• Title/Summary/Keyword: 구토

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Influence Factors for Predicting Postoperative Nausea and Vomiting (수술 후 오심과 구토의 영향요인)

  • Cho, Eun-A;Jang, Ji-Sun;Kim, Kye-Ha
    • The Journal of the Korea Contents Association
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    • v.17 no.6
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    • pp.632-642
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    • 2017
  • The purpose of this study was to determine influence factors for predicting postoperative nausea and vomiting(PONV) for postoperative 24hr. Participants were 332 general surgery(GS), neurosurgery(NS), orthopedic surgery(OS), obstetrics and gynecology(OBGY), otorhinolaryngology (ENT) surgical patients at one hospital in G city. Data were collected from December 2014 to December 2015, and the data were analyzed by t-test, $x^2$-test and logistic regression analysis. Multivariate analysis revealed that non smoking (p=.011), history of motion sickness (p=.020), history of PONV (p=.001), post operative pain (p=.001) were influence factors for PONV. Preoperative intensive management of PONV is necessary if there is a history of non smoker, history of motion sickness and history of PONV before surgery, and postoperative pain should be actively intervened.

The anti-emetic Effect of Needling Acupuncture, Aquapuncture and Moxibustion at BL-21 and CV-12 in Xylazine Induced Vomiting of Dogs (위수혈(BL-21) 및 중완혈(CV-12)에 대한 자침, 수침 및 뜸 처치가 Xylanzine을 투여한 개에서의 구토 억제효과)

  • Kim Yoo-Su;Kim Keon-Woo;Kim Ji-Yong;Liu Jianzhu;Lee Sang-Eun;Song Kun-Ho;Kim Myung-Cheol;Kim Duck-Hwan
    • Journal of Veterinary Clinics
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    • v.22 no.3
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    • pp.202-205
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    • 2005
  • The present study was made in order to clarify the anti-emetic effect by needle-acupuncture (AP), injection-AP and moxibustion in xylazine - induced vomiting of dogs. Twelve mongrel dogs (4 months to 5 year old, 2 to 4 kg of body weight), eleven mongrel dogs (4 months to 5 years old, 2 to 10 kg of body weight) and twelve mongrel dogs (4 months to 1 year old, 2 to 4 kg of body weight) were used for clarification of anti-emetic effect by needle-AP, injection-AP and moxibustion, respectively. The experimental animals were devided into control(6 heads), BL-21(6 heads), CV-12(6 heads) and BL-21+CV-12(6 heads) groups using total 6 dogs with vomiting selected in preliminary experiment, respectively in needle-AP treatment. In addition, the experimental dogs were divided into control (11 heads), BL-21 (6 heads) and CV-12(6 heads) groups using 11 dogs, respectively in injection-AP treatment. In moxibustion treatment the experimental dogs were divided into control (6 heads), BL-21(6 heads) and CV-12(6 heads) groups using 6 dogs, respectively. Five days after the experiment of one group was finished, the other group was examined in each experiment. Acupuncture needle was maintained for 20 minutes in needle-AP treatment. Metoclopramide was used in injection-AP treatment. Commercial moxa was used in moxibustion treatment. Vomiting was induced by intramuscular injection with $2{\%}$ xylazine 20 minutes after treatments of needle-AP, injection-AP and moxibustion, respectively. The vomiting rates of BL-21($33.3{\%}$), CV-12($50{\%}$) and BL-21+CV-12($33.3{\%}$) were lower than that of control($66.7{\%}$) and vomiting times of experimental groups were similar to that of control in needle-AP treatment. The vomiting rates of BL-21 ($0{\%}$) and CV-12($16.4{\%}$) were lower than that of control($66.7{\%}$) and the vomiting time of CV-12 group was similar to that of control group in injection-AP treatment. The vomiting rates of BL-21($33.3{\%}$) and CV-12($33.3{\%}$) were lower than that of control ($66.7{\%}$) and vomiting times of experimental group were similar to that of control group in moxibustion treatment. In conclusion, it was considered that needle-AP, metoclopramide injection-AP and moxibustion at BL-21 and CV-12 were effective for anti-emesis in xylazine induced vomiting of dogs and metoclopramide injection-AP was the most effective method for anti-emesis among them.

