• Title/Summary/Keyword: Chronic gastrointestinal disease

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Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management

  • Lee, Yong Hee;Kim, Yu Bin;Koo, Ja Wook;Chung, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.3
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    • pp.175-185
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    • 2016
  • Purpose: To investigate the epidemiology, clinical manifestations, investigations and management, and prognosis of patients with Henoch-Schonlein purpura (HSP). Methods: We performed a retrospective review of 212 HSP patients under the age of 18 years who were admitted to Inje University Sanggye Paik Hospital between 2004 and 2015. Results: The mean age of the HSP patients was 6.93 years, and the ratio of boys to girls was 1.23:1. HSP occurred most frequently in the winter (33.0%) and least frequently in the summer (11.3%). Palpable purpura spots were found in 208 patients (98.1%), and gastrointestinal (GI) and joint symptoms were observed in 159 (75.0%) and 148 (69.8%) patients, respectively. There were 57 patients (26.9%) with renal involvement and 10 patients (4.7%) with nephrotic syndrome. The incidence of renal involvement and nephrotic syndrome was significantly higher in patients with severe GI symptoms and in those over 7 years old. The majority of patients (88.7%) were treated with steroids. There was no significant difference in the incidence of renal involvement or nephrotic syndrome among patients receiving different doses of steroids. Conclusion: In this study, the epidemiologic features of HSP in children were similar to those described in previous studies, but GI and joint symptoms manifested more frequently. It is essential to carefully monitor renal involvement and progression to chronic renal disease in patients ${\geq}7$ years old and in patients affected by severe GI symptoms. It can be assumed that there is no direct association between early doses of steroids and prognosis.

A Case of Tuberculous Enteritis with Active Pulmonary Tuberculosis in a 12-Year-Old Girl (12세 여아에게서 활동성 폐결핵에 동반된 장결핵 1례)

  • Park, Ga Young;Park, Jae Young;Kim, Chang Hwi;Kwak, Jeong Ja;Park, Jae Ock
    • Pediatric Infection and Vaccine
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    • v.20 no.3
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    • pp.190-196
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    • 2013
  • Intestinal tuberculosis (TB) is presented with nonspecific and variable clinical manifestations such as abdominal pain, diarrhea, fever and weight loss. Diagnosis of tuberculous enteritis may be missed or confused with many other chronic gastrointestinal disorders such as the Crohn disease and intestinal neoplasms. The diagnosis should be based on careful clinical evaluations, such as extra-intestinal signs and colonoscopic and histologic findings. Newer techniques such as PCR tests from the specimens through colonoscopic biopsy may be helpful to confirm diagnosis of tuberculous enteritis. The treatment regimens for pulmonary tuberculosis are generally effective for tuberculous enteritis as well. If not treated early, the prognosis of intestinal tuberculosis is poor. We report a case of tuberculous enteritis diagnosed by colonoscopic biopsy and TB PCR which was presented with diarrhea, abdominal pain, intermittent fever and weight loss in a 12-year-old girl with active pulmonary tuberculosis. The patient was treated successfully with antituberculosis agents for 11 months without any complications.

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The Influence of Health Status and Type of Health Management on Depression in Middle-Aged Women (중년여성의 건강상태와 건강관리형태가 우울에 미치는 영향)

