• 동의신경정신과학회지
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• 제33권1호
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• pp.21-31
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• 2022

Objectives: To perform correlation analysis between the Core Seven Emotions Inventory-Short Form (CSEI-s), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), upper gastrointestinal symptoms, and gastroscopic findings and to compare emotional characteristics with upper gastrointestinal endoscopic findings. Methods: In this study, medical records of 38 participants who visited the hospital for examination purposes or complained upper gastrointestinal symptoms and completed the CSEI-s, BAI, BDI, and Questionnaire for upper gastrointestinal symptoms were analyzed using SPSS (Statistical Package for the Social Sciences) version 25.0. Frequency Analysis, Descriptive Analysis, Independent t-test, Mann-Whitney's U-test, and Correlation analysis were performed. Results: The upper gastrointestinal symptom group showed higher levels of anger, sorrow, depression, and anxiety than the asymptomatic group. On gastroscopy, the normal group had higher levels of Joy than the abnormal group. The reflux esophagitis group showed higher levels of thought, depression, sorrow, and anxiety than the non-reflux esophagitis group. Joy showed a negative correlation with BDI score. However, anger, depression, sorrow, BAI, and BDI score showed positive correlations. Conclusions: Results of this study suggest that CSEI-s can be used to treat patients with upper gastrointestinal symptoms and reflux esophagitis.

• Journal of Acupuncture Research
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• 제30권2호
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• pp.31-41
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• 2013

Objectives : This study was to evaluate inhibitory effects of Naegwan-acupuncture($PC_6$) on acute RE(reflux esophigitis) rat induced by pylorus and forestomach ligation operation. Methods : Twenty seven SD rats were divided three groups (intact normal rat; RE control rat; RE control rat respectively stimulated by Naegwan point($PC_6$)). All rats was fasted for 18 h but free water, we induced RE by pylorus and forestomach ligation operation. Six hour after the operation, rats were sacrified, collected bloods in the abdominal vein, dissected a esophagus and stomach. The stomach was washed a 1 ml PBS to research gastric volume, pH, acidity and mucin release of gastric juice, esophagus was cut longitudinally and pictured a innter mucosa area to research damages in esophagus. The proinflammatory cytokine and chemokine including IFN-${\gamma}$, TNF-${\alpha}$, IL-$1{\beta}$, IL-6 and MCP-1 were analyzed by ELISA kit. Results : 1. Significantly, death rate of $PC_6$ acupuncture rat group was decreased compared to that of RE control group. 2. Gastric Volume, gastric injury and esophageal mucosa demage were decreased significantly, too. 3. Compared with RE, all of the proinflammatory cytokine and chemokine analyzed in serum of $PC_6$ were decreased remarkably. Especially, there were significant meanings TNF-${\alpha}$, IL-6 and MCP-1 in serum of $PC_6$ were decreased. Conclusion : The results suggest that antiinflammatory and protecting effects of PC6 could attenuate the severity of reflux esophagitis and prevent the esophageal mucosal damage, and validate its therapeutic use in esophageal reflux disease.

• Journal of Chest Surgery
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• 제34권11호
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• pp.843-847
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• 2001

배경: 식도질환의 수술 후 식도재건술은 아직도 식도수술에 관여하는 외과의사에게 해결해야 될 부분이 많이 있다. 1996년 1월부터 1999년 12월가지 흉부식도암환자 27명에서 흉부식도절제술 후 15예의 식도-위 문합술과 12예의 유리총장 이식술을 시행하였다. 저자들은 식도암 수술 후 문합부 누출, 문합부위의 협착, 역류성식도염, 수술시간, 호흡기 합병증 등을 양 군을 나누어 비교하였다. 대상 및 방법: 고식적 우회술 또는 식도인공삽입술, 인두식도와 식도 위 결합부위의 암은 본 연구에서 제외하였다. 우측 개흉술로 식도를 절제하였고, 자동봉합기를 사용하여 식도-위 문합을 시행하였다. 유리공장이식술의 경우 근위부의 식도는 6예에서 자동봉합기를 사용하였으며, 6예의 근위부와 12예의 원위부는 수기통합하였다. 모든 식도 재건술은 후종격동을 경유하였다. 결과: 3예의 수술사망을 포함하여 3예의 문합부 누출, 2예의 이식공장괴사 등 중한 합병증과 11예의 역류성 식도염, 5예의 문합부 협착이 발생되었다. 식도-위 문합술의 평균 수술시간은 300$\pm$160분, 유리공장이식술은 550$\pm$280분이었다. 결론: 역류성 식도염은 식도-위 문합군에서 더 많았고, 수술시간은 유리공장이식군에서 더 길었다(p<0.05). 적절한 환자의 선택과 장시간의 수술에 따르는 술 후 합병증을 줄일 수 있다면, 식도재건수술후의 역류식도염을 감소시키는 수술로 유리공장이식술이 우수하다고 판단된다.