Clinical experience with amitriptyline for management of children with cyclic vomiting syndrome (주기성 구토 증후군 소아에서 구토 예방을 위한 amitriptyline의 임상 경험)

  • Sim, Ye-Jee;Kim, Jung-Mi;Kwon, Soonhak;Choe, Byung-Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.538-543
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    • 2009
  • Purpose : To report the clinical experience with amitriptyline for managing children with cyclic vomiting syndrome (CVS). Methods : Totally, eleven children (eight males) were diagnosed with CVS. Of these, medical records were reviewed for eight children treated with amitriptyline; three children were not treated because one was not followed up and two were kept under observation to study the natural course without medication, because the frequency of vomiting had recently decreased to less than one episode per year. The eight amitriptyline-treated children were divided into three groups by the therapeutic response: (1) complete remission (CR), with no recurrence of symptoms after treatment; 2) partial remission (PR), in which the frequency of symptoms decreased by almost 50% after treatment; and (3) no response. Results : For the eight amitriptyline-treated children, the mean age of symptom onset was 4.7 (0.3-7) yr and mean age at diagnosis was 8.9 (6.0-11.3) yr. The mean number of vomiting episodes was 8.8 (2-25) per year, and the duration of vomiting in each episode ranged from 3 hours to 5 days. CR was achieved in five (62.5%) of the eight amitriptyline-treated children (0.2-0.8 mg/kg/day orally, at night) and PR was achieved in three children (37.5%). Two children relapsed on discontinuation of amitriptyline by their parents decision but showed improvement on remedication. No adverse effects were noted throughout the study period. Conclusion : Amitriptyline can be used in long-term prophylaxis for the management of children with CVS aged over 6 yr. However, a large-scale study is needed to ascertain its effects.

Granisetron in the Treatment of Radiotherapy-Induced Nausea and Vomiting (방사선치료 중 오심 및 구토에 대한 그라니세트론의 효과)

  • Hong, Seong-Eon;Kang, Jin-O
    • Radiation Oncology Journal
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    • v.17 no.2
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    • pp.141-145
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    • 1999
  • Purpose : Granisetron is a potent, the most selective 5-HT3 receptor antagonist and is reported to b effective in treatment of radiation-induced emesis. The antiemetic efficacy and safety of oral granisteron was evaluated in patients with receiving highly emetogenic treatment by conventional fractionated irradiation. Materials and Methods : Patients with various cancers who were being treated with irradiation were accrued into the present study. The intensity of nausea was evaluated on first 24 hours and on day-7 by patients according to the degree of interference with normal daily life as followings; a) none; b) present but no interference with normal daily life (mild): c) interference with normal daily life (moderate): and d) bedridden because of nausea (severe). Non or mild state was considered to indicate successful treatment. The efficacy of antiemetic treatment was graded as follows; a) complete response; no vomiting, no worse than mild nausea and receive no rescue antiemetic therapy over the 24h period, b) major response; either one episode of vomiting or moderate/severe nausea or had received rescue medication over 24h period, or any combination of these, c) minor response; two to four episodes of vomiting over the 24h period, regardless of nausea and rescue medication, d) failure; more than four medication. The score of the most symptom was recorded and the total score over 24 hours was summarized. The complete or major response was considered to indicate successful treatment. Results : A total of 10 patients were enrolled into this study, and all were assessable for efficacy analysis. Total nausea control was achieved in 90$\%$ (9/10:none=60$\%$ plus mild=30$\%$) of total patients after 7 days. The control of vomiting by granisteron was noted in seven patients (70$\%$) of complete response and three (30$\%$) of major response with a hundred-percent successful treatment over 7 days. The minor response or treatment failure were not observed. No significant adverse events or toxicities from granisetron were recorded in patient receiving granisetron. Conclusion : We concluded that granisetron is a highly effective antiemetic agent in controlling radiotherapy-induced nausea or vomiting with a minimal toxicity profile.

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Feel my body - 소화기 정기검진 나중으로 미뤄선 안 되는 이유

  • Im, Jong-Pil
    • 건강소식
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    • v.39 no.9
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    • pp.14-15
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    • 2015
  • 46세의 회사원 김씨는 구토 증상이 있어 도통 음식을 먹을 수가 없다며 내원하였다. 구토의 원인을 밝히기 위해 여러 가지 검사를 시행한 결과 위암 중에서도 분화가 되지 않는 미만형(Diffuse type) 위암으로 진단되었다. 김씨는 슬하에 13살 난 아들과 10살 난 딸을 둔 한 집안의 가장이었다. 그래서 더욱 안타까운 상황이었다.

