• Title/Summary/Keyword: pylorus

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Measurement of the Mucosal Surface Distance in the Early Gastric Cancer Using CT Gastrography (조기 위암에서 CT Gastrography를 이용한 위점막 표면 거리 측정)

  • Choi, Hyang-Hee;Yu, Wan-Sik;Ryeom, Hun-Kyu;Lee, Jae-Hyuk;Choi, Jae-Jeong;Kim, Hee-Su;Cleary, Kevin;Mun, Seong-Ki;Chung, Ho-Young
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.161-166
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    • 2006
  • Purpose: Recently, the incidence of early gastric cancer (EGC) patients is rapidly increased in Korea. However, they're often not perceptible by surgical palpation or inspection. The aim of this study is 1) to develope a software that can locate the tumor and measure the mucosal distance from an anatomic landmark to the tumor using CT gastrography and 2) to compare the distance measured by the developed software with the distance measured by the pathologic findings. Materials and Methods: Between January 2004 and September 2005, sixty patients (male=45, female=15, mean 57.8 years old) estimated for EGC with preoperative CT scans and undergone gastrectomies in Kyungpook National University Hospital were enrolled in this study. Preoperative CT scans were performed after insufflations of room air via 5 Fr NG tube. The scans included the following parameters: (slice thickness/reconstruction interval: 0.625 mm, kVp: 120, mAs: 200). 3D volume rendering and measurement of the surface distance from the pylorus to the EGC were performed using the developed software. Results: The average difference between the lesion to pylorus distances measured from pathologic specimens and CT gastrography was $5.3{\pm}2.9\;mm(range,\;0{\sim}23\;mm)$. The lesion to pylorus distance measured from CT gastrography was well correlated with that measured from the pathologic specimens (r=0.9843, P<0.001). Conclusion: These results suggest that the surface distance from an anatomic landmark to the EGC can be measured accurately by CT gastrography. This technique could be used for preoperative localization of early gastric carcinomas to determine the optimal extent of surgical resection.

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Swelling and Drug Release Characteristics of PVP Hydrogel Polymerized by $\gamma$-Irradiation Method (김마선 조사법으로 합성한 PVP하이드로겔의 팽윤과 약물방출특성)

  • 심창구;오정숙;신병철
    • YAKHAK HOEJI
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    • v.37 no.5
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    • pp.511-519
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    • 1993
  • The short and variabke transit of drug throught GI tracj and the inter-and intra-subject variations of the transit restrict the sustained drug absorption after oral adminstration. These restrictions may be solved by retaining the dosage forms in the stomach. Then the dosage form will act as a platform which releases the drug slowly and makes the GI absorption occur for a long time. In this study, as the platforms, PVP hydrogels were synthesized by chemical and y-irradiation method in the cylindrical test tube. The chemical method means the synthesis of the hydrogel by heating the mixed solution of N-vinyl-2-pyrrolidone [monomer], acrylated albumin [crosslinking agent], 2, 2'-agobis(2-methylpropionitrile) [initiator] and proxyphylline [drug] at $65^{\circ}C$ for 5 hr. The $\gamma$-irradiation method means the synthesis of the hydrogel by irradiation with $^{60}$ Co $\gamma$-ray of the mixed solution of the monomer, acrylated albumin, and flurbiprofen [drug] at room temperature with total 0.2 Mrad for 3 hr. Our intention is to design the hydrogel tablet (diameter : 1.20 cm, thickness : 0.60 cm) which swells in the gastric fluid after oral administration to such a size that passing through the pylorus could be inhibited during the period of drug release. After releasing drug, the hydrogel should be degraded by the enzymeatic digestion in the stomach, or by hydrolysis and eventually solubilized. Thus, in votro tests were performed to examine the factors that affect swelling and drug release from the PVP hydrogels. Experimental results show that the hydrogels swell to a size larger than the diameter of the pylorus(l.3$\pm$0.7 cm) and the hydrogel prepared by the chemical method is digested by pepsin. But the hydrogel prepared by the $\gamma$-irradiation method was not digested by the pepsin and just collapsed with time. Thus, the swelling of the hydrogel synthesized by $\gamma$-irradiation was independent albumin acrylation time and pepsin concentration. But drug content and radiation dose affected the swelling and drug release kinetics of the hydrogel. Drug release from the hydrigels was prolonged up to about 24 hr. Therefore, it was concluded that by adjusting these factors, the albumin-crosslinked PVP hydrogel synthesized by $\gamma$-irradiation method is expected to be retained in the stomach for up to 60hr and be a potential platform of drugs for long-term GI absorption.

