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全文: "gastrectomy"
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  • Satoshi ITO, Teiji IZUMI, Masaaki ARAKAWA
    Internal Medicine
    1999年 38 巻 9 号 751
    発行日: 1999年
    公開日: 2006/03/27
    ジャーナル フリー
  • Kunihiro Iwata, Kyoji Ogoshi, Tomoo Tajima, Hiroyasu Makuuchi
    Annals of Cancer Research and Therapy
    2000年 8 巻 1-2 号 97-111
    発行日: 2000年
    公開日: 2009/01/20
    ジャーナル フリー
    Four hundred forty-two patients underwent gastrectomy for carcinoma of the stomach to determine the impact of various gastrectomy procedures on patients' prognosis, and to assess the phenotypes of lymphocytes before and after gastrectomy. During the 3-6 postoperative months, there were significant differences between patients who received total gastrectomy and subtotal gastrectomy as regards the CD4+/CD8+ ratio. The 10-year survival rates of patients who received a subtotal gastrectomy were significantly better than those of patients who underwent total gastrectomy. A Cox multivariate analysis revealed that the extent of resection was a significantly related to independent covariate with patient prognosis.
  • T. KOBAYASHI, T. HOSOBA, M. MORI, H. MIMURA, J. MIYAKE, K. HAMAZAKI, H. TSUGE, K. ORITA, T. YAMASATO, T. NEYA, M. MIZUTANI, S. NAKAYAMA
    Journal of Smooth Muscle Research
    1994年 30 巻 3 号 85-96
    発行日: 1994年
    公開日: 2011/10/28
    ジャーナル フリー
    The effects of subtotal-gastrectomy (gastrectomy) on the spontaneous motility and caerulein-induced relaxation of the sphincter of Oddi (SO) were investigated in the dog. The spontaneous motility and the response to caerulein ofthe SO were recorded using perfusion method.
    The basal perfusion pressure (5.1±0.5 cmH2O) and the frequency of phasic contractions (6.1±0.5 cycles/min, c/min) of the SO increased to 8.2±0.6 cmH20 (p<0.05) and 9.3±0.4c/min (p<0.05) after gastrectomy, respectively. They were observed one month after operation (7.8±0.5 cmH2O and 9.1±0.9 c/min, p<0.05), but did not change by vagotomy with sympathectomy (vagosympathectomy).
    In the spontaneous motility of the SO, the motility index increased to 143.7±18.7% (p<0.05) at 4 hrs and 135.0±9.1% (p<0.05) at one month after gastrectomy, but did not increase after vagosympathectomy.
    Caerulein had an inhibitory effect on the SO motility in the normal animal (48.0±4.2%). Gastrectomy reversed to the excitatory effect from theinhibitory effect to caerulein at 4 hrs (127.6±5.3%, p<0.05) and at one month (126.6±5.3%, p<0.05) after operation, but not reversed by vagosympathectomy and sham gastrectomy. The excitatory response to caerulein after gastrectomy was not effected by vagosympathectomy. It is concluded that gastrectomy induced the SO dysfunction, an increase of the perfusion pressure and the frequency of phasic contractions of the SO, and a change of the response to caerulein of the SO. Thesealterations suggests that one of the mechanisms of the regulation of the SO motility exist as the reflex from the stomach and/or uppermost duodenum through intrinsic nervous pathways.
  • Satoshi Mizutani, Takeshi Shioya, Kentaro Maejima, Masanori Yoshino, Osamu Komine, Hideki Bou, Masao Ogata, Masanori Watanabe, Tetsuo Shibuya, Akira Tokunaga, Takashi Tajiri
    Journal of Nippon Medical School
    2007年 74 巻 3 号 241-245
    発行日: 2007年
    公開日: 2007/07/12
    ジャーナル フリー
    We conducted a clinicopathological study of cases of gastric carcinoma with pyloric stenosis and examined treatment outcomes and the prognosis of cases of stage IV gastric carcinoma with pyloric stenosis and the validity of gastrectomy as palliative surgery in these cases. The outcomes of 49 surgeries for gastric carcinoma with pyloric stenosis were compared with those of 671 surgeries for gastric carcinoma without pyloric stenosis. The diagnosis of pyloric stenosis was confirmed with both upper gastrointestinal endoscopy and an upper gastrointestinal barium series. The frequency of pyloric stenosis in patients with gastric carcinoma was 7.3%. Serosal invasion was observed in about 70% of all cases. Of these cases, 53.1% were classified as stage IV. The resection rate was 73.5%, and the resection was classified as curative in 44.9% of cases. The incidence of complications after surgery in cases of stage IV gastric carcinoma was 47.1%. The median survival time was significantly greater in patients undergoing resection group than in those not undergoing resection (p=0.025). Most patients with gastric cancer and pyloric stenosis can be considered to have stage IV disease, which is associated with high rates of morbidity and mortality; thus, prevention of complications, and therefore, avoidance of gastrectomy is recommended in such patients. Nonetheless, in this study, gastrectomy was shown to improve prognoses in these patients.
