Following gastric surgery, 25~50% of patients experience dumping symptoms. Early dumping usually involves both gastro-intestinal and vasomotor complaints, while late dumping involves mainly the latter. Management is mainly achieved by dietary modification. Drug therapy has been investigated without consistent success. However, the somatostatin analogue octreotide alleviates dumping by slowing gastric emptying, inhibiting insulin release, decreasing enteric peptide secretion and intestinal absorption of water and sodium, slowing monosaccharide absorption, increasing gut transit time and preventing hemodynamic changes. We report a case with the place of octreotide in the medical management of the dumping syndrome. The patient was 71-year-old male who had taken total gastrectomy for gastric cancer in 1987. He had been well except intermittent abdominal pain for 8 years after total gastrectomy. But he had suffered from sudden symptoms such as hypoglycemic shock and fainting, which start 2~3 hours after ingesting of a meal for recent 5 years. Studies for diagnosing insulinoma were all negative. We start diet modification and medication such as acarbose to him with impression of dumping syndrome, but there were no improvement of his symptoms. Then we start octreotide, 50 g, given subcutaneously, three-times per day, 30 min prior to each meal. His symptom was dramatically improved.
Abdominal Pain ; Absorption ; Acarbose ; Aged ; Drug Therapy ; Dumping Syndrome* ; Food Habits ; Gastrectomy ; Gastric Emptying ; Hemodynamics ; Humans ; Hypoglycemia ; Insulin ; Insulinoma ; Intestinal Absorption ; Male ; Meals ; Octreotide* ; Shock* ; Sodium ; Somatostatin ; Stomach Neoplasms ; Syncope ; Water

BACKGROUND: AND PURPOSE: The aim of this study was to determine the diagnostic performance and safety of a new ¹⁸F-labeled amyloid tracer, ¹⁸F-FC119S. METHODS: This study prospectively recruited 105 participants, comprising 53 with Alzheimer's disease (AD) patients, 16 patients with dementia other than AD (non-AD), and 36 healthy controls (HCs). In the first screening visit, the Seoul Neuropsychological Screening Battery cognitive function test was given to the dementia group, while HC subjects completed the Korean version of the Mini Mental State Examination. Individuals underwent ¹⁸F-FC119S PET, ¹⁸F-fluorodeoxyglucose (FDG) PET, and brain MRI. The diagnostic performance of ¹⁸F-FC119S PET for AD was compared to a historical control (comprising previously reported and currently used amyloid-beta PET agents), ¹⁸F-FDG PET, and MRI. The standardized uptake value (SUV) ratio (ratio of the cerebral cortical SUV to the cerebellar SUV) was measured for each PET data set to provide semiquantitative analysis. All adverse effects during the clinical trial periods were monitored. RESULTS: Visual assessments of the ¹⁸F-FC119S PET data revealed a sensitivity of 92% and a specificity of 84% in detecting AD. ¹⁸F-FC119S PET demonstrated equivalent or better diagnostic performance for AD detection than the historical control, ¹⁸F-FDG PET (sensitivity of 80.0% and specificity of 76.0%), and MRI (sensitivity of 98.0% and specificity of 50.0%). The SUV ratios differed significantly between AD patients and the other groups, at 1.44±0.17 (mean±SD) for AD, 1.24±0.09 for non-AD, and 1.21±0.08 for HC. No clinically significant adverse effects occurred during the trial periods. CONCLUSIONS ¹⁸F-FC119S PET provides high sensitivity and specificity in detecting AD and therefore may be considered a useful diagnostic tool for AD.