• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.24 no.4
• /
• pp.384-391
• /
• 2021

Purpose: The Cow's Milk-related Symptom Score (CoMiSS^TM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSS^TM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSS^TM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSS^TM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSS^TM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSS^TM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSS^TM values were retrospectively and prospectively determined. Lower CoMiSS^TM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSS^TM in clinical practice.

• Journal of Korean Medicine Rehabilitation
• /
• v.25 no.4
• /
• pp.113-121
• /
• 2015

Objectives Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disorders. The aim of this study was to evaluate changes in symptoms, quality of life, HRV (Heart Rate Variability) before and after abdominal manipulation therapy in functional dyspepsia patients. Methods We recruited twenty functional dyspepsia patients from the volunteers who applied for this clinical trial. State of Patients were assessed by NDI-K (Nepean Dyspepsia Index Korean Version), HRV (Heart Rate Variability) before treatment. After 4 times of abdominal manipulation therapy for 2 weeks, state of patients were assessed by the same methods. Results Total symptom score and total quality of life score of NDI-K were significantly improved by the abdominal manipulation therapy. After the treatment, the number of subjects within normal range of LF/HF ratio was significantly increased. Although the median of LF/HF ratio did not significantly changed, interquartile range was reduced. Conclusions Abdominal manipulation therapy possibly can be an effective treatment for functional dyspepsia patients, but further studies are needed to demonstrate the effectiveness of abdominal manipulation therapy for functional dyspepsia patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.27 no.2
• /
• pp.88-94
• /
• 2024

Purpose: Infantile hypertrophic pyloric stenosis (IHPS) is a common gastrointestinal disease in neonates and hypochloremia metabolic alkalosis is a typical laboratory finding in affected patients. This study aimed to analyze the clinical characteristics of infants with IHPS and evaluate the association of clinical and laboratory parameters with ultrasonographic findings. Methods: Infants diagnosed with IHPS between January 2017 and July 2022 were retrospectively evaluated. Results: A total of 67 patients were included in the study. The mean age at diagnosis was 40.5±19.59 days, and the mean symptom duration was 11.97±9.91 days. The mean pyloric muscle thickness and pyloric canal length were 4.87±1.05 mm and 19.6±3.46 mm, respectively. Hyponatremia and metabolic alkalosis were observed in five (7.5%) and 36 (53.7%) patients, respectively. Serum sodium (p=0.011), potassium (p=0.023), and chloride levels (p=0.015) were significantly lower in patients with high bicarbonate levels (≥30 mmol/L). Furthermore, pyloric canal length was significantly higher in patients with high bicarbonate levels (p=0.015). To assess metabolic alkalosis in IHPS patients, the area under the receiver operating characteristic curve of pyloric canal length was 0.910 and the optimal cutoff value of the pyloric canal length was 23.5 mm. Conclusion: We found a close association between laboratory and ultrasonographic findings of IHPS. Clinicians should give special consideration to patients with pyloric lengths exceeding 23.5 mm and appropriate fluid rehydration should be given to these patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.6 no.1
• /
• pp.10-16
• /
• 2003

Purpose: To evaluate the risk of gastrointestinal bleeding associated with use of low-dose aspirin in children. Methods: Among about 250 children who received low-dose aspirin (5 mg/kg/day) under the diagnosis of Kawasaki disease, from March 1995 to May 2001, at Eul-Ji general hospital, 100 children were enrolled in this study. We reviewed the medical records and interviewed the children's parents over the phone to confirm the existence of gross gastrointestinal bleeding. Results: The age of the children at the beginning of medication ranged 4~118 months. About 75% of them was younger than 3 years old. The duration of medication ranged 0.5~17 months. About 70% of the children took the medicine for 2~3 months. Only 1 child (1%) had hematochezia during medication without any accompanying gastrointestinal symptom, and cimetidine for 1 week had cleared up the bleeding. The total duration of medication of 100 children was 341.5 months, and only 1 child had gastrointestinal bleeding. This translates into a rate of clinically significant gastrointestinal bleeding of 3.5 episodes/100 children/year. Conclusion: The long-term use of low-dose aspirin is safe, but, is associated with the risk of gastrointestinal bleeding in children. Careful follow-up and efforts to reduce the risk of gastrointestinal bleeding are necessary during long-term low-dose aspirin therapy in children.

