• Journal of Yeungnam Medical Science
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• 제15권1호
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• pp.67-74
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• 1998

Successful management of duodenal obstruction in newborn infant implies not only satisfactory nutrition but also achievement of normal growth. To aid early diagnosis and management, we evaluated the diagnostic methods, operative interventions and clinical characteristics of thirty-nine infants with congenital duodenal obstructions. In the 11-year period from July 1986 through June 1997, thirty-nine patients with congenital duodenal obstruction (23 males and 16 females) were treated and reviewed at the Department of Pediatric Surgery, Yeungnam University Hospital. The ratio of male to female was 1.4:1, and 29 cases(74.1%) among total 39 patients were newborn. There were 5 premature patients and 16 patients of small for gestational age. The most common causes of the congenital duodenal obstruction was malrotation (26 cases, 66.7%) and followed by annular pancreas (9 cases, 23.1 %), type 1 atresia (3 cases, 7.7%) and wind-sock anomaly (1 case, 2.6%). Common symptoms were vomiting, abdominal distention, jaundice. Plain abdominal X-ray study combined with upper gastrointestinal series was the most commonly used diagnostic method. The operative procedures were performed by same pediatric surgeon utilizing Ladd's procedure in 26, duodenoduodenostomy in 8, duodenojejunostomy in 4, excision of wind-sock membrane in 1. A total of 15 associated congenital anomalies were found in 9 patients. Postoperative complications occurred in 13(33.3%). Overall mortality was 2.6%(1/39). Bilious vomiting and plain abdominal radiologic study were most useful for the diagnosis of congenital duodenal obstruction. Early diagnosis and operative intervention were important to prevent complications such as sepsis and peritonitis.

• 대한한의학회지
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• 제22권3호
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• pp.51-62
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• 2001

Objectives : In Oriental Medicine, the improvement of constipation is very important for patients at the acute stage of cerebrovascular accident. For constipation, oral medicine has usually been used but is not available to stroke patients with dysphagia and mental disorder, and may bring about side effects on the gastrointestinal tract. In such cases, general enema has been used for assistant therapy, We needed to develop a more effective enema technique on constipation of stroke patients. Methods : Sixty-three patients were researched. We treated 29 patients with Bo-Ryu enema and 34 patients with general enema. To compare the effect of the Bo-Ryu enema group with that of the general enema group, we analyzed general characteristics, bowel movement, abdominal examination and related symptoms. Results : Sixty-three patients comprised the Bo-Ryu (n=29) and general (n=34) enema groups. Between the Bo-Ryu and general enema groups, the Bo-Ryu enema was more effective than the general enema in the number of bowel movements, total and corrected amount of stool, tonus of rectus abdominis muscle and abdominal discomfort. However, there were not significant differences in the power of abdominal muscle, digestion and physical power. Among the subgroups, Bo-Ryu enema group was most effective in the number of bowel movements, total amount of stool and tonus of rectus abdominis muscle, and Bo-Ryu enema group was best in the corrected amount of stool and abdominal discomfort. Conclusions : Bo-Ryu enema should be considered as an effective and safe treatment for patients with constipation during the acute stage of cerebrovascular accident.

• 성인간호학회지
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• 제29권3호
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• pp.313-322
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• 2017

Purpose: The purpose of this study was to identify over time the changes of cancer symptom, depression and quality of life (QOL) among people who had stomach or colorectal cancer. Methods: Of the 74 participants recruited, 67 participated in the study. Participants were asked to complete three instruments at three different time. The instruments were the M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module, Hospital Anxiety Depression Scale, and the Functional Assessment of Cancer Therapy-General. The questionnaires were administered before chemotherapy, toward the end of chemotherapy, and six months after the completion of adjuvant therapy. Data were analyzed using descriptive statistics and repeated measure ANOVA. Results: At the immediately after chemotherapy point, the most frequent symptom was lack of appetite, followed by fatigue and problem with remembering things. The mean score for depression was 8.27 with a prevalence of 31.3%. The mean score for quality of life was 61.88 out of 135. Repeated measures ANOVA showed a significant increase in cancer symptom (F=23.22, p<.001) and depression (F=35.29, p<.001) after chemotherapy. However, improvement was observed 6 months after the completion of chemotherapy. QOL (F=33.73, p<.001) also showed similar patterns as observed with cancer symptom and depression. Cancer symptom was the strongest predictor of QoL at pre-chemotherapy point. but depression was the strongest predictor at immediately after chemotherapy point. Conclusion: Chemotherapy is highly associated with cancer symptom, depression and QOL in patients with cancer. The nursing intervention is needed to relieve depression as well as cancer symptoms to improve QOL in patients undergoing chemotherapy from baseline to follow-up.

• 대한한의학방제학회지
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• 제19권2호
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• pp.11-22
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• 2011

Objectives : Hwangyeonhaedok-tang(HHDT) has been traditionally used for various clinical symptoms associated with gastrointestinal disorder, cardiovascular diseases, and inflammation in the Oriental medicine. However, little is known for antioxidant and anti-inflammatory effects of HHDT on dextran-sulfate sodium(DSS)-induced colitis in mice. Methods : In this study, we investigated an antioxidant and anti-inflammatory effects of HHDT on DSS-induced colitis in mice. An experimental colitis was induced by daily treatment with 5% DSS. HHDT was orally administrated the various concentrations(25-100 mg/kg, body weight/day) for 7 days with one time per day. Results : HHDT reduced significantly clinical sign of DSS-induced colitis, including body weight loss, shorten colon length, disease activity index(DAI), and histological colon injury. HHDT also inhibited significantly serum NO and prostaglandine $E_2(PGE_2)$ productions in DSS-induced colitis mice. Furthermore, HDDT increased significantly an superoxide anion(SOD), catalase, and glutathione peroxidase(GPx) activity of the colon tissue in DSS-induced colitis mice. Conclusions : These results suggest that HHDT administration could reduce significantly the clinical signs and inflammatory mediators, and increase antioxidant activity in DSS-induced colitis model mice and is a good candidate for further evaluation as an effective anti-ulcerative agent.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• Clinical and Experimental Pediatrics
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• 제58권11호
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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.

• 임상간호연구
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• 제18권2호
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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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• 제18권2호
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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.

• 대한한방내과학회지
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• 제25권4호
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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.

• 대한한방내과학회지
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• 제28권2호
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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.