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The Relation of HRV, PSQI and IQ with Symptoms of Insomnia Patients (수면장애와 동반된 임상증상에 따른 심박변이도와 수면 관련 설문간의 상관성 연구)

  • Yang, Dong-Ho;Oh, Kyong-Min;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.143-169
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    • 2008
  • Objective: This study was to investigate the relation of what insomnia patients' symptoms with Heart Rate Variability(HRV), Pittsburgh Sleep Quality Index (PSQI) and Insomnia Questionaire(IQ). Methods: For this study, we carried out HRV, PSQI and IQ of 43 patients with insomnia who have come to Donguei oriental hospital of Donguei university from September 2007 to May 2008. We studied the relationship HRV with PSQI and IQ. For every symptom, this study classified the patients as none-symptom, symptom groups and analyzed each group's HRV, PSQI and IQ. Result : 1. The rate of xerostomia in female group is significantly higher than male group. 2. P1 (hypnagogic time), P3(awakening time), LF has negative correlation with age. The score of PI (hypnagogic time), P3(awakening time), P4(time of recoverable sleep) in the group whose age is more than 50 are higher than the group whose age is lesser than 50. 3. The frequency of using hypnotics(P6) in the group whose duration of onset are over 1 year was significantly higher than the score in the group whose duration of onset were below 1 year. 4. The accompanied symptoms in the group who started sleep disorder after stressor are higher than the number in the group whose duration of onset were poor-defined. 5. The drinking group have lower rate of anorexia, higher score of P1 (hypnagogic time) and TP than non-drinking group. 6. The score of P-total(general quality of sleep) have negative correlation with NNSO, HF, TP and positive correlation with LF/HF. 7. The score of P1(hypnagogic time) have negative correlation with LF. 8. The score of P5a(frequency of delayed hypnagogue) have positive correlation with LF/HF. 9. The score of P5e(frequency of cough or snoring) have negative correlation with RMSSD. 10. The score of I1a(degree of onset insomnia), I1b(degree of maintenance insomnia) have negative correlation with NN50, pNN50, HF. 11. The score of I1c(degree of termination insomnia) have negative correlation with RMSSD, NN50, pNN50, HF, TP and positive correlation with MHR, LF/HF. 12.. The score of P5i(frequency of night pain), LF/HF in the group with headache are higher than the group without headache. 13. The score of P5a(frequency of delayed hypnagogue), P5c(frequency of awakening for urine of stool) in the group with xerostomia are higher than the group without xerostomia. 14. The score of P9(degree of unrecoverable sleep) and I5a(degree of onset insomnia) in the group with chest discomfort are lower than the group without chest discomfort. 15. The score of P7(frequency of drowsiness for daytime) in the group with palpitation are lower than the group without palpitation. 16. The score of P5c(frequency of awakening for urine of stool), P5f(frequency of burning sensation), P5h(frequency of nightmare), I1c(degree of termination insomnia) in the group with burning sensation of upper trunk are higher than the group without burning sensation. 17. The score of NN50, pNN50, LF, TP in the group with anorexia are lower than the group without anorexia. 18. The score of P-total(general quality of sleep), P2(duration for sleep start) in the group with constipation are higher than the group without constipation. 19. The score of P4(recoverable sleep time) in the group with depression are higher than the group without depression. 20. In the group with anxiety, the score of P1(time of hypnagogue), P5a(frequency of onset insomnia) are lower and the score of I1b(degree of maintenance insomnia), I4(objective degree of impairment by insomnia) are higher than the group without anxiety. 21. The score of NN50, pNN50, HF, TP in the group with inertia are lower than the group without inertia. 22. The accompanied symptoms haver posirive correlation with P5f(frequency of burning sensation), P5h(frequency of nightmare), P5i(frequency of night pain) and LF/HF. Conclusion: This study provides insights into the complicated relations of the pattern of sleep disorder with many symptoms such as headache, chest discomfort, depression and any others. And this study showed that autonomic nervous system have important function in the regulation of sleep.

