• Korean Journal of Psychosomatic Medicine
• /
• v.20 no.2
• /
• pp.135-138
• /
• 2012

The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).

• Journal of Chest Surgery
• /
• v.38 no.7 s.252
• /
• pp.514-517
• /
• 2005

Gastrointestinal stromal tumor is documented on every part of the gastrointestinal tract. It develops in the stomach and the small intestine most commonly, and also in the esophagus. A 44 year-old male patient was admitted due to dysphagia and weight loss. Chest CT showed about $15\times11\times11cm$ sized, well-defined, and lobulated soft tissue mass with central necrosis was noted in the posterior wall of lower esophagus throughout the lesser curvature of upper stomach. We performed the distal esophagectomy and total gastrectomy using thoracoabdominal incision. The tumor was positive at CD117 (c-kit) and CD 34, and was diagnosed as malignant GIST of the distal esophagus and upper stomach. The patient is on routine follow up at the out patient department for nineteen months up to now.

• The Korean journal of helicobacter and upper gastrointestinal research
• /
• v.18 no.4
• /
• pp.225-230
• /
• 2018

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

• Journal of Chest Surgery
• /
• v.34 no.2
• /
• pp.189-193
• /
• 2001

위기관지 누공은 매우 드문 질환으로 대부분의 경우 외상, 상부위장관 수술, 횡경막하 농양, 양성 위궤양, 신생물 등 이 원인으로 생각된다. 식도암의 Ivor Lewis 수술후 2년과 3년에 양성 위궤양으로 인해 발생한 재발성 위기관지 누공 1예를 문헌고찰과 함께 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.9 no.2
• /
• pp.169-175
• /
• 2006

Purpose: Esophagogastroduodenoscopy (EGD) is a very useful procedure in diagnosing gastrointestinal diseases. However, there can be some difficulty in performing this procedure in children due to the associated discomfort. Recently, sedative agents such as midazolam have been introduced to alleviate this problem quite successfully. In our study, we attempted to confirm the safety and efficacy of midazolam use by monitoring the vital signs of children undergoing endoscopy. Methods: We analyzed data on 244 children who received EGD in the department of pediatrics at Severance Hospital, Yonsei University between August 2003 and July 2005. We evaluated $O_2$ saturation, heart rate and change of mental status before and during the procedure and analyzed the results using the SPSS 12.0 package (Chi-square test, cross table method, etc.). Results: There was no significant difference in vital signs measured before and during EGD between midazolam treated and non treated children. There was no significant relationship between the amount of midazolam given and $O_2$ saturation or a change of mental status. Regarding the $O_2$ saturation, it was decreased during EGD in both groups with p<0.01 though no difference was noted between the groups; the $O_2$ level was maintained above 95% in all patients. The heart rate was also increased during EGD in both groups with a p<0.01; however, no significant difference was noted between the groups. Conclusion: We confirmed the safety of low dose midazolam by evaluating the vital signs of children during endoscopies. However, the doses used were not sufficient for sedation or to obtain an amnestic effect.

• Journal of The Korean Radiological Technologist Association
• /
• v.28 no.1
• /
• pp.104-111
• /
• 2002

PURPOSE : The purpose of this study is to evaluate the value of the transabdominal sonography of the upper GI tract together with the abdominal examination in screening test. MATERIALS & METHODS : The transabdominal sonography of the upper GI tract togeth

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.12 no.2
• /
• pp.156-162
• /
• 2009

Purpose: The aim of this study was to investigate the clinical usefulness of upper gastrointestinal (GI) endoscopy in children with Henoch-Sch$\"{o}$nlein purpura (HSP). Methods: We retrospectively analyzed the clinical, endoscopic, and histopathologic records of children with HSP who had been admitted to the Department of Pediatrics of Gil Hospital and underwent upper GI endoscopy between January 2002 and June 2009. Patients were classified into the following two groups for statistical analysis: duodenal involvement (+) and duodenal involvement (-). Results: Fifty-one children with HSP underwent upper GI endoscopy; the mean age was 7.2${\pm}$2.9 years. The upper GI endoscopy showed abnormalities of the duodenum in 38 cases (74.5%), 22 of which had duodenal ulcers. Among the biopsy specimens obtained from the duodenum of 37 cases, 13 cases (35.1%) had leukocytoclastic vasculitis, neutrophil debri, and/or extravasation of RBCs. Steroid use was more frequent in the duodenal involvement (+) group (86.8%) than the duodenal involvement (-) group (53.8%; p=0.02). The mean length of hospitalization was 13.9${\pm}$8.43 days in the duodenal involvement (+) group and 8.1${\pm}$4.62 days in the duodenal involvement (-) group (p=0.003). The recurrence rate was significantly higher in the duodenal involvement (-) group than the duodenal involvement (+) group (p=0.027), whereas none of the other study parameters, such as the age of onset, renal involvement, and steroid use, led to significantly higher or lower recurrence rates. Conclusion: These results suggest that duodenal involvement can influence the clinical course and prognosis of HSP in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.4 no.2
• /
• pp.148-154
• /
• 2001

