• 동의신경정신과학회지
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• 제33권1호
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• pp.21-31
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• 2022

Objectives: To perform correlation analysis between the Core Seven Emotions Inventory-Short Form (CSEI-s), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), upper gastrointestinal symptoms, and gastroscopic findings and to compare emotional characteristics with upper gastrointestinal endoscopic findings. Methods: In this study, medical records of 38 participants who visited the hospital for examination purposes or complained upper gastrointestinal symptoms and completed the CSEI-s, BAI, BDI, and Questionnaire for upper gastrointestinal symptoms were analyzed using SPSS (Statistical Package for the Social Sciences) version 25.0. Frequency Analysis, Descriptive Analysis, Independent t-test, Mann-Whitney's U-test, and Correlation analysis were performed. Results: The upper gastrointestinal symptom group showed higher levels of anger, sorrow, depression, and anxiety than the asymptomatic group. On gastroscopy, the normal group had higher levels of Joy than the abnormal group. The reflux esophagitis group showed higher levels of thought, depression, sorrow, and anxiety than the non-reflux esophagitis group. Joy showed a negative correlation with BDI score. However, anger, depression, sorrow, BAI, and BDI score showed positive correlations. Conclusions: Results of this study suggest that CSEI-s can be used to treat patients with upper gastrointestinal symptoms and reflux esophagitis.

• 정신신체의학
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• 제8권2호
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• pp.172-180
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• 2000

연구목적 : 상부 위장관의 소화 장애를 가진 환자들이 스트레스를 지각하였을 때 나타내는 반응 및 소화장애 증상의 여러 변인들과의 관계를 알아봄으로써 특정 정신신체질환군에서의 스트레스에 대한 반응특성과 해당 질환과의 연관성을 알아보고자 한다. 방법 : 소화장애 증상으로 인천기독병원 소화기내과를 방문하여 위내시경 소견 상 병변이 확인된 84명의 환자와 94명의 정상 대조군을 대상으로 국내에서 개발된 스트레스반응 지각척도를 사용하여 스트레스를 인지하였을 때 나타내는 반응을 비교분석하였다. 또한 환자군에서 현재 호소하는 소화장애 증상의 기간, 소화장애의 과거력, 증상의 심각도, 심리적 고통의 존재 여부에 따라 스트레스에 대한 지각반응이 어떻게 나타나는지 평가하였다. 결과 : 스트레스반응 지각척도는 8개의 하위척도로 구성되어 있으며 연구 대상자 178명에서 8개 하위척도와 척도전체의 내적 일치도는 .65~.95로써 통계적으로 유의하게 높았다. 환자군이 대조군에 비해서 척도의 전체총점과 일반적 신체증상척도, 특정신체증상척도의 접수가 통계적으로 유의하게 더 높았다. 소화장애 증상과 스트레스반응 지각척도와의 관련성은 소화장애의 기간, 소화장애의 과거력, 증상의 심각도는 특정신체증상을, 심리적 고통의 존재는 인지기능의 저하와 일반적 부정적 사고를 잘 예측해 주는 것으로 나타났다. 결론 : 실제 상부위장관에 병변을 가진 소화장애 환자들은 정상인에 비해서 강한 스트레스 반응 지각을 나타내었으며 특히 스트레스를 경험하고 인지하였을 때 감정, 인지, 행동 영역의 반응보다는 자율신경계 및 특정신체부위와 연관된 신체증상을 주로 경험하고 있음을 알 수 있다. 또한 이들은 소화장애의 기간이 길고, 과거력이 있을수록, 그리고 증상이 심할수록 스트레스에 대해 소화기 증상을 주로 한 특정신체증상으로 반응하며 심리적 고통을 주는 스트레스의 존재는 인지기능을 저하시키고 부정적인 사고반응을 일으킴을 알 수 있다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2999-3001
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• 2015

