The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.
In order to study the regional distribution and relative frequency of the immunoreactive endocrine cells in the gastrointestinal tract of the Mongolian gerbil, Meriones unguiculatus, the gastrointestinal tract was divided into 9 portions (cardia, fundus, pylorus, duodenum, jejunum, ileum, cecum, colon and rectum) and immunostained by immunohistochemical (PAP) method using 8 types of specific antisera against cholecystokinin (CCK)-8, gastrin, secretin, pancreatic polypeptide(PP), somatostatin, serotonin, glucagon and insulin. CCK-8-, gastrin-, somatostatin- and serotonin-immunoreactive cells were demonstrated in this study. These immunoreactive cells were found in the gastric gland regions of the pylorus or between parietal and chief cells of the fundus with round to spherical shaped, and in the interepithelial regions of the intestinal tract with spherical to spindle shaped except for jejunum where some of immunoreactive cells were also observed in the intestinal glands with round to spherical shaped. CCK-8-immunoreactive cells were restricted to the pylorus and duodenum with numerous and a few frequency, respectively. Gastrin-immunoreactive cells were restricted to the pylorus with numerous frequency. Similar to those of gastrin-immunoreactive cells, somatostatin-immunoreactive cells were restricted to pylorus with moderate frequency. Serotonin-immunoreactive cells were detected throughout whole gastrointestinal tract except for cardia and cecum with moderate or numerous frequency. However, no secretin-, PP-, glucagon- and insulin-immunoreactive cells were observed in this study. From these results, the appearance type, regional distribution and relative frequency of immunoreactive endocrine cells in the gastrointestinal tract of the Mongolian gerbils were somewhat lowered or restricted compared to those of other mammals and these differences were might be caused by feeding habits and species specification.
The effects of noradrenaline on the contractile and electrical activities were investigated using the circular muscle strips with intact mucosa prepared from the antrum and fundus of guinea-pig stomach. Electrical responses of circular muscle cells were recorded using glass capillary microelectrodes filled with 3 M KCI. All experiments were performed in tris-buffered Tyrode solution which was aerated with 100% $O_2\;and\;kept\;at\;35^{\circ}C$. The results obtained were as follows: 1) The spontaneous contractions recorded from the antral and fundic circular muscle strips with intact mucosa were suppressed dose-dependently by the application of noradrenaline, whereas those recorded from the mucosa-free strips were potentiated in a dose-dependent manner. 2) The inhibitory influences on the contractile activities in the normal intact strips were developed via both ${\alpha}-adrenoceptors\;and\;{\beta}-adrenoceptors$, while the excitatory influences in the mucosa-free strips resulted from the strong excitatory effect via ${\alpha}-adrenoceptors$ and the weak inhibitory effect via ${\beta}-adrenoceptors$. 3) Noradrenaline produced hyperpolarization of membrane potential, and increased the amplitude and the maximum rate of rise of slow waves in the mucosa-free strips of antral and fundic circular muscle. 4) Apamin blocked the appearance of the component of initial suppression of spontaneous phasic contractions observed in the mucosa-free strips of antral circular muscle after the application of noradrenaline. 5) The inhibitory influences on the contractile activities in the normal strips with intact mucosa remained unaffected even in the strip with separate mucosa, in which mucosa and muscle layer were mechanically disconnected . From the above results, following conclusions could be made. (1) There are no regional differences between the effects of noradrenaline on the antral circular muscle and those on the fundic circular muscle. (2) Excitatory responses to noradrenaline observed in the mucosa-free strip result from the dominant ${\alpha}-excitatory$ and tile weak ${\beta}-inhibitory$ action of noradrenaline. (3) Inhibitory responses to noradrenaline in the normal strips with intact mucosa develop via both ${\alpha}-inhibitory\;and\;{\beta}-inhibitory$ actions.
