위암 환자의 양전자 방출 컴퓨터 단층 검사에서 복와위(伏臥位) 촬영의 유용성에 대한 연구

남궁혁,박훈희,오신현,반영각,김정열,임한상,이창호,NamKoong, Hyuk,Park, Hoon-Hee,Oh, Shin-Hyun,Bahn, Yung-Kag,Kim, Jung-Yul,Lim, Han-Sang,Lee, Chang-Ho 대한핵의학기술학회 2010 핵의학 기술 Vol.14 No.2

위암 환자의 PET/CT검사 시에 전신 검사를 한 후 물을 약 300 mL 정도 마시게 한 후 환자의 위가 위치한 부분을 추가적으로 검사를 진행하고 있다. 이는 오랜 금식으로 인해 위의 위-아래 위벽이 붙어있어 진단에 어려움이 있기에 물을 마시게 함으로써 위벽을 팽창시켜 진단의 효율을 높이기 위함이다. 검사 시에 보통 환자의 자세는 앙와위즉, 바르게 누운 자세에서 검사가 이루어지고 있다. 본 연구에서는 같은양의 물을 먹이고 복와위 즉, 바르게 엎드린 자세에서 촬영하여 앙와위에서 촬영 시와 위 체부의 용적의 팽창 정도를 비교하고, 이를 바탕으로 위의 구조상 하단부에 위치한 유문부와 위의 아래쪽 병변에 대한 정확한 위치와 진단의 효율을 높이고자 한다. 또한, 두 자세의 검사 영상을 비교하여 위의 용적의 차이를 수치화 시키고, 표준화 섭취계수의 변화가 있는지의 여부를 알아보고자 한다. 본원에서 2009년 7월-2010년 1월까지 조기 위암과 진행성 위암을 진단 받고, 수술을 하기 전의 환자와 부분절제를 한 후 추적 검사를 하고 있는 30명을 대상으로 하였다. 검사를 위해 환자에게 $^{18}F$-FDG 7.4 MBq(0.2 mCi/kg)을 정맥주사하고 60분간 누운 자세로 안정을 취하도록 하였다. 검사 시작 전 물을 300 mL 마시게 한 후 먼저 환자를 앙와위로 눕히고 위 부분을 PET/CT 촬영하고, 전신 촬영 한 후 환자에게 다시 물을 300 mL 마시게 한 후 복와위로 눕히고 위 부분을 PET/CT 촬영하였다. 위 체부의 용적을 앙와위와 복와위에서 비교해본 결과 30명의 환자에서 앙와위 평균 위 체부의 용적은 460.29 $mm^2$이고, 복와위 평균 위 체부의 용적은 641.39 $mm^2$로 평균적으로 약 41.3%확장된 것으로 나타났다. 그리고, 앙와위와 복와위에서 위 종양의 최대 표준화 섭취 계수를 각각의 환자에게서 비교해 보았을 때 거의 차이가 없는 것으로 나타났다. 위의 결과로 보았을 때 앙와위 검사보다 복와위에서 환자의 검사가 위 체부의 용적이 보다 더 확장된다는 것을 알 수 있었다. 또한 표준화 섭취 계수의 변화가 없는 것으로 나타났기 때문에 앙와위에서의 판독 결과와 다르지 않다는 것을 보여주고 있다. 거동이 불편한 환자에게는 복와위 추가 촬영이 어렵겠지만, 앙와위 추가 촬영과 더불어 복와위 추가 촬영을 한다면 위암환자의 진단에 많은 도움이 되리라 생각되고, 거동이 불편한 환자에게 사용할 수 있는 복와위 에서의 보조용구의 연구에도 도움이 되리라 사료된다. Purpose: Currently, PET/CT scan has been known to provide useful information to both preoperative and postoperative examination of cancer patients. Contracted stomach by the long fasting could cause difficulties of interpretation because of its size on reconstructed image data. To solve this problem, after the whole body PET/CT scan, patients were administrated in drinking 300 mL of water to expand stomach and performed additional scan on stomach region. Not only PET/CT scan but also CT performs this water-administration, and patients were take oral solution to make stomach expand for stomach cancer. When this scan performed, patients lay supine position. In this study, we evaluated the capacity of stomach through PET/CT scan with drinking water performed in supine and prone position so that we can distinguish exact location of cancer around pylorus and inferior wall of stomach. Furthermore, image data from supine and prone positions were analyzed the difference of volume of stomach through the change of standardized uptake values. Materials and Methods: From July 2009 to January 2010 in severance hospital, 30 patients who were diagnosed as early gastric cancer or advanced gastric cancer were chosen. All patients had PET/CT scan before the operation and have had follow-up PET/CT. The patients fast for at least 8 hours, and had an injection intravenously with $^{18}F$-FDG, 7.4 MBq (0.2 mCi/kg) per kilogram. They were rested for 60 minutes. Before the examination, all patients were administrated to drink water for 300 mL Patients had PET/CT scan with supine position around the region of stomach, whole body, and around the region of stomach with prone position after drinking another 300 mL of water respectively. Results: As a results of comparison between stomach capacity of 30 patients in supine and prone position, the study draw results that average capacity of stomach body was 460.29 $mm^2$ in supine position, and 641.39 $mm^2$ in prone position for 30 patients. The change of capacity shows 41.3% expanded in prone position. And there was no noticeable difference at maximum standardized uptake values in supine position and prone position. Conclusion: As results, stomach would have more expanded capacity in prone position than supine position. For patients who have physical disabilities to move freely, additional scan in prone position will be obstacle to perform. However, if additional scan in supine position add with the scan in prone position, it will be easier to diagnose stomach cancer. Moreover, we believe that this study will help the research for inventing support tools for patients who have physical disabilities in prone position.

