• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.2
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• pp.79-87
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• 2024

Purpose: Recently, the prevalence of eosinophilic gastrointestinal disease (EGID) has shown an increasing trend worldwide. As the diagnosis of EGID requires invasive endoscopy with biopsy, noninvasive markers for detecting EGID in suspected patients, particularly children, are urgently needed. Therefore, this study aimed to evaluate the diagnostic accuracy of serum eosinophil cationic protein (ECP) beyond peripheral eosinophil counts in pediatric patients with EGID. Methods: Overall, 156 children diagnosed with EGID were enrolled and 150 children with functional abdominal pain disorder (FAPD) were recruited as controls. All participants underwent endoscopic biopsy in each segment of the gastrointestinal (GI) tract and serum ECP measurement, as well as peripheral eosinophil percent and absolute eosinophil count. Results: Comparing EGID (n=156) with FAPD (n=150) patients, serum ECP levels were significantly higher in pediatric patients with EGID than in those with FAPD (25.8±28.6 ㎍/L vs. 19.5±21.0 ㎍/L, p=0.007), while there was no significant difference in peripheral eosinophil percent and absolute eosinophil counts between the two groups. Serum ECP levels were correlated with peripheral eosinophil percent (r=0.593, p<0.001) and the absolute eosinophil count (r=0.660, p<0.001). The optimal cutoff value of serum ECP for pediatric EGID was 10.5 ㎍/mL, with a sensitivity of 69.9% and a specificity of 43.4% with an area under the receiver operating characteristic curve of 0.562. Conclusion: The combination of serum ECP levels and peripheral eosinophil counts, when employed with appropriated thresholds, could serve as a valuable noninvasive biomarker to distinguish between EGID and FAPD in pediatric patients manifesting GI symptoms.

• Journal of Korean Academy of Nursing
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• v.43 no.5
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• pp.579-586
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• 2013

Purpose: This article provides an update and overview of a nursing research program focused on understanding the pathophysiology and management of irritable bowel syndrome (IBS). Methods: This review includes English language papers from the United States, Europe, and Asia (e.g., South Korea) from 1999 to 2013. We addressed IBS as a health problem, emerging etiologies, diagnostic and treatment approaches and the importance of a biopsychosocial model. Results: IBS is a chronic, functional gastrointestinal disorder characterized by recurrent episodes of abdominal pain and alterations in bowel habit (diarrhea, constipation, mixed). It is a condition for which adults, particularly women ages 20-45, seek health care services in both the United States and South Korea. Clinically, nurses play key roles in symptom prevention and management including designing and implementing approaches to enhance the patients' self-management strategies. Multiple mechanisms are believed to participate in the development and maintenance of IBS symptoms including autonomic nervous system dysregulation, intestinal inflammation, intestinal dysbiosis, dietary intolerances, alterations in emotion regulation, heightened visceral pain sensitivity, hypothalamic-pituitary-adrenal dysregulation, and dysmotility. Because IBS tends to occur in families, genetic factors may also contribute to the pathophysiology. Patients with IBS often report a number of co-morbid disorders and/or symptoms including poor sleep. Conclusion: The key to planning effective management strategies is to understand the heterogeneity of this disorder. Interventions for IBS include non-pharmacological strategies such as cognitive behavior therapy, relaxation strategies, and exclusion diets.

• The Journal of Pediatrics of Korean Medicine
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• v.18 no.1
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• pp.139-152
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• 2004

Objective: The aim of this study was to find about relation between Chiljung(七情) and chronic recurrent abdominal pain in children. Methods: It was surveyed the oriental medical book concerning Chiljung(七情) and western medical book concerning Chronic recurrent abdominal pain. Results: Chronic recurrent abdominal pain which is common disorder in children is mostly functional abdominal pain due to stress. The Stress can be defined as spiritual factor which lead to imbalance of body homeostasis in medicine. In oriental medicine, it is considered as Chiljung(七情) disorder. The gastrointestinal disease due to stress are peptic ulcer, chronic gastritis, irritable bowel syndrome, chronic abdominal pain, vomitting etc. In oriental medicine pathology mechanism, it is considered as discord with liver and spleen, depression of spleen-energy. It comes within the category of depression. Children with chronic recurrent abdominal pain is dependent on parents and they have an introspective nature, compulsive idea which is intolerable for failure.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.224-229
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• 2015

