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Differential diagnoses of magnetic resonance imaging for suspected acute appendicitis in pregnant patients

World Journal of Emergency Medicine 2018年第1期9卷 26-32页

作者： Ji yong jung Ji Ung Na Sang Kuk Han Pil Cho Choi Jang Hee LEE Dong Hyuk Shin Department of Emergency Medicine Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine

BACKGROUND: Accurate and timely diagnosis of acute surgical disease in pregnant patient is chal enging. Although magnetic resonance imaging(MRI) is the most accurate modality to diagnose acute appendicitis in pregnant patients, it is often used as a last resort because of high cost and long scan time. We performed this study to analyze differential diagnoses of appendix MRI and to investigate if there are any blood tests that can predict surgical condition in pregnant ***: A retrospective, cross-sectional study was conducted on 46 pregnant patients who underwent non-enhanced appendix MRI in suspicion of acute appendicitis from 2010 to 2016. Differential diagnoses of appendix MRI were analyzed and blood tests were compared between those who had surgical and non-surgical ***: Appendix MRI differentiated two surgical disease; acute appendicitis and ovarian torsion; and various non-surgical conditions such as uterine myoma, hydronephrosis, ureterolithiasis and diverticulitis among clinically suspected acute appendicitis in pregnancy. The diagnostic accuracy of MRI for acute appendicitis in this study was 93.5%. Patients who had surgical disease showed significantly higher WBC count(≥11,000/mm^3), proportion of neutrophils in the WBC(≥79.9%), neutrophil-to-lymphocyte ratio(NLR≥6.4), levels of C-reactive protein(CRP≥1.82 mg/dL) and bilirubin(≥0.66 mg/dL) than those who had non-surgical ***: MRI can reliably differentiate surgical conditions and several blood tests(WBC, proportion of neutrophils in the WBC, NLR, CRP, bilirubin) can help anticipate acute surgical condition among pregnant patients suspected to have acute appendicitis.

关键词： Appendicitis Magnetic resonance imaging Pregnancy Neutrophils

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Patient-reported ejaculatory function and satisfaction in men with lower urinary tract symptoms/benign prostatic hyperplasia

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Asian Journal of Andrology 2018年第1期20卷 69-74页

作者： Min Chul Cho jung Kwon Kim Sang Hoon Song Sung yong Cho Sang Wook Lee Soo Woong Kim Jae-Seung Paick Department of Urology Seoul National University Boramae Medical Center Seou107061 Korea Department of Urology Seoul National University College of Medicine Seoul 03080 Korea Department of Urology Asan Medical Center Seou105505 Korea Department of Urology Kangwon National University College of Medicine Chuncheon 24289 Korea

This study aimed to investigate perceived ejaculatory function/satisfaction before treatment for lower urinary tract symptoms （LUTS）/benign prostatic hyperplasia （BPH） and to identify associations between specific categories of ejaculatory dysfunctions （EjDs） and LUTS. A total of 1574 treatment-naive men with LUTS/BPH were included in this study. All patients underwent routine evaluation for LUTS/BPH including the International Index of Erectile Function and a 5-item questionnaire developed to assess ejaculatory volume/force/pain/satisfaction/latency time. Patients who had sexual intercourse over the past 4 weeks were classified as sexually active group. A total of 783 patients were categorized as sexually active group. Decreased ejaculatory volume and force were reported by 53.4% and 55.7% of 783 sexually active men, respectively, There was a strong correlation between ejaculatory volume and force. Ejaculatory pain/discomfort, premature ejaculation （PE）, and delayed ejaculation （DE） were reported in 41,0%, 16.3%, and 41.4% of the patients, respectively. Over 40.0% of men without decreased ejaculation volume/force were satisfied with ejaculatory function, whereas approximately 6.0% of men with decreased volume/force were satisfied with ejaculatory function. About 30.0% of men with decreased volume/force had orgasmic dysfunction, while approximately 10.0% of men without decreased volume/force did. Decreased ejaculatory volume or force was associated with LUTS severity after adjusting for other influential factors including testosterone level, erectile function, and prostate size on ultrasonography, but PE or DE or ejaculatory pain/discomfort was not. In conclusion, a considerable portion of men with LUTS/BPH appear to have a variety of EjDs. Ejaculatory volume/force and satisfaction/orgasm do not always appear to be concordant. Ejaculatory volume or force is independently associated with LUTS severity, whereas PE or DE or ejaculatory pain/discomfort is not.

