Lee, Jin Beom;Lee, Yong Soon;Yoo, Eun Sun;Kim, Hae Soon;Son, Se Jeong;Park, Eun Ae;Lee, Seung Joo;Sung, Sun Hee;Seo, Jeong Wan
Clinical and Experimental Pediatrics
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v.45
no.4
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pp.466-472
/
2002
Purpose : The diagnosis of Meckel's diverticulum is difficult and delayed because it presents with various clinical symptoms. We evaluated clinical, imaging and pathologic findings of Meckel's diverticulum to facilitate detection of Meckel's diverticulum in children. Methods : Review of clinical, imaging, surgical and pathological findings in 10 children aged 7 days to 14 years with Meckel's diverticulum during an 8-year period, 1993-2001, at Ewha Womans University Hospital was undertaken. Results : The male to female ratio was 2.3 : 1. The chief complaint was painless lower gastrointestinal( GI) bleeding; others were abdominal pain, abdominal distention and vomiting, in order of frequency. The diagonsis before surgery were Meckel's diverticulum in 5 patients, non-reducible intussusception in 3 patients and intestinal obstruction in 2 patients. The diverticulum was located between 35 cm to 70 cm proximal to the ileocecal valve. The length of the diverticulum ranged from 4 cm to 12 cm and 80% of it was within 5 cm. A Meckel scan($^{99m}Tc-pertechnetate$ scintigraphy) after cimetidine administration was done in 6 cases. All 5 cases that presented with lower GI bleeding had ectopic gastric mucosa confirmed on pathology. Out of 5 cases of ectopic gastric mucosa, only 4 cases were positive on the Meckel's scan. Conclusion : In cases of unexplained GI bleeding, obstruction, or inflammation diagnostic workup should be carried out to rule out Meckel's diverticulum. Laparoscopy, high resolution ultrasonography and computed tomography of the abdomen may be indicated in the assessment of pediatric patient with lower GI bleeding, especially in patients with suspected bleeding from Meckel's diverticulum showing negative Meckel's scan.
The aim of this study was to investigate the dietary and lifestyle factors related to bowel pattern of female high school and college students in Gyeonggi Province. The total of 202 self-administered questionnaires (high school students 77 ; college students 125) were analyzed. All respondents were devided into four groups based on their self-reported pattern of defecation: 18 subjects ($9.0\%$) comprised the normal group, 73 ($36.1\%$) the constipation group, 73 ($36.1\%$) the constipation/diarrhea group, and 38 ($18.8\%$) the diarrhea group. Regularity of exercise was significantly higher in the college students than high school students, and times spending on a chair were longer in the high school students than college students. Most students ($72.7\%$) reported that they had stress. Fourty point six percent of the subjects reported that they had 3 meals per day, which tended to be higher in the normal and diarrhea group than constipation and constipation/ diarrhea group. Most students (69.7) skipped breakfast which was lower in the normal group than the other groups. The most preferred dietary fiber food was korean cabbage kimchi. Fifty-eight point four percent of the subjects reported that they had irregular bowel movement. Bowel movement was more irregular in the high school students than college students, and in the constipation group than the other groups. Of the subjects, $77.7\%$ had defecation frequency between three per week and three per day. Those who spent within 10 minutes for defecation were $79.6\%$, and those had difficulty in evacuating were $76.0\%$. High school students and those with constipation and constipation/diarrhea had a significantly lower defecation frequency, longer time spent at the toilet, and greater difficulty in evacuating than college students and normal and diarrhea group. The percentage of those who had feelings of residue in the intestine after defecation was $92.5\%$, and it was greater in the constipation or diarrhea group than in the normal group. Most students ($93.5\%$) reported that they had abdominal pain or discomfort. These results suggest that decreasing times spending on a chair, decreasing stress, keeping 3 meal per day at regular hours, and increasing dietary fiber intake are associated with desirable bowel pattern.