  • Chung, Myung Sill;Kim, Yeon-Ha;Lim, Kyung-Choon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.24 no.3
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    • pp.250-258
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    • 2018
  • Purpose: This study aimed to investigate the influence of health status and types of health management on depression in middle-aged women. Methods: A convenience sample of 188 participants was recruited from health centers in S city. Using a structured questionnaire, data was collected and analyzed by t-test, ANOVA, Pearson's correlation, and linear regression using SPSS/WIN 23 program. Results: Results of the regression analysis showed that perceived current health status (${\beta}=-0.55$, p<.001), no caregiver (${\beta}=0.47$, p<.001), chronic diseases lasting more than three months (${\beta}=0.36$, p<.001), perceived health status compared to peer group (${\beta}=0.32$, p<.001), walking for health (${\beta}=-0.20$, p=.002), caregiver except family (${\beta}=0.18$, p=.001), and gastrointestinal disease (${\beta}=0.10$, p=.022) influenced depression in middle-aged women. Overall, approximately 69.7% of total variance explained this model (adjusted $R^2=0.678$, F=57.21, p<.001). Conclusion: This study suggests that it is more important to understand the level of perceived health status in middle-aged women. Furthermore, it is necessary to develop programs that include various health management methods and strengthen the health care with the help of families and neighbors in order to manage depression in middle-aged women.

Effect of Aloe on Learming and Memory lmpaiments in Dementia Animal Model SAMP8 (치매동물모델 SAMP8에 있어서 기억. 학습장해에 미치는 알로에의 영향 III. SAMP8의 신경전달물질 및 그 대사산물에 미치는 알로에의 투여효과)

  • Choi, Jin-Ho;Kim, Dong-Woo;Kim, Jae-il;Han, Sang-Seop;Shim, Chang-Sub
    • Journal of Life Science
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    • v.6 no.2
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    • pp.142-148
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    • 1996
  • Aloe(Aloe arborescens M$_{ILL}$) has been used as a home medicine for the past several thousand in the world, and has been studied on anti-bacterial and anti-fungal activities, hypotension, atherosclerosis, myocardiac infartion, apoplexy, diabetes as a chronic digenerative disease, tumors, gastrointestinal tract, liver and pancreas' diseases, and genitourinary tract etc. SAMP8 as a learing and memory impairment animal model were fed basic and/or experimental diets with 1.0% freezing dried(FD)-aloe for 8 months. The passive avoidance tests such as acqusition trial and retention test were significantly higher in aloe group than in control group. Grading score of senescence resulted in a marked decreases in aloe group compared with control group. Acetylcholinesterase(AChE) activity was remarkably increased in aloe group compared with control group. Neurotransmitters such as dopamine(DA) and serotonin(5-HT) almost did not change by the feeding of aloe-added diet, but their metabolites such as homovanillic acid(HVA) and 5-hydroxy-indole acetic acid(5-HIAA) in aloe group were significantly increased compared with control group. Therefore, the ratios of HVA/DA and 5-HIAA/5-HT as a ratio of metabolite on neurotransmitter were significantly increased by the feeding of aloe-added diet. These results suggest that aloe vara may be activated acetylcholinesterase, the metabolite of neurotransmitter, and ratios of metabolite on neurotransmitter, resulting ina greater prevention of learning and memory impairments such as Alzheimertype dementia.

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A Clinical Survey of 9 dogs with Naturally Occurring Hypoadrenocorticism (자연발생 부신겉질저하증에 걸린 9마리 개에 대한 고찰)

  • Ko Young-hwan;Bae Bo-kyoung;Bhang Dong-ha;Choi Ul-soo;Youn Hwa-young;Hwang Cheol-yong;Choi Min-cheol;Yoon Jung-hee;Lee Chang-woo
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.130-135
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    • 2005
  • A retrospective study was performed with 9 cases of spontaneous canine hypoadrenocorticism presented to the Veterinary Medical Teaching Hospital of Seoul National University. The disease occurred mostly in young to middle­aged dogs. Most dogs had chronic nonspecific signs such as episodic anorexia, lethargy and vomiting, but 3 dogs were brought to the hospital with an acute adrenal crisis. Serum biochemical analysis revealed azotemia, abnormal concentration of sodium, potassium, and chloride in almost all the patients. Diagnoses were made based on lack of adrenocortical response to exogenous adrenocorticotropic hormone(ACTH). Most dogs have been responded well with mineralocorticoid and glucocorticoid replacement except for a dog which died during treatment for adrenal crisis. Three dogs treated with fludrocortisone acetate(final median dosage, $31.0{\mu}g/kg/day$) for mineralocorticoid supplementation showed some adverse effects, such as excessive appetite and polyuria/polydipsia. In this study, it was suggested that clinicians should also consider hypoadrenocorticism when they diagnose a patient showing nonspecific gastrointestinal signs with unknown cause or laboratory findings which mimic primary renal diseases.

