• The Korean Journal of Physiology and Pharmacology
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• v.23 no.5
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• pp.419-426
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• 2019

Mosapride accelerates gastric emptying by acting on 5-hydroxytryptamine type 4 ($5-HT_4$) receptor and is frequently used in the treatment of gastrointestinal (GI) disorders requiring gastroprokinetic efficacy. We tested the effect of mosapride on 5-hydroxytryptamine type 3 ($5-HT_3$) receptor currents because the $5-HT_3$ receptors are also known to be expressed in the GI system and have an important role in the regulation of GI functions. Using the whole-cell voltage clamp method, we compared the currents of the $5-HT_3$ receptors when 5-HT was applied alone or was co-applied with mosapride in cultured NCB-20 cells known to express $5-HT_3$ receptors. The $5-HT_3$ receptor current amplitudes were inhibited by mosapride in a concentration-dependent manner. Mosapride blocked the peak currents evoked by the application of 5-HT in a competitive manner because the $EC_{50}$ shifted to the right without changing the maximal effect. The rise slopes of $5-HT_3$ receptor currents were decreased by mosapride. Pre-application of mosapride before co-application, augmented the inhibitory effect of mosapride, which suggests a closed channel blocking mechanism. Mosapride also blocked the opened $5-HT_3$ receptor because it inhibited the $5-HT_3$ receptor current in the middle of the application of 5-HT. It accelerated desensitization of the $5-HT_3$ receptor but did not change the recovery process from the receptor desensitization. There were no voltage-, or use-dependency in its blocking effects. These results suggest that mosapride inhibited the $5-HT_3$ receptor through a competitive blocking mechanism probably by binding to the receptor in closed state, which could be involved in the pharmacological effects of mosapride to treat GI disorders.

• The Journal of Pediatrics of Korean Medicine
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• v.33 no.4
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• pp.1-25
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• 2019

Objectives The purpose of this study is to analyze the trends of Chinese clinical research in the last 5 years of Chinese herbal medicine treatment for anorexia in children, and to find ways to utilize the diagnostic criteria and herbal medicine treatment for children who have anorexia in Korea. Methods The authors searched literatures using China National Knowledge Infrastructure published from January 1, 2015 to June 18, 2019. Selected literatures were collected in order of recent publication year. And then, demographic data, duration of illness, intervention, treatment period, outcome, and adverse events were analyzed. In addition, the diagnostic criteria for anorexia in children are categorized and presented in chart. Results A total of 50 papers were included in the analysis of this study. In the selected studies, the most commonly used diagnostic criteria for anorexia in children were ${\ll}$Zhu Futang Practice of Pediatrics${\gg}$ in Western medicine and ${\ll}$Diagnostic and therapeutic criteria for TCM syndromes${\gg}$ in traditional Chinese medicine. As a result, in all the studies reporting total efficacy, the total effective rate of the treatment group treated with herbal medicine was significantly higher than that of the control group. Also, appetite recovery rate and weight gain were significantly higher, gastric emptying time and appetite recovery time were significantly shorter in the treatment group. Conclusions Herbal medicine treatment can help improve anorexia in children. In Korea, diagnostic criteria for anorexia in children should be established. In addition, criteria should be established to evaluate the effectiveness of herbal medicine treatment.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.76-86
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• 2023

Backgrounds/Aims: The aim of this study was to describe short- and long-term outcomes of patients who underwent pancreatoduodenectomy (PD) at a typical United Kingdom hepatopancreatobiliary unit. Methods: A retrospective analysis of all PD patients with histologically-confirmed pancreatic ductal adenocarcinoma (PDAC), ampullary adenocarcinoma (AA), or distal cholangiocarcinoma (CC) from September 1st, 2006 to May 31st, 2015 was carried out. The following information was obtained: demographics, comorbidities, preoperative investigations, neoadjuvant treatment, operative details, postoperative management, complications, adjuvant treatment, five-year recurrence, and five-year survival. Effects of selected preoperative variables on short- and long-term outcomes were investigated. Results: Of 271 included patients, 57.9% had PDAC, 25.8% had AA, and 16.2% had CC. In total, 67.9% experienced morbidity and 17.3% developed a Clavien-Dindo grade ≥ III complication. The 90-day mortality was 3.3%. Clinically-relevant postoperative pancreatic fistula, bile leak, gastrojejunal leak, postpancreatectomy haemorrhage and delayed gastric emptying affected 8.1%, 4.1%, 0.0%, 9.2%, and 19.9% of patients, respectively. American Society of Anesthesiologists grade III-VI correlated with overall morbidity (p = 0.002) and major morbidity (p = 0.009), but not 90-day mortality or five-year survival. The same pattern was observed in patients with a preoperative serum bilirubin > 29 µmol/L and/or a neutrophil/lymphocyte ratio > 3.1. Five-year cancer recurrence and five-year survival were 68.3% and 22.5%, respectively. PDAC patients had higher five-year recurrence but lower five-year survival rates (both p = 0.001). Conclusions: In our series, the majority of patients experienced a complication. However, few patients experienced major morbidity. Surgical risk factors did not affect five-year survival.

