• 정신신체의학
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• 제9권1호
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• pp.49-57
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• 2001

연구목적 : 기능성 소화장애증 환자에서 실제적인 위장 운동 기능의 이상을 알아볼 수 있는 위 배출능 검사를 시행하여 위장 운동 기능 이상의 유무 및 위장 운동 기능과 정신병리(특히 불안과 우울), 지각된 스트레스, 스트레스의 매개변인인 대처방식, 사회적 지지와의 연관성을 알아보고자 하였다. 방법 : 원광의대 소화기 내과에 가능성 소화장애증을 주소로 내원히여 방사선 검사 및 심전도 검사 제반 내시경 및 생화학적 검사에서 이상소견을 보이지 않고 식도운동검사 및 24 시간 위-식도 역류검사를 실시하여 이상 소견을 보이지 않는 환자 30명으 대상으로 지각한 스트레스의 양 및 SCL-90-R, BDI, STAI, 대처방식, 사회적 지지와 위 배출능 검사를 시행하여 상관관계를 분석하였다. 결과 : 1) 위 배출 반감시간은 $118.50{\pm}23.64$분이었으며, 위 배출능 검사에서 정상 범위를 벗어난 환자는 없었다. 2) 위 배출 반감시간은 우울 및 상태 불안과 유의한 정적인 상관이 있었다. 3) 위 배출 반감시간은 지각된 스트레스, 대처방식, 사회적 지지와 유의한 상관이 없었다. 결론 : 이상의 결과로 보아 기능성 소화장애증 환자의 생리적 기능인 위 배출반감시간은 우울 빛 불안과 유의한 상관이 있으며 스트레스 매개변인과는 연관이 없었다. 이는 스트레스 인자와 반응사이의 매개변인보다는 그 결과로 생각되는 정신병리가 위장 생리 활성과 연관이 있고 이런 측면이 신경정신과적 중재 및 치료에 고려 될 수 있음을 시사하고 있다.

• 농촌의학ㆍ지역보건
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• 제28권1호
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• pp.79-92
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• 2003

1998년 3월 경상북도 경주시에 거주하는 30세 이상의 소화불량 증상이 있는 주민 중 내시경 검사를 통한 신속 요소분해 반응검사(CLO검사) 상 양성으로 확진된 사람에 대하여 H. pylori에 대한 3제 요법(tripotassium dicitrato bismuthate 600mg bid, amoxicillin 500mg qid, metronidazole 250mg qid 복합제제)을 실시하였다. 1년 후 요소호기검사에서 음성이었던 사람 87명 중 추적 가능하였던 86명을 대상으로 H. pylori에 대한 성공적인 제균 치료 1년 후(2000년 4월), 2년 6개월 후(2001년 10월)의 재감염률을 파악하고, 재감염과 관련된 요인을 분석하였다. 재감염을 판정하기 위하여 요소호기검사와 재감염 관련 요인을 파악하기 위하여 설문조사를 실시하였는데, 설문내용에는 위암 및 위궤양 등에 대한 가족력, 위장관계 관련 증상, 사회경제적 및 인구학적 특성, 투약 및 건강관련행위 등이 포함되었다. 2년 6개월 동안 추적조사가 완료된 77명을 대상으로 H. pylori 제균 후 1년 후의 재감염률은 15.6%였고, 2년 6개월 후의 요소호기검사에서 양성으로 판정 받은 대상자는 77명중 13명으로 재감염률은 16.9%였다. 연령, 성별, 사회경제적 특성, 교육수준, 가족력 등은 재감염과 관련성이 없었고, 요소호기검사에서 음성이라고 판정 받고 난 후 1년 간 연구 대상자 본인이 느끼는 주관적 소화불량 증상 중 '식후 포만감'이 있는 경우와 '상복부 팽만감' 증상여부는 재감염과 유의한 관련성이 있었다. 단변량분석에서 치료순응도와 음주가 유의한 변수였으며, 다중로지스틱회귀분석에서는 최근 1년 동안의 소화불량 증상 점수가 2-3점인 경우만이 교차비가 4.5로 통계학적으로 유의한 영향을 미치는 변수였다. 식사 중 소금 섭취량이 많은 경우 교차비가 8.7이었지만 통계학적으로 유의하지는 않았다. 결론적으로 1년 재감염률은 15.6%, 2년 6개월 재감염률은 16.9%이었으며, 개인의 주관적인 소화불량 증상 호소 정도와 치료순응도는 지역사회에서 H. pylori 재감염을 예측할 수 있는 근거로써 H. pylori 감염에 대한 추적검사시 추적검사 대상자 선별을 위한 근거로 활용될 수 있을 것이다.

