• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8613-8618
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• 2016

Background: The symptoms of small bowel malignancies are mild and frequently nonspecific, thus patients are often not diagnosed until the disease is at an advanced stage. Moreover, the lack of sufficient studies and available data on small bowel cancer makes diagnosis difficult, further delaying proper treatment for these patients. In fact, only a small number of published studies exist, and there are no studies specific to Thailand. Radiologic and endoscopic studies and findings may allow physicians to better understand the disease, leading to earlier diagnosis and improved patient outcomes. Objective: To retrospectively analyze the clinical, radiologic, and endoscopic characteristics of small bowel cancer patients in Thailand's Siriraj Hospital. Materials and Methods: This retrospective analysis included 185 adult patients (97 men, 88 women; mean age = $57.6{\pm}14.9$) with pathologically confirmed small bowel cancer diagnosed between January 2006 and December 2013. Clinical, radiologic, and endoscopic findings were collected and compared between each subtype of small bowel cancer. Results: Of the 185 patients analyzed, gastrointestinal stromal tumor (GIST) was the most common diagnosis (39.5%, n=73). Adenocarcinoma was the second most common (25.9%, n = 48), while lymphoma and all other types were identified in 24.3% (n = 45) and 10.3% (n = 19) of cases, respectively. The most common symptoms were weight loss (43.2%), abdominal pain (38.4%), and upper gastrointestinal bleeding (23.8%). Conclusions: Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST. Obstruction and ulcerating/circumferential masses were findicative of adenocarcinoma, as revealed by radiology and endoscopy, respectively. Finally, no specific symptoms were related to lymphoma.

• Journal of Korean Medical classics
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• v.19 no.2 s.33
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• pp.248-265
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• 2006

Impulse of ki refers to palpitation around the navel, it is mostly caused by impairment of yang due to erroneous sweating, deficiency of the spleen yang. Behcet's syndrome caused by prolonged damp-heat and pathogenic germs. Its symptoms are characterized by conjunctival congestion, blue canthus and ulceration of the oral cavity, restlessness all the time, etc. It is advisable to follow the therapeutic principles of clearing away heat and drying damp, detoxicating and sterilizing. Lily disease is one of the emotional disease. It caused by yin deficiency of the heart and lung, found in mental depression or convalescence after a critical disease. Its symptoms are characterized by restlessness, reticence, insomnia, failure to walk, poor appetite, a subjective hot or cold, bitter taste and dark urine. It is advisable to follow the therapeutic principle of nourishing yin to clear away heat. Cholera refers to the disease marked by sudden severe vomiting and diarrhea, and colic of the heart and the abdomen. It is mostly caused by deficiency of the ki in the middle-energizer, emotional stress, etc. It is characterized by such symptoms as sudden severe vomiting and diarrhea, restlessness, etc. It is advisable to follow the therapeutic principles of warming yang and removing toxic substances, and strengthening the spleen and stomach. Heat invasion of blood chamber due to affection of the exterior pathogens, pathogenic heat invading the blood in deficiency and fighting with the blood. Its symptoms are marked by fever, feeling of the fullness, etc. There are deficiency of blood, hot blood and stasis of blood. The different therapeutic treatment should be taken according to different types thereof.

• Korean Journal of Biological Psychiatry
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• v.14 no.3
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• pp.194-200
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• 2007

Objectives:This study was performed to investigate the differences of the clinical feature between panic disorder with agoraphobic patients and panic disorder without agoraphobic patients. Methods:Two hundred nine patients meeting the criteria of DSM-IV panic disorder were recruited. One group was panic disorder with agoraphobia(n=78, 42 male(53.8%), mean age $37.6{\pm}9.9$ years), another was panic disorder without agoraphobia(n=131, 81 male(61.8%), mean age $40.5{\pm}10.3$ years). The numbers and frequency of panic symptoms were compared between two groups with t-test, and the logistic regression analysis were used for predicting panic disorder with agoraphobia. Results:The number of panic symptoms during panic attack was significantly higher in the group of panic disorder with agoraphobia than the group of panic disorder without agoraphobia(p<0.05).'Sweating','nausea or abdominal distress','fear of losing control of going crazy','chills or hot flushes'were more frequent in the group of panic disorder with agoraphobia(p<0.05). Among panic symptoms on logistic regression analysis,'sweating',' nausea or abdominal distress','fear of losing control or going crazy'turned out to correlate significantly with risk of development of agoraphobia in panic disorder. Conclusion:These results suggest that the frequency of some symptoms during panic attack may be a predictor of agoraphobia in patients with panic disorder.