• 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.

• The Korea Journal of Herbology
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• v.34 no.6
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• pp.45-55
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• 2019

Objective : Diabetic gastroparesis is a complication that is defined as delayed gastric emptying and upper gastrointestinal symptoms and often occurs in long-standing diabetic patients. Bojungikgi-tang (BJT) is a traditional oriental herbal formula that has long been used for the treatment of digestive disorders. The purpose of this study was to investigate the effects of BJT on streptozotocin (STZ)-induced diabetic gastroparesis rat model. Methods : Sprague-Dawley (SD) male rats (250-270g) were divided into 13 groups including normal group, STZ-induced diabetic control group, BJT diet (7 various concentrations), and insulin-, glibenclamide-, metformin-treated group were used for the experiments for the comparison. Diabetic gastroparesis was induced by intraperitoneal injection of STZ. The water intake, food intake, body weights and fasting blood glucose levels were measured. After 4 weeks the animals were sacrificed and gastrin, leptin, insulin, hemoglobin A1C (HbA1c), lactate, lactate dehydrogenase (LDH), bilirubin, creatinine, albumin and lipid levels were evaluated. Results : Intraperitoneal injection of BJT for 4 weeks resulted in increased levels of gastrin in blood and decreased leptin and lactate concentration in STZ-induced diabetic gastroparesis rat model. BJT did not affect insulin, fasting glucose, HbA1c, and lipid levels in STZ-induced diabetic gastroparesis rat model. Conclusion : These results indicated that BJT would have protect effect on diabetic gastroparesis through the improvement effect of gastric motility and fatigue syndrome in STZ-induced diabetic rats. This study shows that BJT might be effective for treatment of diabetes and its complications such as gastroparesis.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.115-121
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• 2012

Purpose: Severe pancreaticoduodenal injuries are relatively uncommon, but may result in high morbidity and mortality, especially when management is not optimal, and determining the appropriate treatment is often difficult. The objective of this study was to review our experience and to evaluate the role of a pancreaticoduodenectomy (PD) in treatment of pancreaticoduodenal injuries. Methods: We performed a retrospective review of 16 patients who underwent an emergency PD at our hospital for severe pancreaticoduodenal injury from 1990 to 2011. Demographic data, clinical manifestations, mechanism and severity of the injury, associated injuries, postoperative complications and outcomes were reviewed. Results: The mean age of the 16 patients was $45{\pm}12years$ ($mean{\pm}standard$ deviation), and 15(93.8%) patients were male. All patients underwent an explorative laparotomy after a diagnosis using abdominal computed tomography. Almost all patients were classified as AAST grade higher than III. Thirteen(83.3%) of the 16 patients presented with blunt injuries; none presented with a penetrating injury. Only one(6.3%) patients had a combined major vascular injury. Fifteen patients underwent a standard Whipple's operation, and 1 patient underwent a pylorus-preserving pancreaticoduodenectomy. Two of the 16 patients required an initial damage-control procedure; then, a PD was performed. The most common associated injured organs were the small bowel mesentery(12, 75%) and the liver(7, 43.8%). Complications were intraabdominal abscess(50%), delayed gastric emptying(37.5%), postoperative pancreatic fistula(31.5%), and postoperative hemorrhage (12.5%). No mortalities occurred after the PD. Conclusion: Although the postoperative morbidity rate is relatively higher, an emergency PD can be perform safely without mortality for severe pancreaticoduodenal injuries. Therefore, an emergency PD should be considered as a life-saving procedure applicable to patients with unreconstructable pancreaticoduodenal injuries, provided that is performed by an experienced hepatobiliary surgeon and the patient is hemodynamically stable.

• Korean Journal of Plant Resources
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• v.24 no.1
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• pp.61-68
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• 2011

Loperamide-induced constipation reduced gastric emptying, small-intestinal and colonic motility, and these effects were prevented by Actindia chinensis(Gold Kiwi Fruit, GKF). In this study, the effects of Actindia chinensis on constipated male Sprague-Dawley rats induced by loperamide(2 mg/kg, s.c.,5 days) were investigated. Rats were randomly assigned to the normal control rats(regular diet), constipated rats(regular diet plus loperamide), constipated rats treated with 2.5% GKF(regular diet supplemented with 2.5% GKF plus loperamide), constipated rats treated with 5% GKF (regular diet supplemented with 5% GKF plus loperamide). There was less fecal excretion and lower fecal water content in loperamide-treated rats than in control rats. Oral administration of GKF blocked the decrease of fecal excretion and fecal water content in the loperamide-treated rats. Mucus production of crypt cell and mucus contents at fecal and mucosa surface were reduced by loperamide-treated rat. But colonic crypt cell contained increased mucin in the GKF treated group and mucus layer stained with alcian blue was significantly thicker in GKF treated rats compared with in loperamide-treated rats. In isolated rat ileum, loperamide produced inhibition of ileal motility. Pretreatment with methanolic extracts of GKF in isolated rat ileum prevented inhibition by loperamide. These findings indicated that the GKF was effective for alleviation of inhibition of colonic peristalsis by loperamide and that GKF might be of value in the prevention of constipation.

