• 제목/요약/키워드: Duodenal ulcer

검색결과 86건 처리시간 0.025초

각기 다른 유문-십이지장의 기질적 병변 3증례에 대한 장음 측정 보고 : 장음의 주주파수를 중심으로 (Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases)

  • 윤상협
    • 대한한방내과학회지
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    • 제36권3호
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    • pp.276-283
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    • 2015
  • Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

양성자 펌프 억제제 투여로 악화된 과증식 위용종 1예 (A Case of Aggravated Hyperplastic Gastric Polyps after Treatment with Long-term Proton Pump Inhibitors)

  • 김호태;박종완;엄석현;곽태영;황홍석;김영성;곽동협;김정희
    • Journal of Yeungnam Medical Science
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    • 제30권2호
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    • pp.141-144
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    • 2013
  • Hyperplastic gastric polyps (HPPs) are the most common type of gastric polyps. They are assumed to be caused by chronic inflammation and regenerative proliferation, although this has not been clearly investigated yet. Many studies suggested the development of fundic gland polyps and carcinoid during long-term proton pump inhibitor (PPI) therapy, but the relationship between PPIs and HPPs is still unclear. We encountered a patient who showed aggravation of HPPs after long-term use of PPIs. A 58-year-old male patient with liver cirrhosis visited our hospital because of hematemesis. We started PPI medication after confirming esophageal variceal bleeding and duodenal ulcer with blood clot in its base via emergency endoscopy. He took PPIs for three years because of an intractable duodenal ulcer. There was a marked increase in the size of the pre-existing polyps and in the development of new polyps. We presumed that the PPIs caused the aggravation of the HPPs, so we stopped their administration. After five months, the HPPs shrank and the polyps were partially degraded. More prospective studies are needed to investigate the relationship between HPPs and PPIs.

새로운 프로톤 펌프 억제제, IY-81233의 항위염과 항궤양작용 (Antigastric and Antiulcerative Action of a New Proton Pump Inhibitor (IY-81233))

  • 김승희;김진;강석연;이송득;홍성걸;김동연;문애리
    • Biomolecules & Therapeutics
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    • 제4권3호
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    • pp.285-290
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    • 1996
  • This study was designed to determine the effect of newly synthesized antiulcer agent, 5-pyrrolyl-6-halo-2-(pyridyl-2-methylthio)benzimidazole derivatives (IY-81233), on various experimental ulcers and on the secretion of prostaglandin $E_2(PGE_2)$ into the gastric lumen of rat. IY-81233 was previously reported to have a strong inhibitory effect on $H^+/K^$-ATPase and on gastric acid secretion in rats. Oral administration of IY-81233 at concentrations of 0.2, 2.0, and 20 mg/kg inhibited gastric lesions and duodenal ulcer induced by indomethacin, HCI-ethanol, water-immersion stress, cysteamine, and acetic acid in a dose dependent manner. Their IC$IC_{50}$ values were 3.4, 1.4, 0.8, 1.3, and 1.2 mg/kg, respectively. These results indicate that IY-81233 is a potent antiulcer agent although it is slightly less potent than omeprazole in healing of gastritis and ulcers. The secretion of $PGE_2$ into gastric lumen was also investigated in relation to the cytoprotective effect by IY-81233 in rats. The $PGE_2$ level was not changed significantly by an oral administration of IY-81233, suggesting that IY-81233 has little effect on the gastric protection. Therefore, it can be concluded that IY-81233 exerts prominent antiulcer activity by suppressing gastric acid secretion via an inhibition of a proton pump and not by protecting the gastrointestinal mucosa against various ulcerative stimuli.

