• Advances in pediatric surgery
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• 제2권1호
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• pp.72-76
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• 1996

Annular pancreas is a rare congenital anomaly with the descending duodenum encircled by a ring of pancreatic tissue, which may cause partial or complete obstruction of the duodenum. In newborn, the symptoms can be those of duodenal stasis resulting from partial intestinal obstruction secondary to some degree of duodenal stenosis. A male newborn weighing 2.0 Kg was born by C-section delivery at 37 weeks' gestation to a 27-year-old mother who had a hydramnios. He was in relatively good condition at birth except regurgitation of saliva and intermittent apnea. A plain film of the abdomen showed the double-bubble of gas filled stomach and proximal duodenum, and upper gastrointestinal series showed a dilated proximal duodenum, with a complete obstruction of the descending duodenum. Intraoperative finding revealed encirclement of the duodenal second portion by pancreatic tissue. Duodenojejunostomy was performed. After the operation, he had developed two serious complications, neonatal septicemia by Enterobacter cloacae on postoperative day 12 and systemic candidiasis on postoperative day 19, and been managed with ventilatory support, antibiotics, and antifungal agents with recovery.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.12.1-12.9
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• 2020

Coronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.

• 대한한방내과학회지
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• 제42권6호
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• pp.1331-1340
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• 2021

A 42-year-old patient with functional dyspepsia had suffered from early satiation and postprandial fullness for 1 year despite Western medicine treatment. We treated her with the Spleen Daoyin method, along with acupuncture, moxibustion, and herbal medicine and scored her symptoms using a 4-point Functional Dyspepsia-related Quality of Life (4p-FD-QoL) questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a visual analogue scale (VAS). A 7-day Spleen Daoyin treatment decreased her 4p-FD-QoL score from 61 to 51, with a marked decrease in the emotional part (18 to 10). Her GSRS score did not change, but her bloating score decreased from 3 to 1. Her VAS score decreased from 6.6 to 4.3 for upper abdomen discomfort, but lower abdomen discomfort was unchanged. The patient showed high compliance and satisfaction with exercise therapy and reported no adverse events. Spleen Dayoin may be a useful therapy for functional dyspepsia, especially when accompanied by psychological problems.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권2호
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• pp.86-92
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• 2018

Purpose: Celiac disease is a common non-communicable disease with varied presentations. Purpose of this study was to find the duodeno-endoscopic features in celiac disease and to compare duodeno-endoscopic and histological findings between typical and atypical celiac disease in children. Methods: Hospital based observational study was conducted at Sir Padampat Mother and Child Health Institute, Jaipur from June 2015 to May 2016. Patients were selected and divided in two groups- typical and atypical celiac disease based upon the presenting symptoms. Upper gastrointestinal endoscopy and duodenal biopsy was performed for serology positive patients. Results were analysed using appropriate statistical test of significance. Results: Out of 101 enrolled patients, 47.5% were male. Age ranged from 1 to 18 years. Study showed that 54.5% were typical and 45.5% were atypical. Patients presenting with atypical symptoms were predominantly of older age group. On endoscopy, scalloping, mosaic pattern, reduced fold height and absent fold height; and in histology, advanced Marsh stage were significantly higher in the typical group. Conclusion: Awareness of atypical presentations as well as duodeno-endoscopic features may have considerable practical importance for the diagnosis of celiac disease in children. Scalloping, mosaic pattern, reduced fold height and nodularity are main endoscopic markers of celiac disease in children. Endoscopic markers of duodenal mucosa may be important in early diagnosis of celiac disease, in children subjected to endoscopy for atypical presentations or indication other than suspected celiac disease.

• 대한불안의학회지
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• 제2권1호
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• pp.28-32
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• 2006

Objectives : Non-cardiac chest pain (NCCP) can be divided into gastroesophageal reflux disease (GERD) related NCCP and non-GERD related NCCP. Our study was designed to examine the differences in clinical characteristics and psychological mood states between the two clinical syndromes. Methods : After some cardiologic evaluations such as treadmill exercise, coronary angiography, and echocardiography, 27 patients with NCCP were enrolled in this study. They were divided into patients with GERD related NCCP (12 patients) and those with non-GERD related NCCP (15 patients) using the upper gastrointestinal endoscopy and the ambulatory 24 hour esophageal pH monitoring. Clinical characteristics such as typical reflux symptoms and psychological mood states were measured. Patients who showed scores more than 10 on the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) were defined as depressed or anxious group. Anxiety sensitivity Index (ASI) was also measured in all patients. All parameters were compared between patients with GERD related NCCP and those with non-GERD related NCCP. Results : The two groups showed a difference in typical reflux symptoms. Patients with non-GERD related NCCP had higher scores on the BDI, BAI and ASI than those with GERD related NCCP. Among all NCCP patients, 14 patients (51.9%) were suggested to have possible depression or anxiety disorders. Conclusion : The non-GERD related NCCP was shown to be associated with psychological mood states such as anxiety and depression. Thus, we suggest that routine measurement of psychological mood states should be necessary in the evaluation and treatment of NCCP.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4433-4437
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• 2016

