• Clinical Endoscopy
• /
• v.57 no.2
• /
• pp.209-216
• /
• 2024

Background/Aims: Endoscopic ultrasonography-guided gastrojejunostomy is a minimally invasive method for the management of gastric outlet obstruction. Conventionally, a lumen-apposing metal stent (LAMS) is used to create an anastomosis. However, LAMS is expensive and not widely available. In this report, we described a tubular fully covered self-expandable metallic stent (T-FCSEMS) for this purpose. Methods: Twenty-one patients (15 men [71.4%]; median age, 66 years; range, 40-87 years) were included in this study. A total of 19 malignant (12 pancreatic, 6 gastric, and 1 metastatic rectal cancer) and 2 benign cases were observed. The proximal jejunum was punctured with a 19 G needle. The stomach and jejunum walls were dilated with a 6 F cystotome, and a 20×80 mm polytetrafluoroethylene T-FCSEMS (Hilzo) was deployed. Oral feeding was initiated after 12 to 18 hours and solid foods after 48 hours. Results: The median procedure time was 33 minutes (range, 23-55 minutes). After two weeks, 19 patients tolerated oral feeding. In patients with malignancy, the median survival time was 118 days (range, 41-194 days). No serious complications or deaths occurred. All patients with malignancy tolerated oral food intake until they expired. Conclusions: T-FCSEMS is safe and effective. This stent should be considered as an alternative to LAMS for gastric outlet obstruction.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.16 no.2
• /
• pp.127-130
• /
• 2013

Rapunzel syndrome refers to a very rare condition in which swallowed hair forms a gastric trichobezoar that has a long tail extending into the small bowel. We describe a case of Rapunzel syndrome in an 8-year-old girl who presented with abdominal mass, epigastric pain and vomiting. Abdominal computed tomography scan showed a markedly dilated stomach filled with coarse heterogeneous materials. Upper gastrointestinal endoscopy revealed a huge hairy ball with a tail extending through the pylorus. We performed a surgical laparotomy and successfully removed a huge trichobezoar with a long tail extending into the middle portion of jejunum. Psychiatric consultation with review showed her past history of trichotillomania and trichophagia 4 years ago. But her parents denied further psychiatric therapy and she was lost to the follow-up. Rapunzel syndrome should be included in the differential diagnosis in children with chronic abdominal pain and trichophagia.

• Journal of Pharmaceutical Investigation
• /
• v.24 no.3
• /
• pp.19-25
• /
• 1994

The single-pass perfusion technique was employed in order to investigate the effect of water flux from the rat jejunum in the normal experimental conditions. Our results suggested that water flux below ${\pm}0.75%/cm$ of jejunal length was considered normal. Water flux was $-0.131\;{\pm}\;0.311%/cm$ of jejunal length in a citrate buffer and should be corrected in order to determine the permeabilities of the compounds. Perfusion rate up to 0.5 ml/min had no effects on the permeability of ampicillin. Neither the effective permeabilities nor the wall permeabilities of aminopenicillins were influenced by water flux during experiments in rats.

• Journal of Korean Neurosurgical Society
• /
• v.47 no.3
• /
• pp.224-227
• /
• 2010

Small bowel injury resulting from unforeseen penetration of the anterior annulus fibrosus and longitudinal ligament is a rare complication of lumbar microdiscectomy. The patient complained of abdominal tenderness and distention immediately after microdiscectomy for L4-5 and L5-S1 disc herniation. Using abdominal computed tomography, we found several foci of air overlying the anterior aspect of the vertebral body at the L5-S1 level. Segmental resection of the small bowel including small tears and primary anastomosis of the jejunum were performed. Here, we present a case of intestinal perforation after lumbar microdiscectomy and discuss technical methods to prevent this complication with a review of literature.

• Advances in pediatric surgery
• /
• v.5 no.2
• /
• pp.141-145
• /
• 1999

Idiopathic small bowel ulceration distal to the duodenum is rare. Less than 5 % of the reported cases were in children. In the majority of the patients, a single ulcer of unknown cause is found in the jejunum or ileum. The diagnosis is difficult and usually made at the time of surgical exploration for complications, such as perforation, hemorrhage or obstruction. We treated a pediatric patient with perforation of an idiopathic ileal ulceration. The child was an 11-year-old boy who sustained blunt abdominal trauma. The involved ileal segment was resected. Pathologic findings were compatible with idiopathic small bowel ulceration. The clinical and pathological aspects of idiopathic ulcerations are discussed, and the literature reviewed.

