• 대한의용생체공학회:의공학회지
• /
• 제28권2호
• /
• pp.250-257
• /
• 2007

Functional gastrointestinal disorders affect millions of people of all age regardless of race and sex. There are, however, rare diagnostic methods for the functional gastrointestinal disorders because functional disorders show no evidence of organic and physical causes. Our research group identified recently that the gastrointestinal tract well in the patients with the functional gastrointestinal disorders becomes more rigid than healthy people when palpating the abdominal regions overlaying the gastrointestinal tract. The aim is, therefore, to develop a diagnostic method for the functional gastrointestinal disorders based on quantitative measurement of the rigidity of the gastrointestinal tract well using ultrasound technique. For this purpose, a preliminary ultrasound diagnostic system was developed and verified through phantom tests. The system consisted of transmitter, ultrasonic transducer, receiver, TGC, and CPLD, and verified via a phantom test. For the phantom test, ten soft-tissue specimens were harvested from porcine. Five of them were then treated chemically to mimic a rigid condition of gastrointestinal tract well, which was induced by functional gastrointestinal disorders. Additionally, the specimens were tested mechanically to identify if the mimic was reasonable. The customized ultrasound system was finally verified through application to human subjects with/without functional gastrointestinal disorders(Normal and Patient Groups). It was identified from the mechanical test that the chemically treated specimens were more rigid than normalspecimen. This finding was favorably compared with the result obtained from the phantom test. The phantom test also showed that ultrasound system well described the specimen geometric characteristics and detected an alteration in the specimens. The maximum amplitude of the ultrasonic reflective signal in the rigid specimens $(0.2{\pm}0.1Vp-p)$ at the interface between the fat and muscle layers was explicitly higher than that in the normal specimens $(0.1{\pm}0.0Vp-p)$ (p<0.05). Clinical tests using our customized ultrasound system for human subject showed that the maximum amplitudes of the ultrasonic reflective signals nea. to the gastrointestinal tract well for the patient group$(2.6{\pm}0.3Vp-p)$ were generally higher than those in normal group$(0.1{\pm}0.2Vp-p)$ (p<0.05). These results suggest that newly designed diagnostic system based on ultrasound technique may diagnose enough the functional gastrointestinal disorders.

• Journal of Gastric Cancer
• /
• 제22권3호
• /
• pp.184-196
• /
• 2022

Purpose: Total or proximal gastrectomy of the upper-third early gastric cancer (u-EGC) often causes severe post-gastrectomy syndrome, suggesting that these procedures are extremely invasive for patients without pathologically positive lymph node (LN) metastasis. This study aimed to evaluate the clinical applicability of a stomach function-preserving surgery, local resection (LR), with prophylactic left gastric artery (LGA)-basin dissection (LGA-BD). Materials and Methods: The data of patients with u-EGC (pathologically diagnosed as T1) were retrospectively analyzed. Total gastrectomy was performed in 30 patients, proximal gastrectomy in 45, and subtotal gastrectomy in 6; the LN status was evaluated assuming that the patients had already underwent LR + LGA-BD. This procedure was considered feasible in patients without LN metastases or in patients with cancer in the LGA basin. The reproducibility of the results was also evaluated using an external validation dataset. Results: Of the 82 eligible patients, 79 (96.3%) were cured after undergoing LR + LGA-BD, 74 (90.2%) were pathologically negative for LN metastases, and 5 (6.1%) had LN metastases, but these findings were only observed in the LGA basin. Similarly, of the 406 eligible tumors in the validation dataset, 396 (97.5%) were potentially curative. Tumors in the lesser curvature, post-endoscopic resection status, and small tumors (<20 mm) were considered to be stronger indicators of LR + LGA-BD as all subpopulation cases met our feasibility criteria. Conclusions: More than 95% of the patients with u-EGC might be eligible for LR + LGA-BD. This function-preserving procedure may contribute to the development of u-EGC without pathological LN metastases, especially for tumors located at the lesser curvature.

