• Advances in pediatric surgery
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• v.10 no.1
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• pp.43-46
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• 2004

Two cases of trichobezoar with unusual presentation in female children are described. The first case is a 7-year-old female with a 3-day history of abdominal pain, obstipation, and emesis. She developed intestinal obstruction and showed double bezoars in the stomach and intestine respectively. She had been in a habit of biting or sucking hairs before sleeping from infancy until 5 years of age. The other patient is a 6-year-old girl referred for an epigastric mass, emotional disturbance and trichotillomania. In spite of the psychological treatment, 4 laparotomies were necessary due to repeated recurrences.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.352-356
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• 1990

A rare benign tumor of the pericardium was found in a 47-year-old woman with epigastric discomfort. She was initially thought to have an anterior mediastinal tumor but was proved to have a massive intrapericardial lipoma without malignant condition. The tumor was measured 26X20X5 cm in size and 2,200 gm in weight. Calcifications and necroses were found around the three pedicles. The tumor was removed easily by dividing the pedicles. With the brief review of literature, we report the case.

• 대한미세수술학회:학술대회논문집
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• 1996.10a
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• pp.171.1-171.1
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• 1996

• Journal of Chest Surgery
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• v.33 no.10
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• pp.847-850
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• 2000

Isolated bronchogenic cysts of the diaphragm are rare abnormalities. They are usually asymptomatic unless secondarily infected or large enough to cause compression of vital structures. The patient was a 31-year-old man and had no symptoms except mild postprandial epigastric discomfort. The chest X-ray and chest C-T examination revealed a mediastinal mass at the left cardio-vertebro-phrenic angle. We performed the operation under the impression of solid mass at mediastinum. We revealed that the mass was bronchogenic cyst in diaphragm. Therefore we report this case with review of literatures.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.308-322
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• 2015

Objectives: Whether there exists a distinct pathogenesis in subgroups of functional dyspepsia (FD), the classification of epigastric pain syndrome (EPS), and postprandial distress syndrome (PDS) remains controversial. We aimed to investigate the number of fungiform papillae (FP) in the subgroups of FD and its correlation with the severity of dyspepsia symptoms and spleen qi deficiency. Methods: Patients with FD were enrolled from August to November 2014. All patients were evaluated using a questionnaire and divided into 2 groups according to the Rome III criteria for FD. The severity of dyspepsia symptoms and spleen qi deficiency were separately assessed by Nepean Dyspepsia Index-Korean (NDI-K) version and Spleen qi deficiency questionnaire (SQDQ). The number of FP was measured on the anterior part of tongue, within an area of 9 mm ², using a digital cam Results: The NDI-K score, SQDQ score, and number of FP in the EPS group were significantly greater than those in the PDS group. Also, the EPS group had more patients diagnosed with spleen qi deficiency. The number of FP showed a significant positive correlation with epigastric pain and burning. Furthermore, the number of FP was significantly associated with the score of some items in NDI-K and SQDQ, even though not with the total score. Conclusions: Thus, measurement of the number of FP could be a new evaluation indicator for allocation into FD subtypes and to investigate the severity of dyspepsia symptoms and spleen Qi deficiency reflecting visceral hypersensitivity.

• Parasites, Hosts and Diseases
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• v.30 no.3
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• pp.231-234
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• 1992

A 58-year-old chronic alcoholism patient, who complained of epigastric discomfort, nausea, and frequent loose stool was diagnosed as strongyloidiasis accompanied by duodenal ulcer. The symptoms first appeared two years ago and aggravated during the recent 3 months, and he lost 4 kg of his body weight. Stool examination revealed rhabditoid nematode larvae, which were confirmed as those of Strongyloides stercoralis after cultivation of them to alariform larvae. At duodenoscopy, duodenal ulcer was found. The patient was treated with albendagole (200 mg, bid, for 14 days) for stronglyloidiasis and with colloidal bismuth sulfate(240 mg, bid, for 6 weeks) for duodenal ulcer. After the medication, the symptoms of loose stool and epigastric discomfort were much improved and he was discharged with no clinical problems. This is an interesting case which suggests that S. stercoralis infection could be related with ulceration of the duodenal mucosa.

