This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, 'H. pylori test and treatment' strategy is not suitable for the initial diagnostic approach for uninvestigated dyspepsia. Long-term empirical pharmacological therapy is not recommended in Korea because of the possibility of missing or delaying the diagnosis of gastric cancer. There have been a lot of evidences showing that early upper GI endoscopy might be more effective than empirical medication, which is different from Western countries. However, cut-off age for early endoscopy is not clear, especially in case of young age. Further research is necessary to define highrisk age for gastric cancer and for a health economic study in the management of patients with dyspepsia in Korea.
Dyspepsia/*diagnosis ; Endoscopy, Digestive System ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans

This review tried to set up an initial diagnostic strategy in patients with functional dyspepsia. Dyspepsia was defined as chronic or recurrent pain, or discomfort centered in the upper abdomen (i.e., epigastrium), excluding heartburn and acute abdominal conditions. We reviewed the available data in order to produce currently applicable recommendations for the diagnosis of dyspepsia in Korea. Two investigators independently conducted an independent literature search of published reports on dyspepsia and diagnosis, including alarm symptoms, Helicobacter pylori (H. pylori) test, empirical pharmacological therapy, and early upper gastrointestinal (GI) endoscopy. The evidence concerning alarm features does not allow clear guideline whether early endoscopy should be performed or not. In Asia, including Korea, the prevalence of H. pylori and gastric cancer are high. Therefore, 'H. pylori test and treatment' strategy is not suitable for the initial diagnostic approach for uninvestigated dyspepsia. Long-term empirical pharmacological therapy is not recommended in Korea because of the possibility of missing or delaying the diagnosis of gastric cancer. There have been a lot of evidences showing that early upper GI endoscopy might be more effective than empirical medication, which is different from Western countries. However, cut-off age for early endoscopy is not clear, especially in case of young age. Further research is necessary to define highrisk age for gastric cancer and for a health economic study in the management of patients with dyspepsia in Korea.
Dyspepsia/*diagnosis ; Endoscopy, Digestive System ; Helicobacter Infections/diagnosis ; Helicobacter pylori ; Humans

Supragastric belching is the most important factor in the etiology of excessive belching complaints. Supragastric belching is a belching disorder with a behavioral origin. The standard diagnosis is made by monitoring the esophageal impedance. Supragastric belching has been shown to be associated with globus, as well as reflux symptoms in proton pump inhibitor non-responders in gastroesophageal reflux disease; however, the pathophysiology of supragastric belching in patients with gastroesophageal reflux disease or functional dyspepsia has not been clarified. Patient education with behavioral therapy is the treatment of choice in isolated supragastric belching. On the other hand, the best management of supragastric belching associated with globus, gastroesophageal reflux disease, and dyspepsia remains to be studied.
Diagnosis ; Dyspepsia ; Electric Impedance ; Eructation* ; Esophagus ; Gastroesophageal Reflux ; Hand ; Humans ; Patient Education as Topic ; Proton Pumps

So-called Brunners gland adenoma is characterized by a nodular proliferation of histologically normal Brunners gland, accompanied hy duots and scattered stromal elements. This benign tumor of the duodenum is rare and is not eaey to discover because of non-specific symptoms. The clinical presentation can vary from vague upper abdominal symptoms with dyspepsia and nausea to diarrhea, jaundice, obetruction and gastrointestinal bleeding. The diagnosis is usually made by radiologic studies and gastroduodenal endoscopy which can also provide definitive treatment. The management of Brunners gland adenoma is complete removal of the lesion and pathologic examination, always necessary to define the nature of the lesion and exclude malignacy. We experienced two cases of Brunner's gland adenoma in the duodenal bulb. The patients complained of epigastric discomfort and bloating respectively. The endoscopic examination revealed round semipedunculated polypoid mass covered with normal muosa at duodenal bulb. One case with a small adenoma (size: 0.7 x 0.7 cn) had been removed by endoscopic polypectomy and the other case with a relatively large polyp (aize: 2.0x2.0cm) had been treaed by transduodenal exploration and excision of the polyp.
Adenoma* ; Diagnosis ; Diarrhea ; Duodenum ; Dyspepsia ; Endoscopy ; Hemorrhage ; Humans ; Jaundice ; Nausea ; Polyps

Menetrier's disease is a rare disease characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss and edema due to gastric protein loss. The 48-year-old male patient was admitted to the Hangang Sacred Heart Hospital with cheif complaints of indigestion and epigastric pain. The diagnosis of Menetriers disease is established by radiologic, endoscopic, and pathologic examination. He was treated with soft diet, antacid, H2- receptor antagonist, and IV albumin. We report a case of Menetriers disease with brief review of literatures.
Diagnosis ; Diet ; Dyspepsia ; Edema ; Gastritis, Hypertrophic* ; Heart ; Humans ; Male ; Middle Aged ; Rare Diseases ; Stomach ; Weight Loss

Leimyosarcoma of the inferior vena cava is a rare disorder and may present with symptoms of obstruction of the normal flow of blood. We report a case of leiomyosarcoma of the inferior vena cava in 55-year-old female patient. The tumor was discovered incidentally by ultrasonography of the abdomen which was performed to evaluate epigastric pain and indigestion. Further radiological studies including CT and inferior vena cavography confirmed the presence of a 5cm sized mass in the inferior vena cava . The microscopic examination of a specimen obtained by a catheter from inferior vena cava mass revealed malignant mesenchymal tumor. The tumor was completely resected with reconstruction of the inferior vena cava and left renal vein. The diagnosis of leiomyosarcoma was made by micoscopic and immunohistochemical findings of the resected tumor.
Abdomen ; Catheters ; Diagnosis ; Dyspepsia ; Female ; Humans ; Leiomyosarcoma* ; Middle Aged ; Renal Veins ; Ultrasonography ; Vena Cava, Inferior*

