• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권2호
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• pp.103-109
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• 2008

목 적: 소아에서 식도염은 성인과 달리 나이별로 다양하고, 비특이적인 증상이나 징후를 보인다. 또한 식도염을 진단하기 위한 상부 위장관 내시경과 조직 생검을 시행하는 것도 쉽지 않다. 이에 본 연구에서는 소아에서 식도염의 유병률과 조직 검사의 필요성 및 위험 인자에 대해 알아보고자 하였다. 방 법: 2006년 1월부터 2007년 12월까지 가천의대 길병원 소아과에 내원하여 급만성 상복부 복통을 보인 환자들 266명을 대상으로 문진 및 신체 검사, 상부 위장관 내시경과 함께 식도 및 위 조직 생검을 시행하였다. 식도염의 진단은 조직 검사로 확진 하였으며, H. pylori 감염 여부는 CLO 검사, H&E 염색과 Giemsa 염색 혹은 요소호기검사로 확인하였다. 식도염과 관련된 위험인자 및 내시경 소견과 조직학적 소견의 관련성을 비교분석하였다. 결 과: 상부 내시경과 조직 생검을 시행 환자 266명 중 조직학적 식도염 환자는 전체 266명 중 53명(19.9%)이었으며, 남자 18명(34.0%), 여자 35명(66.0%)으로 평균 나이는 11.6${\pm}$0.87세였다. 내시경 소견의 민감도는 41.5%, 특이도는 77.0%, 양성 예측도 31.0%였다. 조직학적 식도염 환자 중 역류성 식도염은 50명, 호산구성 식도염은 2명, 캔디다 감염증에 의한 식도염은 1명이었다. 모든 연령에서 복통이 가장 흔한 증상으로 나타났으며, 8세 이하 환아들에서 구토가 의미 있게 많았다(p<0.05). 봄에 좀더 많이 내원하는 것으로 나타났으며(OR 2.5, 95% CI 1.2544 to 4.8286), H. pylori 감염군에서 식도염의 가능성이 의미 있게 높게 나타났다(OR 2.5, 95% CI 1.1598 to 4.2798). 결 론: 상부 위장관 증상이 있는 환자에서 상부 위장관 내시경 검사를 시행할 때, 특히 학령 전기 환자에서 구토를 동반한 위장관 증상이 있거나, 봄에 내원시, H. pylori 감염이 있을 경우 식도염의 가능성이 더욱 높으므로 식도 조직 생검을 고려해야 할 것으로 생각된다.

• Journal of Yeungnam Medical Science
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• 제18권1호
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• pp.75-84
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• 2001

1997년 1월부터 2001년 4월까지 영남대학교 의과대학 부속병원 소아과에 이물질을 삼켜 내원한 15세 이하의 환아를 대상으로 성별 및 연령에 따른 발생빈도, 발생시간, 이물질의 크기와 종류 및 위장관내의 위치, 임상증상, 이물질에 의한 위내시경 소견, 이물질의 제거 혹은 자연 배출되기까지의 기간, 치료 방법 등을 조사 분석하였다. 성별 분포는 총 37례 중 남아가 25예(67.5%) 여아가 12예(32.5%)였으며, 남녀비는 2.1:1이였다. 연령별 분포는 1세 이상 2세 미만이 7예(19%)로 가장 많았다. 이물질을 삼킨 시간별 분포는 오후 3시와 4시경이 11예로 가장 많았으며 대부분이 오후에 발생하였다. 이물질의 종류로는 동전이 20예(54%), 손목에 끼는 팔찌자석, 바둑알, 탄력붕대를 고정하는 클립, 열쇠고리, 빨래집게에 부착된 C형의 클립이 각각 1예였다. 위장관내 이물질의 위치는 위장이 16예(43.2%)로 가장 많았으며 상부식도가 12예(32.5%), 소장이 5예(13.5%), 하부식도가 4예(10.8%)였다. 병원에 도착 당시의 임상증상은 무증상이 22예(59.4%)로 가장 많았으며, 구토가 7예(19.0%), 상복부 통증이 3예(8.1%), 오심과 연하곤란이 각각 2예(5.4%), 복통이 1예(2.7%)였다. 치료방법으로 이물질을 삼킨 총 37예 중 20예(54.0%)에서 내시경으로 이물질이 제거되었으며, 3예(8.1%)에서는 이물질의 자연 배출이 확인되었고, 수술적 제거를 시행한 경우는 없었다. 이물질을 삼킨 후 제거될 때까지의 시간은 12예(52.2%)가 12시간 이내에 제거되었으며, 4예(17.4%)가 24시간 이내에 제거되었고, 가장 긴 기간은 7일이었다. 내시경으로 이물질이 제거된 환아에서의 내시경 소견은 15예에서는 정상 소견이었으며, 5예에서 이물질에 의한 이상소견이 있었다. 상부 위장관 이물질을 제거하기 위해 내시경을 시행한 경우 안전하게 이물질을 제거할 수 있었으며 내시경을 시행함에 따른 부작용이나 합병증은 없었다. 따라서 소아에서 상부위장관 이물질의 제거에는 위내시경이 안전한 방법으로 생각되어진다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권6호
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• pp.2739-2745
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• 2014

