• 제목/요약/키워드: Gastric bleeding

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High Dietary Salt Intake Increase of Gastric Ulcer in Stressed Rats (침수.속박스트레서에 의한 위궤양 모델 쥐에서 식염의 섭취 수준이 궤양 발병 및 회복에 미치는 영향)

  • 이상아
    • Journal of Nutrition and Health
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    • v.30 no.8
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    • pp.920-929
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    • 1997
  • This study examined the effect of dietary salt levels on the incidence and cure of gastric ulcer in rats. Two sets of experiment were conducted . In the first experiment, the rats were divided into 3 groups. The 3 groups were fed 0%, 4%, and 8% NaCl diets respectively for 20days. The rats were given water -immersion restraint stress at the end of the dietary period , and sacrificed. The ulcer index by histological test was higher in rats fed the 8% NaCl diet than those in the other groups. The hexosamine and glutathione levels were significantly lower in the rats fed the 8% NaCl diet. Hematocrit and total iron binding capacity(TIBC) showed lower values caused by bleeding of gastric mucosa. The second experiment was designed to determine the effect of soldium concentration on the cure of gastric ulcer . As the gastric ulcer was recovered, ulcer length was gradually deceased in the control group but not changed in the 8% NaCl diet group. The gastric hexosamine and hepatic glutathione were increased in the control group but decreased in the 8% NaCl diet group. The hematologic indices of stressed rats showed the same tendency. As a result, dietary salt per se did not cause gastric ulcer . Once an ulcer is formed by stress or any other factor, higher levels of dietary salt may be detrimental to gastric mucosa, thereby delaying the healing of the ulcer. It is recommended that dietary salt intake be reduced in stress-prone people.

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Systemic Analysis on Laparoscope-Assisted Gastrectomy for Patients with Gastric Cancer

  • Hu, Jun-Hong;Tang, Hong-Na;Ma, Yong-Ping;Wang, Chen-Yu;Yao, Kun-Hou;Zhang, Jun-Jie;Ren, Xue-Qun
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.5
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    • pp.2027-2029
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    • 2015
  • Background: Laparoscope-assisted gastrectomy in treating patients with gastric cancers developed with a background of highly invasive traditional surgery and is being increasingly performed in the Asian Pacific area. This study systemically investigated the technique and clinical results for comparison with traditional radical subtotal gastrectomy for gastric cancers. Methods: Clinical studies evaluating the effectiveness and side effects of laparoscope-assisted gastrectomy in treating patients with gastric cancers were identified using a predefined search strategy. Summary rates of effectiveness and side effects of laparoscope-assisted gastrectomy were calculated. Results: Thirteen clinical studies which including 1,412 patients with gastric cancer treated by laparoscope-assisted gastrectomy were considered eligible for inclusion. Systemic analysis showed that, for all patients, the pooled resection rate was 100%. Major adverse effects were anastomotic stenosis, abdominal abscess, abdominal bleeding, postoperative ileus. Treatment related death occurred in 0. 71% (10/1412). Conclusion: This systemic analysis suggests that laparoscope-assisted gastrectomy in treating patients with gastric cancers is associated with good curative rate and acceptable complications.

Induction of Heme Oxygenase-1 by Traditional Herb Mix Extract Improves MKN-74 Cell Survival and Reduces Stomach Bleeding in Rats by Ethanol and Aspirin in vivo

  • Kang, Young-Jin;Moon, Hyung-Suk;Kim, Hye-Jung;Seo, Han-Geuk;Lee, Jae-Heun;Chang, Ki-Churl
    • The Korean Journal of Physiology and Pharmacology
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    • v.11 no.2
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    • pp.65-70
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    • 2007
  • Chinese herb medicines have traditionally been used to treat or alleviate the symptom of various diseases. The rationale for use of certain herbs to certain disorder is now getting unveiled by modern technology. In the present study, we investigated whether herb mix extract(HMX), which is alleged to be useful for gastric ulcer, protects stomach from oxidative stress. Rats were allowed to normal diet with and without HMX (1, 5, 10 mg/kg) for 30 days. To induce gastric ulcer, ethanol (75%, 1.5 ml) or acidified aspirin (100 mg/kg in 0.2 N HCl) was administered by oral route in 24 h-fasted rats and examined the gastric ulceration(bleeding) by measuring the size 1 h after the treatment. Results indicated the area of gastric bleeding was significantly less in HMX fed rats than in normal diet fed ones, and it was dependent on the duration and amount of HMX. To investigate the underlying mechanism by which HMX protects stomach from oxidative stress, expression of enzymes like heme oxygenase (HO), cyclooxygenase (COX), and inducible nitric oxide (iNOS) were investigated in MKN-74 cells, where aspirin or H. pylori was introduced. The results were compared with RAW 264.7 cells to check if there's cell specificities exist. The expression of HO-1 but not COX-2, iNOS was significantly increased by HMX. Furthermore, HO-1 inhibitor, SnPP IX reduced the HO-1 activity and reversed the survival rate in HMX-treated MKN-74 cells. There's no difference between RAW 264.7 cells and MKN-74 cells. We, thus, concluded that HMX is beneficial for protection from oxidative injury, and induction of HO-1 by HMX in gastric cells is, at least, responsible for protection from oxidative stress such as ethanol, aspirin and possibly H. pylori infection.