关键词： dysfunction ejaculation lower urinary tract symptoms (LUTS) satisfaction

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Comparative standardized ileal amino acid digestibility and metabolizable energy contents of main feed ingredients for growing pigs when adding dietary β-mannanase

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Animal Nutrition 2019年第4期5卷 359-365页

作者： Se Min Jeon Abdolreza Hosseindoust Yo Han Choi Min Ju Kim Kwang Yeol Kim Jun Hyung Lee Dong yong Kil Beob Gyun Kim Byung Jo chae Department of Animal Resources Science College of Animal Life SciencesKangwon National UniversityChuncheon 24341South Korea Swine Division National Institute of Animal ScienceRural Development AdministrationCheonan 31000South Korea Department of Animal Science and Technology Chung-Ang UniversityAnseong-siGyeonggi-do 17546South Korea Department of Animal Science and Technology Konkuk UniversitySeoul 143-701South Korea

The present study was conducted to test whether the dietary supplementation of β-mannanase affects amino acids(AA) digestibility,metabolizable energy(ME) contents of corn,wheat,soybean meal,distillers dried grains with solubles,and palm kernel meal(PKM),nutrient digestibility,and growth performance of *** Exp.1,22 cannulated pigs were used for 10 dietary treatments including 5 feed ingredients and 2 β-mannanase concentrations(0 and 0.5 g/kg of the diet) in 6 periods in an incomplete Latin square design to determine the AA and energy *** Exp.2,200 growing pigs were randomly allotted to 4 treatments with 2 nutrient levels(high and low) and 2 concentrations of β-mannanase(2×2 factorial arrangement) in 2 phases(phase 1,d 0 to 21;and phase 2,d 22 to 42).In Exp.1,β-mannanase increased the mean standardized ileal digestibility(SID) of AA in all feed *** amount of digestible energy was increased(P <0.05) in β-mannanase-treated *** fed β-mannanase showed a greater(P <0.05) digestibility of gross energy(GE).The feed-to-gain(F:G) ratio was improved(P <0.01) in pigs fed high-nutrient *** fed β-mannanase in the diets had greater(P <0.05) average daily gain and F:*** phase 2,the concentration of fecal ammonia was decreased(P <0.05) in pigs fed β-*** the 2 experiments,it can be concluded that β-mannanase increases the SID of AA,which has to be considered in balancing the rations.

关键词： Growing pigs β-mannanase Standardized ileal amino acids Ammonia Metabolizable energy

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Deep-learning-based gas identification by timevariant illumination of a single micro-LEDembedded gas sensor

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Light(Science & Applications) 2023年第5期12卷 826-837页

作者： Incheol Cho Kichul Lee Young Chul Sim Jae-Seok Jeong Minkyu Cho Heechan jung Mingu Kang yong-Hoon Cho Seung Chul Ha Kuk-Jin Yoon Inkyu Park Department of Mechanical Engineering Korea Advanced Institute of Science and Technology(KAIST)291 Daehak-roYuseong-guDaejeon 34141Republic of Korea Department of Physics Korea Advanced Institute of Science and Technology(KAIST)291 Daehak-roYuseong-guDaejeon 34141Republic of Korea SENKO Co. Ltd.485Oesammi-DongOsan-SiGyeonggil-Do 18111Republic of Korea

Electronic nose(e-nose)technology for selectively identifying a target gas through chemoresistive sensors has gained much attention for various applications,such as smart factory and personal health *** overcome the crossreactivity problem of chemoresistive sensors to various gas species,herein,we propose a novel sensing strategy based on a single micro-LED(μLED)-embedded photoactivated(μLP)gas sensor,utilizing the time-variant illumination for identifying the species and concentrations of various target gases.A fast-changing pseudorandom voltage input is applied to the μLED to generate forced transient sensor responses.A deep neural network is employed to analyze the obtained complex transient signals for gas detection and concentration *** proposed sensor system achieves high classification(~96.99%)and quantification(mean absolute percentage error~31.99%)accuracies for various toxic gases(methanol,ethanol,acetone,and nitrogen dioxide)with a single gas sensor consuming 0.53 *** proposed method may significantly improve the efficiency of e-nose technology in terms of cost,space,and power consumption.

