• Clinical Endoscopy
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• v.56 no.6
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• pp.754-760
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• 2023

Background/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas. Methods: This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data. Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days. Conclusions: EVT is a safe and effective initial management option for esophageal leaks and perforations.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2361-2367
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• 2016

Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past. With the growing spectrum of indications, tissue sampling for diagnostic purposes has become common. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in staging of upper gastrointestinal malignancies, especially esophageal, gastric and ampullary tumors.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup2
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• pp.29-34
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• 2008

Upper gastrointestinal bleeding (UGIB) is defined as bleeding in the gastrointestinal tract where the source of bleeding is proximal to the ligament of Treitz. UGIB is uncommon, but a potentially serious lifethreatening problem in children. The clinical manifestation of UGIB in children ranges from asymptomatic microcytic anemia to hypovolemic shock. As the etiology of UGIB varies with age, it is important to be aware of the specific etiologies at different ages when assessing children with UGIB. It is imperative that each child with UGIB be evaluated carefully, including an assessment of the patient's cardiorespiratory status along with other diagnostic studies for determining the underlying cause of bleeding.

• Clinical Endoscopy
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• v.57 no.1
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• pp.73-81
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• 2024

Background/Aims: Upper gastrointestinal bleeding (UGIB) is a life-threatening condition that necessitates early identification and intervention and is associated with substantial morbidity, mortality, and socioeconomic burden. However, several diagnostic challenges remain regarding risk stratification and the optimal timing of endoscopy. The PillSense System is a noninvasive device developed to detect blood in patients with UGIB in real time. This study aimed to assess the safety and performance characteristics of PillSense using a simulated bleeding model. Methods: A preclinical study was performed using an in vivo porcine model (14 animals). Fourteen PillSense capsules were endoscopically placed in the stomach and blood was injected into the stomach to simulate bleeding. The safety and sensitivity of blood detection and pill excretion were also investigated. Results: All the sensors successfully detected the presence or absence of blood. The minimum threshold was 9% blood concentration, with additional detection of increasing concentrations of up to 22.5% blood. All the sensors passed naturally through the gastrointestinal tract. Conclusions: This study demonstrated the ability of the PillSense System sensor to detect UGIB across a wide range of blood concentrations. This ingestible device detects UGIB in real time and has the potential to be an effective tool to supplement the current standard of care. These favorable results will be further investigated in future clinical studies.

• Asian-Australasian Journal of Animal Sciences
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• v.15 no.10
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• pp.1482-1488
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• 2002

The aim of this study was to explore the effects of fiber sources on gut development and bacterial activity in the gastrointestinal tract of piglets. Eighteen crossbred (Duroc${\times}$Landrace${\times}$Yorkshire) barrows were fed a basal diet based on corn plus soybean meal or similar diets in which a portion of the corn and soybean was replaced by 5% wheat bran or 5% sugar beet pulp. The results indicate that pigs fed diets containing 5% wheat bran or 5% sugar beet pulp had lower liver weights than control pigs (p<0.01). The relative weight of the pancreas in pigs fed diets containing 5% sugar beet pulp was greater than that of control pigs or pigs fed diets containing 5% wheat bran (p<0.05). The pH of the ileal digesta of pigs fed the diet containing 5% wheat bran was higher than that of control pigs or pigs fed the diet containing 5% sugar beet pulp (p<0.05). The lipase activity in the distal jejunum, proximal, and distal ileum of pigs fed the control diet was higher than that of pigs fed the diets containing 5% wheat bran or 5% sugar beet pulp (p<0.05). The concentration of volatile fatty acids anterior to the caecum was greater for the pigs fed the diet containing 5% sugar beet pulp, while the concentration of volatile fatty acids posterior to the ileum was greater for the pigs fed the diet containing 5% wheat bran. This means that sugar beet pulp increased the bacterial fermentation precaecum, while wheat bran increased the bacterial fermentation post-ileum. The concentration of bacterial nitrogen and bacterial protein/total protein in ileal digesta of pigs fed the control diet was higher (p<0.05) than that of pigs fed the diets contained either fiber source. Bacterial protein/total protein in the feces of pigs fed the diet containing 5% sugar beet pulp was higher than that of pigs fed the control diet. This means that inclusion of 5% wheat bran or sugar beet pulp in diets influenced the development of the digestive tract of piglet. The mechanism by which dietary fiber reduced specific activity of lipase needs further consideration. Dietary fiber influenced the bacterial activity in the digestive tract of piglets, sugar beet pulp increased the fermentation in the upper gastrointestinal tract, and while wheat bran increased the fermentation in the lower gastrointestinal tract.

