• 제목/요약/키워드: digestive disease

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Serum Gastrin and the Pepsinogen I/II Ratio as Markers for Diagnosis of Premalignant Gastric Lesions

  • Shafaghi, Afshin;Mansour-Ghanaei, Fariborz;Joukar, Farahnaz;Sharafkhah, Maryam;Mesbah, Alireza;Askari, Kurosh;Geranmayeh, Siamak;Mehrvarz, Alireza;Souti, Fatemeh;Sokhanvar, Homayoon;Fakhrieh, Saba;Aminian, Keyvan;Yousefi-Mashhour, Mahmud;Khosh-Sorur, Mahmud;Rasoulian, Javid
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3931-3936
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    • 2013
  • Background: Iran is a country with very high incidences of stomach cancer, especially in Northern parts. Here we assessed prognostic value of serum screening biomarkers among people >50 years old for early detection of precancerous lesions in a hot spot for gastric carcinoma in Guilan Province, North Iran. Methods: A cross-sectional population-based survey was conducted on 1,390 residents of Lashtenasha city with the mean age (SD) of 61.8 (9.02) years old (50.8% females) to assess the association of gastrin and the pepsinogen (PG) I/II ratio with premalignant gastric lesions. Blood samples were taken for CBC, blood group, and serologic exams (PGI, PGII, and gastrin 17) from each subject. Expert gastroenterologists performed upper GI endoscopy and ROC curves were generated to determine appropriate cutoff points. Results: Mean values of PGI, PGII, PGI/PGII and gastrin were significantly different between patients with and without atrophy or metaplasia (P<0.05). To diagnose atrophy and intestinal metaplasia, a significantly higher AUC was observed for the PGI/PGII ratio (70 and 72%, respectively) compared to the PGI (56, 55%), PGII (63, 64%) and gastrin (59, 61%) (all p<0.001). Conclusions: Biomarker tests such as the PGI/II ratio can be used in the screening and diagnosis of subjects at high gastric cancer risk in our region.

Enhanced Recovery after Surgery for Gastric Cancer Patients Improves Clinical Outcomes at a US Cancer Center

  • Desiderio, Jacopo;Stewart, Camille L.;Sun, Virginia;Melstrom, Laleh;Warner, Susanne;Lee, Byrne;Schoellhammer, Hans F.;Trisal, Vijay;Paz, Benjamin;Fong, Yuman;Woo, Yanghee
    • Journal of Gastric Cancer
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    • 제18권3호
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    • pp.230-241
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    • 2018
  • Purpose: Enhanced recovery after surgery (ERAS) protocols for gastric cancer patients have shown improved outcomes in Asia. However, data on gastric cancer ERAS (GCERAS) programs in the United States are sparse. The purpose of this study was to compare perioperative outcomes before and after implementation of an GC-ERAS protocol at a National Comprehensive Cancer Center in the United States. Materials and Methods: We reviewed medical records of patients surgically treated for gastric cancer with curative intent from January 2012 to October 2016 and compared the GC-ERAS group (November 1, 2015-October 1, 2016) with the historical control (HC) group (January 1, 2012-October 31, 2015). Propensity score matching was used to adjust for age, sex, number of comorbidities, body mass index, stage of disease, and distal versus total gastrectomy. Results: Of a total of 95 identified patients, matching analysis resulted in 20 and 40 patients in the GC-ERAS and HC groups, respectively. Lower rates of nasogastric tube (35% vs. 100%, P<0.001) and intraabdominal drain placement (25% vs. 85%, P<0.001), faster advancement of diet (P<0.001), and shorter length of hospital stay (5.5 vs. 7.8 days, P=0.01) were observed in the GC-ERAS group than in the HC group. The GC-ERAS group showed a trend toward increased use of minimally invasive surgery (P=0.06). There were similar complication and 30-day readmission rates between the two groups (P=0.57 and P=0.66, respectively). Conclusions: The implementation of a GC-ERAS protocol significantly improved perioperative outcomes in a western cancer center. This finding warrants further prospective investigation.