위암조직에서 Ribonuclease와 Ribonuclease Inhibitor의 상호작용에 관한 연구

박경남,안광무,고재경 한양대학교 의과대학 1994 한양의대 학술지 Vol.14 No.1

In order to understand the processes involved in carcinogenesis and suppression of stomach cancer, activities of ribonuclease(RNase) and RNase inhibitor were measured in the stomach cancer tissue and were compared with those in the control tissue of the stomach. Also separated were RNases and RNase inhibitors from stomach cancer tissue by a DEAE cellulose colimn chromatography to find out the RNase and RNase inhibitor specific to the stomach cancer. Activities of acid and neutral RNase were signigicantly decreased in stomach cancer tissue and positive rates of the enzymes as markers for the stomach cancer were high suggesting the use of RNases as a biochemical marker for the stomach cancer. Activity of RNase inhibitor expressed as latent RNase activity was unchanged, although it tended to be decreased. RNases in the stomach cancer tissue was separated by a DEAE-cellulose column chromatography into six isozymes, of which RNase isozyme Ⅱ was found to be specific to the cancer and RNase isozyme V was activated. The RNase isozyme Ⅲb isolated in the control tissue disappeared from the cancer tissue. Of the RNase isozymes isolated from the stomach cancer tissue, RNase Ⅰ,Ⅱ and Ⅲ isozymes were nonseretory type of RNase active against RNA as substrate, RNase Ⅳ and Ⅴ isozymes secretory type of RNase active against poly C and RNase Ⅳ mixed type of RNase. On the other hand, RNase isozymes from the control tissue of the stomach were all secretory type of RNase except for RNase isozyme I. This indicated that RNase isozymes Ⅲ and Ⅵ isolated from the cancer tissue appeared to be different in nature from those from the control tissue. Activity of RNase inhigitor measured with poly C as a substrate was increased in RNase isozymes Ⅳ,Ⅴ and Ⅵ of the stomach cancer tissue, being increased greatly in the RNase isozyme Ⅴ. Observations that the RNase isozyme V isolated from the stomach cancer tissue was activated and exhibited higher acctivity of RNase inhibitor suggested that interaction between RNase isozyme V and RNase ingibitor play an important role in carcinogenesis and suppression of stomach cancer.

