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ABSTRACT: The aim of this study is to verify the effect of two-day fasting prior to intestinal ischemia-reperfusion (I/R) injury on bacterial translocation (BT).
Mail Sprague-Dawley rats were divided into four groups: group 1, control rats that underwent sham operation only; group 2, rats fasted for two days prior to sham operation; group 3, rats that underwent occlusion of mesenteric vessels for 30 min followed by reperfusion for 4 hr; and group 4, rats fasted for two days prior to the same intestinal I/R injury as in group 3. In all groups, E. coli labeled with (99m)Tc were inoculated into the terminal ileum. Two hr after inoculation of E. coli, the rats were killed. A segment of ileum was obtained for histological examination and samples of mesenteric lymph nodes (MLNs), liver, lung, blood, and spleen were obtained for radioactivity determination.
There were no significant differences in the intestinal mucosa and radioactivity of all samples between groups 1 and 2. Group 3 showed significantly shorter mucosa and villi, and higher radioactivity of samples, except for MLNs, compared to group 1. Group 4 showed similar mucosa and villi, but significantly higher radioactivity of samples, except for MLNs, compared to group 3.
Two-day fasting without I/R injury does not cause mucosal change and BT, but in cases following intestinal I/R injury, two-day fasting increases the susceptibility of BT to systemic organs in rats.
Journal of Investigative Surgery 01/2011; 24(6):262-6. · 1.09 Impact Factor
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ABSTRACT: This research sought to identify the utility value of chest computed tomography (CT) when it comes to the diagnosis of lung metastasis in cases of colorectal cancer.
From September 2004 to January 2008, 266 patients who were treated for colorectal cancer at Department of Surgery, Hanyang University College of Medicine, were divided into two groups: one that underwent preoperative and postoperative periodical chest CT (periodical inspection group, PIG; May 2006 to January 2008, 135 patients) and one that did not undergo periodical chest CT (non-periodical inspection group, NPIG; September 2004 to April 2006, 131 patients) for comparison.
The overall lung metastasis diagnosis rates did not manifest any significant difference. The times to diagnose lung metastasis patients were 6.3 months and 15.7 months for the PIG and the NPIG, respectively (P = 0.022). The size of the metastatic lung nodule was smaller in the PIG than in the NPIG (< 1 cm in 9/9 patients vs. < 1 cm in 6/9 patients in the PIG and the NPIG, respectively; P = 0.02). A solitary lung metastasis was more frequently found in the PIG (5/9 patients) than in the NPIG (1/11 patients) (P = 0.024). During the follow-up period, 100% (2/2 patients) and 60% (3/5 patients) of the patients in the PIG and the NPIG, respectively, with stage III cancer underwent a lung metastasectomy (P = 0.002).
Chest CT enables early diagnosis with a smaller size and a lower number of lung metastases in patients with colorectal cancer. Moreover, pulmonary the rate of the pulmonary resection for selected patients may be improved. However, the contribution of chest CT to increasing the survival rate must be investigated in a prospective randomized study.
Journal of the Korean Society of Coloproctology 10/2010; 26(5):359-64.
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ABSTRACT: In this study, we fabricated non-woven matrices using blends of polycaprolactone and gelatin with various spinning volumes to control the immobilized heparin content, which was ultimately intended to increase the immobilization efficiency of bFGF. The amount of bFGF on the heparin conjugated fibrous matrices depended on the thicknesses of the swollen matrices ranging from 35.4 ± 6.5 to 162.3 ± 14.0 ng and ≈90% of the bFGF was gradually released over a period of up to 56 d. The released bFGF enhanced the proliferation of human umbilical vein endothelial cells and human mesenchymal stem cells. In conclusion, our heparin-conjugated fibrous matrices have the potential to be used as a growth factor delivery system in tissue engineering applications.