강화지역 남녀 장수노인의 사회적, 신체적 건강상태조사 (A Study on Social Factors and Physical Health Status of the Long-Lived Elderly People in Ganghwa-gun Area)

  • 한혜경;최성숙;김명화;이성동
    • 대한지역사회영양학회지
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    • 제10권1호
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    • pp.111-121
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    • 2005
  • This study was to performed to assess social factors and physical health status. The subjects of the study were 103 elderly people of age over 85 years living in Ganghwa-gun area. The method of this research was based on the interview-survey with questionnaire. Chi-square test was the main data analysis method. The subject group was composed of 36 males and 67 females, the average age being 91.0 $\pm$ 3.2 years old for the males and 91.1 $\pm$ 3.4 years old for the females. The aged average height and weight were 161.0 $\pm$ 7.9 cm and 54.6 $\pm$ 7.8 kg in males, 141.0 $\pm$ 8.2 cm and 42.2 $\pm$ 7.9 kg in females which were lower than the Korean average standard but the mean BMIs of both male and female showed normal range. Their level of education was lower and they tended to be religious. The aged population might be economically poor. Their level of living standards tended to have been lower-middle and lower class. The mean age of their parents' death were 64.3 $\pm$ 17.2 years in males, 59.0 $\pm$ 14.9 years in females for the father and 70.9 $\pm$ 15.5 years in males, 66.8 $\pm$ 16.6 years in females for the mother. The rate of living together with their family or spouse in the female aged was $83.2\%$ higher than in the male aged. They tended to have engaged in hobbies that require less movement. Of the kinds of hobby, 'TV watching ($47.8\%$ in male and $44.9\%$ in female) was the highest. Ratios of the drinking and the smoking elderly were $30.6\%$, $25.0\%$ in male and $7.5\%$, $18.8\%$ in female but they tended to have never drunken and smoked. Of the subjects, $42.9\%$ spend 8$\~$9 hours for sleeping in male and $35.8\%$ spend 10 hours for sleeping in female. They tended to have not done any particular health behavior. The most common diseases were digestive disease in male, arthritis and hypertension in female. Most elderly males ($47.3\%$) and females ($61.2\%$) had 1$\~$2 diseases.

50인 미만 소규모사업장의 보건관리 실태 (Current State of Occupational Health in Small-Scale-Enterprises of Korea)

  • 윤순녕;김영임;정혜선;김순례;유경혜;송영숙;김화중
    • 지역사회간호학회지
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    • 제11권1호
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    • pp.90-104
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    • 2000
  • This study was carried out to investigate the current state of occupational health management and characteristics of employees working in small-scale-enterprises (SSE) employing less than 50 workers. Samples were chosen among the two thousands employees working in 838 factories where located in Youngdungpo-Ku, Seoul, Korea. The study results were as followed: 1. Most factories investigated in the study were manufactures (68.6%) which were established in 5 to 10 years ago (29.2%), employing less than 5 workers (72.9%) and registered in accident compensation insurance (23.0%). 2. Health screening was undertaken in 24.9% workplaces for periodic health examination and in 1.5% for special health examination. Environmental monitoring was done in 3.3% factories. Very few factories displayed Material Substance Data Sheet (MSDS) in 3.1% among the total factories. 3. Workplaces usually had their own toilets in 75.9% and washing basin in 58.6% as types of sociowelfare facilities. 4. Employees responded in the study were mostly in the range of age from 30 to 39 in 34.7%. male in 84.8%. the married in 70.3%. manual workers in 42.0%. mostly working regularly 51 hours per a week in 48.2% and earned 710.000 Won to 1.000.000 Won per month in 35.0%. Medical utilization for employees were covered by factories sponsored medical insurance in 12.7% and by provincial sponsored medical insurance in 83.4%. 5. Two point six percents of employees were suffered by diseases. The health complaints indicated were mainly digestive problems in 46.7% and hypertension in 24.4%. 6. Employees wore personal protective equipments for work such as gloves in 48.1%. safety shoes in 30.5%. ear plug in 5.5% and mask in 6.9%. Based on the results of study, we recommend that various types of occupational health management should be developed according to workplace working condition of each factory. In addition to the development of occupational health strategies. we think that it is more important to monitor and to allocate how effectively they operate each other on the basis of longitudinal continuity. Besides, we would like to insist that these all management effort should be focused on prevention of disease and occupational health education of employees.

