• Title/Summary/Keyword: Gastrointestinal Diseases

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Current status of image-enhanced endoscopy in inflammatory bowel disease

  • Young Joo Yang
    • Clinical Endoscopy
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    • v.56 no.5
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    • pp.563-577
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    • 2023
  • In inflammatory bowel disease (IBD), chronic inflammation leads to unfavorable clinical outcomes and increases the risk of developing colorectal neoplasm (CRN); thereby highlighting the importance of endoscopically evaluating disease activity as well as detecting and characterizing CRN in patients with IBD. With recent advances in image-enhanced endoscopic (IEE) technologies, especially virtual chromoendoscopy (VCE) platforms, this review discusses state-of-the-art IEE techniques and their applicability in assessing disease activity and surveillance colonoscopy in patients with IBD. Among various IEE, VCE demonstrated the capacity to identify quiescent disease activity. And endoscopic remission defined by the new scoring system using VCE platform better predicted clinical outcomes, which may benefit the tailoring of therapeutic strategies in patients with IBD. High-definition dye-chromoendoscopy (HD-DCE) is numerically superior to high-definition white light endoscopy (HD-WLE) in detecting CRN in IBD; however, discrepancy is observed in the statistical significance. VCE showed comparable performance in detecting dysplasia to HD-WLE or DCE and potential for optical diagnosis to differentiate neoplastic from nonneoplastic lesions during surveillance colonoscopy. Applying these novel advanced IEE technologies would provide opportunities for personalized medicine in IBD and optimal treatment of CRN in patients with IBD.

Diet-Induced Gut Dysbiosis and Leaky Gut Syndrome

  • Yu-Rim Chae;Yu Ra Lee;Young-Soo Kim;Ho-Young Park
    • Journal of Microbiology and Biotechnology
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    • v.34 no.4
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    • pp.747-756
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    • 2024
  • Chronic gut inflammation promotes the development of metabolic diseases such as obesity. There is growing evidence which suggests that dysbiosis in gut microbiota and metabolites disrupt the integrity of the intestinal barrier and significantly impact the level of inflammation in various tissues, including the liver and adipose tissues. Moreover, dietary sources are connected to the development of leaky gut syndrome through their interaction with the gut microbiota. This review examines the effects of these factors on intestinal microorganisms and the communication pathways between the gut-liver and gut-brain axis. The consumption of diets rich in fats and carbohydrates has been found to weaken the adherence of tight junction proteins in the gastrointestinal tract. Consequently, this allows endotoxins, such as lipopolysaccharides produced by detrimental bacteria, to permeate through portal veins, leading to metabolic endotoxemia and alterations in the gut microbiome composition with reduced production of metabolites, such as short-chain fatty acids. However, the precise correlation between gut microbiota and alternative sweeteners remains uncertain, necessitating further investigation. This study highlights the significance of exploring the impact of diet on gut microbiota and the underlying mechanisms in the gut-liver and gut-brain axis. Nevertheless, limited research on the gut-liver axis poses challenges in comprehending the intricate connections between diet and the gut-brain axis. This underscores the need for comprehensive studies to elucidate the intricate gut-brain mechanisms underlying intestinal health and microbiota.

Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis

  • Suprabhat Giri;Vaneet Jearth;Harish Darak;Sridhar Sundaram
    • Clinical Endoscopy
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    • v.55 no.6
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    • pp.742-750
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    • 2022
  • Background/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regarding the influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety of thin- and thick-wire snares for CSP. Methods: A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for comparative studies evaluating the outcomes of thin- versus thick-wire snares for CSP. Results: Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wire snare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97-1.09), overall bleeding (RR, 0.98; 95% CI, 0.40-2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97-1.04), and involvement of submucosa in the resection specimen (RR, 1.28; 95% CI, 0.72-2.28). There was no publication bias and a small study effect, and the relative effects remained the same in the sensitivity analysis. Conclusions: CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors other than snare design may play a role in improving CSP outcomes.

