• Title/Summary/Keyword: Upper gastrointestinal symptoms

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Psychometric Analysis of a Persian Version of the European Organization for Research and Treatment of Cancer OG25 Quality of Life Questionnaire in Oesophagogastric Cancer Patients

  • Hesari, Ali Esmaeili;Lari, Mohsen Asadi;Shandiz, Fatemeh Homai
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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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.

A Study on the Diverticulum of Esophagus and Duodenum (식도(食道) 및 십이지장(十二指腸)의 게실(憩室)에 관(關)한 연구(硏究))

  • Moon, Soo-Hyung;Im, Nam-Sung;Lee, Jai-Hoang;Kim, Kang-Sueck
    • The Journal of the Korean life insurance medical association
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    • v.4 no.1
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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.

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A Case of Gastric Volvulus in a 3-year-old Female (3세 소아에서 발생한 Gastric Volvulus 1례)

  • Lee, Jin-Tae;Kim, Hwa-Jung;Kim, Hee-Sup;Tchah, Hann;Park, Ho-Jin;Kim, Han-Sun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.3 no.1
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    • pp.89-92
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    • 2000
  • Acute gastric volvulus is uncommon but surgically emergent. Normally, the stomach is held in position by four ligaments: gastrophrenic, gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus and esophagus provides further anchorage. A normal diaphragm also helps to prevent abnormal displacement of abdominal viscera and development of gastric volvulus. Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial volvulus is the rotation of the stomach around an axis extending from the hiatus of the diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around an axis transecting the lesser and greater curvatures of the stomach. The symptoms of gastric volvulus depend on its type, the extent and degree of rotation and obstruction, and associated defects. Classic clinical features of acute gastric volvulus, as by Borchardt in 1904, include unproductive retching, acute, localized epigastric distention, and the inability to pass a NG tube. The presence and severity of these features depend on the degree of gastric obstruction of both the gastroesophageal junction and pyloric outlet. It may be suspected on plain abdominal radiographs and usually confirmed by upper gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to avoid recurrence, and correction of any underlying anatomic abnormality. Any associate defect should be repaired and the stomach must be fixed. The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric volvulus.

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Clinical Study of Congenital Duodenal Obstruction (선천성 십이지장 폐쇄증의 임상적 연구)

  • Huh, Young-Soo;Lim, Myeung-Kook;Park, Sung-Kyu
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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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.

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Effect of Yijin-tang on Gastric Motility in STZ-Induced Diabetic Rats (이진탕(二陳湯)이 STZ 유발(誘發) 당뇨병(糖尿病) 흰쥐의 위(胃) 운동성(運動性)에 미치는 영향(影響))

  • Hur, Won-Young;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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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.

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Clinical Manifestations of Eosinophilic Esophagitis in Children and Adolescents: A Single-Center, Matched Case-Control Study

  • Roh, Ji Hyeon;Ryoo, Eell;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.4
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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.

Clinical Evaluation of $Doxycycline(Vibramycin^{\circledR})$ in Respiratory Tract Infection ($Doxycycline(Vibramycin^{\circledR})$의 호흡기감염증(呼吸器感染症)에 대(對)한 임상적(臨床的) 효과(效果))

  • Lim, J.K.;Kim, M.S.;Shin, S.G.;Yoon, H.I.;Hong, S.A.
    • The Korean Journal of Pharmacology
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    • v.11 no.2
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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.

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Clinical Features of Eosinophilic Esophagitis: A Single Center Experience in Ecuador

  • Munoz, Fabian Vasconez;Almeida, Pamela Hernandez;Carrion-Jaramillo, Estefania;Montalvo, Andrea Vasconez
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.4
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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.

