• 한국식품영양학회지
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• 제10권2호
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• pp.186-192
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• 1997

성별, 직업, 성품, 생활양식이 전혀 다른 K43과 C45 환자의 위 내시경적 소견과 치료방법을 논의하였다. K43은 잘못된 식습관과 스트레스에 의한 미란성 위염환자로서 제산제와 함께 H2-수용체 길항제, H+/K+-pump 억제제, prostaglandin 제제, colloidal bismuth, sucralfate prokinetics 등 전통적인 약물에서부터 부작용을 감소시킨 최근에 개발된 약물에 이르기까지 효과가 인정된 약물들을 폭넓게 사용하였으나 증상을 개선치 못하였으며, 임상병리 검사와 상복부 초음파 검사는 정상이었으나, 소화생리기능 검사에서 visceral hypersensitivity를 나타내었다. 그러나 C45는 평소에 두통으로 NSAIDs를 습관적으로 복용한 경험에 의하여 발생되었을 것으로 추정되는 전형적인 위·십이지장 궤양의 환자로서 H. pylori 박멸제와 함께 일반적인 소화성 궤양의 치료제로 활동기에서 치유기로 증상을 크게 완화시켰다. 특히 K43은 amitryptyline을 투여하였으나 난치성 환자로 남아 있다. 이러한 원인불명의 비궤양 환자는 미국에서 해마다 15%씩 증가하는 추세에 있고 적절한 치료법도 없으며, 우리 나라에서는 통계치도 없는 실정인 점을 지적하고 싶다.

• 한국임상약학회지
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• 제27권2호
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• 한국보건간호학회지
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• 제10권1호
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• pp.106-117
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• 1996

This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3209-3212
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• 2012

Introduction: Colorectal carcinoma (CRC) is the most common gastrointestinal malignancy in the older population, but it is also quite frequent among young adults in developing countries. The aim of this study was to update the trends of clinicopathological features of CRC in young Nepalese. Methods: A retrospective comparative study on the data retrieved from the surgical records of all patients between 20 to 39 years of age with CRC was carried out for periods of 5 years each from 1999 to 2003 (early) and 2004 to 2008 (recent), treated at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results: The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were $34{\pm}4.7$ and $31.8{\pm}5.1$ years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

• 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.