• The Korean Journal of Pain
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• v.6 no.1
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• pp.129-132
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• 1993

Paraplegia complicating a block of the celiac plexus with alcohol for recurrent stomach cancer is described. A 33 year old male patient was admitted to control for severe epigastric pain. With the patient in prone position, the needle was advanced further than 2 cm on the anterior margin of $L_1$ vertebral body under fluoroscopy. 3 ml of 1% lidocaine and 5 ml of conray were injected through each needle, and the diffusion of the contrast medium was checked, This was followed by 7 ml of pure alcohol and 8 ml of 50% alcohol for each needle. At that time, the patient was very satisfied with loss of abdominal pain. About 30 minutes after injection of alcohol, suddenly patient complained of severe burning pain on back and both extremities. Thereafter, loss of sensation and paralysis in both extremities were developed slowly. The senstivity to cold recovered 3 days after block. By the 33rd day after the block, sensation had recovered in both extremities, the bladder and rectum. Movement of the right ankle joint and left great toe was also possible.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1051-1062
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• 2019

Objectives: Chest pain presents diagnostic and therapeutic challenges because of its various etiologies. Many patients have chest pain from unknown causes and persistent chest pain in spite of standard treatment. The purpose of this study was to investigate the effectiveness of a Korean herbal medicine called Pyungjinsujeom-san (PSS) in relieving chest pain. Methods: We reviewed the electronic medical records of patients who visited the Korean Medical Clinic of Cardiology at Kyunghee University Hospital at Gangdong from January 2009 to July 2019, with the chief complaint of chest pain and who were treated with PSS. The mean severity of chest pain measured on the Numerical Rating Scale was compared before and after the administration of PSS. Results: The mean severity of chest pain of 20 patients decreased significantly from 6.80±1.61 to 1.35±0.9 after taking PSS (p<0.001). Most patients had symptoms of phlegm and food retention, including indigestion, postprandial fullness, and epigastric pain.Conclusions: These results suggest that PSS may be effective in relieving chest pain from various causes, particularly in patients with symptoms of phlegm and food retention.

• Childhood Kidney Diseases
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• v.22 no.2
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• pp.75-80
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• 2018

Nutcracker syndrome is a phenomenon that the left renal vein (LRV) is pressed between the superior mesenteric artery (SMA) and the aorta. Clinical characteristics include gross or microscopic hematuria, orthostatic proteinuria, abdominal pain, and back pain. It occurs due to LRV squeezing caused by narrowed aortomesenteric angle. SMA syndrome is a disease that the third part of the duodenum is prone to intestinal obstruction by narrowed angle between the SMA and the abdominal aorta. Clinical symptoms include postprandial abdominal distension, epigastric pain, nausea, and vomiting. SMA syndrome and nutcracker syndrome have common features that result from narrowed aortomesenteric angle. However, it is very rare for both syndromes to occur simultaneously, so the two syndromes are regarded as separate diseases. This is a report on a case of nutcracker syndrome with SMA syndrome in a child who presented gross hematuria, recurrent abdominal pain and vomiting. To our knowledge, nutcracker syndrome simultaneous with SMA syndrome has not been previously reported in pediatric patient, especially with an exhibition of gross hematuria. This case suggests that the simultaneous presence of SMA syndrome with the same pathogenesis needs to be considered when nutcracker syndrome is suspected in pediatric patients with hematuria.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.308-322
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• 2015

