• The Journal of Korean Medicine
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• v.27 no.1 s.65
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• pp.146-154
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• 2006

Objectives : Siguan points (LI4, LR3) have been most frequently applied for various diseases, especially different digestive disorders such as constipation, abdominal pain or various intestinal inflammatory diseases. The fact that gastrointestina movement is closely connected with physiologic functions or pathologic process of alimentary canal led us to ask the question if Siguan points affects on intestinal motility. Design: To investigate the effect of Siguan acupuncture on the intestinal movement in both physiologic and pathologic conditions, we divided the experimental animals into 12 groups. Six groups were pre-treated with loperamide (0.5 mg/kg, sc) or scoploamine (0.5 mg/kg, sc) to suppress the intestinal movement and another three groups were pretreated with carbachol (0.5 mg/kg, po) to activate it, whereas the rest three groups didn't receive any pretreatment to be kept in the physiological condition. After the administration with charcoal meal, mice were acupunctured bilaterally on sham point or Siguan points as the manner of tap-stimulation, with the exception of no acupuncture groups. Methods : Mice were scarified in twenty minutes after the administration of charcoal to measure the distance of charcoal passage from stomach-duodenal junction. The effect on intestinal movement was presented by calculating the relative distance where charcoal arrived to total length of small intestine. Results : In physiological state, charcoal meal passed around 53%, and there was no significant difference between Siguan points and sham points groups. On the other hand. Siguan points-sitimulation significantly ameliorated loperamide or scoplolamine-induced suppressed travel rate of 17.3 % and 18.6% in sham point into 26% and 26.3% respectively (p<0.05). In carbachol-induced accelerated condition, Siguan points-stimulation didn't affect intestinal motility comparing to sham point group passed about 97.6%. Conclusions : These results postulate that acupuncture at Siguan points have a therapeutic effect by restoring cholinergic activity on pathogenically suppressed intestinal peristalsis, but does not affect the gastrointestinal motility in the normal or accelerated condition.

• Journal of Digestive Cancer Reports
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• v.9 no.1
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• pp.1-7
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• 2021

The length, the frequency, and the methods of surveillance for intraductal papillary mucinous neoplasm (IPMN) of the pancreas are still debating. According to the recent guidelines, IPMN is stratified into "high-risk stigmata" or absolute indication and "worrisome features" or relative indication as a guide in managing these patients, either those with resection of the lesion or those under surveillance. The risk of malignant transformation was quite low for branch duct-IPMNs without worrisome features or high risk stigmata. However, because the incidence rate of pancreatic cancer in these patients increase linearly with time, continued long-term surveillance is therefore important for patients with low-risk, as well as higher-risk, IPMN. Considering the high prevalence of malignancy, main duct-IPMN should be treated by surgical resection. Among patients with these type IPMNs, segmental dilatation of the main pancreatic duct without any mural nodules and larger than 10 mm of main pancreatic duct might not be immediately resected and need very careful examination and observation. The risk related to a major pancreatic resection must balance the risk of surveillance in patients with IPMN of the pancreas who have co-morbidity and are elderly.

• Journal of Digestive Cancer Research
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• v.5 no.2
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• pp.86-90
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• 2017

Background: The aim of this study was to investigate clinicopathologic features of type 3 gastric neuroendocrine neoplasm (NEN) by treatment modality. Methods: The Korean Society of Gastrointestinal Cancer conducted the Korean Gastroenteropancreatic Neuroendocrine Tumor Registry, a retrospective registry database of gastroenteropancreatic neuroendocrine tumors from 16 hospitals in Korea. The normal serum gastrin level range was defined as <100 pg/mL, and gastric NEN patients with normal gastrin level were selected for analysis. Results: Among 358 patients with gastric NEN, 21 (5.9%) patients were classified with type 3 gastric NEN. The median age was 53 years (range 30-74). According to the WHO 2010 classification, 13 (61.9%) patients had grade 1, and 8 (38.1%) patients had grade 2 or 3. Endoscopic treatment was performed in 14 (66.7%) patients, and surgery was performed in 7 (33.3%) patients. The tumor size was smaller in the endoscopic treatment group than in the surgery group (0.6 cm vs 1.3 cm, p=0.006). After treatment, there was one recurrence in the surgery group. Conclusion: In small size Type 3 gastric NEN, endoscopic treatment was associated with a good prognosis, compared to surgery. Thus, endoscopic treatment can be used an alternative modality in selected cases of type 3 gastric NEN.