Kim, Jin-Seong;Ryu, Bong-Ha;Park, Dong-Won;Ryu, Ki-Won;Yoon, Joo-Ho
The Journal of Internal Korean Medicine
/
v.22
no.1
/
pp.29-38
/
2001
When I evaluated the component variation of Naesowhajung-tang by the three types of extraction method, and each type's effects on the gastrointestinal tract, I got the following results. 1. The output ratio of extracts made out of Naesowhajung-tang were not significantly different among 13.8% of water extract(Sample-I), 13.5% of 50% ethanol extract(Sample-II), and 15.6% of water extract by spray dryer(Sample-III). 2. magnolol, honokiol, hesperidin, naringin, poncirin and glycyrrhizin Sample II had the largest amount of the following contents: magnolol, honokiol, hesperidin, naringin, poncirin and glycyrrhizin. 3. All the extracts of Naesowhajung-tang showed the inhibitory effect on the smooth muscle contraction of the isolated ileum in mice and fundus-strip in rats induced by acetylcholine chloride and barium chloride. 4. High concentration Sample-II was recognized to be effective in preventing gastric ulcers in Shay's rats. but not in the other rat group. 5. All the extracts of Naesowhajung-tang were recognized to be effective in preventing gastric ulcers induced by Ethanol-HCl in rats. 6. The increase of transport ability in the small intestine was recognized only when the concentration of all the samples was doubled, but not in the other concentrations. 7. The increase of transport ability in the large intestine was recognized only when the concentration of Sample-II was doubled, but not in other concentration. Using the results mentioned above, I suggest that Sample-II has more significant effects on the gastrointestinal tract than the others.
Park, Juno;Kwon, Taek-Hyun;Park, Youn-Kwan;Chung, Hung-Seob;Lee, Hoon-Kap;Suh, Jung-Keun
Journal of Korean Neurosurgical Society
/
v.30
no.5
/
pp.592-599
/
2001
Objective : The anterior communicating artery(ACoA) is known to be the most frequent location of intracranial aneurysms, but the complex arterial anatomy of the ACoA region makes this aneurysm among the most difficult one to treat. In the treatment of ACoA aneurysms, the direction of aneurysmal fundus is known to be very important in the surgical tactics. All ACoA aneurysms in our series were classified according to its direction, and analyzed the clinical features in order to investigate the prognostic factors influencing upon the surgical outcome. Methods : The authors reviewed 236 cases of ruptured ACoA aneurysms that were operated from 1990 to 1997, were classified according to Pia's classification. Results : The incidence rate of the ACoA aneurysm was 35.1%(236/672). Ventral group was more common than dorsal group, especially in ventro-caudal projection subgroup(36.0%). Poor preoperative clinical grade(Hunt-Hess grade IV and V) patients were more common in dorsal group(13.1%) than ventral group(2.6%). Rebleeding and intracerebral hematoma were more commonly seen in ventral group. However, vasospasm, hydrocephalus, hyponatremia, and intraventricular hemorrhage were observed more frequently in dorsal group. Worse outcome was more common in dorsal group than ventral group, especially in dorso-caudal projection subgroup. Also, poor outcome was identified in patients with intracerebral hematoma, intraventricular hemorrhage, hyponatremia, and hypertension, although statistically insignificant. In cases with the A1 dominancy, there was no difference in surgical outcome between the right and left side approach. The higher the aneurysmal neck from the planum sphenoidale, the worse outcome via pterional approach. Conclusion : It seems that the preoperative clinical grade, aneurysmal direction, and the height of aneurysmal neck, especially in the pterional approach, would be the major prognostic factors, and that intracerebral hematoma, intraventricular hemorrhage, hyponatremia, hydrocephalus and the intraoperative aneurysmal rupture would be the minor prognostic factors.