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TREATMMENT OF CHRONIC RUMINATION THROUGH REVERSE OF REINFORCEMENT (행동치료를 통한 시설아동의 만성 구토행위 치료)

  • Chung, Bo-In;Kim, Sin-Ja;Lee, Jum-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.172-177
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    • 1990
  • The reverse of reinforcement technique was used in treating rumination of a 12-year old (estimated age) mentally retarded child in a residential setting. The subject's rumination pattern was first to vomit the food onto the floor and then to eat it back in several attempts. Consequently, the way to reverse the contingency of rumination in this child was to take away the discharge whenever rumination occurred. An ABAB single subject design was adopted to evaluate the treatment effect. In baseline 1 the frequency of his rumination for 2.5 hours after eating was an average of 46(range= 30-62), while decreased to 6.7 in treatment condition 1. However, when the discharge was not taken away in baseline 2, his rumination increased to 34 times and then decreased to zero to 1 time when the reverse of reinforcement was reinstituted in treatment condition 2. The results clearly indicate that the reverse of reinforcement which was implemented in the form of removing the discharge from the floor was successful. It was reported that the treatment effect has been maintained over 10 months post treatment.

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Topiramate can reduce the number of episodic attacks in cyclic vomiting syndrome : a case report (Topiramate 투여로 호전된 주기성 구토증 1례)

  • Yum, Mi-Sun;Bae, Keun Wook;You, Su Jeong;Ko, Tae Sung
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.386-389
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    • 2007
  • Cyclic vomiting syndrome (CVS) is a paroxysmal, recurrent vomiting disorder of unknown pathophysiology and target organ. It has been hypothesized that CVS shares the same mechanism as migraine. We describe here a 5-year-old boy with CVS characterized by episodic vomiting attacks. These recurrent vomiting episodes began at 3 years of age, occurred every month and lasted for 5 days at a time. At the time of admission, no abnormal physical or neurological findings were observed and laboratory findings, including brain MRI and endoscopic examination, revealed nothing specific. The vomiting episodes were self-limited but recurrent and severely interrupted his daily life. When this patient was treated with topiramate, he showed a marked increase of symptom-free periods.

Narrative changes and implications revealed in the formation process of (<토끼전>의 형성 과정에 드러난 서사적 변화와 의미 연구)

  • Hwang, Yun-jeong
    • Journal of Korean Classical Literature and Education
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    • no.37
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    • pp.217-252
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    • 2018
  • In the [Samguk sagi], is the origin story of , a Pansori novel from the late Joseon period. is derived from an Indian folktale. This article examines the narrative changes from the Indian folktale. Through this, I attempt to examine how the short fable developed into a fascinating story with numerous variants like . The five kinds of stories that I have observed all indicate the development of a common narrative. They also have a common character: terrestrial animals, deputy, and aquatic animals. However, in the original story, the more the character is brought up, the greater the persuasiveness of the action. In addition, the scale of the conflict expands due to the reorganization of the incident. Moreover, the theme of the narrative has diversified by utilizing the space as a contrast. Discussions reveal that a single story or storyteller does not create a fascinating story. The implication being that several narratives and numerous people together make the narrative changes.

Effectiveness of acupuncture-type interventions to prevent nausea and vomiting during and after cesarean delivery under spinal anesthesia : A systematic review