Background: This study aimed to evaluate upper gastrointestinal polyps detected during esophago-gastroduodenoscopy tests. Materials and Methods: We conducted a retrospective analysis on data regarding 55,987 upper gastrointestinal endoscopy tests performed at the endoscopy unit of Istanbul Education and Research Hospital between January 2006 and June 2012. Results: A total of 66 upper gastrointestinal polyps from 59 patients were analyzed. The most common clinical symptom was dyspepsia, observed in 41 cases (69.5%). The localizations of the polyps were as follows: 29 in the antrum (43.9%), 15 in the corpus (22.7%), 11 in the cardia (16.7%), 3 in the fundus (4.54%), 3 in the second portion of the duodenum (4.54%), 2 in the bulbus (3.03%) and 3 in the lower end of the esophagus (4.54%). Histopathological types of polyps included hyperplastic polyps (44) (66.7%), faveolar hyperplasia (8) (12.1%), fundic gland polyps (4) (6.06%), squamous cell polyps (4) (6.06%), hamartomatous polyps (3) (4.54%), and pyloric gland adenoma (3) (4.54%). Histopathological analysis of the gastric mucosa showed chronic atrophic gastritis in 30 cases (50.84%), HP infection in 33 cases (55.9%) and intestinal metaplasia in 19 cases (32.20%). In 3 cases with multiple polyps, adenocarcinoma was detected in hyperplastic polyps. Conclusions: Among polypoid lesions of the upper gastrointestinal tract, the most common histological type is hyperplastic polyps. Generally, HP infection is associated with chronic atrophic gastritis and intestinal metaplasia. The incidence of adenocarcinoma tends to be higher in patients with multiple hyperplastic polyps.

• 약학회지
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• 제37권5호
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• pp.520-526
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• 1993

The purpose of this study is to assess the clinical efficacy and safety of NRM granules which were newly developed as a combination product containing antacids, digestive enzymes and herb drugs for the treatmet of various symptoms of upper gastrointestinal disorders taking SGN granules of similiar but different composition as a control. One hundred and twenty one patients were randomly allocated to receive one pack of either NRM granule(80 cases) or SGN granules(41 cases) three times a day after meal and undergone symptomatic, endoscopic and clinical laboratory assessment before and after two weeks of treatment. The results were as follows; 1. All symptoms except anorexia showed improvements in more than 90% of total cases with each symptom in the NRM group. 2. The general improvement rate was 97.5% in NRM group, and was superior to the(92.5%) of SGN group. 3. Two cases of NRM group and one case of SGN group developed mild nausea, and onecase of SGN group developed mild epigastric soreness. No cases of the two groups developed laboratory(blood, biochemical, urine) abnormalities. 4. The overall clinical efficacy rate was 95.0% in NRM group, 87.8% in SGN group. kccording to the result of this trial, it was concluded that NRM granule was an effective and safe drug and(but not statistically significant) was slightly more efficient than SGN for treatment of various symptoms in upper gastrointestinal disorders.

• Journal of Gastric Cancer
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• 제12권3호
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• pp.187-193
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• 2012

Purpose: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. Materials and Methods: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. Results: There were 5 males and 5 females. The mean age was $56.5{\pm}0.5$ years. The mean operation time was $188.5{\pm}0.5$ minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was $25.2{\pm}0.5$. The length of proximal resection free margin was $3.1{\pm}0.1$ cm and distal was $3.7{\pm}0.1$ cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. Conclusions: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.

