• Title/Summary/Keyword: Digestive Symptoms

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Clinical, Radiologic, and Endoscopic Manifestations of Small Bowel Malignancies: a First Report from Thailand

  • Tangkittikasem, Natthakan;Boonyaarunnate, Thiraphon;Aswakul, Pitulak;Kachintorn, Udom;Prachayakul, Varayu
    • 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.

The Validity and Reliability of Reflux Symptom(RSI) Index and Reflux Finding Score(RFS) (역류증상지수와 역류소견점수의 타당성과 신뢰도)

  • Lee, Byung-Joo;Wang, Soo-Geun;Lee, Jin-Choon
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.18 no.2
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    • pp.96-101
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    • 2007
  • Laryngopharyngeal reflux (LPR) is the retrograde movement of gastric contents into the larynx, pharynx, and upper aero-digestive tract. LPR differs from gastroesophageal reflux in that it is often not associated with heartburn and regurgitation symptoms. Otolaryngological manifestations of acid reflux include a wide range of pharyngeal and laryngeal symptoms. Belafsky et al. developed a useful self-administered tool, the reflux symptom index (RSI), for assessing the degree of LPR symptoms. Patients are asked to use a 0 to 5 point scale to grade the following symptoms: 1) hoarseness or voice problems; 2) throat clearing; 3) excess throat mucus or postnasal drip ; 4) difficulty swallowing; 5) coughing after eating or lying down; 6) breathing difficulties ; 7) troublesome or annoying cough; 8) sensation of something sticking or a lump in the throat; 9) heartburn, chest pain, indigestion or stomach acid coming up. A RSI score greater than 13 is considered abnormal. As there is no validated instrument to document the physical findings and severity of LPR, Belafsky et al. developed an eight-item clinical severity scale for judging laryngoscopic finding, the reflux finding score (RFS). They rated eight LPR-associated findings on a scale from 0 to 4 : subglottic edema, ventricular obliteration, erythema/hyperemia, vocal-fold edema, diffuse laryngeal edema, posterior commissure hypertrophy, granuloma/granulation tissue, and thick endolaryngeal mucus. A RFS score of greater than 7 was found to suggest LPR-associated laryngitis. Although both indices (RSI and RFS) are widely used, there is some controversy about their validity (sensitivity and specificity) and reliability (intra-rater and inter-rater) in LPR diagnosis and treatment. We discuss the validity and reliability of RSI and RFS with literature review.

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The Analysis of MMPI and Clinical Study for Somatization Disorder and Depressive Disorder Patients (우울증성 장애 및 신체형 장애 환자에 대한 MMPI분석과 임상고찰)

  • Choe, Byeong-Man;Jung, In-Chul;Lee, Sang-Ryong;Park, Ji-Un
    • Journal of Oriental Neuropsychiatry
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    • v.13 no.2
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    • pp.41-56
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    • 2002
  • The Analysis of MMPI and Clinical Study was carried out the 28 patients with somatoform disorder and depressive disorder who were treated in Daejeon University Oriental Hospital from 19 June 2001 to 17 April 2002. The results were summarized as follows. 1. The ratio of female was higher, especially in the depressive disorder, the ratio of female was higher and in the age distribution, the 40 aged were higher frequence. 2. In the somatoform disorder, symptoms appeared to be busy in physical symptoms, and they were in descending order the digestive organs system, head and face portion and musculoskeletal system symptoms, in the depressive disorder, appeared to be busy in psychosomatic system symptoms and in the prescription drugs, soyosan(逍遙散), punsimkiyyin(分心氣飮) were used to be busy. 3. In the scales of L, F, K, somatoform disorder showed ${\wedge}$ typed graph, and depressive disorder showed ${\vee}$ typed graph. 4. In the somatoform disorder, scales of Hs, Hy, D, Pa were higher, and in the depressive disorder, scales of Hy, Hs, Pd, D were higher. 5. In the scales of Hs, D, Hy, somatoform disorder showed ${\vee}$ typed graph, and depressive disorder showed/typed graph. 6. the average of T-scores and the ratio over 65 score and 70 score showed common distribution.