A 40 year-old male patient admitted for dyspnea and edema of the lower extremities. A pulsatile abdominal mass with a bruit was palpable in the right lower quadrant. Four months previously, he had underwent left partial lam-inectomy ($L4{\sim}5$) and discectomy at the L4 level due to disc protrusion, Computed tomography showed an ilio-iliac AV fistula with pseudoaneurysm at the L5 level. Because massive bleeding occurred when the aneurysm was entered, we closed the aneurysm and performed resection and suture of the aorta and both iliac arteries very near the aneurysm. After exclusion of the arterial side, we performed reduction angioplasty at the aneurysm and aorto-biiliac reconstruction with an artifcial graft. Twenty-four months after operation, he is doing well and hasn't had any complications on the follow-up.
Purpose: Alvarado scoring system was evaluated regarding its usefulness for the early diagnosis of acute appendicitis in adult and in reduction of the incidence of negative appendicectomies. To evaluate the accuracy of diagnosing appendicitis using the Alvarado score in children. Methods: Prospectively, we surveyed 122 patients (male 67, female 55) suffering from abdominal pain, who had visited to the emergency department of Chosun University Hospital from June 2002 to May 2003. The Alvarado score has been computed from the white blood cell count, neutrophil count, body temperature, resistance in the right lower quadrant, length of symptoms, nausea and vomiting. Each patient was evaluated by a pediatric resident and then by a general surgeon independently. Results: Out of 170 total children who visited to the emergency department due to abdominal pain, 122 patients were associated with appendicitis. A total of 122 patients (67 male and 55 female) were visited to the emergency room with suspected appendicitis. From 105 operated patients, 92 (87.6%) were diagnosed acute appendicitis and erronous diagnostic rate was 12.4%, pathologically. Mean alvarado score of appendicitis group was $5.40{\pm}1.24$ whereas those of non-appendicitis group was $3.73{\pm}1.82$ (p<0.05). From 6 Alvarado score high sensitivity (86.4%) and high specificity (80.0%) were observed. Sensitivity of ultrasonography or computed tomography was 92.5%. Conclusion: We found that Alvarado score system is a noninvasive, safe diagnostic method, which is simple, reliable and repeatable. Alvarado score is useful system for a first, rapid and economic evaluation for the appendicitis in children.
Journal of Physiology & Pathology in Korean Medicine
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v.24
no.5
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pp.727-736
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2010
This study is about researching mechanistic pattern identification of disease for DongEuiBoGam NaeGyungPyen by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of uterine, urine and excrements parts of DongEuiBoGam NaeGyun gPyen in NaeGyungPyen of DongEuiBoGam are these. Menstrual irregularities in DongEuiBoGam can be classified flui d-humor depletion, blood deficiency, qi deficiency, qi stagnation, qi stagnation complicated by heat, blood stasis, blood deficiency complicated by heat, syndrome of heat entering blood chamber, syndrome of cold entering blood chamber. The disease pattern of abdominal pain after menstruation in DongEuiBoGam is blood deficiency complicated by heat, and a dysmenorrhea represents blood stasis with heat, fluid-humor deficiency. Advanced menstruation represent dual heat of the qi and blood, delayed menstruation is blood deficiency. The disease pattern of inhibited urination in DongEuiBoGam can be classified deficiency heat pattern of kidney yin deficiency(yin deficiency with effulgent fire), kidney qi deficiency, yin deficiency with yang hyperactivity, fluid-humor depletion, spleen-stomach dual deficiency, and excess he at pattern of bladder excess heat. The disease pattern of urinary incontinence in DongEuiBoGam can be classified deficiency pattern of kidney-bladder qi deficiency, consumptive disease, lung qi deficiency, kidney yin deficiency(yin deficiency with effulgent fire), kidney yang deficiency and excess pattern of lower energizer blood amassment, bladder excess heat. And most of them are deficiency from deficiency-excess Pattern Identification. The disease pattern of diarrhea in DongEuiBoGam can be classified deficiency pattern of qi deficiency, qi fall, spleen yang deficiency, kidney yang deficiency and so on and excess pattern of wind-cold-summerheat-dampness-fire, phlegm-fluid retention, dietary irregularities, qi movement stagnation. And most of them are deficiency from deficiency-excess Pattern Identification. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.
