• Title/Summary/Keyword: 증상경험

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Subjective and Functional Results after a Proximal Gastrectomy: Prospective Study for Comparison of Reconstruction Procedures (근위부 위절제술 후 재건 술식에 따른 경과 관찰)

  • Kim, Ji-Hoon;Yook, Jeong-Hwan;Kim, Byung-Sik;Oh, Sung-Tae
    • Journal of Gastric Cancer
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    • v.6 no.1
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    • pp.1-5
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    • 2006
  • Purpose: A proximal gastrectomy is performed for gastric cancer in the upper part of the stomach to preserve the function of the stomach after surgery. An esophagogastrostomy is one of the common reconstruction methods for a proximal gastrectomy, but this method results in a high incidence of reflux esophagitis. This study was undertaken to compare subjective and functional results between esophagogastrostomy and jejunal interposition reconstructions. Materials and Methods: From June 1998 to December 2002, proximal gastrectomies were performed in 33 patients with tumors in the upper third of the stomach; 8 had reconstruction using jejunal interposition between the esophagus and the remnant stomach (JI group) while 25 had reconstruction using esophagogastrostomy (EG group). The postroperative courses of the patients were reviewed in terms of symptoms, weight changes, and endoscopic findings. Results: The mean age of the patients was 59 years; 26 were men and 7 were women. There were no significant differences in general complications, operating times, or histologic features between the two groups. Fifty-two percent (52%) of the EG group complained of dysphagia, and 16% them experienced heartburn and acid belching. Twelve percent (12%) of the JI group complained of dysphagia, but heartburn and acid belching did not occur. Incidences of reflux esphagitis (36%) and balloon dilatation for anastomotic stricture (16%) were more common in the EG group than in the JI group (0% and 12%). Conclusion: To prevent or minimize complications, such as reflux esophagitis and postoperative symptoms, a proximal gastrectomy with a jejunal interposition is an alternative method as an organ-preserving surgical strategy to improve quality of life for patients. (J Korean Gastric Cancer Assoc 2006;6:1-5)

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Clinical investigation of lipoid pneumonia in adults (성인에서 발생한 지방성 폐렴의 임상적 고찰)

  • Hyun, Jae Geun;Rhee, Chong H.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.965-975
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    • 1996
  • Background : Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 10 July 1996, were included. They hadn a history of laking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients look 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X - ray. The major radiologic findings by simple chest X - ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and Lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X -ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene". Conclusion: Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

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Clinical Analysis of Primary Malignant Lymphoma of the Lung (원발성 폐림프종의 임상 고찰)

  • Kim, Jae-Bum;Park, Nam-Hee;Kum, Dong-Yoon;Noh, Dong-Sub;Lee, Jae-Hoon;Han, Seung-Bum;Jung, Hye-Ra;Park, Chang-Kwon
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.435-440
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    • 2007
  • Background: Primary malignant lymphoma of the lung is a very rare neoplasm. Although the prognosis of lymphoma is favorable, the clinical features, prognostic factors and management have not been clearly defined. Material and Method: We retrospectively reviewed the records of 8 patients we managed between 1994 and 2000. They all had malignant lymphoma on the pathologic examination of the lung wit no evidence of mediastinal adenopathy and extrathoracic disease, and no past history of lymphoma. Result: The study group consisted of 3 males and 5 female patients with a mean age of 53.9 years. Three patients were asymtomatic and 5 patients were seer with pulmonary or systemic symptoms. The diagnostic methods were 3 CT needle aspiration biopsies, 1 bronchoscopic biopsy and 4 surgical methods (wedge resection, lobectomy). There were 3 patients with MALT lymphoma, two with diffuse large B-cell lymphoma, two with small lymphocytic lymphom, and one with follicular lymphoma. The 8 patients were treated with a variety of modalities, including surgery, chemotherapy, radiotherapy and combination therapy. The 8 patients have survived for a median follow-up of 38 months. Conclusiian: Although this entity of lymphoma appears to have a good prognosis, further clinical experience and long-term follow-up are needed to identify its clinical features, prognostic factors and management.