Cyclic vomiting syndrome (CVS) is a functional disorder characterized by stereotypical episodes of intense vomiting separated by weeks to months. Although it can occur at any age, the most common age at presentation is 3-7 years. There is no gender predominance. The precise pathophysiology of CVS is not known but a strong association with migraine headaches, in the patient as well as the mother indicates that it may represent a mitochondriopathy. Studies have also suggested the role of an underlying autonomic neuropathy involving the sympathetic nervous system in its pathogenesis. CVS has known triggers in many individuals and avoiding these triggers can help prevent the onset of the episodes. It typically presents in four phases: a prodrome, vomiting phase, recovery phase and an asymptomatic phase until the next episode. Complications such as dehydration and hematemesis from Mallory Wise tear of the esophageal mucosa may occur in more severe cases. Blood and urine tests and abdominal imaging may be indicated depending upon the severity of symptoms. Brain magnetic resonance imaging and upper gastrointestinal endoscopy may also be indicated in certain circumstances. Management of an episode after it has started ('abortive treatment') includes keeping the patient in a dark and quiet room, intravenous hydration, ondansetron, sumatriptan, clonidine, and benzodiazepines. Prophylactic treatment includes cyproheptadine, propranolol and amitriptyline. No mortality has been reported as a direct result of CVS and many children outgrow it over time. A subset may develop other functional disorders like irritable bowel syndrome and migraine headaches.

• Journal of The Korean Society of Clinical Toxicology
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• v.3 no.2
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• pp.130-134
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• 2005

Lithium is mainly prescribed for manic and depressive disorder, also frequently prescribed for the other diseases such as migraine, cluster headache, alcoholism, and obsessive-compulsive disorder. An acute lithium intoxication occurs in cases of patients ingesting large amount lithium at a time, a chronic lithium intoxication occurs in patients on chronic lithium therapy. Acute or chronic lithium poisoning occurs frequently in case of patients on chronic lithium therapy ingesting larger dose than prescribed. Manifestations of lithium poisoning are various. It is possible nervous, cardiovascular, renal, gastrointestinal and endocrine systems to be involved. Due to intracellular high concentration, mortality rate is high in acute lithium intoxication patients on chronic lithium therapy. We report a case of acutely intoxicated 40-year-old male on chronic lithium therapy. His chief complaints were deterioration and high fever. On his arrival to an emergency department, he was in cardiac arrest. He restored return of spontaneous circultion (ROSC) 5 minutes later after cardiopulmonary cerebral resuscitation (CPCR) and referred to department of internal medicine for hemodialysis. Vigorous treatment was given to the patient, but he was expired at 4th hospital day.

• Journal of Acupuncture Research
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• v.34 no.3
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• pp.39-48
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• 2017

Objectives : The objective of this study was to evaluate the effect of Dokhwaljihwang-tang (DJT) intravenous pharmacopuncture on cisplatin-induced emesis and gastric mobility disorder in Wistar rats. Methods : Thirty rats were randomly divided into six groups and cisplatin was administered to all groups except the normal group. The cisplatin group (n=5) received a cisplatin injection only. The saline group (n=5) was injected with cisplatin followed by 0.4 mL of saline. Groups DJT-1, DJT-2, and DJT-3 were injected with cisplatin, followed by 0.315 g/kg, 0.104 g/kg, and 0.034 g/kg of DJT, respectively. Body weight, food intake, and kaolin intake of rats were measured 12 h, 24 h, and 36 h after cisplatin injection. Residual food in the stomach was measured 48 h after cisplatin injection. Results : There was no significant difference in weight. The food intake was not significantly different 12 h after cisplatin administration. All groups except the normal group showed significantly decreased food intake after 24 h. After 36 h, food intake was not significantly different between groups DJT-1, DJT-2, and DJT-3 and the normal group. The kaolin intake of groups DJT-1 and DJT-2 was significantly decreased at 12 h and 24 h after cisplatin injection. Kaolin intake and residual food in the stomach were significantly decreased in groups DJT-1, DJT-2, and DJT-3. Conclusion : In a Wistar rat model, DJT intravenous pharmacopuncture is suggested to be effective for cisplatin-induced emesis and gastric motility disorder. In the future, it is necessary to study the mechanism and chemical composition of each individual constitutive drug.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.10 no.2
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• pp.117-128
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• 2007

Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE mediated hypersensitivity disorder, which is associated with mainly gastrointestinal symptoms and has a delayed onset. The vomiting and/or diarrheal symptoms of FPIES typically begin in the first month of life in association with a failure to thrive, metabolic acidosis, and shock. Therefore, the differential diagnosis of FPIES and neonatal or infantile sepsis-like illnesses or gastroenteritis is difficult. The early recognition of indexes of suspicion for FPIES may help in the diagnosis and treatment of this disorder. The diagnosis of FPIES is generally made through clinical practice and food-specific IgE test findings are typically negative in this condition. Therefore, oral cow's milk challenge (OCC) remains the valid diagnostic standard for FPIES. An investigation of positive OCC outcomes helps to find out a diagnostic algorithm of criteria of a positive challenge in FPIES. Moreover, it has not been clearly determined in infantile FPIES when $1^{st}$ follow up-oral food challenge (FU-OFC) should be performed, with what kind of food protein (e.g., cow's milk, soy), and how much protein should be administered. Hence, to prevent the risk of inappropriate FU-OFC or accidental exposure and achieve appropriate dietary management, it is necessary to identify tolerance rates to major foods under the careful follow up of infantile FPIES patients. On the other hand, small intestinal enteropathy with villous atrophy is observed in FPIES and this enteropathy seems to be in part induced by both of epithelial apoptosis and intercellular junctional complex breakdown. The purpose of this report is to introduce an update on diagnostic and therapeutic approaches in FPIES and suggest the possible histopathological evidences in this disorder.

• Journal of Korean Biological Nursing Science
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• v.24 no.2
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• pp.131-139
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• 2022

Purpose: This study aimed to examine the changes in stress, occupational stress, and subjective health problems of novice female nurses within the first 18 months of work. Methods: This was a longitudinal study conducted with a secondary data analysis based on the Shift Work Nurse's Health and Turnover (SWNHT) study. The participants were 178 female novice nurses who participated in all 3 data collection activities (on the first day of orientation before ward placement [T0], 6 months after work [T1], and 18 months after work [T2]). The stress, occupational stress, 8 subjective health problems (upper musculoskeletal pain, leg/foot discomfort, depression, anxiety or emotional disorder, sleep disturbance, headache, gastrointestinal disorder, menstrual disorder, and others), and the greatest health problem during the study period were measured, respectively. Data were analyzed using SPSS 26.0 to obtain descriptive statistics. Results: The subjective health of novice female nurses were found to be poor at T1 compared to T0 on both physical (upper musculoskeletal pain, leg/foot discomfort, and sleep disturbance) and psychological health problems (depression and stress). However, the psychological health problems of the participants were alleviated at T2 whereas; physical health problems persisted until T2. Conclusion: Novice nurses had poor health problems 6 months after work. Sleep disturbance and musculoskeletal pain persisted although other health problems such as depression and stress were alleviated over the period. Strategies to prevent and manage different health problems of novice female nurses at different work duration are urgently needed.

• Korean Journal of Psychosomatic Medicine
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• v.10 no.2
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• pp.78-91
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• 2002

Objective : The purpose of this study was to develop the somatization rating scale (SRS), and then to use the scale in clinical pracitice. Methods: First, a preliminary survey was conducted for 109 healthy adults to obtain 40 response items. Second, a preliminary questionnaire was completed by 215 healthy subjects. Third, a comparison was made regarding somatization responses among 242 patients (71 with anxiety disorder. 73 with depressive disorder, 47 with somatoform disorder, and 51 with psychosomatic disorder) and 215 healthy subjects. Results : Factor analysis yielded 5 subscales : cardiorespiratory and nervous responses, somatic sensitivity, gastrointestinal responses, general somatic responses, genitourinary, eye and muscular responses. Reliability was computed by administering the SRS to 62 healthy subjects during a 2-week interval. Test-retest reliability for 5 subscales and the total score was significantly high, ranging between .86-.94. Internal consistency was computed, and Cronbach's ${\alpha}$ for 5 subscales ranged between .72-.92, and .95 for the total score. Convergent validity was computed by correlating the 5 subscales and the total score with the total score of the global assessment of recent stress (GARS) scale, the perceived stress questionnaire (PSQ), and the symptom checklist-90-revised (SCL-90-R). The correlations were all at significant levels. Discriminant validity was computed by comparing the total score and the 5 subscale scores of the patient and control groups. Significant differences were found for 5 subscales and the total score. Only the depressive disorder group was siginificantly higher than control group in all the subscale scores and total scores of SRS among 4 patient groups. In somatic sensitivity, only depressive disorder patients were significantly higher than the normal controls, whereas in general somatic subscale, depressive disorder and somatoform disorder groups were significantly higher than the normal controls. In total scores of the SRS, female subjects were significantly higher than males. Conclusion : These results indicate that the SRS is highly reliable and valid, and that it can be utilized as an effective measure for research in stress- and somatization-related fields. The depressive disorder and somatoform disorder groups showed more widespread somatization than the anxiety and psychosomatic disorder groups.

• Journal of Society of Preventive Korean Medicine
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• v.19 no.1
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• pp.95-107
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• 2015

Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.