Objectives: Whether there exists a distinct pathogenesis in subgroups of functional dyspepsia (FD), the classification of epigastric pain syndrome (EPS), and postprandial distress syndrome (PDS) remains controversial. We aimed to investigate the number of fungiform papillae (FP) in the subgroups of FD and its correlation with the severity of dyspepsia symptoms and spleen qi deficiency. Methods: Patients with FD were enrolled from August to November 2014. All patients were evaluated using a questionnaire and divided into 2 groups according to the Rome III criteria for FD. The severity of dyspepsia symptoms and spleen qi deficiency were separately assessed by Nepean Dyspepsia Index-Korean (NDI-K) version and Spleen qi deficiency questionnaire (SQDQ). The number of FP was measured on the anterior part of tongue, within an area of 9 mm ², using a digital cam Results: The NDI-K score, SQDQ score, and number of FP in the EPS group were significantly greater than those in the PDS group. Also, the EPS group had more patients diagnosed with spleen qi deficiency. The number of FP showed a significant positive correlation with epigastric pain and burning. Furthermore, the number of FP was significantly associated with the score of some items in NDI-K and SQDQ, even though not with the total score. Conclusions: Thus, measurement of the number of FP could be a new evaluation indicator for allocation into FD subtypes and to investigate the severity of dyspepsia symptoms and spleen Qi deficiency reflecting visceral hypersensitivity.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1268-1277
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• 2019

Objective: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of functional dyspepsia in a fibromyalgia patient with a history of long-term NSAIDs use. Methods: The patient was diagnosed as a Soeumin, one of the four constitution types in Korean medicine, and treated with herbal medicines such as Seungyangikgibuja-tang and Pyeongjinsunjeom-san. Acupuncture and moxibustion treatment were also performed. The severity of symptoms was assessed using the Numerical Rating Scale (NRS) of epigastric pain, daily oral intake changes, the Korean Gastrointestinal Symptom Rating Scale (KGSRS), the Gastrointestinal Symptom Score (GIS), and the Functional Dyspepsia-Quality of Life (FD-QOL) score. Results: After treatment for 48 days, the severity of epigastric pain decreased from NRS 8 to NRS 0, and daily oral intake was increased. The KGSRS score decreased from 55 to 43, the GIS score was reduced from 18 to 10, and the FD-QOL score also decreased from 69 to 55. Conclusions: This study suggests that Korean medical treatment could be an effective option for treating functional dyspepsia in fibromyalgia patients with a history of long-term NSAIDs use.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1245-1254
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• 2021

Objectives: This study investigated the clinical characteristics and symptoms of patients with reflux esophagitis (RE) visiting a Korean medicine hospital. Methods: We retrospectively reviewed the medical records of patients with an RE diagnosis who visited a Korean medicine hospital from June 15, 2020, to April 15, 2021. We analyzed the clinical characteristics and the results of a symptoms questionnaire. Results: Our sample included 1,151 patients (711 females). The median age was 58 years; the most common age bracket was 60-69 years. A total of 837 patients (72.7%) presented with symptoms lasting more than one year, and 1,035 (89.9%) had been prescribed medications for more than three months before visiting a Korean medicine hospital. Belching (77.6%) and acid regurgitation (70.9%) were the most frequent symptoms, followed by epigastric pain (61.6%) and throat globus (58.5%). Throat globus was the most bothersome symptom, and 72.4% of the patients experienced the symptom on more than five days in the preceding two weeks. Patients with a longer symptom duration were older (p<0.01) and more likely to be overweight (p=0.03). Patients experiencing symptoms for more than five years were more likely to report throat globus (p=0.02), hoarseness (p<0.01), and coughing (p<0.01). Conclusions: Most RE patients visiting a Korean medicine hospital were females in their sixties with chronic and refractory RE. Atypical symptoms (belching, epigastric pain, and throat globus) were common. Throat globus was highly prevalent in severe cases, suggesting that it warrants attention when treating RE patients.

• CELLMED
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• v.2 no.2
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• pp.15.1-15.3
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• 2012

Kampo medicine, a Japanese traditional herbal medicine, has been used in clinical practice in Japan. The most appropriate Kampo formula should be chosen for each individual by the four diagnostic procedures. Fuku shin, the abdominal exam, is one of the most important approaches in the procedures. There are several abdominal conformations (signs) when administering Fuku shin. In Kampo medicine, psychiatric illness-marked by depression and anxiety-has been shown to be related with an abdominal conformation, Shin ka hi koh (Epigastric Obstructive Hardness). The aim was to see the occurrence of abdominal conformations in each level of depression and anxiety symptoms. Two hundred fifteen patients were assigned to high-, moderate-, or low-level psychiatric comorbidity based on the Hospital Anxiety and Depression Scale and were studied regarding the occurrence of major abdominal conformations. Moderate and high psychopathological groups showed the higher occurrence of Shin ka hi koh [Low, 21%; Moderate, 67%; High, 74%] ($p$ < 0.0001). In conclusion, moderate and high psychopathological patients showed the higher occurrence of a specific abdominal sign.

