• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권2호
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• pp.141-146
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• 2018

Nowadays, Klebsiella oxytoca is described as a causative organism for antibiotic-associated hemorrhagic colitis (AAHC). Here we report two cases of pediatric AAHC, from which K. oxytoca was cultured after starting amoxicillin-clavulanate or amoxicillin treatment. The patients developed severe abdominal pain and a large amount of bloody diarrhea. K. oxytoca was obtained in intestinal fluid culture of a boy through the colonoscopy. On the other hand, colonic tissue culture and intestinal fluid culture were negative of the other patient. K. oxytoca was detected in stool culture when he was admitted. These cases showed characteristic endoscopic findings of segmental hemorrhagic colitis, and both boys recovered spontaneously within 2-3 days after they stopped taking the antibiotics. Therefore, in children who develop relatively large amount of bloody diarrhea after antibiotic treatment, we should consider AAHC caused by K. oxytoca.

• 한국동물위생학회지
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• 제30권2호
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• pp.269-274
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• 2007

The aim of this study was to examine the epidemiological features of Eimeria in calves with acute diarrhea. Samples were collected from between 15 days and 90 days old calves (n=83) in Gimje area from March 2006 to March 2007. Feces of bloody diarrhea were examined for the presence of Eimeria oocysts using a sucrose flotation method. Out of 83 calves, 62 (74.6%) had Eimeria oocysts. In the results of monthly analysis, the highest prevalence (12.0%) of Eimeria oocysts was found on June. In the seasonal infection rate, spring was the highest prevalence (30.1%), followed by summer (24.0%). Furthermore, the highest prevalence (44.5%) was found in calves from between 31 - 60 days old in the analysis by ages. However, there was no significant differences between female and male sex even though the prevalence was slightly bigger in female than in male. The prevalence of the present study to detect Eimria oocysts for infection may have been affected by weather-conditions in the spring. Young calves should be separated to minimize the infection from cattle as much as possible. Additional studies are necessary to find other factors for infection and combining molecular methods with a highly sensitive system for Eimeria detection could be a reliable and economic way of Eimeria eradication.

• 대한암한의학회지
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• 제17권2호
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• pp.17-22
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• 2012

Background : Sulfasalazine for treating ulcerative colitis has a clinical limitation due to its adverse effects. This case is about a patient with ulcerative colitis who could not tolerate sulfasalazine and was improved by Do-che decoction-based Korean medicine. Method and Results : Purulent and bloody diarrhea more than 20 times a day, mild fever, chilling and tenesmus were main symptoms of this patient who was diagnosed as ulcerative colitis 10 years ago. Do-che decoction-based Korean medicine which was recommended for purulent and bloody diarrhea in Dong-Ui-Bo-Gam, the classic literature of Traditional Korean Medicine was given to the patient for more than 1 month. After treatment, the frequency of purulent and bloody diarrhea, tenesmus and fever was decreased remarkably, and C-reactive protein, erythrocyte sedimentation rate, white blood cell count and maximum temperature also dropped to the normal range. Conclusion : Do-che decoction-based Korean medicine has a potential effect and may be a alternative therapeutic option in patients with ulcerative colitis who cannot tolerate sulfasalazine due to its adverse effects.

• Clinical and Experimental Pediatrics
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• 제48권3호
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• pp.235-250
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• 2005

Acute diarrhea is one of the most common diseases that are seen in pediatric patients. In the management of acute diarrhea, several differential diagnostic criteria should be considered based on clinical and/or laboratory findings. These criteria include : (1) normal variant stool versus diarrhea (2) infectious versus non-infectious condition and (3) bacterial versus non-bacterial etiology. The use of antibiotics should be considered to manage diarrhea caused by bacteria accompanying fever and bloody diarrhea in the following cases : (1) patients with serious clinical course, (2) under three months, (3) immunocompromised patients, (4) patients with nutritional deficiency and (5) patients presenting with moderate-to-severe dehydration. In patients presenting with the symptoms suspected to be bacterial origin, whose clinical course is not serious, antibiotic therapy is not necessary. These patients are easily manageable at OPD level. Moreover, except for some cases in which the use of antibiotics is inevitable, pediatric diarrhea can be managed by providing the suitable foods alone with no necessity of other specific drugs. Accordingly, it is crucial not so much to depend on the drugs as to provide appropriate foods including oral rehydration solution(ORS) with no further episodes of diarrhea. Special attention should be paid to the fact that younger pediatric patients will undergo nutritional deficiency unless acute diarrhea is properly managed.