关键词： Deep illumination transient

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National trends in alcohol and substance use among adolescents from 2005 to 2021:a Korean serial cross‑sectional study of one million adolescents

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World Journal of Pediatrics 2023年第11期19卷 1071-1081页

作者： Sangil Park Hyunju Yon chae Yeon Ban Hyoin Shin Seounghyun Eum Seung Won Lee Youn Ho Shin jung UShin Ai Koyanagi Louis Jacob Lee Smith Chanyang Min AbdullahÖzgür Yeniova So Young Kim Jinseok Lee Vlasta Hadalin Rosie Kwon Min Ji Koo Guillaume Fond Laurent Boyer Sunyoung Kim Jong Woo Hahn Namwoo Kim Eléa Lefkir Victoire Bondeville Sang Youl Rhee Jae Il Shin Dong Keon Yon Ho Geol Woo Department of Neurology Kyung Hee University Medical Center23 Kyungheedae‑roDongdaemun‑guSeoul 02447South Korea Department of Medicine Kyung Hee University College of MedicineSeoulSouth Korea Department of Precision Medicine Sungkyunkwan University School of MedicineSuwonSouth Korea Department of Pediatrics CHA Gangnam Medical CenterCHA University School of MedicineSeoulSouth Korea Department of Dermatology CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea Research and Development Unit Parc Sanitari Sant Joan de DeuCIBERSAMISCIIIBarcelonaSpain Catalan Institution for Research and Advanced Studies(ICREA) Pg.Lluis CompanysBarcelonaSpain Faculty of Medicine University of Versailles Saint-Quentin-en-YvelinesMontigny‑le‑BretonneuxFrance Centre for Health Performance and WellbeingAnglia Ruskin UniversityCambridgeUK Center for Digital Health Medical Science Research InstituteKyung Hee University Medical CenterKyung Hee University College of MedicineSeoulSouth Korea Division of Gastroenterology Department of Internal MedicineFaculty of MedicineTokat Gaziosmanpaşa UniversityTokatTurkey Department of Otorhinolaryngology‑Head&Neck Surgery CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea Department of Biomedical Engineering Kyung Hee UniversityYonginSouth Korea Faculty of Medicine University of LjubljanaLjubljanaSlovenia Department of Biomedical Engineering University of MichiganAnn ArborMIUSA Department of Human Biology University of TorontoTorontoONCanada AP-HM Aix-Marseille UniversityCEReSS-Health Service Research and Quality of Life CenterMarseilleFrance FondaMental Foundation CreteilFrance Department of Family Medicine Kyung Hee University College of MedicineSeoulSouth Korea Department of Pediatrics Seoul National University Bundang HospitalSeongnamSouth Korea Department of Neuropsychiatry Seoul National University HospitalSeoulSouth Korea Faculty of Medicine University of Rennes 1RennesFrance Department

Background Although previous studies have provided data on early pandemic periods of alcohol and substance use in adolescents,more adequate studies are needed to predict the trends of alcohol and substance use during recent periods,including the mid-pandemic *** study investigated the changes in alcohol and substance use,except tobacco use,throughout the pre-,early-,and mid-pandemic periods in adolescents using a nationwide serial cross-sectional survey from South *** Data on 1,109,776 Korean adolescents aged 13–18 years from 2005 to 2021 were obtained in a survey operated by the Korea Disease Control and Prevention *** evaluated adolescents’alcohol and substance consumption prevalence and compared the slope of alcohol and substance prevalence before and during the COVID-19 pandemic to see the trend *** define the pre-COVID-19 period as consisting of four groups of consecutive years(2005–2008,2009–2012,2013–2015,and 2016–2019).The COVID-19 pandemic period is composed of 2020(early-pandemic era)and 2021(midpandemic era).Results More than a million adolescents successfully met the inclusion *** weighted prevalence of current alcohol use was 26.8%[95%confidence interval(CI)26.4–27.1]from 2005 to 2008 and 10.5%(95%CI 10.1–11.0)in 2020 and *** weighted prevalence of substance use was 1.1%(95%CI 1.1–1.2)from 2005 to 2008 and 0.7%(95%CI 0.6–0.7)between 2020 and *** 2005 to 2021,the overall trend of use of both alcohol and drugs was found to decrease,but the decline has slowed since COVID-19 epidemic(current alcohol use:βdiff 0.167;95%CI 0.150–0.184;substance use:βdiff 0.152;95%CI 0.110–0.194).The changes in the slope of current alcohol and substance use showed a consistent slowdown with regard to sex,grade,residence area,and smoking status from 2005 to *** The overall prevalence of alcohol consumption and substance use among over one million Korean adolescents from the early and mid-stage(2020–2021)of the COVID