Purpose: Ingested foreign bodies present a common clinical problem. It is well known that most of them pass uninterrupted through the gastrointestinal tract. We evaluated the role of endoscopy and Foley catheter for removal of foreign bodies in the gastrointestinal tract. Methods: We investigated retrospectively 60 cases with foreign bodies in the gastrointestinal tract. They had been treated at Wonju Christian Hospital, Yonsei University of Korea, from January, 1996 through December, 1999. Results: The age of the patients ranged from 7 months to 13 years. Patients under 5 years were 57 cases (97%) and there was no significant difference in sex (M : F=1.07 : 1). 45 cases of the patients had no symptom. The most common foreign bodies were coins (43 cases). The most common location was esophagus (31 cases). The number of foreign body removal using flexible endoscopy and Foley catheter was 22 (36.7%) and 18 (30.0%) cases, respectively. In 18 cases (30.0%), foreign bodies passed spontaneously. Only 1 case (1.7%), curtain pin impaction at ileocecal region, required surgery. Conclusion: Early foreign body removal from esophagus and stomach is recommended to lessen the morbidity and complication. Fluoroscopic foley catheter technique and flexible endoscopy for removal of esophageal foreign bodies in children is safe and effective.

• Journal of Life Science
• /
• v.27 no.7
• /
• pp.812-816
• /
• 2017

Although amaranth, a red-colored tar dye, is usually used in foods, cosmetics, and pharmaceutics, its bioavailability and intestinal absorption have not previously been investigated. Therefore, the purpose of this study was to investigate the pharmacokinetics properties and intestinal permeability of amaranth in rats following the intravenous and oral administration of this dye. Amaranth rapidly disappeared from the plasma following the intravenous injection, with a half-life of 38.8 minutes. However, the plasma concentration of amaranth was increased to 400 minutes following the oral administration of amaranth, and the absorption time and bioavailability of amaranth were calculated to be 356 minutes and 55.6%, respectively. This suggests that once amaranth exists in the gut, this dye may be efficiently and effectively absorbed. Consistent with this result, the intestinal permeability of amaranth was comparable to atenolol, a marker compound of moderate permeability, and to one-third of caffeine's intestinal permeability (a highly permeable compound). In conclusion, a significantly long absorption time and substantial intestinal absorption of amaranth was observed following the oral administration of amaranth at a dose of 300 mg/kg in rats, despite the rapid elimination of this dye from the plasma. These results may suggest the necessity of a careful and limited use of amaranth dye when it is added to food, lip-care cosmetics, and orally administered pharmaceutics.

• Journal of Chest Surgery
• /
• v.35 no.12
• /
• pp.914-916
• /
• 2002

Actinomycosis of the lung is a chronic, suppurative granulomatous infection which is caused by Actinomyces israelii. It is believed to enter the thorax by way of the bronchial tree, by aspiration of contaminated aerosol particles in the upper digestive tract. Symptoms of chronic cough, sputum, hemoptysis, low grade fever, chest pain, and weight loss are common. Chest X-ray shows mass like lesion, pulmonary infiltration, abscess, and tuberculosis like lesion, which makes differential diagnosis from lung cancer very difficult. Surgical intervention is needed for the diagnosis and treatment, and diagnosis of actinomycosis is achieved when histologic examination reveals sulfur granules containing filamentous organisms. Penicillin is the drug of choice. Two or three months of penicillin treatment is recommended to treat the oropharyngeal or dental abscess to avoid recurrences. We present a case of actinomycosis which is suspected to malignant with review of literatures.