Anti-Inflammatory Effects of Paraprobiotic Lactiplantibacillus plantarum KU15122 in LPS-Induced RAW 264.7 Cells

  • Hye-Won Lee;Hee-Su Jung;Na-Kyoung Lee;Hyun-Dong Paik
    • Journal of Microbiology and Biotechnology
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    • v.34 no.7
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    • pp.1491-1500
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    • 2024
  • Inflammation is a biodefense mechanism that provides protection against painful conditions such as inflammatory bowel disease, other gastrointestinal problems, and irritable bowel syndrome. Paraprobiotics have probiotic characteristics of intestinal modulation along with merits of safety and stability. In this study, heat-killed Lactiplantibacillus plantarum KU15122 (KU15122) was investigated for its anti-inflammatory properties. KU15122 was subjected to heat-killed treatment for enhancement of its safety, and its concentration was set at 8 log CFU/mL for conducting different experiments. Nitric oxide production was most remarkably reduced in the KU15122 group, whereas it was increased in the LPS-treated group. In RAW 264.7 cells, KU15122 inhibited the expression of inducible nitric oxide synthase, cyclooxygenase-2, interleukin (IL)-1β, IL-6, and tumor necrosis factor-α. ELISA revealed that among the tested strains, KU15122 exhibited the most significant reduction in PGE2, IL-1β, and IL-6. Moreover, KU15122 inhibited various factors involved in the nuclear factor-kappa B, activator protein-1, and mitogen-activated protein kinase pathways. In addition, KU15122 reduced the generation of reactive oxygen species. The anti-inflammatory effect of KU15122 was likely attributable to the bacterial exopolysaccharides. Conclusively, KU15122 exhibits anti-inflammatory potential against inflammatory diseases.

The Prevalence of Chronic Degenerative Disease and Utilization of Medical Facility in Rural Population (농촌지역(農村地域) 주민(住民)의 만성퇴행성질환(慢性退行性疾患) 유병률(有病率) 및 이용의료기관(利用醫療機關))

  • Ann, Kil-Soo;Chun, Byung-Yeol;Yeh, Min-Hae
    • Journal of agricultural medicine and community health
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    • v.21 no.2
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    • pp.209-220
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    • 1996
  • This study was performed to investigate the prevalence of chronic disease and utilization of medical facility in rural area. 5,797 persons were randomly selected from 28,883 rural residents who were over 30 years old and living in Moonkyung city in Kyungsangpook Province during the period October 1 1983 to February 28 1994. The person prevalence rate was 336 per 1,000. The prevalence rate in men(278 per 1,000) was higher than that(388 per 1,000) in women. The spell prevalence rate in men(367) was significantly higher than that(429) in women (p<0.05). The prevalence was increased with the age, 106 in the 30's. 223 in the40's, 336 in the 50's, 407 in the 60's, and 457 in the age group of 70 above. Of all chronic diseases, the prevalence of neuralgia ranked first(128), chronic gastrointestinal disorders(64), degenerative arthritis(54). hypertension (44) and diabetes (14) were followed in descending order. In men, the prevalence of neuralgia ranked first, chronic gastrointestinal disorders, degenerative arthritis, hypertension and bronchial asthma were followed in descending order. In women, the prevalence of neuralgia ranked first, degenerative arthritis, chronic gastrointestinal disorders, hypertension and diabetes were followed in descending order. The prevalences of neuralgia, degenerative arthritis and hypertension were significantly higher in women than those in men, however, those of cardiovascular disease, pulmonary tuberculosis and liver cirrhosis in men were significantly higher than those in women(p<0.05). Most patients with chronic diseases were more likely to utilize hospital and/or local clinics than public health facility or community health providers. Patients with neuralgia, degenerative arthritis and bronchial asthma tended to utilizing local clinics initially, however, they were changed to visit public health facility or community health providers afterwards. Patients with hypertension or pulmonary tuberculosis were more likely to visit public health facility, however, those with diabetes, cancer, heart failure, CVD, liver cirrhosis were more likely to visit hospital.