关键词： Alcohol Adolescent Corona virus disease 2019 South Korea Substance use

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Salvage living donor liver transplantation for recurrent hepatocellular carcinoma after prior laparoscopic hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2018年第5期17卷 473-476页

作者： Seok-Hwan Kim Ki-Hun Kim Tae-yong Ha Dong-Hwan jung Gil-Chun Park Sung-Gyu Lee Division of Hepatobiliary Surgery and Liver Transplantation Department of SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea Department of Surgery Chungnam National University HospitalChungnam National University School of MedicineDaejeonKorea

Salvage liver transplantation(LT)is frequently performed on patients who experience recurrent hepatocellular carcinoma(HCC)after primary hepatectomy for HCC[1,2].The main concern in these patients is the technical feasibility of salvage LT,especially as prior hepatectomy may result in heavy adhesions[3,4].Salvage living donor LT(LDLT)is a more demanding procedure than salvage deceased donor LT(DDLT)using an entire donor graft with a long vascular pedicle[5,6].Because less than optimal dissection of perihepatic adhesions could result in uncontrollable pinpoint bleedings at the dissection surface[1,5],many transplant surgeons avoid performing salvage *** invasive laparoscopic hepatectomy(LH)results in fewer intraperitoneal adhesions than the open method,reducing the difficulty of surgical dissection during future LT[7–10].To date,however,no study has compared salvage LDLT for recurrent HCC after LH to that after open hepatectomy(OH).

关键词： LDLT experience recurrent

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Effects of Ginkgo biloba extracts with mirodenafil on the relaxation of corpus cavernosal smooth muscle and the potassium channel activity of corporal smooth muscle cells

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Asian Journal of Andrology 2011年第5期13卷 742-746页

作者： jung Jun Kim Deok Hyun Han Soo Hyun Lim Tae Hun Kim Mee Ree chae Kyung Jin Chung Sung Chul Kam Ju-Hong Jeon Jong Kwan Parks Sung Won Lee Department of Urology Samsung Medical Center Sungkyunkwan University School of Medicine Seou1135-710 Korea Department of Urology Gachon University Gil Hospital Incheon 405-760 Korea Department of Urology Gyeengsang National University College of Medicine Gyeongsangnam-do 660-702 Korea Department of Physiology and Biophysics Seeul National University College of Medicine Seeul 110-799 Korea Department of Urology Medical School Chonbuk National University and Institute for Medical Sciences Chonbuk National University and Research Institute and Clinical Trial Center of Medical Device of Chonbuk National University Hospital Jeonju-si 561-712 Korea

In this study, we investigated the effects of a combination of Ginkgo biloba extracts （GBE） and phosphodiesterase type 5 （PDE-5） inhibitors on the muscular tone of the corpus cavernosum and potassium channel activity of corporal smooth muscle cells. Strips of corpus cavernosum from male New Zealand white rabbits were mounted in organ baths for isometric tension studies. After contraction with 1 × 10^-5 mol I^-1 norepinephrine, GBE （0.01-1 mg ml^-1） and mirodenafil （0.01-100 nmol I^-1） were added together into the organ bath. In electrophysiological studies, whole-cell currents were recorded by the conventional patch-clamp technique in cultured smooth muscle cells of the human corpus cavernosum. The corpus cavemosum was relaxed in response to GBE in a dose-dependent manner （from 0.64%±8.35% at 0.01 mg ml^-1 to 52.28%±11.42% at 1 mg ml^-1）. After pre-treatment with 0.03 mg ml^-1 of GBE, the relaxant effects of mirodenafil were increased at all concentrations, After tetraethylammonium （TEA）（1 mmol I^-1） administration, the increased effects were inhibited （P〈0.01）. Extracellular administration of GBE increased the whole-cell K^＋ outward currents in a dose-dependent fashion. The increase of the outward current was inhibited by I mmol 1-1 TEA. These results suggest that GBE could increase the relaxant potency of mirodenafil even at a minimally effective dose. The K＋ flow through potassium channels might be one of the mechanisms involved in this synergistic relaxation.