The conclusions were obtained from the detailed survey of 1,285 students experiencing menstruation, who were chosen among 1,717 students in middle & high school girls in Seoul. The survey was conducted during July 20-July 24, 1971. 1. Age of Menarche An average age of menarche was 13.3$\pm$1.07. The earliest age of menarche was 9 and the latest age 18. Ages of menarche were between 12 and 14 in 84.3 percent of the students surveyed. a. By present age distribution, the aged students were lower, than younger students in the average age of menarche. b. By father′s educational levels, among the students whose fathers were graduated from high schools, college & ever the earliest average age of menarche was found with 13.2, and among the students whose fathers were graduated from primary schools that wag latest with 13.6. c. By father′s occupations, among the students whose fathom engaged in "workers not classifiable"the earliest age of menarche was found with 12.5$\pm$0.27, among the students whose fathers were in "service business"the second was 12.9$\pm$1.07, and among the students whose fathers were in "miners, quarrymen and related workers"that was latest with 13.8$\pm$1.14. d. By economic status, among the students of "wealthy"families the age of menarche was 13.1$\pm$0.25, the among the students of "ordinary"families the lags of menarche 13.3$\pm$1.06. and the among the students of "poor" families that was 13.8$\pm$0.31. e. By home discipline, among the students being treated "rigid" the age of menarche was 13.5$\pm$1.13, among the students being treated "moderate"the age of menarche was 13.3$\pm$0.22, and those being treated "indifferent" that was 13.0$\pm$0.26. f. By students physical condition, among the students of "good" condition the average of menarche was 13.3$\pm$0.16, and among the students "poor" that was 13.5$\pm$0.31. 2. Menstruation a. For the six months after the average of menarche 39.0 percent of the students had normal menstruations, and 61.3 percent of them had abnormal ones. Of the students with abnormal menstruation 21.7 percent had abnormal menstruation from time to time, 25.4 percent had no menstruation for one month to three months, 7.2 percent had menstruation for four to six months and 6.7 per cent had no menstruation for more than sin months. Most students became to have normal menstruations a few months later the age of menarche. b. At the time interviewed, the percentile of cycle of menstruation as following: 23 days types: 46.8 percent 30 days types: 40.6 percent others : 12.6 percent The average cycle of menstruation was every 28.9 days. c. The average duration of menstruation is 4.69 days. d. The subjective symptoms during menstruation period: Out of the total 89.7 per cent had some pains, while 10.3 percent had no symptom. Among the symptoms, abdominal pain occupied 29.9 percent, neurotic symptoms 19.0 percent and lumbago 15.1 percent. e. By attitude or Action at first physical change, "Treated it by own experience" : 30.0 percent "Don′t know what to do because of ignorance" : 20.1 percent "Asked others about it" : 43.0 percent
Background: Gastric cancer is the most common gastrointestinal cancer and a leading cause of cancer mortality in Nepal. Survival of gastric cancer patients depends on the stage at which diagnosis is made. The aim of this study was to analyze the presentation and outcomes of gastric cancer patients treated at a tertiary care hospital in Nepal. Materials and Methods: A retrospective analysis of 140 consecutive histologically proven gastric adenocarcinoma cases managed at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal for the period of January 2009 to December 2013 was carried out. Results: One hundred forty out of the total 186 patients with histologically proven gastric adenocarcinoma, were admitted for surgery. The mean age was $59.6{\pm}12.4yrs$ (range 29 to 78 yrs) and the male: female ratio was 2:1. Sixty three (45%) patients featured Tibeto-Burman descent though this ethnic group accounts for only 18% of the Nepalese population. Two-thirds or more patients presented with abdominal pain, anorexia, weight loss and/or vomiting. In 86 (61.5%) of the patients the tumor was located in the lower $3^{rd}$ of the stomach and in only 15% of the patients the tumor was located at the upper $3^{rd}$. Early gastric cancer was diagnosed postoperatively in only 4%. In 54%, the disease was locally advanced and metastatic lesions were found in 14% of the patients. Subtotal (73) or total (11) curative gastrectomies (D1, D1+ or D2) were performed in 84 (60%) patients with average lymph node retrieval of $16.6{\pm}8.2$. Palliative gastrectomies or procedures were performed in 23% of the patients and no intervention (open & close/biopsy) was employed in 15% of the patients. Perioperative morbidity was seen in 10% and mortality in 4%. Three, four and five year survival rates up to the recent follow-up were 17.9%, 11.9% and 8.3%, respectively. Conclusions: Gastric cancer in Nepal is usually diagnosed at an advanced stage and has a poor prognosis. Thus, early detection is the key to improve the survival of gastric cancer patients.