엽천사(葉天士)의 통보위부법(通補胃腑法)에 관(關)한 고찰(考察)

정경숙 ( Kyung Suk Jung ),백유상 ( You Sang Baik ),장우창 ( Woo Chang Jang ),정창현 ( Chang Hyun Jeong ) 대한한의학원전학회 ( 구 대한원전의사학회 ) 2012 대한한의학원전학회지 Vol.25 No.2

Objective: This study began with a recognition of the increase in internal disorders caused by functional impairment of the Spleen-Stomach(脾胃) due to modern dietary culture and environment. Method: Way of studying is select and analysis sentences which is include ``Stomach-Yin(胃陰)``, ``Stomach-Jin(胃津)``, ``Spleen-Stomach-Yin(脾胃陰)``, ``Stomach-Yang(胃陽)``, ``Spleen-Stomach-Yang (脾胃陽)`` in Imjeungjinamuian(臨證指南醫案), and organize relevant paper. Result & Conclusion: In the history of the Spleen-Stomach Theory(脾胃學說), the theoretical mainstream was focused on On-yang(溫養), which was supplemented with methods of sweeten-cool-moisturize(甘凉濡潤) and communication-descent(通降法) by Ye, Tianshi(葉天士). Ye, Tianshi followed the academic theory of Li, Dongyuan(李東垣), putting emphasis on Stomach-gi(胃氣), along with some unique developments of his own. He specifically argued that the Spleen and Stomach be treated separately, and while accepting the methods of Li Dong-yuan in Spleen treatment, asserted that the Stomach-Yin be treated with medicinals with sweet/plain and sweet/cool/moist(甘平與甘凉濡潤) characteristics, and Stomach-Yang be kept firmly, as to prevent obstruction and reflux, by means of medicinals that communicate the Yang softly(通陽柔劑). As a result, the Yin-Yang(陰陽), Dryness-Dampness(燥濕) and Cold-Heat(寒熱) balance of the Yin-Jang (陰臟), Spleen and the Yang-Bu(陽腑), Stomach, the Stomach-Yin and Stomach-Yang was achieved both theoretically and in treatment by means of both communication and supplementation, adding accuracy to clinical application of the Spleen-Stomach Theory.

레빈튜브 삽입후 물 점적 주입 나선식 CT의 유용성 : 위아전절제 환자의 추적 CT 검사로서 기존 방법과의 비교

박영진 대한영상의학회 1998 대한영상의학회지 Vol.38 No.4

Purpose : To access the usefulness of newly designed Leven tube inserted drip infusion spiral CT for the evaluation of remnant stomach and anastomosis site in patients who have undergone subtotal gastrectomy for stomach cancer. Material and Methods : A new technique named Levin tube inserted drip infusion spiral CT was used to prospectively study 23 patients. A 16Fr Levin tube was inserted into the remnant stomach ; 500ml of tap water was drip infused just before CT scanning and an additional 500ml of water was infused during IV contrast injection. Water was infused by gravity, using a water bottle suspended at a height of 90cm(Group A). The 31 patients who underwent conventional spiral CT scanning immediately after the divided ingestion of 900ml diluted gastrografin were selected as a control group(Group B). The anatomic delineation of the anastomosis site was graded by two radiologists as excellent(3), good(2), fair(1) or poor(0). To evaluate the degree of distension, the maximal diameters of remnant stomach and the anastomosis site, and the thickness of the stomach wall, were also measured. Results : In group A, anatomic delineation of the anastomosis site was excellent, compared to group B(mean score: 2.91 vs 1.19, p<0.01). In addition, the maximum diameters of remnant stomach and anastomosis site were significantly larger in group A than in group B(transverse A-P remnant stomach and anastomosis site: 92.4$\pm$16.0mm, 97.6$\pm$26.5mm, 29.7$\pm$7.3mm vs 50.6$\pm$12.9mm, 53.5$\pm$14.4mm, 7.7$\pm$4.4mm, p<0.01). The mean thickness of distended stomach wall in group A was 3.2$\pm$1.7mm ; in group B, measurement was possible in only a few cases, but their number was too smallfor comparison. Conclusion : In patients who had undergone subtobal gastrectomy, Levin tube inserted drip infusion spiral CT showed excellent anatomic delineation of the site of anastomosis and remnant stomach. We found that because it increases the distension of remnant stomach and the anastomosis site, this technique is effective for the evaluation of postoperative stomach.