• The Journal of Pediatrics of Korean Medicine
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• v.30 no.3
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• pp.42-51
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• 2016

Objectives The purpose of this study is to report a case of iron deficiency anemia in a child with repetitive bleeding in the upper gastrointestinal tract caused by Helicobacter pylori infection, and summarize review of a western literature. Methods A 13-year-old patient, who were suffering from iron deficiency anemia from repetitive bleeding in the upper gastrointestinal tract, was administered by Ikwiseungyang-tang gamibang (益胃升陽湯加味方) and Samchulgeonbitang (蔘出健脾湯). After several tests, we realized that an iron deficiency anemia was related to Helicobacter pylori. Results By herb medication, the patient's symptoms were alleviated. Conclusions Helicobacter pylori infection is one of the reasons of refractory iron-deficiency anemia which is unresponsiveness to oral iron therapy. We report the findings of herb medication along with summarization of a western literature.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.23
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• pp.10267-10272
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• 2015

To evaluate the value of combined detection of serum CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS for the clinical diagnosis of upper gastrointestinal tract (GIT) cancer and to analyze the efficacy of these tumor markers (TMs) in evaluating curative effects and prognosis. A total of 573 patients with upper GIT cancer between January 2004 and December 2007 were enrolled in this study. Serum levels of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were examined preoperatively and every 3 months postoperatively by ELISA. The sensitivity of CEA, CA19-9, CA24-2, AFP, CA72-4, SCC, TPA and TPS were 26.8%, 36.2%, 42.9%, 2.84%, 25.4%, 34.6%, 34.2% and 30.9%, respectively. The combined detection of CEA+CA199+CA242+CA724 had higher sensitivity and specificity in gastric cancer (GC) and cardiac cancer, while CEA+CA199+CA242+SCC was the best combination of diagnosis for esophageal cancer (EC). Elevation of preoperative CEA, CA19-9 and CA24-2, SCC and CA72-4 was significantly associated with pathological types (p<0.05) and TNM staging (p<0.05). Correlation analysis showed that CA24-2 was significantly correlated with CA19-9 (r=0.810, p<0.001). The levels of CEA, CA19-9, CA24-2, CA72-4 and SCC decreased obviously 3 months after operations. When metastasis and recurrence occurred, the levels of TMs significantly increased. On multivariate analysis, high preoperative CA72-4, CA24-2 and SCC served as prognostic factors for cardiac carcinoma, GC and EC, respectively. combined detection of CEA+CA199+CA242+SCC proved to be the most economic and practical strategy in diagnosis of EC; CEA+CA199+CA242+CA724 proved to be a better evaluation indicator for cardiac cancer and GC. CEA and CA19-9, CA24-2, CA72-4 and SCC, examined postoperatively during follow-up, were useful to find early tumor recurrence and metastasis, and evaluate prognosis. AFP, TPA and TPS have no significant value in diagnosis of patients with upper GIT cancer.

• Journal of the Korean Society of Food Science and Nutrition
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• v.21 no.6
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• pp.627-632
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• 1992

The effect of dietary pectin in the upper gastrointestinal transit rate was studied. Rats fed fiber-free diet or 10% pectin diet were offered 51-$CrCl_3,$ a transit marker. The movement of 51-Cr dose through the gastrointestinal tract was measured at intervals from 20 minutes to 6 hours after dosing. pectin significantly increased gastric emptying rate upto 3 hours after dosing. Pectin also increased small intestinal transit rate from 3 hours to 4 hours after dosing. The results suggest that delayed gastric emptying is not likely the important aspect of the mechanism by which pectin could flatten the post-prandial response of serum glucose and insulin.