Relationship between XRCC1 Polymorphism and Acute Complication of Chemoradiation Therapy in the Patients with Colorectal Cancer (대장, 직장암 환자에서 화학방사선치료의 급성 부작용과 XRCC1 유전자 다형성과의 상관관계)

  • Kim Woo-Chul;Hong Yun-Chul;Choi Sun-Keun;Woo Ze-Hong;Nam Jeong-Hyun;Choi Gwang-Seong;Lee Moon-Hee;Kim Soon-Ki;Song Sun-U.;Loh John-Jk
    • Radiation Oncology Journal
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    • v.24 no.1
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    • pp.30-36
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    • 2006
  • Purpose: It is well known from clinical experience that acute complications of chemoradiation therapy vary from patients to patients. However, there are no known factors to predict these acute complications before treatment starts. The human XRCC1 gene is known as a DNA base excision repair gene. We investigated the possibilities of XRCC1 gene polymorphisms as a predictor for the acute complications of chemoradiation therapy in colorectal cancer patients. Materials and Methods: From July 1997 to June 2003, 86 colorectal cancer patients (71 rectal cancer, 13 sigmoid colon cancer and 2 colon cancer patients) were treated with chemoradiation therapy at the Department of Radiation Oncology, Inha University Hospital. Twenty-two patients were in stage B, 50 were in stage C, 8 were in stage D and 6 patients were unresectable cases. External radiation therapy was delivered with 10MV X-ray at a 1.8 Gy fraction per day for a total dose of radiation of $30.6{\sim}59.4 Gy$ (median: 54 Gy). All the patients received 5-FU based chemotherapy regimen. We analyzed the acute complications of upper and lower gastrointestinal tract based on the RTOG complication scale. The initial and lowest WBC and platelet count were recorded during both the RT period and the whole treatment period. Allelic variants of the XRCC1 gene at codons 194, 280 and 399 were analyzed in the lymphocyte DNA by performing PCR-RFLP. Statistical analyses were carried out with the SAS (version 6.12) statistical package. Results: When all the variables were assessed on the multivariate analysis, recurrent disease revealed the factors that significantly correlated with upper gastrointestinal acute complications. Arg399Gln polymorph isms of the XRCC1 gene, the radiation dose and the frequencies of chemotherapy during radiation therapy were significantly correlated with lower gastrointestinal complications. Arg399Gln polymorph isms also affected the decrease of the WBC and platelet count during radiation therapy. Conclusion: Although the present sample size was too small for fully evaluating this hypothesis, this study suggests that Arg399Gln polymorph isms of the XRCC1 genes may be used as one of the predictors for acute complications of chemoradiation therapy in colorectal cancer patients.

A Case of Late-onset Episodic Myopathic Form with Intermittent Rhabdomyolysis of Very-long-chain acyl-coenzyme A Dehydrogenase (VLCAD) Deficiency Diagnosed by Multigene Panel Sequencing (유전자패널 시퀀싱으로 진단된 성인형 very-long-chain acyl-coenzyme A dehydrogenase (VLCAD) 결핍증 증례)

