OBJECTIVETo study the regulative action of mica monomer powder preparation on the chief and parietal cells as well as G and D cells in the gastric mucosa of the experimental atrophic gastritis (CAG) rats.

METHODSIntervention therapy was given to the experimental CAG rats at three different doses of mica monomer powder preparation to evaluate the changes of chief and parietal cells as well as G and D cells in the gastric mucosa and the histopathological changes of gastric mucosa.

RESULTSMica monomer powder preparation at three different doses could increase the amount of chief and parietal cells as well as G and D cells in gastric mucosa of the experimental CAG rats and alleviate and control the inflammation of gastric mucosa and the atrophy of gastric mucosa glands. Especially, better effects were shown in the mid and high dose groups.

CONCLUSIONMica has the pharmacological action of protecting the gastric mucosa, enhancing blood flow of the gastric mucosa, and consequently improving the inflammatory responses of the gastric mucosa. One of the mechanisms is associated with promoting the secretion of gastric acid and gastric pepsin and regulating the neuroendocrine mechanism including gut hormone secretion (gastrin and somatostatin) by increasing the number of chief and parietal cells as well as G and D cells.

Aluminum Silicates ; pharmacology ; Animals ; Cell Count ; Chief Cells, Gastric ; drug effects ; pathology ; Chronic Disease ; Gastric Mucosa ; drug effects ; pathology ; Gastrin-Secreting Cells ; drug effects ; pathology ; Gastritis, Atrophic ; pathology ; Inflammation ; Parietal Cells, Gastric ; drug effects ; pathology ; Powders ; Rats ; Rats, Sprague-Dawley ; Somatostatin-Secreting Cells ; drug effects ; pathology

Dieulafoy's lesion is a rare cause of repetitive and massive gastrointestinal bleeding, and this is characterized by an isolated arteriole protruding through a small mucosal defect. Dieulafoy's lesion is generally found in the stomach within 6 cm of the gastroesophageal junction, and usually on the lesser curvature, but many lesions have been reported in extragastric locations, including the esophagus, small bowel and rectum. A Dieulafoy's lesion in the ampulla of Vater is extremely rare, and only one such case has been reported in the Korean population. We experienced a rare case of Dieulafoy's lesion in the ampulla of Vater with massive pulsatile bleeding, and this was successfully treated by transparent cap-assisted endoscopic hemoclipping. We report here on this case with a review of the relevant literature.
Ampulla of Vater ; Arterioles ; Esophagogastric Junction ; Esophagus ; Hemorrhage ; Rectum ; Stomach

Dieulafoys lesion consists of abnormally large gastric submucosal artery which ruptures into the stomach causing massive or recurrent intragikstric bleeding. The lesion is very small and easily overlooked even at laparatomy and aan only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. Three patients who were admitted with bleeding of upper gastrointestinal tract and eventually diagnosed as having Dieulafoys lesions were analysed. All were men with age range of 44 to 55 years. All patient were asymptomatic before presenting with hematemesis. Two of the three patients had had history of upper Gl bleeding. One patient used analgesics daily for ureteral colic and two patient drank alcohol excessively. Gastroscopy was performed during the bleeding episode in all three patients. Dieulafoy's lesion was seen in all three cases and in the second case, there was concomittent diffuse petechia in the whole stomach. The lesion was situated on the posterior wall of upper body in one, on anterior wall of upper body in another, lesser curvature side of gastric fundus in the other case. All three patient underwent laparotomy for persistent bleeding and the lesion was suture ligated only in two patients while in one patient vagotomy and pyloroplasty was added. Resection biopsy was performed in two cases and both revealed only normal gastric mucosa. All patients discharged after complete recover.
Analgesics ; Angiography ; Arteries ; Biopsy ; Endoscopy ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Hematemesis ; Hemorrhage ; Humans ; Laparotomy ; Male ; Renal Colic ; Rupture ; Stomach ; Sutures ; Upper Gastrointestinal Tract ; Vagotomy