  • Ming-Tsan LIN
    Journal of Nutritional Science and Vitaminology
    2015年 61 巻 Supplement 号 S115
    発行日: 2015年
    公開日: 2015/11/24
    ジャーナル フリー
    Gastric cancer is one of the most common gastrointestinal cancer, which gastrectomy offers best curative intent. Multidisciplinary team cares enhance gastrectomy cases fast recovery.
  • Yoshinori YAMASHITA, Tetsuya TOGE, Thomas E. ADRIAN
    Journal of Smooth Muscle Research
    1997年 33 巻 2 号 37-48
    発行日: 1997年
    公開日: 2010/07/21
    ジャーナル フリー
    Several problems are associated with gastric resection, including the dumping syndrome, reflux esophagitis, and malabsorption. A better understanding of the pathophysiological changes will shed light on new and improved therapy. Serum levels of seven circulating gastrointestinal hormones following a standardized solid meal and a brief score of symptoms were evaluated in 10 patients after partial distal gastrectomy and 12 patients after total gastrectomy, both groups reconstructed by Billroth II anastomosis, and 9 age-matched healthy controls. Patients underwent resection for gastric cancer and were studied 45±10 months after surgery. At the time of study, the patients had adapted well to surgery and no longer exhibited the severe symptoms of dumping seen immediately post-operatively .In contrast, the total gastrectomy patients exhibited the symptoms of reflux esophagitis .The gastrointestinal hormone changes could be divided into three patterns; obtunded responses (gastrin, PP), normal release (motilin, GIP) and increased secretion (CCK, neurotensin, PYY). In these, the early reaction of neurotensin correlated with the scores of late dumping syndrome and reflux esophagitis. In the literature, many gastrointestinal hor mones have been shown to respond as an enhancement rather than adaptation . In other gastrointestinal hormones, secretin belonged to the obtunded type and enteroglucagon were classified in the increased type. However, pathophysiological significance of these hormonal changes remained uncertain. The late adaptive changes in gastrointestinal hormone secretion may help to compensate for loss of gastric motor function which accompanies gastric resection. On the other hand, these hormonal changes may exacerbate the esophageal reflux following gastrectomy.
  • Norikazu ARAKURA, Tetsuya ITO, Eiji TANAKA, Takeji UMEMURA
    信州医学雑誌
    2015年 63 巻 6 号 385-389
    発行日: 2015/12/10
    公開日: 2016/01/22
    ジャーナル フリー
    Aims : We assessed the success rate at our endoscopic center in patients with a Billroth I gastrectomy and compared it to the rate in patients without a gastrectomy, retrospectively, and assessed the clinical utility of a multi-bending duodenoscope for bile duct cannulation in patients with a Billroth I gastrectomy.
    Patients and Methods : Six-hundred and twenty patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with the use of a conventional single-bending duodenoscope and 26 patients who underwent ERCP with a multi-bending duodenoscope were enrolled. Of the 620 patients, 560 had no history of gastrectomy and the remaining 60 had had a Billroth I gastrectomy. The latter 26 patients included six patients whose bile duct cannulation was unsuccessful by conventional endoscope (three of whom were without gastrectomy and the other three had had a Billroth I gastrectomy).
    Results : The success rate of bile duct cannulation in the patients who underwent ERCP with the conventional duodenoscope was higher in those without gastrectomy (89%) than in those with a Billroth I gastrectomy (85%), but the difference was not significant. Bile duct cannulation was successful with the multi-bending duodenoscope in all three patients with a Billroth I gastrectomy whose previous cannulation by conventional endoscopy was unsuccessful. In contrast, the cannulation was not successful in all three patients without gastrectomy whose previous cannulation was unsuccessful by conventional endoscopy. The success rate in the 20 naive patients without gastrectomy was 95% by multi-bending duodenoscope. The incidence of post-ERCP pancreatitis was similar between the patients with the use of the single- (7.6%) and multi-bending (7.7%) duodenoscopes.
