• 제목/요약/키워드: pyloric

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각기 다른 유문-십이지장의 기질적 병변 3증례에 대한 장음 측정 보고 : 장음의 주주파수를 중심으로 (Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases)

  • 윤상협
    • 대한한방내과학회지
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    • 제36권3호
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    • pp.276-283
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    • 2015
  • Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

The Proteinase Distributed in the Intestinal Organs of Fish 3. Purification and Some Enzymatic Properties of the Alkaline Proteinases from the Pyloric Caeca of Skipjack, Katsuwonus vagans

  • PYEUN Jae-Hyeung;KIM Hyeung-Rak;HEU Min-Soo
    • 한국수산과학회지
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    • 제21권2호
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    • pp.85-96
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    • 1988
  • Purification and some properties of alkaline proteinases in the pyloric caeca of skipjack, Katsuwonus vagans, were investigated. Four alkaline proteinases, temporarily designated proteinases I, II, III and IV, were identified from the tissue extract of the pyloric caeca by ammonium sulfate fractionation, DEAE-Sephadex A-50 chromatography, and Sephadex G-100 and G-200 gel filtration. Result of disc-polyacrylamide gel electrophoretic analysis showed that the purified proteinases II and III were homogenous with the yields of $1.5\%\;and\;1.2\%$, and those specific activities were increased to 33 to 37 fold over that of the crude enzyme solution, respectively. Molecular weight of the proteinases II and III determined by sephadex G-100 gel filtration were 28,500 and 24,200, respectively. The optimum conditions for the caseinolytic activity of the two enzymes were pH 9.6 and $48^{\circ}C$. The reaction rates of the two alkaline proteinases were constant to the reaction time to 80 min in the reaction mixture of $3.4{\mu}g/ml$ of enzyme concentration and $2\%$ casein solution. The Km values against casein substrate determined by the method of Lineweaver-Burk were $0.56\%$ for proteinase II and $0.30\%$ for proteinase II. The proteinases II and III were inactivated under the presence of $Ag^+,\;Hg^{2+},\;Ni{2+},\;Fe^{2+},\;and\;Cu^{2+}$, and but activated by $Mn^{2+}\;and\;Ca^{2+}$ and markedly inhibited by the soybean trypsin inhibitor and N-p-toluenesulfonyl-L-lysine chloromethyl ketone. Therefore, the proteinases II and III were found to be a group of serine proteases and assured to be trypsin-like proteinases.

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비후성 유문 협착증에서 수술 후 무제한 임의 식이법 (Ad Lib feeding)의 유용성 (Usefulness of Ad Lib Feeding for Hypertrophic Pyloric Stenosis)

  • 전학훈;손석우
    • Advances in pediatric surgery
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    • 제11권1호
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    • pp.27-33
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    • 2005
  • Infantile hypertrophic pyloric stenosis (HPS) is a relatively common entity. A number of studies for the postoperative feeding schedule has been studied to allow for earlier hospital discharge and improve cost-effectiveness in the treatment of HPS. The purpose of this study was to compare 3 feeding-methods and to evaluate the usefulness of ad lib feeding for HPS. The authors retrospectively reviewed the records of 116 patients who underwent pyloromyotomy for HPS from 1995 to 2004. Three cases were excluded because of the duodenal perforation during pyloromyotomy. Three feeding-methods were defined as: Conventional feeding (>10 hours nothing by mouth and incremental feeding every 2 hours, C), Early feeding(for 4 to 8 hours nothing by mouth and incremental feeding every 2 hours, E), and Ad lib feeding (for 4 hours nothing by mouth and ad lib feeding, A). Time to normal feeing in C, E and A were $51{\pm}24$, $34{\pm}12$ and $24{\pm}6$ hours, respectively. Hospital-stay in C, E and A were $72{\pm}17$, $55{\pm}13$ and $43{\pm}12$ hours, respectively. There were statistically significant differences according to the method of feeding. Frequency of postoperative emesis in C, E and A were 38 %, 47 % and 53 %, but was not significant statistically. Ad lib feeding decreased time to normal feeding and hospital stay, and did not increase postoperative emesis. We conclude that ad lib feeding is recommended for patient with pyloromyotomy in HPS.