• Gut and Liver
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• 제12권6호
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• pp.633-640
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• 2018

Background/Aims: Obesity is a risk factor for gastroesophageal reflux disease (GERD), with several studies demonstrating positive associations between body mass index (BMI) and GERD symptoms. However, little is known about the effect of BMI changes on erosive esophagitis (EE). In this study, we investigated whether BMI reduction could resolve EE. Methods: A retrospective cohort study was performed to assess the natural course of EE according to changes in BMI. Participants undergoing health check-ups from 2006 to 2012 were enrolled, and 1,126 subjects with EE were included. The degree of esophagitis was measured by upper endoscopy and serially checked over a 5-year follow-up. Logistic regression and Cox proportional hazards models were used to investigate the association between BMI reduction and EE resolution. Results: Substantial weight loss is associated with EE resolution. The adjusted odds ratio for EE resolution was 1.44 (95% confidence interval [CI], 1.09 to 1.92) among participants with a decrease in BMI compared to those with no decrease in BMI. The EE resolution rate was related to the degree of BMI reduction. The effect of weight loss on EE resolution was higher among subjects who lost more weight. Compared with subjects with no decrease in BMI, the hazard ratios for EE resolution were 1.09 (95% CI, 0.89 to 1.35), 1.31 (95% CI, 1.01 to 1.72) and 2.12 (95% CI, 1.44 to 3.12) in subjects with BMI reductions of ${\leq}1$, 1-2, and >$2kg/m^2$, respectively. Conclusions: EE resolution is associated with a decrease in BMI, and weight loss is potentially an effective GERD treatment.

• Journal of Chest Surgery
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• 제39권12호
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• pp.920-926
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• 2006

배경: 식도-위 문합의 수술기법 향상과 술 후 관리기법의 발전은 문합부 누출, 폐렴 등의 위험한 조기 합병증을 감소시켰지만, 수술 후 환자의 삶의 질에 중요한 영향을 미치는 문합 부위의 협착 또는 위식도 역류에 의한 증상은 상대적으로 간과되고 있는 경향이 있다. 본 연구에서는 점차 중요시되고 있는 식도암 환자의 수술 후의 삶의 질과 관련하여 식도-위 문합부의 협착과 역류를 종합적으로 분석하여, 식도-위 문합술의 질적 평가를 시행하고 관련된 인자들에 대한 분석을 하고자 하였다. 대상 및 방법: 고려대학교 구로병원에서 1995년 1월부터 2004년 12월까지 식도 절제술 후 식도-위 문합술을 시행 받은 환자들 중, 외래 추적 기간 중 내시경을 시행 받은 53명을 대상으로 환자들의 병력, 수술 후 투약내용, 문합 위치, 문합 방법, 내시경 소견상 역류성 식도염의 존재 여부와 문합부 협착 유무 및 시행되어진 중재적 시술에 대해 조사하였다. 결과: 총 53명의 환자 중 남자 환자가 85%(n=45)였고, 수술 당시 연령은 $60.3{\pm}8.87$세($39{\sim}81$세)였다. 평균 추적관찰 기간은 $29{\pm}23.6$개월($5{\sim}111$)이었다. 식도-위 문합을 흡수성 봉합사로 시행한 경우가 23명이었고 EEA를 이용한 경우가 30명이었으며, 문합 방법에 따른 협착이나(p=0.64)이나 역류성 식도염의 빈도 차이는 없었다(p=0.41). 문합 위치가 경부인 경우는 26명, 흉부인 경우는 27명이었으며, 문합 위치에 따른 협착의 빈도는 차이가 없었으나(p=0.44), 역류성 식도염은 경부 문합 26명 중 3명(12%)에서만 발견되어 흉부 문합군(52%)에 비해 통계적으로 유의한 차이를 보였다(p<0.01). 결론: 식도-위 문합 시 경부 문합은 흉부 문합에 비해 문합부 협착의 빈도는 차이가 없고, 역류성 식도염의 빈도는 현저히 적으며, 식도암의 경우 더 여유 있는 절제면을 제공할 수 있는 장점이 있으리라 판단된다. 따라서 식도절제술 및 위-식도 문합 시 특별한 금기증에 해당하지 않는다면 경부 문합을 선호할 수 있을 것으로 생각된다. 문합 방법에 따른 역류성 식도염과 협착의 빈도에서는 유의한 차이를 발견할 수 없었으나, 수술 시간의 단축 등의 몇몇 장점으로 인해 기계 문합을 선호할 수 있을 것으로 생각된다. 향후 식도암의 수술 기법과 술 후 관리의 향상으로 인하여 문합 부위의 역류로 인한 증상과 환자의 일상 생활의 질에 대한 중요성이 지속적으로 강조될 것으로 생각되며, 이에 따른 적극적인 anti-reflux 수술에 대한 고려도 필요할 것으로 생각된다.

