• Clinical and Experimental Pediatrics
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• v.58 no.11
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• pp.440-445
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• 2015

Purpose: Chest pain is common in children and adolescents and is a reason for referral to pediatric cardiologists. Although most cases of chest pain in these age groups are benign and do not require treatment, timely diagnosis is important not to miss life-threatening diseases requiring prompt treatment. We investigated certain clinical characteristics that may be useful in the diagnosis of such critical diseases. Methods: Patient medical records between July 2006 and September 2013 were retrospectively examined. We included 517 patients who presented with chest pain to the Department of Pediatrics at Kyung Hee University Hospital in Gangdong. Results: Most cases of chest pain were idiopathic in origin (73.6%), followed by cases with respiratory (9.3%), musculoskeletal (8.8%), cardiac (3.8%), gastrointestinal (2.9%), and psychiatric (1.4%) causes. In 6 patients (1.2%) with air-leak syndrome including pneumothorax or pneumomediastinum, the pain was abrupt, continuous, and lasted for a short period of 1-2 days after onset in the older adolescents. Of the patients with cardiac pain, 13 had cardiac arrhythmias (65.0%), 6 had congenital heart diseases (30%), and 1 had coronary aneurysms caused by Kawasaki disease (5.0%). One patient with atrial flutter had only symptoms of syncope and chest pain. Conclusion: The abrupt, continuous chest pain of a short duration in the older children was characteristic of air-leak syndrome. In patients with pneumomediastinum, radiological diagnosis was difficult without careful examination. Combined syncope should not be neglected and further cardiac workup is essential in such patients.

• Journal of Korean Clinical Nursing Research
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• v.18 no.2
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• pp.264-274
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• 2012

Purpose: This study was conducted to identify the quality of life (QOL) of adolescents who have inflammatory bowel disease. Methods: This was a descriptive comparative study, and participants were 58 adolescents with inflammatory bowel disease and 55 healthy adolescents. The Korean version of $PedsQL^{TM}$ 4.0 scale was used. Ten adolescents with inflammatory bowel disease were also interviewed. Data were analyzed with SPSS Win. Results: Average score on QOL for these adolescents was statistically lower (p<.001) than healthy adolescents, especially for physical and school functioning. QOL of the adolescents who had the disease for more than 4 years, and were taking 3 or more medications was lower QOL than other adolescents with this disease. In interviews, adolescents complained of physical malfunctioning. In emotional functioning, they worried about the reoccurrence of bloody diarrhea, and mood changes. As for social functioning, dietary restrictions, gastrointestinal symptoms, and poor peer relationships were primary concerns. Lastly, in school functioning, frequent absences and lower academic performance were problems. Conclusion: Considering these results, adolescents with inflammatory bowel disease felt anxious because of the uncertain origin of their disease and unpredictable course of the illness. Interventions should include diaries on food, along with education and counseling as nursing interventions.

• The Korean Journal of Physiology and Pharmacology
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• v.18 no.2
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• pp.149-153
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• 2014

Nausea and emesis are a major side effect and obstacle for chemotherapy in cancer patients. Employ of antiemetic drugs help to suppress chemotherapy-induced emesis in some patients but not all patients. Ginger, an herbal medicine, has been traditionally used to treat various kinds of diseases including gastrointestinal symptoms. Ginger is effective in alleviating nausea and emesis, particularly, for cytotoxic chemotherapy drug-induced emesis. Ginger-mediated antiemetic effect has been attributed to its pungent constituents-mediated inhibition of serotonin (5-HT) receptor activity but its cellular mechanism of action is still unclear. Emetogenic chemotherapy drugs increase 5-HT concentration and activate visceral vagal afferent nerve activity. Thus, 5-HT mediated vagal afferent activation is essential to provoke emesis during chemotherapy. In this experiment, water extract of ginger and its three major pungent constituent's effect on 5-HT-evoked responses were tested on acutely dispersed visceral afferent neurons with patch-clamp methods. The ginger extract has similar effects to antiemetic drug ondansetron by blocking 5-HT-evoked responses. Pungent constituents of the ginger, [6]-shogaol, [6]-gingerol, and zingerone inhibited 5-HT responses in a dose dependent manner. The order of inhibitory potency for these compounds were [6]-shogaol>[6]-gingerol>zingerone. Unlike well-known competitive 5-HT3 receptor antagonist ondansetron, all tested ginger constituents acted as non-competitive antagonist. Our results imply that ginger and its pungent constituents exert antiemetic effects by blocking 5-HT-induced emetic signal transmission in vagal afferent neurons.