• Journal of Digestive Cancer Research
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• v.1 no.1
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• pp.36-42
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• 2013

Background/Aims: Gemcitabine is regarded as a reference regimen for advanced pancreatic cancer and shows relatively safe toxicity profiles compared with other cytotoxic agents. However, many oncologists are appeared to be still reluctant to treat elderly pancreatic cancer patients with cytotoxic chemotherapy because of predicted low response rate and potential adverse events. Methods: All patients who were received gemcitabine based chemotherapy between 2007 and 2010 were identified and clinical, laboratory, radiographic data were retrospectively reviewed. Patients were divided into two groups based on their ages: less than 65, and equal or more than 65 years old. Gemcitabine, at a dose of 1,000 mg per square meter of body surface area, was administered by intravenously over 30 minutes weekly for 3 weeks followed by 1 week rest, alone or along with other chemotherapeutic agents including cisplatin, capecitabine and erlotinib. Results: A total of 61 patients were identified and all patients were not eligible to receive operation because of advanced stage at diagnosis. Twenty three patients (37.7%) were equal or more than 65 year of age. Mean age was 56 years old and 71 years old in each group. Laboratory data including CA 19-9 were not significantly different. More gemcitabine monotherapy was delivered (56.5% vs. 26.3%, p=0.029) and less second or third line therapy was adminis- tered (17.4% vs. 50.0%, p=0.014) in elderly group. Cholangitis occurred and stent placement were performed similarly in both groups. Conclusion: Gemcitabine based chemotherapy can be administered safely to elderly pancreatic cancer patients and comparable response rate and progression free survival can be expected as young patients.

• Genomics & Informatics
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• v.18 no.1
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• pp.9.1-9.5
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• 2020

Ulcerative colitis is a form of inflammatory bowel disease characterized by chronic inflammation of the colon and rectum. The abnormal lesions in the digestive system caused by ulcerative colitis and intermittent colitis are of major clinical importance. MDM2 is a phospho-protein that functions as a ubiquitin ligase for p53. Recently, a T>G substitution in the promoter of the MDM2 gene (rs309) has been identified. In this case-control study, 174 ulcerative colitis biopsy samples and 82 control samples were collected from colonoscopy centers, hospitals, and clinics in Mazandaran and Gilan Provinces in Iran from October 2014 to May 2015. This MDM2 polymorphism was investigated in DNA samples (extracted from biopsy samples) by amplification-refractory mutation system polymerase chain reaction. The mean age of patients with ulcerative colitis was 46.5 years (range, 28 to 69 years) and that of control individuals was 45.3 years (range, 26 to 71 years). Seventy-eight patients (44.82%) were men and 96 (55.18%) were women. The distribution of the TT, TG, and GG genotypes was 17.93%, 27.59%, and 34.48%, respectively, in the ulcerative colitis patients and 31.70%, 24.40%, and 43.90%, respectively, in the control individuals (odds ratio of GG for ulcerative colitis, 7.142; 95% confidence interval, 2.400 to 9.542; p = 0.001). It was found that a single-nucleotide polymorphism at rs309 in the MDM2 gene was associated with ulcerative colitis. A direct relationship was found between age and ulcerative colitis, while no relationship was found with sex. This finding is of note because the occurrence of intestinal inflammation and subsequent ulcers can precede the development of cancer.

• Journal of Chest Surgery
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• v.35 no.12
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• pp.914-916
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• 2002

Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.99-105
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• 1996

The reconstruction of esophageal defect after ablative surgery have more difficult than other digestive tract tumor because the restoration of anatomical and physiologic function is difficult, the risk of tumor invasion into the adjacent tissue is large. The reconstruction of cervical esophus was depended on the degree of resection of the esophagus, various reconstruction method was developed to minimize functional deficiency and deformity of cervical region. Recently, the free jejunal transfer or free radial forearm flap was commonly utilized for esophageal reconstruction due to development of technique of the microvascular anastomosis. After the esophageal reconstruction used by free jejunal transfer was reported by Seidenberg in 1951, jejunum is most commonly used for reconstruction of esophgus. Becaue of, it have been tubed anatomical similarity with muscular layer, relative small risk of complication, possible of oral intake within 10 days after operation, and early rehabilitaion. Authors have been treated esophageal defect with free jejunal transfer in 7 patients after resection of lesion in 6 eshageal cancer and 1 esophageal stricture from December 1994 to January 1996. We were transferred jejunum used by intercostal artery as recipient artery in 3 cases, it was satisfied with results. If intercostal artery was utilized as recipient artery for free jejunal transfer, we believe that any site of intrathoracic or intraabdominal esophageal defect is possible to recontruction.