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Distributions and Incidences of Elementary School Children with Lactose Intolerance Symptoms after Drinking Milk in Korea

  • Kim, Ki-Hwan;Choi, Ji-A;Kang, Seung-Beom;Lee, Kyung-Sang;Yoon, Sung-Sik
    • Food Science of Animal Resources
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    • v.31 no.6
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    • pp.893-898
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    • 2011
  • Milk contains a number of nutrients required for human growth and development, such as disaccharide lactose which is significantly contained in milk and dairy products. About two thirds of world populations are reportedly suffering from lactose intolerance after drinking milk. Lactose intolerance is defined as a maldigestion of lactose in the human intestine with typical symptoms of abdominal pains, bloating, and diarrhea. In this study, incidence of lactose intolerance has been investigated for the elementary school children for 1 year from July, 2010 to June, 2011. It is found that about 70% of the total elementary students have joined the school milk program. Out of 636 total students that participated in this study, 449 were from the metropolis, 85 from middle-sized city, and 102 from the small town including rural areas (small town/rural areas). For distributions of lactose intolerance, 154 students (24.2%) were found to be positive among the total 636 subjects. Based on the size of the city, the symptoms were the most prevalent for the students in the small town/rural areas at 31.4% (32/102), followed by 30.6% (26/85) in middle-sized city, and 21.4% (96/449) in the metropolis. On the other hand, gender had no significant effect on the incidence of lactose intolerance, shown those for boys and girls were 24.8% (77/310), 23.6% (77/326), respectively. Further research is needed to confirm the correct incidence of lactose intolerance symptoms as the frequency is significantly affected by subject's digestive functions including irritable bowel syndrome.

Distribution of Symptoms and Syndrome Differentiation Using Common Clinical Document Forms - Focused on Deficiency Syndrome Differentiation - (한의 공통 임상 기록 서식을 이용한 변증(辨證)과 증상(症狀)의 분포 조사 - 허증(虛證)을 중심으로 -)

  • Moon, Jin-Seok;Kim, Jeong-Cheol;Kang, Byoung-Gab;Kim, Bo-Young;Kang, Kyung-Won;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.14 no.2
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    • pp.47-66
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    • 2008
  • Background: It is insufficient information that are syndrome differentiations and detail symptoms in Korean. Methods: 19 traditional korean medical agencies collected 190 cases with vital sign, body measurement, patient own symptoms report and doctor diagnosis. And then we analyzed general distributions and comparisons of deficiency and non-deficiency. Results: The most past histories, in order, were the arthritis(20%), gastroenteropathy, hypertension, anemia, diabete mellitus. In chief complains, musculoskeletal occupies 60 percent of the total, and digestive system, head in order. In the syndrome differentiation, it appeared deficiency, spleen, Qi deficiency in order. Age(p=0.000), systolic blood pressure(p=0.044) and the waist-hip ratio(p=0.000) was significantly higher in the deficiency group compared with non-deficiency group. Patients with condition which dislikes the wind and with anxiety and with amazing and fear(驚恐) were significantly more in deficiency group(p=0.029, p=0.017, p=0.044). Conclusions: These statistics are continually revised report and it will be reported comparison of several syndrome differentiations and therapeutic effects by treatment methods.

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A Case of Podostroma Cornu-Damae Intoxication Induced Pancytopenia and Skin Desquamation: Successful Treatment with Granulocyte Colony Stimulation Factor (G-CFS) (과립구집락자극인자 투여로 치료한 범혈구감소증과 피부 박리를 보인 붉은사슴뿔버섯 중독 1례)

  • Kim, Jung Seok;Kim, Gyu Won;Chung, Jae Il;Sim, Myoung Ki;Yoon, Ki Chul;Choi, Yong Hoon;Yi, Ha Ram;Choi, In Zoo;Shim, Chan Sup;Han, Joung Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.13 no.1
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    • pp.50-54
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    • 2015
  • Podostroma cornu-damae is a rare species of fungus belonging to the Hyocreaceae family. Its fruit body is highly toxic, as it contains trichothecene mycotoxins. The morphology is similar to that of immature Ganoderma lucidum, making identification difficult for non-experts. We experienced such a case of a 56- year-old male who picked and consumed podostroma cornu-damae, and consumed. Later that day, he developed digestive system symptoms, including nausea, vomiting, and abdominal pain. He presented to the emergency room (ER), there were no abnormal physical findings, symptoms improved after gastric lavage, and the patient voluntarily discharged himself on the same day. The following day, as the symptoms gradually deteriorated, he was admitted via the ER. He was presented with severe pancytopenia, alopecia, desquamation of skin, and acute renal failure. He recovered without any complications after conservative care, antibiotics therapy, and granulocyte colony stimulating factor administration. The most commonly reported complications of podostroma cornu-damae intoxication were reported pancytopenia, infection, disseminated intravascular coagulation, acute renal failure, etc. since Prevention is especially important because its toxicity can be lethal and there is no particular treatment to date, prevention is especially important. Promotion and education for the public are needed.