• The Journal of Internal Korean Medicine
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• v.25 no.4
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• pp.418-425
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• 2004

The Guillain-Barre Syndrome(GBS), also called acute inflammatory demyelinating polyneuropathy and Landry's ascending paralysis, is an inflammatory disorder of the peripheral nerves - those outside the brain and spinal cord. It is characterized by the rapid onset of weakness and, often, paralysis of the legs, arms, breathing muscles and face. Finally, it leads to respiratory embarrassment and death. There is often a history of antecedent respiratory or gastrointestinal infection. Recently one patient was admitted with GBS. This patient was a 30 year-old man with quadriparesis, both facial palsy, numbness of hands and feet, and gait disturbance. After two weeks of oriental medicine and acupuncture treatment most symptoms improved. Therefore, this application of oriental medicine is reported with a plea for further investigation.

• The Journal of Internal Korean Medicine
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• v.28 no.2
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• pp.242-249
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• 2007

Backgrounds & Objectives : Yukgunjatanggranule (YGJT) ha been used for the treatment of functional dyspepsia, regarded as one of the gastric dysmotility diseases, but its mechanisms of cation are not yet well known, We investigated the effects of YGJT on gastric emptying and its mechanisms of action in rats. Methods : Gastric emptying was measured by glass beads (1mm in diameter) expelled from the stomach for 1 hour and 2 hours after administration ofnormal saline (NS) or YGJT 41.6mg/kg or 124.8mg/kg in rats. By the same method, gastric emptying was measured only for 2 hours after administration of NS of YGJT 124.8mg/kg in rats treated with atropine sulfate (1mg/kg, s.c), quinpirole HCl(0.3mg/kg, i.p.), NAME (NG-nitro-L-arginine methyl ester, 75mg/kg, s.c.) or cisplatin (10mg/kg, i.p.) to delay gastric emptying. Results : YGJT 124.8mg/kg improved gastric emptying more than NS or YGJT 41.6mg/kg (p=0.046). Under delayed gastric emptying, YGJT 124.8mg/kg improved gastric emptying in the group treated with cisplatin ($3.1{\pm}1.3$ vs. $6.6{\pm}3.1$, p=0.015), quinpirole HCl ($4.7{\pm}2.8$ vs. $5.5{\pm}5.6$, p=0.874) and NAME ($2.2{\pm}1.4$ vs. $4.7{\pm}6.0$, p=0.414), but aggravated it with atropine sulfate ($1.8{\pm}0.9$vs. $1.7{\pm}1.0$, p=0.957). Conclusions : YGJT improves gastric emptying through the cholinergic pathwas, and shows some effect against the toxicity of cisplatin. Therefore, we expect that it would be effective in relieving gastrointestinal symptoms in functional dyspepsia patients and cisplatin-treated patients.

• The Journal of Internal Korean Medicine
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• v.29 no.1
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• pp.67-79
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• 2008

Backgrounds & Objectives : The aims of this study were to observe how morphology was changed and whether gastric motility was impaired in streptozotocin(STZ)-induced diabetic rats(DR), and whether Yijin-tang(YJT) was able to restore their impaired gastric motility. Methods : We investigated the change of body weight, feed intake and blood glucose between normal rats (NR) and DR for 12 weeks after induction of diabetes. At the time of 12 weeks after induction of diabetes, gastric surface area, gastric slow wave and gastric emptying rate were measured. Results : Decreased body weight, increased feed intake and increased gastric surface area were observed in DR, compared with NR. The percentage of normogastria decreased but that of bradygastria increased in DR, compared with NR. YJT 90mg/kg had no effect on the correction of gastric slow wave. YJT 90mg/kg and 270mg/kg had a significant effect on improvement of gastric emptying, more than normal saline (NS) in both NR and DR but the gastric emptying rate of DR was significantly lower than that of NR when YJT 90mg/kg and YJT 270mg/kg were administered. Conclusions : We can expect that administration of YJT would be effective on the improvement of gastric emptying and upper gastrointestinal symptoms as a juvantia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.4
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• pp.319-328
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• 2020

Purpose: To examine the prevalence and clinical manifestations of eosinophilic esophagitis (EoE) in Korea children. Methods: The study was designed as a 1:2 matching case-control study. Using information from the endoscopic database of a tertiary center, we retrospectively reviewed the medical records of patients aged 18 years or younger who underwent upper gastrointestinal endoscopy between January 2014 and December 2017. A total of 21 patients were diagnosed with EoE based on current diagnostic criteria. In addition, 42 controls with normal esophageal biopsy findings matched to each EoE case by sex, age (±1 months), and season were randomly selected during the study period. Results: The mean age of EoE diagnosis was 12.1±4.0 years and the male-to-female ratio was 2:1. The proportion of allergic diseases in patients with EoE (28.6%) was higher than that in the controls (6.8%) (p=0.04). Most EoE patients tested for allergy were positive for at least one antigen, which was significantly different to the controls (88.2% vs. 47.4%, p=0.01). Characteristic endoscopic findings of EoE were noted in 19 patients (90.5%), but 2 patients (9.5%) showed normal esophageal mucosa. The clinical symptoms of EoE were improved by a proton-pump inhibitor in 10 patients (50.0%), and by an H₂ blocker in 9 patients (45.0%). Only one patient (5.0%) required inhaled steroids. Conclusion: While EoE is rare in the Korean pediatric population, the results of this study will improve our understanding of the clinical manifestations of the disease.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.6
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• pp.511-520
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• 2020