PET/CT 검사에서 Stomach의 추가 촬영을 줄이기 위한 수분 섭취의 유용성

이승환,배성복,정병곤,이규찬,이광철,배원규,Lee, Seung-Hwan,Bae, Seong-Bok,Jeong, Byeong-Gon,Lee, Gyu-Chan,Lee, Gwang-Cheol,Bae, Won-Gyu 대한핵의학기술학회 2011 핵의학 기술 Vol.15 No.1

암 환자의 영상에서 stomach의 병변과 분비물을 구분하기란 쉽지 않다. 이 연구의 목적은 검사 전 충분한 수분 섭취로 stomach의 병변과 분비물의 분별력을 높임으로서 추가 촬영을 줄이기 위하여 시행하였고 본 연구는 총 228명의 암 환자로 2010년 8월 18일부터 2010년 9월10일까지 진행하였으며, 2010년 8월 18일부터 2010년 8월 31일까지는 수분섭취 제한환자가 115명이었고, 2010년 9월 1일부터 2010년 9월 10일까지는 촬영 직전 수분을 500 cc 정도 섭취한 후 검사를 진행한 환자로 113명이었다. 이 검사를 시행한 결과 전체 암 환자 228명을 대상으로 촬영 수분 섭취 제한 환자는 총 115명이고, 이중 추가 촬영이 없는 환자가 89명이었고, stomach 추가 촬영을 진행한 환자가 13이었으며, 기타 추가 촬영을 진행한 환자는 13명이었다. 그리고 촬영 직전 수분을 500 cc 정도 섭취한 후 검사를 진행한 환자 113명 중 추가 촬영이 없는 환자가 109이었고, stomach 추가 촬영을 진행한 환자가 1명이었으며, 기타 추가 촬영을 진행한 환자는 3명에 해당하였다. 이와 같은 결과로도 수분을 500 cc 정도 섭취하고 검사를 진행한 환자에게서 추가 촬영이 줄었음을 알 수 있었으나, 정확한 유의성을 알기 위하여 pearson의 chi-square test를 시행한 결과 유의확률이 0.05보다 작은 0.001이었으므로 두 집단은 유의한 관련성이 있음을 알 수 있고 최소 기대빈도가 6.94로서 5보다 작은 기대빈도가 없었으므로 pearson의 정확한 검정을 할 필요는 없었고, 위의 연구로 인하여 물을 검사 직전 약 500 cc 정도 섭취하고 촬영을 진행하면 stomach 추가 촬영을 현저히 줄일 수 있으며 기타 추가 촬영 또한 줄일 수 있음을 알 수 있었고 검사 지연 시간 또한 줄일 수 있을 것으로 사료된다. Purpose: With the introduction of PET since 1994, test methods have made rapid progress. Accordingly, the studies on the diagnosis and treatment of cancer as well as treatment response evaluation PET test are useful. However, it is difficult to divide stomach lesions and secretion. The purpose of this study is to reduce additional shooting by dividing lesions and secretion of stomach. Materials and Method: This study aiming at total 228 cancer patients was conducted from Aug 18 to Sep. 10, 2010. Among them, 115 patients had a test without water intake before shooting from Aug. 8 to 31 and 113 had a test after drinking 500 cc water right before shooting from Sep. 1 to 10 The Discovery ST PET/CT (GE Healthcare, USA) was used, and pearson's chi-square test was conducted to analyze significance through SPSS (Ver.18). Results: Among the total 228 cancer patients, there were 115 who had a test without water intake before shooting, 89 who had no double additional shooting, 13 who had stomach additional shooting and 13 who had other additional shooting. In addition, 109 had no additional shooting among 113 who had a test after taking 500 cc water, 1 had stomach additional shooting and 3 had other additional shooting. According to the findings above, the patients who had a test without water intake show reduced additional shooting, but for more exact significance, pearson's Chi-square test was carried out and the significance percentage was 0.001 that is smaller than 0.05, which means two groups have a significant relationship. As the minimum expectation frequency was 6.94 and there was no expectation frequency smaller than 5, so that it doesn't need to carry out pearson's exact verification. Conclusion: The above analysis has found that if one drinks 500cc water before the test, not only stomach additional shooting but also other additional shooting can be dramatically reduced, and test delay can be also reduced.