• Clinical and Experimental Pediatrics
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• v.48 no.1
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• pp.63-67
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• 2005

Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.868-876
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• 2020

The purpose of this study was to report the clinical effects of Korean medicine on a patient who suffered from Early Dumping Syndrome with diarrhea, abdominal pain, anorexia, and insomnia after gastrectomy. The patient was treated with herbal medicine, acupuncture and moxibustion use in combination with Western medicine for 4 weeks. Though anorexia was maintained at a similar level, other clinical symptoms (diarrhea, abdominal pain, and insomnia) were improved after Korean medicine treatment. Therefore, Korean medicine may be effective for treatment of Early Dumping Syndrome after gastrectomy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.3
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• pp.193-196
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• 2015

A fecaloma refers to a mass of accumulated feces that is much harder than a mass associated with fecal impaction. Fecalomas are usually found in the rectosigmoid area. A 10-year-old male with chronic constipation was admitted because of increasing abdominal pain. An abdominal computed tomography scan and a simple abdominal x-ray revealed rapidly evolving mechanical obstruction in the small intestine. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, surgical intervention may be needed. In this case, an emergency operation was performed and a $4{\times}3{\times}2.5cm$ fecaloma was found in the distal ileum. We thus report a case of ileal fecaloma inducing small bowel obstruction in a patient with chronic constipation, who required surgical intervention. When symptoms of acute small intestinal obstruction develop in a patient with chronic constipation, a fecaloma should be considered in differential diagnosis.

• The KIPS Transactions:PartB
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• v.10B no.2
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• pp.197-204
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• 2003

Because most conventional systems of medical diagnosis focus on small subsets of classes of diseases of particular human organs, it is difficult to diagnosis when dealing with symptoms are related to many diseases. The author proposes an intelligent diagnosis system for diseases associated with acute abdominal pain based on fuzzy relational products (IDS-DAAP) to implement conventional system (DS-DAAP). Compared with DS-DAAP, new approach with IDS-DAAP shows that the system proposed here improves diagnosis rate and reduces diagnosis time.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.6
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• pp.510-518
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• 2022

Purpose: Recently, great interest has been focused on dietary fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) for the treatment of functional abdominal pain (FAP). Several meta-analyses, including those on the adult population, have been published, potentiating its role. However, pediatric studies are scarce. We aimed to evaluate the effect of a low-FODMAP diet on the severity of FAP in children. Methods: This clinical trial included 50 patients aged 3-18 years with irritable bowel syndrome and FAP that were not otherwise specified. The patients were instructed to receive a low FODMAP diet guided by a dietitian. The primary outcome was the percentage of responders after 2 months of dietary intervention compared with baseline. Other outcomes included changes in stool consistency and quality of life (QoL) scores using the KIDSCREEN-10 questionnaire, and weight-for-age z-scores. Results: After the dietary intervention, 74% of patients showed more than 30% lower pain intensity, as examined using the Wong-Baker Faces pain rating scale. Their QoL significantly improved, and patients have gained weight. Conclusion: A low FODMAP diet can improve pain intensity and QoL among children with functional abdominal pain, with no detrimental effects on body weight.

• Journal of Physiology & Pathology in Korean Medicine
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• v.37 no.1
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• pp.19-24
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• 2023

Postoperative adhesive small bowel obstruction (ASBO) is an intractable disorder which sometimes leads to adhesiolysis or small bowel resection. These therapeutic reoperations, however, also have many limitations including complications. An 80-year-old female, who had undergone 4-abdominal surgeries, visited the hospital with continuous vomiting. Based on her clinical symptoms and history, multiple air-fluid levels and distention of the small bowel in an abdominal X-ray, we diagnosed her with postoperative incomplete ASBO. We conducted acupuncture and an herbal medicine enema to stimulate bowel movement and relieve pain. The patient came in complaining of abdominal pain and vomited more than 10 times on hospital day 0 stopping on hospital day 4. Comparing hospital day 0 with hospital day 4, the abdominal pain decreased from a numerical rating scale (NRS) 10 to 4. There were no side effects such as redness or burns during the treatment process. This study presented an acupuncture-based treatment will be helpful for clinicians managing cases of ASBO with poor performance in elderly individuals.