• 대한기관식도과학회지
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• 제19권1호
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• pp.11-14
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• 2013

Gastro-esophageal reflux disease (GERD) is a recurrent, long-term gastrointestinal condition characterised by the abnormal reflux of stomach contents into the esophagus. Heartburn is the most dominant symptom, which can be life long and can considerably reduce quality of life. The main goals of treatment are to alleviate symptoms and prevent relapses, esophageal stricture and adenocarcinoma. This paper presents a review comparing the effectiveness of omeprazole with Nissen fundoplication surgery for the treatment of GERD. Nissen fundoplication is more effective in controlling heartburn symptoms, healing esophagitis and preventing relapses than omeprazole. Quality of life, in terms of productivity and ability to work, is difficult to assess in the omeprazole group and, as a result, a comparison of this aspect is limited. Although fundoplication is expensive in the short term, it is more cost-effective than omeprazole. Nurses need to be aware of the effectiveness of omeprazole and fundoplication to provide patients with accurate information, which assists patients in decision making regarding treatment options.

• 대한약학회:학술대회논문집
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• 대한약학회 2002년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2
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• pp.265.2-265.2
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• 2002

It is well known that flavonoids are the inhibitory effects on inflammations. This study was designed to determine the anti-inflammatory effects of luteolin-7-O-${\beta}$D-glucuronopyranoside (LGC). newly synthesized flavonoids. which was extracted from Salix gilgiana leaves. We investigated the protective action of LGC on reflux esophagitis and gastritis in rats. Esophagitis and gastritis were induced by surgical procedures and the exposure to indomethacin (50 mg/kg), respectively. LGC was injected intraduodenally immediately after the surgical procedures and the exposure to indomethacin (omitted)

• Journal of Gastric Cancer
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• 제20권1호
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• pp.72-80
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• 2020

Purpose: Proximal gastrectomy (PG) is a function-preserving surgery in cases of proximally located early-stage gastric cancer. Because gastroesophageal reflux is a major pitfall of this operation, we devised a modified esophagogastrostomy (EG) anastomosis to fix the distal part of the posterior esophageal wall to the proximal part of the anterior stomach wall to produce an anti-reflux mechanism; we named this the SPADE operation. This study aimed to show demonstrate the clinical outcomes of the SPADE operation and compare them to those of previous PG cases. Materials and Methods: Case details of 56 patients who underwent PG between January 2012 and March 2018 were retrospectively reviewed: 30 underwent conventional esophagogastrostomy (CEG) anastomosis using a circular stapler, while 26 underwent the SPADE operation. Early postoperative clinical outcome-related reflux symptoms, endoscopic findings, and postoperative complications were compared in this case-control study. Results: Follow-up endoscopy showed more frequent reflux esophagitis cases in the CEG group than in the SPADE group (30% vs. 15.3%, P=0.19). Similarly, bile reflux (26.7% vs. 7.7%, P=0.08) and residual food (P=0.01) cases occurred more frequently in the CEG group than in the SPADE group. In the CEG group, 13 patients (43.3%) had mild reflux symptoms, while 3 patients (10%) had severe reflux symptoms. In the SPADE group, 3 patients (11.5%) had mild reflux symptoms, while 1 had severe reflux symptoms (absolute difference, 31.8%; 95% confidence interval, 1.11-29.64; P=0.01). Conclusions: A novel modified EG, the SPADE operation, has the potential to decrease gastroesophageal reflux following a PG.

