• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권3호
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• pp.243-250
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• 2020

Purpose: Gastric delta cells (D-cells), which are somatostatin-secreting cells, are the main paracrine inhibitor of acid secretion. The number of D-cells was studied in children presenting with upper gastrointestinal (UGI) disease. Methods: We retrospectively investigated the number of D-cells in the gastric body and antrum through immunofluorescence examinations according to symptoms, endoscopic findings, and Helicobacter pylori infection in 75 children who visited Hanyang University Hospital Pediatrics. Results: The mean patient age was 12.2±3.3 years. The male-to-female ratio was 1:1.4. The mean D-cell number per high-power field in the antrum and body was 20.5 and 12 in children with substernal pain, 18.3 and 10.3 in vomiting, 22.3 and 6 in diarrhea, and 9.3 and 6 in abdominal pain, respectively (p>0.05). According to endoscopic findings, the mean D-cell number in the antrum and body was 14.3 and 6 with gastritis, 14 and 9.3 with reflux esophagitis, 16.7 and 8.7 with duodeno-gastric reflux, 19.3 and 12.7 with gastric ulcer, 16 and 13.7 with duodenitis, and 12.3 and 4 with duodenal ulcer, respectively (p>0.05). The D-cell number in the gastric body was 2.7 and 8.7 in children with current H. pylori infection and non-infected children, respectively (p=0.01), while those in the antrum were 15.5 and 14, respectively, with no statistical significance. Conclusion: The D-cell number was lower in the gastric body of children with current H. pylori infection. Further studies concerning peptide-secreting cells with a control group would provide information about the pathogenic pathways of UGI disorder.

• 대한임상독성학회지
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• 제7권2호
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• pp.113-120
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• 2009

Purpose: Though caustic injury of the upper digestive tract can lead to severe sequelae, there are few clinical studies on this subject. This study was undertaken to evaluate the clinical characteristics, the endoscopic findings and the risk factors of the upper digestive lesions in patient with caustic ingestion injury. Methods: We retrospectively reviewed the medical records of 137 patients who ingested caustic materials and who visited to our emergency room from January, 2000 to June, 2009. Results: The most common ingested agent was sodium hypochlorite (44.5%), followed by acetic acid (19.7%), hydrochloric acid (11.7%) and lye (8.0%). Ingestion for suicidal attempt (62.0%) was more frequent than accidental ingestion (30.7%). Grade IIa injury was the most frequent finding on endoscopy of the esophagus and Grade 1 injury was the most frequent finding on endoscopy of the stomach. For the late sequelae, there were 9 cases (6.6%) of esophageal stricture and 2 cases (1.5%) of gastric outlet obstruction. The initial signs and symptoms did not correlate with the development of stricture, but leukocytosis, and grade III injury were related to the risk of developing stricture. Conclusion: Caustic injury of the upper gastrointestinal tract is frequently observed on early endoscopy and it can cause significant late sequelae such as stricture. Therefore, it is necessary to evaluate these patients with regular follow up endoscopic examinations for the management of late sequelae.

• Journal of Preventive Medicine and Public Health
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• 제31권4호
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• pp.728-739
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• 1998

