• Journal of Gastric Cancer
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• 제21권2호
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• pp.155-168
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• 2021

Purpose: Previous studies have demonstrated the usefulness of the controlling nutritional status (CONUT) score in nutritional assessment and survival prediction of patients with various malignancies. However, its value in advanced gastric cancer (GC) treated with neoadjuvant chemotherapy and curative gastrectomy remains unclear. Materials and Methods: The CONUT score at different time points (pretreatment, preoperative, and postoperative) of 272 patients with advanced GC were retrospectively calculated from August 2004 to October 2015. The χ² test or Mann-Whitney U test was used to estimate the relationships between the CONUT score and clinical characteristics as well as short-term outcomes, while the Cox proportional hazard model was used to estimate long-term outcomes. Survival curves were estimated by using the Kaplan-Meier method and log-rank test. Results: The proportion of moderate or severe malnutrition among all patients was not significantly changed from pretreatment (13.5%) to pre-operation (11.7%) but increased dramatically postoperatively (47.5%). The pretreatment CONUT-high score (≥4) was significantly associated with older age (P=0.010), deeper tumor invasion (P=0.025), and lower pathological complete response rate (CONUT-high vs. CONUT-low: 1.2% vs. 6.6%, P=0.107). Pretreatment CONUT-high score patients had worse progression-free survival (P=0.032) and overall survival (OS) (P=0.026). Adjusted for pathologic node status, the pretreatment CONUT-high score was strongly associated with worse OS in pathologic node-positive patients (P=0.039). Conclusions: The pretreatment CONUT score might be a straightforward index for immune-nutritional status assessment, while being a reliable prognostic indicator in patients with advanced GC receiving neoadjuvant chemotherapy and curative gastrectomy. Moreover, lower pretreatment CONUT scores might indicate better chemotherapy responses.

• Journal of Microbiology and Biotechnology
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• 제31권1호
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• pp.92-103
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• 2021

Lactobacillus casei, one of the most widely used probiotics, has been reported to alleviate multiple diseases. However, the effects of this species on intestinal diseases are strain-specific. Here, we aimed to screen L. casei strains with inflammatory bowel disease (IBD)-alleviating effects based on in vitro physiological characteristics. Therefore, the physiological characteristics of 29 L. casei strains were determined, including gastrointestinal transit tolerance, oligosaccharide fermentation, HT-29 cell adhesion, generation time, exopolysaccharide production, acetic acid production, and conjugated linoleic acid synthesis. The effects of five candidate strains on mice with induced colitis were also evaluated. The results showed that among all tested L. casei strains, only Lactobacillus casei M2S01 effectively relieved colitis. This strain recovered body weight, restored disease activity index score, and promoted anti-inflammatory cytokine expression. Gut microbiota sequencing showed that L. casei M2S01 restored a healthy gut microbiome composition. The western blotting showed that the alleviating effects of L. casei M2S01 on IBD were related to the inhibition of the NF-κB pathway. A good gastrointestinal tolerance ability may be one of the prerequisites for the IBD-alleviating effects of L. casei. Our results verified the efficacy of L. casei in alleviating IBD and lay the foundation for the rapid screening of L. casei strain with IBD-alleviating effects.

• Clinical Endoscopy
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• 제56권3호
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• pp.333-339
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• 2023

Background/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea. Methods: We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed. Results: In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m². Body mass index reduction was 3.72±2.63 kg/m² at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain. Conclusions: IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

• Clinical Endoscopy
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• 제56권4호
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• pp.446-452
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• 2023

Background/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes. Methods: We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated. Results: Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, -0.76 [-1.49 to -0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28-0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27-0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, -0.48; 95% CI, -1.05 to 0.08; p=0.09) when using an abdominal compression device. Conclusions: Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.

