• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1162-1171
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• 2020

Objectives: The aim of this study was to determine the therapeutic effects of a traditional Korean treatment on the symptom improvement and loss of bile juice in cases of functional dyspepsia of gastric dysmotility complicated by bile juice reflux. Methods: Dyspeptic symptoms, gastric motility (electrogastrography and bowel sound analysis), and gastric mucosa (gastroendoscopy) were evaluated. The treatment consisted of Banwhasashim-tang (extract) used as a herbal drug. Both ST36 electrical stimulation and simple immersion stimulation of CV11, 12, and 13 in the abdomen were also applied. Results: Dyspeptic symptoms, including a foreign body sensation in the throat, indigestion, and upper abdominal pain, were all relieved by the treatment and gastric myoelectrical activity and gastric pyloric function were improved. Bile juice disappeared from the gastric mucosa. Conclusion: The traditional Korean treatment was effective at relieving dyspeptic symptoms and bile juice reflux by improving the pyloric sphincter function.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.17-20
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• 2010

Purpose: The hepatobiliary scan is the examination which is the possibility of knowing the function of liver, gall bladder and closing of the biliary tract. Also, after subtotal gastrectomy, the increased gastric-bile reflux is known as the primary reason of reflux gastritis. In this study, according to changing the acquisition method, we tried to prove the reflux time and reflux index in patients who underwent subtotal gastrectomy. Materials and Methods: From Oct 2008 to Jan 2009, 72 patients with subtotal gastrectomy who took the hepatobiliary scan (man: 52, woman: 20, age range: 31-77, mean age: $60.5{\pm}7$) in our department. We used the radiopharmaceutical $^{99m}Tc$-mebrofenin 185 MBq/0.5 cc. After 5 minutes, we acquired 300,000 counts anterior image on supine, and then we acquired right lateral and $45^{\circ}$ LAO position by using the time setting method. We acquired 30 min, 60 min, 90 min, 120 min and fatty meal by the same method. We painted the ROI of liver, GB and CBD on 30 min anterior image and LAO image in patients had occurred the bile juice reflux. And then we painted the ROI of stomach on others image. We calculated the reflux index from those values. Results: According to this study, we found out 40 patients (55.6%) who had occurred the gastric-bile juice reflux (1 person from 30 min, 7 persons from 60 min, 4 persons from 90 min, 28 persons from after fatty meal). Hourly, the bile reflux highest level is 6 persons from 60 min, 2 persons from 90 min, 32 persons from fatty meal among those people. The reflux index of anterior is 0.85-23.36% (mean 6.53%). The reflux index of LAO is 1-29.13% (mean 8.89%). By visual assessment, we can distinguish that there were 26 of the 40 patients (65%) had occurred the reflux on LAO image more than anterior image. Conclusion: We find out that the patients with subtotal gastrectomy had occurred gastric-bile juice reflux more than 50% from hepatobiliary scan. And after eating fatty meal, we can know that it's the most possible to occur the gastric-bile juice reflux. When it happened, we have to change the acquisition method to reduce the overlap between colon and stomach. This study will be more valuable in diagnosis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.113-117
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• 2007

Although the prevalence of laryngopharyngeal reflux (LPR) is presumed to be very high, basic researches on LPR have not been active so far. This is a review of present status and prospect of researches on LPR to help readers' understanding of current trend on LPR research. In vitro and in vivo researches on acid/pepsin, intercellular junctions, bile juice, carbonic anhydrase, cytokines, and Helicobacter pylori were discussed. Considering that quality of life is getting more important in accordance with longer life span and that a fair proportion of LPR patients do not respond to conventional therapy, researches on pathogenesis and pathophysiology of treatment measures are necessary and it is anticipated for more and more researchers to concern themselves in basic research on LPR in the future.

• Journal of Gastric Cancer
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• v.1 no.3
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• pp.144-149
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• 2001

Purpose: Gastric stump cancer is defined as a cancer that develops in the stomach after a resection in cases of non-malignant or malignant gastric disease. The interval between the gastrectomy and the detection of gastric stump cancer must be over 5 years. Since duodenogastric reflux gastritis is a precancerous condition and one of the most important factors inducing gastric stump cancer, we compared the bile-acid content of gastric juice between gastric stump cancer patients and controls. Materials and Methods: To evaluate retrospectively the surgical treatment of patients with gastric stump cancer, we reviewed the cases histories of 1016 stomach cancer patients who had been operated on at the Department of General Surgery, Kosin University Gospel Hospital, between 1995 and 1998. The gastric juice was collected during the operations on the gastric stump cancer patients by using a needle puncture of the fundus of the stomach and during the endoscopic examinations of the control subjects. The samples were analyzed for various bile acids (gas chromatography/mass spectrometry). Results: The 6 gastric stump cancer cases accounted for $0.6\%$ of all gastric cancer patients; 5 patients were first operated on for a peptic ulcer and the remaining one for an adenocarcinoma of the stomach. All of the cases were men. The reconstruction method after the initial gastrectomy was a Billroth II in all cases. The sites of the gastric stump cancer were the anastomotic sitein 2 patients, the upper body in 2, the fundus in 1 and the cardia in 1. The operative methods were 3 total gastrectomies, 2 subtotal gastrectomies with Roux en Y anastomosis, and 1 partial gastrectomy with lymph node dissection and had a curative intention in all patients. All of the patients were still surviving at the time of this report. The gastric juices of 4 gastric stump patients showed significantly higher contents of cholic acid ($36.42{\mu}g/ml$) compared to the gastric juices of 35 control subjects ($36.42{\mu}g/ml$)(p$\leq0.0001$). Chenodeoxycholic acid and lithocholic acid were not significantly different. Conclusion: The gastric juice of gastric stump cancer patients contained a significantly higher cholic acid content. At the time of the initial gastrectomy, an operative method that prevents duodenogastric reflux may prevent or minimize the development of gastric stump cancer, and more aggressive surgical treatment may improve survival.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.100-109
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• 1998

The anomalous pancreaticobiliary duct union (APBDU) might cause the formation of choledochal cyst and malignancies of hepatopancreaticobiliary system. The purpose of this study is to make an experimental animal model of APBDU similar to that of human. One to two-month-old Mongrel dogs (n=12) were divided into two groups; the control group (n=2) had a sham operation performed, and in the experimental group (n=10) the end of distal ' common bile duct (CBD) was anastomosed to the side of the dorsal pancreatic duct making APBDD. Serum was obtained for chemical analysis on the 10th postoperative day. The dogs were sacrificed at the 5th week (n=3), the 6th week (n=3), the 7th week (n=2), the 8th week (n=2) and the 6th month (n=2) after the experimental surgery. With sacrifice, operative cholangiogram was taken, and bile juice was obtained for chemistry and bacterial culture. The en-bloc specimens of the hepatopancreaticobiliary system were removed for microscopic examination. Serum and bile juice amylase levels were elevated in the experimental group(n=10), but not in the control group(n=2). Operative cholangiograms of control group revealed no evidence of bile duct dilatation.. On the other hand, the bile duct in the experimental group was markedly dilated without any evidence of stenosis at the anastomosis site (n=10). Histologic examination of the hepatopancreaticobiliary system in the experimental group resembled the findings of choledochal cyst in human. The APBDU of this animal model can produce bile duct dilatation by pancreaticobiliary reflux. We think that this animal model can be potentially promising for the research about the APBDU associated hepatopancreaticobiliary diseases.