• Journal of Yeungnam Medical Science
• /
• 제33권2호
• /
• pp.166-169
• /
• 2016

Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and self-expanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권6호
• /
• pp.459-461
• /
• 2009

Polycythemia vera is one type of myeloproliferative disorder which occurs due to the clonal proliferation of hematopoietic stem cell related to the production of leukocyte and megakaryocyte which produces a little less than erythrocyte. Polycythemia vera has a peak incidence in the sixth decade of life with males affected slightly more frequently than females. Vasquez first described polycythemia vera as an autonomous erythrocytosis in 1892, and a further description, delineation of the disease process and a complete course outline were made in 1899, 1903 and 1938, respectively. Symptoms include pruritus, tinnitus, vertigo, gastrointestinal (GI) pain, and bleeding gums. Hyperuricemia and hyperuricosuria are present in about 40% of these patients. Complications are hemorrhage, thrombosis, post-polycythemic myeloid metaplasia, and leukemic transformation. In case of surgery, complications such as hemorrahge and thrombosis are highly likable to happen. We report a case of preoperative and postoperative of a 63-year-old male, who was diagnosed as oral cavity cancer in the mouth floor, with known history of hypertension and polycythemia vera. We considered that conservative management would be an advisable treatment for patients with uncontrolled systemic disease.

• Journal of Korean Foot and Ankle Society
• /
• 제8권1호
• /
• pp.58-63
• /
• 2004

Purpose: The purpose of this study is to evaluate the effectiveness of low-dose gabapentin for interdigital neuroma. Metrials and Methods: Between April 2000 and June 2003, 32 patients (39 feet) with interdigital neuroma were treated with using low-dose gabapentin. Two of the 32 patients were male, and thirty were female, and the average age was 47.4 years. The follow-up was 6 to 44months (mean 15.1 months). All cases were diagnosed by physical examination and ultrasonography or MRI. Low-dose gabapentin (300-600 mg) was prescribed and shoe modification was recommended. The patients were evaluated through questionnaire. Results: Neuroma was found in twenty one cases at the third intermetatarsal space, and thirteen at the second intermetatarsal space. The sensitivity of ultrasonography was 96% and that of MRI was 79%. Overall satisfaction was rated as excellent or good by 18 cases (57%). Average pain relief ratio was 50.3%, and in 14 cases, more than 80% of pain relief was noted. Nine (28%) of 32 patients showed they had no activity restrictions, such as daily activities or work, whereas 8 (25%) had mild restrictions and 15 (47%) had major restrictions. Twelve of 15 patient with major restrictions had been treated operatively (neurectomy; 10 cases, decompression; 2 cases). One case had gastrointestinal problem. Conclusion: Low-dose gabapentin for interdigital neuroma was one of the effective conservative treatments. The operation may be preserved for patient with the persist symptoms, nevertheless the conservative treatments and use of low-dose gabapentin.

• The Korean Journal of Nuclear Medicine
• /
• 제15권2호
• /
• pp.67-74
• /
• 1981

The fasting serum gastrin levels were measured by radioimmunoassay in 32 normal healthy subjects without recognized gastrointestinal symptoms and 90 patients with various gastric diseases, who were visited or admitted to National Medical Center from February to June, 1981. The following results were obtained; 1) The fasting mean serum gastrin level in normal subjects was $55.9{\pm}26.3pg/ml$, and there was no difference between male and female. 2) The gastrin levels in gastric and duodenal ulcer were $85.0{\pm}28.4$ and $76.0{\pm}43.0pg/ml$ respectively, and it's values were elevated as compared with normal subjects. In gastric ulcer, the gastrin level was elevated than that of duodenal ulcer, but no significant difference in each other. 3) The gastrin level in stomach cancer was $89.5{\pm}42.2pg/ml$, and it's values were markedly elevated as compared with values in normal subjects. 4) The gastrin level in gastritis was $73.4{\pm}37.4pg/ml$, and it's values were elevated as compared with values in normal subjects. 5) The gastrin level in post-gastrectomy state was $50.3{\pm}16.3pg/ml$, and it's values were slightly decreased as compared with values in normal subjects.