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Management of Non-pain Symptoms in Terminally Ill Cancer Patients: Based on National Comprehensive Cancer Network Guidelines (말기암환자에서 통증 외 증상의 관리: 최신 NCCN(National Comprehensive Cancer Netweork) 권고안을 중심으로)

  • Lee, Hye Ran
    • Journal of Hospice and Palliative Care
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    • v.16 no.4
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    • pp.205-215
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    • 2013
  • Most terminally ill cancer patients experience various physical and psychological symptoms during their illness. In addition to pain, they commonly suffer from fatigue, anorexia-cachexia syndrome, nausea, vomiting and dyspnea. In this paper, I reviewed some of the common non-pain symptoms in terminally ill cancer patients, based on the National Comprehensive Cancer Network (NCCN) guidelines to better understand and treat cancer patients. Cancer-related fatigue (CRF) is a common symptom in terminally ill cancer patients. There are reversible causes of fatigue, which include anemia, sleep disturbance, malnutrition, pain, depression and anxiety, medical comorbidities, hyperthyroidism and hypogonadism. Energy conservation and education are recommended as central management for CRF. Corticosteroid and psychostimulants can be used as well. The anorexia and cachexia syndrome has reversible causes and should be managed. It includes stomatitis, constipation and uncontrolled severe symptoms such as pain or dyspnea, delirium, nausea/vomiting, depression and gastroparesis. To manage the syndrome, it is important to provide emotional support and inform the patient and family of the natural history of the disease. Megesteol acetate, dronabinol and corticosteroid can be helpful. Nausea and vomiting will occur by potentially reversible causes including drug consumption, uremia, infection, anxiety, constipation, gastric irritation and proximal gastrointestinal obstruction. Metoclopramide, haloperidol, olanzapine and ondansetron can be used to manage nausea and vomiting. Dyspnea is common even in terminally ill cancer patients without lung disease. Opioids are effective for symptomatic management of dyspnea. To improve the quality of life for terminally ill cancer patients, we should try to ameliorate these symptoms by paying more attention to patients and understanding of management principles.

Dietary behavior types and clinical symptomology of elementary school students in Ulsan Metropolitan City (울산지역 일부 초등학생의 식행동 유형과 임상증상 유형)

  • Hong, Soon Myung;Seo, Jeong Hee;Bok, Mi Jung
    • Korean Journal of Human Ecology
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    • v.21 no.5
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    • pp.947-956
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    • 2012
  • This study aims to investigate both general dietary behaviors and clinical symptoms of diet related effects among fifth grade students at an elementary school in Ulsan Metropolitan City, and to categorize those relationships in terms of their comparative differences. The findings of this study are as follows. 1. Out of 694 students polled, 53.7% were of boys and 46.2% were girls with average age of $11.9{\pm}0.3$, average height of $145.1{\pm}6.8cm$, and average weight of $39.7{\pm}9.7kg$. Obesity in boys (5.5%) exceeded girls (3.9%) whereas children categorized as underweight showed girls (14.6%) slightly exceeded boys (10.4%). 2. Dietary behaviors were largely the result of four factors - unbalanced diet, balanced diet, protein and fruits and healthy dietary habits. Of these factors, protein and fruits ($4.04{\pm}1.03$) ranked first, balanced diet ($3.38{\pm}1.04$) second, healthy dietary habits ($3.04{\pm}1.01$) third and unbalanced diet ($2.23{\pm}0.6$) ranked last. 3. When Dietary behaviors were classified with four low ranking factors, they were divided into four types such as convenience (22.4%), good diet (24.7%), busy contemporary modern man (24.3%) and healthy dietary habits (26%). 4. Clinical symptoms include colds ($2.27{\pm}1.15$) followed by headaches ($2.17{\pm}1.19$), stomachaches ($2.16{\pm}1.15$), dizziness ($2.02{\pm}1.15$), atopic allergy ($1.95{\pm}1.30$), prevalence for cold sores ($1.86{\pm}1.07$), allergy ($1.65{\pm}1.05$), and constipation ($1.54{\pm}0.87$). 5. According to the results, clinical symptoms were divided into two groups - unhealthy (40.1%) and healthy (59.9%). 6. By analyzing the relationship between dietary behavior types and clinical symptom types, the convenience factor included slightly more of the unhealthy group (56.3%), whereas the good diet (71.1%), busy contemporary modern person (55.8%) and healthy dietary habits (69.7%) included more of healthy group (p<.001). Since the majority of students belonging to the unhealthy group had convenience dietary behavior, education about desirable dietary activities is needed for these students. In addition, nutrition information and information on possible clinical symptoms caused by nutritional imbalance should be provided for students and their households.

Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形) (藏府와 身形의 病機 및 病症에 대한 比較考察)

  • Baek, Sang-Ryong
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.21-21
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exegenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usuable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki)穀氣) 내 that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Maridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily froms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and connot fulfil their own functions. Because the meridian symtem unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.

Comparative study on patterns and symptoms of disharmony(病機病症) between the internal organs(藏府) and external bodily form(身形) (장부(藏府)와 신형(身形)의 병기(病機) 및 병증(病症)에 대한 비교고찰(比較考察))

  • Baek, Sang-Ryong
    • Journal of Korean Medical classics
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    • v.13 no.2 s.17
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    • pp.22-42
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    • 2000
  • All living things including human being consist of soul(spirit) and body. Soul is the root of a life and body frames it. I wrote this paper to tell how internal injury due to endogenous etiological factors and affection due to exogenous pathogenic factors, affect the internal organs and the external bodily from. This paper begins with description of the patterns of disharmony of the internal organs. General disorders of each Five-Jang(五藏) an be classified into two types of soul and body. The Liver and the Heart which lead changing to Yang(陽) of vital energy, have close relationship with spiritual symptoms because spirit is related to Yang. The Lung, Kidneys, the Spleen which lead changing to m(陰) of vital energy, mainly connected with physical disorders because body is relatively close to m. The Five-Jang are ruled by the Five-Phases(五行) system and cause troubles with Oche(五體) and the nine body orifice. Otherwise the main function of the Six-Bu(六府) is to receive food, absorb the usable portions, and transmit and excrete waste. Therefore they can cause such problems as abdominal pain, distention, difficulty in urination, and constipation. The spleen is responsible for sending Grain-Ki(穀氣) so that is closely connected with the six-Bu. The Gall bladder takes care of control of giving out spirit. That's why it presents many symptoms related to the spirit that is ruled by the Five-Jang. Patterns of disharmony of external bodily form is influenced by the state of Meridians. Bodily forms get divided into many parts by the function of six-meridians(六經) to which they belong. Six-meridians have their own function related to excretion, related to excretion, retention, and balance(開闔樞). If local bodily forms get affected by pernicious influences, the Meridians to which they are attached will lose harmony and cannot fulfil their own functions. Because the meridian system unifies all parts of the body, the whole body will be under the influence of the affection although local parts of the bodily forms get affected. Therefore the symptoms of disharmony should be considered in a synthetic view. There are however, also cases which should be focused on the very meridian channels affected. Disorder within a Meridian generates derangement in the pathway make it not to benefit the muscles and skin belong to it. Because the meridians connect the interior organs with the exterior bodily form, they are influenced by each other.

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The Study on The ischemic heart disease Explained In Nei-jing(內經) (내경(${\ll}$內經(${\gg}$)에 나타난 허혈성 심질환에 대한 연구)