• Journal of Gastric Cancer
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• 제24권2호
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• pp.137-144
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• 2024

Purpose: Laparoscopic proximal gastrectomy (LPG) is a viable choice for treating proximal gastric lesions. However, the occurrence of severe reflux has limited its widespread adoption. To address this issue, the double flap technique (DFT), which incorporates artificial lower esophageal sphincteroplasty, has been developed to prevent reflux problems after proximal gastrectomy. In this study, we aimed to investigate the usefulness of this technique using high-resolution manometry (HRM), impedance pH monitoring, and esophagogastroduodenoscopy (EGD). Materials and Methods: The findings of pre- and postoperative 6-month HRM, pH monitoring, and EGD were compared for 9 patients who underwent LPG with DFT for various proximal gastric lesions at Incheon St. Mary's Hospital from January 2021 to December. Results: A total of 9 patients underwent proximal gastrectomy. Approximately half of the patients had Hill's grade under II preoperatively, whereas all patients had Hill's grades I and II in EGD findings. In the HRM test, there was no significant difference between distal contractile integral (1,412.46±1,168.51 vs. 852.66±495.62 mmHg·cm·s, P=0.087) and integrated relaxation pressure (12.54±8.97 vs. 8.33±11.30 mmHg, P=0.27). The average lower esophageal sphincter (LES) pressure was 29.19±14.51 mmHg preoperatively, which did not differ from 19.97±18.03 mmHg after the surgery (P=0.17). DeMeester score (7.02±6.36 vs. 21.92±36.17, P=0.21) and total acid exposure time (1.49±1.48 vs. 5.61±10.17, P=0.24) were slightly higher, but the differences were not statistically significant. Conclusions: There is no significant functional difference in HRM and impedance pH monitoring tests after DFT. DFT appears to be useful in preserving LES function following proximal gastrectomy.

• 한국식품영양과학회지
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• 제32권4호
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• pp.621-626
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• 2003

설탕의 40%를 프락토올리고당이나 이소말토올리고당으로 대치하여 구운 스폰지 케이크를 2주간 섭취하게 하여 여대생의 변비개선에 대한 효과를 살펴보았다. 두 올리고당 모두 섭취 후 배변 횟수와 변의 경도를 유의적으로 개선시켰다. 프락토올리고당을 첨가한 스폰지 케이크를 섭취한 군에서는 배변시간이 섭취 1주 후부터 유의적으로 감소하였으며, 이소말토올리고당을 첨가한 스폰지 케이크를 섭취한 군에서는 변의 모양, 변색, 배변 시 노력과 배변 후 상쾌함 등이 섭취 전보다 섭취 후에 유의적으로 개선되었다. 섭취 중에 나타난 소화장애 현상으로는 설사, 복통, 메스꺼움, 더부룩함, 방귀, 식욕 감소, 체중감소, 복부 팽만감 등이 나타났고, 프락토올리고당을 첨가한 스폰지 케이크 섭취 군에서는 이들 장애현상 중 복부 팽만감이나, 방귀, 메스꺼움 현상이 섭취 후 1~2시간 안에 나타나기 시작하여, 실험 기간 내내 지속되었다. 반면 이소말토올리고당을 첨가한 스폰지 케이크를 섭취한 군에서는 2~3일 정도 소화장애 현상이 나타났으나, 그 후에는 섭취 후에 장애 현상이 없어졌다. 섭취종료 일주일 후에는 프락토올리고당에 의한 소화장애 현상은 곧 사라졌으나, 대부분의 피검자들은 섭취 전에 나타난 변비현상이 다시 나타났다. 배변상황의 개선여부와 소화장애 현상을 종합적으로 판단하였을 때, 두 올리고당 모두 인체의 장기능 개선에는 효과가 있었으나, 비교적 안전성이 좋은 이소말토올리고당을 첨가한 스폰지 케이크 섭취가 변비 치료에는 더 긍정적으로 나타났다.