To improve wellness and quality of life by recognizing the health efforts of stress, the author estimated the relationships between stress, subjective symptoms and clinical diagnosis through a questionnaire and a battery of specified laboratory tests; electrocardiography, blood pressure, cholesterol, aspartate aminotransferase(AST), alanine aminotransferase(ALT), gamma glutamyl transferase$(\gamma-GTP)$, fasting blood sugar, gastro-endoscopy or UGI, abdominal sonography, etc. The data was gathered from 337 clients who were undergoing multiphasic screening program at a University Hospital from January to March 1998. The mean age of subjects was $46.5{\pm}11.2$ years and the mean of body mass index was $24.0{\pm}3.7kg/m^2$. The mean vol of stress was $18.5{\pm}6.0$ expressed as the score out of 40. By general characteristics and lift style among male, mean level of stress was significantly higher in case of lower socioeconomic status, habitual drug use, longer daily working time(>10 hours), no regular exercise, drinkers, irregular meal, skip-ping breakfast(p<0.05). In case of female, that was significantly higher in case of lower education, lowe. socioeconomic status, longer daily working time(>10 hours), no regular exercise, drinkers, smokers, irregular meal, skipping breakfast(p<0.05). Significant correlations were observed between stress and subjective symptoms in all kinds of organ system (p<0.01). Correlation coefficients of stress among male were relatively high with neuro-psychiatric symptom$(\gamma=0.476)$ and cardio-vascular symptom$(\gamma=0.361)$ in order, and correlation coefficients of stress among female was highest with neuro-psychiatric symptom$(\gamma=0.371)$. The prevalence of the diagnosis through the battery of laboratory tests was high in upper gastrointestinal disorders and hypercholesterolemia in order in both sex group. Among male the mean score of stress was significantly high in ulcerative peptic disorder of upper gastrointestine and hepatopathy in order (p<0.05) . Among female that was significantly high in diabetes mellitus. In summary, it is likely that there are associations between stress, subjective symptoms and clinical diagnosis. To promote wellness and quality of life it would be of value that periodic stress evaluation program and stress management including apropriate control of smoking and drinking, regular exercise and meal.

• 대한방사선기술학회지:방사선기술과학
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• 제30권4호
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• pp.343-347
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• 2007

폭포상위는 비만형의 체격을 가진 사람에게 더 현저하다고 알려져 있다. 이에 본 연구에서는 폭포상위를 가진 자의 신체적 요인인 성별, 나이, 신장, 몸무게 및 비만상태를 조사 분석하여 폭포상위와 연관성이 있는지를 알아보고자 하였다. 일부지역 한 검진기관 2007년 1월부터 12월까지 상부위장관조영술을 실시한 3,320명 중 폭포상위를 가진 자 564명을 연구대상자로 하여 다음과 같은 결론을 얻을 수 있었다. 1. 폭포상위의 정도는 3.320명 중 564명(16.9%)으로 나타났다. 2. 폭포상위를 가진 자 564명 중 비만도 120% 이상인 자는 226명(40.1%)으로 높게 나타났다. 3. 비만도 120% 이상인 자 중 성별에서는 여성이 63.7%로 남성보다 높게 나타났으며, 연령에서는 $50{\sim}59$세 45.6%, 신장은 $151{\sim}160\;cm$에서 49.1%로 나타났으며, 몸무게는 76 kg 이상에서 31.0%로 가장 높게 나타났다. 4. 폭포상위를 가진 자의 증상과 비만인 자의 증상과는 무증상이 62.6%, 57.5%로 나타났으며, 다음으로 소화불량증 16.8%, 17.3%, 속쓰림 10.8%, 15.0% 순으로 나타났다. 결론적으로 폭포상위는 비만일수록 높게 나타난다는 사실을 알 수 있었으며, 비만일수록 성별에서는 남성보다 여성이, 연령별에서는 50대, 신장에서는 $151{\sim}160\;cm$, 몸무게에서는 76 kg 이상에서, 증상으로는 무증상 다음으로 소화불량증, 속쓰림 순으로 높게 나타남을 알 수 있었다. 이는 통계에 의한 조사이므로 폭포상위와 비만과의 연관성을 사실적인 확인을 할 수는 없었으나 앞으로 폭포상위와 비만과의 관계에 대해 더욱 더 많은 연구가 이루어져야 하겠다고 사료된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제8권2호
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• pp.164-171
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• 2005

