• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.98-104
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• 2019

We report a rare case of Meckel's diverticulum in a boy who initially presented with chronic iron deficiency anemia (IDA) without any history of gastrointestinal (GI) bleeding at 8 years-old. Isolated small bowel Crohn's disease was suspected based on findings of small bowel ulcers on capsule endoscopy. At four years from initial presentation, he developed massive GI bleeding. Abdominal computed tomographic angiography and small bowel series revealed findings suggestive of Meckel's diverticulum. Meckel's diverticulum should be suspected in children with unexplained chronic IDA even in the absence of prominent GI bleeding and negative findings on repetitive Meckel's scans. Moreover, Meckel's diverticulum should be included in the differential diagnosis of isolated small bowel Crohn's disease when the disease is limited to a short segment of the distal small bowel, as ulcers and inflammation may result as a consequence of acid secreted from adjacent heterotopic gastric mucosa constituting the Meckel's diverticulum.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제15권1호
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• pp.19-22
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• 2012

Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract and characterized by relapsing and remitting episodes, with progression over time to complications of stricture, fistulas, or abscesses. The etiology is unknown, although the common opinion is that the disease arises from a disordered immune response to the gut contents in genetically predisposed individuals. Infliximab is a mouse-human chimeric antibody against tumor necrosis factor ${\alpha}$, and has proven to be effective in active Crohn's disease for both induction and maintenance therapy. Despite the growing experience with infliximab in Crohn's disease, optimal treatment strategies still need to be determined. The purpose of this review is to summarize the current knowledge on the use of infliximab in Crohn's disease and to discuss the yet-unsolved issues.

• The Korean journal of internal medicine
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• 제39권1호
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• pp.77-85
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• 2024

Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

• 대한한방소아과학회지
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• 제18권1호
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• pp.139-152
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• 2004

Objective: The aim of this study was to find about relation between Chiljung(七情) and chronic recurrent abdominal pain in children. Methods: It was surveyed the oriental medical book concerning Chiljung(七情) and western medical book concerning Chronic recurrent abdominal pain. Results: Chronic recurrent abdominal pain which is common disorder in children is mostly functional abdominal pain due to stress. The Stress can be defined as spiritual factor which lead to imbalance of body homeostasis in medicine. In oriental medicine, it is considered as Chiljung(七情) disorder. The gastrointestinal disease due to stress are peptic ulcer, chronic gastritis, irritable bowel syndrome, chronic abdominal pain, vomitting etc. In oriental medicine pathology mechanism, it is considered as discord with liver and spleen, depression of spleen-energy. It comes within the category of depression. Children with chronic recurrent abdominal pain is dependent on parents and they have an introspective nature, compulsive idea which is intolerable for failure.

• Clinical and Experimental Pediatrics
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• 제46권12호
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• pp.1248-1252
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• 2003

목 적 : 소아에 있어서 흉부 통증은 재발성 복통과 더불어 소아과 영역에서 흔히 접하게 되는 문제로, 정확한 원인을 규명하기란 쉽지 않으며 다양한 원인에 의해 발현된다. 소아에서의 흉부 통증은 양성적이고 통증의 경과가 양호하며, 원인을 모르는 경우가 많아 이런 환아들에게서 행해지는 검사가 어떠한 의의가 있는지에 대해서도 정보가 그리 많지 않다. 이에 저자들은 소아 흉부 통증 환자의 특징에 대해 알아보고 검사의 유용성에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 한양대학교병원 소아과에 만성적 흉부 통증을 주소로 내원한 환아 33명(남아 15명, 여아 18명)을 대상으로 흉부 통증의 원인 및 시행하였던 검사들에 대한 결과를 후향적으로 분석하였다. 결 과 : 대상 환아의 연령은 10-12세 사이와 4-6세 사이가 각각 11례(33.3%)로 가장 많은 분포를 보였으며 남, 여 성별의 차이는 없었다. 흉부 통증의 원인으로는 특발성이 15례(45.5%), 심혈관계 검사의 이상을 보인 경우 9례(27.3%), 위장관 질환 6례(18.2%), 호흡기 질환 2례(6%), 흉부 좌상 1례(3%) 순이었다. 대상 환아들에서 보인 심혈관계 검사상 이상 소견은 흉부 통증과 직접적 연관이 있다고 하기 어려웠다. 병력 청취 및 진찰을 통해 상부 위장관 질환이 의심되는 6례에서 이에 대한 검사를 시행하였고 모두에서 상부 위장관 질환의 소견이 관찰되었으며 이에 대한 치료 이후 증상의 재발은 관찰되지 않았다. 결 론 : 소아에서의 흉부 통증은 양성적이고 특발성인 경우가 많으나 심혈관 질환이나 위장관 질환 등의 가능성도 생각해야하며 이를 위해 정확한 병력 청취 및 진찰에 근거해 적절한 검사를 시행함으로써 효과적인 진단 및 치료가 가능할 것이다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권3호
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• pp.161-164
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• 2020

Crohn's disease is a chronic inflammatory disease that involves the upper and lower gastrointestinal tracts, including the oral cavity. For the conventional treatment of inflammatory bowel diseases, steroids are usually used as induction therapy, and azathioprine is used as maintenance therapy. Steroids are associated with various side effects. Under rare circumstances, they can even cause psychotic symptoms, and reports on steroid-induced psychosis in the pediatric population are few. Here, we report the first case of steroid-induced psychosis in a 16-year-old female with Crohn's disease administered with steroids as induction therapy in South Korea. She showed psychotic symptoms, including auditory hallucination, loosening of association, and idea of reference, after 2 weeks of administering prednisolone 60 mg/day. One week after steroid discontinuation, the patient gradually recovered and was treated with quetiapine. Therefore, pediatricians should be aware of serious psychiatric adverse effects when administering corticosteroids for various indications.