• Journal of Digital Convergence
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• v.10 no.10
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• pp.347-352
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• 2012

As medical treatment is developing with technology, the men's average life expectancy is extended. Therefore, primary medical care becomes emphasized in order to reduce the medical expenses in the long term by satisfying individual's life being healthy. The date for this thesis was collected from January 2011 to June 2011. 889 patients who visited the university hospital emergency room and hospitalized in internal medicine, were picked as the research subjects and they were targeted to be recorded the distribution of chief complaint and principal diagnosis of the patients. Also, this record was used to apply to the standard Classification of Diseases(as known as ICD) and the method of detailed classification of the primary medical care(as known as ICPC) to compare each other. In order to analysis, frequency analysis was used to see vital statistics and the cross tabulations were used to see the distribution of chief complaint according to ICD and ICPC. Results of the research were Abdominal pain(17.7%), Dyspnea(13.5%), Fever (12.5%), and Haematemesis (9.8%), and those symptoms represented the 54.5% of overall chief complaints that is treated in primary care. Therefore, it is acceptable to use the classification of the primary medical care at doc-in-a-box. Also, in case of diagnosis of abdominal pain, it is classified to R10 in ICD and 116 patients(18.7%) belonged to it, but according to ICPC, it is subdivided to Epigastric(11.5%) and General(5.8%). ICPC classification, which is focused to primary medical care is more detailed than ICD classification. Because the data that is collected for this thesis is from only one hospital, it is hard to represent to all the cases, but ICPC in emergency medical care, it has more classification available and it can subdivide the patients effectively, so it is meaningful.

• Journal of Chest Surgery
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• v.27 no.4
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• pp.331-334
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• 1994

Pneumatic rupture is a rare cause of esophageal injury, as evidenced by only 19 cases reported in the literature. We experienced one case of esophageal rupture due to bursting of a truck inner tube. The patient, who was a 45-year old male, had severe chest pain, respiratory distress, flushing in the face and neck, and subcutaneous emphysema after tire explosion. Three days after the incident, a diagnosis of rupture of the thoracic esophagus was established by esophagogram using water soluble contrast media, and then emergency operation was done. The operation involved mediastinal and thoracic drainage and resection of the esophagus combined with cervical esophagostomy and feeding gastrostomy. On the 105th day after the operation, cervical esophagogastrostomy via substernal route was performed. The patient was successfully treated with the staged operations. As in the other reported cases, the injury was located in the lower one third of the esophagus. Four main characteristics of the clinical signs of pneumatic rupture are 1] wounds or burns to the face or mouth, 2] chest pain or epigastric pain, 3] subcutaneous emphysema, and 4] respiratory distress. We emphasize that the high index of suspicion of esophageal rupture is very important in diagnosis and that diagnosis should be based on the same findings common to other forms of esophageal injury.

• Clinical and Experimental Pediatrics
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• v.59 no.sup1
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• pp.72-75
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• 2016

Eosinophilic gastroenteritis is a rare disease characterized by prominent eosinophilic tissue infiltration of the gastrointestinal tract. Here, we report a case of eosinophilic gastroenteritis in an 18-year-old patient with prolonged nephrotic syndrome who presented with abdominal pain and peripheral hypereosinophilia. During the previous 2 years, he had visited local Emergency Department several times because of epigastric pain and nausea. He had been treated with steroid-dependent nephrotic syndrome since 3 years of age. Tests ruled out allergic and parasitic disease etiologies. Gastroduodenoscopy with biopsy revealed marked eosinophilic infiltration in the duodenum. Renal biopsy findings indicated minimal change disease spectrum without eosinophilic infiltration. The oral deflazacort dosage was increased, and the patient was discharged after abdominal pain resolved. To our knowledge, this is the first report of eosinophilic gastroenteritis in a patient with minimal change disease.