목 적: 건강한 만삭아로 출생한 신생아에서 상부위장관 출혈의 임상적 특징, 위내시경 소견, 연관된 위험요소 등을 알아보고자 하였다. 방 법: 2002년 1월부터 2003년 12월까지 을지의과대학교 을지병원 신생아 중환자실에 토혈 혹은 혈변을 주소로 입원하여 위내시경상 출혈성 위염 또는 궤양으로 진단된 9명의 환아들을 대상으로 산전인자, 모체인자, 분만소견, 내시경 소견, 예후 등을 후향적으로 조사하였다. 결 과: 1) 9명의 환아 중 원내 출생아는 5명(5명/3,734명)으로 발생률은 0.13%였고, 모두 적정체중 만삭아로 출생 시 가사소견은 없었다. 2) 산모들의 병력상 산전에 위염, 소화성 궤양, 제산제 복용 등의 기왕력, 위장관 질환의 가족력은 없었고, 분만과정 중 특이소견 없었다. 3) 토혈, 혈변, 반복되는 구토가 주증상이었으며, 출생 후 $4.4{\pm}3.8$일에 발생하였고, 입원 시 활력증후는 양호하였고, 혈액검사소견도 정상이었다. 내시경 검사상 출혈성 위염이 6예, 위궤양이 3예였다. 4) 모든 환아는 $H_2$ 수용체 차단제 치료와 보존적 치료을 실시하였고, 치료 시작 후 $0.9{\pm}0.3$일 이내에 임상증상은 호전되었다. $H_2$ 수용체 차단제는 $18.6{\pm}5.0$일 치료하였으며 추적관찰상 증상이 재발된 환아는 없어서 추적 내시경은 실시하지 않았다. 결 론: 만삭아에서 출혈을 동반한 상부위장관 점막질환은 대부분 예후가 양호하여 임상증상이 호전된 경우에는 추적 위내시경 검사는 불필요한 것으로 사료된다.

• Advances in pediatric surgery
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• 제16권2호
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• pp.126-133
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• 2010

Malrotation is a congenital anomaly that becomes symptomatic more frequently during infancy. The indication for surgical treatment at that age is straightforward. In older children, the diagnosis may be more difficult because of chronic and vague complaint. The aim of this study is to compare the symptoms, rate of volvulus and surgical findings in children younger and older than one year. A retrospective study of 40 patients in a a single medical center diagnosed with malrotation from April 1996 to May 2010 was performed. There were 20 (50 %) boys and 20 (50 %) girls. At the time of operation, 27 (67.5 %) patients were younger and 13 (32.5 %) were older than 1 year. Vomiting was seen in 20 cases (74.1 %) of the younger group compared to 2 cases (15.4 %) of the older group. Abdominal sonography and upper gastrointestinal series showed a sensitivity of 100%. Operative findings: 12 (44.4 %) of the younger group presented with volvulus compared to none of the older group. The Ladd's procedure was routinely performed with appendectomy in all cases and bowel resection was requires when volvulus included bowel necrosis or other anomalies were found. After definite procedures, surgical correction for adhesive obstruction was necessary in 5 menbers (18.5 %) of the younger group and 1 patient (7.7 %) in the older group. There was 1 death due to respiratory failure and pneumonia. Abdominal pain was more frequent symptom and bilious vomiting was less frequent. Volvulus did not occur in the older group. Malrotation should be diagnosed promptly in children over 1 year of age by upper gastrointestinal series and abdominal ultrasonography even though symptoms are not as clear cut as in infants.

• 대한한방내과학회지
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• 제23권2호
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• pp.244-252
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• 2002

Functional dyspepsia refers to upper abdominal pain or discomfort with or without symptoms of early satiety, nausea, or vomiting with no definable organic cause. In this study, we recognized that dyspepsia was decreased with herbal medication (Banhabakchulchunma-tang) and acupuncture therapy. And we aimed to evaluate the Gastrointestinal Symptoms Rating Scale (GSRS) in these cases. The GSRS indicated that Oriental medicine treatment could be effective in the Functional dyspepsia. And it is helpful in decreasing symptoms of patients and in improving quality of life.

• Journal of Neurogastroenterology and Motility
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• 제25권3호
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• pp.387-393
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• 2019