• Asian-Australasian Journal of Animal Sciences
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• 제21권2호
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• pp.252-261
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• 2008

Two experiments were conducted to compare the effects of feeding organic acids and antibiotic growth promoters in weaned pigs. In Exp. 1, 96 nursery pigs (Large White$\times$Landrace; initial weight $7.80{\pm}0.07kg$) were randomly allotted into one of four dietary treatments. Pigs in treatment 1 were fed a complex starter diet. Treatments 2 to 4 were the same as treatment 1 but supplemented with antibiotics (200 ppm chlortetracycline plus 60 ppm Lincospectin), 0.5% potassium diformate or 0.5% dry organic acid blend ACTIVATE Starter DA (ASD). During the 4-week post-weaning period, pigs fed ASD or antibiotics had better gain (p = 0.03) and feed efficiency (p = 0.04) than pigs fed the control diet. On d 14 post-weaning, pigs fed the control diet had the lowest fecal lactobacilli count among all dietary treatments (p = 0.02), whereas pigs fed ASD or antibiotics had a trend for lower fecal E. coli count compared to the control pigs (p = 0.08). Serum insulin-like growth factor-1 (IGF-1) of pigs fed ASD did not differ from pigs fed the control diet (p>0.05) at d 14 after weaning. In Exp. 2, 24 weaned pigs (Large White$\times$Long White; initial weight $5.94{\pm}0.33kg$) were allotted into four groups and housed individually. Pigs were fed a control diet or diets supplemented with antibiotics (100 ppm colistin sulfate, 50 ppm Kitasamycin plus 60 ppm Olaquindox), 0.5% or 1% ASD. All pigs were orally challenged with E. coli $K88^+$ on d 5. During d 5 to 14 after challenge, pigs fed antibiotics, 0.5% or 1% ASD had better gain (p = 0.01) and feed efficiency (p = 0.03) than pigs fed the control diet. On d 14, compared to the control pigs, pigs fed 0.5% ASD had higher lactobacilli in the duodenum and pigs fed 1% ASD and antibiotics had a trend for higher lactobacilli in the ileum (p = 0.08). Pigs fed antibiotics, 0.5% or 1% ASD diets tended to have decreased ileal E. coli count compared to those fed the control diet (p = 0.08). Serum interleukin-6 and cortisol and digesta pH values were not affected by treatment or time. These results indicate that feeding ASD can improve the growth performance of weaning pigs, mainly via modulating intestinal microflora populations without affecting gastrointestinal pH or immune indices.

• Journal of Gastric Cancer
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• 제8권2호
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• pp.104-109
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• 2008

목적: 국내 위 점막하 종양의 임상병리학적 양상과 치료방법에 대해 파악하고자 전국조사를 실시하였다. 대상 및 방법: 국내 47개 병원에서 2005년부터 2006년까지 위 점막하 종양으로 수술 받은 환자 878명의 자료를 수집하여, 진단명, 증상, 위치, 수술법, 사망률, 종양의 크기, 악성도 등을 조사하였다. 결과: 위 점막하 종양의 수술 후 진단으로는 위장관 간질 종양(Gastrointestinal stromal tumor, GIST)이 586명(66.8%)으로 가장 많았고, 평활근종(Leiomyoma) 97명(11.1%), 신경초종(schwannoma) 70명(8.0%), 이소성 췌장(Ectopic pancreas) 68명(7.8%), 유암종(carcinoid) 16명(1.8%) 순이었다. 환자의 평균 나이는 56.0세, 남녀 비는 1:1.18이었으며, 50.9%의 환자가 증상 없이 발견되었다. 위 상부 1/3에 위치한 위 점막하 종양이 가장 흔했으며(n=449, 52.0%), GIST의 55.4% (n=319), 평활근종의 84.5% (n=82)가 위 상부 1/3에 위치하였다. 복강경적 접근이 전체 환자의 44.2% (n=388)에서 시행되었으며, 수술방법으로는 쐐기 절제술(n=726, 82.8%)이 가장 빈번히 시행되었다. 전체 환자 중 1명(0.1%)만이 수술 후 30일 이내에 사망하였다. GIST 환자 중 115명(21.1%, 115/544)이 고위험도의 악성도를 가졌고, 41명(8.3%, 45/495)에서 수술 후 imatinib mesylate 항암 치료를 하였다. 결론: 조사된 국내 점막하 종양의 약 2/3가 GIST였으며, 약 1/2에서 복강경하 절제술이 이루어졌다. 향후 이 보고가 위점막하 종양의 진료 및 연구의 참고자료로 활용되기를 기대한다.