• 대한한의학원전학회지
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• 제34권1호
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• pp.47-65
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• 2021

Objectives : An accurate judgment of prognosis when treating diseases is crucial. While the 『Shanghanlun(傷寒論)』 deals with the prognosis of the Three Yin Diseases with great importance, full-scale studies have been lacking. This paper aims to study the Three Yin Diseases with a focus on prognosis analysis. Methods : Among the Three Yin Disease verses, those that could provide clues to prognosis were selected and analysed. Conclusions & Results : When Yang pulse patterns such as long(長脈)·floating(浮脈)·rapid(數脈) pulses and Yang symptoms such as fever, vexing heat, mild perspiration, thirst, warmth in hands and feet are present in Yin disease, it could be taken as signs of Yang Qi restoration. In these situations, Yin Cold pattern such as diarrhea and reversal cold disappear and the prognosis is positive. However, despite Yang pulse patterns and symptoms, there are cases where diarrhea happens as a result of cold dampness being eliminated due to Yang Qi restoration. Also, when Yang Qi starts communicating smoothly after its restoration in the Three Yin Diseases, perspiration can happen. When diarrhea and reversal cold, which are patterns of Yin Cold get worse, with pulse patterns such as unfelt(脈不至)·replete(實脈)·fulminating(脈暴出) pulses, false heat symptoms such as fever and hot flashes happen, accompanied with Yang Qi depleted symptoms such as inability to lie down due to agitation, continuous perspiration, sore throat, dyspnea, and exaggerated breathing happen. When fast pulse, fever, and perspiration are present due to depression and stagnation of ministerial fire, symptoms such as bloody stool with pus, purulent abscess, sore throat, and inability to lie down due to agitation show, which signal negative prognosis. In bad cases of Reverting Yin Disease, there is continuous diarrhea and bloody stool with pus, which can be due to either Kidney Yang deficiency or depression and stagnation of ministerial fire. It could also be caused by excessive heat.

• 한국임상수의학회지
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• 제12권1호
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• pp.911-916
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• 1995

Ionophorous antibiotics have been used popularly for the protection of avian coccidiosis, though Halo-fuginone which is derived from an extract of the Dichroa febrifuga, was developed as an antimalarial and anticoccidial agent. The antibiotics are regarded as the causes of residues in the avian products, therefore the author has tried to find out more safe herbal materials for the control of avian coccidiosis. Thus, the extracts of 5 kinds of herbs, roots of Pulsatilla koreana Nakai and Sophora flavescens Aiton, nuts of Quisqualis indica Linne, whole herbs of Artemisia annua Linne and Polygonum aviculare Linne, were investigated on the efficacy against E tenella. Survival rates, bloody diarrhea, lesion scores, body-weight gains and feed conversion rate were investigated at the 1st and the 2nd week after infection. The bloody diarrhea in the groups treated with P koreana, A annua, Q indica and P aviculare were milder than those in the groups treated with S flavescens and infected control. The lesion score in the groups treat.4 with herb extracts(2.00$\pm$0.82~2.65$\pm$0.89) were lower than those in the control group (2.80$\pm$0.7l). But, there was not significant in all infected groups. The body weight gai in the groups treated with P koreana, S flavescens, A annua and Q indica(291.74$\pm$15.76~303.43$\pm$51.90) were higher than that in the control group (283.71$\pm$16.53) but there was not significant. In a conclusion, analyzing the data of the survival rates, bloody diarrheal symptoms, lesion scores, body weight gains and oocyst excretions, the extract of S flavescens, P koreana, A annua and Q indica were effective. The further research on the above herbal materials will have been carried out by the author and the other researchers by means of the chemical analysis of the components.

• Childhood Kidney Diseases
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• 제1권2호
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• pp.170-175
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• 1997

