• Herbal Formula Science
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• v.23 no.1
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• pp.161-169
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• 2015

Objectives : This study is aimed to report the outcomes of the treatment of a patient with chronic anal fissure during a 8-year period. Methods : Basic patient’s data was analyzed as a CARE guideline. And related psychological state was measured with BAI, STAI-X-II test. Results : The treatment is based on Shanghanlun and the patient reported better outcomes. The main symptoms of the patient were chronic constipation, blood in the stool. The main clinical findings were that the patient’s symptoms got worse during the examination period because of the anxiety of the exam. And loss of appetite and digestive disorders are due to Jue-Yin-Bing(厥陰病) and the clue of bleeding can be found in article 375 in Shanghanlun. The main diagnoses was chronic anal fissure and main interventions were Chijasi-tang according to article 375 in Shanghanlun and counseling on anxiety. As a results bleeding has stopped after taking herbal medicine and constipation has been treated at the same time. After 6 months, the patient performed BAI, STAI-X-II test and scores got lowered indicating decreasing anxiety level. Conclusion : Chijasi-tang with counseling achieved valid positive results to the patient with chronic anal fissure.

• Journal of Pharmaceutical Investigation
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• v.37 no.2
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• pp.95-99
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• 2007

To develop topical nitroglycerin (NTG) preparation far chronic anal fissure treatment, the release rate of NTG should be controlled carefully. For this, microemulsion was prepared from the phase diagram construction with Cremophor ELP, ethanol and Labrafil $M1944CS^{(R)}$ and the topical gel was prepared by dispersing NTG containing microemulsion into hydrophilic polymers. in viかo release characteristics were evaluated with Franz diffusion cell using cellulose membrane and compared with control hydrogels. The release rate of NTG was followed $1^{st}$ order kinetics and, when comparing the NTG release from control hydrogel with that from the microemulsion-based hydrogel, the NTG release rate was controlled by the content of polymers within continuous phase and the concentration of dispersed phase.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.32 no.1
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• pp.1-15
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• 2019

Objectives : The purpose of this study is to analyze the trend of Korean medical treatments on Anal diseases and skin disorder around anal. Methods : Based on KCI, OASIS, NDSL, KISS with the keyword 'Anal', 'Hemorrhoid', 'Ani', 'Anal fistula', 'incontinence', 'anal prolapse', 'anal fissure'. published in 2000-2018.11.10., total 9 studies have been found and analyzed. Results : Among 9 studies, 15 cases were selected. Acupuncture, herb medicine, phamacopuncture, moxibustion, fumigation therapy and habit correction were used as treatment for Anal disease. All of research which selected have reported that the Korean medical treatment was effective. Conclusions : According to the results, Korean medical treatments can be effective treatment for anal diseases. Based of this result, studies which is multifocal will be needed steadily.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.8 no.1
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• pp.70-75
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• 2005

Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.

• Journal of Society of Preventive Korean Medicine
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• v.20 no.3
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• pp.83-91
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• 2016

Objectives : The Levator Ani Muscles Training(LAMT) is one of the well known very effective prevention and treatment method of some specific diseases in the anal organs, digestion system, urinary organs and genital organs, which means LAMT could be considered as an independent exercise. Methods : Chinese databases were searched and found one good source named CNKI(China National Knowledge Infrastructure) where there were downloaded 154 articles, out of which were finally selected 82 used for the introduction of the historical background, health-effectiveness, working mechanism, training methods, etc. Results : LAMT as an independent exercise, is considered very effective for the prevention of diseases in the anal organs, e.g. hemorrhoids, anal fissure, rectal prolapse; urinary organs, e.g. urinary incontinence, frequent micturition; digestion system, e.g. visceroptosis, diarrhea, chronic enteritis; genital organs, e.g. prostatitis, impotence, premature ejaculation, feminine vaginal relaxation, sexual indifference, etc. It is also told LAMT is effective for coronary heart disease, hyperyension and varicose veins of lower extremity to a certain degree. LAMT is also very similar to the Kegel exercise in couple of aspects. They are equally effective for the urinary incontinence and impotence. Conclusions : LAMT as an independent exercise has developed and become more and more health-effective, especially through the combination with the Qigong exercise, and thus many training methods have been introduced. There are not many scientific research and development with very limited accomplishments even in China. It is strongly required to strengthen the research and development activities so that LAMT will become one of the very effective natural healing soonest possible.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.1
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• pp.31-38
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• 2006

Purpose: Infantile constipation is one of the most common problems in pediatric gastrointestinal outpatient clinic. We planed to show the clinical feature of infantile constipation and explore the possible relationship between diets and symptoms of constipation. Methods: We analyzed the medical records and telephone questionnaire about infants under 2 years of age with constipation, who visited outpatient clinic of Department of Pediatrics, Ilsan Paik Hospital during the time from March 2002 to February 2005. Data including the symptoms and signs of constipation, diet history, and past-medical history were analyzed. Results: Total 96 infants, 40 male and 56 female, were enrolled in this study. The mean age was 9 months. Twenty-three infants were exclusively breast milk fed (BMF), 20 infants were cow's milk fed (CMF) and 53 infants had a history of mixed feeding with cow's milk and breast milk (MMF). Patients showed painful defecation (95.8%), abdominal distension (53.1%), palpable rectal stool (35.1%), hard stool (30.2%), blood-tinged stool (29.2%) and anal fissure (16.7%). Patients with exclusive cow milk feeding had prominent clinical features, such as anal fissure (p=0.03), hematochezia (p=0.04) and palpable rectal stool (p=0.025). Patients who had a history of larger intake of liquid food had a tendency to get anal skin tag (p<0.05). Conclusion: Exclusive breast milk feeding seemed important to avoid constipation with clinical significance. To educate caregivers in appropriate way of the weaning food may help the infants with constipation.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.92-96
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• 2014

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

• Clinical and Experimental Pediatrics
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• v.46 no.3
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• pp.236-241
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• 2003

Purpose : This study was performed to know the clinical profile and effectiveness of colonoscopic polypectomy in patients with solitary juvenile polyp. Methods : This study included 19 children, aged 1.8 to 11.4 years, who underwent colonoscopic polypectomy and histologically proven solitary juvenile polyps between March 1998 and August 2002. We analyzed their detailed history, clinical manifestations, colonoscopic examination, method of anesthesia and results of colonoscopic polypectomy. Results : The mean age of the 19 cases was $4.7{\pm}2.8year$. The male to female ratio was 1 : 1.1. Hematochezia, the main indication of colonoscopy, was present in all cases. Combined symptoms were mucoid stool or diarrhea(42%), abdominal pain(26%), constipation(11%) and anal fissure(11%). Anemia(Hb <10 g/dL) in four cases recovered spontaneously after polypectomy. Complications associated with premedication, sedation and colonoscopy itself did not occur. Bleeding developed in two cases(11%) after polypectomy. One of them was controlled with hemoclipping. The main site of polyps was the rectosigmoid colon in 15 cases(79%). The size of the polyps ranged from 0.5 to 3.5 cm. The interval between the onset of symptoms and polypectomy was from 0.1 to 42 months. Conclusion : Juvenile polyps are a common cause of benign, chronic and recurrent rectal bleeding. Colonoscopic polypectomy is a simple, safe and effective therapeutic method. So earlier colonoscopy might avoid uneffective treatment and prevent untoward problems such as fear of parents and anemia.

• Journal of Preventive Medicine and Public Health
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• v.25 no.1 s.37
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• pp.88-100
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• 1992

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.