关键词： calcium-activated potassium channels erectile dysfunction Ginkgo biloba phosphodiesterase inhibitors smooth muscles

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Quality of life outcomes including neuropathy-associated scale from a phase II,multicenter,randomized trial of eribulin plus gemcitabine versus paclitaxel plus gemcitabine as first-line chemotherapy for HER2-negative metastatic breast cancer:Korean Cancer Study Group Trial(KCSG BR13-11)

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Cancer Communications 2019年第1期39卷 271-278页

作者： Ji-Yeon Kim Seri Park Seock-Ah Im Sung-Bae Kim Joohyuk Sohn Keun Seok Lee Yee Soo chae Ki Hyeong Lee Jee Hyun Kim Young-Hyuck Im Tae-yong Kim Kyung-Hun Lee Jin-Hee Ahn Gun Min Kim In Hae Park Soo jung Lee Hye Sook Han Se Hyun Kim Kyung Hae jung Yeon Hee Park Korean Cancer Study Group Division of Hematology-Oncology Department of MedicineSamsung Medical CenterSungkyunkwan University School of Medicine81 Irwon-roGangnam-guSeoul 06351South Korea Department of Health Sciences and Technology Samsung Advanced Institute for Health Sciences and TechnologySungkyunkwan UniversitySeoul 06351South Korea Department of Internal Medicine Seoul National University HospitalCancer Research InstituteCollege of MedicineSeoul National UniversitySeoul 03080South Korea Department of Oncology Asan Medical CenterUniversity of Ulsan College of MedicineSeoul 05505South Korea Division of Medical Oncology Department of Internal MedicineYonsei University College of MedicineSeoul 03722South Korea Center for Breast Cancer National Cancer CenterGoyang 10408South Korea Department of Internal Medicine Kyungpook National University HospitalDaegu 41944South Korea Deparment of Internal Medicine Chungbuk National University HospitalCheongju 28644South Korea Department of Internal Medicine Seoul National University Bundang HospitalSeoul National University College of MedicineSeongnam 13620South Korea

Background: A phase II clinical trial of the comparison between eribulin plus gemcitabine (EG) and paclitaxel plus gemcitabine (PG) as first-line chemotherapy for patients with metastatic breast cancer (MBC) found that the EG regimen was less neurotoxic, but was similar in efficacy to the PG regimen. In the present study, we analyzed functional assessment of cancer therapy-taxane (FACT-Taxane) questionnaires from patients in this clinical trial to determine their quality of life (QoL). Methods: QoL was assessed using the Korean version of the FACT-Taxane questionnaires. After baseline assessment, QoL was assessed every 2 cycles for 12 cycles and every 3 cycles thereafter. The linear mixed model was used to evaluate the difference in QoL between the EG and PG arms. Results: Of the 118 enrolled patients, 117 responded to the FACT-Taxane questionnaires at baseline, 1 in the PG arm did not. Baseline QoL scores were not different between the EG and PG arms. During treatment, taxane subscale scores were significantly higher in the PG arm than in the EG arm after 2-13 cycles of chemotherapy (all P < 0.05), except for the 11th cycle. Neuropathy-specific analysis showed that patients in the PG arm had earlier and more severe neuropathic symptoms than those in the EG arm (P < 0.001). Conclusions: In our QoL analysis, the EG regimen delayed and decreased neuropathy as compared with the PG regimen. Therefore, eribulin would be a reasonable substitute for paclitaxel as first-line chemotherapy for MBC.

关键词： Metastatic breast cancer Eribulin Paclitaxel Neuropathy Quality of life Functional assessment of cancer therapy-taxane questionnaires

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Does the bile duct angulation affect recurrence of choledocholithiasis?