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An histochemical study of endocrine cells in the alimentary tract of the red-eared slider, Trachemys scripta elegans (붉은귀거북이 소화관 내분비세포에 관한 조직화학적 연구)

  • Lee, Hyeung-sik;Ku, Sae-kwang;Park, Ki-dae;Lee, Jae-hyun;Lee, Mal-soon
    • Korean Journal of Veterinary Research
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    • v.40 no.2
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    • pp.247-256
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    • 2000
  • The regional distributions and relative frequencies of endocrine cells were studied histochemically (Grimelius and Masson-Hamperl (M-H) silver methods) in the alimentary tract of the red-eared slider, Trachemys scripta elegans. Samples were taken from the esophagus, fundus, pylorus, duodenum, jejunum, ileum and large intestine. Argyrophil (Grimelius-positive) cells and argentaffin (M-H-positive) cells were found in the whole alimentary tract in this study. Spherical to spindle and/or oval to round-shaped argyrophil or argentaffin cells were located in the gastric glands of the stomach regions, in the basal portion of the epithelium of intestinal tract or the esophagus with variable frequencies. Argentaffin cells were more numerously detected in the whole alimentary tract compared with those of argyrophil cells in this study. Argyrophil cells were observed in the whole alimentary tract including the esophagus and the most predominant region was the rectum with moderate frequency. The relative frequency of these cells was rare in the esophagus, fundus, duodenum, jejunum and ileum, respectively and a few frequency in the pylorus. Argentaffin cells were also observed in the whole alimentary tract including the esophagus and the most numerously demonstrated region was the rectum with numerous frequency. They were observed with a few frequencies in the remaining regions of the alimentary tract except for the rectum, respectively. However, to know the exact type of the argyrophil cells and argentaffin cells that were observed in this study, more developmental methods such as immunohistochemistry were needed.

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A Comparative Study on the Effects of Pinellia ternata, Zingiber officinale and Sobanhatang on Reflux Esophagitis (역류성 식도염에 대한 반하(半夏), 생강(生薑), 소반하탕(小半夏湯)의 효과 비교)