  • Sohn, Young Bae;Ahn, Sunhyun;Jang, Ja-Hyun;Lee, Sae-Mi
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.19 no.1
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    • pp.20-25
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    • 2019
  • Very-long-chain acyl-CoA dehydrogenase (VLCAD) deficiency (OMIM#201475) is an autosomal recessively inherited metabolic disorder of mitochondrial long-chain fatty acid oxidation. The clinical features of VLCAD deficiency is classified by three clinical forms according to the severity. Here, we report a case of later-onset episodic myopathic form of VLCAD deficiency whose diagnosis was confirmed by plasma acylcarnitine analysis and" multigene panel multigene panel sequencing. A 34-year old female patient visited genetics clinic for genetic evaluation for history of recurrent myopathy with intermittent rhabdomyolysis. She suffered first episode of rhabdomyolysis with acute renal failure requiring hemodialysis at twelve years old. After then, she suffered several times of recurrent rhabdomyolysis provoked by prolonged exercise or fasting. Physical and neurologic exam was normal. Serum AST/ALT and creatinine kinase (CK) levels were mildly elevated. However, according to her previous medical records, her AST/ALT, CK were highly elevated when she had rhabdomyolysis. In suspicion of fatty acid oxidation disorder, multigene panel sequencing and plasma acylcarnitine analysis were performed in non-fasting, asymptomatic condition for the differential diagnosis. Plasma acylcarnitine analysis revealed elevated levels of C14:1 ($1.453{\mu}mol/L$; reference, 0.044-0.285), and C14:2 ($0.323{\mu}mol/L$; 0.032-0.301) and upper normal level of C14 ($0.841{\mu}mol/L$; 0.065 -0.920). Two heterozygous mutation in ACADVL were detected by multigene panel sequencing and confirmed by Sanger sequencing: c.[1202G>A(;) 1349G>A] (p.[(Ser 401Asn)(;)(Arg450His)]). Diagnosis of VLCAD deficiency was confirmed and frequent meal with low-fat diet was educated for preventing acute metabolic derangement. Fatty acid oxidation disorders have diagnostic challenges due to their intermittent clinical and laboratorial presentations, especially in milder late-onset forms. We suggest that multigene panel sequencing could be a useful diagnostic tool for the genetically and clinically heterogeneous fatty acid oxidation disorders.

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A Comparative Study of Food Habits and Body Satisfaction of Middle School Students According to Clinical Symptoms (일부 남녀 중학생의 건강 관련 임상증상에 따른 식습관과 체헝관심도에 관한 연구)

  • Sung, Chung-Ja
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.34 no.2
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    • pp.202-208
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    • 2005
  • This study was conducted to examine the food habits, knowledge of nutrition and actual conditions of food ingestion of adolescent middle school students according to questionnaire answers. Questionnaires were completed by 524 students, divided into a healthy group (n=289) and an unhealthy group (n=235) according to clinical signs. Further questions were asked of the two groups in the areas of food habits, knowledge of nutrition and nutritional attitude. The results were as follows: Mean age of all subjects was 14, heights for male and female students were 162.0 em, and 157.2 cm, weights were 53.4 kg, and 49.4, respectively. Heights and weights of male students were greater than those of female students. The body mass index (BMI) for male and female students was 20.3 kg/$m^2$ and 20.0 kg/$m^2$, respectively, and all data were within normal ranges. There were no significant differences in mean age, height, weight, and BMI between the healthy and unhealthy groups. There was no significant difference in body image recognition between the two groups, although the ratio of dissatisfaction with their own body shape was significantly higher in the female unhealthy group (46.1%), than in the female healthy group (33.0%) (p<0.05). In the area of the struggle to control body weight during the previous year, the female unhealthy group (59.4%) was higher than the female healthy group (38.4%) (p<0.01). There was no significant difference in the scores between the two groups in the areas of knowledge of nutrition and the nutritional attitude. Meal frequency and meal patterns were showed that having breakfast less than 4x/week was significantly higher in the female unhealthy group (44.0%), than in the female healthy group (30.7%) (p<0.01). Meal frequency for suppers<4x/week showed that the female unhealthy group (18.8%) was also higher than the female healthy group (10.7%). Therefore, the unhealthy group exhibited a higher pattern of missing both breakfast and supper. The male unhealthy group (16.7%) dined out more frequently than the male healthy group (12.3%) (p<0.01), and female unhealthy group also indulged in snacking significantly more frequently than the female healthy group. The unhealthy group also ate only 1 item for meals more frequently than the healthy group and no significant difference. The conclusion of this study is that adolescent Korean middle school students, who showed a higher incidence of clinical symptoms, representing an unhealthy status, missed breakfast and supper, and dined out and indulged in snacking more frequently. Their quality of breakfast and satisfaction of body image were also lower than the healthy group. These results indicated that there is a high correlation between a Korean adolescent's health status, food habits and body image satisfaction. It is recommended that a more intense program of nutritional education and monitoring be introduce into the current Korean middle-school system in order to optimally support and maximize the health potential of the current population of Korean student.