• 정신신체의학
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• 제24권1호
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• pp.66-73
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• 2016

연구목적 소방관에서 기능성 소화불량의 유병률이 높고 기능성 소화불량의 발현과 악화에 심리사회적 요인이 깊이 연관되어 있음에도 불구하고 이에 관한 연구는 매우 부족한 상황이다. 따라서 본 연구에서는 소방관들을 대상으로 기능성 소화불량에 관련되는 심리사회적 요인의 특징을 알아보고 삶의 질에 미치는 영향을 파악하고자 하였다. 방 법 소방관 1,217명을 대상으로 로마 III 진단기준에 따라 기능성 소화불량 집단을 선별하였다. 인구학적 요인을 조사하였으며 심리사회적 요인을 평가하기 위해 Patient Health Questionnaire-9(PHQ-9), Generalized Anxiety Disorder questionnaire-7(GAD-7), Korean Occupational Stress Scale(KOSS), Ways of Coping Checklist(WCCL), Rosenberg's Self-Esteem Scale(RSES) 그리고 World Health Organization Quality of Life Scale abbreviated version(WHOQOL-BREF)를 사용하였다. 기능성 소화불량에 따라 집단을 나누고 교차분석(chisquare test)과 독립표본 t-검정(independent t-test)을 사용하여 집단 간의 차이를 알아보았다. 또한 KOSS의 각 하위 영역별로 기능성 소화불량의 위험도를 평가하기 위해 로지스틱 회귀분석(logistic regres-sion analysis)을 시행하였다. 기능성 소화불량 집단의 삶의 질과 독립변인들의 상관관계를 파악하기 위해 Pearson 상관분석(Pearson's correlation test)을 시행하였으며, 위계적 회귀분석(hierarchical regression anal-ysis)을 통해 기능성 소화불량 집단의 삶의 질에 영향을 미치는 예측 요인을 알아보았다. 결 과 기능성 소화불량 집단은 남성(p=0.006)이 많았고, PHQ-9(p<0.001), GAD-7(p<0.001), KOSS(p<0.001) 점수가 유의미하게 높았으며, RSES(p=0.008), WHOQOL-BREF(p<0.001) 점수는 유의미하게 낮았다. KOSS 하위 영역 중 높은 직무요구도(OR 1.94, 95% CI : 1.29-2.93), 부적절한 보상(OR 2.47, 95% CI : 1.61-3.81), 그리고 불편한 직장 문화(OR 1.51, 95% CI : 1.01-2.24)에서 기능성 소화불량의 위험도가 높았다. 기능성 소화불량 집단의 삶의 질에 대한 최종 회귀모델에서 우울증상과 직무스트레스가 낮고, 자아존중감이 높은 것이 삶의 질의 42.0%를 설명했다. 결 론 본 연구 결과 기능성 소화불량 및 삶의 질에 대한 심리사회적 요인의 영향이 확인되었다. 따라서 향후 기능성 소화불량의 평가에 있어 내과적 접근 뿐만 아니라 정신건강의학과적인 접근이 동시에 이루어져야 할 것으로 판단된다.

• 대한소화기학회지
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• 제72권6호
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• pp.286-294
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• 2018

Background/Aims: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. Methods: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. Results: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. Conclusions: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.

