• Title/Summary/Keyword: Acute abdominal pain

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Clinical Characteristics and Ultrasonographic Findings of Acute Bacterial Enterocolitis in Children

  • Chun, Peter;Lim, Taek Jin;Hwang, Eun Ha;Mun, Sang Wook;Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.20 no.2
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    • pp.107-113
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    • 2017
  • Purpose: This study clarified the bacterial pathogens currently causing acute infectious enterocolitis (AIE) in children and evaluated the clinical characteristics and ultrasonographic findings according to the different pathogens. Methods: Medical records regarding age, sex, clinical symptoms, laboratory data, identified enteropathogens, ultrasonographic findings, treatment, and outcome of 34 patients who were diagnosed with AIE via stool examination using multiplex polymerase chain reaction (PCR) or culture, were retrospectively reviewed. Results: Twenty-four patients (70.6%) were male. The mean age of the patients was $8.5{\pm}6.2$ (range, 1.1-17.1) years. Six bacterial pathogens were isolated: Salmonella species (spp.) (32.4%), Campylobacter spp. (20.6%), verotoxin-producing Escherichia coli (14.7%), Staphylococcus aureus (11.8%), Clostridium difficile (8.8%), and Shigella spp. (2.9%). Abdominal pain occurred in all patients regardless of pathogen. The patients infected with Salmonella were older than those infected with verotoxin-producing E. coli (p<0.05). C-reactive protein levels were higher in patients with Salmonella and Campylobacter infections than in those with verotoxin-producing E. coli infection (p< 0.05), the other clinical and laboratory data were indistinguishable between pathogens. Ultrasonography demonstrated diverse involvement of bowel segments according to pathogen. Wall thickening of both the ileum and the entire colon was the most common lesion site regardless of pathogen. Conclusion: Various bacterial agents cause AIE and the symptoms are diverse symptoms, however, all most children recovered spontaneously. Use of multiplex PCR on stool samples warrants improvement of its sensitivity for diagnosis of enteropathogenic bacteria. Ultrasonographic examination is useful for diagnosis of AIE; it can also detect the disease extent and severity.

Surgical Treatment of Aortoiliac Arterial Occlusion: Report of 2 Cases (대동맥하단부-장골동맥의 급,만성 폐쇄성 동맥질환 2례)

  • 마중성
    • Journal of Chest Surgery
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    • v.5 no.1
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    • pp.19-24
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    • 1972
  • The recent development of cardiovascular surgery as well as aortoarteriogaphy has been established excellent operative result with great aid of limb-salvage. However, less consideration or less experience still exists on the regard of vascular accident and vascular disease, as well as vascular surgery in Korea. During the last 13 years, we experienced only two cases of aorto-iliac occlusion,acute and chronic, regardless of having had more than 300 cases of mitral valvotomy and gradual increasing tendency of arteriosclerosis and hypertension in Korea. Therefore it is noteworthy to report the cases in order to promote the consideration for vascular surgery. Case 1; 52 year old female who had 20 years history of mitral stenosis with uricular fibrillation and received medical treatment for recent 1 year in the medical department. 10 days before admission, acute saddle emboli developed and 15 days after the onset, embolectomy through both common femoral arteries on the groin and abdominal approach was made. The progression of emboll to the right popliteal bifurcation was found by arteriography on operating table and retrograde flushing with heparin solution by the polyethylene catheter inserted through posterior tibial artery. The operation was successful, but 9 hours after operation sudden death occurred. Considering this case, first, mitral valvotomy already before might prevent peripheral embolizatlon, secondarily, the more early detection and surgery might also prevent the progression of emboli. Thirdly, although preoperative or postoperatlve heparinization is controversial for mitraI stenosis, heparinization might prevent additional emboli to vital organs in this case Cases 2; 66 year old female who had 4 years history of left hip and calf intermittent claudication and has had rest pain, inability to walk and ischemic necrosis on the the left leg since last 3 months prior to admission to the orthopedic department under the suspicion of herniated disc. Absence of pulsation on the groin and aortography evidenced aortoillac occlusion predominantly on the left side. Thromboendarterectomy was made and the operative result was successful with absence of claudication, healing of ulcer and aortographic patency of occlusive site. This chronic occlusion is considered to result from arteriosclerosis in origin with the evidence of moderate hypertension, x-ray evidence of calcified plaque on the aortic knob and operative finding of palpable plaques.