Background/Aims Delayed gastric emptying (GE) is associated with high morbidity and mortality in subjects with diabetes. The aim of this study is to investigate associations between GE time and the major cardiovascular events (coronary heart diseases and ischemic stroke) in diabetic subjects with upper gastrointestinal (UGI) symptoms. Methods Among 259 subjects with chronic UGI symptoms who underwent gastric emptying study (GES) over 13 years, 122 diabetic subjects without gastric surgery and/or rapid GE were enrolled in this study. We also gathered data about baseline demographics, clinical characteristics, estimated GE half-time (GE T½) and incidence of cardiovascular events following GES. Results The mean age of subjects was 64.0 ± 17.4 years. There were 86 women and 104 subjects with type 2 diabetes. There were 52 (42.6%) subjects with normal GE, 50 (41.0.%) subjects with mild delayed GE, and 20 (16.4%) subjects with marked delayed GE. During follow-up (median, 207 weeks), cardiovascular events occurred in 7 (13.5%) subjects with normal GE, 4 (8.0%) subjects with mild delayed GE and 7 (35.0%) subjects with marked GE (P = 0.015). Univariate analysis showed that GE T½ was significantly associated with incidence of cardiovascular events (crude OR, 1.74; 95% CI, 1.12-2.69; P = 0.014). In a multivariate model, association between GE T½ and incidence of cardiovascular events remained statistically significant after adjustment for baseline characteristics and comorbidities (adjusted OR, 1.94; 95% CI, 1.21-3.12; P = 0.006). Conclusion A delay of GE was associated with an increased incidence of cardiovascular events in diabetic subjects with chronic UGI symptoms.

• 대한한방내과학회지
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• 제42권4호
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• pp.488-509
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• 2021

Purpose: Functional dyspepsia (FD) is a chronic syndrome accompanied by repetitive digestive symptoms that appear in the upper gastrointestinal tract and are not caused by specific diseases. Psychological symptoms like anxiety, depression, insomnia, and somatization are frequently observed in FD. The purpose of this study was to review the effect of herbal medicine on the psychological symptoms that accompany FD. Methods: Database search (PubMed, EMBASE, KISS, Kmbase, KoreanMed, NDSL, OASIS, CNKI) was performed on February 24, 2021; a total of 1825 studies were searched. After the screening, 22 studies were included. Results: The studies were assessed by Cochrane RoB 2 and sorted into a table according to psychological symptoms. Meta-analysis was performed to estimate the effect of herbal medicine. Twenty of the twenty-two studies reported that herbal medicine was significantly more effective than the control group. Only three of the studies did not have a high risk of bias. Conclusion: Herbal medicine was significantly effective with or without Western medicine and had fewer adverse effects. Severe adverse effect was not reported. Psychological symptoms in FD affect onset and duration of FD, and some FD patients want to be treated for their anxiety before other symptoms. Reliable information about treatment for the psychological symptoms of FD is lacking. We reviewed the effect of herbal medicine treatment in this study, the results of which could be selected for primary or secondary treatment for FD.

• 대한방사선기술학회지:방사선기술과학
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• 제22권2호
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• pp.17-21
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• 1999

There were four types of stomach contour included eutonic, hypotonic, steerhorn, and cascade. The aim of this study is to clarify relationship between incidence of stomach cancer and contour variation of the stomach. Double-contrast upper gastrointestinal study was performed in 1,546 patients, who had dyspepsia or other gastrointestinal tract symptoms. The radiographs were classified into the four types including eutonic, hypotonic, steerhorn, and cascade according to stomach contour in relation to body build. We also reviewed pathologic reports on endoscopic biopsy or surgical specimen. We studied the presence of relationship between incidence of stomach cancer and variation of stomach contour. We also examined the incidence of gastritis and gastric ulcer to the stomach contour variation. Of total 1,546 patients, eutonic stomach were 438(28.3%), hypotonic 911(58.9%), steerhorn 102(6.5%) and cascade 95(6.2%). Stomach cancer was found in 139(31.7%) of 438 eutonic stomachs, in 135(14.8%) of 911 hypotonic, in 42(41.2%) of 102 steerhorn, and in 24(36.9%) of 95 cascade (p=0.001). In hypotonic stomach, the incidence of stomach cancer was lower compared to the other three types significantly (p<0.05). Gastritis or gastric ulcer was found in 146(33.3%) of eutonic stomach, in 293(32,1%) of hypotonic, in 36(35.2%) of steerhorn, and in 26(27.3%) of cascade (p=0.640). In conclusion, gastric contour variation seems to be a factor affecting development of stomach cancer. The patients with hypotonic stomach may have lower incidence of stomach cancer than that of the other types. There was no relationship between the contour and gastritis or gastric ulcer.