    Conclusion : Our preliminary data suggest that the success rate of bile duct cannulation in the patients who underwent ERCP with the single-bending duodenoscope (TJF-260V) was higher in those without gastrectomy (89%) than in those with a Billroth I gastrectomy and a multi-bending duodenoscope might be beneficial for bile duct cannulation in patients with a Billroth I gastrectomy.
  • Teruo Kiyama, Takashi Mizutani, Takeshi Okuda, Itsuo Fujita, Naoyuki Yamashita, Kengo Ikeda, Hitoshi Kanno, Toshiro Yoshiyuki, Shunji Kato, Akira Tokunaga, Takashi Tajiri
    Journal of Nippon Medical School
    2006年 73 巻 4 号 214-220
    発行日: 2006年
    公開日: 2006/08/28
    ジャーナル フリー
    The purpose of this study was to clarify the safety and value of laparoscopic surgery for gastric cancer. This retrospective study involved 101 patients with gastric cancer treated with laparoscopic surgery at the Nippon Medical School Hospital from February 2001 through July 2005. The following variables were evaluated: age, sex, comorbid conditions, tumor size, location, gross type, histological type, depth of wall invasion, and presence or absence of lymph node metastasis. The surgical variables investigated included operating time, blood loss, postoperative complications, and length of postoperative stay. Mean tumor diameter was 24.1 ± 18.4 mm, and most tumors were located in the lower third of the stomach. Endoscopic examination revealed that 98 of the tumors were early gastric cancers. The mean operation time was 255 ± 74 min, and mean blood loss was 128 ± 162 g. Local gastrectomy without lymphadenectomy was performed in 13 cases, and pylorus-preserving gastrectomy with perigastric lymphadenectomy was performed in 16 cases. Distal gastrectomy with systemic lymphadenectomy was performed in 56 cases. Proximal or total gastrectomy with lymph node dissection for tumors located in the upper half of the stomach was performed in 16 cases. The mean postoperative hospital stay was 13.3 ± 7.6 days. No patients died during the admission. Postoperative surgical complications occurred in 10 patients (10%) and consisted of anastomotic bleeding in 3 patients, pneumohypoderma in 1 patient, and remote infection in 6 patients. The only medical complication was a stroke in 1 patient. We conclude that laparoscopy-assisted gastrectomy is a safe and useful operation for most early gastric cancers. If patients are selected properly, laparoscopy-assisted gastrectomy can be a curative and minimally invasive treatment for gastric cancer.
  • Nobuyasu Imabayashi
    関西医科大学雑誌
    1989年 41 巻 Supplement 号 S18-S26
    発行日: 1989/12/20
    公開日: 2013/02/19
    ジャーナル フリー
    One hundred and twenty-five cases of pr oximal gastric cancer out of 842 cases of primary gastric cancer seen between 1976 and 1985 were investigated. The incidence of proximal gastric cancer and the incidence of stages I and II have been increasing. Investigation of survival rates indicates the necessity of curative resection of proximal gastric cancer. Proximal gastrectomy could achieve the aim of radical, i. e., curative treatment, if it is performed in appropriate cases of proximal gastric cancer, that is: 1) carcinoma arising in the proximal third of the stomach without cancer expansion to the middle third of the stomach,2) superficial cancer limited to submucosa invasion, and 3) no metastasis into lymph nodes along distal portion of stomach. Splenectomy was thought to be unnecessary for curative surgery in patients with superficial cancer.