검색용 MeSH 필터와 단어인접탐색 기법을 활용한 KoreaMed 검색 효율성 향상 연구

정소나(So-Na Jeong),정지나(Ji-Na Jeong) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.5

의학학술문헌에는 해부학적 조직이나 기관명이 종양, 질환 또는 감염 용어들과 서로 조합하여 사용되는 언어적 특성을 가지고 있다. 의학학술문헌을 검색할 때 데이터베이스가 제공하는 통제어휘도구인 Medical Subject Headings (MeSH)를 활용하면 합성어, 동의어, 그리고 관련어를 추가로 검색할 수 있어 검색효율이 높다. 본 연구에서는 위암(Stomach Neoplasms) 어휘군을 검색용 필터로 추가하는 방법과 동시출현용어의 거리를 측정하여 단어인접탐색 기법으로 검색효율성을 향상시키는 연구를 수행하였다. 검색용 MeSH에 추가할 어휘군을 결정하기 위해 실험데이터로 PubMed에서 중심주제어가 “Stomach Neoplasms”인 2007년∼2016년 논문 8,625편을 내려 받아 논문제목으로부터 Stomach와 Neoplasms 관련 용어의 동시출현여부를 분석하였다. 검색효율성은 KoreaMed에서 검색되는 MEDLINE 학술지를 대상으로 “Stomach Neoplasms”가 MeSH로 색인되어 있는 277편으로 검증하였는데 MEDLINE MeSH, MeSH on Demand, 그리고 KoreaMed MeSH Indexer의 “Stomach Neoplasms” 색인어 추출여부와 검색용 필터로 어휘군을 적용했을 때, 그리고 동시출현 용어의 단어인접검색 기법을 적용했을 때 “Stomach Neoplasms”의 매칭여부를 비교하였다. 가장 출현빈도가 높은 용어는 “Gastric Cancer”로 2,780회 출현하였다. “Gastric Adenocarcinoma”, “Gastric MALT Lymphoma” 등과 같이 “Stomach” 용어와 “Neoplasms" 관련 조직학적 용어가 조합된 경우는 7,376개(88.51%)였다. 동시출현 거리가 2단어인 용어는 “Stomach”와 “Neoplasms”의 합성어로 5,234개(70.95%)였다. 연구 결과 MeSH용어를 제외하고 973개의 용어를 후보어휘군으로 선정하였다. MEDLINE MeSH와 KoreaMed MeSH Indexer의 MeSH 매칭률은 209편(75.5%)이었는데 검색필터를 적용한 결과 263편(94.9%)으로, 동시출현 용어의 13단어 단어인접탐색 기법을 적용한 경우 268편(96.7%)으로 매칭률이 향상되었다. 본 연구를 통해 자연어 검색에 있어서 검색효율을 향상시키는 수단으로 검색용 시소러스를 사용하면 색인비용에 대한 부담이 적고, 통제어의 망라적 장점과 자연어가 가지는 용어의 특정성을 유지할 수 있음을 증명하였다. 또한 불리안 검색보다는 단어인접탐색 기법을 활용하면 정확률을 높일 수 있어 검색 효율성이 향상됨을 알 수 있었다. This study examined the method for adding related to “stomach neoplasms” as filters to the Medical Subject Headings (MeSH) for search as well as a method for improving the search efficiency through a word-proximity search by measuring the distance of co-occurring terms. A total of 8,625 articles published between 2007 and 2016 with the major topic terms “stomach neoplasms” were downloaded from PubMed article titles. The vocabulary to be added to the MeSH for search were analyzed. The search efficiency was verified by 277 articles that had “Stomach Neoplasms” indexed as MEDLINE MeSH in KoreaMed. As a result, 973 terms were selected as the candidate vocabulary. “Gastric Cancer” (2,780 appearances) was the most frequent term and 7,376 compound words (88.51%) combined the histological terms of “stomach” and “neoplasm”, such as “gastric adenocarcinoma” and “gastric MALT lymphoma”. A total of 5,234 compounds words (70.95%), in which the co-occurring distance was two words, were found. The matching rate through the MEDLINE MeSH and KoreaMed MeSH Indexer was 209 articles (75.5%). The search efficiency improved to 263 articles (94.9%) when the search filters were added, and to 268 articles (96.7%) when the 13 word-proximity search technique of the co-occurring terms was applied. This study showed that the use of a thesaurus as a means of improving the search efficiency in a natural language search could maintain the advantages of controlled vocabulary. The search accuracy can be improved using the word-proximity search instead of a Boolean search.

