INTRODUCTION: As the number of diabetics increase with younger onset and longer duration, patients are confronted with higher incidence of diabetes related complications such as distal extremity vasculopathy, neuropathy and various infectious diseases. Such diabetics are more prone to a much higher rate of onychomycosis compared to normal subjects and because this could trigger irreversible consequences, confirmation of fungal involvement should be promptly taken care of. Itraconazole is a widely used drug nowadays and compared to drugs such as griseofulvin and ketoconazole, has many advantages in efficacy, cost, duration of therapy which eventually results in better patient compliance. OBJECTIVE: Our study was designed to better dictate the usage of itraconazole in diabetics so these patient can receive quality treatment when it is needed. METHOD: The study consisted of 101 patients with both onychomycosis and diabetes who were receiving treatment in Eulji hospital. They all received 3 pulses of itraconazole and were evaluated for efficacy and safety of their treatment. The patients were observed on routine examinations for 36 weeks and at their visits they were interviewed and received microscopic examinations. RESULT: Eighty four percent of the patients showed clinical and mycological improvement with 33% of them showing total clearance. There were no hypo- or hyperglycemic events and 17 patients complained of mostly mild side effects such as indigestion. Two patients dropped out of the study due to epigastric pain and peripheral extremity swelling. CONCLUSION: The use of itraconazole in the treatment of onychomycosis seemed to be effective and relatively safe for diabetics.
Communicable Diseases ; Diabetes Complications ; Dyspepsia ; Extremities ; Griseofulvin ; Humans ; Incidence ; Itraconazole* ; Ketoconazole ; Onychomycosis* ; Patient Compliance

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD), functional dyspepsia (FD), and peptic ulcer disease (PUD) impact the daily lives of affected individuals. The aim of this study was to compare the risk factors and impacts on life quality of overlapping FD or PUD in patients with GERD. METHODS: Data from patients diagnosed with GERD were collected between January and November 2009. FD was defined using the Rome III diagnostic criteria. The overlapping GERD-FD or GERD-PUD groups were classified as concomitant GERD and FD or peptic ulcers. The characteristics of these individuals were analyzed. RESULTS: There were 63, 48, and 60 patients in the GERD only, overlapping GERD-FD, and overlapping GERD-PUD groups, respectively. Significantly younger age, female gender, lower body weight and body mass index, and higher rates of tea consumption were noted in the GERD-FD group. Patients in the GERD-FD group exhibited the lowest quality of life scores, both with respect to physical and mental health, on the Short Form 36 domains. CONCLUSIONS: Patients with concomitant GERD and FD were more likely to be younger and female. Overlapping GERD and FD had the worst impact on the quality of life of the affected individuals.
Adult ; Age Factors ; Dyspepsia/*complications ; Female ; Gastroesophageal Reflux/*complications ; Humans ; Life Style ; Male ; Middle Aged ; Peptic Ulcer/*complications ; Quality of Life ; Questionnaires ; Risk Factors

Helicobacter pylori is a gram-negative bacterium that was first isolated in 1982. Since then, H. pylori infection in humans has been shown to be associated with gastritis, peptic ulcer disease, gastric carcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma as well. The epidemiology, transmission, and pathogenicity of H. pylori has been a subject of intensive study. Successful treatment improves the cure rate of peptic ulcerations and treatment with antimicrobials also decreases the recurrence rate of these diseases. Better regimens having less toxicity and a good eradication rate have also been developed. A better understanding of the pathophysiologic mechanisms relating to H. pylori induced mucosal damages would result in more options for the prevention of peptic ulcers and carcinogenesis. Korea has a relatively high incidence of H. pylori infection and gastric cancer. Growing interest has developed in view of its importance in being associated with various gastroduodenal diseases. Furthermore, along with a high incidence of H. pylori-related disease in Korea, because the interaction between H. pylori, host factors and environmental factors is important in disease pathogenesis, we need to have precise data on the characteristics of H. pylori-related diseases that occur in Korea. In the present report we review the epidemiology, transmission route, diagnosis, pathogenesis, treatment methods and relationship with gastroduodenal diseases with in special references to basic and clinical data that have been published.
Dyspepsia/etiology ; Helicobacter Infections/*complications/diagnosis/etiology ; *Helicobacter pylori ; Human ; Korea ; Peptic Ulcer/etiology ; Stomach Neoplasms/etiology

OBJECTIVETo investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones.

METHODSA total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects.

RESULTS(1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05).