  • HISAFUMI KINOSHITA, HIROYASU IMAYAMA, KOTARO HASHINO, SHIGEAKI AOYAGI
    The Kurume Medical Journal
    2000年 47 巻 2 号 105-108
    発行日: 2000/06/15
    公開日: 2009/08/11
    ジャーナル フリー
    We studied cholelithiasis that occurred after gastrectomy in 52 patients (35 males and 17 females) encountered at our department between January, 1978 and December, 1998. Gastrectomy had been performed for gastric or duodenal ulcer in 35, gastric cancer in 14, gastroptosis in 2, and gastric trauma in 1 of these patients. Reconstruction after gastrectomy was performed by the Billroth II method (B-ll method) in 31 patients, Billroth I method (B-I method) in 17, Roux-en-Y method (Roux-Y method) in 3, and esophagogastrostomy in 1. The period between gastrectomy and discovery of gallstones was 1-5 years in 9, 5-10 years in 10, and 10 years or longer in 33, or more than 60% of the patients. Gallstones were present in the gallbladder alone in 33, bile duct alone in 9, gallbladder and bile duct in 10; the percentage of bile duct stones was high. The type of stones was bilirubin-calcium stones in 21, black stones in 12, pure cholesterol stones in 1, combined stones in 4, mixed stones in 12, and others in 2; pigment stones accounted for 63.5%. Gallstones were symptomatic in 78.8% of the patients, and abdominal pain was the most frequent symptom. Bile was positive on bacterial culture in 68.4%, and Gram-negative bacilli were the most frequently isolated. Lymph node dissection, vagotomy, cholestasis, and biliary tract infection are considered to be related to cholelithiasis after gastrectomy.
  • SHIGEO UKYO
    THE JOURNAL OF VITAMINOLOGY
    1962年 8 巻 1 号 57-67
    発行日: 1962/03/10
    公開日: 2010/02/26
    ジャーナル フリー
    The intestinal absorption of orally administered Co60-B12 was studied in Japanese subjects having undergone gastrectomy by means of either fecal or urinary excretion test or hepatic uptake method. At the same time, in conformity of the reports that D-sorbitol is able to enhance B12 absorption in normal persons, the effect of the agent was investigated in gastrectomized subjects. Results obtained are as follows:
    1. In extensive gastric resection such as total or subtotal gastrectomy, a strikingly defective B12 absorption was observed in all the cases tested by either method. The defect in B12 absorption was corrected by the addition of hog intrinsic factor, indicating that the lack of intrinsic factor is responsible for the defect. In partial gastrectomy, however, B12 absorption was found to be normal in all the cases but one. Thus the author was led to a conclusion that the more extensive the gastric resection, the more defective the B12 absorption in general.
    2. As regards the enhancing effect of D-sorbitol, it was noted that the addition of the agent did correct the defective B12 absorption in subtotal gastrectomy, but did not in total gastrectomy. So it was concluded (a) that D-sorbitol had no intrinsic factor activity itself and (b) that the agent could enhance B12 absorption only when the resected stomach preserved the function of intrinsic factor secretion, no matter how little it may be.
    3. Of interest was the B12 absorption in a case of subtotal gastrectomy; neither hog intrinsic factor nor D-sorbitol was effective for the enhancement of the B12 absorption, whereas tetracycline administration resulted in a marked improvement of the defective B12 absorption. Thus the defective absorption was demonstrated to be due solely to abnormal bacterial population in the intestine rather than to the lack of intrinsic factor.
    4. In addition, some brief comments were made on the relation between B12 absorption and megaloblastic anemia following gastrectomy.
  • 服部 孝雄, 伊藤 一二, 平田 克治, 飯塚 紀文, 阿部 克己
    GANN Japanese Journal of Cancer Research
    1966年 57 巻 5 号 441-451
    発行日: 1966/10/31
    公開日: 2008/10/23
    ジャーナル フリー
    A large dose of Mitomycin-C was given during gastrectomy and on the first postoperative day in 489 gastric cancer patients. Both from the analysis of the postoperative complications and from the post-operative mortality, the harmlessness of this method was shown. The intermediate results of gastrectomy were investigated in 515 non-curative gastrectomy cases. The cases in which a large-dose administration of Mitomycin-C was carried out during gastrectomy showed an excellent survival rate at 6, 12, and 18 months after the operation as compared with the control group. The transplantation of homologous bone marrow cells seems to diminish the possibility of recurrence in enhancing the effect of chemotherapy, and its mechanism was discussed.