The purpose of this study was to examine the ultrastructural characteristic of the normal pylorus mucosa, and their structural changes induced by the ligation of common bile duct of the male rabbits weighing about 1.5 kg each. Experiment animals were divided into normal, sham operation, and experimental groups. Common bile duct ligation was performed under ether anesthesia and anjmals were sacrificed on the 1st, 3rd, 5th, 7th and 14th day after operation. The mucosal specimen of the pylorus, were fixed and embedded with common method. The sections were cut on a LKB-V ultratome, and observed under a JEM 100CX II electron microscope. The results were as follow : 1. In the early stages (1st, 3rd, 5th day groups) following the ligation, surface mucous cells have the various electron densities and shape of the mucous granules. In the late stages (7th, 14th day groups) following the ligation, many surface mucose cells containing numerous electron dense mucous granules are seen. 2. In the early stage of the ligation of bile duct, secretory function of EC cells was depressed, but in the later stage, the cells showed recovered secretory activity. 3. Secretory function of D cells was depressed on the early groups after the ligation of common bile duct, but they showed recovered secretory activity from the late groups after the ligation of the common bile duct. 4. Secretory function of G cells was activated on the early groups after the ligation of common bile duct, but they showed depressed secretory activity from the late groups after the ligation of the common bile duct. Considering the above findings, common bile duct ligation probably causes the dysfunction of the pyloric surface mucous cells that results in delayed mucous formation and secretion, and recovered mucous secretory function on the late stages. EC cells and G cells, depressed the secretory activities on the early stages and recovered on the late stages of the ligation of common bile duct. But D cells in the pyloric mucosa was activated on the early groups after the ligation of common bile duct ligation, but they was depressed secretory activities on the late groups.
Anesthesia ; Animals ; Bile Ducts ; Common Bile Duct* ; Ether ; Gastrin-Secreting Cells ; Humans ; Ligation* ; Male ; Mucous Membrane* ; Pylorus ; Rabbits ; Somatostatin-Secreting Cells

BACKGROUND: CD99 is characteristically expressed in Ewing's sarcoma/primitive neuroendocrine tumors and its immunoreactivity has also been reported in gastrointestinal neuroendocrine tumors. However, the normal distribution of CD99 reactive cells in gastrointestinal mucosa and their function are not fully understood. METHODS: We performed an immunohistochemical study using antibodies to CD99 and gastrin on formalin fixed and paraffin embedded tissue of the stomach. RESULTS: CD99 were strongly expressed in the gastric glands of neonate (3/3) and infant (1/1) cases but not detected in the fetal period (0/30). In adults, CD99 was observed in 36.8% (7/19). The number of CD99 positive cells were fewer in adult (3.48+/-6.43) than in neonate (5.66+/-0.58) and infant (11.33+/-2.21). CD99 was mostly located along the cytoplasmic membrane of glandular cells but cytoplasmic expression was also evident in neonate and infant cases. The G cells and CD99 expressed cells were reduced in the area showing intestinal metaplasia and atrophic change. As a result of the double stain, some of the G cells coexpress CD99 antigen, which were more in neonate (29%) than in adult (2.6%). CONCLUSIONS: The CD99 positive cells were found in the gastric pyloric antrum during the postnatal period and progressively reduced with age. This suggests the participation of CD99 protein in the differentiation and secretory process of neuroendocrine cells.
Adult ; Antibodies ; Cell Membrane ; Cytoplasm ; Formaldehyde ; Gastric Mucosa* ; Gastrin-Secreting Cells ; Gastrins ; Humans* ; Infant ; Infant, Newborn ; Metaplasia ; Mucous Membrane ; Neuroendocrine Cells ; Neuroendocrine Tumors ; Paraffin ; Pyloric Antrum ; Secretory Pathway ; Stomach