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The Review of a Standardized Method in Retention-Enema: a Clinical Study (보류관장의 표준화된 방법을 위한 고찰: 임상논문을 중심으로)

  • Song, Eun-Young;Lee, Eui-Ju;Bu, Yong-Min;Shin, Seung-Won;Chai, Kwang-Min;Yoo, Jung-Hee;Kim, Hyo-Jin;Baek, Jong-Heon;Lee, Jun-Hee;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.2
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    • pp.108-114
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    • 2013
  • Objectives This study was aimed to review a standardized method of retention enema by extracting elements associated with methods of retention enema from papers involved. Methods 1) Data sources : Retrieval was made, using 'Enema' or 'Retention Enema' as search words in MEDLINE, The Cochrane Library, KISS, RISS, and NDSL DB. 2) Study selection : Two authors excluded irrelevant papers and chose qualified abstracts in the rest of the papers. The chosen studies were reviewed fully by the authors so that they could screen the significant papers based on the exclusion criteria. 3) Data extraction : Data on the total number of subjects, the target disease, the type, quality, length, diameter of catheter, the insertion length of catheter, the sample, the sample volume, the process of retention enema and the number of performing retention enema were extracted from the selected studies. Results & Conclusions The retention enema can be applied to gastrointestinal diseases, genitourinary diseases, metabolic diseases such as hypertension and diabetes, headaches and neurological disorders. The standardized treatment method is as following: 1) inserting a rental tube of 18-28 Fr that measures 20 to 30 cm into the patient's anus, 2) injecting herbal medicines which have purgative action or benefit on stomach and intestinal tract at the rate of 4 ml/min, and 3) holding them for 10 to 15 minutes.

Salivary Flow According to Elderly's Whole Health and Oral Health Status: According to Application of Oral exercise and Salivary Gland Massage

  • Oh, Ji-Young;Noh, Eun-Mi;Park, Hye-Young;Lee, Min-Kyung;Kim, Hye-Jin
    • Biomedical Science Letters
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    • v.25 no.3
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    • pp.218-226
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    • 2019
  • In old age, measures to cope with the natural phenomenon of aging and various diseases of the elderly due to the deterioration of physical function are also a challenge for this society. While interest in systematic health is increasing, it is true that awareness and interest in oral-related diseases is relatively lacking. This study aims to present basic data necessary to improve the quality of life for senior citizens aged 65 or older by improving the oral dryness caused by systemic health. By research method, improve oral dryness caused by whole-body health with the elderly over 65 and promote their oral health, inducing the increase of the salivary flow rate through oral health care education, oral exercise, and salivary gland massage. First, on the DMSQ according to the general characteristics of the elderly, the recognition of the whole body and oral health status, independent sample t-test and One-way ANOVA were conducted. Second, on changes in the salivary flow rate and saliva pH according to the general characteristics of the elderly, recognition of oral and whole-body health status, and whole-body health, paired samples t-test was conducted. Studies have shown that salivary gland flow increased significantly after oral exercise and salivary gland massage, the salivary flow rate significantly increased. In all variables of the recognition of the oral health status, the salivary flow rate increased after oral exercise and salivary gland massage, and in the whole-body health, regardless of hypertension, diabetes, cardiovascular disorders, and osteoporosis, the salivary flow rate increased after oral exercise and salivary gland massage, and the salivary flow rate increased after oral exercise and salivary gland massage if the subjects responded that they did not have thyroid abnormality, anemia, abnormalities of breathing, hypotension, gastrointestinal disturbance, or kidney diseases. As a comprehensive analysis of this study, many felt oral dryness when they had a problem with the whole-body health, and many felt oral dryness when they had a problem with oral health cognition. After applying oral exercise and salivary gland massage as intervention methods in the oral health care for the elderly, the salivary flow rate significantly increased, and it is judged that the methods were very effective for controlling oral dryness. Furthermore, it is judged that the factors affecting oral health, whole-body health, and oral dryness would be identified, which would be helpful for the promotion of whole-body health and oral health. It is judged that continuous research would be needed so that measures for the application of the oral care program and system for the elderly would be prepared in the future.