PURPOSE: The aim of this study was to evaluate the baseline awareness of symptoms and risk factors for ovarian cancer and to assess health beliefs in women. METHODS: Women aged over 20 to under 70 years were recruited using convenient sampling (n=207). Questionnaire survey were included on demographics, symptoms/risk factors awareness, intention to test and health belief about ovarian cancer. Survey response rate was analyzed using SPSS Window version 21.0. RESULTS: The level of ovarian cancer awareness was very low at an urban in South Korea. and the total score was 20~30 points. Especially, participants were not aware symptoms including indigestion, abdominal fullness and risk factors including late menopause, family history of ovarian/breast cancer and BRCA1/2 mutation carrier. Regarding main symptoms of ovarian cancer, 82.9% of participants did not choose to visit gynecology but they wanted to visit internists. In terms of Health beliefs, overall women agreed or strongly agreed for perceived seriousness and benefit, but the score of perceived sensitivity and barriers(inversed score) were poor with 2.02, 2.40 of 4, respectively. CONCLUSION: Many symptoms and risk factors of ovarian cancer are not well-recognized by women. Therefore, evidence-based interventions are neeeded not only to improve women's awareness but also to detect at early stage of ovarian cancer. The results of this study highlights with the need for efforts to improve health beliefs.
Demography ; Diagnosis ; Dyspepsia ; Female ; Gynecology ; Humans ; Intention ; Korea ; Menopause ; Ovarian Neoplasms* ; Risk Factors

A clinieal Observation was done on the 110 cases (male; 52 cases, female; 58 cases) of duodenitis under the gastroduodenoscopic examination among the patients who were performed endoscopic examination because of seeking for the cause of dyspepsia period from Aug. 1981 to Sep. 1981 at Department of lnteral Medicine of BNUH. The results were summerized as follow 1) Normal finding(Grade 0) was highest as 40% in the incidence according to grade of duodenits. Next was moderate (Grade II & II) as 24. 5%, the 3rd was mild(Grade I) as 20% and lowest in severe(Grade IV) duadenitis as 15.5%, 2) Sex distribution of duodenitis showed 37 cases in male and 29 cases in female. And male was slightly higher in incidence than female. 3) Age distribution of duodenitis revealeii 3rd decade and 4th decade were highest in incidence, 30 cases and 28 cases respectively. The order of frequency was 5th decade, 6th decade, 1st decade and 7th decade. 4) Duodenitis was slightly higher in after 4th decade than before 4th decade. 5) The 56 cases of duodenitis except for 1 case were aasociated with gastroduodenal diseases such as gastritis, peptic ulcer or gastric carcinoma. Association of gastritis is highest as 79. 4%. 6) Acurracy of diagnosis in duodenitis on X-ray study was 3 cases in 20 cases. Generally X-ray study was little value in diagnosis of duodenitis.
Age Distribution ; Diagnosis ; Duodenitis* ; Dyspepsia ; Female ; Gastritis ; Humans ; Incidence ; Male ; Peptic Ulcer ; Sex Distribution

We report a rare case of a gastric plasmacytoma treated with endoscopic resection and oral thalidomide therapy. A 70-year-old man was admitted to our hospital with indigestion. He had no specific medical history and unremarkable laboratory results. Gastroendoscopic findings revealed a focal, erythematous, flat elevated lesion in the anterior wall of the stomach antrum. A biopsy revealed atypical lymphocytes. Endoscopic submucosal dissection (ESD) with an insulation-tipped knife was performed 45 days after diagnosis. Radiological and hematological evaluations, including a bone marrow biopsy, were performed and showed no involvement of other organs. The patient was diagnosed with extramedullary gastric plasmacytoma. Follow-up gastroendoscopy was performed three times during a 2-year period and showed nonspecific ESD scarring. The patient's condition was found to be stable.
Aged ; Biopsy ; Bone Marrow ; Cicatrix ; Diagnosis ; Dyspepsia ; Follow-Up Studies ; Humans ; Lymphocytes ; Plasmacytoma* ; Stomach ; Thalidomide*

Hemangioma in the esophagus is an uncommon tumor. There have only been about 30 cases reported in the world literatures. It occurs predominantly in men and although majority are asymptomatic, may cause bleeding and dysphagia. Hemangioma in the esophagus was diagnosed with a barium swallowed esophagography and endoscopy. The main treatment modes recommended are surgery and endoscopic resection. We experienced one case of cav ernous hemangioma occurring at the distal esophagus. The patient was a forty-six year old male with dysphagia and indigestion. Barium esophagogram showed a filling defect at the distal portion. Esophagoscopy showed a bluish polypoid mass. Surgical resection was per formed and the pathologic diagnosis was confirmed as cavernous hemangioma. Postoperative course was uneventful and the patient had been followed up without any problems.
Barium ; Deglutition Disorders ; Diagnosis ; Dyspepsia ; Endoscopy ; Esophageal Neoplasms ; Esophagoscopy ; Esophagus* ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Male