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상부 소화관 질환증상에 대한 제산.소화효소제와 생약제를 함유한 복합제제 세립의 유용성 (Evaluation of Clinical Use by Comparative Efficacy and Safety Study of Fine Granvles for Upper Gastrointestinal Disorders Including Symptoms)

  • 전형식;김주현;황일순;추현광;박현철;정숙향
    • 약학회지
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    • 제37권2호
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    • pp.172-181
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    • 1993
  • The purpose of this study was to evaluate the clinical efficacy and safety of NRM which was newly developed as a combination product containing antacids, digestive enzyme and herbal drugs, and OTA powder, called OHTA'S ISAN on the morret, for the treatment of various symptoms in upper gastrointestinal diseases. 63 patients were recruited, 36 as a treated group with NRM and 27 as a controlled one with OTA. Patients were randomly allocated to receive either NRM or OTA t.i.d. for treatment of upper G-1 symptoms and undergone endoscopic, symptomatic and clinical laboratory assessments before and after 2 weeks. The results were as follows; 1. The general improvement rates of subjective symptoms in upper G-1 diseases were observed in 100%(32/32) for NRM and in 92%(23/25) for OTA. 2. The overall effective rates in terms of the symptoms and endoscopic findings were 88.9%(32/36) for NRM and 85.2%(23/27) ,or OTA respectively. 3. In NRM group, no significant side effects by NRM were observed except a mild and transient vomiting in one patient, but in OTA group treatment was discontinued due to nousea in one patient, However, there were no clinically significant changes detected in the laboratory parameters. According to the result of this trial, it is cocluded that NRM was safe and effective and (but not statistically significant) was superior to OTA in the treatment of gastrointestinal diseases caused by gastritis, gastric and duodenal ulcer, functional gastrointestinal disorder, non-ulcer dyspepsia etc.

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지역소재 종합병원에서 소화성궤양 환자의 약물요법 사용실태 분석 (The Study of Different Regimens Prescribed for the Treatment of Peptic Ulcer Disease in a Community Hospital)

  • 박영미;오정미
    • 한국임상약학회지
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    • 제10권3호
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    • pp.111-119
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    • 2000
  • The objective of this study was to evaluate the efficacy and the pattern of regimens prescribed for the treatment of peptic ulcer disease in a regional community hospital. 226 patients were treated as an outpatient and followed for one year. 88 patients $(38.9\%)$ had gastric ulcer (GU) alone, 6 patients $(2.7\%)$ had duodenal ulcer (DV) alone, 5 patients $(2.2\%)$ had gastroesophageal reflux disease (GERD) alone, 25 patients $(11.1\%)$ had both GU and DU, 88 patients $(38.9\%)$ had both GU and GERD, and 14 patients $(6.2\%)$ had both DU and GERD. During this study period no one was treated for Zollinger-Ellison Syndrome. The disease showed higher occurrence in male population (139 patients, $61.5\%$) and among the ages of 30 and 40 $(62.4\%)$. The average age of these patients was 41.3 years and there was no difference between the genders. $81.4\%$ of these patients underwent CLO test to check for the existence of Helicobacter and $66.3\%$ of these Patients showed the positive response. $65.6\%$ of patients with GU and $80\%$ of patients with DU showed the positive response and there was no difference between the genders $(65.4\%\;vs.\;67.6\%)$. 184 patients $(81.4\%)$ were deemed to be cured based on the disappearance of their symptoms after completing the regimens. Compliance rate did not differ for gender or different diseases, while showing a difference in age. Patients between the ages of 20 to 30 years old showed the worst compliance rate. In addition, the compliance was lower among the patients who had previous occurrence of the disease, and this was more evident among female patients. Although 184 patients out of the total 226 patients were deemed to be cured, 36 patients $(20.65\%)$ of these returned to the hospital for relapsed diseases within one year. The factors that affected for patients to relapse were the diseases accompanied by ulcer and social environments, such as smoking, alcohol consumption, and previous history of the diseases (smoking P<0.001, alcohol consumption P<0.02, previous history of disease P<0.05). The regimen using $H_2$ receptor antagonists+tripotassium dicitrato bismuthate+clarithromycin showed the lower rate of relapse, and the regimens of omeprazole (OMP)+amoxicillin+tripotassium dicitrato bismuthate and OMP+amoxicillin+metronidazole showed better compliance rate. Patient education by pharmacists on the importance of compliance to regimens and the risk factors fer relapse can provide a better patient care. This would ultimately result in more cost-effective treatments by preventing additional cost for treating relapsed symptoms in approximately $20\%$ of patients.