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기혈수변증(氣血水辨證)에 의한 기능성 소화불량 환자의 변증유형 분석 (Analysis of symptom pattern through comprehensive diagnosis of Qui Xui Shui in patients with functional dyspepsia)

  • 임중화;유종민;장선영;김현경;이준석;윤상협;김진성;류봉하;류기원;한숙영
    • 대한한방내과학회지
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    • 제25권2호
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    • pp.224-237
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    • 2004
  • Background & Object : It is well known that functional dyspepsia is one of the most common diseases. While many dyspepsia patients have been helped with oriental medical therapy, there has not been a study based on the concepts of oriental medicine. The aim of this study was to perform a fundamental epidemiological survey and to analyse the symptom pattern of functional dyspepsia. Methods : 86 patients(27 males, 59 females) diagnosed with functional dyspepsia in Kyunghee Oriental Medical Center from May to December 2002 were involved in this investigation. The disease characteristics of functional dyspepsia(based on Rome criteria II) and the Qui Xue Shui diagnostic procedure were investigated by questionnaire and physical examination. The total score and composition ratio of each comprehensive diagnosis were calculated from the symptom score described in the questionnaire. Results : The total score from the Qui Xue Shui diagnostic procedure was found to be influenced by the number of functional dyspepsia symptoms(p=0.026) and the patient's own cognition of their current dyspeptic situation(p=0.006), in addition to digestive ability and general congnition(p=0.006), and was not associated with sex, duration of dyspeptic symptoms in one year, or the total illness period, In the composition ratio of the Qui Xue Shui diagnostic procedure, only Qui-yu(p=0.048) diagnosis was accurate regarding the number of symptoms in one year, total illness period, or the patients' own congnition of their current dyspeptic situation, But the value of the composition ratio among the total factors involved was most similar to that of sex. Conclusions : Thus, it is shown here that the total score of using the Qui Xue Shui diagnostic procedure is mainly dependent on dyspeptic symptoms and the patinets' own cognition of their current dyspeptic situation, and that regular symptom patterns in the Qui Xue Shui diagnostic procedure exist in dyspeptic patients.

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도시 중년 남성의 스트레스 정도와 식습관 및 웰빙 관련 태도에 관한 연구 (A Study of Stress, Food Habits and Well-Being Related Attitudes in Urban Middle-Aged Men)

  • 명춘옥;남혜원;박영심
    • 동아시아식생활학회지
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    • 제19권2호
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    • pp.157-168
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    • 2009
  • The principal objective of this study was to provide basic data regarding health care services for middle-aged men, via an analysis of the relationships among stress level, food habits and well-being-related attitudes with social-demographic characteristics and health-related factors. The main findings of this study were as follows. The average age of the participants was $48.7{\pm}5.2$. With regard to health status, 18.8% of the participants were diagnosed with digestive diseases within the past year. Stress levels were higher in the participants with lower levels of educational attainment. Furthermore, participants who had become divorced or lived separately from their families, participants who did not have their own houses, and participants who reported low marital satisfaction also had high levels of stress. Our food habits scores revealed meaningful differences among the study subjects, and were shown to vary with marital satisfaction, occupation, and residence type. In terms of both the importance and practice level of well-being-associated food habits, the most frequent response in this study was 'Consume home-made food rather than processed or ready-to-eat food' ($4.30{\pm}0.86$, $3.68{\pm}1.04$). In terms of importance level, the factors most relevant to well-being in terms of food habits were education level, marital satisfaction, residence type, self-assessed health status, smoking, drinking, regular exercises and leisure activities. With regard to practice levels, the degree to which subjects engaged in food habits targeted toward well-being differed meaningfully depending on marital status, marital satisfaction, residence type, family type, self-assessed health status, smoking, drinking, nutritional supplement intake, regular exercises and leisure activities. After analyzing the correlation among stress level, food habit score and the attitude towards well-being-related dietary habits (importance and practice level), we observed a meaningful relationship between the four factors at the level of p<0.001. According to the above result, continuous attention to health, including the appropriate control of smoking and drinking, as well as, stress management, via regular exercises and appropriate food habits is expected to exert a positive influence on the prevention of disease, and is also expected to improve quality of life. For all well-being-associated items, the importance level was shown to be higher than the practice level. Thus, in order to foster health-oriented food habits, we recommend that a new plan be designed, targeted toward ease of active practice for middle-aged men.