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북극여우의 위장췌 내분비세포에 관한 면역조직화학적 연구 (Immunohistochemical study on the gastro-entero-pancreatic(GEP) endocrine cells of the blue fox, Alopex lagopus)

  • 이재현;이형식
    • 대한수의학회지
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    • 제33권3호
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    • pp.369-379
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    • 1993
  • 북극여우의 위장췌 내분비세포의 부위별 분포, 출현빈도 및 세포의 종류를 밝히고자 면역조직화학적으로 관찰하였던 바 위장관에서는 6종, 췌장에서는 4종의 면역반응세포가 동정되었다. 5-HT 및 somatostatin면역반응세포는 전 위장관에 다수 분포하였으나 이중 somatostatin 면역반응세포는 장관에서 소수로 관찰되었다. Gas/CCK 면역반응세포는 주로 유문부와 십이지장에 국한하여 다수 분포하였다. Glucagon 면역반응세포를 분문부와 위저부에서 다수 그리고 장관에서 소수 관찰되었다. BPP 면역반응세포는 분문부와 위저부에 중등도, 대장에 소수 분포하였다. 다수의 porcine CG 면역반응세포가 분문부와 위저부에서만 동정되었다. 한편 췌장에서는 somatostatin, glucagon, BPP 및 insulin 등 4종의 면역반응세포가 췌도 및 외분비부에서 관찰되었다. 이상의 결과는 위췌장 내분비세포의 부위별 분포와 출현빈도가 동물종에 따라 매우 상이하다는 사실을 시사한다.

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단일 술자에 의해 시행된 배꼽상부 피부절개 및 복강경 유문근 절개술의 임상적 결과 비교 (Comparison of Pyloromyotomy with Supraumbilical Incision and Laparoscopic Pyloromyotomy for Hypertrophic Pyloric Stenosis Performed by a Single Surgeon)

  • 이종우;김대연;김성철;남궁정만;황지희
    • Advances in pediatric surgery
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    • 제20권2호
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    • pp.43-47
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    • 2014
  • Purpose: Hypertrophic pyloric stenosis (HPS) is known to be one of the most common cause of surgery for infants and pyloromyotomy was considered to the standard treatment. There has been an ongoing debate about whether laparoscopic pyloromyotomy (LP) or open pyloromyotomy (OP) is the best option for treating HPS. The aim of this study is to evaluate safety and effectiveness of LP by comparing the clinical results of both surgical strategies performed by single surgeon. Methods: Between January 2000 and December 2013, 60 patients who underwent pyloromyotomy at Asan Medical Center performed by a surgeon were followed: open-supraumbilical incision (n=36) and LP (n=24). The parameters included sex, age and body weight at operation. Clinical outcomes included operation time, time to full feeding, postoperative hospital stay, and postoperative complications. Results: There were no significant differences in characteristics, postoperative hospital stay between the two groups. Time to full feeding was shorter in LP (OP 24.5 hours vs. LP 19.8 hours; p=0.063). In contrast, the mean operation time was longer in LP (OP 37.5 minutes vs. LP 43.5 minutes; p=0.072). Complications such as perforation of mucosal layer (OP 1 vs. LP 0) and wound problems (OP 2 vs. LP 0) were found to be not worse in laparoscopic group as compared with open group. Conclusion: There has no difference both laparoscopic and open-supraumbilical incision in terms of postoperative hospital stay, time to full feeds and frequency of complications.

발생기 흰쥐 위와 소장점막의 gastrin, somatostatin 및 serotonin세포에 대한 면역조직화학적연구 (Immunohistochemical Studv on the Gastrin, Somatostatin and Serotonin Cells in the Gastric and Small Intestinal Mucosa of Rat during Development)