Effect of Four Main Gastrectomy Procedures for Proximal Gastric Cancer on Patient Quality of Life: A Nationwide Multi-Institutional Study

  • Koji Nakada;Akitoshi Kimura;Kazuhiro Yoshida;Nobue Futawatari;Kazunari Misawa;Kuniaki Aridome;Yoshiyuki Fujiwara;Kazuaki Tanabe;Hirofumi Kawakubo;Atsushi Oshio;Yasuhiro Kodera
    • Journal of Gastric Cancer
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    • v.23 no.2
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    • pp.275-288
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    • 2023
  • Purpose: This study aimed to examine the effects of 4 main types of gastrectomy for proximal gastric cancer on postoperative symptoms, living status, and quality of life (QOL) using the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45). Materials and Methods: We surveyed 1,685 patients with upper one-third gastric cancer who underwent total gastrectomy (TG; n=1,020), proximal gastrectomy (PG; n=518), TG with jejunal pouch reconstruction (TGJP; n=93), or small remnant distal gastrectomy (SRDG; n=54). The 19 main outcome measures (MOMs) of the PGSAS-45 were compared using the analysis of means (ANOM), and the general QOL score was calculated for each gastrectomy type. Results: Patients who underwent TG experienced the lowest postoperative QOL. ANOM showed that 10 MOMs were worse in patients with TG. Four MOMs improved in patients with PG, while 1 worsened. One MOM was improved in patients with TGJP versus 8 MOMs in patients with SRDG. The general QOL scores were as follows: SRDG (+39 points), TGJP (+6 points), PG (+3 points), and TG (-1 point). Conclusions: The TG group experienced the greatest decline in postoperative QOL. SRDG and PG, which preserve part of the stomach without compromising curability, and TGJP, which is used when TG is required, enhance the postoperative QOL of patients with proximal gastric cancer. When selecting the optimal gastrectomy method, it is essential to understand the characteristics of each and actively incorporate guidance to improve postoperative QOL.

Clinical Analysis on 106 cases of $Henoch-Sch{\ddot{o}}nlein$ Purpura (알레르기성 자반증 106례에 대한 임상적 고찰 : $Henoch-Sch{\ddot{o}}nlein$ 자반증을 중심으로)

  • Han, Dong-Ha
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.570-585
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    • 2007
  • A clinical study of 106 cases of $Henoch-Sch{\ddot{o}}nlein$ purpura was made. The author analyzed the result of Korean traditional medical therapy. It was observed more frequently in female at the sex ratio of 1:1.3. The most prevalent age group was $4{\sim}9$ years(56.6%). In seasonal incidence, the cases were frequent during spring(50%), and the main specific history was upper respiratory tract infection(48.1%). The duration of contraction was $420.9{\pm}1079.3$ days. The adults were more chronic than children (p<0.05), The clinical manifestation showed in the skin (100%), the gastrointestinal tract(62.3%), the joints(64.2%), the kidney(25.3%), genitourinary system(11.3%), headache(6.6%), and scalp edema(4.7%) respectively. The first outbreak of symptoms was showing of skin purpura in 77 cases(72.6%) the highest frequency. and the gastrointestinal tract and joints were 16(15.1%) and 12 cases(11.3%) respectively. Of all patients, 22 cases(20.8%) experienced recurrences and 47 patients(44.3%) experienced hospitalization treatment. In the patients group which were recurrence experiences, the recurrence rate was high with patients(63.2%) who usually enjoyed meats and convenience foods and in patients(84%) who treated URI with chemical drugs(p<0.05). The patients group(68.9%) that took steroids also experienced a relatively high recurrence rate. Out of the patients(68.9%) who took treatment with steroids, 46.6% experienced side effects, in orders moon face(100%), weight gain(47.1%), appetite increase(52.9%), and acne. alopecia(11.8%), etc. There was a statistically significant relationship between the period of taking the steroid and the side effects(p<0.05), As the result of the herbal medicine treatment(treatment period: $6.7{\pm}6.2$ weeks, a follow-up survey during $15{\sim}24$ months), 67 patients(91.8%) among the 73 patients(68.9%) under 18 years old recovered completely but 3 cases(4.5%) recurred. 23 patients(69.7%) among the 33 patients(31.3%) above 19 years recovered completely but 5 cases(21.7%) recurred.

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