  • Lee, Seul-hee;Baik, Tai-Hyeun
    • The Journal of Korean Medicine
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    • v.40 no.2
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    • pp.17-34
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    • 2019
  • Objectives: This study was carried out to observe and compare the effects of Pinellia ternata, Zingiber officinale and Sobanhatang on the reflux esophagitis induced by gastric fundus and pylorus ligation in mice with esomeprazole. Methods: Antioxidant effects were measured by DPPH radical scavenging activity at four different concentration of 0.125, 0.25, 0.5 and $1.0mg/102{\mu}{\ell}$. Zingiber officinale water extract(ZE), Pinellia ternata water extract(PE) and Sobanhatang water extract(SBE) and esomeprazole were treated orally for 14 days before gatric fundus and pylorus ligation. In the histochemistry, changes in suface mucous cells, muscle tissue and connective tissue in gastro esophageal junction(GEJ) and mast cell on the esophageal mucosa were observed. The change of Hemo oxygenase(HO)-1, ghrelin, gastrin and substance P in gastric body tissue were measured by immunohistochemistry. Results: DPPH radical scavenging activity exhibited concentration dependently increases in ZE, PE, SBE. ZE was significantly higher at all concentrations than PE. The gastric surface mucous cells were more in the treated group than in the reflux esophagitis elicited group(GE) in the order of PE, SBE, ZE and esomeprazole treateded group(PT, SBT, ZT, ET). Lower esophageal sphincter muscle damage and intercellular space in the GEJ were less in the treated group than GE. In the esophageal mucosa, the mast cell distribution and the migration of inflammatory cells were lower in the treateded troup than GE in order to ZT, SBT, PT and ET. The antioxidative enzyme, HO-1 was more in the order of ZT, SBT, control group, PT, ET than in GE. ZT was significantly higher than the other groups and SBT was significantly higher than ET. Ghrelin was found to be higher in ZT, ET, SBT and PT than in GE, and ZT was significantly higher than all other groups except ET. Gastrin showed the highest positivity in GE, and was lower in the order of ET, ZT, SBT, PT, and control group. Substance P was the highest in GE, and was lower in the order of ET, ZT, SBT, PT and control group, and PT were significantly lower than ET. Conclusion: ZT, PT and SBT showed superior antioxidative, anti-inflammatory and mucosal protective effects on mouse reflux esophagitis as compared with ET. In particular, ZE was more effective in antioxidant and gastric motility enhancement, while PE was more effective in mucosal protection and anti-inflammatory effects. Sobanhatang is expected to be effective treatment because it has advantages of both drugs and reduces toxicity.

Postprandial Asymptomatic Glycemic Fluctuations after Gastrectomy for Gastric Cancer Using Continuous Glucose Monitoring Device

  • Ri, Motonari;Nunobe, Souya;Ida, Satoshi;Ishizuka, Naoki;Atsumi, Shinichiro;Hayami, Masaru;Makuuchi, Rie;Kumagai, Koshi;Ohashi, Manabu;Sano, Takeshi
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.325-334
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    • 2021
  • Purpose: Although dumping symptoms are thought to involve postprandial glycemic changes, postprandial glycemic variability without dumping symptoms remains poorly understood due to the lack of a method that allows the easy and continuous measurement of blood glucose levels. Materials and Methods: Patients having undergone distal gastrectomy with Billroth-I (DG-BI) or Roux-en-Y reconstruction (DG-RY), total gastrectomy with RY (TG-RY) and pylorus preserving gastrectomy (PPG) for gastric cancer 3 months to 3 years prior, diagnosed as pathological stage I or II, were prospectively enrolled from March 2018 to January 2020. The interstitial tissue glycemic levels were measured every 15 min, up to 14 days by continuous glucose monitoring. Moreover, using a diary recording the diet and symptoms, asymptomatic glucose profiles without sugar supplementation within 3 h postprandially were compared among the four procedures. Results: A total of 40 patients were enrolled, 10 patients for each of the four procedures. There were 47 glucose profiles with DG-BI, 46 profiles with DG-RY, 38 profiles with TG-RY, and 46 profiles with PPG. PPG showed the slowest increase with a subsequent gradual decrease in glucose fluctuations, without hyperglycemia or hypoglycemia, among the four procedures. In contrast, TG-RY and DG-RY showed spike-like glycemic variability, sharp rises during meals, and rapid drops. The glucose profiles of DG-BI were milder than those of RY. Conclusions: The asymptomatic glycemic changes after meals differ among the types of surgical procedures for gastric cancer. Given the mild glycemic fluctuations in PPG and the glucose spikes in TG-RY and DG-RY, pylorus preservation and physiological reconstruction without changes in food pathways may optimize postprandial glucose profiles after gastrectomy.