  • Kim, Eun-Sook;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Jin-Moo;Lee, Chang-Hoo;Lee, Kyung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.22 no.2
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    • pp.209-221
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    • 2009
  • 목 적: 이 논문은 제왕절개 분만을 위한 척수마취로 인해 수술 중 또는 그 후에 발생할 수 있는 오심 및 구토에 대한 침관련 치료의 항구토 효과를 규명하기 위한 계통적 리뷰 논문이다. 방 법: 제왕절개 분만을 위한 척수마취로 인해 발생할 수 있는 오심 및 구토를 예방하기 위한 침관련 치료에 대한 randomized clinical trials(RCT's)를 검색하기 위해 2008년 3월까지 수록된 6개의 데이터베이스(MEDLINE, EMBASE, The Cochrane Library, CINAHL, AMED and PsycINFO)를 검색하였다. 논문의 선정 기준은 원저이며, 플라시보 대조군을 설정한 무작위 임상시험이고, 오심 또는 구토에 대한 결과가 실려 있는 것으로 하였다. 결 과: 총 5개의 논문을 선정하였으며 각 논문들의 연구방법은 일반적으로 좋은 편이었다. 5개의 논문들을 종합한 결과는 수술중 오심 발생률(OR=0.468, 95%CI:0.250 -0.876, P=0.018), 수술 후 오심 발생률(OR=0.616, 95%CI:0.042-0.942, P=0.026), 수술 후 구토 발생률(OR=0.640, 95%CI:0.432-0.948, P=0.026)이 침관련 치료군이 대조군에 비해서 통계적으로 의미있게 적었다. 결 론: 본 문헌 고찰을 통해 제왕절개 수술을 위해 시행한 척수 마취로 인해 수술중 또는 수술후 발생한 오심 및 구토에 대해 침관련 치료가 예방효과가 있음을 밝힐 수 있었다.

A Prospective Randomized Comparative Clinical Trial Comparing the Efficacy between Ondansetron and Metoclopramide for Prevention of Nausea and Vomiting in Patients Undergoing Fractionated Radiotherapy to the Abdominal Region (복부 방사선치료를 받는 환자에서 발생하는 오심 및 구토에 대한 온단세트론과 메토클로프라미드의 효과 : 제 3상 전향적 무작위 비교임상시험)

  • Park Hee Chul;Suh Chang Ok;Seong Jinsil;Cho Jae Ho;Lim John Jihoon;Park Won;Song Jae Seok;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.127-135
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    • 2001
  • Purpose : This study is a prospective randomized clinical trial comparing the efficacy and complication of anti-emetic drugs for prevention of nausea and vomiting after radiotherapy which has moderate emetogenic potential. The aim of this study was to investigate whether the anti-emetic efficacy of ondansetron $(Zofran^{\circledR})$ 8 mg bid dose (Group O) is better than the efficacy of metoclopramide 5 mg lid dose (Group M) in patients undergoing fractionated radiotherapy to the abdominal region. Materials and Methods : Study entry was restricted to those patients who met the following eligibility criteria: histologically confirmed malignant disease; no distant metastasis; performance status of not more than ECOG grade 2; no previous chemotherapy and radiotherapy. Between March 1997 and February 1998, 60 patients enrolled in this study. All patients signed a written statement of informed consent prior to enrollment. Blinding was maintained by dosing identical number of tablets including one dose of matching placebo for Group O. The extent of nausea, appetite loss, and the number of emetic episodes were recorded everyday using diary card. The mean score of nausea, appetite loss and the mean number of emetic episodes were obtained in a weekly interval. Results : Prescription error occurred in one patient. And diary cards have not returned in 3 patients due to premature refusal of treatment. Card from one patient was excluded from the analysis because she had a history of treatment for neurosis. As a result, the analysis consisted of 55 patients. Patient characteristics and radiotherapy characteristics were similar except mean age was $52.9{\pm}11.2$ in group M, $46.5{\pm}9.5$ in group O. The difference of age was statistically significant. The mean score of nausea, appetite loss and emetic episodes in a weekly interval was higher in group M than O. In group M, the symptoms were most significant at 5th week. In a panel data analysis using mixed procedure, treatment group was only significant factor detecting the difference of weekly score for all three symptoms. Ondansetron $(Zofran^{\circledR})$ 8 mg bid dose and metoclopramide 5 mg lid dose were well tolerated without significant side effects. There were no clinically important changes In vital signs or clinical laboratory parameters with either drug. Conclusion : Concerning the fact that patients with younger age have higher emetogenic potential, there are possibilities that age difference between two treatment groups lowered the statistical power of analysis. There were significant difference favoring ondansetron group with respect to the severity of nausea, vomiting and loss of appetite. We concluded that ondansetron is more effective anti-emetic agents in the control of radiotherapy-induced nausea, vomiting, loss of appetite without significant toxicity, compared with commonly used drug, i.e., metoclopramide. However, there were patients suffering emesis despite the administration of ondansetron. The possible strategies to improve the prevention and the treatment of radiotherapy-induced emesis must be further studied.

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