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-소화계질환(消化系疾患)에 관(關)한 한의학원리(韓醫學原理)의 고찰(考察)- (A STUDY OF PRINCIPLES OF ORIENTAL MEDICINE CONCERNING THE DISEASE OF DIGESTIVE SYSTEM)

  • 이종형
    • 대한한방내과학회지
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    • 제1권1호
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    • pp.7-19
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    • 1976
  • 소화계질환(消化系疾患)이라고 하면 그 범위(範圍)가 매우 넓으나 대체로 크게 두가지로 구분(區分)할 수 있다. 하나는 소화기계통장기(消火器系統臟器)의 기질적(器質的) 질환(疾患)이고 다른 하나는 음식물(飮食物)의 섭취(攝取) 소화(消火) 흡수(吸收) 및 영양화(營養化)에 관계(關係)되는 기능적(機能的)인 질환(疾患)이다. 한의학상(韓醫學上) 소화계질환(消化系疾患)은 다분(多分)히 후자(後者) 즉(卽) 기능적(機能的) 질환(疾患)쪽을 많이 연구(硏究)한 경향(傾向)이 있으며 이것을 [비위내상(脾胃內傷)]위장병(胃腸病)이라고 부르고 있다. 한의학상(韓醫學上) 음식물(飮食物)과 질병(疾病)에 관(關)한 관찰(觀察)은 일찍이 상고시대(上古時代)로부터 매우 고조(高潮)되였던 것으로 생각된다. 내경(內經)(B. C200)에 의(依)하면 인간(人間)이 그 수명(壽命)을 다함에 있어 무엇보다도 음식(飮食)의 절제(節制)를 잘해야 한다는 설명(說明)이 있고, 천금방(千金方)(AD682)에는 신체(身體)를 강건(强健)케 하는 기본(基本)은 음식(飮食)에 있으며 의자(醫者)가 질병(疾病)을 치료(治療)함에 있어 마땅히 먼저 식치(食治)(식이요법(食餌療法))를 하되 식치(食治)로 낫지 않거던 용약(用藥)하라고 하였고, 삼인방(三因方)(AD1174)는 질병(疾病)의 삼대원인(三大原因) 중(中) 음식(飮食)으로 일어나는 원인(原因)을 가장 중요(重要)한 것으로 보았고 1250년대(年代) 이동원(李東垣)은 [비위론(脾胃論)]을 저술(著述)하여 소화계(消化系)에 관(關)한 이론(理論)을 특별(特別)히 천명(闡明)하였다. 이와 같이 한의학(韓醫學)은 음식(飮食)과 양생(養生), 영양(榮養)과 질병(疾病), 그리고 소화기능(消火機能)에 관(關)하여 고대(古代)로부터 중요시(重要視)해온 것이다. 그러나 그 이론(理論)들이 다분(多分)히 현상적관찰(現象的觀察)과 경험적추리(經驗的推理)로서 설명(說明)되었기 때문에 현대의학(現代醫學)(서양의학(西洋醫學))과 같은 조직해부학(組織解剖學) 및 생화학적(生化學的)인 이론(理論)과는 상위(相違)한 점(點)이 많다. 더욱이 음양오행설(陰陽五行說)이라는 다분(多分)히 형이상적(形而上的)인 학(學) 사유(思惟)로서 관찰추리(觀察推理)되였기 때문에 현대의학(現代醫學)과의 비교설명(比較說明)이 거의 불가능(不可能)하며 또한 한의학이론(韓醫學理論)의 과학적근거제시(科學的根據提示)도 현재(現在)로서는 어려운 형편(形便)이다. 그러나 이 의학(醫學)은 이미 2,000여년간(餘年間) 동양(東洋)에서 전래(傳來)한 경험의학(經驗醫學)으로서 동양인(東洋人)들은 이 의학(醫學)으로 소화계질환(消化系疾患)을 포함(包含)한 여러 가지 인간(人間)의 질병(疾病)을 치료(治療)해 왔고 현재(現在)도 이 의학(醫學)으로 치료(治療)를 하고 있고 실제적(實際的)으로 많은 치효(治效)를 보고 있는 것이다. 그러므로 이 의학(醫學)속에는 아직도 현대과학(現代科學)으로서 해명(解明)되지 못하는 어떤 요소(要素)들이 깃들여 있는 것이 확실(確實)하며 이것을 밝혀내기 위해서 우리 의학자(醫學者)들은 이 의학(醫學)에 관(關)한 모든 것을 연구(硏究)해 보아야 한다. 이런 뜻에서 본고찰(本考察)은 한방(漢方)의 역대제문헌(歷代諸文獻)을 섭렵(涉獵)하여 소화계질환(消化系疾患)에 관(關)한 제이론(諸理論)들을 발췌(拔萃), 한방(漢方)에서 보는 (1) 소화기관(消化器官)의 생리(生理) (2) 병리(病理), 증후(證候) (3) 치법원리(治法原理)을 조사고찰(調査考察)해 본 것이다.