CONCLUSIONSGan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

Adult ; Case-Control Studies ; Diarrhea ; etiology ; Dyspepsia ; blood ; complications ; psychology ; Gastrointestinal Hormones ; blood ; Humans ; Irritable Bowel Syndrome ; blood ; complications ; psychology ; Psychological Tests ; Qi ; Serotonin ; Surveys and Questionnaires ; Yang Deficiency

No abstract available.
Adult ; Cough/etiology ; Diagnosis, Differential ; Dyspepsia/etiology ; Female ; Humans ; Lung/radiography/surgery ; Sarcoidosis, Pulmonary/complications/*radiography/surgery ; Tomography, X-Ray Computed/methods

PURPOSE: The aim of this study is to evaluate the feasibility and safety of cardia preserving proximal gastrectomy, in early gastric cancer of the upper third. MATERIALS AND METHODS: A total of 10 patients were diagnosed with early gastric cancer of the upper third through endoscopic biopsy. The operation time, length of resection free margin, number of resected lymph nodes and postoperative complications, gastrointestinal symptoms, nutritional status, anastomotic stricture, and recurrence were examined. RESULTS: There were 5 males and 5 females. The mean age was 56.5+/-0.5 years. The mean operation time was 188.5+/-0.5 minutes (laparoscopic operation was 270 minutes). Nine patients were T1 stage (T2 : 1), and N stage was all N0. The mean number of resected lymph nodes was 25.2+/-0.5. The length of proximal resection free margin was 3.1+/-0.1 cm and distal was 3.7+/-0.1 cm. Early complications were surgical site infection (1), bleeding (1), and gastro-esophageal reflux disease (1) (this symptom was improved with medication). Late complications were dyspepsia (3) (this symptom was improved without any treatment), and others were nonspecific results of endoscopy or symptom. CONCLUSIONS: Cardia preserving proximal gastrectomy was feasible for early gastric cancer of the upper third. Further evaluation and prospective research will be required.
Biopsy ; Cardia ; Constriction, Pathologic ; Dyspepsia ; Endoscopy ; Female ; Gastrectomy ; Gastroesophageal Reflux ; Hemorrhage ; Humans ; Lymph Nodes ; Male ; Nutritional Status ; Postoperative Complications ; Recurrence ; Stomach Neoplasms

The association between choledochal cysts and pregnancy is unlikely to be etiological, but may rather be an aggravation or precipitation of a preexisting condition. Although choledochal cysts rarely occur in pregnancy, the aim of this study is to elucidate the condition associated with pregnancy because delayed or inappropriate therapy may be catastrophic for both mother and child. Authors reviewed 18 cases of choledochal cyst, of which 2 were aggravated during pregnancy, managed at the Department of Surgery, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, during the period from 1990 to 1995. The results were as follows: The ratio of female to male was 2.6:1 which revealed predominance in female and most frequent age group was above sixty years old(33%). In non-pregnant patients, the most common symptoms were abdominal pain(78%) and all pregnant patients had pain, jaundice, nausea and vomiting, and indigestion. Transaminase and bilirubin were elevated in all pregnant patients. In all patients, US(88%, 100%) was the most common preoperative diagnostic study and one case was diagnosed during explo-laparotomy. Pregnant patients have cholecystitis in two cases and nonpregnant patients had cholecystitis(19%), CBD stone(19%), and others. The operative procedures were performed in 9 cases and pregnant patients were operated by cyst excision and Roux-en-Y hepaticojejunostomy in one case, and also Roux-en-Y choledochocystojejunostomy in one case. According to Todani's classification, in non pregnant patients, type I was the most common(63%), in pregnant patients, two cases were type I. Postoperative complications occurred in 3 cases, wound infection(6%) and cholangitis(6%) in non pregnant patients, pleural effusion(6%) in pregnant patients. Two cases of choledochal cyst in pregnancy were 25 years old at 29.4 weeks and 36 years old at 16 weeks into pregnancy.
Adult ; Bilirubin ; Child ; Cholecystitis ; Choledochal Cyst* ; Classification ; Dyspepsia ; Female ; Heart ; Humans ; Jaundice ; Male ; Mothers ; Nausea ; Postoperative Complications ; Preexisting Condition Coverage ; Pregnancy* ; Surgical Procedures, Operative ; Vomiting ; Wounds and Injuries

OBJECTIVETo observe the therapeutic effect of Modified Banxia Houpo Decoction (MBHD) in treating patients with functional dyspepsia (FD) accompanied with psychological factors, and to compare it with Domperidone, Neurostan, and Domperidone + Neurostan.