Advance in fiberoptic endoscopy have improved diagnostic capabilities and management in patients with gastric polyps and increased experience with endoscopic polypectomy offers the most simple and safe method in removal of gastric polyps. Sixty six endoscopic gastric polypectomies was performed in 59 patients who visited Chonnam National University Hospital from 1980 to 1989 The results obtained were as follows. 1) The most patients were in the seventh decade followed by fifth, fourth decade. The ratio of male to female was 1: 1.95. 2) The common clinical symptoms with which patients presented were epigastric discomfort (54. 2%), epigastric pain (44.1%), indigestion (16.9%), nausea and vomiting (13.6%) and hematemesis (3.4%). The associated diseases of gastric polyp were chronic superficial gastritis (28.8%), chronic atrophic gastritis (13.6%), benign gastric ulcer, gastric caecer, cancer of ampulla of Vater. 3) The number of patients with single gastric polyp wa 47 (79.7%), and that of multiple gastric polyps was 12 (20.3%). The most common location of gastric polyps was gastric antrum (66.6%) follawed by gastric body (27.3%) and gastric fundus (6.1%). 4) The removed polyps were mostly 1.0 cm to 2.0 cm in size and in the gross findings by Yamadas classification, type IV (48.5%) was most common. 5) Histogical examinations revealed that 49.6% of remoyed polyps were hyperplastic polys and 18. 7% of those were adenomatous polyps. Only one case of adenomatous polyp had contaied focally malignant change of mucosa. 6) Almost all cases were in the absenee of significant complications, but three patients showed bleeding at the site of polypectomy, which controlled by conservative means.
Adenomatous Polyps ; Ampulla of Vater ; Classification ; Dyspepsia ; Endoscopy ; Female ; Gastric Fundus ; Gastritis ; Gastritis, Atrophic ; Hematemesis ; Hemorrhage ; Humans ; Jeollanam-do ; Male ; Mucous Membrane ; Nausea ; Polyps ; Pyloric Antrum ; Stomach Ulcer ; Vomiting

To avoid residual cancer in resection lines, some authors have recommended routine frozen section study of both resection margins during gastric cancer surgery. Therefore, to evaluate the significance of the routine frozen section study of resection margins in radical gastric cancer surgery, the authors analysed frozen resection margins of 2107 consecutive curative gastrectomy cases from Jan. 1988 to Jun. 1994. The following results were obtained. We experienced 117 cases of true positive resection margin by frozen section examination. In 65 cases, proximal resection margin was positive. In 52 cases distal resection margin was positive. True positive frozen resection rate was 5.6%(117/2107) total, 3.1% in proximal resection margin, 2.5% in distal resection margin. In 19 cases, frozen section study was false negative. The false negative rate was 14.0%. In 4 cases, frozen section study was false positive. The false positive rate was 0.2%. The results of diagnostic accuracy of frozen section study was as follows.: accuracy was 98.9%, sensitivity 86.0%, specificity 99.8%, positive predictive value 96.7%, negative predictive value 99.0%. Among the cancer located at antrum and body, the proximal margin was positive in 43 cases (EGC: 10 cases, AGC: 33 cases). The distance from tumor border to the proximal margin was greater than 2 cm in 2 EGC cases and greater than 6 cm in 8 AGC cases. Among the cancer located at cardia, the proximal margin was positive in 22 cases (EGC: 1, AGC: 21). The distance from the esophagogastric junction to the proximal margin was greater than 3 cm in 3 cases. Among the cancer located at pylorus, the distal margin was positive in 23 cases (AGC: 23). The distance from the pyloric ring to the distal margin was greater than 2 cm in 6 cases. Among the cancer located in antrum and body, the distal margin was positive in 29 cases (EGC: 3, AGC: 26). The distance from the tumor border to the distal margin was greater than 6 cm in 1 case. In conclusion, the present study indicates that resection margin can be infiltrated by the cancer cell though the distance to resection margin is greater than the recommended distance and frozen section study offers acceptable diagnostic accuracy, so we recommend the routine frozen section study of resection margins during gastric cancer surgery.
Cardia ; Esophagogastric Junction ; Frozen Sections* ; Gastrectomy ; Neoplasm, Residual ; Pylorus ; Sensitivity and Specificity ; Stomach Neoplasms