Analysis of Prescriptions for Asthma at Primary Health Care Using National Health Insurance Database (건강보험자료를 이용한 의원의 천식처방 분석)

  • 이의경;박은자;배은영;이숙향
    • YAKHAK HOEJI
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    • v.47 no.4
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    • pp.244-251
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    • 2003
  • Asthma is a chronic inflammatory disease of the airway and the prevalence rate is increasing. As the burden of asthma to the society is significant due to the increasing hospital admissions and emergency visits, National Heart, Lung and Blood Institute (NHLBI, USA) and World Health Organization (WHO) have developed comprehensive guidelines to help clinicians and patients make appropriate decisions about asthma care. The aim of study was to analyze the pattern of asthma prescriptions based on the national asthma guidelines for the patients visiting primary health care providers. Prescription data for asthma were obtained from the Korean National Health Insurance claims database of January 2002. Ten percent of the primary health care providers were sampled based on their specialty areas, and 20% of the claim cases were randomly chosen. Study results showed that prescription rate for oral beta-2 agonists was 44.3%, and that for oral theophylline was 46.9%. Oral steroids were prescribed for the 28.2% of the claims. Utilization of inhalers was low for both bronchodilators (20.3%, beta-2 agonists inhalers), and steroids (8.4% steroids inhalers). Bronchodilators were more preferred to the longterm anti-inflammatory controllers among the primary health care providers. Prescription rate for antibiotics was 46.0% for asthmatic patients. Also gastrointestinal drugs were prescribed for 59.0%, antitussives 65.3%, antihistamines 25.3% and analgesics 29.4%, respectively. This study presented that the prescribing pattern of the primary health care providers for the asthma was quite different from the national and international guidelines. More efforts need to be made to reduce the gap between the present pattern of asthma prescription and the guidelines.

Bowel Wall Thickening on Computed Tomography in Children: A Novel Method of Measurement and Its Clinical Significance

  • Lee, Do Kyung;Cho, Ky Young;Cho, Hyun-hae;Seo, Jeong Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.3
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    • pp.279-287
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    • 2021
  • Purpose: The clinical implications of bowel wall thickening (BWT) on abdominal computed tomography (CT) among children are unknown. We aimed to suggest a new method for measuring BWT and determining its clinical significance in children. Methods: We retrospectively analyzed 423 patients with acute abdomen who underwent abdominal CT; 262 were classified into the BWT group. For this group, the pediatric radiologist described the maximal bowel wall thickness (MT), normal bowel wall thickness (mm) (NT), and their ratios for each segment of the bowel wall. Results: In the thickened bowel walls, the thickness differed significantly between the small bowel (6.83±2.14 mm; mean±standard deviation) and the colon (8.56±3.46 mm; p<0.001). The ratios of MT to NT in the small bowel (6.09±3.17) and the colon (7.58±3.70) were also significantly different (p<0.001). In the BWT group, 35 of 53 patients had positive fecal polymerase chain reaction results; 6 patients infected with viruses predominantly had BWT in the small intestine, while the terminal ileum and the colon were predominantly affected in 29 patients with bacterial infections. In the initially undiagnosed 158 patients with BWT, the symptoms improved spontaneously without progression to chronic gastrointestinal disease. Conclusion: This study provides a clinical reference value for BWT in the small intestine and colon using a new method in children. The BWT on abdominal CT in children might indicate nonspecific findings that can be observed and followed up without additional evaluation, unlike in adults.

Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSSTM) Values in Symptomatic Infants

  • Kozlowska-Jalowska, Anna;Horvath, Andrea;Vandenplas, Yvan;Szajewska, Hania
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.4
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    • pp.384-391
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    • 2021
  • Purpose: The Cow's Milk-related Symptom Score (CoMiSSTM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSSTM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSSTM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSSTM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSSTM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSSTM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSSTM values were retrospectively and prospectively determined. Lower CoMiSSTM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSSTM in clinical practice.

The inhibitory effect of Orostachys japonicus on dextran sulfate sodium-induced colitis in mice (Dextran sulfate sodium으로 유도된 궤양성 대장염에 대한 와송의 억제효과)

  • Myung, Noh-Yil
    • The Korea Journal of Herbology
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    • v.29 no.4
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    • pp.29-34
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    • 2014
  • Objectives : Ulcerative colitis (UC) is an inflammatory bowel disease, which is one of chronic gastrointestinal disorders. Orostachys japonicus (OJ) has been used as a traditional medicine for various diseases including gastric cancer, gastric ulcers and intoxication. However, the regulatory effect of OJ on intestinal inflammation has not been fully understood, yet. The aim of this study was to investigate the effect of OJ on dextran sulfate sodium (DSS)-induced colitis in mice. Methods : To ascertain the pharmacological effects of OJ, the colitis mice were induced by drinking water containing 5% DSS for 7 days. Mice were randomized into groups receiving OJ (100 mg/kg), sulfasalazine (150 mg/kg) as a positive control, or water as a negative control. We evaluated the effects of OJ on DSS-induced the clinical signs, measuring weight loss and colon length. In addition, the inhibitory effect of OJ on the tumor necrosis factor-${\alpha}$ (TNF-${\alpha}$) level was determined by enzyme-linked immunosorbent assay in colitis tissue. Results : The results indicated that mice treated with DSS showed remarkable clinical signs, including weight loss, and reduced colon length. However, treatment with OJ significantly improved the weight loss and DAI as clinical symptoms. Moreover, OJ reduced the TNF-${\alpha}$ levels in DSS-treated colon tissues. Conclusions : Collectively, the findings of this study provide us with novel insights into the pharmacological actions of OJ as a potential medicine for use in the treatment of ulcerative colitis.

Systematic exploration of therapeutic effects and key mechanisms of Panax ginseng using network-based approaches

  • Young Woo Kim;Seon Been Bak;Yu Rim Song;Chang-Eop Kim;Won-Yung Lee
    • Journal of Ginseng Research
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    • v.48 no.4
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    • pp.373-383
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    • 2024
  • Background: Network pharmacology has emerged as a powerful tool to understand the therapeutic effects and mechanisms of natural products. However, there is a lack of comprehensive evaluations of network-based approaches for natural products on identifying therapeutic effects and key mechanisms. Purpose: We systematically explore the capabilities of network-based approaches on natural products, using Panax ginseng as a case study. P. ginseng is a widely used herb with a variety of therapeutic benefits, but its active ingredients and mechanisms of action on chronic diseases are not yet fully understood. Methods: Our study compiled and constructed a network focusing on P. ginseng by collecting and integrating data on ingredients, protein targets, and known indications. We then evaluated the performance of different network-based methods for summarizing known and unknown disease associations. The predicted results were validated in the hepatic stellate cell model. Results: We find that our multiscale interaction-based approach achieved an AUROC of 0.697 and an AUPR of 0.026, which outperforms other network-based approaches. As a case study, we further tested the ability of multiscale interactome-based approaches to identify active ingredients and their plausible mechanisms for breast cancer and liver cirrhosis. We also validated the beneficial effects of unreported and top-predicted ingredients, in cases of liver cirrhosis and gastrointestinal neoplasms. Conclusion: our study provides a promising framework to systematically explore the therapeutic effects and key mechanisms of natural products, and highlights the potential of network-based approaches in natural product research.