Kim, Heui-Jeen;Ko, Kwang-Wook;So, In-Suk;Kim, Ki-Whan
The Korean Journal of Physiology
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v.21
no.2
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pp.225-239
/
1987
The effects of adenosine on the mechanical contractions and electrical activities were investigated in guinea-pig stomach. Spontaneous contractions of the antral region were recorded with force transducer, and the phasic contractions of fundic region were induced by electrical field stimulation. Electrical responses of smocth muscle cells were recored using glass capillary microelectrodes filled with 3M-KCl. Field stimulation was applied transmurally by using a pair of platinum wire (0.5 mm in diameter) placed on both sides of tissue. All experiments were performed in tris-buffered Tyrode solution which was aerated with 100% $O_2$ and kept at $35^{\circ}C$. The results obtained were as follows. 1) Adenosine suppressed the spontaneous contractions of antrum in a dose-dependent manner. 2) The inhibitory effect on antral spontaneous contractions was not influenced by the administration of guanethidine $(5{\times}10^{-6}\;M)$ and atropine $10^{-6}\;M$, or in the presence of dipyridamole $10^{-7}\;M$. 3) The phasic contractions of fundus induced by electrical field stimulation, which disappeared rapidly by the addition of tetrodotoxin $(3{\times}10^{-7}\;M)$, were potentiated by adenosine in the presence of guanethidine. 4) Adenosine decreased the amplitude and the maximum rate of rise of slow waves, and the increased amplitude and rate of rise evoked in the high calcium solution or in the presence of TEA were decreased by adenosine. 5) The non-adrenergic, non-cholinergic inhibitory junction potential (IJP) was inhibited by adenosine in the antral region, while the excitatory junction potential (EJP) in the fundic region was potentiated. From the above results, the following conclusions could be made. 1) Adenosine suppresses the spontaneous contractions of antrum strip by the decrease in amplitude and rate of rise of slow waves. 2) The release of neurotransmitter(s) from non-adrenergic, non-cholinergic nerve terminals is inhibited by adenosine.
Purpose: The aim of this study was to analyze the clinical and the histopathological characteristics of mucosa associated lymphoid tissue (MALT) lymphomas in the stomach. Materials and Methods: We retrospectively reviewed the medical records of 22 patients who had been treated at Samsung Medical Center from Jan. 1995 to Sep. 2000 and who had been pathologically proven to have a MALT lymphoma. The factors we analyzed were operative procedure, tumor stage, and histopathological characteristics. Results: Of 3658 patients with a gastric malignancy, 22 patients proved to have a MALT lymphoma ($0.6\%$). There were 7 men and 15 women whose ages ranged from 25 years to 70 years (mean, 48.8 years). Forteen cases were located in the antrum, 4 ($18\%$) in the body and 4 ($18\%$) in the fundus or the high body. Nineteen of these patients were managed with total gastrectomy and splenectomy and 3 with radical subtotal gastrectomy. Histopathologically the tumor was limited to the mucosa in 3 patients ($1.36\%$), to the submucosa in 13 ($59.1\%$) and extended to the muscularis propria in 6 ($27.3\%$). Lymph node involvement was seen in 12 patients ($54.6\%$). There was no splenic or hepatic involvement. Bone marrow involvement was not seen in any patients. H. pylori was identified in 11 patients (50$\%$). During the mean follow-up period of 32.7 months, there were no reports of tumor recurrence or death. Conclusion: MALT lymphomas rarely disseminate by the time of diagnosis and rarely involve the bone marrow. Lymph node involvement is relatively high and a total gastrectomy is effective in managing patients with a MALT lymphoma.