• Advances in pediatric surgery
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• v.16 no.1
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• pp.11-17
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• 2010

Pancreatic tumors in children are relatively rare, and their prognosis differs from that in adults. The purpose of this study is to examine the clinical characteristics, treatment, and prognosis for children with pancreatic tumors. We retrospectively reviewed the medical records of children under 15 years of age with pancreatic tumors who were treated surgically at Asan Medical Center between January 1992 and November 2009. There were 16 patients, fourteen of whom were pathologically diagnosed with solid pseudopapillary tumor. The other two patients were diagnosed with pancreatoblastoma and acinar cell carcinoma, respectively. Six patients of the 16 patients (38 %) were male, and there was a male-to-female ratio of 1:1.6. The initial presentations were upper abdominal pain in eight patients (50 %), palpable abdominal mass in three, and vomiting in one. Four patients were diagnosed incidentally. Six patients' tumors were located in the pancreatic head, six in the pancreatic body, and four in the pancreatic tail, respectively. The surgical procedures performed included distal pancreatectomy (n=7, 44 %), median segmentectomy (n=3), enucleation (n=3), pancreaticoduodenectomy (n=2), and pylorus-preserving pancreaticoduodenectomy (n=1). Three patients underwent laparoscopic surgery. The median tumor size was 6.5 cm (1.8~20 cm). Early surgical complications included pancreatic fistula (n=4), bile leakage (n=1), and delayed gastric emptying (n=1). A late complication in one patient was diabetes. The median follow-up period was five years and four months, and all patients survived without recurrence. While pancreatic tumors in adults have a poor prognosis, pancreatic tumors of childhood are usually curative with complete resection and thus have a favorable prognosis.

• Journal of Haehwa Medicine
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• v.18 no.1
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• pp.19-28
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• 2009

Objectives: This study was conducted to help clinical studies for treating Functional Dyspepsia with acupuncture. We inspected tendency of studies of acupuncture treatment for functional dyspepsia and analyzed the assessing instrument for it by scrutinizing Pubmed recent publications. Materials and Methods: We inspected 8 theses and scrutinized their objectives, periods, participants, materials and methods, the instrument of assessment for the studies, and criteria and symptom score for questionaire, results and JADAD score. Results: 1. Most studies were published by oriental doctors except one which was published by an American doctor. More and more studies are being published in America and written in English recently. So it is considered that western doctors think that the acupuncture treatment is useful as unorthodox medicine for functional dyspepsia. 2. Among the 4 clinical studies, 2 studies were RCT and 1 study was not RCT and 1 study with vagueness. All 4 clinical studies were not double-blinded because they were about comparison between acupuncture treatment and medicine. 3. ST36, PC6, CV12, BL21 were chiefly used, and auricular point, ST40, SP6 were also used. Manual acupuncture were used in 2 studies, and low frequency pulse and electroacupuncture were used in other studies respectively. 4. 4 clinical studies used 0~3 points symptom score as the instrument of assessment. Additional assessments were on gastric emptying time, EGG and plasma level of motilin. All thesis were not verified of validity and reliability. 5. Among the 4 reviewed thesis, 2 theses were about acupuncture as one of the various treatment of functional dyspepsia, and the other 2 theses were about efficacy of acupuncture treatment. And the result generally showed effectivity of acupuncture treatment. Conclusion: Acupuncture treatment for functional dyspepsia is considered useful as in unorthodox medicine by western doctors, and it is necessary to provide objective instrument for assessing acupuncture treatment for functional dyspepsia.

• The Journal of the Convergence on Culture Technology
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• v.10 no.3
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• pp.865-872
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• 2024

Loperamide-induced constipation reduced gastric emptying, small-intestinal and colonic motility, and these effects were prevented by Fruit and vegetable complex extracts(FVCE). In this study, the effects of FVCE on constipated male Sprague-Dawley rats induced by loperamide(3 mg/kg, s.c.,14 days) were investigated. Rats were randomly assigned to the normal control rats(regular diet), constipated rats(regular diet plus loperamide), constipated rats treated with 200 mg FVCE(regular diet supplemented with 200 mg/kg/day FVCE plus loperamide), constipated rats treated with 400 mg FVCE(regular diet supplemented with 400 mg/kg/day FVCE plus loperamide). There was less fecal excretion and lower fecal water content in loperamide-treated rats than in control rats. Oral administration of FVCE blocked the decrease of fecal excretion and fecal water content in the loperamide-treated rats. Mucus production of crypt cell and mucus contents at fecal and mucosa surface were reduced by loperamide-treated rat. But colonic crypt cell contained increased mucin in the FVCE treated group and mucus layer stained with alcian blue was significantly thicker in FVCE treated rats compared with in loperamide-treated rats. In isolated rat ileum, loperamide produced inhibition of ileal motility. Pretreatment with water extracts of FVCE in isolated rat ileum prevented inhibition by loperamide. These findings indicated that the FVCE was effective for alleviation of inhibition of colonic peristalsis by loperamide and that FVCE might be of value in the prevention of constipation.