  • Horst Hamelmann, Hans Troidl, Henning Rohde
    日本消化器外科学会雑誌
    1976年 9 巻 5 号 687
    発行日: 1976年
    公開日: 2011/03/02
    ジャーナル フリー
  • Hiromichi Maeda, Tsutomu Namikawa, Ken Okamoto, Eri Munekage, Makoto Toi, Makoto Hiroi, Atsunori Takeshita, Kazuhiro Hanazaki, Michiya Kobayashi
    Annals of Cancer Research and Therapy
    2017年 25 巻 1 号 17-21
    発行日: 2017/02/14
    公開日: 2017/06/22
    ジャーナル フリー

    Reports suggest that jejunal pouch interposition (JPI) after proximal gastrectomy is superior in terms of food intake volume and prevention of reflux esophagitis early after surgery. However, the long-term results and late complications of the procedure are not well known. This case report describes an excessive pouch dilatation necessitating surgical intervention as a late complication of JPI. The patient was a 62-year-old woman with early gastric cancer who underwent proximal gastrectomy. Gastrointestinal continuity was restored with JPI. The patient’s postoperative course was uneventful and follow-up imaging studies showed no signs of tumor recurrence. However, the patient gradually started to experience difficulty eating food and complained of postprandial nausea and vomiting. Contrast radiography of the upper gastrointestinal tract revealed a dilated jejunal pouch, which eventually required surgical intervention. The jejunal pouch and remnant stomach were resected, followed by Roux-en-Y reconstruction. The postoperative course was uneventful and the symptoms subsided. The present case highlights the importance of a clinical study focusing on the long-term results of this surgical procedure.

  • Takeshi AOKI, Masahiko MURAKAMI, Hirohisa KATO, Tetsuo SAWATANI, Atsushi SATO, Mitsuo KUSANO
    The Showa University Journal of Medical Sciences
    2005年 17 巻 1 号 1-6
    発行日: 2005年
    公開日: 2010/09/09
    ジャーナル フリー
    Reflux esophagitis is a common intractable postoperative complication, especially after procedures such as total gastrectomy, when it manifests itself as alkali esophagitis. Although medications such as proton pump inhibitors (PPI) are said to be efficacious in the treatment of reflux esophagitis, the mechanism of the curative effect of such drugs remains unclear. To address this issue, we performed esophago-duodenostomy on Wistar rats after total gastrectomy, to establish a rat model for reflux esophagitis. An esophagoduodenostomy with an end-to-side anastomosis was performed following a total gastrectomy, and animals were sacrificed at 4, 7, 14, 21, and 28 days after the operation. Esophageal epithelial lesions following histological sectioning were observed under the microscope after fixing the specimens in formalin, and the image analysis of the affected area was carried out on a computer. Lesions were detected as early as seven days after the operation. The total area of the lesions of the esophageal epithelium reached a peak 21 days following the operation, and consisted of sores, ulcers, cornification, mamilliform hyperplasia and hypertrophy. The results enabled us to establish a critical reflux esophagitis model following esophago-duodenostomy after total gastrectomy in rats.
  • 武藤 完雄, 間島 進, 吉田 弘一, 軽部 克己, 手島 貞一, 山口 巌
    The Tohoku Journal of Experimental Medicine
    1963年 81 巻 3 号 267-278
    発行日: 1963/12/25
    公開日: 2008/11/28
    ジャーナル フリー
  • Kyoji Ogoshi, Toshio Mitomi, Kaichi Isono, Kouzaburou Kimura, Kunio Okajima, Kimiyoshi Tsuji, Minoru Sugita
    Annals of Cancer Research and Therapy
    1998年 7 巻 2 号 109-120
    発行日: 1998/12/31
    公開日: 2009/01/20
    ジャーナル フリー
    To evaluate the effectiveness of immunotherapy using PSK, an immunomodulator, a controlled study was implemented from February 1987 to November 1989 at 16 institutions in Japan. Postoperative adjuvant therapy completely accomplished was continued for at least 3 months until to the tumor progression. The aim of the present retrospective study was to evaluate the indications for PSK therapy by using 653 patients drawn from this controlled study, who were completely accomplished therapies. Two hundred twenty-two patients underwent surgery alone, 184 received gastrectomy plus complete PSK therapy, 146 received gastrectomy plus complete chemotherapy, and 101 received gastrectomy plus complete chemotherapy plus PSK. There was a significant difference in survival between patients receiving gastrectomy alone and PSK, but not between those receiving chemotherapy and chemotherapy + PSK. There was also a significant difference in survival between patients with and without PSK. Among CEA-negative patients, there was a significant difference in survival between patients receiving gastrectomy alone and those receiving PSK, while among CEA-positive patients, there was a significant difference in survival between both gastrectomy alone and PSK, and chemotherapy and chemotherapy + PSK. Using the Cox's proportional-hazard model, we identified that PSK therapy prolonged survival times in patients with abnormal levels of IAP, ASP, SA, and CEA, while in those with normal level of ACT with statistical significance, and that the stata of CEA and SA levels might be best predictive values of response to PSK treatment in gastric cancer.