Background: Health-related quality of life (HRQL) is a fundamental outcome in oncology patients and quality of life (QOL) assessment requires clinically relevant questionnaires. The purpose of this study was translation and definition of measurement properties and the clinical validity of Quality of Life Questionnaire (QLQ)-OG25 module in Persian patients with oesophagus, oesophagogastric junction (OGJ) or gastric cancers. Materials and Methods: The translation procedure followed European Organization for Research and Treatment of Cancer (EORTC) guidelines. Both EORTC QLQ-OG25 and a core questionnaire (EORTC QLQ-C30) were administered to patients with oesophagus (150), OG junction (93) and gastric (32) cancer undergoing multi-modal treatments. Convergent and discriminant validity, Cronbach's alpha coefficient and known-groups comparisons were used to examine reliability and validity. Results: In all, 275 patients (mean age 62 years) completed both questionnaires. Compliance rate was high and the questionnaire module was well accepted. We found good reliability for multi-item subscales of QLQ-OG25 (Cronbach's alpha coefficients 0.76-0.89). About 73% had TNM staging and scales distinguished between clinically distinct groups of patients. However, patients in palliative group experienced compromised functional status and worse treatment-associated symptoms than those in the potentially curative group. Test-retest scores were consistent. Multi-trait scaling analysis demonstrated good convergent and discriminant validity. Conclusions: Overall, the Persian version of QLQ-OG25 demonstrated psychometric and clinical validity that supports its application as a supplement to the original tool (EORTC QLQ-C30) when assessing HRQL in patients with upper-gastrointestinal (GI) cancer both in curative and palliative phases.

• 보험의학회지
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• 제4권1호
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• pp.77-85
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• 1987

We'd performed the upper gastrointestinal study for a total of 1,033 insureds-male 630, female 403 persons-who were examined at medical dept. of Dae Han Kyoyuk Insurance Co., Ltd., from August, 1986 to January, 1987. The results on diverticulum were as follows; 1. The incidence rate of duodenal diverticulum is exceptionally higher than esophageal diverticulum. 2. In all of 53 insured who have duodenal diverticulum and esophageal diverticulum, there was little difference between male and female in the incidence rate of diverticulum; 5.08% in male, 5.21% in female. 3. The possessing rate of both diverticulums increased by age regardless of sex. ; 0.71% in 20yrs, 2.12% in 30yrs, 11.11% in 40yrs, 12.75% in 50yrs, 30.43% in 60yrs more. 4. The possessing rate of both diverticulums in male is 0% in 20yrs, 1.97% in 30yrs, 7.21% in 40yrs, 15.09% in 50yrs, 27.27% in 60yrs more and in female, 1.16% in 20yrs, 2.40% in 30yrs, 7.87% in 40yrs, 10.20% in 50yrs, 33.33% in 60yrs more. 5. Those who have duodenal diverticulum 47 insureds felt the following subjective symptoms; uncomfortable 8.51%, heartburn and tingling each 4.26%, sore throat 2.13%and esophageal diverticulum's heartburn 16.67%. 6. There occurred the following complications in 47 insureds with duodenal diverticulum-gastric polyp, erosive gastritis, antral gastritis, cascade stomach, fatty liver, polyp in GB and choledocholithiasis; each 2.13% and cholelithiasis 6.38% and cascade stomach. 7. All duodenal diverticulum occurred in duodenal inlet. 8. The number of lesion was single in all esophageal diverticulum, but there was each one case with 2 lesions and 3 lesions in duodenal diverticulum.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제3권1호
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• pp.89-92
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• 2000

위 염전증은 소아에서 드믈지만 응급을 요하는 질환으로 최근 비사출성, 비담즙성 구토를 주소로 내원한 3세 환아에서 치험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 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.

• 대한한방내과학회지
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• 제29권1호
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• pp.67-79
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• 2008

Backgrounds & Objectives : The aims of this study were to observe how morphology was changed and whether gastric motility was impaired in streptozotocin(STZ)-induced diabetic rats(DR), and whether Yijin-tang(YJT) was able to restore their impaired gastric motility. Methods : We investigated the change of body weight, feed intake and blood glucose between normal rats (NR) and DR for 12 weeks after induction of diabetes. At the time of 12 weeks after induction of diabetes, gastric surface area, gastric slow wave and gastric emptying rate were measured. Results : Decreased body weight, increased feed intake and increased gastric surface area were observed in DR, compared with NR. The percentage of normogastria decreased but that of bradygastria increased in DR, compared with NR. YJT 90mg/kg had no effect on the correction of gastric slow wave. YJT 90mg/kg and 270mg/kg had a significant effect on improvement of gastric emptying, more than normal saline (NS) in both NR and DR but the gastric emptying rate of DR was significantly lower than that of NR when YJT 90mg/kg and YJT 270mg/kg were administered. Conclusions : We can expect that administration of YJT would be effective on the improvement of gastric emptying and upper gastrointestinal symptoms as a juvantia.

• 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.

• 대한약리학회지
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• 제11권2호
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• pp.47-53
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• 1975

Pan-Korean multi-center trial of doxycycline in the treatment of upper and lower respiratory infection was carried out in the summer(from May to October) of 1975. A total of 204 patients between the ages of 3 and 75 was treated by 37 physicians including the internal medicine, pediatrics and ENT specialist in 17 general hospitals and 2 private clinics all-over the country. The dosage recommended was 200 mg on the first day of therapy followed by 100 mg daily thereafter. The pediatric dosage was 4 mg/kg on the first day and then 2mg/kg on each successive day. The subjective and objective signs of respiratory infection such as temperature, cough, sputum, pain and associated inflammatory symptoms were assessed using the carefully designed protocols and it showed rapid improvement by the fifth day (80%) of therapy. Only minor side-effects were reported and these were mild and mainly limited to gastrointestinal tract. The overall evaluation of the trial showed that 170 patients(83.3%) had a very good or good result, 13 patients (6.4%) a moderate and another 13 patients (6.4%) a negative result.

• 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.