An experimental study on the effects of Dokwhaljiwhang-tang affecting gastro-intestinal track and central nervous system in rats and mice (독활지황탕(獨活地黃湯)의 위장관(胃腸管) 및 중추신경(中樞神經)에 미치는 효능(效能)에 관(關)한 실험적(實驗的) 연구(硏究))

  • Jin, Hyon-Chol
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.2
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    • pp.187-201
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    • 1997
  • An experimental study was done to examine the effects of Dokwhaljiwhang-tang on gastro-intestinal track and central nervous system and were undertaken by being carried out with rat. The following results have been obtained ; 1. Dokwhaljiwhang-tang showed to have an inhibitory effect on the smooth muscle contraction of the isolated ileum by acetylcholene chloride and barium chloride. 2. Dokwhaljiwhang-tang showed to have an inhibitory effect on the contraction of the gastric fundus-strip by acetylcholine chloride and barium chloride. 3. The preventive effect was recognized on the pylorus-ligated ulcer, by administration of Dokwhaljiwhang-tang. 4. The preventive effect was not recognized on the indomethacine -induced ulcer, by administration of Dokwhaljiwhang-tang. 5. The inhibitory effects on the secretion gastric juice, free acidity were recognized, by administration of Dokwhaljiwhang-tang 6. The transport ability in the small intestine was increased, by administration of Dokwhaljiwhang-tang. 7. The transport ability in the large intestine was increased, by administration of Dokwhaljiwhang-tang. 8. The analgesic effect was recognized, by administration of Dokwhaljiwhang-tang. 9. The effect of sleeping time was not recognized, by administration of Dokwhaljiwhang-tang. according to the results, it is considered that Dokwhaljiwhang-tang has effects of gastric ulcer, chronic gastritis,hyper-acidity, gastroptosis such as abdominal discomfort, gastric acid, indigestion and anorexia.

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Effects of Amomi Semen Butanol Fraction on Gastritis and Helicobacter pylori (위염 및 Helicobacter pylori에 미치는 Amomi Semen Butanol 추출물의 영향)

  • Kang, Min-Hee;Jeong, Choon-Sik
    • Korean Journal of Pharmacognosy
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    • v.35 no.4 s.139
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    • pp.350-356
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    • 2004
  • In a preliminary screening of plant extracts for the antigastritic and anti- Helicobacter pylori (H. pylori) actions in rats, the ethanol extract of Amomi Semen (AS) showed positive activity in HCl Ethanol-induced gastric lesions and H. pylori. Among the systematic fractions of hexane, chloroform, butanol and water, the most potent butanol fraction significantly reduced HCl, Ethanol-induced gastric lesions at the oral dose of 350 mg/kg. Also butanol fraction has an inhibitory effect on the growth of H. pylori $(MIC=1.43\;{\mu}g/mL)$. In pylorus ligated rats, butanol fraction showed decrease in the volume of gastric secretion and acid output, of which effects were stronger in other fractions. We isolated 6 subfractions by column chromatography. The protective effects of 6 subfractions of Amomi Semen were also significant in the HCl, Ethanol induced gastric lesion model. These results might suggest that they had inhibitory action in gastric lesion through inhibition of gastric acid secretion. Butanol fraction of AS can be applied as treatment of H. pylori. Butano fractions and ethanol extract of AS was carried out or the development of a new gastroprotective supplementary product.

Pharmacological properties of the reversible inhibitor of the gastric $H^+/K^+$ ATPase, AU-164

  • Kim, Hyo-Jung;Yum, Eul-Kgun;Choi, Jong-Kwon;Cheon, Hyae-Gyeong
    • Biomolecules & Therapeutics
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    • v.5 no.3
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    • pp.228-232
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    • 1997
  • AU-164 was synthesized as a reversible gastric $H^+/K^+$ ATPase inhibitor, and its effects were tested in various systems. AU-164 inhibited rabbit gastric $H^+/K^+$ ATPase with an $IC_{50}$/ of 9 $\mu$M. On the other hand, AU-164 was a weak inhibitor for dog kidney $Na^+/K^+$ ATPasc, indicating the selectivity for gastric $H^+/K^+$ ATPase. The reversible property of the AU-164-induced inhibition of $H^+/K^+$ ATPase was confirmed by filtering the inhibition mixture through Sephadex G-25M column. In vivo basal acid secretion was also inhibited by AU-164 under the pylorus ligation of Sprague-Dawley rats. In addition, AU-164 protected dose dependently gastric lesion induced by ethanol in rats. The $ED_{50}$ value of 62 mg/kg p.o was estimated. These results suggest that AU-164 is a potent, selective and reversible gastric $H^+/K^+$ ATPase inhibitor, and that AU-164 has a potential use for the clinical therapeutics of peptic ulcer disease.