Paclitaxel has been widely used for treating many solid tumors. Although colonic toxicity is an unusual complication of paclitaxel-based chemotherapy, the reported toxicities include pseudomembranous colitis, neutropenic enterocolitis and on rare occasions ischemic colitis. $Genexol-PM^{(R)}$, which is a recently developed cremophor-free, polymeric micelle-formulated paclitaxel, has shown a more potent antitumor effect because it can increase the usual dose of paclitaxel due to that $Genexol-PM^{(R)}$ does not include the toxic cremophor compound. We report here on a case of a 57-year-old man with advanced non-small cell lung cancer and who developed ischemic colitis after chemotherapy with $Genexol-PM^{(R)}$ and cisplatin. He complained of hematochezia with abdominal pain on the left lower quadrant. Colonoscopy revealed diffuse mucosal hemorrhage and edema from the sigmoid colon to the splenic flexure. After bowel rest, he recovered from his symptoms and the follow-up colonoscopic findings showed that the mucosa was healing. Since then, he was treated with pemetrexed monotherapy instead of a paclitaxel compound and platinum.
Kim, Hong-Tae;Kim, Ju-Wan;Jin, Tae-Won;Kim, Ji-Eun;Lim, Mee-Kyoung;Yeo, Sang-Geon;Jang, Kwang-Ho;Oh, Tae-Ho;Lee, Keun-Woo
Journal of Veterinary Clinics
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v.24
no.3
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pp.372-378
/
2007
The Artemisia capillaris THUNB is a perennial herb that belongs to the family Compositae spp and probably the most common plant among the various herbal folk remedies being used in the treatment of abdominal pain hepatitis chronic liver disease, jaundice and coughing in Korea. Recently the biological and pharmacological actions of herb have been studied well such as antibacterial, antidiabetic and antitumor activities. This experiment was conducted to investigate antitumor and immunomodulatory effects of Artemisia capillarix extracts against Hepa-1c1c7 and Sarcoma 180 cancer cells on in vivo experimental tests. On in vivo experimental tests using 280 ICR mice the gain of body weight in the control-group mice bearing Sarcoma 180 ascites tumor was 1.5 times more than that of the normal-group mice after 33 days. However, the gain of body weight in all experimental groups administered with Artemisia capillaris extracts was significantly lower than that of the control-group mice (P<0.05). The mean survival times of mice administered with Artemisia capillaris extracts of 25 and 100 mg/kg for 28 days were shown to be 25.39% and 15.39% longer than that of the control-group mice injected with saline (P<0.05). Artemisia capillaris extracts showed the highest tumor inhibition effects, which were 42.4% and 27.2% when intraperitoneally injected with doses of 25 and 100 mg/kg once a day for 28 days in inoculated ICR mice with Sarcoma 180 solid tumor cells (P<0.05). The results suggest that Artemisia capillaris methanol extracts have prominent antitumor effects on the cancer cell lines Hepa-1c1c7 and Sarcoma 180.
Since the first cases of tsutsugamushi disease reported in Korea in 1986. many cases has been reported and its occurrence has been increasing. Only 2 cases has been reported in Taegu city and Kyungpook area. We experienced an outbreak of 26 cases of tsutsugamushi disease in this area and their clinical manifestations are ; 1. The outbreak occurred in September to November in 1988 and its peak occurrence was in October. 2. Mean age was 52 years old (18 to 69 years old) and peak incidence was in the 6th decade. 3. Major symptoms and abnormal signs are fever/chills(88%), myalgia(65%), headache(54%), nausea and vomiting(31%), and abdominal pain(27%). The eschar was detected on lower part of body in most of cases. and more frequently in male(M : F 100 vs 58%). 4. Patients were treated with tetracyclines(TC) and/or chlorampenicol(CM) and mean duration of defervescence from initiation of antibiotic therapy was 2.1 days with TC and 2.5 days with CM. 5. Complications are 2 cases of meningitis and 1 cases of shock. and all cases were recovered without any sequlae. As above, tsutsugamushi disease occurs in Taegu city and Kyung Pook area as other part of Korea and clinical manifestations are similar to other reports.
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