• 대한한의학방제학회지
• /
• 제29권1호
• /
• pp.57-70
• /
• 2021

Obejectives : The purpose of this study was to analyze the papers from 2015 to 2019 to identify trends in gastrointestinal studies in Korean medicine. Methods : The search for related papers was conducted in 10 oriental medicine journals that were actively reported and published, easy to search using the Internet, and freely accessible to researchers. Results : There were many studies related to the stomach, and in particular, there were many papers confirming the effectiveness of Korean medicine treatment for functional digestion, hypersensitive intestinal syndrome, and gastrointestinal reflux diseases. It is regrettable that only about 60 papers of research on gastrointestinal diseases have been published in 10 journals over the past five years of research on gastrointestinal diseases. Conclusions : These results suggest that the need to promote practical research on functional gastrointestinal disorders should be evaluated higher in the Korean medical community, and the development of gastrointestinal-related treatments for Korean medicine can improve the quality of life for all of us.

• 대한한방소아과학회지
• /
• 제28권1호
• /
• pp.32-42
• /
• 2014

Objectives The purpose of this study is to establish relationship between allergic diseases and functional gastrointestinal disorders in children and adolescents using objective criteria and questionnaires. Methods This study surveyed 237 children and adolescents who visited the department of Pediatrics of ${\bigcirc}{\bigcirc}$ Korean Medicine Hospital from September 23rd, 2013 to December 26th, 2013. The Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Korean-translated Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-Rome III) were used. We analyzed the data by using PASW Statistics 18.0 with Chi-square test, Fisher's exact test and Linear by linear association. Results There was no significant difference between prevalence of allergic diseases and functional gastrointestinal disorders. Also, there was no strong relationship between the number of allergic diseases and the functional gastrointestinal disorders. However, some parts showed significant relationships - such as asthma symptoms ever and belch; asthma symptoms last 12 months and belch; allergic rhinitis diagnosis ever and belly aches and abdominal pain around and below the belly button; allergic rhinitis treatment last 12 months and belly aches and abdominal pain around and below the belly button; and atopic dermatitis diagnosis ever and irritable bowel syndrome (respectively; p=0.046, p=0.008, p=0.004, p=0.029, p=0.035). And as the number of allergic diseases increases, the prevalence of functional gastrointestinal disorders are 19.4%, 31.3%, 41.7%, 31.0% respectively. Conclusions Although there was no significant relationship between allergic diseases and functional gastrointestinal disorders, some gastrointestinal symptoms were related to allergic diseases.

• 대한한방내과학회지
• /
• 제38권6호
• /
• pp.980-999
• /
• 2017

Objectives: This study aimed to evaluate the efficacy of Daegunjoong-tang for improvement of gastrointestinal motility after surgery due to gastrointestinal cancer by analyzing the existing clinical research. Methods: Clinical studies about Daegunjoong-tang for improvement of gastrointestinal motility after surgery due to gastrointestinal cancer were identified in a literature search using the search term "Daikenchuto AND cancer AND ileus." The studies were analyzed in terms of design, inclusion and exclusion of participants, intervention, control, outcomes, and results. Results: Nine articles were identified in the literature search. Four trials included colon cancer participants with colectomy, and three studies included gastric cancer with total gastrectomy. The intervention in each case was Daegunjoong-tang, and most interventions were made by a pharmaceutical company with a Good Manufacturing Practice facility. The most frequently used control was a placebo. The methods were diverse, including measuring gastrointestinal function, motility, quality of life, symptom scores with a numeric rating scale, and blood tests. Safety was investigated by recording adverse events. Conclusions: Some issues were discovered by reviewing the existing clinical research about Daegunjoong-tang for improvement of gastrointestinal motility after surgery for gastrointestinal cancer. These results will be utilized as evidence for using Daegunjoong-tang in clinical practice and designing a clinical trial for Korean patients.