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비투과 표지자 KOLOMARK를 이용한 개의 위배출시간검사에 대한 유용성 (Usefulness of Gastric Emptying Time Test for Dog byUsing Radiopaque Marker KOLOMARK)

  • 조영권;김선칠
    • 한국방사선학회논문지
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    • 제6권4호
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    • pp.267-273
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    • 2012
  • 개에서 이물, 신생물, 유문동비후, 위수술, 전해질불균형, 위확장성 염전 등에 의한 비정상적인 위 배출시간은 임상에서 소화기 질환으로 중요하다. 그러므로 위장관 운동이상에 대한 정확한 진단을 위하여 정상적인 위장관 운동시간에 대한 자료가 필요하다. 이 연구의 목적은 개에서 기존의 BIPS를 이용하는 검사 방식이 아닌 국내에서 개발한 방사선 비투과성 Kolomark를 이용한 위배출시간 검사에 대한 임상적 유용성에 대한 기초자료를 제공하기 위한 것이다. Beagle 9마리가 이번 실험에 사용되었으며 평균 체중 평균 10.3kg이며 평균 2.5살이었다. 검사를 위해 12시간 금식을 시행하였으며 화학적 보정은 하지 않은 채 검사 직전 하루 사료급여량의 25%용량에 Kolomark 1개의 capsule과 함께 급여하였고 2, 4, 8, 12시간 때 Ventrodorsal, Right lateral자세로 촬영하였다. 관심판독부분은 분문에서 위유문부까지의 위장 전체를 관찰하였으며 분석방법으로는 각 시간대별로 위장 내에 남아있는 Kolomark를 카운트하여 비모수검정인 Friedman 검정방법을 이용하여 P값이 0.05 미만인 경우를 유의한 것으로 판정하였다. 구강으로 Kolomark를 섭식 후 위에서 소장으로 완전히 Kolomark가 빠져나가는데 걸리는 평균시간은 7.55시간이었다. 이번 연구에서 성숙한 개에서 음식물 투여 후에 나타나는 위장관 통과시간을 Kolomark를 이용하여 정상적인 위장관 운동시간에 대한 기초자료가 되리라 판단된다.