  • 최병태;조운복
    • 한국동물학회지
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    • 제37권4호
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    • pp.478-487
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    • 1994
  • The developmental changes of three enteroendocrine cells, i.e. gastrln, somatostatin and serotonin, of gastric and small intestinal mucosa in pre- and postnatal rat were examined by peroxidase-antiperoxidase (PAP) method. In the course of development, gastrin cells were obsenred in the pyloric gland region and the whole part of small intestine, while somstostatin and serotonin cells in the whole gastric gland region and small intestine. More entroendocrine cells were detected in the pyloric gland region and duodenum than in the other portion. In the stomach, gastrin, somatostatin and serotonin ceils were first obsenred in the pyloric Bland region on 17, 19 and 19 days of gestation respectively. The small intestinal gastrin and serotonin cells were first appeared in the duodenum and iriunum on 17 and 15 days of gestation respectively, and somatostBtin cells in duodenum on 17 days of gestation. The number of cells examined from the stomach were increased from fetal to weanling period and showed a decrease during adult period: the notable increase was shown at the end of suckling period or at early weanling period. The cells of the small intestine increased from fetal to suckling period, especially, these cells markedly increased at the end of fetal period or at early suckling period, and decreased from weanling period. The shape of these cells was oval or fusiform during fetal period. In the stomach, most of gastrin cells turned out to be oval and open-type from suckling period, while the remaining two tripes of cells were oval and open- or closed-type. In the small intestine, 311%Ves of cells examined were changed to fusiform and open-type from the end of fetal period. Three types of cell were distributed over the stratified epithelium on 15 and 17 days of gestation. In the stomach, these cells were distributed lower gastric pit and gland from the following fetal period, and were detected mainly on the upper part of gland from suckling period, and then obsenred on the whole part of gland. In the small intestine, most of cells distributed over only between epithelium of villi on 19 days of gestation, increased in number on the crypt from following fetal period, and also observed abundantly in the crypt at adult period.

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북극여우의 위장췌 내분비세포에 관한 면역조직화학적 연구 (Immunohistochemical study on the gastro-entero-pancreatic(GEP) endocrine cells of the blue fox, Alopex lagopus)

  • 이재현;이형식
    • 대한수의학회지
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    • 제33권4호
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    • pp.579-589
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    • 1993
  • 북극여우의 위장췌 내분비세포의 부위별 분포, 출현빈도 및 세포의 종류를 밝히고자 면역조직화학적으로 관찰하였던 바 위장관에서는 6종, 췌장에서는 4종의 면역반응세포가 동정되었다. 5-HT 및 somatostatin 면역반응세포는 전위방관에 다수 분포하였으나 이중 somatostatin 면역반응세포는 장관에서 소수로 관찰되었다. Gas/CCK 면역반응세포는 주로 유문부와 십이지장에 국한하여 다수 분포하였다. Glucagon 면역반응세포는 분문부와 위저부에서 다수 그리고 장관에서 소수 관찰되었다. BPP 면역반응세포는 분문부와 위저부에 중등도, 대장에 소수분포하였다. 다수의 porcine CG 면역반응세포가 분문부와 위저부에서만 동정되었다. 한편 췌장에서는 somatostatin, glucagon, BPP 및 insulin 등 4종의 면역반응세포가 췌도 및 외분비에서 관찰되었다. 이상의 결과는 위췌장 내분비세포의 부위별 분포와 출현빈도가 동물종에 따라 매우 상이하다는 사실을 시사한다.

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Hypertrophic Pyloric Stenosis: 10 Years' Experience with Standard Open and Laparoscopic Approach

  • Zampieri, Nicola;Corato, Valentina;Scire, Gabriella;Camoglio, Francesco Saverio
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제24권3호
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    • pp.265-272
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    • 2021
  • Purpose: Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques. We also analyzed the incidence of HPS in infants in the last 10 years in relation to the demographic trend of our province. Methods: We analyzed all the cases of HPS treated at our Unit between January 2010 and December 2019. The data were obtained from operating systems. Data about the demographic trends, in particular, the number of births and the population residing in the province of Verona from 2010 to 2019, were also retrieved. Results: During the study period, 60 patients were treated for HPS and met the inclusion criteria. Of these, 56 males and 4 females with an average age of 38±14 days at surgery were included. No differences were found in terms of the duration of surgery, post-operative complications, duration of hospitalization, and weight at the time of surgery. The only statistically significant data was the chlorine level in cases with and without post-operative vomiting (97±3.5 vs. 102±3.3 mmol/L, p<0.05). There was a lower incidence of HPS from 2014 to 2019; however, there was no significant evidence regarding the correlation between this and the reduced birth rate recorded in the province of Verona during the same period. Conclusion: Although laparoscopic pyloromyotomy is a highly complex procedure, it is a feasible alternative to the classic open technique.