• Journal of Acupuncture Research
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• 제40권2호
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• pp.143-149
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• 2023

Functional dyspepsia (FD) is a chronic and recurrent upper gastrointestinal symptom that has no organic cause. A 49-year-old male patient positive for human immunodeficiency virus (HIV) visited the clinic because of FD and constipation. He received complex Korean medicine treatment, including acupuncture and herbal medicines, from April 14 to July 18, 2022 (27 times) in the outpatient department. Gastrointestinal Symptom Rating Scale (GSRS), Nepean Dyspepsia Index (NDI), FD-related quality of life (FD-QoL), Euro QoL visual analog scale (EQ-VAS), and Numerical Rating Scale (NRS) were used as evaluation tools in this study. Symptoms were relieved after 3 months of treatment, and his QoL improved (GSRS, 15-3; NDI, 110-21; FD-QoL, 52-20 [eating status, 10-3; liveliness status, 12-8; psychological, 1-0; role-functioning status, 18-9]; EQ-VAS, 40-65; NRS, 8-4). The results revealed that complex Korean medicine treatment could alleviate FD and constipation in patients with HIV.

• 정신신체의학
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• 제6권1호
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• pp.3-12
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• 1998

Objective : The sensation of dysphagia, heartburn, globus hystericus, and functional dyspepsia are common symptoms of the functional upper gut disorders. This study was designed to investigate quantity of perceived stress, depression, and anxiety in the patients with functional upper gut symptoms whose esopahgeal manometry(EM) and gatroesophageal reflux (GERT) test were normal. Methods : A total of 38 patients who complained of the symptoms had been tested with 24-hour ambulatory EM and conventional GERT in our gastrointestinal clinic. Thirty patients whose tests had been normal(patients group) were assessed with Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), and Spielberger Stait-Trait Anxiety Inventory(STAI) and compared with 30 patients(control group) without functional upper gut symtpoms in the hepatobiliary clinic. The two groups were also assessed by quantity of perceived stress during the last year through self-report. Results: 1) These patients tended to be predominently female, older, and possessed a lower education than control group. 79% of 38 patients who had been tested were normal. 2) Compared to the control group, the patients had significantly higher mean scores on four subscales(somatization, depression, anxiety, and positive symptom distress index). 3) The patient group had significantly more perceived stress than the control group. 4) The patients group had significantly higher levels of depression than the control gorup, but there was not any significant difference in the STAI. 5) There were significant positive correlations between the BDI score and the STAI-trait, the STAI-stait and the STAI-trait, the quantity of perceived stress and the STAI-trait. Conlusion : The patients with functional upper gut symptoms displayed more, psychological distress, sornatization, anxiety, and deperssion. Among them, patients had higer depression than control group. Functional upper gut symtoms could be more appropriately viewed as somatic symptoms of depression. These findings suggest that such patients need to have psychiatric intervention and treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10981-10984
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• 2015

Background: Esophagogastroduodenoscopy (EGD) is the standard technique for diagnosis of patients presenting with upper gastrointestinal symptoms. Some reports have shown high prevalence of esophageal cancer in the northern part of Afghanistan. The aim of this study was to investigate epidemiological profile of esophageal cancer among patients in this region. Materials and Methods: We identified 364 consecutive patients that received EGD examinations to examine upper gastrointestinal tract at the endoscopy unit of Balkh regional Hospital from March 2012 to March 2013. The case subjects included both in-patients and out-patients aged 16 years or more. We evaluated the results retrospectively. Results: The cases consisted of 184 (51%) males and 180 (49%) females. The mean age was $47.3{\pm}17.8$ and the age range 17-88 years. Ninety two cases had esophageal cancer, out of which 58 (63.0%) were male. The mean age at time of diagnosis was $57.8{\pm}13.2years$. Uzbek-Turkmen peoples were more common among patients with esophageal cancer (52.2%). Dysphagia was the most frequent symptom among patients with esophageal cancer at the time of presentation, seen in 77 (84.8%) of cases. Conclusions: Our results showed high incidence of esophageal cancer in the northern part of Afghanistan, especially in the Uzbek-Turkmen ethnic group.