• Asian-Australasian Journal of Animal Sciences
• /
• 제30권1호
• /
• pp.100-110
• /
• 2017

Objective: The gastrointestinal tract of sheep contain complex microbial communities that influence numerous aspects of the sheep's health and development. The objective of this study was to analyze the composition and diversity of the microbiota in the gastrointestinal tract sections (rumen, reticulum, omasum, abomasum, duodenum, jejunum, ileum, cecum, colon, and rectum) of sheep. Methods: This analysis was performed by 454 pyrosequencing using the V3-V6 region of the 16S rRNA genes. Samples were collected from five healthy, small tailed Han sheep aged 10 months, obtained at market. The bacterial composition of sheep gastrointestinal microbiota was investigated at the phylum, class, order, family, genus, and species levels. Results: The dominant bacterial phyla in the entire gastrointestinal sections were Firmicutes, Bacteroidetes, and Proteobacteria. In the stomach, the three most dominant genera in the sheep were Prevotella, unclassified Lachnospiraceae, and Butyrivibrio. In the small intestine, the three most dominant genera in the sheep were Escherichia, unclassified Lachnospiraceae, and Ruminococcus. In the large intestine, the three most dominant genera in the sheep were Ruminococcus, unclassified Ruminococcaceae, and Prevotella. R. flavefaciens, B. fibrisolvens, and S. ruminantium were three most dominant species in the sheep gastrointestinal tract. Principal Coordinates Analysis showed that the microbial communities from each gastrointestinal section could be separated into three groups according to similarity of community composition: stomach (rumen, reticulum, omasum, and abomasum), small intestine (duodenum, jejunum, and ileum), and large intestine (cecum, colon, and rectum). Conclusion: This is the first study to characterize the entire gastrointestinal microbiota in sheep by use of 16S rRNA gene amplicon pyrosequencing, expanding our knowledge of the gastrointestinal bacterial community of sheep.

• Journal of Digestive Cancer Research
• /
• 제2권1호
• /
• pp.1-4
• /
• 2014

Palliative care for cancer aims to relieve the discomfort and pain from the cancer itself and associated conditions. Gastrointestinal cancers originate from the tube like structure of gastrointestinal tract and cause complications such as obstruction, bleeding, adhesion, invasion, and perforation to adjacent organ. Recent advances in interventional endoscopy enables endoscopy physicians to do safe and effective care for gastrointestinal cancer patients. Endoscopic palliation includes stent, hemostasis, nutritional support and targeted drug delivery. Self expandable metallic stent is one of the most important modalities in gastrointestinal palliation. Through the endoscopy or over the wire pre-placed by endoscopy, stents restore the gastrointestinal luminal patency and relieve the obstructive condition. Endoscopic hemostasis is another important palliation in gastrointestinal cancer patients. Epinephrine injection, argon plasma coagulation and thermal cauterization are usual modalities for hemostasis. Histoacryl glue and fibrin glue are also available. Hemostatic nanopowder spray is newly reported effective in benign disease and is supposed to be effective also in cancer bleeding. Enteral feeding tubes including gastro- or jejunostomy and nosoduodenal tubes are placed by using endoscopic guidance. Enteral feeding tubes role as the route of easily absorbable or semi-digested nutrients and effectively maintain both patients calorie requirements and gut microenvironment. Photodynamic therapy is the one of the outstanding medical employments of photo-physics. Especially for superficial cancers in esophagus, photodynamic therapy is very useful in cancer removal and maintaining organ structure. In biliary neoplasm, photodynamic therapy is well known to be effective in cancer ablation and biliary ductal patency restoration. Targeted drug delivery is the lastest issue in palliative endoscopy. Debates and questions are still on the table. In this article, the role of endoscopic interventions in palliative care for the gastrointestinal tumors will be thoroughly reviewed.