OBJECTIVE: To evaluate the curative effect and safety of endoscopic full-thickness resection (EFR) in the treatment of gastric tumor originated from the muscularis propria.
 METHODS: Clinical data were collected from 34 patients, who underwent EFR of gastric tumor originated from muscularis propria, to observe the resection rate and complications from November 2012 to August 2014.
 RESULTS: Of the 34 patients, 15 were male, 19 were female, with the age of 38.3-70.6 (52.3±4.3) years old. The lesions of 25 patients located in the fundus of stomach and the rest was in the gastric body. EFR was successfully performed in the 34 patients with no need for surgery. The complete resection rate was 100%. Lesion diameter ranged from 1.0 to 5.0 (2.8±1.2) centimeters. The operation time was 50-100 (76.5±18.2) min. Patients with pneumoperitoneum were relieved after abdominal puncture exhaust, without post-operation bleeding and perforation. The hospitalization duration was 3-5 (3.6±0.8) days. Except 1 case, the remaining 33 cases were spindle cell tumors, consistent with the results of immunohistochemistry. The risk for two lesions with 4.5 cm and 5.0 cm was moderate. The risk of invasion was low or very low in the remaining 31 cases. Among them, 2 stromal tumors near the cardia showed a differentiation tendency toward smooth muscle. No lesion residual or recurrence happened during the follow-up period (range 5-23 months) in 34 cases. 
 CONCLUSION EFR is a safe and effective method for gastric tumor originated from muscularis propria.
Adult ; Aged ; Cardia ; Female ; Gastric Fundus ; Gastric Mucosa ; Gastroscopy ; Humans ; Immunohistochemistry ; Length of Stay ; Male ; Middle Aged ; Operative Time ; Stomach Neoplasms

The endoscopic fine needle aspiration cytology may add to the diagnostic accuracy of endoscopic biopsy and brush cytology. It is also of particular value in submucosal, infiltrative and ulceronecrotic tumors. Endoscopic fine needle aspiration cytology was done with sclerotherapy needle(23 gauge) in. the 17 patients with submucosal tumor(18 cases), extrinsic compression(2 cases), infiltrative gastric cancer(one case) and cancer of the ampulla of Vater(one case) on the upper gastrointestinal endoscopy. Endoscopic fine needle aspiration cytology established the diagnosis in 6 cases(submucosal tumor of the stomach; 2 cases, submucosal tumor of the duodenum; one case, extrinsic mass of the duodenum; one case, infiltrative cancer of the stomach; one case, and the cancer of ampulla of Vater; one case) of 17 cases. There were negative results for malignancy in 7 cases and material insufficiency in 4 cases. Five cases of the positive results with endoscopic fine needle aspiration cytology were not diagnosed with endoscopic forceps biopsies. There was no complication. We conclude that endoscopic fine needle aspiration cytology is a simple and safe technique and is of particular value in submucosal tumor, extrinsic compression of the upper gastrointestinal tract by tumor, and infiltrative gastric cancer.
Ampulla of Vater ; Biopsy ; Biopsy, Fine-Needle* ; Diagnosis* ; Duodenum ; Endoscopy, Gastrointestinal ; Humans ; Sclerotherapy ; Stomach ; Stomach Neoplasms ; Surgical Instruments ; Upper Gastrointestinal Tract

Dieulafoy's lesion is an uncommon but important cause of massive upper gastrointestinal bleeding. The lesion usually occurs in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction but extragastric locations of Dieulafoy's lesion are rare. In this study, diagnosis of Dieulafoy's lesion was frequently made by endoscopy instead of surgery. Hemostasis was achieved by endoscopic treatment in more than 90% of patients. We report the successful application of endoscopic hemoclipping for treatment of active bleeding from Dieulafoy's lesion in the ampulla of Vater of the duodenum.
Ampulla of Vater* ; Diagnosis ; Duodenum ; Endoscopy ; Esophagogastric Junction ; Hemorrhage ; Hemostasis ; Humans ; Stomach