• 대한영상의학회지
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• 제84권3호
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• pp.520-535
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• 2023

위장관 출혈은 단일 질환이 아니라 광범위한 위장 질환의 증상 및 임상적 발현이다. 임상적 양상에 따라 명백한 출혈, 잠재 출혈, 원인 불명 출혈로 나눌 수 있으며, 출혈 위치에 따라 Treiz 인대를 기준으로 상부 또는 하부 위장관 출혈로 분류할 수 있다. 혈관 질환, 용종, 종양, 크론병, 이소성 췌장 및 이소성 위조직 등 다양한 질환이 위장관 출혈을 일으킬 수 있다. 명백한 출혈을 위한 영상 검사기법은 CT 혈관조영술, 고식적 혈관조영술 및 핵의학적 검사 등이 사용된다. 잠재 위장관 출혈을 평가하기 위한 영상검사로는 CT 소장조영술이 주로 사용되며, 위장관을 적절히 팽창해서 영상을 획득해야 위음성 혹은 위양성을 최소화하여 진단능을 높일 수 있다. CT 소장조영술에서 진단이 확실하지 않은 경우, Meckel scan이 보완적으로 사용될 수 있다. 원인 불명 위장관 출혈에 대한 검사는 임상 양상과 임상의 혹은 영상의학과 의사의 선호도에 따라 다양한 검사가 시행될 수 있으며, 이에 대한 추가적인 연구가 필요하다.

• 정신신체의학
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• 제14권1호
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• pp.62-66
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• 2006

서론: 치료저항성 환자 치료 시 선택될 수 있는 여러 약물들의 병용 투여에 의해 예측할 수 없는 심각한 부작용을 야기하는 약물 상호작용이 일어날 수 있다. 저자들은 만성 정신분열병 환자에서 클로자핀(clozapine)과 부스피론(buspirone)을 병용 투여한 후 상부위장관 출혈이 의심되는 사례가 있어 보고하고자 한다. 증례: 망상형 정신분열병으로 진단받은 69세 여자 환자로 입원 당시 혈색소가 약간 감소된 것을 제외하고는 신체검사와 검사실 검사 상 다른 특이 소견은 없었다. 불안 증상이 심하여 부스피론 15mg을 올란자핀(olnazapine) 30mg과 같이 투여하였다. 하지만, 병력상 약물에 반응이 좋지 않고 본원 입원 치료에서 치료 반응이 없어 올란자핀을 클로자핀으로 교체하였다 인원 11주째, 클로자핀으로 교체한 지 4주가 지난 후, 환자는 클로자핀 300mg과 부스피론 60mg을 복용하고 있었다. 이 시점에서 약 4일 동안 간헐적으로 복통, 발한, 저혈압, 구토, 발열과 함께 토혈, 흑색변 소견 보였지만, 위내시경과 위장조영촬영에서 상복부위장관 출혈 소견은 발견되지 않았다. 모든 약물을 중단한 후, 상부위장관 출혈 의심 증상은 사라졌다. 이후 클로자핀만 단독으로 투여한 후, 정신병적 증상 호전을 보였고 상부위장관 출혈 소견도 재발하지 않았다. 고찰: 상부위장관 출혈은 클로자핀과 부스피론 각각의 약리학적 작용 및 부작용의 측면에서는 예상할 수 없었던 부작용이었으나, 정신분열병 치료를 위해 투여하고 있던 클로자핀에 추가적으로 항불안 효과가 있는 부스피론을 복합 투여하는 동안 발생하였으며 부스피론을 중단한 이후에는 동일한 부작용이 재발하지 않았다. 따라서, 저자들은 상부위장관 출혈 부작용의 발생 원인을 클로자핀과 부스피론 두 약물의 상호작용에 의한 것으로 보고 참고 문헌에 기초하여 몇 가지 가능한 기전들에 대해 고찰해 보았다. 두 약물의 상호작용에 대한 명백한 기전은 아직 밝혀지지 않았으나 상부위장관 출혈은 잠재적으로 생명에 치명적인 부작용이므로 클로자핀과 부스피론의 병용 투여 시 특별한 주의를 요한다.