plasma gastrin concentration in the rats with chronic gastric fistula. After the medial nucleus of amygdala was damaged bilaterally by radiofrequency a. c. through stereotaxically inserted electrodes, the gastric juice was collected in the basal and histamine-stimulated states for 1 hour. The gastric juice was also collected while the medial nucleus of amygdala was stimulated with biphasic square wave in the both states. After the collection of the gastric juice, blood samples were drawn from the abdominal aorta for the radioimmunoassay of plasma gastrin. The results were as follows: 1) The damage of the medial amygdala significantly decreased the gastric juice volume and the acid output in the histamine-stimulated state. 2) The electrical stimulation of the medial amygdala significantly increased the gastric juice volume and the acid output in the histamine-stimulated state, and the acid output in the basal state. 3) The damage of the medial amygdala significantly decreased the plasma gastrin concentration but the electrical stimulation of the medial amygdala did not affect the plasma gastrin concentration. It is therefore suggested that the medial amygdala has a facilitatory influence on the histamine-stimulated gastric acid secretion in rats, and the influence may not be attributed to gastrin release.

• 한국가시화정보학회지
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• 제7권2호
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• pp.22-27
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• 2010

The delayed gastric emptying flows have been visualized in this study when a gastric graft replaced an esophagus after esophagectomy. To construct visualization models for gastric grafts, the path data of gastric graft were extracted from the CT images for real patients and then the experimental models were made from silicone tube by considering elasticity of real stomach. During experiments, 200 ml of water or glycerin was poured into the gastric graft model and the gastric emptying time for total volume of fluid to pass pylorus was measured from the successive images captured by a high speed CCD. The gastric emptying time was compared according to the change of diameter and path (front or rear path) of gastric graft, and pyloroplasty or not. In case that the pyloroplasty was not conducted, the smaller was the diameter of gastric graft, the shorter was the gastric emptying time. However, if the pyloroplasty was conducted, the larger diameter of gastric graft was better for the gastric emptying. Although the rear path gave rise to longer gastric emptying time than the front path, it did not matter, if the pyloroplasty was conducted.

• Journal of Gastric Cancer
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• 제18권4호
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• pp.368-378
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• 2018

Purpose: Fibrinogen and platelets have been reported to play important roles in tumorigenesis and cancer progression. The aim of this research was to investigate the combination of functions of fibrinogen, platelets, and mean platelet volume (MPV) in predicting the survival of patients with gastric cancer (GC). Materials and Methods: A retrospective study was conducted with 1,946 patients with GC and 299 patients with benign gastric tumor to analyze their fibrinogen, platelet, and MPV levels, and other clinicopathological characteristics along with their prognoses. Several indicators were evaluated along with fibrinogen, platelets, and MPV and their prognostic abilities were assessed. Univariate and multivariate survival analyses were conducted to determine the independent risk factors for overall survival. Results: Increased levels of fibrinogen, platelets, and MPV were observed with the progress of the GC stages. Elevated fibrinogen, platelets, and the combined indicators, including fibrinogen*MPV (FM), platelet*fibrinogen*MPV (PFM), fibrinogen/MPV (FMR), platelet*fibrinogen (PF), platelet*fibrinogen/MPV (PFMR), platelet*MPV (PM), and platelet/MPV (PMR), foreboded poor prognosis. Meanwhile fibrinogen and FMR can be considered as independent risk factors for overall survival in patients with non-metastatic GC. But these indicators can hardly predict survival of patients in stage IV. Conclusions: Elevated fibrinogen, platelets, and MPV levels were in accordance with advanced stages, and fibrinogen, platelet, and MPV, in combination, can be used to predict survival of patients with non-metastatic GC. FMR was an independent prognostic factor for overall survival of patients with GC.

• Journal of Gastric Cancer
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• 제13권1호
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• pp.44-50
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• 2013

Purpose: Laparoscopic gastrectomy has been adopted for the treatment of gastric cancer, and despite the technical difficulties, totally laparoscopic distal gastrectomy has been considered less invasive than laparoscopy-assisted distal gastrectomy. Although there have been many reports regarding the feasibility and safety of totally laparoscopic distal gastrectomy at large volume centers, few reports have been conducted at low-volume centers. The purpose of this study is to try to assess the feasibility and safety of totally laparoscopic distal gastrectomy at a low volume center through the analysis of short-term outcomes of totally laparoscopic distal gastrectomy compared with laparoscopy-assisted distal gastrectomy. Materials and Methods: The clinical data and short-term surgical outcomes of 35 patients who had undergone laparoscopy-assisted distal gastrectomy between April 2007 and March 2010, and 37 patients who underwent totally laparoscopic distal gastrectomy between April 2010 and August 2012 were retrospectively reviewed. Results: There was no significant difference in the demographic and clinical data. However the reconstruction method and extent of lymphadenectomy showed statistically significant differences. Operation time and estimated blood loss did not show significant differences. Surgical and medical complications did not show significant differences but postoperative courses including time-to-first oral intake and postoperative hospital stay were significantly increased. Conclusions: Our study shows that totally laparoscopic distal gastrectomy is technically feasible at a low volume center. Therefore, totally laparoscopic distal gastrectomy can be considered as one of the surgical treatment for early gastric cancer. However the possibility that totally laparoscopic distal gastrectomy may have less benefit should also be considered.