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Helicobacter pylori 관련 철분 결핍 빈혈 (H. pylori-associated Iron-Deficiency Anemia)

  • 최연호
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제9권2호
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    • pp.129-138
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    • 2006
  • Lots of cases relating Helicobacter pylori infection to iron-deficiency anemia have been described in the literature and H. pylori infection has emerged as a cause of refractory iron-deficiency anemia which is unresponsive to oral iron therapy. H. pylori-associated iron-deficiency anemia can be treated by H. pylori eradication. It is not thought to be attributable to gastrointestinal blood loss, such as duodenal ulcer. The mechanism by which H. pylori infection contributes to iron-deficiency anemia remains unclear. However, four possible explanations can be posited for this relationship; occult blood loss secondary to chronic gastritis, reduced iron absorption due to hypo- or achlorhydria, increased iron consumption by H. pylori, and iron sequestration in gastric mucosa. H. pylori-associated iron-deficiency anemia seems to develop in populations at increased risk for iron depletion. When pubescent girls, including athletes, are found to have iron-deficiency anemia refractory to iron administration, they should be evaluated for H. pylori infection.

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한약 정위단의 현미 감정연구 (Microscopic Identification of the Chinese Patent Medicine Jeong Wi Dan)

  • 박상일;황명석;채소청;박종희
    • 생약학회지
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    • 제29권1호
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    • pp.40-43
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    • 1998
  • 'Jeong Wi Dan' is Chinese patent medicine. which is used for stomachic disorder, gastric and duodenal ulcer. This medicine is in the large of pills consisting 14 kinds of powdered crude drugs. For the identification of individual ingredients in such powdery mixtures, microscopic method may advantageously be used as it requires only a small amount of specimens. In this paper, effective of this method will be exemplified by the identification of the ingredients in Jeong We Dan which contains 14 powdered crude drug ingredients.

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소아 알레르기성 자반증의 위장관 내시경 소견 (Endoscopic Findings of Children with Henoch-Schonlein Purpura)

  • 이동훈;박철한;박지민;박근수;김흥식;강진무
    • Clinical and Experimental Pediatrics
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    • 제46권6호
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    • pp.572-575
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    • 2003
  • 목 적 : 알레르기성 자반증 환아에서 상부위장관 내시경 소견을 관찰하고, 또한 위장관 증상이 있는 환아와 없는 환아에서 상부위장관 내시경 소견의 차이가 있는지 보고자 이 연구를 시행하였다. 방 법 : 1996년 9월부터 2002년 10월까지 계명대학교 동산병원 소아과에 입원하였던 알레르기성 자반증 환아 중 위장관내시경 검사를 실시한 65명을 대상으로 하였다. 위장관 증상의 유무에 따른 내시경 소견을 비교 관찰하였으며 피부 병변 3일 전부터 퇴원까지의 기간 동안 복통, 구토, 위장관 출혈, 설사 등의 증상을 기록하여 위장관 증상의 유무를 판단하였다. 결 과 : 위장관 내시경을 시행한 65명 중 위장관 증상이 있던 환아는 53명이었고, 증상이 없는 환아는 12명이었다. 6-10세 연령군이 많았고 위장관 증상은 남아에서 그리고 증상으로는 복통과 구토가 많았다. 위장관 내시경을 시행한 65명 중 십이지장 점막에 이상 병변의 빈도가 가장 높았으며, 병변의 양상에 따른 빈도는 십이지장염 12명, 위염과 십이지장염 9명, 십이지장미란 6명, 위염 5명, 십이지장궤양 5명, 위궤양 2명, 결장미란 1명의 순으로 관찰되었으며 정상소견은 25명이었다. 증상이 있던 환아 53명 중 38명에서 그리고 증상이 없던 환아 12명 중 2명에서 위장관 내시경 소견상 이상 소견을 보였다. 결 론: 위장관 증상이 있는 알레르기성 자반증 환아에서는 내시경 검사를 시행하는 것이 병변의 진단과 치료에 도움이 되었으나 더 많은 예에서 연구가 필요하리라 생각된다.