• Journal of Gastric Cancer
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• 제9권4호
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• pp.215-222
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• 2009

목적: 원위부 위절제술 후 재건술의 하나인 Billroth II 위공장문합술은 오랫동안 사용되어온 방법이나 역류성 위염의 빈도가 높다는 것이 문제점 중의 하나이다. 이를 보완하기 위한 여러 시도가 있었으나 그 중 잔위의 크기에 따라 Roux-en-Y 위공장문합술, Braun 공장문합술 및 Billroth II 위공장문합술을 달리 시행한 후 그 적용의 적합성을 알아보고자 하였다. 대상 및 방법: 2003년 9월부터 2007년 4월까지 하부 및 중위 위선암으로 단일 술자에 의해 원위부 위절제를 받은 후 잔위의 크기가 10% 이하일 때 Roux-en-Y 위공장문합술 (14명)을, 잔위가 10~20%일 때 Braun 공장문합술(17명)을, 잔위가 20~40%일 때 Billroth I이 부적합하다고 판단된 경우 - Billroth II 위공장문합술(14명)을 시행 후, 각각의 치료성적을 분석하였다. 분석 방법은 전화 설문과 의무기록을 조사하여 환자의 증상 및 내시경 소견을 평가하였고 술 후 영양 상태를 평가하기 위하여 혈중알부민, 혈색소농도 및 체중의 변화를 측정하였다. 결과: 수술 사망률 0%, 수술 합병률 8.9% (4/45)로 모든 수술은 안전하게 시행되었다. 내시경 소견에서 역류성 위염은 Roux-en-Y군, Braun군 및 Billroth II군에서 각각 7.63%, 18.65%, 40.0%에서 보였다(P=0.13). 가벼운 역류성 식도염이 Roux-Y군과 Braun군에서 각각 1명씩 있었다. 내시경적 위저류는 Roux-en-Y군에서 2예가 보였으며 이 중 1예는 역류성식도염의 원인이 되었다. Roux-en-Y군과 Braun군이 Billroth II 군보다 식사량의 감소가 적었으며(각각 7.1%, 0.0%, 28.7%, P=0.036), 식후 불편감(각각 14.3%, 23.5%, 57.1%, P=0.035)과 역류 증상(각각 0.0%, 11.8%, 42.9%, P=0.009)을 적게 호소하였다. 결론: 작은 잔위를 가지는 환자에서 시행된 Roux-en-Y 위공장문합술과 Braun 공장문합술은 역류증상의 방지와 위절제 후 불편감을 줄이는데 효과적이라고 생각하며, 10% 미만의 잔위에서는 Roux-en-Y를, 그 외의 경우에는 Braun 문합을 확대적용을 고려하는 것이 좋겠다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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• pp.511-517
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• 2019

Purpose: On the basis of evidence, we aimed to reevaluate the necessity of the empirical proton pump inhibitor (PPI) trial for children with suspected gastroesophageal reflux disease (GERD). Methods: We analyzed the frequency of GERD in 85 school-age children with gastroesophageal reflux (GER) symptoms, who received 24-hour esophageal pH monitoring and/or upper endoscopy. According to the reflux index (RI), the children were classified into normal (RI <5%), intermediate (5%${\leq}$ RI <10%), or abnormal (RI ${\geq}$10%) groups. Results: Fifty six were female and 29 were male. Their mean age was $12.6{\pm}0.5$ (${\pm}$standard deviation) years (range: 6.8-18.6). The RI analysis showed that the normal group included 76 patients (89.4%), the intermediate group included 6 patients (7.1%), and the abnormal group included 3 patients (3.5%). The DeMeester score was $5.93{\pm}4.65$, $14.68{\pm}7.86$ and $40.37{\pm}12.96$ for the normal, intermediate and abnormal group, respectively (p=0.001). The longest reflux time was $5.56{\pm}6.00$ minutes, $9.53{\pm}7.84$ minutes, and $19.46{\pm}8.35$ minutes in the normal, intermediate, and abnormal group, respectively (p=0.031). Endoscopic findings showed reflux esophagitis in 7 patients. On the basis of the Los Angeles Classification of Esophagitis, 5 of these patients were included in group A, 1 patient, in group B and 1 patient, in group C. Conclusion: The incidence of GERD was very low in school-age children with GER symptoms. Therefore, injudicious diagnostic PPI trials would be postponed until the actual prevalence of GERD is verified in future prospective studies.