• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.302-308
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• 1999

Background: It is well known fact to the patients of duodenal ulcer that their condition is frequently accompanied with reflux esophagitis. Therefore this condition is called an "acid-related disorder" because it is commonly associated with increased acidity. But there has been disputes on the effect of Helicobacter pylori eradication in these two conditions and whether H. pylori infection may have a protective role in reflux esophagitis. Only few reports have dealt with the prevalence of reflux esophagitis and gastroesophageal reflux in patients with peptic ulcer The aim of this study is to estimate the prevalence of gastroesophageal reflux and to analyze the pattern of the pathologic reflux in peptic ulcer patients. Materials and Methods: The study population consisted of 57 patients with endoscopically confirmed duodenal and/or gastric ulcer who all underwent 24hr ambulatory esophageal pH monitoring. Results: The prevalance of gastroesophageal reflux in peptic ulcer patients was 54.2% and 54,5% in gastric ulcer, and 62.5% in duodenal ulcer, 50% in combined ulcer, respectively. The prevalence of gastroesophageal reflux in the control group was 22.7% Conclusion: We discovered significantly higher prevalence of gastroesophageal reflux in patients with peptic ulcer disease than in those without it. In conclusion, the presence or absence of gastroesophageal reflux must be considered in the setting of peptic ulcer disease management.

• The Korean Journal of Nuclear Medicine
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• v.29 no.3
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• pp.313-318
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• 1995

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid delivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISIDA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows : 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenoscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

• Journal of Gastric Cancer
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• v.6 no.1
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• pp.11-17
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• 2006

Purpose: The five-year survival rate is over 95% for radically resected early gastric cancer. The development of diagnostic techniques enables early detection of gastric cancer, so the life expectancy of patients with early gastric cancer is prolonged. Therefore, a limited number of surgeries are performed these days for the purpose of increasing the quality of life. The purpose of this study is to assess the postoperative quality of life after a pylorus-preserving gastrectomy (PPG) compared with that after a subtotal gastrectomy with gastroduodenal anastomosis (B-I). Materials and Methods: One hundred seven (107) patients who underwent gastric surgery for early gastric cancer from January 1999 to December 2003 at the Department of Surgery of Chonnam National University Hospital were selected. We compared patients who underwent a PPG with those who underwent a B-I. The clinical results were compared by using the chi-square test and the Student's T-test. The data were considered to be significant when the P value was less than 0.05. Results: Twenty-nine patients (29) underwent a PPG, and the other seventy-eight (78) patients underwent a B-I. There was no significant difference between the two groups on sex, age, and postoperative abdominal symptoms. The patients who underwent a PPG showed shorter operation times and less reflux gastritis and esophagitis on endoscopic evaluation than the patients who underwent a B-I. Conclusion: The pylorus-preserving gastrectomy (PPG) is a more physiologic operation than the subtotal gastrectomy with gastroduodenal anastomosis (B-I) and improves the postoperative quality of life.

• Journal of Yeungnam Medical Science
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• v.9 no.2
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• pp.342-350
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• 1992

To investigate the effect of bile acid on gastric mucosa, we performed biologic test using Sprague-Dawley rat. Mixture solution of TDCA 15mM and HCl of pH 3 was given into stomach to one group and HCl of pH 3 was given into stomach to another group. The significant gastric mucosal change was vasodilatation and edema, that was disappeared progressively. These findings suggest the bile acid can damage gastric mucosa.

• Journal of Gastric Cancer
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• v.1 no.3
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• pp.144-149
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• 2001

Purpose: Gastric stump cancer is defined as a cancer that develops in the stomach after a resection in cases of non-malignant or malignant gastric disease. The interval between the gastrectomy and the detection of gastric stump cancer must be over 5 years. Since duodenogastric reflux gastritis is a precancerous condition and one of the most important factors inducing gastric stump cancer, we compared the bile-acid content of gastric juice between gastric stump cancer patients and controls. Materials and Methods: To evaluate retrospectively the surgical treatment of patients with gastric stump cancer, we reviewed the cases histories of 1016 stomach cancer patients who had been operated on at the Department of General Surgery, Kosin University Gospel Hospital, between 1995 and 1998. The gastric juice was collected during the operations on the gastric stump cancer patients by using a needle puncture of the fundus of the stomach and during the endoscopic examinations of the control subjects. The samples were analyzed for various bile acids (gas chromatography/mass spectrometry). Results: The 6 gastric stump cancer cases accounted for $0.6\%$ of all gastric cancer patients; 5 patients were first operated on for a peptic ulcer and the remaining one for an adenocarcinoma of the stomach. All of the cases were men. The reconstruction method after the initial gastrectomy was a Billroth II in all cases. The sites of the gastric stump cancer were the anastomotic sitein 2 patients, the upper body in 2, the fundus in 1 and the cardia in 1. The operative methods were 3 total gastrectomies, 2 subtotal gastrectomies with Roux en Y anastomosis, and 1 partial gastrectomy with lymph node dissection and had a curative intention in all patients. All of the patients were still surviving at the time of this report. The gastric juices of 4 gastric stump patients showed significantly higher contents of cholic acid ($36.42{\mu}g/ml$) compared to the gastric juices of 35 control subjects ($36.42{\mu}g/ml$)(p$\leq0.0001$). Chenodeoxycholic acid and lithocholic acid were not significantly different. Conclusion: The gastric juice of gastric stump cancer patients contained a significantly higher cholic acid content. At the time of the initial gastrectomy, an operative method that prevents duodenogastric reflux may prevent or minimize the development of gastric stump cancer, and more aggressive surgical treatment may improve survival.