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Pathological Changes in Cultured Korean Catfish (Silurus asotus) Artficially Infected with Aeromonas veronii (Aeromonas veronii의 실험적 감염에 의한 양식 메기, Silurus asotus의 병리학적 변화)

  • Kim, Jin-Do;Do, Jeong-Wan;Choi, Hye-Sung;Seo, Jung-Soo;Jung, Sung-Hee;Jo, Hyae-In;Park, Myung-Ae;Lee, Nam-Sil;Park, Sung-Woo
    • Korean Journal of Environmental Biology
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    • v.31 no.4
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    • pp.486-492
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    • 2013
  • Recently, a new disease showing symptoms such as epidermal exfoliation and muscular necrosis occurred in cultured Korean catfish. Although the mortality of fishes was low but the economic damages owing to loss of commercial value were severe. The authors isolated the causative agent from diseased fish and observed pathological changes both in naturally and artificially infected fish. The causative bacteria was identified as Aeromonas veronii. Subsequently we observed the daily death and pathological symptoms of artificially infected fish with Aeromonas veronii. Symptoms of artificially infected fish were similar to those of naturally infected fish and all fish died within 7 days after infection. Histopathological changes on the naturally infected fish revealed severe congestion and necrotic degeneration in the liver, spleen and kidney. Some bacterial aggregates with inflammatory degeneration were observed in the heart, and congestion and fibrosis in the lamina propria of digestive tube were predominant. In artificially infected fish, skin erosion and necrotic degeneration of muscle tissue around injected region were particularly manifested. Degeneration of hepatocytes in liver and hyalic degeneration around ellipsoids in spleen were partially observed. However, there were no predominant signs in digestive tube in artificially infected fish.

Effects of life style on psychosomatic a subjective a symptoms of the dental technology students (일 대학 치기공과 재학생의 생활습관이 심신 자각증상에 미치는 영향)

  • Kwon, Soon-Suk;Lee, Hye-Eun
    • Journal of Technologic Dentistry
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    • v.38 no.1
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    • pp.37-49
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    • 2016
  • Purpose: This research is performed through the analysis of the dental technology students' life-style factors of their daily lives that have a close relation with health, and the self-reported symptoms which are related to psychosomatic diseases, for the production of basic data for the change of life-styles and the development of educational programmes. Methods: This research has been performed through questionnaires from the beginning of October of 2014 till the end of November through the Dental Technology students of G-do, chosen by random sampling method after informed consent, where out of the 270 papers, 258 results were used for the analysis. Results: Firstly, the results of the research was as follows: Non-smokers accounted for 61.2%, student who did not do regular physical activities accounted for 50.4%, students who had sleeping hours of 6 to 7 hours accounted for 35.7%, students who eat snacks accounted for 63.2%, students who eat breakfast once to twice a week accounted for 30.6%, students who had an average number of drinks of once to twice a week accounted for 39.9%, and students with BMI of '$18.5^{\circ}{{\neq}}22.9$' accounted for 56.2%, being the highest. Secondly, in gender, smoking (p<.001), regular physical activity (p<.001), BMI (p<.001), eat snacks (p<.05), average number of drinks (p<.05), and of the health check-up, eat breakfast (p<.05), of the year level, eat snack (p<.01), BMI (p<.01), hours of sleep (p<.05), of major satisfaction, regular physical activity (p<.01), and BMI (p<.05), and there was a significant statistical difference, but there were no significant statistical difference in religion. Thirdly, of the bodily self-reported symptoms of the correlation analysis within the life-style variables and the self-reported symptoms, multiple subjective symptoms (I), respiratory (A), eye and skin (B), and digestive organs (C) were the highest in the correlation analysis with regular physical activity (p<.01), and of mental health, impulsiveness (H), mental instability (J), and depression (K) showed highest results in correlation analysis with regular physical activity (p<.01, p<.05), lie scale (L) and irregular and life (G) with eat breakfast (p<.01), and aggressiveness (F) with BMI (p<.01), showed highest results in correlation analysis. Fourthly of the Dental technology students' bodily self-reported symptoms, life-style factors which had a statistically significant effect appeared to be regular physical activity (p<.001) and BMI (p<.05), and of the mental self-reported symptoms, causes that did not have statistically significant effect appeared to be regular physical activity (p<.05) and eat breakfast (p<.05). Conclusion: This research concludes that in order to develop correct life-style habits for health promotion and reduce self-reported symptoms related to the Dental Technology students' diseases, education for the recognition of the necessity of self health promotion must be conducted, and a education programme scheme for the Dental technology curriculum for practicing the correct life-style habits in daily life is required.