애역에 關한 東西醫學的 考察

崔炳甲,李始炯 대한동의병리학회 1998 동의생리병리학회지 Vol.12 No.2

애역(딸꾹질)에 대한 韓方的 文獻考察을 통하여 原因, 機轉, 症狀, 治法, 治方을 考察한 후 西洋醫學的 觀點을 비교·검토하여 韓洋方에 대한 애역의 관점차이와 서로 유사한 점을 비교하여 보았다. 딸꾹질은 일생동안 누구나 경험하는 疾患이며 대개 일시적인 症狀으로 곧 소실되지만 난치성 딸꾹질은 기질적인 원인질환이 있는 경우가 많으며, 韓方에서는 애역의 原因을 대체로 胃氣의 降濁失調로 因한 胃氣上逆으로 보았다. 韓方的인 觀點이 주로 辨證論治를 爲主로 하여 發展한데 반하여 洋方的인 觀點은 主로 原因疾患이 先行된 경우는 선행되어진 原因疾患을 위주로 한 치료와 대증적 약물요법, 수술요법 등의 治療方法으로 귀납되었다. 향후 韓方的 觀點과 洋方的 觀點의 상호이해를 통한 지속적인 硏究가 필요하다고 사료된다. Through the bibliographic study between oriental and western medicine about hiccup, I studied difference and similarity between oriental and western view point of hiccup. We have experienced at least one more hiccup for whole life. General hiccup disappears soon, but incurable one mostly happens under the organic disease. On the point of view of oriental medicine, We have regarded cause of hiccup as adverse rising of the stomach-qi(胃氣上逆). In orient the treatment of hiccup has been mostly progressed through diagnosis and treatment based on overall analysis of symptoms and signs(辨證論治), but in western that has been mostly done through treatment of disease(pharmacotherapy, operative therapy) which causes hiccup. It is thought that the persistant study about hiccup should be continued under the reciprocal correspondence between orient and west. 1. Adverse rising of the stomach-qi(胃氣上逆), the most general cause of hiccup is caused by failure of descending of the stomach-qi(胃氣降濁失調). And hiccup can be caused by cold and deficiency syndrome of the stomach(胃中虛寒), deficiency syndrome of the stomach and the spleen(脾胃虛), adverse rising of stomach fire(胃火上衝), phlegm retention(痰飮), exopathic disease(外感傷寒), elongated disease(久病), indigestion(食滯), emotional stress(情志不舒) and deficiency syndrome of liver and kidney-Yin(肝腎陰虛). Adverse rising of the stomach-qi(胃氣上逆), cold and deficiency syndrome of the stomach(胃中虛寒), deficiency syndrome of the stomach and the spleen(脾胃虛), adverse rising of the stomach fire(胃火上衝) and indigestion(食滯) which cause hiccup are similar to the stimulus or distension of the G-I tract, peritonium and diaphragm on western medicine. Exopathic disease(外感傷寒) is similar to any kinds of infectious disease. Elongated disease(久病) is similar to uremia, diabetes and electrolytic unbalance. Emotional stress(情志不舒) is associated with psychogenesis. 2. There are several treatment methods of hiccup, such as warming the middle jiao(溫中祛寒), regulating the stomach and preventing hiccup(화위지애), regulating the flow of qi to resolve the phlegm(理氣化痰), promoting the production of the body fluid and nourishing the stomach(生津養胃) and clearing away heat(淸降泄熱), which are adapted to each cause of hiccup. These are similar to western pharmacotherapy of the sedative and anticonvulsant for decreasing stimulation of the stomach, diaphragm and peritonium. 3. Sternutatory(취체법) and the insufflations(후법) such as sulphur insuflation(유황후법) and arsenic trioxide insufflation(웅황후법) are similiar to several methods, such as sternutatory, pharynx stimulation and gas insufflation method, for inhibiting the afferent fiber of vagus nerve on non-medication therapy.