• 대한방사선기술학회지:방사선기술과학
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• 제30권4호
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• pp.343-347
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• 2007

폭포상위는 비만형의 체격을 가진 사람에게 더 현저하다고 알려져 있다. 이에 본 연구에서는 폭포상위를 가진 자의 신체적 요인인 성별, 나이, 신장, 몸무게 및 비만상태를 조사 분석하여 폭포상위와 연관성이 있는지를 알아보고자 하였다. 일부지역 한 검진기관 2007년 1월부터 12월까지 상부위장관조영술을 실시한 3,320명 중 폭포상위를 가진 자 564명을 연구대상자로 하여 다음과 같은 결론을 얻을 수 있었다. 1. 폭포상위의 정도는 3.320명 중 564명(16.9%)으로 나타났다. 2. 폭포상위를 가진 자 564명 중 비만도 120% 이상인 자는 226명(40.1%)으로 높게 나타났다. 3. 비만도 120% 이상인 자 중 성별에서는 여성이 63.7%로 남성보다 높게 나타났으며, 연령에서는 $50{\sim}59$세 45.6%, 신장은 $151{\sim}160\;cm$에서 49.1%로 나타났으며, 몸무게는 76 kg 이상에서 31.0%로 가장 높게 나타났다. 4. 폭포상위를 가진 자의 증상과 비만인 자의 증상과는 무증상이 62.6%, 57.5%로 나타났으며, 다음으로 소화불량증 16.8%, 17.3%, 속쓰림 10.8%, 15.0% 순으로 나타났다. 결론적으로 폭포상위는 비만일수록 높게 나타난다는 사실을 알 수 있었으며, 비만일수록 성별에서는 남성보다 여성이, 연령별에서는 50대, 신장에서는 $151{\sim}160\;cm$, 몸무게에서는 76 kg 이상에서, 증상으로는 무증상 다음으로 소화불량증, 속쓰림 순으로 높게 나타남을 알 수 있었다. 이는 통계에 의한 조사이므로 폭포상위와 비만과의 연관성을 사실적인 확인을 할 수는 없었으나 앞으로 폭포상위와 비만과의 관계에 대해 더욱 더 많은 연구가 이루어져야 하겠다고 사료된다.

• 대한한방내과학회지
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• 제27권1호
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• pp.276-287
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• 2006

Background & Objective : The herbal medicine Sojukgunbihwan granule has been used for the treatment of functional dyspepsia, generally categorized as a gastric dysmotility disease. However, its mechanisms are not yet well known. Therefore, the effects of Sojukgunbihwan granules on gastric motility in rats was investigated. Methods : The myoelectrical activity of the gastric smooth muscle was recorded by a bipolar electrode placed at the gastric antrum of rats. The contractile waves were measured for 30 minutes before and after intragastric administration of each solution(normal saline, Pyungwisan 40mg/kg, Sojukgunbihwan granules 60mg/kg) and expressed as the motility index. Gastric emptying was measured by the number of glass beads expelled from the stomach(containing one hundred 1mm glass beads) within an hour after glass beads and test drugs(normal saline, Pyungwisan 40mg/kg, Pyungwisan 120mg/kg, Sojukgunbihwan granules 60mg/kg, Sojukgunbihwan granules 180mg/kg) were administered. In another series of experiments to evaluate the mechanisms of Sojukgunbihwan granules under delayed conditions, the rats were treated with atropine sulfate(1 mg/kg, s.c.), cisplatin(10mg/kg, i.p.), and NAME($N^G$-nitro-L-arginine methyl ester, 75mg/kg, s.c.) respectively. Results : Intragastric administration of Sojukgunbihwan granules increased the myoelectrical activity significantly, gastric motility index rose 25%, and gastric emptying of glass beads was significantly enhanced over a period of 60minutes. Under the delayed gastric emptying induced by atropine sulfate, cisplatin, and NAME, Sojukgunbihwan granules aggravated gastric emptying in the atropine sulfate($5.71{\pm}3.45\;vs\;3.71{\pm}4.42$) and cisplatin($13.86{\pm}3.53\;vs\;5.14{\pm}5.05$, p<0.01) treated groups, but enhanced gastric emptying in the NAME treated group($5.00{\pm}3.21\;vs\;11.71{\pm}5.65$, p<0.05). Conclusions : Results suggest that Sojukgunbihwan granules stimulate gastric motility through cholinergic and 5-hydroxytryptamine 3 receptors. Results are indicative of Sojukgunbihwan as an especially effective remedy in dysmotility-like functional dyspepsia with impaired reservoir functions such as gastric adaptive relaxation.