METHODSRecruited were 89 FD patients accompanied with anxiety and/or depression, who were randomly assigned to four groups, i.e., the MBHD group (23 cases), the Domperidone group (22 cases), the Neurostan group (22 cases), and the Domperidone + Neurostan group (22 cases). Corresponding medication lasted for4 weeks. The psychological scoring was performed using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA). The improvement rate of FD symptoms, the ratios of FD symptoms scoring <2, and the improvement rate of FD symptoms >50% were calculated by the scoring of FD symptoms. The gastric emptying rates of patients in each group were compared using the examinations of gastric emptying.

RESULTSThere was no statistical difference in pre-treatment HAMD, HAMA, FD symptoms scoring, and the gastric emptying rate among the 4 groups (P >0.05). The psychological scoring and FD symptoms scoring significantly decreased in the 4 groups except the Domperidone group after 4-week treatment (P<0.01, P <0.05). The psychological scoring and FD symptoms scoring were obviously lower in the MBHD group than in the Domperidone group (P <0.05). The improvement rate of FD symptoms, the ratios of FD symptoms scoring <2, and the improvement rate of FD symptoms >50% were the highest in the Domperidone + Neurostan group, followed by the MBHD group, and then the Domperidone group. After treatment the gastric emptying rate obviously increased in each treatment group when compared with before treatment in the same group (P <0. 01), and there was no statistical difference among these groups after treatment.

CONCLUSIONSMBHD had certain therapeutic effects on FD patients accompanied with psychological factors. Its effect was associated with gastric emptying. Besides, its improvement of the psychological state and symptoms was superior to that of Domperidone.

Adolescent ; Adult ; Anxiety Disorders ; complications ; Depression ; complications ; Domperidone ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Dyspepsia ; complications ; drug therapy ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome ; Young Adult

Functional dyspepsia is one of the most common gastrointestinal disorders encountered in clinical practice. Functional dyspepsia is currently defined by Rome III criteria as the chronic dyspeptic symptoms (postprandial fullness, early satiety, epigastric pain or burning) in the absence of underling structural or metabolic disease that readily explain the symptoms. According to the Rome III consensus, functional dyspepsia can be subdivided into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Although the Rome III criteria have been published more than 8 years ago, not much effort has been put into validating these criteria and direct scientific evidence supporting the validity of the subdividing functional dyspepsia into PDS and EPS are lacking. This article is intended to review the validity of the Rome III criteria on the subdivisions of functional dyspepsia, i.e. PDS and EPS. The impact of sleep disorder, Helicobacter pylori-associated dyspepsia, and the emerging drug therapies in functional dyspepsia will also be discussed in this article.
Anti-Anxiety Agents/therapeutic use ; Diagnosis, Differential ; Dyspepsia/complications/*diagnosis/drug therapy ; Gastrointestinal Agents/therapeutic use ; Helicobacter Infections/complications/diagnosis ; Humans ; Serotonin Receptor Agonists/therapeutic use ; Severity of Illness Index ; Sleep Wake Disorders/etiology

OBJECTIVETo investigate the proportions of functional dyspepsia (FD) and structural diseases within the dyspeptic outpatients in hospitals of different ranking in central area Shaanxi province, and to explore the safety in adopting "symptom and treatment" algorithm used in Western countries.

METHODSA clinical epidemiology survey was carried out by means of a stratified sample of 3 019 dyspeptic outpatients through standardized questionnaire. All of the patients were followed for 4 - 24 weeks, and finally received their diagnoses through a consistent criteria.

RESULTSProportionally, FD in all the outpatients took up 44.8% with 44.7% benign organic causes and 10.5% malignant diseases. In the patients who had marked alarm symptoms, the proportion of benign and malignant diseases rose to 52.1% and 29.2%, respectively. They were significantly higher than those without alarm symptoms (39.2%, 2.9%) (P < 0.01). All of the dyspeptic patients were divided into 7 groups according to different ages. 64.5% of FD patients were younger than 25 years and the rate of FD declined with age. It was found that only four patients below 35 years old had malignance. The number of cases increased significantly in age 35 - 45 group and reached 30.8% in 65 - 74 group.

CONCLUSIONThere were some differences noticed within dyspeptic patterns between local area in China and Western countries, and the "symptom and treatment" approach was not entirely suitable to the local area in China.

Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Child ; China ; epidemiology ; Dyspepsia ; diagnosis ; epidemiology ; etiology ; Esophageal Motility Disorders ; complications ; diagnosis ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prevalence ; Stomach Diseases ; complications ; diagnosis ; epidemiology