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Anti-inflammatory and Anti-gastritis Effect of Sogunjung-tang Mixed Soft Extract (소건중탕 혼합단미연조엑스의 항염증 및 항위염 효과)

  • Kim, Myoung-Jin;Choi, Hye-Min;Nam, Won-Hee;Kim, Se-Jin;Son, Su-Mi;Kim, Jung-Ok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.35 no.6
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    • pp.235-241
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    • 2021
  • Sogunjung-tang (SGJT) is traditional herbal prescriptions used to treat abdominal pain. In this study, we evaluated the effect on inflammation and gastritis through SGJT formulation development. SGJT composition herbal medicine was boiled in water at 95~100℃ for 3 hours and then concentrated. Sogunjung-tang mix soft extract (STM) was prepared using pharmaceutical excipients such as purified water, sodium benzoate, β-cyclodextrin and CMC-Na. Anti-inflammatory experiment was conducted using STM and lipopolysaccharide (LPS) in RAW 264.7 cells. Cell survival was measured by MTT method. Nitric oxide (NO) was measured using griess reagents, and pro inflammatory cytokines were measured by enzyme-linked immunosorbent assay and RT-PCR. Also, we verified STM validity in acute gastritis using the ICR mouse. STM was administered oral for three days. And 150 mM HCl in 60% ethanol was oral administered 0.5 mL one hour after the last drug administration. Mice were sacrificed 1 hour after 150 mM HCl in 60% ethanol administration. The gastric mucosa was visually observed. STM were not toxic in RAW 264.7 cells. Treatment of STM inhibited the production of NO and inflammatory cytokine at the protein and mRNA levels. Also, in the acute gastritis model with the mouse, the treatment of STM improved gastric mucosal bleeding and edema. In summary, it was confirmed that the treatment of STM exerts anti-inflammatory and anti-gastritis effects. Therefore, we suggest that STM may provide a preclinical evidence for the prevention and treatment of inflammatory and gastritis diseases.

Anti-Viral Activities of Probiotics against Viral Gastroenteritis: A Review (바이러스성 위장염에 효과를 가지는 프로바이오틱스: 총설)

  • Jung-Whan Chon;Hye-Young Youn;Hyeon-Jin Kim;Hyungsuk Oh;Seok-Hyeong Kang;Won-Uk Hwang;Hajeong Jeong;Hyun-Ju Kim;Kun-Ho Seo;Kwang-Young Song
    • Journal of Dairy Science and Biotechnology
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    • v.41 no.3
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    • pp.87-102
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    • 2023
  • Globally, acute gastroenteritis is responsible for two million pediatric deaths. In particular, viral gastroenteritis is the most common cause of acute diarrhea, and most children aged <5 years are infected at least once. The common symptoms include profuse watery diarrhea, vomiting, abdominal pain, and fever. Viral gastroenteritis is generally caused by rotavirus, norovirus, astrovirus, and adenovirus. Recently, probiotics use has increased rapidly worldwide due to its inhibitory effect against viral gastroenteritis. In addition, probiotics are known to have anti-inflammatory and anti-allergic effects and enhance immunity without any side effects. Therefore, this review focuses on the anti-viral effects of probiotics on viral gastroenteritis. Furthermore, this review would provide basic data that could be used for developing new products that have improved functionality by addition of probiotics to milk and dairy food.

Computed Tomography Assessment of Severity of Acute Pancreatitis in Bangladeshi Children

  • Kaniz Fathema;Bazlul Karim;Salahuddin Al-Azad;Md. Rukunuzzaman;Mizu Ahmed;Tasfia Jannat Rifah;Dipanwita Saha;Md. Benzamin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.3
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    • pp.176-185
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    • 2024
  • Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.

Usefulness of a Alvarado Scoring System for the Diagnosis of Acute Appendicitis in Children (소아 충수돌기염 진단에서 Alvarado Scoring System의 유용성)

  • Yang, Eun Seok;Yoon, Sung Kwan;Kim, Eun Young;Rho, Young Il;Park, Sang Kee;Park, Yeong Bong;Mun, Gyeong-Rae
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.1-7
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    • 2004
  • Purpose: Alvarado scoring system was evaluated regarding its usefulness for the early diagnosis of acute appendicitis in adult and in reduction of the incidence of negative appendicectomies. To evaluate the accuracy of diagnosing appendicitis using the Alvarado score in children. Methods: Prospectively, we surveyed 122 patients (male 67, female 55) suffering from abdominal pain, who had visited to the emergency department of Chosun University Hospital from June 2002 to May 2003. The Alvarado score has been computed from the white blood cell count, neutrophil count, body temperature, resistance in the right lower quadrant, length of symptoms, nausea and vomiting. Each patient was evaluated by a pediatric resident and then by a general surgeon independently. Results: Out of 170 total children who visited to the emergency department due to abdominal pain, 122 patients were associated with appendicitis. A total of 122 patients (67 male and 55 female) were visited to the emergency room with suspected appendicitis. From 105 operated patients, 92 (87.6%) were diagnosed acute appendicitis and erronous diagnostic rate was 12.4%, pathologically. Mean alvarado score of appendicitis group was $5.40{\pm}1.24$ whereas those of non-appendicitis group was $3.73{\pm}1.82$ (p<0.05). From 6 Alvarado score high sensitivity (86.4%) and high specificity (80.0%) were observed. Sensitivity of ultrasonography or computed tomography was 92.5%. Conclusion: We found that Alvarado score system is a noninvasive, safe diagnostic method, which is simple, reliable and repeatable. Alvarado score is useful system for a first, rapid and economic evaluation for the appendicitis in children.

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Domestic and Foreign Research Trend on the Pediatric Chuna Treatment (소아 추나에 대한 국내·외 연구 동향)

  • Lee, Jin Hwa;Han, Jae Kyung;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.4
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    • pp.67-76
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    • 2015
  • Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.