Macromolecular Bioscience 09/2010; 11(1):122 - 130. · 3.89 Impact Factor
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ABSTRACT: The aim of this study was to determine the outcome and to identify possible predictors of success for biofeedback therapy after perineal rectosigmoidectomy (PRS) or coloanal or ileoanal J pouch. A retrospective chart review of all patients with electromyography-based biofeedback therapy due to fecal incontinence after PRS or a J pouch procedure was undertaken. Follow-up was obtained by telephone survey. Fourteen patients (4 men and 10 women) were included in this study. In the 9 patients after PRS, the frequency of daily bowel movements was 3.6+/-2.8 preoperatively, 4.1+/-3.2 prebiofeedback, and 2.2+/-1.3 postbiofeedback (P<.05). The frequency of daily incontinent episodes was reduced from 2.4+/-2.2 preoperatively and 2.0+/-1.9 prebiofeedback to 0.26+/-0.3 postbiofeedback (P<.05). The incontinence scores decreased from 17+/-3.1 preoperatively to 16+/-2.1 prebiofeedback and to 8.2+/-5 postbiofeedback (P<.001). At a follow-up of 15.8+/-7.1 months, 5 patients after the J pouch had decreased daily bowel frequency from 6.6+/-4.2 prebiofeedback to 3.3+/-2 postbiofeedback and 3.1+/-2 at follow-up (P<.05). The frequency of daily incontinent episodes was reduced from 1.9+/-1.3 prebiofeedback to 0.9+/-0.7 postbiofeedback to 0.7+/-0.8 at follow-up (P<.05). The incontinence scores decreased from 13.4+/-2.7 prebiofeedback to 8.8+/-5.1 postbiofeedback to 6.8+/-5.5 at follow-up (P<0.05). In both groups, the postbiofeedback incontinence score correlated with the prebiofeedback incontinence score. Furthermore, there was no correlation between outcome and age, interval between surgery and biofeedback therapy, frequency of biofeedback sessions, or manometry results in either group. Biofeedback therapy is an effective option for patients with fecal incontinence after perineal rectosigmoidectomy or colonic or ileal J pouch.
Surgical Innovation 06/2005; 12(2):135-8. · 2.13 Impact Factor
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ABSTRACT: Linitis plastica of the colon is an uncommon presentation of primary colorectal cancer. This entity of colorectal cancer is characterized by a diffuse infiltrating tumor with desmoplastic reaction and poor prognosis. Although widespread infiltration is the main feature of linitis plastica, the tumor extending to more than 2 segments of the colon is uncommon. We report a case of primary linitis plastica involving the entire colon, ileum and appendix. The clinical characteristics are discussed with a review of literatures.
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 10/2003; 42(3):237-41.
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ABSTRACT: Porous scaffolds composed of gelatin and beta-glucan were prepared using the freeze-drying method. The scaffold had an inter-connected pore structure with average pore size of 90-150 microm. Results for the contact angle and cell attachment revealed that a high gelatin content was suitable for cellular attachment and distribution in two- or three-dimensional fibroblast cultures, because the gelatin had acidic residues, and arginine-glycine-aspartic acid groups. To prepare a stratified wound dressing to mimic the normal human skin, fibroblasts and keratinocyte cells were isolated from a child's foreskin, and were co-cultured in gelatin/beta-glucan scaffolds were cross-linked using 1-ethyl-(3-3-dimethylaminopropyl) carbodiimide hydrochloride. An in vivo study showed that after 1 week, the artificial dermis containing the fibroblasts enhanced the re-epithelialization of a full-thickness skin defect rather than the acellular scaffold.