• Journal of Nutrition and Health
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• v.26 no.3
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• pp.268-276
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• 1993

Coffee is known to increase pancreatic secretion of digestive enzymes. The mutagen, aflatoxin B1(AFB1) is contained in fermented foods and known to increase the specific activities of pancreatic chymotrypsin, trypsi, amylase, and lipase. Nowadays, coffee intake is increased among Koreans who have consumed relatively high amount of traditional fermented foods. Therefore, this study was performed to examine the effect of coffee and AFB1 on pancreatic exocrine function and structure. Rats were divided into 10 experimental groups. The first five groups were W(control group), LD(0.2g decaffeinated coffee/Kg B.W), HD(3g decaffeinated coffee/Kg B.W), LC(0.2g coffee/Kg B.W), and HC(3g coffee/Kg B.W). The second five groups were WA, LDA, HDA, LCA, HCA, same as first five groups in caffieine level but treated with AFB1. The result of this experiment showed that the caffeine intake did not influence significantly on the growth and feed efficiency. But water intake was increased by caffeine intake and AFB1 treatment. The weights of pancreas and liver were increased as the caffeine intake was increased. Trypsin activities were tend to increase in concentrated coffee groups(HD, HC). AFB1 treated groups showed the higher trypsin level than the AFB1 untreated groups. Amylase activities were tend to increase in concentrated coffee groups(HD, HC) of AFB1 untreated animals. AFB1 treated did not show the additional effect on the stimulated amylase secretion by coffee. Lipase activities were tend to decrease in concentrated coffee groups(HD, HC) of AFB1 untreated animals. Lipase activities were increased in the order named WA group, coffee groups, decaffeinated coffee groups in AFB1 treated animals. AFB1 treated groups showed the higher lipase level than AFB1 untreated groups. In the histologic observation of pancreas HCA group showed more dense compound tubuloalveolar glands and proliferation of nuclei than normal. The result suggested a development of a atypia which is ongoing phase to a cancer.

• Perspectives in Nursing Science
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• v.17 no.2
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• pp.61-71
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• 2020

Purpose: This mixed method study aimed to investigate patients' level of anxiety and their experience of this before undergoing esophagogastroduodenoscopy (EGD). Methods: A total of 125 patients answered a questionnaire assessing their pre-EGD level of anxiety, and a total of 17 patients participated in individual interviews regarding their experience of EGD-related anxiety. The SPSS Software program was used for survey data analysis and content analysis was used for qualitative data. Results: The mean anxiety score was 40.00±9.86 and the factors related to anxiety levels were being female (p<.001) and being a relatively young age (20-30 years old, p=.004). There were no significant differences shown in level of anxiety according to the purpose EGD was performed for: screening, diagnosis, or disease follow-up. In the qualitative analysis, however, patients who underwent a follow-up procedure as a result of stomach cancer exhibited more complicated feelings of anxiety and helplessness than others. For those who underwent EGD for diagnostic reasons, they worried about the test results and were concerned about possible life changes after diagnosis. Those for whom EGD was performed for screening purposes expressed concern only in the event of EGD complications. Conclusion: This study explored the nature of pre-EGD anxiety according to the purpose of the procedure. Nurses and doctors should be aware that patients undergoing EGD may have different levels and experiences of pre-procedure anxiety.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.474-477
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• 2002

Equipment to cauterize tumors by an electrically heated Kanthal wire is under development. The wire( alloy of iron, chromium and Aluminum) keeps sufficient strength up to 1400 degrees in Celsius. Although AC 50Hz current source is used in the prototype experiment, RF current will be used in future. The diameter of the Kanthal wire was 0.3 mm which was connected to Kanthal wire of 0.8 mm. The thicker wire was used as a leading wire. The possibility of application of the heating wire in combination with an ultrasound endoscope was determined, where ultrasound endoscope is to be used to monitor the location on the wire and an extent of a tumor in digestive organs. This procedure requires the wire to be applied inside ultrasound transmitting media. First, the wire was applied in the degassed water in which a chicken liver sample was submerged. The wire, however, burned out in water soon after it became red-hot at 12 A. The reason is that large current is required for the wire to become red-hot due to strong convection. Starch paste of 3 weight percent was employed instead of water. This made the wire red-hot approximately at 6 A, showing the increased viscosity of the starch decreased the convection and the wire was cover by the steam. The liver sample was cauterized successively, while the location of the wire and the liver was monitored by an ultrasound diagnosis equipment outside the plastic vessel of the starch paste.