• The Journal of Internal Korean Medicine
• /
• 제41권5호
• /
• pp.734-739
• /
• 2020

Objectives: The purpose of this study was to propose a diagnostic method for classifying patients with dyspepsia by symptom type. The correlation between symptom types and X-ray findings was studied in 62 patients with indigestion. Methods: In this study, the complaints and abdominal X-ray findings were collected for 62 patients who visited the outpatient Korean medicine clinic. The medical information related to dyspepsia was grouped for similar patients and classified by symptom type. Results: The patients with dyspepsia were classified into three types according to their medical symptoms: Distention type (N=43, 68.3%), Abdominal Pain type (N=16, 25.5%), and Constipation type (N=12, 19.0%). Intestinal fecal findings (80.6%) on x-rays were noted in most of the cases, followed by intestinal gas pattern findings (14.5%). Conclusion: Classifying patients with dyspepsia by symptom types is an appropriate diagnostic method due to the unclear pathophysiology of indigestion and the difficulty in applying a Korean medical dialectic. Irrespective of the symptom types, the large number of fecal material findings (80.6%) on x-rays means an effect on the interior environment of the body where intestinal feces accumulate easily and decreased gastrointestinal motility in patients with indigestion. This can be correlated with "food accumulation (食積)" as intestinal feces are tangible substances. In addition, gas in the intestine increases visceral sensitivity, causing abdominal distention or pain. The gas pattern findings (14.5%) on x-ray were observed in the "Distention type" and "Abdominal pain type," but not in the "Constipation type."

• Journal of Oriental Neuropsychiatry
• /
• 제18권3호
• /
• pp.309-319
• /
• 2007

Chest pain is classified into two major categories of cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is caused by cardiovascular disease, for example, myocardial infarction, angina pectoris, valvular heart disease, cardiac enlargement or hypertrophy, dissecting aortic aneurysm, pericarditis, myocarditis, etc. When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain. Non-cardiac chest pain is caused by pulmonary, gastrointestinal, musculoskeletal disease, psychiatric factor, etc. In tills case, we treated a 54-year old female patient who was diagnosed with dilated cardiomyopathy and suspicious sick sinus syndrome. She complained of chest pain, exertional dyspnea, dizziness and headache. For treatment, we made use of Yugultangami(六鬱湯加味) and Daejobwan(大造丸). Before and after treatment, we measured Heart rate variability(HRV). In result, the clinical symptoms were improved and there was a significant increase in assessmeut by Heart rate variability(HRV). Tills result suggests that Yugultaugami aud Daejowhan have a good effect on cardiac chest pain.

• Herbal Formula Science
• /
• 제22권1호
• /
• pp.65-78
• /
• 2014

Objectives : The purpose of this study was to investigate the interpretation of the Ondam-tang(Ondam-tang, here-in-after referred to as "ODT") prescription in order to obtain the evidence for clinical applications. Methods : We have analyzed the interpretation on the ODT prescription through translations and comparisons based on classic books about the oriental medical prescriptions. Result : 1. ODT was first mentioned in the Jiyangfang(集驗方) which was quoted in the Waitaimiyao (外臺秘要). After that, in book Sanyinjiyibingzhengfanglun(三因極一病證方論), Chen-yan(陳言) completed and recorded in a book organizing prescriptions of ODT now in frequent use. 2. The Banha(半夏) removes the dam(痰-phlegm) and relieves emesis. The Jinpee(陳皮) encourages strengths, and the Bokryoung composes oneself and produces the water. The Licorice(甘草) relieves people's mind, and the Ginger relieves gastrointestinal problems and relieves emesis. Juk-yeo(竹茹) abate of the fever of the Sangcho(上焦). Jisil(枳實) encourages strength, controlling Samcho(三焦) as releasing the congestion of energy. In these ways, numerous symptoms resulted from the imbalances of the Gallbladder(膽) are treated. 3. Meaning of "on(溫-warm)" in ODT regains the original characteristic of the Gallbladder(膽). 4. Treatment mechanism of ODT is 'cooling the Gallbladder(膽)' and 'remedies Samcho(三焦)' and 'eliminates dam(痰)' and 'cure Kiwool(氣鬱-which is kind of depressions) and Saengyen(生涎-which is kind of phlegm)' and 'removes a mismatch between Gallbladder(膽) and Stomache(胃)'. Conclusion : In this study, we have demonstrated various methodologies. This paper will be useful to the future researchers and clinicians to conduct a study on herbal medicines such as the ODT.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제23권5호
• /
• pp.423-429
• /
• 2020