Biomaterials 07/2003; 24(14):2503-11. · 7.40 Impact Factor
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ABSTRACT: One of the hazards of colorectal surgery is ureteric injury. The aim of this study was to evaluate the results of ureteric catheterization regarding its safety and operative time. One-hundred sixty two patients underwent laparoscopic segmental left or right colectomy. The mean time for placement of ureteric catheters was 11.4 min for the right hemicolectomy and 11.3 min for the left hemicolectomy group. The mean preparation times for right hemicolectomy and left hemicolectomy (group 1 vs. group 2) were 54.7 vs. 39.1 min (p=0.00001) and 61.4 vs. 47.6 min (p=0.006), respectively. There were no significant differences in the laparoscopic operative time in either the right or left hemicolectomy groups (134.2 vs. 145.5 min and 198.4 vs. 170.1 min, respectively). There was no morbidity directly related to the ureteric catheters and in fact the incidence of postoperative urinary tract infection was lower in group 1 (1.5%) than in group 2 (5.3%) (p<0.05). Although the use of ureteric catheters added a mean of 11.3 min to the surgical procedure, the overall anesthetic time for right hemicolectomy was no longer than that for left hemicolectomy. The morbidity rate was quite acceptable. Thus, ureteric catheters may be useful in selected cases of laparoscopic left and right colorectal resections.
Journal of Korean Medical Science 10/2002; 17(5):633-5. · 0.99 Impact Factor
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ABSTRACT: PURPOSE: Major therapeutic decisions are rendered based on a single colonic transit study. Therefore, the aim of this study was to assess the reproducibility of colonic transit time in patients with chronic constipation. MATERIALS AND METHODS: Fifty-one patients with chronic idiopathic constipation were randomly selected to undergo two separate colonic transit tests. All clinical conditions, methodology, and patients' instructions were identical on both occasions. The gamma rate (linear correlation analysis) was undertaken between the first and second colonic transit times. Groups were divided according to the diagnoses of colonic inertia (slow-transit constipation), paradoxical puborectalis contraction, and chronic idiopathic constipation (normal-transit constipation). RESULTS: In 35 of 51 patients (69 percent), the results were identical between the two studies; however, in 16 patients (31 percent), the results were disparate (gamma correlation coefficient =0.53;P<0.01). The specific correlation coefficients for patients with colonic inertia, paradoxical puborectalis contraction, and chronic idiopathic constipation were 0.12, 0.21, and 0.60 (P<0.01), respectively. Moreover, the success rate of colectomy for colonic inertia was significantly higher in patients who underwent a repeat transit study confirming inertia than in patients who underwent colectomy based on a single study. CONCLUSIONS: Overall, colonic transit time is reproducible in patients with chronic constipation. The correlation coefficient is best for patients with idiopathic constipation and worst for patients with colonic inertia. This new finding suggests that suboptimal surgical outcome may be attributable to inaccurate diagnosis. Because of this poor correlation coefficient, in patients with colonic inertia, consideration should be given to repeating the colonic transit study before colectomy to help secure the diagnosis and improve outcome.
Diseases of the Colon & Rectum 12/2000; 44(1):86-92. · 3.13 Impact Factor
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ABSTRACT: PURPOSE: The aim of this study was to evaluate any differences in functional outcome in patients with mucosal ulcerative colitis after restorative proctocolectomy and ileal pouch-anal anastomosis with use of the double stapling technique relative to the type of tissue in the stapled doughnut. METHODS: Between September 1988 and June 1997, the pathology of all patients with mucosal ulcerative colitis who underwent ileal pouch-anal anastomosis with use of the double stapling technique were reviewed. Information was obtained regarding the tissue types in the distal tissue rings (doughnuts) obtained from the stapled ileal pouch-anal anastomosis. The level of anastomosis was classified according to the type of tissue in the distal doughnut: Group I—patients in whom the anal transitional zone was removed and the distal doughnut included squamous epithelium or transitional epithelium and Group II—patients in whom the anal transitional zone was preserved because the distal doughnut revealed only columnar epithelium. Functional outcomes were assessed and compared by detailed questionnaires mailed to all patients at least one year after ileal pouch-anal anastomosis surgery. RESULTS: Distal doughnuts were obtained from the stapled ileal pouch-anal anastomosis in 222 patients with mucosal ulcerative colitis. Follow-up data at a mean of 38 (range, 12–132) months were obtained in 138 (62.2 percent) patients, including 72 males, with a mean age of 46.9 (range, 13–79) years. Group I consisted of 40 patients (29 percent; 35 (25.4 percent) who had squamous epithelium and 5 (3.6 percent) who had transitional epithelium in the distal tissue rings). Group II consisted of 98 patients (71 percent) with columnar epithelium in the distal tissue rings. Age at diagnosis and operation, duration of disease, length of follow-up, and stage of pouch surgery were similar in the two groups. Incontinence scores, frequency of bowel movement, use of a protective pad, discrimination between gas and stool, use of antidiarrheals, life-style alteration, and patient satisfaction showed similar functional results between the two groups. CONCLUSIONS: The tissue type in the stapler distal doughnut did not greatly influence functional outcome. Failure to identify a relationship may attest to the variable height and composition of the anal transitional zone.