가자미 식해 발효에서 Lactobacillus brevis GS1022과 Pediococcus inopinatus GS316의 균총 변화 연구 (Change in Lactobacillus brevis GS1022 and Pediococcus inopinatus GS316 in Gajami Sikhae Fermentation)

  • 임수정;배은영;설민경;조영제;정희영;김병오
    • 생명과학회지
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    • 제30권6호
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    • pp.491-500
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    • 2020
  • 유산균은 장 건강, 심장질환, 우울증, 비만 등을 예방하고 치료할 수 있다고 널리 알려져 있고, 특히 한국은 다양한 발효식품에서 유산균을 섭취할 수 있다. 하지만 국내 발효식품에서 분리된 유산균에 대한 연구는 대부분 김치에 한정되어 있기 때문에 대표적인 어류 전통 발효식품인 식해류의 유산균에 대한 연구는 미비한 실정이다. 따라서 본 연구는 한국의 전통발효식품인 가자미 식해의 발효에 관여하는 유산균의 배양일에 따른 균총의 변화를 관찰하고, 가자미 식해로부터 프로바이오틱스로 이용 가치가 있는 균을 분리하기 위해 시행되었다. 포항의 가정집에서 제조된 가자미 식해에서 유산균을 제조일로부터 50일까지 5일 간격으로 분리하고 동정하였고, 동정 결과 P. pentosaceus, P. inopinatus, Lc. mesenteroides, L. brevis, L. plantarum 5개 균주가 발효에 관여함을 알 수 있었다. 발효가 진행됨에 따라 초기 발효에는 Pediococcus sp.가, 중기 이후부터는 Lactobacillus sp.가 우세하게 발효에 관여하는 것을 확인할 수 있었다. 분리한 유산균 중 우수한 프로바이오틱 활성을 가지는 균주를 알아보기 위하여 산내성, 담즙산 내성 시험을 통해 균주를 선별한 뒤 응집능, 표면 소수성, 항균 활성, 항산화 활성 등을 평가하였다. 그 결과 본 연구의 가자미 식해 분리 균주 중 최종적으로 선택된 소화액 내성이 뛰어난 L. brevis GS1022와 응집능이 뛰어난 P. inopinatus GS316은 프로바이오틱 균주로 이용할 가치가 충분하다고 사료된다.

Spatial Inequalities in the Incidence of Colorectal Cancer and Associated Factors in the Neighborhoods of Tehran, Iran: Bayesian Spatial Models

  • Mansori, Kamyar;Solaymani-Dodaran, Masoud;Mosavi-Jarrahi, Alireza;Motlagh, Ali Ganbary;Salehi, Masoud;Delavari, Alireza;Asadi-Lari, Mohsen
    • Journal of Preventive Medicine and Public Health
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    • 제51권1호
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    • pp.33-40
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    • 2018
  • Objectives: The aim of this study was to determine the factors associated with the spatial distribution of the incidence of colorectal cancer (CRC) in the neighborhoods of Tehran, Iran using Bayesian spatial models. Methods: This ecological study was implemented in Tehran on the neighborhood level. Socioeconomic variables, risk factors, and health costs were extracted from the Equity Assessment Study conducted in Tehran. The data on CRC incidence were extracted from the Iranian population-based cancer registry. The $Besag-York-Molli{\acute{e}}$ (BYM) model was used to identify factors associated with the spatial distribution of CRC incidence. The software programs OpenBUGS version 3.2.3, ArcGIS 10.3, and GeoDa were used for the analysis. Results: The Moran index was statistically significant for all the variables studied (p<0.05). The BYM model showed that having a women head of household (median standardized incidence ratio [SIR], 1.63; 95% confidence interval [CI], 1.06 to 2.53), living in a rental house (median SIR, 0.82; 95% CI, 0.71 to 0.96), not consuming milk daily (median SIR, 0.71; 95% CI, 0.55 to 0.94) and having greater household health expenditures (median SIR, 1.34; 95% CI, 1.06 to 1.68) were associated with a statistically significant elevation in the SIR of CRC. The median (interquartile range) and mean (standard deviation) values of the SIR of CRC, with the inclusion of all the variables studied in the model, were 0.57 (1.01) and 1.05 (1.31), respectively. Conclusions: Inequality was found in the spatial distribution of CRC incidence in Tehran on the neighborhood level. Paying attention to this inequality and the factors associated with it may be useful for resource allocation and developing preventive strategies in at-risk areas.