Clinical Outcomes of Gastrectomy after Incomplete EMR/ESD

  • Lee, Hye-Jeong;Jang, You-Jin;Kim, Jong-Han;Park, Sung-Soo;Park, Seung-Heum;Park, Jong-Jae;Kim, Seung-Joo;Kim, Chong-Suk;Mok, Young-Jae
    • Journal of Gastric Cancer
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    • v.11 no.3
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    • pp.162-166
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    • 2011
  • Purpose: Endoscopic resection is widely accepted as standard treatment for early gastric cancer (EGC) without lymph node metastasis. The procedure is minimally invasive, safe, and convenient. However, surgery is sometimes needed after endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) due to perforation, bleeding, or incomplete resection. We evaluated the role of surgery after incomplete resection. Materials and Methods: We retrospectively studied 29 patients with gastric cancer who underwent a gastrectomy after incomplete EMR/ESD from 2006 to 2010 at Korea University Hospital. Results: There were 13 incomplete resection cases, seven bleeding cases, three metachronous lesion cases, three recurrence cases, two perforation cases, and one lymphatic invasion case. Among the incomplete resection cases, a positive vertical margin was found in 10, a positive lateral margin in two, and a positive vertical and lateral margin in one case. Most cases (9/13) were diagnosed as mucosal tumors by endoscopic ultrasonography, but only three cases were confirmed as mucosal tumors on final pathology. The positive residual tumor rate was two of 13. The lymph node metastasis rate was three of 13. All lymph node metastasis cases were submucosal tumors with positive lymphatic invasion and no residual tumor in the gastrectomy specimen. No cases of recurrence were observed after curative resection. Conclusions: A gastrectomy is required for patients with incomplete resection following EMR/ESD due to the risk of residual tumor and lymph node metastasis.

Consideration of Cardia Preserving Proximal Gastrectomy in Early Gastric Cancer of Upper Body for Prevention of Gastroesophageal Reflux Disease and Stenosis of Anastomosis Site

  • Kim, Jihoon;Kim, Sungsoo;Min, Young-Don
    • Journal of Gastric Cancer
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    • v.12 no.3
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    • pp.187-193
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    • 2012
  • Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. Materials and Methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. Results: There were 5 males and 5 females. The mean age was $56.5{\pm}0.5$ years. The mean operation time was $188.5{\pm}0.5$ minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was $25.2{\pm}0.5$. The length of proximal resection free margin was $3.1{\pm}0.1$ cm and distal was $3.7{\pm}0.1$ cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

Pharmacological Treatment for Peptic Ulcer Bleeding (소화성 궤양 출혈의 약물 치료)

  • Ma, Dae Won;Kim, Byung-Wook
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.231-234
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    • 2018
  • Peptic ulcer bleeding (PUB) is the most common cause of non-variceal upper gastrointestinal bleeding, and its frequency has been declining over the past decades. However, mortality from PUB persists, and it is still a serious challenge in clinical practice. Although endoscopic intervention is the basic treatment modality for PUB, pharmacological therapy is an important adjunct. The emergence of proton pump inhibitors (PPIs) enables maintenance of intragastric pH >6, which greatly helps in the treatment of PUB. Continuous intravenous infusion of high-dose PPI reduces the re-bleeding rate, thereby helping avoid additional surgery in patients with high-risk stigmata. Moreover, administration of PPIs prior to endoscopy may reduce the need for additional endoscopic intervention. Recently introduced gastric acid suppressants, such as potassium-competitive acid blockers, have shown promising results in further treatment of PUB.

A Case of Gastric Cancer Presenting Acute Disseminated Intravascular Coagulation Palliated with Combination Chemotherapy of Irinotecan and Cisplatin (위암과 동반된 급성 파종성 혈관 내 응고증에 대하여 Irinotecan, Cisplatin 복합화학요법으로 완화요법을 시행한 1예)

  • Lee, Sang-Hoon;Woo, In-Sook;Kim, Seon-Young;Song, Myung-Jun;Rho, Sang-Young;Koh, Su-Jin;Lee, Myung-Ah;Kang, Jin-Hyoung;Hong, Young-Seon;Choi, Myung-Gyu;Lee, Kyng-Shik
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.189-192
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    • 2006
  • Acute disseminated intravascular coagulation (DIC) associated with gastric cancer is not common and has short survival of 1 to 3 weeks. Systemic chemotherapy in spite of hematologic unstability for gastric cancer may prolong survival time. A 47-year-old woman who complained of dyspnea, vaginal bleeding and easy bruisibility was diagnosed to stage IV gastric cancer with acute disseminated intravascular coagulation based on the laboratory data. She also had multiple bone metastases and bone marrow involvement. This is the first case treated with combination chemotherapy of irinotecan and cisplatin for advanced gastric cancer complicated by disseminated intravascular coagulation at the time of diagnosis, With systemic chemotherapy, some of the bleeding symptoms and the DIC process improved, even not completely recovered. However the patient died of disease progression and survival time was 12 weeks.