Diseases of the Colon & Rectum 09/2000; 43(10):1398-1404. · 3.13 Impact Factor
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ABSTRACT: This study was conducted to develop a new sponge type of biomaterial to be used for either wound dressing or scaffold for tissue engineering. We were able to prepare an insoluble matrix composed of gelatin and sodium hyaluronate (HA) by dipping the soluble sponge into 90% (w/v) acetone/water mixture containing a small amount of cross-linking agent, 1-ethyl-3-3-dimethylaminoproplycarbodiimide hydrochloride, EDC. To characterize the sponge, Fourier-transformed infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), and Instron analysis were performed. The obtained results indicate that the chemically cross-linked sponge shows a cross-linking degree of 10–35%, a mean pore size of 40–160 μm, porosity of 35–67%, and a tensile strength of 10–30 gf/cm2. Especially, the porosity measured by image analysis showed a tendency to increase with HA content, resulting in an increased water uptake. The resistance to collagenase degradation in vitro increased for up to 2 days. Silver sulfadiazine (AgSD)-impregnated gelatin-HA sponge was also prepared and compared with conventional vaseline gauze by applying it onto a dorsal skin defect of wistar rat for 5, 12, and 21days. Histological results showed an enhancement of wound healing in AgSD-impregnated gelatin-HA sponge. © 1999 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 48: 631–639, 1999
Journal of Biomedical Materials Research 12/1998; 48(5):631 - 639.
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ABSTRACT: Porous scaffolds composed of gelatin and β-glucan were prepared using the freeze-drying method. The scaffold had an inter-connected pore structure with average pore size of 90–150 μm. Results for the contact angle and cell attachment revealed that a high gelatin content was suitable for cellular attachment and distribution in two- or three-dimensional fibroblast cultures, because the gelatin had acidic residues, and arginine–glycine–aspartic acid groups. To prepare a stratified wound dressing to mimic the normal human skin, fibroblasts and keratinocyte cells were isolated from a child's foreskin, and were co-cultured in gelatin/β-glucan scaffolds were cross-linked using 1-ethyl-(3-3-dimethylaminopropyl) carbodiimide hydrochloride. An in vivo study showed that after 1 week, the artificial dermis containing the fibroblasts enhanced the re-epithelialization of a full-thickness skin defect rather than the acellular scaffold.
Biomaterials.
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ABSTRACT: Gelatin-hyaluronate sponge with and without antibiotic and epidermal growth factor (EGF) were prepared and compared. Four types of sponges were applied on the full-thickness dorsal skin defect of Wistar rat. The effects of antibiotic and EGF in gelatin-hyaluronate sponge on wound healing were investigated by light microscopy and image analyzer at postoperative days of 5, 12 and 21. An immunohistochemical technique, employing PC10, a monoclonal antibody against proliferating cell nuclear antigen (PCNA) was applied to wounded tissue sections. The number of PC10-positive cells was very high for the sponge with EGF at postoperative day 5, then gradually decreased with time. Also we found that antibiotics restrained the cell proliferation during the migratory phase. The sponge with both antibiotic and EGF showed good wound healing performances on the whole for a healing period. The epithelium was regenerated fast with EGF-impregnated sponges at day 5, but each sample had nearly the same length of regenerated epithelium at day 12.
Biomaterials.