Study on the prevalence of allergic diseases based on the health behavior of multicultural families youth - The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014, Centers for Disease Control & Prevention - (다문화가정 청소년의 건강행태에 따른 알레르기질환 유병률 연구 - 질병관리본부 제10차(2014년) 청소년건강행태온라인조사 -)

  • Kim, Hyang-Sug;Jung, Lan-hee
    • Journal of Korean Home Economics Education Association
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    • v.29 no.2
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    • pp.41-52
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    • 2017
  • The purpose of this study was to identify the factors related to allergic diseases based on the health behavior of the youth in multicultural families according to the data from Tenth Korea Youth Risk Behavior Web-Based Survey 2014 (Centers for Disease Control & Prevention). The subjects from 712 multicultural adolescents were analyzed by the SPSS program. For the characteristics of health behavior of the multicultural youth, 267 students (37.5%) have experienced drinking alcohol, 164 students (23.0%) have experienced smoking, and 35 students (4.9%) have experienced taking drugs. Also, 198 students (27.8%) were depressed, 259 students (36.3%) are suffering from stress, and 286 students (40.2%) failed to fully relieve fatigue. In addition, 497 students (69.8%) consider themselves as healthy, 449 students (63.1%) consider themselves as happy, and 251 students (35.3%) consider themselves as overweight. Among the allergic disease of the multicultural youth, 46 middle school students (6.5%) and 35 high school students (4.9%) have asthma, 95 middle school students (13.3%) and 87 high school students (12.2%) have allergic rhinitis, and 67 middle school students (9.4%) and 53 high school students (7.4%) have atopic dermatitis. 47 male students (6.6%) and 34 female students (4.8%) have asthma, 81 male students (11.4%) and 101 female students (14.1%) have allergic rhinitis, and 53 male students (7.4%) and 67 female students (9.4%) have atopic dermatitis. Among the multicultural youth, 81 students (11.4%) have asthma, 182 students (25.5%) have allergic rhinitis, and 120 students (16.8%) have atopic dermatitis. For the allergic diseases from the health behavior of the multicultural youth, depression (p<0.001), alcohol experience (p<0.05), drug experience (p<0.05), health recognition (p<0.05), happiness recognition (p<0.05), and body type recognition (p<0.05) had a statistically significant relationship with asthma. Fatigue recovery recognition (p<0.001), health recognition (p<0.001) and stress recognition (p<0.05) had a statistically significant relationship with allergic rhinitis. Body type recognition (p<0.01), depression (p<0.05), fatigue recovery recognition (p<0.05), health recognition (p<0.05), and happiness recognition (p<0.05) had a statistically significant relationship with atopic dermatitis. Such results show that schools and society need to educate the multicultural youth about health, happiness, and body type recognition which are big factors of allergic diseases. Schools and society also need to be more systematic and continuous in order to help multicultural youth to be have correct recognition of depression, stress and fatigue recovery.

Survey on pesticide use by chinese cabbage growers in gangwon alpine farmland (강원도 고냉지대 배추 경작자들의 농약 사용 실태)

  • Kim, Song-Mun;Choi, Hae-Jin;Kim, Hee-Yeon;Lee, Dong-Kyung;Kim, Tae-Han;Ahn, Mun-Sub;Hur, Jang-Hyun
    • The Korean Journal of Pesticide Science
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    • v.6 no.4
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    • pp.250-256
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    • 2002
  • The objective was to know if chinese cabbage growers in Gangwon alpine farmland control agricultural pests including weeds effectively and use pesticide properly. Examiners visited 185 farmers at Taebaek, Pyongchang, and Jeongseon and surveyed 33 questions on pest control methods pesticide use. Chinese cabbage farmers have noxious plant diseases such as clubroot, bacterial soft rot, downy mildew, anthracnose, and mosaic disease, and also noxious insects such as diamondback moth, aphid, beet armyworm, common cabbage worm, and Japanese native slug. In addition, farmers have noxious weeds such as common chickweed, marsh pepper, hairy crabgrass, common purslane, and horseweed. To control diseases and insects, 51.3% of farmers used many chemical agents, while 20.7% of farmers used chemical agents with too much emphasis on paraquat and glyphosate to control weeds: 87.2% of the answered farmers have a preference of the both non-selective herbicides. Farmers in the survey area selected pesticides on the basis of their own experience and sales managers' recommendation (84.2%) which results in the use of inappropriate pesticides such diniconazole. Many farmers have experienced phytotoxicities (46.7%) and pesticide poisoning (51.2%). We conclude that a systematic educational program for the proper selection and use of pesticides should be conducted for chinese cabbage growers in Gangwon alpine farmland.