  • Hong, Tian-Biao;Lee, Won-Chul
    • The Journal of Internal Korean Medicine
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    • v.19 no.1
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    • pp.144-156
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    • 1998
  • This study has been carried out to investigate the cause, pathological mechanism and treatment of symptoms regarded as the ischemic heart disease in Nei-jing(內經). I've got the following conclusions. 1. From the side of xing-bi(胸痺), the ischemic heart disease(IHD) was caused by that the energy in one's heart wasn't extended in the way of Yin-xie(飮邪), namely waste matter of human body and symptoms and treatment wern't written. 2. From the side of xin-bi (心痺), HID was catched by the mechanisms that the blood vessel is blocked. or the heart's blood was deficient owing to the mutation of mo-bi(脈痺), the lack of yang-ming(陽明) and excessive thoughts and worry and others. The symptoms were feeling oppressed in one's brest, palpitating, sudden dyspnea, the dryness of thorat, frequent belching and the fear by the inverse flow of the energy(氣). The treatment was that the yin(陰) was cured immediately, but the yang(陽) mustn't be attacked. 3. From the side of xing-tong(心痛), IHD was suffered from by mechanisms that following the han-sa(寒邪), namely the cold makes a invasion on humanbody, the vessel was blocked, spasm, filled and the amount of blood flow was poor, or caused by injury of vessel, the inverse flow and the disease of shi-dong(是動病) of shou-shao-xin-jing(手少陰心經) and so on. The pain was cramped into the upper and lower back or lower abdomen or throat and accompanied with nausea, abdominal dropsy, constipation, the impending of breathing and so on. The cure was mainly that acupuncture was applied at the jin-su(筋縮) region or meridian in relation to symptoms, but if the pain were severe, acupuncture mustn't be applied. The prog nosis was worse. 4. From the side of xing-tonge(心痛), IHD was divided into zhen-xing-tong(眞心痛) and jue-xing-tong(厥心痛), but pi-xiog-tong(脾心痛) and wei-xing-tong(胃心痛) out of jue-xing-tong(厥心痛) also included the symptoms of the digestive disease.

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The Frequency and Distress Score of Symptom of Cancer Patients - for the development of Korean Cancer Pain Assessment Tool (K-CPAT) (암 환자의 통증 외 증상의 빈도 및 고통 지수 조사 - "표준형 성인 암성 통증평가 도구"개발을 위해 -)

  • Lee, Myung-Ah;Choi, Youn-Seon;Jang, Se-Kwon;Park, Jean-No;Song, Chan-Hee;Yoon, So-Young;Lee, Ji-Won;Yeom, Chang-Hwan
    • Journal of Hospice and Palliative Care
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    • v.6 no.1
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    • pp.45-50
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    • 2003
  • Purpose : This study was conducted to develop primary assessment tools to evaluate the relationship between symptom prevalence and symptom distress in cancer patients of Korea. Methods : A total of 196 patients diagnosed with cancer admitted in 5 general hospitals from January, 6 to January, 20 in 2003, were entered into the study. These patients were asked to complete the MSAS (Memorial symptom assessment scale). We classified these answers into prevalence and distress and then scored them according to grade and frequency. Results : The five most prevalent symptoms were lack of energy (82.1%), dry mouth (73.5%), pain (73.5%), itching (72.4%), and feeling drowsy (68.9%). Among 24 common prevalent symptoms, the ten most distress the symptoms were dry mouth (2.11), itching (2.07), pain (2.03), lack of energy (1.98), difficulty sleeping (1.96), worrying (1.94), "I don't look like myself" (1.91), constipation (1.88), and difficulty concentration (1.76). Conclusion : These 10 symptoms had high prevalence and distress in cancer patients of Korea. We suggest these symptoms to be applied in developing the primary assessment tool in cancer patients.

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Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine : Lesser Yin Symptomatology (소음인체질병증 임상진료지침: 소음병)