• Journal of Nutrition and Health
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• 제39권3호
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• pp.286-298
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• 2006

The study aimed to identify major factors related to global self-rated health of the community-dwelling elderly people in rural areas. Interviews were conducted with 433 persons over 65 years of age. The socio-economic characteristics, chronic disease status, measures of functional and mental health, life satisfaction, health-related behaviors including smoking, drinking, exercise, social activity, dietary habit, and food intakes were analyzed to determine their influence on self-rated health index. Data on food intake were obtained through the 24-hour recall method. The self-rated health of rural elderly was poor or very poor as reported by 42.6% and 52.4% of the men and women, respectively. Poor self-rated health was found to be related to elderly aged $65{\sim}74$, female, absence of work, more chronic diseases, dependence on Instrumental Activity Daily Living (IADL), higher mental unhealthy days, lower current life satisfaction, less social activity, lower dietary habit scores, lower intake of total food, fruit, eggs, fishes & shell fishes, vitamin C (%RDA), and Nutrient Adequacy Ratio (NAR). The results of the multiple regression analysis showed that poor self-rated health index is significantly associated with more chronic diseases, mental unhealthy days, gastrointestinal disease, musculoskeletal disease, less social activity, and lower intake of fruits. The results also suggested that improving the nutritional status and functional ability, and reducing the burden of chronic diseases are beneficial to the self-rated health index of the elderly.

• 사상체질의학회지
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• 제13권3호
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• pp.134-139
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• 2001

The irritable bowel syndrome(IBS) is the most common gastrointestinal disorder in clinical practice and is characterized by abdominal pain associated with a chronic disturbance of defecation. It is important to discriminate IBS from organic bowel disease. Based on clinical and epidemiologic studies, specific symptom criteria for IBS have been developed. The subject is a 29 year old man who has abdominal pain, chronic diarrhea, general weakness, dizziness, insomnia and has been diagnosed as irritable bowel syndrome. We classified this as Shaoyangin Mangyin(少陽人 亡陰證) and prescribed Hyeongbangjiwhangtang(荊防地黃湯) in accordance with the principle of pyoeumganggi(表陰降氣). In the result, we had the improvement of his symptoms.

• 농촌의학ㆍ지역보건
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• 제21권2호
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• pp.209-220
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• 1996

경상북도 문경시지역 중 9개 읍면에 거주하는 30세이상 주민 28.883명을 대상으로 1993년 10월 1일부터 1994년 2월 28일까지 건강면접조사한 자료중 5,797명을 무작위로 추출하여 만성퇴행성질환 유병률과 이용의료기관실태를 분석하였다. 인당유병률은 1,000명 당 336이었고 남녀별로는 남자는 278, 여자는 388이었다. 건당유병률은 367이었으며 남자 300, 여자 425였다. 건당유병률은 여자가 남자보다 유의하게 높았다(p<0.05). 연령별 인당 유병률은 30대는 106, 40대 223, 50대 366, 60대 407, 70세 이상 457로서 연령이 높아짐에 따라 유병률도 증가하였다. 만성퇴행성질환 건당유병률 1위는 신경통(128), 2위 만성위염(64), 3위 관절염(54), 4위 고혈압(44), 5위 당뇨(14) 순이었다. 남자는 1위가 신경통, 2위 위염, 3위 관절염, 4위 고혈압, 5이 천식이었고, 여자는 1위 신경통, 2위 관절염, 3위 위염, 4위 고혈압, 5위 당뇨였다. 신경통, 관절염, 고혈압 등의 질환은 남자보다 여자의 유병률이 유의하게 높았으며, 주풍(뇌졸증), 결핵, 간경화증 등의 유병률은 여자보다 남자가 유의하게 높았다. 만성퇴행성질환자의 이용의료기관은 최초에는 병 의원 이용율이 높았고, 최종 또는 현재는 보건(지)소, 의원 및 보건진료소를 많이 이용하였다. 질병별로는 신경통, 관절염 천식은 최초에는 의원을, 최종 또는 현재는 보건(지)소, 조건진료소를 많이 이용하였다. 고혈압과 결핵은 최초, 최종 모두 보건(지)소를 가장 많이 이용하였고, 당뇨, 중풍, 암, 심부전증, 간 경화증, 신부전증은 병원을 가장 많이 이용하였다.

• Journal of Medicine and Life Science
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• 제19권1호
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• pp.26-29
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• 2022

Cryptococcus neoformans infection usually occurs in patients with advanced human immunodeficiency virus (HIV) infection or with a CD4 T lymphocyte count of <100 cells/µL. Pulmonary and central nervous system infections are the most frequently encountered forms of cryptococcosis; however, colonic cryptococcosis is uncommon. We describe the case of a 41-year-old antiretroviral-naïve man with HIV infection diagnosed eight years prior and intermittent diarrhea for 4 months who presented to the emergency department with a 1-day history of low-grade fever and confusion. Brain magnetic resonance imaging and cerebrospinal fluid analysis revealed normal results; however, he was diagnosed with Pneumocystis jirovecii pneumonia based on chest computed tomography and bronchoalveolar lavage analysis. Trimethoprim-sulfamethoxazole administration was initiated followed by antiretroviral treatment. Although his condition gradually improved, he developed fever and abdominal discomfort, and the diarrhea worsened. Endoscopy revealed a small ulcer in the distal transverse colon. Histopathological examination of a colon tissue sample revealed cryptococcal infection. He improved substantially during liposomal amphotericin B and fluconazole treatment. We encountered a rare case of colonic cryptococcosis that caused chronic diarrhea in a patient with advanced HIV infection. Colonic cryptococcosis should be considered when patients with acquired immune deficiency syndrome present with gastrointestinal symptoms.