• 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 Gastric Cancer
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• 제3권4호
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• pp.195-200
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• 2003

Purpose: Advancement of computed tomography (CT) hardware and software has allowed thin section scanning and reconstruction of fascinating 2-dimentional (2D) and 3- dimentional (3D) images. Especially, the reconstruction of 3D images of gastrointestinal tract has been used in the detection and diagnosis of pre-malignant and malignant diseases. To compare the efficacy of CT gastrography with conventional upper gastrointenstinal series (UGIs) in gastric cancer patients. Materials and Methods: During Nov. 2002 and Mar. 2003, twenty-seven patients who had gastric cancer received both double contrast upper GI series and CT gastrography prior to radical surgery. Among these patients, nineteen had early gastric cancer (EGC) and 8 had advanced gastric cancer (AGC). Fifteen patients were male and 12 were female. The mean age was 54 yrs (range, $27\∼75$ yrs). The patients were placed on NPO and Stomach was distended with gas in fasting state prior to CT scanning. Double contrast upper GI series were performed as routine manual. CT scan was conducted in all patients using 8 or 16-channel multidetector CT in this study. The collimation and reconstruction for CT scanning were set at 2.5 mm and 1.25 mm, respectively. CT scanning was performed in the supine position. For image processing, CT gastrography, in which raysum and surface rendering images were constructed, virtual and 2D image in coronal and sagittal images were performed. The detectability of gastric cancer was assessed between UGIs and CT gastrography. Results: In AGCs, the detection rate of cancer using CT gastrography and virtual gastroscopy was higher than EGC cases. However, CT gastrography and virtual gastroscopy showed less favorable results than UGIs. Even though only a small number of cases had been studied, we might conclude that CT gastrography and virtual gastroscopy could replace UGIs in the detection of AGC cases. Conclusion: The detection rate used with CT gastrography and Virtual gastroscopy is not better than that of UGIs in early gastric cancer, however, in advanced gastric cancer cases, it is nearly equal to that of UGIs.

• Asian Pacific Journal of Cancer Prevention
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• 제17권5호
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• pp.2351-2360
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• 2016

Management of Helicobacter pylori infection is an important aspect of many upper gastrointestinal tract diseases, such as chronic gastritis, peptic ulcer disease, gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. The Thailand Consensus on H. pylori treatment 2015 consisted of 22 national experts who took active roles, discussed all important clinical information and investigated clinical aspects in four workshops, focuising on: (1) Diagnosis (2) Treatment (3) Follow-up after eradication and (4) H. pylori infection and special conditions. Experts were invited to participate on the basis of their expertise and contribution to H. pylori works and/or consensus methodology. The results of each workshop were taken to a final consensus vote by all experts. Recommendations were developed from the best evidence and availability to guide clinicians in management of this specific infection associated with variety of clinical outcomes.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제1권1호
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• pp.133-137
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• 1998

Although midgut volvulus is clinically characterized by bilous vomiting and abdominal distention, plain abdominal X-ray is usually non-specific and therefore it can be misdiagnosed to other diseases. Upper gastrointestinal contrast study and computed tomography have been used as a routine diagnostic tool but it takes cost and time. Abdominal ultrasonography is a relatively good alternatives in diagnosing midgut volvulus and it relatively saves cost and time. But case presentation of midgut volvulus diagnosed with abdominal ultrasonography are rarely found in literature. We experienced a 6 month old girl who had come to our hospital with bilous vomiting and was diagnosed as midgut volvulus with ultrasonography. Thus we report this case with the presentation of typical ultrasonographic findings of midgut volvulus.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권4호
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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.

• Preventive Nutrition and Food Science
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• 제18권2호
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• pp.104-110
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• 2013

Presence of Helicobacter pylori is associated with an increased risk of developing upper gastrointestinal tract diseases. Antibiotic therapy and a combination of two or three drugs have been widely used to eradicate H. pylori infections. Due to antibiotic resistant drugs, new drug resources are needed such as plants which contain antibacterial compounds. The aim of this study was to investigate the ability of GutGard$^{TM}$ to inhibit H. pylori growth both in Mongolian gerbils and C57BL/6 mouse models. Male Mongolian gerbils were infected with the bacteria by intragastric inoculation ($2{\times}10^9$ CFU/gerbil) 3 times over 5 days and then orally treated once daily 6 times/week for 8 weeks with 15, 30 and 60 mg/kg GutGard$^{TM}$. After the final administration, biopsy samples of the gastric mucosa were assayed for bacterial identification via urease, catalase and ELISA assays as well as immunohistochemistry (IHC). In the Mongolian gerbil model, IHC and ELISA assays revealed that GutGard$^{TM}$ inhibited H. pylori colonization in gastric mucosa in a dose dependent manner. The anti-H. pylori effects of GutGard$^{TM}$ in H. pylori-infected C57BL/6 mice were also examined. We found that treatment with 25 mg/kg GutGard$^{TM}$ significantly reduced H. pylori colonization in mice gastric mucosa. Our results suggest that GutGard$^{TM}$ may be useful as an agent to prevent H. pylori infection.