Tc-99m DISIDA 간담도 Scintigraphy상 우연히 발견된 위장역류의 임상적 의의 (Gastric Reflux on Routine Tc-99m DISIDA Hepatobiliary Scintigraphy)

  • 이강욱;이헌영
    • 대한핵의학회지
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    • 제29권3호
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    • pp.313-318
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    • 1995
  • 통상적인 Tc-99m DISIDA 스캔도중 우연하게 위장역류가 발견되는 경우가 있는데 이의 임상적 의의를 알아보고자 1991년 12월부터 1995년 6월까지 충남대학교병원에서 통상적인 Tc-99m DISIDA 스캔을 시행한 1,553명의 환자들중 우연하게 위장부위로 방사능역류를 보인 36명의 환자들을 대상으로 후향적으로 이러한 환자들의 검사당시 임상상을 알아보았다. 1) 연구기간동안 시행한 Tc-99m DISIDA 스캔상 위장 역류는 2.3%에서 발견되었다. 2) 위장역류를 보인 대상환자중 위장관 및 담도계에 수술을 받은 과거 병력이 있는 경우는 19% 이었으며 역류가 없었던 환자들에서보다 의미있게 많았다(p<0.01). 3) 역류가 발견되는 시점은 Tc-99m DISIDA 정맥주사 후 30분에서 60분 사이가 50%로 가장 많았으며 60분에서 90분 사이가 23% 이었다. 4) 위장 역류를 보인 환자중 87%에서 위내시경 검사상 위염, 위궤양, 십이지장궤양, 위암등의 병변을 보였다. 이상에서 저자들은 Tc-99m DISIDA 스캔상 위-십이지장 역류를 보이는 경우는 역류가 없는 경우보다 위장관이나 담도계에 수술을 받은 병력이 있는 경우가 의미있게 많았으며 이들 중 상당수가 위-십이지장에 질환을 가지고 있음을 알 수 있었다.

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Antigenic Proteins of Helicobacter pylori of Potential Diagnostic Value

  • Khalilpour, Akbar;Santhanam, Amutha;Lee, Chun Wei;Saadatnia, Geita;Velusamy, Nagarajan;Osman, Sabariah;Mohamad, Ahmad Munir;Noordin, Rahmah
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1635-1642
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    • 2013
  • Helicobacter pylori antigen was prepared from an isolate from a patient with a duodenal ulcer. Serum samples were obtained from culture-positive H. pylori infected patients with duodenal ulcers, gastric ulcers and gastritis (n=30). As controls, three kinds of sera without detectable H. pylori IgG antibodies were used: 30 from healthy individuals without history of gastric disorders, 30 from patients who were seen in the endoscopy clinic but were H. pylori culture negative and 30 from people with other diseases. OFF-GEL electrophoresis, SDS-PAGE and Western blots of individual serum samples were used to identify protein bands with good sensitivity and specificity when probed with the above sera and HRP-conjugated anti-human IgG. Four H. pylori protein bands showed good (${\geq}$ 70%) sensitivity and high specificity (98-100%) towards anti-Helicobacter IgG antibody in culture-positive patients sera and control sera, respectively. The identities of the antigenic proteins were elucidated by mass spectrometry. The relative molecular weights and the identities of the proteins, based on MALDI TOF/TOF, were as follows: CagI (25 kDa), urease G accessory protein (25 kDa), UreB (63 kDa) and proline/pyrroline-5-carboxylate dehydrogenase (118 KDa). These identified proteins, singly and/or in combinations, may be useful for diagnosis of H. pylori infection in patients.