목적 : 용혈성 요독 증후군은 서구에서 영아 및 소아의 가장 흔한 급성 신부전의 원인으로 알려져 있으나 국내에서는 발생 빈도가 적다. 이 질환은 아시아 및 일본지역에서는 비교적 드문 질환이었으나 최근 몇년 동안 출혈성 설사를 동반한 용혈성 요독 증후군이 급속히 증가 하고 있다. 이에 저자들은 최근 본원에서 경험한 5례를 대상으로 임상적인 특성과 경과를 관찰 하였다. 방법 : 1996년 1월부터 1996년 12월까지 삼성 서울 병원 소아과에 입원하여 용혈성 요독 증후군으로 진단 받고 치료한 5례의 소아를 대상으로 후향적으로 병록 검토를 시행하였다. 결과 : 1) 발병 당시 연령은 3세 이하가 3례, 9세이상이 2례였다. 2) 계절적 분포는 모든 예에서 여름과 가을에 발생하였고, 전구 증상이 있기전에 여행한 경험이 있는 경우가 3례, 오염된 지하수나 약수를 마신 경력이 있는 경우가 4례 였다. 3) 임상 증상으로는 전신 부종 5례, 핍뇨 4례, 무뇨 2례, 육안적 혈뇨 1례였다. 소화기계 증상은 설사가 전예에서 있었고 1례에서 급성 충수염으로 오인 하여 개복 수술 받았다. 4) 혈액 및 배변 배양 검사에서 동정된 균은 없었다. 5) 무뇨증이 2주일 이상 지속된 2례에서 경피적 신생검이 시행 되었으며, 1례는 주로 사구체를 침범한 혈전성 미세 혈관증을 보였고, 1례는 신부전으로 이행된 국소적 신피질 괴사와 사구체 경화가 있는 만성 괴사성 사구체 신증 소견을 보였다. 6) 임상적 예후는 완전 회복된 경우가 4례, 고혈압이 동반된 만성 신부전이 1례였고, 이 1례에서 시행한 복부 단층 촬영상 전형적인 신피질 괴사 소견과 담석이 관찰 되었다. 결론 : 유행성이면서 예후가 좋은 전형적인 용혈성 요독 증후군은 주로 서구에서 많이 보고되어 왔으나, 최근 몇년 동안 일본 등 아시아 지역에서도 급속히 증가 추세를 보이고 있어, 국내에서도 출혈성 설사를 동반한 용혈성 요독 증후에 대한 면밀한 임상적 관찰이 필요할 것으로 사료된다.

• 한국임상수의학회지
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• 제26권6호
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• pp.578-581
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• 2009

25일령의 한우송아지가 10일 간의 호흡기질환과 출혈성 설사의 병역을 나타내다가 폐사하였다. 이 송아지는 다른 송아지들과 비교해보았을 때 극도로 위축되어 있었다. 꼬리와 회음부의 분변 흔적은 만성설사가 지속되었음을 말해주었다. 부검시 다양한 기관(조직)에서 반상출혈이 관찰되었다. 역전사 중합효소연쇄반응에 의하여 소 바이러스성 설사병 바이러스가 진단되었다. 이 증례는 계통발생분석에서 BVDV-2a 그룹에 속하는데, 이것은 고병원성인 미국 균주890 (U18059)과 유사하다. 본 증례는 BVDV-2가 한국에서 유행하고 있다는 증거를 제공한다. 이를 통해 우리는 BVDV-2의 발생을 재확인하였다.

• 한국동물위생학회지
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• 제29권4호
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• pp.497-501
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• 2006

Acute hemorrhagic enteritis was diagnosed in a seven-month-old male Shitzu dog dying of blood stained diarrhea and vomiting. Clinical findings were anorexia, dullness and sudden death after massive bloody diarrhea. At necropsy, main lesion was the hemorrhage in small intestine, mainly duodenum and jejunum. Microscopically, Gram positive long bacilli were massively detected on the mucose epithelial cells and necrotic debris of small intestine. Coagulative necrosis of epithelial cells and thrombosis of small intestine were also identified. However, there was no lesion of crypt epithelium. Mineral infiltration in both gastric mucosa and renal tubules was detected and proliferation of fibrous tissue was also shown in corticomedullary regions. In bacterial examination, C perfringens was isolated in anaerobic culture and it was confirmed to type A by multiplex PCR. Therefore, the dog was diagnosed as C perfringens type A associated enteritis with uremia.

• Journal of Yeungnam Medical Science
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• 제25권2호
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• pp.182-186
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• 2008

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract that affects the large bowel. Its etiology remains controversial. However, an infectious or immunologic origin is considered the primary cause. The onset of UC is typically slow and insidious, but some patients may present acutely with symptoms mimicking infectious colitis. We report a case of ulcerative colitis mimicking acute hemorrhagic colitis at initial presentation. A 60-year-old man was referred to Yeungnam University Hospital for bloody diarrhea and abdominal pain. Sigmoidoscopy revealed mildly edematous mucosa in the rectum and hyperemic mucosa with petechiae in the sigmoid colon. The patient was treated with antibiotics for several days, and his symptoms improved. However, after one month, his bloody diarrhea relapsed. Follow-up sigmoidoscopy revealed mucosal friability in the rectum and sigmoid colon. He was diagnosed with ulcerative colitis, and his symptoms were improved with mesalazine and a steroid enema.