Purpose: Thickened infant formulas reduce regurgitation frequency and volume. Because the digestive tolerance of locust bean gum-containing formulas is controversial, the effectiveness and tolerance of a locust bean gum-thickened formula in infants presenting with regurgitation was evaluated. No other interventions were allowed during the 1 month follow-up period. Methods: We conducted an open, prospective, observational study of a locust bean gum-thickened formula administered to infants presenting with moderate to severe regurgitation according to parents during 1 month. Effectiveness and tolerance were assessed by evaluating gastrointestinal symptoms and quality of life indicators. Results: A total of 2,604 infants with an average age of 9.3±4.3 weeks were included in this 1 month trial. Regurgitation frequency and estimated volume decreased significantly (p<0.001) and the episodes were resolved completely in 48% of the infants. A significant decrease in duration of crying and episodes of gas (p<0.001), with improvement in quality of life parameters, was observed. Stool frequency increased and stool consistency softened (p<0.001) to levels within the physiologic range, consistent with the increased fiber load (0.42 g/100 mL). Conclusion: Locust bean gum-thickened formula decreased infant regurgitation, was well tolerated, and improved parental quality of life. Stool composition and frequency of the infants remained within the physiologic range.

• Journal of Chest Surgery
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• v.25 no.12
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• pp.1530-1536
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• 1992

From January 1984 to December 1991, One hundred sixty five patients with carcinomoa of the esophagus were treated surgically at the department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. Among them, hospital records were available in 121 patients and were included in this study. There were 115 men and 6 women, with ages ranging from 40 years to 79 years[mean age of 59.2 years]. The most frequent preoperative symptoms included dysphagia[72.7%], weight loss[60.3%], chest pain or discomfort[14.9%], general malaise[13.2%]. All were treated surgically: 100 patients were managed by curative or palliative resection with reconstruction, and 6 by palliative bypass surgery. In 15 patients, explorative thoracotomy or laparotomy was only done due to unresectability. [operability: 87.6%, resectability: 82.6%] All specimens[those from resectable 100 cases] were sent to pathology, and histopathologic examinations were done; squamous cell carcinomas were found in 95 cases, adenocarcinoma in l. Adenosquamous carcinomas were found in 3, and malignant melanoma in l. Postoperative complications occurred in 34 cases; anastomotic site leakage[10], which was followed by empyema in 9 of them, wound problem[7], hepatic failure[6], pneumonia [3], post-operative bleeding[3], chylothorax[2], post-operative stricture[2], sepsis[1], and tracheobronchial fistula[1]. Hospital deaths were in 6 cases[Hospital mortality: 5.0%]. During the follow up period, 26 patients were proven to be recurrence of cancer locally or distantly. The one, two, and five-year actuarial survival raf.es were 71.3$\pm$4.5%, 57.4$\pm$5.6%, 34.7$\pm$8.9%, respectively. The data from this study suggested that esophagectomy with reconstruction of gastrointestinal tract could be performed with a low operative mortality and a few serious postoperative complications and achieved reasonable long term palliation for carcinoma of the esophagus.

• Journal of Nutrition and Health
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• v.43 no.1
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• pp.34-45
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• 2010

The purpose of this study was to evaluate the effects of routine haecho bibimbab (boiled rice with assorted seaweed mixtures) consumption on the bowel habits in humans. Forty free-living adults (female 38, male 2) participated in this study (mean age $41.2\;{\pm}\;7.5$). After a baseline survey on general characteristics, life style and dietary habits, the participants were asked to consume haecho bibimbab during two-week period for lunch. Habitual bowel movements were checked out every day by a questionnaire and nutrient intake was estimated by a 24-hour recalls before and after the study. After 2 weeks of clinical trial, the bowel habits had improved. Haecho bibimbab increased the number of bowel movements, changed hard stools into softer ones. It also lessen the sense of incomplete evacuation, and abdominal pain during defecation, increased water intake (p < 0.001) and improved gastrointestinal problem. The participants believed that haecho bibimbab was effective in improving their constipation symptoms and bowel habits (p < 0.01). Routine haecho bibimbab consumption tended to increase especially vitamin A, E and folate intake (p < 0.01). The present findings suggest that routine seaweed-based lunch meal (haecho bibimbab) consumption may improve bowel habits without side effects.