The Thought of Che-Qi-Jung concerned with Phenomenon of Stress (STRESS 현상(現象)과 관련(關聯)된 제기증(諸氣證)에 관(關)한 문헌적(文獻的) 고찰(考察))

  • Koh, Tae Joon;Lee, Sang Ryong
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.317-327
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    • 2000
  • Through the study about Che-Qi-Jung(諸氣證) concerned with phenomenon of stress, we concluded as fallow. 1. Stressors are recognized three parts, internal cause, external cause, non-interexternal cause, in the oriental medicine. And the reaction of the body about stressors, was expressed change of Qi(氣). 2. The vascular system and autonomic nervous system are tensed or relexed. Because the etiology of Yuk-Em(六淫), Chil-Jeong(七情) make lose up and down, in and out, circulation of Gi(氣). The symtom caused with stress are explained, divided into Chil-Qi(七氣), Gu-Qi(九氣), Joong-Qi(中氣), Qi-Tong(氣痛), Qi-Yuk(氣逆), Qi-Wool(氣鬱). 3. The symtom of Chil-Qi is recognized into psycholoQical stress and Mae-Haek-Qi(梅核氣). The symtom of Gu-Qi is composed of Chil-Qi and Han(寒), Youl(熱), Ro(勞). 4. The symtoms of Qi-Yuk and Joong-Qi are caused by the ascent of Hwa-Qi(火氣). And Hwa-Qi is made by rage and depression. Qi-Yuk is chronic symtom that the ascent of Hwa-Qi is made by out of function in up and down mechanism of Qi. Joong-Qi is acute symtom that patholoQical state of Qi-Yuk take place for a while by sudden psycholoQical shock. 5. The symtom of Qi-Wool is loss of funtion made by depressed state in physioloQical mechanism, and Qi-Wool is observed in depressive psychosis and hypochondriasis and psychogenic. 6. The symtom of Qi-Tong is the pain caused by interference of circulation of Qi-Hyul(氣血). PsycholoQical stimulation such as rage and depression, tense autonomic nervous system. This make convulsion in gastro-intestine or vascular circuluation or abdominal muscles, and the pain is caused by convulsion.

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Whole-liver Radiotherapy Concurrent with Chemotherapy as a Palliative Treatment for Colorectal Patients with Massive and Multiple Liver Metastases: a Retrospective Study

  • Yin, Hang;Lu, Kai;Qiao, Wen-Bo;Zhang, Hai-Yang;Sun, Di;You, Qing-Shan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.4
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    • pp.1597-1602
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    • 2014
  • The purpose of this study was to investigate whether whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases. From January 2007 to December 2012, 19 patients who exhibited massive (with a longest diameter > 5 cm) and invasive liver metastases and multiple metastases were treated with radiotherapy and concurrent chemotherapy. The total radiation dose was 53.4 Gy (range 38.8 Gy-66.3 Gy). All of the patients received a continuous intravenous dose of 5 fluorouracil (5-FU) 225 mg/m2 concurrently with radiation. The median survival time was 19 months. The 1- and 2- year overall survival rates were 78.3% and 14.3%, respectively. Of all of the patients who presented with abdominal pain, 100% experienced a decrease in pain. Decreases in the rates of ascites and jaundice were confirmed by ultrasound and bilirubin levels. No cases of Grade 4 or 5 acute or late toxicity were recorded. There were only two cases of Grade 3 toxicity (elevated bilirubin). These data provide evidence that whole-liver radiotherapy plus a tumor-boost dose with concurrent chemotherapy is beneficial for colorectal cancer patients with massive and multiple liver metastases.

A Case of Extensive Stage Small Cell Lung Cancer Presenting as an Acute Appendicitis with Perforation (전이성 병소에 의해 발생한 급성 충수염의 천공으로 진단된 전신병기 소세포폐암 1예)

  • Shin, Dong Won;Choi, Moon Han;Park, Seung Sik;Park, Sung Woo;Kim, Ki Up;Jang, An Soo;Park, Choon-Sik;Lim, Cheol Wan;Ko, Eun Suk;Paik, Sang Hyun;Kim, Do Jin
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.3
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    • pp.230-234
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    • 2008
  • The incidence of appendiceal metastatic cancer is quite low. In particular, in small cell lung cancer, there is a very low incidence of a metastasis to the appendix. A 75-years old man with right lower quadrant pain, cough and sputum was transferred to our hospital. Abdominal CT revealed acute appendicitis with a perforation. The patient underwent surgery. The frozen sections of the tissue obtained during surgery, indicated a malignancy, but a right hemicolectomy was not performed due to the patient's poor general condition. The histology findings of the appendix were identified as a small cell carcinoma. The abdominal CT scan and chest x-ray at admission day showed a mass in the right lower lobe, and a further evaluation of the lesion was performed including positron emission tomography and flexible bronchoscopy with a biopsy. The pathology findings of the lung mass were also small cell lung cancer. The specimens from both sites stained positive for cytokeratin, cluster designation 56, synaptophysin, chromogranin-A and thyroid transcription factor 1. It was concluded that the appendiceal small cell cancer originated from the lung.