• Journal of Digestive Cancer Research
• /
• 제5권1호
• /
• pp.23-27
• /
• 2017

Although laparoscopic pancreaticoduodenectomy (LPD) is considered as minimally invasive surgery, an advanced level of laparoscopic skill is still required. LPD comprises various procedures including reconstruction. Therefore, establishment of a safe approach at each step is needed. Prevention of intraoperative bleeding is the most important factor in safe completion of LPD. The establishment of effective retraction methods is also important at each site to prevent vascular injury. I also recommend the "uncinate process first" approach during initial cases of LPD, in which the branches of the inferior pancreaticoduodenal artery are dissected first, at points where they enter the uncinate process. This approach is performed at the left side of the superior mesenteric artery (SMA) before isolating the pancreatic head from the right aspect of the SMA, which allows safe dissection without bleeding. Safe and reliable reconstruction is also important to prevent postoperative complications. Laparoscopic pancreatojejunostomy requires highly skilled suturing technique. Pancreatojejunostomy through a small abdominal incision, as in hybrid-LPD, facilitates reconstruction. In LPD, the surgical view is limited. Therefore, we must carefully verify the position of the pancreaticobiliary limb. A twisted mesentery may cause severe congestion of the pancreaticobiliary limb following reconstruction, resulting in severe complications. We must secure the appropriate position of the pancreaticobiliary limb before starting reconstruction. We describe the incidence of intraoperative and postoperative complications and appropriate technique for safe performance of LPD.

• Journal of Gastric Cancer
• /
• 제23권4호
• /
• pp.609-621
• /
• 2023

Purpose: Determination of optimal treatment strategies for HER2-positive advanced gastric cancer (AGC) in randomized trials is necessary despite difficulties in direct comparison between trastuzumab deruxtecan (T-DXd) and nivolumab as third or later-line treatments. Materials and Methods: This single-institution, retrospective study aimed to describe the real-world efficacy and safety of T-DXd and nivolumab as ≥ third line treatments for HER2-positive AGC between March 2016 and May 2022. Overall, 58 patients (median age, 64 years; 69% male) were eligible for the study (T-DXd group, n=20; nivolumab group, n=38). Results: Most patients exhibited a HER2 3+ status (72%) and presented metastatic disease at diagnosis (66%). The response rates of 41 patients with measurable lesions in the T-DXd and nivolumab groups were 50% and 15%, respectively. The T-DXd and nivolumab groups had a median progression-free survival of 4.8 months (95% confidence interval [CI], 3.3, 7.0) and 2.3 months (95% CI, 1.5, 3.5), median overall survival (OS) of 10.8 months (95% CI, 6.9, 23.8) and 11.7 months (95% CI, 7.6, 17.1), and grade 3 or greater adverse event rates of 50% and 2%, respectively. Overall, 64% patients received subsequent treatment. Among 23 patients who received both regimens, the T-DXd-nivolumab and nivolumab-T-DXd groups had a median OS of 14.0 months (95% CI, 5.0, not reached) and 19.3 months (95% CI, 9.5, 25.1), respectively. Conclusions: T-DXd and nivolumab showed distinct efficacy and toxicity profiles as ≥ third line treatments for HER2-positive AGC. Considering the distinct features of each regimen, they may help clinicians personalize optimal treatment approaches for these patients.

• 대한한방내과학회지
• /
• 제39권4호
• /
• pp.794-801
• /
• 2018

Objectives: These cases report the benefits of administration of Banhasasim-tang extracts or decoctions to patients with functional gastrointestinal disorders after motor vehicle accidents. Methods: The patients were treated with Banhasasim-tang extract or decoction three times daily. History-taking and imaging tests were used to differentiate other diseases. We evaluated the patients using the Gastrointestinal Symptom Rating Scale (GSRS), which is used to assess overall gastrointestinal symptoms. Results: Treatment with herbal medicine resulted in a decrease in the patients' complaints of symptoms. The GSRS scale showed improvement in all four cases. Conclusions: Banhasasim-tang, regardless of its form, has beneficial effects in patients with functional gastrointestinal disorders after motor vehicle accidents.