Purpose: Alimentary tract duplication (ATD) is a rare congenital condition that may occur throughout the intestinal tract. Clinical symptoms are generally related to the involved site, size of duplication, or associated ectopic mucosa. This study aimed to identify clinical implications by anatomical locations and age group and then suggest a relevant management according to its distinct features. Methods: We retrospectively reviewed the clinical data of pediatric patients who received a surgical management due to ATD. Furthermore, data including patients' demographics, anatomical distribution of the duplication, clinical features according to anatomical variants, and outcomes were compared. Results: A total of 25 patients were included in this study. ATD developed most commonly in the midgut, especially at the ileocecal region. The most common clinical presentation was abdominal pain, a sign resulting from intestinal obstruction, gastrointestinal bleeding, and intussusception. The non-communicating cystic type was the most common pathological feature in all age groups. Clinically, prenatal detection was relatively low; however, it usually manifested before the infantile period. A laparoscopic procedure was performed in most cases (18/25, 72.0%), significantly in the midgut lesion (p=0.012). Conclusion: ATD occurs most commonly at the ileocecal region, and a symptomatic one may usually be detected before the early childhood period. Surgical management should be considered whether symptom or not regarding its symptomatic progression, and a minimal invasive procedure is the preferred method, especially for the midgut lesion.

• The Journal of Internal Korean Medicine
• /
• 제33권1호
• /
• pp.39-53
• /
• 2012

Objectives : Many studies have shown that helicobacter pylori (H. pylori) infection is associated with gastroduodenal diseases. The purpose of this report was to evaluate recently published research on the influence of oriental herbal medicine on H. pylori infections. Methods : Recently published literature were systematically compared with their findings of how oriental herbal medical treatment affects H. pylori-associated disease. Results : The eradication rate of H. pylori in oriental herbal medicine groups was 66.93% while it was 66.02% in western medicine groups. In oriental herbal plus western medicine groups, interestingly, the rate increased to 84.78%. On the other hand, the total treatment efficacy rate of H. pylori in oriental herbal medicine groups was 91.27%. The treatment efficacy rate in oriental herbal plus western medicine groups rose to a record 93.22%, which was 15.34% higher than the rate in western medicine groups. In addition, the rate of adverse effects was 2.71%, 4.85%, 15.80% in oriental herbal medicine, western medicine, and oriental herbal plus western medicine groups, respectively. Diarrhea was most frequently observed in oriental herbal medicine groups, while nausea was most frequently observed in the other groups. Conclusions : The results of this study showed that herbal medicinal treatment can increase the rate of H. pylori eradication and improve H. pylori-related gastrointestinal symptoms. These findings suggest that herbal medicine can solve the problems including side effects due to antibiotic resistance of standard triple therapy.

• The Journal of Internal Korean Medicine
• /
• 제28권4호
• /
• pp.956-962
• /
• 2007

In cancer patients showing nausea and vomiting, a number of factors can be considered as the cause including brain tumor, electrolyte imbalance, gastrointestinal diseases or types of chemotherapy agents and dose of the drugs. Though nausea and vomiting can be minimized through the use of various anti-emetic drugs, many people still suffer from severe nausea and vomiting with poor quality of life compared with patients who do not show significant nausea and vomiting. In this report, we introduce a case of a cancer patient who suffered from severe nausea and vomiting. The patient was female and 59 years old with NSCLC (non small cell lung cancer) with metastatic brain tumor. Though western conventional medical treatment was used to reduce the symptoms, persistent nausea and vomiting were noted during the admission period. Herbal decoction Gamibokryungbanha-tang was used for nausea and vomiting which were uncontrolled under conventional western medicine; the patient showed remarkable improvement in terms of frequency and severity of nausea and vomiting. Further study will be needed in order to determine the long-term effectiveness of oriental medical treatment on cancer patient with nausea and vomiting.