언체 위(胃)의 해부학적 구획에 따른 그렐린 mRNA 발현의 정량적 분석

전태용,이상엽,김형호 부산대학교 병원 암연구소 2007 부산대병원학술지 Vol.- No.21

Purpose: Ghrelin is a endogenous ligand of the GH secretagogure (GHS) receptor mainly produced by the stomach. However, the ghrelin production capacity according to anatomic subdivisions of human stomach is not yet well established. The purpose of this study was to investigate ghrelin mRNA expression in the anatomic subdivisions of normal gastric tissue as well as in cancer tissue. Subject and Methods: Tissue samples were obtained from 16 individuals who underwent total gastrectomy for stomach cancer. The normal gastric tissues were harvested from the upper, middle, lower portion of stomach and cancer tissues from tumor mass, respectively. Total RNA was reverse transcribed with random hexamer primers and ghrelin mRNA was amplified by real time RT-PCR using specific primers and hybridization probes. Results: In normal gastric tissue, ghrelin mRNA was expressed and in cancer tissue, also. Mean ghrelin mRNA expression of upper, middle, lower portion of stomach and cancer tissues, expressed as the ratio of ghrelin mRNA to β-actin concentration, were 0.78 (range 0.041-3.88),0.20(range 01.28), 0.07 (range 0-0.67), 0.32 (range 0-3.67), respectively. The expression of ghrelin mRNA in upper portion of stomach was significantly higher than that in the lower portion of stomach (P<0.05). There was no correlation between ghrelin mRNA expression in upper portion of stomach and clinical parameters, such as age, sex and BMI. Conclusions: Ghrelin mRNA was expressed in cancer tissue as well as normal gastric tissue. The expression of ghrelin mRNA in the anatomic subdivisions of normal gastric tissue was higher in upper portion compared to the other portion of stomach. These findings provide clues to additional, as yet undefined, gastric neuroendocrine functions of this novel gastrointestinal hormone

폭포상위를 가진 검진자의 신체적 요인 및 비만상태 분석

박명제(Myung-Je Park),지태정(Tae-Jeong Ji),임인철(In-Chul Im) 대한방사선과학회(구 대한방사선기술학회) 2007 방사선기술과학 Vol.30 No.4