• 대한한방내과학회지
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• 제31권4호
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• pp.857-869
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• 2010

Objectives : The aim of this study was to evaluate whether rats with non-obstructive antral dilation could be a useful tool resembling functional dyspeptic patients. We also investigated the effect of Bojoongikki-tang (BJ), and Youngkaechulgam-tang (YK) in antral dilated rats. Methods : Non-obstructive antral dilation was performed by first wrapping a non-absorbable rubber ring (D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum causing pyloric obstruction (PO). After 12 weeks, except for some PO group rats used for the control, the rubber ring was removed by performing another operation. The antral dilated rats (AD) were then divided into three groups, a non-treatment group (AD-NT), and two herbal medicine groups each given an extract solution containing 125 mg/kg of Youngkaechulgam-tang (AD-YK) or Bojoongikki-tang (AD-BJ) for 4 weeks. Then gastric contractility was evaluated by bowel sound measurement, and afterwards the changes of the weight, and morphologic changes of the stomach were evaluated for each group including the normal intact group (NI). Results : Loss of weight and enlargement of the stomach surface area was seen in the PO group. Decrease of gastric motility index was observed in the AD-NT group, while the increased surface area of the stomach was not significantly different from the PO group. Youngkaechulgam-tang seemed to increase gastric contraction, whereas Bojoongikki-tang showed no effect. Weight gain of rats was observed in both the AD-YK and AD-BJ groups, but there seemed to be no change of the dilated stomach surface area. Conclusions : The non-obstructive antral dilated rat seems to be an experimental pathologic model that reflects the gastric dysmotility similar to functional dyspeptic patients with antral dilation. Therefore patients with dysmotility-like dyspepsia with antral function disorders should be treated efficiently. As Youngkaechulgam-tang is shown to increase both gastric contraction and weight in antral dilated rats, it may be used for treating functional dyspepsia. However, Bojoongikki-tang should be used with caution in patients with gastric dysmotility.

• 대한한방소아과학회지
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• 제16권2호
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• pp.1-22
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• 2002

Purpose : This Study was conducted to evaluate clinical characteristic of children with recurrent abdominal pain (RAP) and to be classified by its six subtype in the Oriental Pediatric Text Book and to find out relationship of western classification. Methods : Patients who visited Dong-Eui Oriental Medical hospital from August, 2001 to October, 2002 due to RAP were included. According to questionnaire and history taking, RAP was classified by its six subtype based on Oriental medical theory. Results : 1. Patients with RAP were more internalized, have a close relation with their parents, and have strong desires of success, but social intercourse is low. 2. 76% of Patients have a less desire to eat and 67% of Patients have a diarrhea or constipation. 3. According to questionnaire, first abdominal pain was their $3{\sim}5$ ages most, cause of occurrence was more 'eating cold foods' most, time of AP (abdominal pain) was $1{\sim}2$ hours after eating and no characteristic most, site of AP was the umbilicus most, shape of AP was impotent pain most, cause of reduce pain was abdominal massage and defection most. 4. frequency of RAP's type, AP caused by diet(食積腹痛) is 45.5%, AP caused by cold(寒腹痛) is 29.1%, AP caused by cold in internal organs of deficiency(臟腑虛冷腹痛) is 12.7%, stagnation of qi and stasis of blood(氣滯血瘀腹痛) is 10.9%, AP caused by internal diet and external cold(內食外寒腹痛) is 1.8%. There is no AP caused by parasites(蟲腹痛). 5. During clinical classifications of RAP, cause of occurrence was most important cause of reduce pian, defection practice was helpful for diagnosis, but shape of AP, site of AP was not helpful. 6. With relationship of Oriental classification and western classification, AP caused by diet is similar to dysmotilitylike dyspepsia and irriTable bowel syndrome. AP caused by cold is similar to irriTable bowel syndrome. AP caused by cold in internal organs of deficiency is similar to unspecified dyspepsia. stagnation of qi and stasis of blood and AP caused by internal diet and external cold is not like to western classification. Conclusion : RAP in Childhood is most occurred by food and cold. there is few AP caused by stagnation of qi and stasis of blood and internal diet and external cold. So the study on subclassification and clinical Manifestations of RAP in Childhood is more performed.