• The Journal of Internal Korean Medicine
• /
• v.19 no.2
• /
• pp.125-138
• /
• 1998

To evaluate the radioprotective effects of Bujeongsaengjintang studies were done experimentally. The results were obtained as follows: 1. WBC, Platelet and RBC were significantly increased in Bujeongsaengjintang treated group as compared with control group after exposure to radiation by Liniac. 2. By FACS analysis of splenic leukocyte after exposure to radiation by Liniac, T cell, T-helper cell and macrophase were significantly increased in Bujeongsaengjintang treated group. 3. In histological changes of ileum and jejunum of Balb/C mice after exposure to radiation by Liniac, exclusion and fusion of villi were decreased in Bujeongsaengjintang treated group as compared with control group. From above results, it is suggested that Bujeongsaengjintang is available to a clinic for the protection from damage by radiotherapy to cancer.

• Proceedings of the Ginseng society Conference
• /
• 1993.09a
• /
• pp.110-112
• /
• 1993

Acidic polysaccharide from Korean red ginseng was found to inhibit pancreatic lipase activity and cause reduction of plasma triglyceride level after oral administration of corn oil emulsion to rats. Thus acidic polysaccharide may reduce plasma triglyceride through its inhibitory action on pancreatic lipase and successive inhibition of intestinal absorption of fat due to reduction of lipolysis. In the course of this experiment, we found an unknown ninhydrin positive substance in Korean red ginseng. The unknown substance was identified to be arginyl-fructosyl glucose(Arg - Fru - Glc). Coment of this new compound was $5.37\%$ in Korean red ginseng powder. Sucrase and maltase activities in mucous layer of rat jejunum were found to be inhibited by Arg-Fru-Glc. Physiological significance of the new compound was discussed based on these experimental results.

• Journal of Ginseng Research
• /
• v.22 no.3
• /
• pp.200-205
• /
• 1998

Isolated rabbit jejunal segments were used to study the effects of ginseng total saponins (GTS) , protopanaxatriol saponins (PT) and protopanaxadiol saponins (PD) on intestinal contractility. GTS, PT and PD caused a dose-dependent decrease in intestinal spontaneous movements, and PT was the most efficacious of them. The effect of GTS, PT and PD were not blocked by pretreatment with phentolamine (10-6 M), yohimbine (10-6 M), d1-propranolol (10-6 M), naloxone(10-6∼10-5M), Nu-nitro-L-arginine methyl ester (10-4 M), methylene blue (10-5M), and N-ethylmaleimide (10-4 M). However, pretreatment with tetraethylammonium chloride (3-10 mM) antagonized the effect of GTS, PT and PD. Furthermore, 4-amlnopyridine (1 mM) also inhibited the effect of GTS, PT and PD. The results suggest that GTS, PT and PD inhibited the spontaneous movements in isolated rebait jejunum by causing hyperpolarization through an activation of K+ channels directly.

• Archives of Plastic Surgery
• /
• v.33 no.2
• /
• pp.245-248
• /
• 2006

Besides gastric pull-up or colonic interposition, microvascular technique in esophageal reconstruction has been approved reliable methods. When free intestinal transfer is considered, jejunal free flap is commonly used. We treated the patient who had undergone reconstruction with a right colon interposition and suffered from inability of swallowing because of stricture and necrosis of the interposed flap. Although we have planned jejunal free transfer, we couldn't use jejunum due to adhesion by previous gastrojejunostomy and colon interposition. Salvage procedure with microvascualr free left colon flap was executed successfully. After 9 month follow-up, the patient was able to consume a normal diet.

• Proceedings of the Korean Society of Applied Pharmacology
• /
• 1995.10a
• /
• pp.157-160
• /
• 1995

라니티딘은 최근 위궤양 및 십이지장 궤양의 치료에 통상적으로 많이 처방되는 히스타민 H$_2$ receptor antagonist로 작용하는 약물이다. 이 약물의 Pharma-cokinetics에 대해서는 동물 및 사람에 있어서 이미 많은 연구가 되어 있다(1-4). 수용성 약물인 라니티딘은 정상인에 있어서 경구투여 후 흡수가 신속하나 불완전한 것으로 알려져 있다(4). 경구투여 후 개개인에 따른 처고 혈중농도(Cmax)가 상당히 큰 차이를 보이며, 생체내 이용률(Bioavailability)은 평균 50% 이나 최저 27%에서 최고 88%에 이르기까지 넓은 범위를 보이고 있다. 더욱이 공복 시 경구투여 하거나(5-8), jejunum에 직접 bolus 투여후(9) 혹은 심지어는 정맥주사후의 경우(10)에도 소위 'double-peak phenomenon'이라고 불리 우는 최고 혈중농도에 있어서 bimodal pattern을 나타낸다. 이처럼 highly variable한 약물들은 생물학적 동등성(Bioequivalence) 측면에서 제제를 평가할 때 상당히 중요하고도 어려운 과제이므로, 현재 세계적인 issue가 되고 있다.