Background: Gastric cancer (GC) is the fifth most common cancer worldwide. Since development is usually asymptomatic, it is generally diagnosed at an advanced stage. The value of screening in patients with nonspecific symptoms for GC is controversial. Aim: The study aimed to evaluate whether hematological parameters (platelet count (PC), mean platelet volume (MPV), MPV/PC ratio, red blood cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR)) are useful markers to differentiate between gastric cancer patients and healthy individuals. Materials and Methods: Sixty-one patients with gastric cancer and sixty-one healthy individuals were enrolled to the survey and retrospective analysis of selected blood parameters were performed. Results: The mean values of PC, MPV, RDW, NLR, and PLR were significantly higher in GC patients compared to the control group. No statistical differences were observed in MPV/PC ratios. Likewise, no significant statistical differences were revealed in values of blood parameters among TNM stage groups. The RDW showed the highest diagnostic specificity and sensitivity. Conclusions: Hematological parameters: PC, MPV, RDW, NLR, PLR have diagnostic power and can discriminate patients with gastric cancer from patients without cancer. Blood parameters compared with clinical symptoms might alert physicians and patients and lead to performancce of upper gastrointestinal endoscopy, the gold standard in gastric cancer screening and therebly increase the early detection of cancer.

• Advances in pediatric surgery
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• 제14권1호
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• pp.27-36
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• 2008

Fundoplication is a common surgical procedure for gastroesophageal reflux disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to review our 11 years experience with fundoplication in infants and children. From October 1994 to December 2005, 59 fundoplications in 55 patients were performed at Sungkyunkwan University Samsung Medical Center. Medical records and laboratory results of these children were retrospectively reviewed for sex, age, symptoms and signs, coexisting disease, diagnostic methods, treatment modalities and length of operative time. Open fundoplication was performed in 41 cases and laparoscopic fundoplication in 18 cases. Simultaneous gastrostomy was done in 27 cases. Recurrent GERD symptom occurred in four patients (7.2 %) within 2 years after first fundoplication and all 4 patients had re-do fundoplication. There were no intra- and immediate post-operative complications. Gastrointesitnal symptoms were the most common indication for fundoplication in neurologically normal patients. The most frequent diagnostic studies were upper gastrointestinal series (76.3 %) and 24 hour esophageal pH monitoring (78.2 %). Fundoplication had been increased since 2004 and mostly done laparoscopically. In conclusion, our 11 years' practice of open and laparoscopic fundoplication indicates that both approaches are safe and effective in the treatment of GERD for infants and children.

• 대한한방내과학회지
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• 제41권6호
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• pp.1030-1051
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• 2020

Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.

• Pediatric Infection and Vaccine
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• 제23권2호
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• pp.87-93
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• 2016

목적: 신생아 중환자실(neonatal intensive care unit, NICU)에서 인플루엔자 바이러스 집단 발병의 보고는 흔하지 않으며 그 증상은 다양하다. 저자들은 국내 단일기관 NICU에서 발생한 A형 인플루엔자 바이러스 감염의 집단발병에 대해 보고하고 신생아 특히 미숙아에서의 임상적 특성을 알아보고자 하였다. 방법: 2011-2012년 국내 인플루엔자 바이러스 감염 유행 시기에 고신대학교 복음병원 NICU에 입원한 환자들 중 인플루엔자 바이러스 RT-PCR 검사를 시행한 29명 환자들의 의무기록을 후향적으로 조사하였다. 결과: 대상 환자 중 11명에서 A형 인플루엔자 바이러스 양성이었는데(37.9%), 모두 미숙아였고 이들 중 3명(27%)은 증상이 없었으며 상기도 감염 증상 없이, 발열(18%, 2/11), 호흡곤란(72.7%, 8/11), 소화기 증상(27.3%, 3/11)이 있었다. 증상 소실까지 기간의 중앙값은 5일이었다. 이들은 모두 합병증 없이 생존하여 퇴원하였다. A형 인플루엔자 바이러스 RT-PCR 양성군과 음성군 사이에 검체 채취시 재원기간, CRIB 점수, 기계환기 과거력, 덱사메타손 사용 과거력의 차이가 있었다. 결론: 신생아 특히 미숙아에서 A형 인플루엔자 바이러스 감염의 증상은 비특이적이므로 지역 내 인플루엔자 유행시기에는 NICU 입원 중인 신생아에서 감염질환의 원인 병원체로 인플루엔자 바이러스를 고려해야 한다.

• Journal of Neurogastroenterology and Motility
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• 제25권3호
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• pp.343-362
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• 2019

Background/Aims There has been major progress in our understanding of the irritable bowel syndrome (IBS), and novel treatment classes have emerged. The Rome IV guidelines were published in 2016 and together with the growing body of Asian data on IBS, we felt it is timely to update the Asian IBS Consensus. Methods Key opinion leaders from Asian countries were organized into 4 teams to review 4 themes: symptoms and epidemiology, pathophysiology, diagnosis and investigations, and lifestyle modifications and treatments. The consensus development process was carried out by using a modified Delphi method. Results Thirty-seven statements were developed. Asian data substantiate the current global viewpoint that IBS is a disorder of gut-brain interaction. Socio-cultural and environmental factors in Asia appear to influence the greater overlap between IBS and upper gastrointestinal symptoms. New classes of treatments comprising low fermentable oligo-, di-, monosacharides, and polyols diet, probiotics, non-absorbable antibiotics, and secretagogues have good evidence base for their efficacy. Conclusions Our consensus is that all patients with functional gastrointestinal disorders should be evaluated comprehensively with a view to holistic management. Physicians should be encouraged to take a positive attitude to the treatment outcomes for IBS patients.