  • Yu, Jun-Sang;Jeon, Soo-Hyung;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.55-63
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    • 2014
  • Objectives This research was performed to establish the clinical practice guideline(CPG) for Lesser Yin Symptomatology of Soeumin disease. Methods Dongeui suse bowon(sinchuk edition), textbook for Sasang constitutional medicine, Clinical guidebook for Sasang constitutional medicine, and standardization reports on Sasang constitutional medicine and papers concerning symptomatology of Soeumin Disease, especially Lesser Yin Symptomatology was collected and classified. Additionally experts' conference was held to make agreement on the conflicting issues on a regular basis. Results & Conclusions There was no concerning paper on Lesser Yin Symptomatology. Experts' agreement was needed to establish the CPG. Lesser Yin pattern can be classified into 2 groups; Lesser Yin severe pattern and Lesser Yin critical pattern. There are Lesser Yin pattern accompanied abdominal pain and bowel irritability pattern and Lesser Yin pattern accompanied green tinged watery diarrhea pattern in Lesser Yin severe pattern. There are Visceral syncope pattern and Exuberant yin repelling yang pattern in Lesser Yin critical pattern. Lesser Yin symptomatology has several symptoms like abdominal pain and diarrhea, thirst, oral discomfort, chest discomfort, whole body pain, articular pain and coldness of hands and feet. Additionally there are abdominal pain and diarrhea in Lesser Yin symptomatology accompanied abdominal pain and bowel irritability pattern, there is green tinged watery diarrhea in Lesser Yin pattern accompanied green tinged watery diarrhea pattern and if this symptoms exacerbate, delirious speech and constipation can occur. There are restlessness and coldness on hands and feet in Visceral syncope pattern and severe restlessness and coldness on hands and feet and symptom which the patient cannot drink water in Exuberant yin repelling yang.

All about pain pharmacology: what pain physicians should know

  • Kim, Kyung-Hoon;Seo, Hyo-Jung;Abdi, Salahadin;Huh, Billy
    • The Korean Journal of Pain
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    • v.33 no.2
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    • pp.108-120
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    • 2020
  • From the perspective of the definition of pain, pain can be divided into emotional and sensory components, which originate from potential and actual tissue damage, respectively. The pharmacologic treatment of the emotional pain component includes antianxiety drugs, antidepressants, and antipsychotics. The anti-anxiety drugs have anti-anxious, sedative, and somnolent effects. The antipsychotics are effective in patients with positive symptoms of psychosis. On the other hand, the sensory pain component can be divided into nociceptive and neuropathic pain. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are usually applied for somatic and visceral nociceptive pain, respectively; anticonvulsants and antidepressants are administered for the treatment of neuropathic pain with positive and negative symptoms, respectively. The NSAIDs, which inhibit the cyclo-oxygenase pathway, exhibit anti-inflammatory, antipyretic, and analgesic effects; however, they have a therapeutic ceiling. The adverse reactions (ADRs) of the NSAIDs include gastrointestinal problems, generalized edema, and increased bleeding tendency. The opioids, which bind to the opioid receptors, present an analgesic effect only, without anti-inflammatory, antipyretic, or ceiling effects. The ADRs of the opioids start from itching and nausea/vomiting to cardiovascular and respiratory depression, as well as constipation. The anticonvulsants include carbamazepine, related to sodium channel blockade, and gabapentin and pregabalin, related to calcium blockade. The antidepressants show their analgesic actions mainly through inhibiting the reuptake of serotonin or norepinephrine. Most drugs, except NSAIDs, need an updose titration period. The principle of polypharmacy for analgesia in case of mixed components of pain is increasing therapeutic effects while reducing ADRs, based on the origin of the pain.

Clinical Evaluation of Efficacy of Moltase by Double-blind Test (Double-blind test에 의한 Moltase 의 효력평가(?力評價))

  • Lee, Tong-Ho;Lee, Tae-Hee
    • The Korean Journal of Pharmacology
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    • v.6 no.1
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    • pp.23-26
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    • 1970
  • 1) Efficacy of Moltase, a digestive enzyme preparation, was evaluated by double-blind test. 2) The clinical symptoms assessed in this study were anorexia, vomiting, nausea, eructation, hunger pain, epigastralgia, fullness in epjgastrium, abdominal fullness, constipation, and diarrhea. Effect of Moltase on gastric acidity was also examined by double-blind test. 3) People subjected to this study were 42 students and 22 patients who had signs of chronic dyspepsia. 4) In general, the clinical symptoms were more effectively improved by Moltase than placebos. The marked differences in efficacy between both medication were observed in epigastralgia, fullness in epigastrium, abdominal fullness, and anorexia. 5) Six out of 9 patients with no free gastric acid became to have free gastric acid after Moltase medication.

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