Study on the Validation of Sasang Digestive Function Inventory (SDFI) for Analyzing Pathophysiological Digestive Symptoms and Diagnosing Sasang Types (소화기 소증 분석과 사상체질 진단을 위한 사상소화기능검사(SDFI)의 타당화 연구)

  • Chae, Han;Lee, Jeongyun;Lee, Yong-jae
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.3
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    • pp.1-15
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    • 2021
  • Introduction The clinical usefulness of Sasang Digestive Function Inventory (SDFI) for analyzing Sasang type-specific pathophysiological symptom was illustrated repeatedly. It was revised to enhance its validity, reliability and clinical usefulness, however its clinical studies supporting these were not sufficient yet. Methods 193 healthy university students responded once to Nepean Dyspepsia Index-Korean (NDIK), Functional Dyspepsia-Related Quality of Life (FDQOL), and Dutch Eating Behavior Questionnaire (DEBQ), and twice to SDFI with four weeks of interval. The Body Mass Index (BMI) and Ponderal Index (PI) were also calculated. The 4-week test-retest reliability and correlation coefficients between NDIK, FDQOL, DEBQ, and SDFI were examined using Pearson's correlation. The significant differences between Sasang types in SDFI and its subscales were examined using ANCOVA with the age as covariate. Results The range of test-retest reliability for SDFI and its subscales was from 0.801 to 0.887. The SDFI-total correlated positively with BMI (r=0.323) and DEBQ-External Eating (r=0.433), while the SDFI-Digestion negatively with NDIK (r=-0.472) and FDQOL-total (r=-0.364). The SDFI-Habit correlated positively with BMI (r=0.310) and DEBQ-total (r=0.481), and the SDFI-Appetite with DEBQ-total (r=0.322). The SDFI-total, SDFI-Digestion, and SDFI-Habit scores of Tae-Eum type (35.6±6.25, 12.38±3.24 and 9.89±3.38, respectively) were significantly bigger than those of So-Eum type (29.84±8.31, 9.93±4.28 and 7.66±3.96). Discussion The SDFI was found to be an objective clinical measure with sufficient concurrent validity for measuring eating behavior and quality of life related to overeating and dyspepsia, and illustrated distinctive differences between Sasang types. It might be useful for the effective medical education and integrative medical practice.

Laparoscopic Hiatal Hernia Repair and Roux-en-Y Conversion for Refractory Duodenogastroesophageal Reflux after Billroth I Distal Gastrectomy

  • Park, Joong-Min;Yoon, Sung Jin;Kim, Jong Won;Chi, Kyong-Choun
    • Journal of Gastric Cancer
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    • v.20 no.3
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    • pp.337-343
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    • 2020
  • Distal gastrectomy with Billroth I or II reconstruction may cause duodenogastroesophageal reflux (DGER), thereby resulting in digestive or respiratory symptoms. The mainstay of treatment is medication with proton pump inhibitors. However, these drugs may have limited effects in DGER. Laparoscopic fundoplication has been proven to be highly effective in treating gastroesophageal reflux disease (GERD), but it cannot be performed optimally for GERD that develops after gastrectomy. We report the case of a 72-year-old man with a history of distal gastrectomy and Billroth I anastomosis due to early gastric cancer. GERD due to bile reflux occurred after surgery and was refractory to medical therapy. The patient underwent Roux-en-Y conversion from Billroth I gastroduodenostomy and hiatal hernia repair with only cruroplasty. Fundoplication was not performed. His symptoms improved significantly after the surgery. Therefore, laparoscopic hiatal hernia repair and Roux-en-Y conversion can be an effective surgical procedure to treat medically refractory DGER after Billroth I gastrectomy.