• Preventive Nutrition and Food Science
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• 제21권3호
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• pp.197-201
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• 2016

Helicobacter pylori infection is associated with an increased risk of developing upper gastrointestinal tract diseases. However, treatment failure is a major cause of concern mainly due to possible recurrence of infection, the side effects, and resistance to antibiotics. The aim of this study was to investigate the activities of Centella asiatica leaf extract (CAE) against H. pylori both in vitro and in vivo. The minimum inhibitory concentrations (MICs) against 55 clinically isolated strains of H. pylori were tested using an agar dilution method. The MICs of CAE ranged from 0.125 mg/mL to 8 mg/mL, effectiveness in inhibiting H. pylori growth was 2 mg/mL. The anti-H. pylori effects of CAE in vivo were also examined in H. pylori-infected C57BL/6 mice. CAE was orally administrated once daily for 3 weeks at doses of 50 mg/kg and 250 mg/kg. CAE at the 50 mg/kg dose significantly reduced H. pylori colonization in mice gastric mucosa. Our study provides novel insights into the therapeutic effects of CAE against H. pylori infection, and it suggests that CAE may be useful as an alternative therapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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• pp.293-299
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• 2022

Purpose: Data on eosinophilic esophagitis (EoE) in South America is scarce. Moreover, no studies are available in Ecuador. We evaluated the clinical, endoscopic, and histological characteristics of Ecuadorian children with EoE. Methods: Medical records of 2,711 children who underwent upper gastrointestinal endoscopy (UGE) between 2009 and 2020 at Hospital Metropolitano de Quito, Ecuador were reviewed. Esophageal mucosal biopsies were obtained from 72 patients and the features of 35 children with EoE were described. EoE was diagnosed when there were more than 15 eosinophils in the esophagus, per high power field. Results: EoE was diagnosed in 35 children (9.4±4.5 years) with a male predominance (74%). Abdominal pain (51.4%) and vomiting (31.4%) were dominant symptoms. A history of allergic diseases was noted in 47.1% of the children, which mainly included allergic rhinitis (37.1%) and atopic dermatitis (11.4%). The most common endoscopic findings were furrowing (82.9%) and edema (74.3%). All patients were initially treated with proton-pump inhibitors (PPIs). Those who did not respond to PPIs received steroids (5.7%) and diet therapy (5.7%), and five patients were referred to an allergist. Clinical and histological resolution was observed in 65% of the patients who underwent a second UGE after 6-8 weeks of PPI. Conclusion: Our study describes the clinical features of pediatric EoE in Ecuador. This is the first retrospective study in Ecuador that describes the clinical, endoscopic, and histological manifestations of EoE in a small pediatric population. Almost half of the children who underwent a biopsy had EoE.

• 대한영상의학회지
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• 제83권6호
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• pp.1240-1258
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• 2022

림프계는 염증 및 악성 세포의 확산 경로를 제공한다. 종양이 확산되는 림프절의 위치와 림프 배액 경로를 인지하는 것은 종양의 병기 결정, 치료 방법 선택 및 환자의 예후 예측에 중요하다. 복강 내 악성 종양에서 림프절 전이는 흔하기 때문에 림프절 전이를 발견하고 질병의 확산 방식을 이해하는 것은 영상의학과 의사에게 필수적이다. 이 임상화보에서는 도식적인 그림들과 림프절을 색으로 표시한 CT 영상을 사용하여, 상부 및 하부 위장관, 간, 담낭, 담관 및 췌장의 림프절 위치와 이름, 그리고 림프 배수 경로에 관해 기술하였다. 또한 각 장기에서 발생하는 악성 종양의 국소 림프절의 종류에 대해 기술하고 몇몇 증례의 영상을 제시하였다.

• 대한영상의학회지
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• 제81권5호
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• pp.1069-1082
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• 2020

복부 영상 영역에서는 새로운 건강보험 보장성 강화 대책으로 인하여 2018년 4월 1일 상복부 초음파, 2019년 2월 1일 하복부 초음파와 2019년 11월 1일 복부 MRI가 순서대로 급여 확대되었다. 많은 환자들이 건강보험 급여 혜택을 보게 되었으며 간경화, 담낭용종, 간선종, 이형성 결절, 췌장 낭종과 자가면역성 췌장염, 담석 등이 건강보험에 포함되었다. 그러나 급여화로 인해 각 검사의 적응증, 추적검사 가능 질환과 적용 횟수 등이 보다 복잡해졌으며 획득하여야 할 표준영상과 판독소견서의 양식이 지정되었으며, 따라서 외래나 병실에서 검사를 처방하고 검사실에서 검사를 시행할 때 주의해야 할 필요가 있다.