선천성 장관폐쇄의 방사선학적 분석 (Radiologic Analysis of Congenital Origin Intestinal Obstruction in Neonate and Childhood)

  • 황미수;변우목;김선용;장재천
    • Journal of Yeungnam Medical Science
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    • 제4권1호
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    • pp.33-42
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    • 1987
  • 1983년 5월부터 1987년 6월까지 영남대학교 영남의료원에서 선천성 장관폐쇄증으로 내원한 25예를 대상으로 각각의 임상소견 및 방사선학적 소견을 분석하여 다음과 같은 결과를 얻었다. 1. 비후성유문협착증 6예, 중장이상회전증 4예, 선천성 거대결장 8예, 쇄항 5예, 십이지장폐쇄증 및 회장폐쇄증이 각각 1예였다. 2. 남여비는 16:9였으며, 특히 비후성유문부협착증은 6예중 5예가 남아였다. 3. 비후성유문부협착증은 전예에서 상부위장관조영에서 특징적인 String sign 및 beak sign, shoulder sign 등을 나타냈다. 4. 1예의 십이지장폐쇄증은 double bubble sign을 보였고, 회장폐쇄증은 단순복부 사진상 폐쇄성소장공기팽창과 대장조영술에서는 microcolon을 나타내었다. 5. 4예의 중장이상회전증에서는 대장조영술상 맹장이 우측 상복부에 있었으며 2예는 Ladd's band에 의한 십이지장폐쇄를 보였다. 6. 선천성거대결장은 8예가 전부가 직장 및 하부 S자결장에 국한되어 나타났으며, 1예에서는 장염을 동반하였다. 7. 쇄항은 5예중 3예가 low type, 2예가 high type였고, 4예에서 회음부 및 비뇨생식기에 루관을 형성하였다. 위와 같은 결과와 함께 각각의 발생학적 기전과 방사선학적 소견의 문헌 고찰을 통하여 보다 신속하고 정확한 진단을 내리는데 도움을 주고자 하였다.

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Diethyl maleate가 N-methyl-N'-nitro-N-nitrosoguanidine에 의해서 유발되는 랫드 위암 발생에 미치는 영향에 관한 병리학적 연구 (The Effects of diethyl maleate on the N-methyl-N'-nitro-N-nitrosoguanidine induced gastric carcinogenesis in rats)

  • 박철범;이준섭
    • 대한수의학회지
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    • 제35권4호
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    • pp.793-807
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    • 1995
  • This study was carried out to investigate the effects of diethyl maleate(DEM) on the carcinogenesis of forestomach and pyloric glandular stomach in rats caused by N-methyl-N'-nitro-N-nitrosoguanidine(MNNG). A total of 60 male 6-week-old Wistar rats were given twice intragastric injection of MMNG(200mg/kg BW), then were given diets containing 5% NaCl for 3 weeks until 4th week of the experiment. And then the animals of groups of 1 and 2 were placed on diets containing 0.2% DEM for 16 weeks until the end of 20 weeks of the experiment. On the other hand, the animals of groups of 3 and 4 were placed on basal diets for the same periods. The tissues of forestomach and liver of each group were frozen in liquid nitrogen and the activities of quinone reductase(QR) were determined by measurement of the dicoumarol-sensitive reduction of dichloro-indophenol by NADPH at 600nm. All rats were sacrificed at the end of 20 weeks of the experiment. Every animal was fasted for 24 hrs prior to sacrifice. The forestomach was fixed in 10% neutral phosphate buffered formalin for histology and the pyloric gland was fixed in sublimated formalin for immunohistochemistry of pepsinogen 1 altered pyloric gland(PAPG). The final body weight of the group given MNNG and treated with 5% NaCI and DEM was significantly decreased compared with that of the group 4(p<0.05). Food and water consumption rates were not significantly changed. The preneoplastic and neoplastic lesions of the forestomach given MNNG and treated with 5% NaCI and DEM were significantly increased compared to those of the group 4(p<0.0l). The incidence of PAPG in the groups treated with 0.2% DEM was significantly increased compared with that of the group 4(group 1:p<0.01, group 2:p<0.05). The activities of QR of forestomach in the groups treated with 0.2% DEM were significanitly increased compared with those of the group 4(p<0.001), but those of liver were not significant. These results indicate that DEM exert the enhancing effect of forestomach and glandular stomach carcinogenesis in rats pretreated with MNNG and NaCl.

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