  • Jun IWAMOTO, Yoshihiro SATO, Hideo MATSUMOTO
    Journal of Nutritional Science and Vitaminology
    2014年 60 巻 2 号 71-77
    発行日: 2014年
    公開日: 2014/06/30
    ジャーナル フリー
    Gastrectomy (GX) induces osteopenia in rats. The present study examined the skeletal effects of vitamin K2 in GX rats. Thirty male Sprague-Dawley rats (12 wk old) were randomized by the stratified weight method into the following three groups of 10 animals each: sham operation (control) group; GX group; and GX+oral vitamin K2 (menatetrenone, 30 mg/kg, 5 d/wk) group. Treatment was initiated at 1 wk after surgery. After 6 wk of treatment, the bone mineral content (BMC), bone mineral density (BMD), and mechanical strength of the femoral diaphysis and distal metaphysis were determined by peripheral quantitative computed tomography and mechanical strength tests, respectively. GX induced decreases in the BMC, BMD, and ultimate force of the femoral diaphysis and distal metaphysis. Vitamin K2 did not significantly influence the BMC or BMD of the femoral diaphysis or distal metaphysis in GX rats, but attenuated the decrease in the ultimate force and increased the stiffness of the femoral diaphysis. The present study showed that administration of vitamin K2 to GX rats improved the bone strength of the femoral diaphysis without altering the BMC or BMD, suggesting effects of vitamin K2 on the cortical bone quality.
  • 服部 孝雄, 森 彬, 平田 克治, 伊藤 一二
    GANN Japanese Journal of Cancer Research
    1972年 63 巻 5 号 517-522
    発行日: 1972/10/31
    公開日: 2008/10/23
    ジャーナル フリー
    Long-term results of cancer chemotherapy as an adjunct to gastrectomy were investigated in 704 gastric cancer patients. A single dose of 20-30mg of Mitomycin-C was administered concentratively on the day of and the day following gastrectomy, or intermittently twice a week with a single dose of 10mg. A good response was observed in the group of concentrative administration, especially in the patients of stages III and IV. An effect of combining the allogeneic bone marrow transplantation with cancer chemotherapy should also be emphasized. Concerning the anticancer effect of the transplanted bone marrow cells the possibility of non-specific participation of anaerobic corynebacterium contained in the bone marrow was discussed.
  • Makoto Ishii, Takahiro Toda, Nobutomo Ikarashi, Yoshiki Kusunoki, Risako Kon, Wataru Ochiai, Yoshiaki Machida, Kiyoshi Sugiyama
    Biological and Pharmaceutical Bulletin
    2014年 37 巻 2 号 298-305
    発行日: 2014/02/01
    公開日: 2014/02/01
    [早期公開] 公開日: 2013/11/23
    ジャーナル フリー HTML
    We had previously revealed that drug metabolism, as well as the expression level of hepatic CYP3A, a drug-metabolizing enzyme, increase 12 weeks after gastrectomy in mice. In this study, we elucidated the mechanism of the increased CYP3A expression. The levels of lithocholic acid (LCA)-producing bacteria (Bacteroides fragilis) and LCA in the colon did not show a significant increase up to 4 weeks after gastrectomy compared to the sham operation group. In contrast, at 12 and 24 weeks post-gastrectomy, the levels of Bacteroides fragilis and LCA were significantly higher in the gastrectomy group than in the sham operation group. At 12 and 24 weeks after gastrectomy, the hepatic nuclear translocation of pregnane X receptor (PXR) had also increased. The hepatic CYP3A11 mRNA expression and nuclear translocation of PXR after intraperitoneal administration of LCA to normal mice was significantly higher than those of the control group. The intraperitoneal administration of taurolithocholic acid (TLCA), a taurine conjugate of LCA, caused no change in the expression level of CYP3A11. We suggest that the increase in the expression level of CYP3A after gastrectomy is caused by an increase in the nuclear translocation of PXR, which is triggered by an increase in LCA-producing bacteria.
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