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[en] The first radionuclide gastric emptying study was performed in 1966 and has been the gold standard for gastric emptying detection of gastroparesis for decades, in spite of many other non radionuclide methods proposed and investigated. However, there has been no standardization of the gold standard. The methodology varies considerably between imaging clinics and hospitals, e.g., in the meal, the method of acquisition, processing, quantification, and normal values. Many times the normal values were not validated for the method and meal used. This has frustrated gastroenterologists and other clinicians because it was difficult to compare the results of studies done at different institutions and to have confidence in the results. Consensus Recommendations for Gastric Emptying Scintigraphy have been published simultaneously in 2008 in the Journal of Nuclear Medicine Technology (1) and the American Journal of Gastroenterology (2). Fourteen physicians, half nuclear medicine physicians and half gastroenterologists, met on several occasions, and after much discussion came to these consensus recommendations. This publication recommends the Tougas G, et al. protocol published in 2000 (3). This is a simplified and standardized methodology. It is simplified in the sense that a single image is required only at 0, 1, 2, and 4 hours. It is standardized in that a specific protocol and meal is recommended and normal values based on it were determined with 123 normal subjects from multiple institutions on different continents in different countries. This is by far the largest gastric emptying normal data base that has been published. Simplification is based results of three publications that found no overall significant difference between frequent imaging complicated quantification and a simplified methodology. The rationale for a four hour exam was the results of two publications that had shown increased detection of gastroparesis at four compared to two hours. We have published our experience in 175 patients at Johns Hopkins University with this simplified and standardized protocol (4). At 2 hours 35 patients had delayed emptying; at 4 hours 45 patients had delayed emptying. This was a 32% increase at 4 hours and was significantly different than 2 hours (p <0.02). We also found in that publication that the lag phase, the time before emptying begins was not predictive of overall emptying. (author)
[en] Thirty-six cases of metallic foreign bodies in the stomach were referred for fluoroscopically guided removal by means of a 5-mm diameter magnet coupled to an orogastric tube. The foreign bodies included 29 disk batteries, two nails, two screws, a nut and bolt, an unopened jack knife, and a metallic whistle. The average patient age was 4 years (range, 11 months to 13 years). Removal was successful in 33 of the 36 cases (92%). The three failures were the result of inadvertent passage of the foreign body into the duodenum (two cases) and lack of magnetic attraction (one case). There were no complications. No patient required general anesthesia, hospital admission, or endoscopic surgical intervention
[en] An alpha-fetoprotein-producing gastric cancer is rare, making up only about 3% of all gastric cancers. Further, gastric cancer with metastasis to the scrotum via a transperitoneal route is extremely rare. We report a case of metastatic scrotal mass in a 68-year-old man who had undergone a subtotal gastrectomy and gastroduodenostomy due to signet ring cell type gastric cancer with a description focusing on the radiologic findings
[en] This study examined the change in the attenuation of X-rays with the ROI (Region of Interest) in DR (Digital Radiography) according to the stomach contents by manufacturing a tissue equivalent material phantom to simulate real stomach tissue based on the assumption that there is some attenuation of X-rays and a difference in imaging quality according to the stomach contents. The transit dosage by the attenuation of X-rays decreased with increasing protein thickness, which altered the average ROI values in the film and DR images. A comparison of the change in average ROI values of the film and DR image showed that the image in film caused larger density changes with varying thickness of protein than the image by DR. The results indicate that NPO (nothing by mouth) is more important in film system than in DR system.
[en] Stomach carcinoma is more common disease in Korea than western countries. The reported ultrasonographic findings of gastric carcinoma were thickening of gastric wall and 'pseudokidney' sign. The author analyzed ultrasonographic findings of 101 cases with gastric carcinoma who were performed ultrasonography and gastroscopy at Kyung Hee University Hospital from October 1982 to October 1985. The results were as followings; 1. Types of gastric carcinoma were consisted with infiltrative type 68 cases, infiltrative type with ulceration 16 cases, polypoid type with ulceration 1 case, infiltrative adn polypoid type 4 cases, limits plastica type 3 cases, ulcerative type 1 case and polypoid type 1 case. 2. Extent of the lesions were in body and antrum 45 cases, entire stomach 18 cases, antrum 18 cases, body 12 cases, body and fundus 6 cases. 3. Ultrasonography was useful in demonstrating the extent of the tumor and the presence of materials elsewhere in abdomen