• Asian-Australasian Journal of Animal Sciences
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• v.22 no.7
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• pp.1026-1031
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• 2009

An experiment was conducted to study the effect of graded levels of butyric acid (butyrate) on performance, gastrointestinal tract health and carcass characteristics in young broiler chickens. Control starter (0-3 wk) and finisher (4-5 wk) diets were formulated to contain 2,900 kcal ME/kg and 22% CP, and 3,000 kcal ME/kg and 20% CP, respectively. Subsequently, four other experimental diets were formulated to contain 0.05% antibiotic (furazolidone) or 0.2, 0.4 and 0.6% butyric acid. Each diet was fed at random to 8 replicates of 6 chicks each throughout the experimental period (0-5 wk). The results showed that 0.4% butyrate in the diet was similar to antibiotic in maintaining body weight gain and reducing E. coli numbers but superior for feed conversion ratio. No added advantage on these parameters was obtained by enhancing the concentration of butyrate from 0.4 to 0.6% in the diet. Feed intake and mortality were not influenced by the dietary treatments. A reduction in pH of the upper GI tract (crop, proventiculus and gizzard) was observed by inclusion of butyrate in the diets of broilers compared to either control or antibiotic-fed group. Butyrate at 0.4% was more effective in reducing the pH than 0.2% butyrate. Within the lower GI tract, 0.4 and 0.6% butyrate was effective in lowering pH in the duodenum, but no effect was found in either the jejunum or ileum. The villus length and crypt depth in the duodenum increased significantly in all the butyrate treated diets irrespective of the level tested. Carcass yield was higher and abdominal fat content was lower significantly in all the butyrate treatment groups compared to the control or antibiotic group. From these findings, it is concluded that 0.4% butyric acid supplementation maintained performance, intestinal tract health, and villi development and carcass quality in broiler chickens.

• Journal of Pharmaceutical Investigation
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• v.31 no.1
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• pp.27-35
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• 2001

To evaluate the site-specific permeation of aspalatone (acetylsalicylic acid maltol ester, AM) through gastrointestinal tract, the enzymatic degradation and permeation studies were carried out using gastric, duodenal and jejunal mucosae of rabbits. It was found that $15.2{\pm}11.4%$, $11.6{\pm}5.2$ and $0.8{\pm}0.6%$ of the donor dose of AM, salicylmaltol (SM) and aspirin (ASA) permeated through the upper gastric mucosa after 8 hr of permeation, respectively. After 8 hr of AM permeation, SM and ASA were measured to be $15.0{\pm}1.7$ and $2.6{\pm}0.8%$ of the dose in the donor solutions, respectively, and salicylic acid (SA) was not detected even after 6 hr, suggesting a very low gastric damage. For the gastric mucosa, the increase of donor dose from 100 to $1,000\;{\mu}g/ml$ increased the permeation flux dose-dependently (r=0.9905). For the duodenal and jejunal mucosae, however, AM was fully degraded into SM and SA due to the esterase activities within 30 min. AM and ASA were not detected in the receptor solution. This result indicates that AM is not a prodrug of ASA. Addition of potassium fluoride (0.5%) into the donor solution delayed the degradation of AM, but did not allow the permeation through duodenal mucosa even by the inhibition of esterase activity. The addition of $dimethyl-{\beta}-cyclodextrin$ and $2-hydroxypropyl-{\beta}-cyclodextrin$ (5%) into the donor solutions also did not show favorable effects on the permeation of AM through various mucosae. In comparison of permeation rates of AM and ASA through the upper gastric mucosa, the flux of ASA was 4.2 times faster than AM based on the molar concentration. ASA also was fully degraded in the donor solutions faced with duodenal and jejunal mucosae within 2 hr, and was not detected in the receptor solution, suggesting a slower metabolism compared with AM.