• Journal of Pharmaceutical Investigation
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• 제31권4호
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• pp.265-271
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• 2001

In order to elucidate the influence of intestinal and hepatic first-pass effect on the pharmacokinetics of triflusal, the biotransformation of triflusal in the gastrointestinal tract and liver was designed. Moreover, we tried to establish an HPLC method applicable for bioassay and available to pharmacokinetics, not only with the simultaneous determination of triflusal and its active metabolite, 2-hydroxy-4-trifluoromethyl benzoic acid (HTB), but also with improving sensitivity. After the administration of triflusal (10 mg/kg) and HTB (10 mg/kg) into femoral vein, portal vein (only triflusal) and oral route (only triflusal), pharmacokinetic parameters were investigated from the plasma concentration-time profiles of triflusal and HTB in rats. An HPLC method was developed for the simultaneous determination of triflusal and HTB in rat plasma, urine and bile. The HPLC analysis was carried out using a C18 column and acetonitrile-methanol-water (25:10:65, v/v/v) as the mobile phase and UV detection at 234 nm. Furosemide was used as the internal standard. The calibration curves were linear over the concentration range $0.05-5.0\;{\mu}g/ml$ for triflusal and $0.2-200.0\;{\mu}g/ml$ for HTB with correlation coefficients greater than 0.999 and with intra-day or inter-day coefficients of variation not exceeding 10.0%. This assay procedure was applied to the study of metabolite pharmacokinetics of triflusal and HTB in rats. It was supposed that triflusal was almost metabolized in vivo because urinary and biliary excreted amounts of triflusal could be ignored as it was lower than 1.2% of the administered dose. According to the gastrointestinal and hepatic biotransformation pathways of triflusal, it was found that triflusal was hydrolyzed by about 5% in intestine and metabolized by about 53% in liver, and that the bioavailability of triflusal after oral administration of triflusal was 0.44, and also that the fraction of total elimination rate of triflusal which formed HTB in liver $(F_{mi},\;%)$ was about 98%. These results showed that triflusal was almost metabolized in liver, and the total elimination of triflusal in the body was dependent to the formation rate of HTB from triflusal in liver.

• 대한수의학회지
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• 제33권4호
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• pp.597-603
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• 1993

The purpose of this stady was to investigate division cells by in vivo bromodeoxyuridine(Brdur) immunohistochemistry for labeling the proliferative epithelial cells in the gastrointestinal tracts of rats. Rats were administrated intraperitonially by twice consecutive injections of 24 hr interval with Brdur(0.05mg/g BW/time) and then were sacrificied at 1 hour after last injection. The specimens were taken from the stomach, small intestine(ileum), and large intestine(colon). The well-oriented crypts and villi in the preparations were examined, The crypt columns and villi were devided into 10 segments from crypt base to surface of the lumen or to villis top. Labeling index(LI) was measured by counting the number of Brdur-positive cells against the total number of crypt column cells in the stomach and large intestine and also against the total numbers of crypt column and it's villi epiterial cells in the small intestine. 1. In the stomach, the LI in each part from segment 1 to segment 10 of the crypt column were 4.2%, 5.0%. 6.6%, 9.0%, 11.3%, 15.3%, 9.3%, 15.6%, 11.3%, 0%, respectively and it's mean LI were 8.7%. The Brdur-positive epithelial cells were predominantly located in the middle regions and middle-upper regions of the crypt columns. 2. In the small intestine, the LI in each part from segment 1 to segment 10 of were 62.4%, 50.9%, 27.8%, 22.5%, 18.6%, 12.1%, 7.5%, 4.3%, 2.5%, 1.4%, respectively and it's mean LI were 21.0%. The Brdur-positive epithelial cells were predominantly located in the lower regions of the crypt columns and tended to be less in the higher regions of the villi than that in the crypt column. 3. In the large intestine, the LI in each part from segment 1 to segment 10 of the crypt column were 19.4%, 29.9%, 34.1%, 41.6%, 41.2%, 32.4%, 25.4%, 15.4%, 10.8%, 1.2%, respectively and it's mean LI were 25.1%, The Brdur-positive epithelial cells were predominantly in the middle and middle-lower regions of the crypt columns. 4. The organs with higher LI were ordered as the large intestine(25.1%), small intestine(21.0%) and stomach(8.7%).