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Statistical Observation on Surgical Stomach Disturbance Patient (외과적 위질환환자의 통계적고찰)

  • 안홍자
    • The Korean Nurse
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    • v.12 no.5 s.67
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    • pp.83-92
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    • 1973
  • 1972년 1월부터 1972년 12월말까지 충남대학교 의과대학 부속병원에서 위 수술을 받은 환자 66명을 대상으로 여러 가지 통계 결과 1. 성별 분포에선 남자가 51명 여자가 15명으로 약 3.4:1의 비율을 나타냈다. 2. 연령별 분포에선 $69.7\%$가 40세 이상에서 나타났다. 3. Chief complain은 Indigestion이었다. 4. 증상의 평균 연한은 1년 전후의 Chronic symptom을 경험했다. 5. Vital sign의 변화는 대부분이 별로 나타나지 않았다. 6. 수술 전 수혈은 1000cc 이내로 환자의 $78\%$에 필요했었다. 7. 수술 전의 Hb은 정상보다 낮은 율은 $45.4\%$였고 정상은 $54.6\%$였다. 8. 수술 전의 W.B.C는 정상보다 낮은 율은 $10.6\%$, 정상이 $42.4\%$, 정상보다 높은 율이 $47\%$였다. 9. 수술 전의 Ht치는 정상보다 낮은 율은 $60.6\%$, 정상은 $36.4\%$ 정상보다 높은 율은 $3\%$였다. 10. 수술 전 위액검사 결과는 Cancer인 경우는 Free acid와 Total acid가 모두 거의 정상보다 낮았고 Ulcer인 경우 대부분 높았다. 11. Liver function test에서는 표에서 나타난 대로 많은 변화는 없었다. 12. 병소 부위는 Cancer의 경우 $51.8\%$에서 Pylorus부위에 왔었고 Ulcer의 경우 $62.4\%$에서 Lesser curvature (ciratricial region포함)에 왔었다. 13. 수술방법은 $77.7\%$가 Subtotal gastrectomy였었다. 14. 위 수술을 위한 입원 일자는 $60\%$ 이상에서 $11\~15$일간의 평균을 보였었다.

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Development of Pneumoperitoneum after Endoscopic Retrieval of Gastric Foreign Body in a Dog (개에서 위내 이물의 내시경적 제거 후 발생한 기복증 증례)

  • Kim, Dong-In;Lee, Youngjae;Kang, Byeong-Teck;Kim, Gonhyung;Chang, Dongwoo;Na, Ki-Jeong;Yang, Mhan-Pyo;Kang, Ji-Houn
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.333-336
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    • 2014
  • An 1-year-old, intact female Yorkshire Terrier weighing 1.83 kg was referred for vomiting and anorexia. Survey abdominal radiographs revealed marked gastric distention. Ultrasonography showed a hyperechoic material with acoustic shadowing near the pylorus. A foreign body and ulceration were identified during gastroscopic examination. After endoscopic retrieval of gastric foreign body, unexpectedly abdominal distention was developed. Abdominal radiographs revealed pneumoperitoneum, but no leakage of contrast media was observed in gastrointestinal contrast study. Three days after hospitalization with supportive care, no abnormal findings were detected, and then the dog was discharged. This case describes the development of peumoperitoneum during endoscopic retrieval of gastric foreign body.