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Radiologic Diagnosis of Gastrointestinal Bleeding (위장관 출혈의 영상의학적 진단법)

  • Se Hyung Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.520-535
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    • 2023
  • Gastrointestinal (GI) bleeding is not a single disease but a symptom and clinical manifestation of a broad spectrum of conditions in the GI tract. According to its clinical presentation, GI bleeding can be classified into overt, occult, and obscure types. Additionally, it can be divided into upper and lower GI bleeding based on the Treitz ligament. Variable disease entities, including vascular lesions, polyps, neoplasms, inflammation such as Crohn's disease, and heterotopic pancreatic or gastric tissue, can cause GI bleeding. CT and conventional angiographies and nuclear scintigraphy are all radiologic imaging modalities that can be used to evaluate overt bleeding. For the work-up of occult GI bleeding, CT enterography (CTE) can be the first imaging modality. For CTE, an adequate bowel distention is critical for obtaining acceptable diagnostic performance as well as minimizing false positives and negatives. Meckel's scintigraphy can be complementarily useful in cases where the diagnosis of CTE is suboptimal. For the evaluation of obscured GI bleeding, various imaging modalities can be used based on clinical status and providers' preferences.

Circular Stapled Gastrojejunostomy after Radical Subtotal Gastrectomy - Anastomotic Bleeding and Prevention - (근치적 위아전절제술 후 원형문합기를 이용한 위공장문합술 - 문합부 출혈과 예방 -)

  • Ihn, Myung-Hoon;Kang, Gil-Ho;Cho, Gyu-Seok;Kim, Yong-Jin;Kim, Hyung-Soo;Han, Sun-Uk;Bae, Sang-Ho;Kim, Sung-Yong;Baek, Moo-Joon;Lee, Moon-Soo
    • Journal of Gastric Cancer
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    • v.9 no.4
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    • pp.223-230
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    • 2009
  • Purpose: Circular stapled gastrectomy has been the favored procedure with its feasibility and the shortened operative time, but anastomotic leakage, stenosis and bleeding have been reported as problems. The aim of this study was to identify what can be done to supplement the safety of this technique by examining the potential complications of performing circular stapled gastrojejunosomy after radical subtotal gastrectomy. Materials and Methods: As subjects, this study selected 1,391 patients who underwent gastrojejunostomy after radical subtotal gastrectomy because of gastric cancer at our Department of Surgery from Jan. 1998 to Dec. 2007. The patients were divided into Group I (n=479) who underwent hand-sewn gastrojejunostomy, Group II (n=48) who underwent linear stapled gastrojejunostomy and Group III (n=864) who underwent circular stapled gastrojejunostomy. Group III was re-divided into two subgroups on the basis of the point of time that a visual check was intraoperatively performed at the anastomotic site: Group III-A (n=198) before and Group III-B (n=666) after. The characteristics and complications of the patients were then compared. Results: For the comparison of the complications between Group I, Group II and Group III, anastomotic leakage was found in 7 cases (1.5%) in Group I, in 1 case (2.0%) in Group II and in 10 case (1.2%) in Group III, and anastomotic stenosis were found in 4 cases (0.8%) in Group I, 1 case (2.0%) in Group II and 5 case (0.6%) in Group III. Anastomotic bleeding was found in 32 cases (6.7%) in Group I, in 5 cases (10.4%) in Group II and in 67 cases (7.7%) in Group III. For the comparison of complications between Group III-A and Group III-B, anastomotic bleeding was found in 57 cases (28.8%) in Group III-A and 10 cases (1.5%) in Group III-B and the difference was statistically significant (P=0.037). Conclusion: Circular stapled gastrojejunostomy after radical subtotal gastrectomy is recommended because of the safety and feasibility of this technique, but bleeding at the anastomotic site may be the critical issue. In conclusion, direct inspection for bleeding at the anastomotic site during the operation will improve the safety of performing circular stapler anastomosis.

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Deep Learning based Computer-aided Diagnosis System for Gastric Lesion using Endoscope (위 내시경 영상을 이용한 병변 진단을 위한 딥러닝 기반 컴퓨터 보조 진단 시스템)

  • Kim, Dong-hyun;Cho, Hyun-chong
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.67 no.7
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    • pp.928-933
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    • 2018
  • Nowadays, gastropathy is a common disease. As endoscopic equipment are developed and used widely, it is possible to provide a large number of endoscopy images. Computer-aided Diagnosis (CADx) systems aim at helping physicians to identify possibly malignant abnormalities more accurately. In this paper, we present a CADx system to detect and classify the abnormalities of gastric lesions which include bleeding, ulcer, neuroendocrine tumor and cancer. We used an Inception module based deep learning model. And we used data augmentation for learning. Our preliminary results demonstrated promising potential for automatically labeled region of interest for endoscopy doctors to focus on abnormal lesions for subsequent targeted biopsy, with Az values of Receiver Operating Characteristic(ROC) curve was 0.83. The proposed CADx system showed reliable performance.