• Journal of Sasang Constitution and Immune Medicine
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• v.22 no.3
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• pp.29-42
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• 2010

1. Objective: Gastric Stuffiness (心下痞證) in the Soeumin Taeeum symptomatology (少陰人 太陰病) in Sasang Constitutional Medicine shows an interesting evolutionary process. Originally found in the texts of Sanghanlun (傷寒論), the perspectives regarding the symptoms of Gastric Stuffiness were expanded by many medical scholars and Lee Jema. To comprehend the Jema's concept of Taeeum symptomatology and utilize his prescription clinically, it deserves to study on the Gastric Stuffiness in Donguisuseowon (東醫壽世保元). 2. Methods: Many texts including Sanghanlun (傷寒論) and Dongeuibogam (東醫寶鑑) were reviewed in order to track the evolutionary process concerning the symptoms of Gastric Stuffiness. Also, Lee Jema's works including the different versions of Donguisuseowon (東醫壽世保元) were reviewed to examine the development of Lee's concepts regarding the Gastric Stuffiness in the Soeumin Taeeum symptomatology. 3. Results and Conclusions: 1) Most of the previous concepts on Gastric Stuffiness were generally similar to those found in Sanghanlun, especially in that they addressed Yang deficiency of the middle triple energizeer as the central pathogenic process. 2) Lee Jema's views on the epigastric discomfort in the Soeumin Taeeum symptomatology evoloved over time and culminated in the finalized pathology and therapeutics appearing in his last work, the Shinchuk version of Donguisuseowon (東醫壽世保元). 3) 4 kinds of prescription which invented by Lee Jema to treat the Gastric Stuffiness in the Soeumin Taeeum symptomatology can be matched to the prescription of Sanghanlun respectively. However through evolutionary process of Jema's prescriptions, the indication of them expanded: not only to treat Gastric Stuffiness but to diverse symptoms of Soeumin.

• Archives of Reconstructive Microsurgery
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• v.5 no.1
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• pp.80-91
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• 1996

A free rectus abdominis flap can include a variable amount of muscle length depending on recipient site requirements. There is also great flexibility in flap design in terms of size, orientation of its axis, and the level of its location over the muscle. It is safe to design the skin island across the midline. Though skin islands designed over the most inferior portion of the abdomen have not always proved reliable when based on the superior epigastric artery, free flaps based on the inferior pedicle can be successfully designed in this area. As free flap based on the inferior epigastric vessels, this flap has been useful for large head and neck defects following ablative procedures, for facial contour restoration as a buried flap, for upper extremity defects, for lower extremity defects such as coverage of grade III tibial fractures and for breast reconstruction. A free rectus abdominis muscle or myocutaneus flap was used in 8 patients. The operations were performed between Sep. of 1994 and April of 1996. The patients were tongue cancer 1 case, chronic facial palsy 1 case, unilateral breast reconstruction 1 case, upper and lower extremity injury 5 cases. The free rectus abdominis muscle flaps were 4 cases and the free myocutaneous flaps were 4 cases. There was no failure of the flap, except one partial necrosis. One case of the skin grafts on the muscle flap was regrafted. One case of reoperation due to venous thrombosis was performed. In tongue cancer patient, a orocutaneous fistula was occurred, but conservative treatment and secondandry skin graft were done. In conclusion, a free rectus abdominis flap has many advantages such as a long and constant pedicle, easy dissection, enough soft tissue available, scar on the donor site to be hiddened, no need for changing position. So we think that this flap is the most useful one for small or moderate sized defects on the various sites.

• The Journal of Internal Korean Medicine
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• v.18 no.1
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• pp.86-96
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• 1997

We examined clinical and reseach data about abdominal palpation conducted in japanese oriental medicine from the early stages of its medical history to the latest research, so as to introduce it into korean oriental medicine. That is to say, we studied clinical significance and suitable oriental medicine prescription about following : sweat and moistness of abdominal skin ; temperature of abdominal skin ; palpation and visible peristaltic movement ; meteorism ; tonus of the whole rectus abdominis muscle ; local tonus of parts rectus abdominis muscle ; palpitation of abdominal aorta ; resistance tender on pressure in epigastric region, subcostal region, umbilical region, lower abdomen, para-umbilical region, cecal region, sigmoid region and inguinal region ; sound of fluctuating liquid in the epigastric region. The result was that abdominal palpation was an immediately applicable method of clinical diagnosis in oriental medicine, and is being proven by western medicine methodology today. Therefore we suggest that korean oriental medicine would advance greatly if abdominal palpation were applied.

• Journal of Gastric Cancer
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• v.4 no.3
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• pp.180-185
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• 2004

Recently, we experienced two advanced gastric cancer (AGC) patients younger than 17 years of age. The first case was a 15-year, 2-month-old male who had suffered from epigastric soreness for 5 weeks. His grandfather died of gastric cancer at 39 years of age. Under the diagnosis of AGC, he underwent a total gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 4.5$\times$4 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 42 regional lymph nodes (T2bN2M0). The second case was a 17-year, 11-month-old male who had suffered from epigastric pain for 2 years without familial clustering. Under the diagnosis of AGC, he underwent a distal subtotal gastrectomy with D2 lymph node dissection. There was no evidence of distant metastasis. Pathologic examination revealed a 3$\times$2 cm, signet ring cell adenocarcinoma with subserosal invasion and with metastasis in 9 of 45 regional lymph nodes (T2bN2M0). The two patients have been alive without recurrence for 27 months and 4 months, respectively. Even among teenagers, patients with abdominal complaints should be subjected to a thorough examination of the gastrointestinal tract.