• Pediatric Infection and Vaccine
• /
• v.29 no.2
• /
• pp.96-104
• /
• 2022

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

• Radiation Oncology Journal
• /
• v.11 no.1
• /
• pp.159-166
• /
• 1993

A retrospective analysis was done for 69 patients with Stage I and II non-Hodgkin's lymphoma who were treated from May 1981 to December 1990, in the Department of Radiadtion Oncology, Korea University Hospital. We used Ann Arbor Staging system and Working Formulation for histological classification. Forty-three patients (43/69, $62.3{\%}$) were Stage I and 26 patients (26/69, $37.7{\%}$) were Stage II, and B symptom was found in $10.1{\%}$ (7/69). Nodal lymphoma was $21.7{\%}$ (15/69); 14 patients with supradiaphragmatic disease and 1 patient with infradiaphragmatic disease. Extranodal lymphoma was $78.3{\%}$ (54/69): $64.8{\%}$ (35/54) for head and neck, $25.9{\%}$ (14/54) for gastrointestinal tract. Histologically, low grade consists of $8.7{\%}$ (6/69), intermediate grade $84.2{\%}$ (56/69), high grade $10.1{\%}$ (7/69), and diffuse large cell type was the most frequent form with 36 patients (36/69, $52.2{\%}$). Eighteen patients ($26.1{\%}$) were treated with radiation therapy alone,20 patients ($29.0{\%}$) with radiation therapy combined with chemotherapy, 15 patients ($21.7{\%}$) with radiation therapy combined with surgery and chemotherapy, Median survival duration was 28 months, and the range of survival time was from 1 month to 134 months. Overall five-year survival rate for Stage I and II disease was $54.2{\%}$, with $64.5{\%}$ for Stage I and $37.1{\%}$ for Stage II. For nodal lymphoma,5-year survival rate was $45.9{\%}$, and $56.5{\%}$ for extranodal lymphoma; $60.6{\%}$ for head and neck, $52.9{\%}$ for GI tract primary disease. Local control rate for all patients was $88.4{\%}$ (61/69), with $80{\%}$ (12/15) for nodal lymphoma and $90.7{\%}$ (49/54) for extranodal lymphoma. The total failure rate was $34.8{\%}$ (24/69). Five of 24 ($20.8{\%}$) patients who were failed developed local failure only, $12.5{\%}$ (3/24) local failure with distant failure, and distant failure only were found in $66.7{\%}$ (16/24). Between nodal lymphoma and extranodal lymphoma, there was no significant survival difference, but extranodal lymphoma showed higher incidence.

• Asian Pacific Journal of Cancer Prevention
• /
• v.13 no.7
• /
• pp.3209-3212
• /
• 2012

Introduction: Colorectal carcinoma (CRC) is the most common gastrointestinal malignancy in the older population, but it is also quite frequent among young adults in developing countries. The aim of this study was to update the trends of clinicopathological features of CRC in young Nepalese. Methods: A retrospective comparative study on the data retrieved from the surgical records of all patients between 20 to 39 years of age with CRC was carried out for periods of 5 years each from 1999 to 2003 (early) and 2004 to 2008 (recent), treated at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results: The number of young adults with CRC increased from 28 to 34. However, the proportion of young patients in both groups was 28% of all CRC patients. The mean ages were $34{\pm}4.7$ and $31.8{\pm}5.1$ years in early and recent 5 years, respectively, and the male female ratio changed from 2:3 to 4:3. Abdominal pain as the most common presenting symptom was replaced by bleeding per rectum in recent years. The mean duration from onset of symptoms to seeking medical advice decreased from 7.8 months to 5.6 months in recent years. More patients (85.3%) were subjected to endoscopic examination in recent years than early years (60.7%) and right colonic cancer increased from 10.7% to 26.5%. However, the rectum was the commonest site in both early (71.4%) and recent (50%) groups. CRC was detected significantly at an earlier stage (7.1% vs 32.4%) in recent years with large proportion of modified Dukes B stage. Poorly differentiated adenocarcinoma was the predominant histology in both groups (50% vs 60.7%). Curative resection had risen in recent years (39.3% vs 73.6%). Conclusion: CRC among Nepalese young adults accounts for a high incidence (28%) of all CRC cases. Although right sided colonic cancer has been increasing, rectum is the commonest site. There is also an increasing trend for diagnosis at earlier stages of the disease which can be treated with curative intent.