• Journal of Gastric Cancer
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• 제14권3호
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• pp.196-203
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• 2014

Purpose: Vascular endothelial growth factor (VEGF) is one of the most important growth factors for metastatic tumors. To clarify the role of VEGF-A and C in patients with peptic ulcer disease (PUD) or gastric cancer (GC), we evaluated the expression levels of these two molecules. We also analyzed the effect of Helicobacter pylori infection on VEGF-A and C expression levels. Materials and Methods: Patients with dyspepsia who needed diagnostic endoscopy were selected and divided into three groups: nonulcer dyspepsia (NUD), PUD, and GC, according to their endoscopic and histopathological results. Fifty-two patients with NUD, 50 with PUD, and 38 with GC were enrolled in this study. H. pylori infection was diagnosed by the rapid urease test. After RNA extraction and synthesis of cDNA, the expression levels of VEGF-A and C were determined by quantitative reverse transcriptase polymerase chain reaction. Results: The VEGF-C expression level in the PUD and GC groups was significantly higher than that in the NUD group. Moreover, the VEGF-A expression level in the PUD and GC groups was higher than in the NUD group, although the differences were not statistically significant. Significant positive correlations were also observed between the expression levels of these two molecules in the PUD and GC groups. In addition, the expression levels of these two molecules were higher in H. pylori positive patients with PUD or GC than in H. pylori negative patients of the same groups; however, these differences did not reach statistical significance. Conclusions: Up-regulation of VEGF-C expression during gastric mucosal inflammation may play a role in the development of peptic ulcers or GC.

• 대한약침학회지
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• 제18권1호
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• pp.72-78
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• 2015

Objectives: The stomach is a sensitive digestive organ that is susceptible to exogenous pathogens from the diet. In response to such pathogens, the stomach induces oxidative stress, which might be related to the development of both gastric organic disorders such as gastritis, gastric ulcers, and gastric cancer, and functional disorders such as functional dyspepsia. This study was accomplished to investigate the effect of Ganoderma lucidum pharmacopuncture (GLP) on chronic gastric ulcers in rats. Methods: The rats were divided into 4 groups of 8 animals each: the normal, the control, the normal saline (NP) and the GLP groups. In this study, the modified ethanol gastritis model was used. The rats were administrated 56% ethanol orally every other day. The dose of ethanol was 8 g/kg body weight. The normal group received the same amount of normal saline instead of ethanol. The NP and the GLP groups were treated with injection of saline and GLP respectively. The control group received no treatment. Two local acupoints CV12 (中脘) and ST36 (足三里) were used. All laboratory rats underwent treatment for 15 days. On last day, the rats were sacrificed and their stomachs were immediately excised. Results: Ulcers of the gastric mucosa appeared as elongated bands of hemorrhagic lesions parallel to the long axis of the stomach. In the NP and GLP groups, the injuries to the gastric mucosal injuries were not as severe as they were in the control group. Wound healings of the chronic gastric ulcers was promoted by using GLP and significant alterations of the indices in the gastric mucosa were observed. Such protection was demonstrated by gross appearance, histology and immunehistochemistry staining for Bcl-2-associated X (BAX), B-cell lymphoma 2 (Bcl-2) and Transforming growth factor-beta 1 (TGF-${\beta}1$). Conclusion: These results suggest that GLP at CV12 and ST36 can provide significant protection to the gastric mucosa against an ethanol induced chronic gastric ulcer.