Objectives : This is the experimetal paper to evaluate and compare the effects of Bosimgunbitang(補心健脾湯) with those of Jungjungamiyijintang(正傳加味二陳湯) on contraction of isolated organs, anti-ulcer, secretion of gastric juice, secretion of gastrin in serum, transport ability of intestine, analgesic effect and sedative effect Methods : We used mice and rats administered with the extract of the above herbs. Results: Bosimgunbitang and jungjungamiijintang showed the inhibitory effect on the smooth muscle contraction of the isolated ileum induced by acethylcholine chloride and barium chloride in mice. transport ability of intestine. Bosimgunbitang and jungjungamiijintang showed the inhibitory effect on the contraction of the fundus-strip induced by acethylcholine chloride and barium chloride in rats. The preventive effect on pyloric ulcer, indomethacin induced ulcer and ethanol-HCl induced ulcer bf mice was significant. The inhibitory effect of Bosimgunbitang on gastric free acidity, total acidity in Shay rats was significant. The inhibitory effect of on gastrin secretion in serum was significant after only 1 hour when the Bosimgunbitang and jungjungamiijintang was administered. The promoting effect of the jungjungamiijintang on the transport ability of small intestine was significant in the high concentration. The promoting effect of the Bosimgunbitang and jungjungamiijintang on the transport ability of large intestine was significant. The analgesic and the sedative effect were recognized. It meaned that Bosimgunbitang and jungjungamiijintang effected on the C.N.S.. Conclusion : Bosimgunbitang and jungjungamiijintang have the inhibitory effect on the smooth muscle abnormal contraction of the isolated ileum and the anti-ulcer effect to prevent, secretion of gastric juice and gastrin in serum. And they also have to increase a transport ability of intestine, analgesic effect and sedative effect. Jungjungamiijintang especially is eminent for analgesic effect while Bosimgunbitang has excellent sedative effect.
Gastric carcinoid tumor is a neoplasm that arises from enterochromaffine-like (ECL) cells in the gastric fundus. It is a rare disease that comprises less than 2% of all gastric neoplasms; however its incidence has been recently increasing. We experienced one case of gastric carcinoid tumor that was revealed to be multiple polypoid lesions. A 29-year-old female patient visited a hospital three years ago due to syncope. The blood hemoglobin was measured as 6.0 g/dl. Gastroscopy revealed multiple polypoid lesions with bleeding; therefore endoscopic clipping was performed. The polyps were diagnosed as carcinoid tumor via endoscopic biopsy. She was transferred to our hospital because of persistent iron deficiency anemia that was caused by bleeding at the gastric polyps. Gastroscopy revealed more than twenty various-sized polypoid lesions from the mid-body to the antrum. The blood hemoglobin level was 9.0g/dl. Total gastrectomy was performed under the diagnosis of gastric carcinoid tumor with bleeding. All of the gastric polyps were diagnosed as carcinoid tumors, and any metastasis to the regional lymph nodes was not found. Eighteen months after operation, the blood hemoglobin was increased to 12.8g/dl with no evidence of recurrence. Surgical resection should be considered for treating gastric carcinoid tumor with continuous bleeding.
Journal of the Korea Academia-Industrial cooperation Society
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v.21
no.4
/
pp.226-235
/
2020
This study was undertaken to investigate factors that affect the assessment of complications in diabetic eye and kidney diseases. Data was obtained from the National Community Health Survey, 2017. The subjects included were 25,829 respondents who had been diagnosed with diabetes. Logistic regression analysis was applied to determine the factors affecting associated diabetic eye disease (fundus examination) and kidney disease (microalbuminuria examination) complications. The diabetic eye disease complication rate was 35.6%, and diabetic kidney disease complication rate was 39.8%. Complications arising due to diabetes were determined to be 35.6% for eye diseases and 39.8% for kidney related diseases. Ed. Notes: The original sentence is not very lucid. I have suggested an alternate edit. I leave it to the author's discretion to accept or reject the same. Please delete whichever sentence is not suitable. Walking activity (OR=1.03, OR=1.02), hemoglobin A1c (HbA1c) recognition (OR=2.33, OR=2.33), blood glucose level recognition (OR=1.61, OR=1.71), diabetes drug therapy (OR=2.67, OR=3.05), and diabetic management education (OR=1.45, OR=1.47) were more likely to be evaluated for eye and kidney disease complications. Our results indicate that to increase the rate of screening for diabetic complications, it is necessary to develop a diabetes management system that includes the type and timing of diabetic complications, as well as different promotional methods that recognize HbA1C and blood glucose levels. Ed. Notes: Do you mean 'screening' methods? Please revise appropriately, if required. In addition, it is essential to develop a guideline for the management of diabetes mellitus, and to incorporate a screening test for diabetic complications in the national screening system.
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