There were four types of stomach contour included eutonic, hypotonic, steerhorn, and cascade. The aim of this study is to clarify relationship between incidence of stomach cancer and contour variation of the stomach. Double-contrast upper gastrointestinal study was performed in 1,546 patients, who had dyspepsia or other gastrointestinal tract symptoms. The radiographs were classified into the four types including eutonic, hypotonic, steerhorn, and cascade according to stomach contour in relation to body build. We also reviewed pathologic reports on endoscopic biopsy or surgical specimen. We studied the presence of relationship between incidence of stomach cancer and variation of stomach contour. We also examined the incidence of gastritis and gastric ulcer to the stomach contour variation. Of total 1,546 patients, eutonic stomach were 438(28.3%), hypotonic 911(58.9%), steerhorn 102(6.5%) and cascade 95(6.2%). Stomach cancer was found in 139(31.7%) of 438 eutonic stomachs, in 135(14.8%) of 911 hypotonic, in 42(41.2%) of 102 steerhorn, and in 24(36.9%) of 95 cascade (p=0.001). In hypotonic stomach, the incidence of stomach cancer was lower compared to the other three types significantly (p<0.05). Gastritis or gastric ulcer was found in 146(33.3%) of eutonic stomach, in 293(32,1%) of hypotonic, in 36(35.2%) of steerhorn, and in 26(27.3%) of cascade (p=0.640). In conclusion, gastric contour variation seems to be a factor affecting development of stomach cancer. The patients with hypotonic stomach may have lower incidence of stomach cancer than that of the other types. There was no relationship between the contour and gastritis or gastric ulcer.
This study was designed to determine the effects of protein sources on the curation of gastric ulceration, protein metabolism, and nitrogen balance in rats with gastric ulcer induce by restraint and water immersion stress. After the rats were fed 10% casein diet for 3 weeks, four groups of the rats were forced in 5$\times$5$\times$15cm plexiglass cage. The restraint and water immersion stress was carried at 20$\pm$2$^{\circ}C$ for 8-hour. The other one group(control group) was not exposed to stress. After stress 4 kinds of different diets containing 20% protein were given for 5 days. The protein sources were casein, whey protein, soy protein, gluten. The control group was fed to 10% casein diet. The results were as follows ; the weights of rats were not different among the diet groups During the experiment period follows ; the weights of rats were not different among the diet groups during the experiment period (for 5 days). The ulcer index of rats fed 10% gluten and soy protein diet was significantly higher than those of casein and whey protein diet groups(p<0.05). The level of serum albumin was not significantly different among diet groups. But hematocrit and the level of $\alpha$-amino-N, BU and UUN of plant protein diet groups were higher than animal diet groups, the urinary hydroxyproline of soy protein group was the highest and the whey protein was the lowest. The digestibility and BV of nitrogen of gluten diet group were significantly higher than those of casein and whey protein diet groups(p<0.05). The animal proteins had more curative effects of ulcer than plant animals. The results of this study provide useful information concerning diet therapy for the patients with gastrointestinal diseases and the field of enteral diet materials.
Purpose: This study was performed to assess the clinical usefulness of transabdominal ultrasonography (TUS) in detecting peptic ulcer disease (PUD) in children. Methods: Twenty-four patients (19 boys, 5 girls; mean age, $10.6{\pm}4.5years$ [range, 3.0-17.9 years]) who were admitted to the hospital for acute abdomen or gastrointestinal bleeding and diagnosed with PUD by endoscopy and who underwent TUS were included. Clinical data were retrospectively collected by reviewing patient medical records. Gastric ulcer (GU) was suspected when the gastric wall exceeded 8 mm in thickness and had lost its five-layer structure on TUS. Duodenal ulcer (DU) was suspected if the duodenal wall thickness exceeded 5 mm. Results: Sensitivity of TUS in diagnosing PUD was 66.7% for GU and 38.9% for DU. Mean age and body weight of the 11 patients suspected with PUD on TUS were $10.9{\pm}4.4years$ and $38.1{\pm}17.2kg$, respectively. For 13 patients without suspected PUD, they were $12.1{\pm}4.1years$ and $39.6{\pm}17.0kg$, respectively. There was a significant difference in height, weight, and body mass index between patients who were suspected to have PUD and those who were not suspected on TUS (p=0.014, 0.008, and 0.005, respectively). A significant difference in the sensitivity of TUS in diagnosing PUD was found between patients under 30 kg and those over 30 kg (88.9% and 20.0%, respectively; p=0.003). Conclusion: TUS investigation of the stomach and duodenum is an efficient method for PUD detection in children with low body weight. TUS can be used in preliminary diagnostic work-up before further invasive tests.
The gastrointestinal disorders (GI disorders) is one of the most common diseases in Korea. The community pharmacists are often faced with the complaints of symptoms due to the GI disorders. However the drugs used to treat the GI disorders are frequently abused by the patients themselves because these drugs are easily available and have high placebo effects. Therefore, we have reviewed the digestive diseases statistics of 1996 to find out the frequencies of the GI disorders in the outpatients of Samsung Medical Center. Using these statistic data, we figured out the frequently diagnosed GI disorders and analysed commonly used prescriptions from February 1st to 28th of 1997. In addition, we also evaluated the commonly used drugs in these prescriptions. About twenty thousands of patients visited the hopital because of their GI symptoms in 1996. It was found that dyspepsia, viral hepatitis, and gastric and duodenal ulcer disease are frequently diagnosed in these patients. In a point of view on other GI disorders, gastritis and duodenitis, irritable bowel syndrome, gastroesophageal reflux disease, constipation and diarrhea were commonly detected. And a number of drugs were prescribed to treat the GI disorders, which included the prokinetics, Histamine-2 receptor antagonists, proton pump inhibitor, antacids, tranquillizers, antidepressants, antispasmodics, laxatives and so on. Interestingly, there were many prescriptions composing of the antibiotic regimens to eradicate H. pylori which has been proven to cause peptic ulcers.
Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.
Ku, Seo-kwang;Lee, Hyeung-sik;Kim, Jong-dae;Lee, Jae-hyun
Korean Journal of Veterinary Research
/
v.40
no.1
/
pp.153-165
/
2000
To identify, the effects of acua-acupuncture of Bletillae rhizoma extract on the duodenal ulcer induced by HCl-aspirin in rats, the changes of histological profiles, number of mucous-producing goblet cells (PAS-positive cells), and morphology and/or number of chole-cystokinin (CCK)-8 and serotonin-immunoreactive (IR) cells in the gastrointestinal tract were observed after acua-acupuncture of Bletillae rhizoma extract on Ganshu locus ($BL_{14}$). Samples were collected at 1, 3 and 5 days after treatment. Histologically, very severe injury, atrophy of villus, necrosis of epithelial cell and hemorrhage, to the duodenal mucosa including epithelium were observed in HCl-aspirin administrated control groups, and these injuries were increased with time intervals. But in acua-acupuncture groups and nontreated normal groups, no gross lesion of ulcer was demonstrated and histologically minor injury to the apex of villas epithelium was observed. Compared to the PAS-positive cells of the control groups, those of the acua-acupuncture groups were increased. Severe degranulation of CCK-8- and serotonin-IR cells were observed in the control groups but these phenomena seldom occur in the acua-acupuncture groups. Serotonin-IR cells were significantly decreased in control groups but increased in the acua-acupuncture groups compared to control groups. However, these degranulation of IR cells of the aqua-acupuncture groups were less severe than those of normal groups, and number of serotonin-IR cells were lower than those of normal groups but these phenomena were decreased with time intervals and in 5 days after treatment, they were observed like those of normal groups. These result indicated that acua-acupuncture of Bletillae rhizoma extract would be accelerated the healing of the duodenal ulcer but the functional mechanisms were unknown.
Background: Gastric ulcer (GU) is a common gastrointestinal disease that can be induced by many factors. Finding an effective treatment method that contains fewer side effects is important. 20 (S)-ginsenoside Rg3 is a kind of protopanaxadiol and has shown superior antiinflammatory and antioxidant effects in many studies, especially cancer studies. In this study, we examined the treatment efficacy of 20 (S)-ginsenoside Rg3 on GU. Methods: Three kinds of GU models, including an alcohol GU model, a pylorus-ligated GU model, and an acetic acid GU model, were used. Mouse endothelin-1 (ET-1) and nitric oxide (NO) levels in blood and epidermal growth factor (EGF), superoxide dismutase, and NO levels in gastric mucosa were evaluated. Hematoxylin and eosin staining of gastric mucosa and immunohistochemical staining of ET-1, inducible nitric oxide synthase (NOS2), and epidermal growth factor receptors were studied. Ulcer index (UI) scores and UI ratios were also analyzed to demonstrate the GU conditions in different groups. Furthermore, Glide XP from $Schr{\ddot{o}}dinger$ was used for molecular docking to clarify the interactions between 20 (S)-ginsenoside Rg3 and EGF and NOS2. Results: 20 (S)-ginsenoside Rg3 significantly decreased the UI scores and UI ratios in all the three GU models, and it demonstrated antiulcer effects by decreasing the ET-1 and NOS2 levels and increasing the NO, superoxide dismutase, EGF, and epidermal growth factor receptor levels. In addition, high-dose 20 (S)-ginsenoside Rg3 showed satisfactory gastric mucosa protection effects. Conclusion: 20 (S)-ginsenoside Rg3 can inhibit the formation of GU and may be a potential therapeutic agent for GU.
In order to investigate the effect of Daewhajungeum on the isolated organs, gastrointestinal tract and C.N.S., some kinds of experiments using mice and rats were done. The results were as follows; 1. Daewhajungeum showed the inhibitory effect on the smooth muscle contraction of the isolated ileum and colon induced by acethylchorine chloride and barium chloride in mice. 2. Daewhajungeum showed inhibitory effect on the contraction of the fundus-strip induced by acethylchorine chloride and barium chloride in rats. 3. The preventive effect on pyloric ulcer, indomethacin induced ulcer and ethanol-HCl induced ulcer of mice was recognized. 4. The effect on the acidity of gastric juice was suppressed, but the effect on the pepsin output was not recognized. 5. The transport ability of small and large intestine was significantly decressed. 6. The analgesic effect and the sedative effect were recognized so that the effect of the C.N.S was suggested.
A 73-year-old male visited our hospital with a complaint of general weakness. He underwent pyloric preserving pancreas-toduodenectomy due to ampullary cancer three years ago. Abdominal computed tomography scan at initial visit revealed multiple hepatic masses. A PET-CT scan showed multiple FDG uptakes at whole liver. He underwent hepatic artery infusion chemotherapy (HAIC) for five cycles. During the first cycle of HAIC, he developed gastric ulcer bleeding and endoscopic hemostasis was done successfully. Esophagogastroduodenoscopy after the 5th cycle of HAIC revealed ulcer scar at gastric angle. PET-CT scan at 12 months showed no FDG uptake at liver, but a focal FDG uptakes at stomach and peri-gastric lymph nodes were newly developed. Esophagogastroduodenoscopy revealed about 3 cm sized mass at gastric angle. He underwent surgery and pathologic examination revealed large cell neuroendocrine carcinoma. We report a case of gastric large cell neuroendocrine carcinoma with liver metastasis treated with HAIC followed by surgery.
Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.
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