• Journal of the Korean Dietetic Association
• /
• v.18 no.4
• /
• pp.283-296
• /
• 2012

As a disease that reduces quality of life, functional dyspepsia (FD) is associated with foods that may worsen its symptoms or cause it. The purpose of this study was to examine the nutritional status and dietary behaviors of FD patients. We investigated food intake, food intake frequency, and dietary habits of 45 FD subjects according to the Rome III Diagnosis Criteria. Average age and body mass index (BMI) were 47.7 years and $22.6kg/m^2$ (males: $23.4kg/m^2$, females: $22.1kg/m^2$), respectively. Average energy intake was 77% of Korean Dietary Reference Intake (KDRI), and it was less than that of the Korea National Health and Nutrition Examination Surveys (KNHANES). Other nutrient intake levels were similar to the KNHANES. Energy intake proportion of carbohydrates : protein : fat was 56 : 18 : 26, and the ratio of fat intake was higher than that of the KNHANES. Beans, laver, tomato, and yogurt were consumed very frequently. In the results of meal regularity, dietary behaviors and composition of diet were relatively good. It is likely that the patient controlled their diet by eating cautiously and by reducing alcohol drinking and smoking. Our results indicate that FD patients' nutritional status by consumption of nutrients was at a level of normal healthy people and that dietary habits were better than normal adults. However, their fat intake levels were somewhat higher than normal people. Therefore, further research is required to identify the relationship between dietary intakes and FD.

• The Journal of Internal Korean Medicine
• /
• v.40 no.5
• /
• pp.814-821
• /
• 2019

Objective: This case study reports on the result of Korean medicine treatment of diffuse esophageal spasm. Methods: A 46-year-old female Korean patient with diffuse esophageal spasm received electroacupuncture, herbal medicine, and moxibustion treatment for 2 weeks in hospital. Results: Decreases in the visual analog scale (VAS) (from 8.7 to 7.0), numeric rating scale (NRS) (from 7.0 to 5.5), gastrointestinal symptom rating scale (GSRS) (from 9 to 6), and gastroesophageal reflux disease-health related quality of life questionnaire (GERD-HRQL) (from 46 to 38) scores were observed after the treatment. Conclusion: Evaluation of Korean medicine treatment is worthwhile for rare diseases like diffuse esophageal spasm.

• Journal of Gastric Cancer
• /
• v.22 no.3
• /
• pp.220-234
• /
• 2022

Purpose: The incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased in recent years, and the optimal surgical strategy for AEG remains highly controversial. We aimed to evaluate the safety and efficacy of proximal gastrectomy with double-tract reconstruction (PG-DT) for the treatment of patients with AEG. Materials and Methods: We retrospectively analyzed patients with Siewert type II/III AEG between January 2013 and July 2018. Clinicopathological characteristics, survival, surgical outcomes, quality of life (QOL), and nutritional status were compared between the PG-DT and total gastrectomy with Roux-en-Y anastomosis (TG-RY) groups. Results: After propensity score matching, 33 patients in each group were analyzed. There were no statistical differences between the 2 groups in terms of disease-free survival and overall survival. The surgical option was not an independent prognostic factor based on the multivariate analysis. In addition, no differences were found in terms of surgical complications. There were no significant differences in QOL assessed by the Visick grade, Gastrointestinal Symptom Rating Scale, or endoscopic findings. Furthermore, the long-term nutritional advantage of the PG-DT group was significantly greater than that of the TG-RY group. Conclusions: PG-DT is a safe and effective procedure for patients with local Siewert type II/III AEG, regardless of the TNM stage.