The Patterns of Medical Utilization on Dermatoses among Rural Inhabitants (농촌지역 주민들의 피부 질환에 대한 치료 행태)

  • Kim, Chang-Yoon;Joo, Ree;SaKong, Joon;Chung, Jong-Hak;Kwak, Tae-Hun
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.103-113
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    • 1999
  • The authors surveyed the inhabitants of a rural area to assess the patterns of medical utilization on dermatoses. Seven hundred and sixty new outpatients of dermatoses were examined and surveyed with formed questionnaire from March 1997 to February 1999. The results are as follows; 1. Among 760 new outpatients, the number of male patients was 283(37.2%) and that of female patients was 477(67.3%). 2. The most common dermatoses was Tinea pedis(34.9%), and follows senile pruritus, contact dermatitis, housewife eczema, seborrheic dermatitis, numular dermatitis, atopic dermatitis, Tinea corporis, Tinea ungium, acne vulgaris, impetigo, keratolysis exfoliativa, chronic urticaria, Tinea cruris and Molluscum contagiosum in orders. 3. Drug store was the most frequent places where patients initially visited for their skin diseases(39.6%) and followed by non dermatologic clinic, dermatologic clinic and general hospital in orders. 4. One hundred and twenty one(15.9%) patients have been experienced folk treatment. It was founded that the topical vinegar application or soaking was the most common method. Many patients felt no symptom improvement after the folk treatment(48.8%). Seventeen point four percent of patient felt symptom worsened. The results of this study suggest that many of the rural inhabitants are lack of understanding on their dermatoses. So many physician who are in charge of the primary care in rural area have to pay attention to the common dermatoses and educate patients on their medical utilization.

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DEVELOPMENTAL AND CLINICAL CHARACTERISTICS IN CHILDREN WITH NOCTURNAL ENURESIS : RESULTS OF A MULTICENTER STUDY (야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 발달학적 및 임상적 특성을 중심으로)

  • Cho Soo-Churl;Shin Min-Sup;Hwang Jun-Won;Han Sang-Won;Park Kwan-Hyun;Lee Sang-Don;Kim Kyung-Do;Kim Kun-Suk;Suh Hong-Jin;Lee Yoo-Sik;Chung Jae-Yong;Kim Young-Kyoon;Kim Jae-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.1
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    • pp.32-39
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    • 2006
  • Objectives : The aim of this study was to examine the developmental and clinical characteristics associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed a parent questionnaire consisting of a Child Behavior Checklist(CBCL). Data related to the prenatal, perinatal and developmental history, past and current medical history were collected. Ninety-three normal students were selected as the control group. Results : The nocturnal enuresis group attained diurnal and nocturnal urinary control significantly later than those in the normal control group.49.2% of the children with nocturnal enuresis had the family history of nocturnal enuresis. Daytime incontinence was present in 41.3% of the nocturnal enuresis group. The percentages of sleep-related disturbances were significantly higher in the nocturnal enuresis group when compared to the normal control group.42.6% of the children with nocturnal enuresis experienced pharmacotherapy, and 0.4% experienced enuresis alarms. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have a high genetic load and a possibility of developmental delay, which supports the neurodevelopmental point of view with regard to the etiology of nocturnal enuresis. The physicians in Korea prefer pharmacological interventions to alarm interventions in treating Korean children with nocturnal enuresis.

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