  폭포상위는 비만형의 체격을 가진 사람에게 더 현저하다고 알려져 있다. 이에 본 연구에서는 폭포상위를 가진 자의 신체적 요인인 성별, 나이, 신장, 몸무게 및 비만상태를 조사 분석하여 폭포상위와 연관성이 있는지를 알아보고자 하였다. 일부지역 한 검진기관 2007년 1월부터 12월까지 상부위장관조영술을 실시한 3,320명 중 폭포상위를 가진 자 564명을 연구대상자로 하여 다음과 같은 결론을 얻을 수 있었다.<BR>  1. 폭포상위의 정도는 3.320명 중 564명(16.9%)으로 나타났다.<BR>  2. 폭포상위를 가진 자 564명 중 비만도 120% 이상인 자는 226명(40.1%)으로 높게 나타났다.<BR>  3. 비만도 120% 이상인 자 중 성별에서는 여성이 63.7%로 남성보다 높게 나타났으며, 연령에서는 50~59세 45.6%, 신장은 151~160㎝에서 49.1%로 나타났으며, 몸무게는 76㎏ 이상에서 31.0%로 가장 높게 나타<BR>났다.<BR>  4. 폭포상위를 가진 자의 증상과 비만인 자의 증상과는 무증상이 62.6%, 57.5%로 나타났으며, 다음으로 소화불량증 16.8%, 17.3%, 속쓰림 10.8%, 15.0% 순으로 나타났다.<BR>  결론적으로 폭포상위는 비만일수록 높게 나타난다는 사실을 알 수 있었으며, 비만일수록 성별에서는 남성보다 여성이, 연령별에서는 50대, 신장에서는 151~160㎝, 몸무게에서는 76㎏ 이상에서, 증상으로는 무증상 다음으로 소화불량증, 속쓰림 순으로 높게 나타남을 알 수 있었다. 이는 통계에 의한 조사이므로 폭포상위와 비만과의 연관성을 사실적인 확인을 할 수는 없었으나 앞으로 폭포상위와 비만과의 관계에 대해 더욱 더 많은 연구가 이루어져야 하겠다고 사료된다.   Cascade Stomach is commonly found in obese patients. This study examined the physical factors, such as gender, age, height, weight and level of obesity, associated with a cascade stomach.<BR>  Over a 12 month period between 2007 a series upper gastrointestinal examinations were carried out on 3,320 people, which included 564 patients with a Cascade Stomach. The results are as follows :<BR>  1. A cascade stomach was observed in 564(16.9%) out of 3,320 subjects.<BR>  2. A body mass index(BMI) > 120% was observed in 226 of the 564 cascade stomach patients.<BR>  3. Among those with a BMI > 120, 63.7% were female, 45.6% were aged between 50-59 years, 49.1% were between 151-160㎝ in height and 31.0% were above 76㎏ in weight.<BR>  4. The symptoms observed in the cascade stomach and obesity groups were subclinical(62.6% and 57.5%, respectively), dyspepsia(16.8% and 17.3%, respectively) and gastric soreness(10.8% and 15.0%, respectively).<BR>  The incidence of a cascade stomach is higher in those with obesity. In addition, there is a higher incidence in females, those aged between 50 and 59, those between 151 and 160㎝ in height and those weighing more than 76㎏. The main symptoms observed were subclinical, followed in order by dyspepsia and gastric soreness. This study showed a strong association between a cascade stomach and obesity. However, more studies will be needed to confirm this.

Inflammatory Responses in the Muscle Coat of Stomach and Small Bowel in the Postoperative Ileus Model of Guinea Pig

최홍규,이영호,박종필,Kevin Min,박효진 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.6

Purpose: Small intestinal function returns first after surgery, and then the function of the stomach returns to normal after postoperative ileus (POI). The aim of this study was to investigate inflammatory responses in the muscle coat of stomach and small intestine in guinea pig POI model. Materials and Methods: The distance of charcoal migration from pylorus to the distal intestine was measured. Hematoxylin and eosin (H&E) and immunohistochemical stain for calprotectin were done from the histologic sections of stomach, jejunum and ileum obtained at 3 and 6 hour after operation. Data were compared between sham operation and POI groups. Results: The distance of charcoal migration was significantly reduced in the 3 and 6 hour POI groups compared with sham operated groups (p<0.05). On H&E staining, the degree of inflammation was significantly higher in the stomach of 3 hour POI groups compared with jejunum and ileum of POI groups or sham operated groups (p<0.05). Calprotectin positive cells were significantly increased in the muscle coat of stomach of 3 hour POI groups compared with jejunum and ileum of POI groups or sham operated groups (p<0.05). There was strong association between the degree of inflammation and calprotectin positive cells in stomach. Conclusion: Postoperative ileus induced by cecal manipulation significantly increased the degree of inflammation and calprotectin positive cells in the muscle coat of stomach as a remote organ. The relevance of degree of inflammation and the recovery time of ileus should be pursued in the future research.