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World Journal of Gastroenterology 2011年第36期17卷 4118-4123页

作者： Dong Beom Seo Byoung Wook Bang Seok Jeong Don Haeng Lee Shin Goo Park yong Sun Jeon jung Il Lee Jin-Woo Lee Division of Gastroenterology Department of Internal MedicineInha University School of MedicineIncheon 400-711South Korea Division of Gastroenterology Department of Internal Medicine and Center for Advanced Medical Education by BK21 ProjectInha University School of Medicineand Utah-Inha DDS and Advanced Therapeutics Research CenterIncheon 400-711South Korea Department of Occupational and Environmental Medicine Inha University School of MedicineIncheon 400-711South Korea Department of Radiology Inha University School of MedicineIncheon400-711South Korea

AIM:To investigate whether bile duct angulation and T-tube choledochostomy influence the recurrence of ***:We conducted a retrospective study including 259 patients who underwent endoscopic sphincterotomy and cholecystectomy for choledocholithiasis between 2000 and *** imaginary line was drawn along the center of the bile duct and each internal angle was measured at the two angulation sites ofthe bile duct *** values of both angles were added *** then tested our hypothesis by examining whether T-tube choledochostomy was performed and stone recurrence occurred by reviewing each subject's medical ***:The overall recurrence rate was 9.3% (24 of 259 patients).The mean value of sums of angles in the recurrence group was 268.3°± 29.6°,while that in the non-recurrence group was 314.8°± 19.9° (P < 0.05).Recurrence rate of the T-tube group was 15.9% (17 of 107),while that of the non T-tube group was 4.6% (7 of 152) (P < 0.05).Mean value of sums of angles after T-tube drainage was 262.5°± 24.6° and that before T-tube drainage was 298.0°± 23.9° in 22 patients (P < 0.05).CONCLUSION:The bile duct angulation and T-tube choledochostomy may be risk factors of recurrence of bile duct stones.

关键词：胆总管结石复发率胆管平均价值危险因素患者切除术括约肌

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Reduction of gastrointestinal motility by unilateral thyroparathyroidectomy plus subdiaphragmatic vagotomy in rats

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World Journal of Gastroenterology 2012年第33期18卷 4570-4577页

作者： Jun Ho Lee Oh Deog Kwon Seon Ho Ahn Keun Han Choi Ji Hye Park Seoul Lee Bong Kyu Choi Kyu yong jung Department of Pharmacology Wonkwang University School of Medicine Jeonbuk 570-749 South Korea Department of Clinical Pathology College of Veterinary Medicine Kyungpook National University Daegu 702-701 South Korea Department of Internal Medicine Wonkwang University School of Medicine Jeonbuk 570-749 South Korea

AIM: To investigate whether the combined methods of unilateral thyroparathyroidectomy (TPX) and subdiaphragmatic vagotomy (VAX) can be adapted for rats and used as a reliable method to produce a rat model of long-term reduction of gastrointestinal (GI) motor function. METHODS: Male Sprague-Dawley rats were randomly divided into 3 groups, normal, sham-operated and unilateral TPX plus VAX. The TPX plus VAX rats received VAX 7 d after application of TPX, and dietary intake and fecal output were then measured daily for 1 *** completion of the experiments, gastric emptying and small bowel transit were measured in vivo, and the contractile responses of colonic strips to excitatory and inhibitory neurotransmitters were estimated using isometric force transducers in vitro. RESULTS: In comparison with normal and sham-operated rats, rats which received unilateral TPX plus VAX showed a significant decrease in body weight and in fecal pellet number and weight throughout the entire week. Application of TPX plus VAX to rats markedly delayed gastric emptying and small bowel transit. In TPX plus VAX rats, the longitudinal muscles of the proximal colon showed a significant reduction in contractile responses to acetylcholine (5 × 10-6 mol/L), and a dramatic attenuation of contractile responses was also observed in both the longitudinal and circular muscles of the distal colon. However, the spontaneous contractility of the colonic strips from TPX plus VAX rats was not significantly affected by treatment with N-nitro-Larginine-methyl ester (0.1 mol/L). CONCLUSION: The results indicate that unilateral TPX plus VAX reduced the motor function of the GI tract in rats, and the reduced gut motility is likely mediated, at least in part, by inhibition of the excitatory neurotransmitter system.

关键词：大鼠模型迷走神经胃肠道胃蠕动单方兴奋性神经递质抑制性神经递质 VAX

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