The Gastroprotective and Antioxidative Effects of Lonicera japonica water extract on HCl/ethanol-induced Gastric Mucosa Damage in Rats (인동(忍冬) 열수 추출물의 항산화 효과 및 HCl-Ethanol로 유도된 위염 동물 모델에서의 위 점막 손상 보호 효과)

  • Sim, Mi-Ok;Lee, Hyun Joo;Jang, Ji Hun;Jung, Ho-Kyung;Yang, Beodul;Woo, Kyeong Wan;Hwang, Taeyeon;Kim, Sunyoung;Nho, Jonghyun;Cho, Hyun-Woo
    • The Korea Journal of Herbology
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    • v.34 no.6
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    • pp.57-62
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    • 2019
  • Objective : Gastritis is a major complication of gastrointestinal disease. Lonicera japonica is used in folk medicine to treat different diseases such as exopathogenic wind-heat, epidemic febrile diseases, sores, carbuncles and some infectious diseases. Therefore, this study examined the effects of Lonicera japonica water extract (LJE) on HCl/ethano-linduced acute gastric ulceration and anti-oxidants properties. Methods : LC-ESI-IT-TOF MS was employed for rapid identification of major compound from LJE. The antioxidant activities were evaluated through total polyphenol and flavonoid contents and radical scavenging assays and superoxide dismutase (SOD)-like activity. SD rats were randomly divided into five different groups including the normal group, ulcer group, positive group (20 kg/mg of omeprazole, ip), and experimental groups (100 kg/mg and 500 kg/mg of LJE, ip). Results : 4,5-Dicaffeoyl quinic acid, loganic acid, secologanic acid, sweroside, loganin, vogeloside were identified based on the detection of the molecular ion with those of literature data. The LJE was possessed free radical scavenging activities such as DPPH (IC50=189.7 ㎍/㎖), ABTS (IC50=164.5 ㎍/㎖), and SOD-like activity (IC50=405.02 ㎍/㎖). Macroscopic and histological analyses showed LJE treated group were significantly reduced to an extent that it allowed leukocytes penetration of the gastric walls compared with the ulcer group. In addition, an ulcer inhibition rate and prostaglandin E2 levels were increased in rats treated with LJE. Conclusion : The present study has demonstrated the antioxidantive and gastroprotective effect of LJE, these findings suggested that LJE has the potential for use in treatment of gastric disorders.

Morbidity and Medical Facilities Utilization Patterns of High School Students in Urban and Rural Areas (도시(都市)와 농촌(農村), 고등학생(高等學生)의 상병(傷病) 및 의료이용(醫療利用) 양상(樣相))

  • Kim, Sung-Pha;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.3 no.2
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    • pp.96-108
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    • 1990
  • This study was conducted to assess the morbidity and medical facilities utilization patterns of high school students in urban and rural areas, and to contribute to establishment of school health policies. A questionnaire survey was carried out for 1,979 of one boy's and one girl's high school in Pusan and 1,315 of one boy's and one girl's high school in Kyungnam province from March 27 to April 8, 1989. The summarized result is as follows. The number of students who were sick or injured in one month period was 378.0 of 1,000 students. One sick or injured student experienced 1.2 events on the average and thus the incidence rate was 453.2 per 1,000 students for a month. The morbidity rate of the urban area (550.8) was higher than that of the rural area (306.5) while the rate for girl students (561.9) was higher than that of the boy students (328.3) (P<0.01). Especially, the girl students (740.7) in the urban area showed two times higher morbidity rate than that of the girl students in the rural area. Out of all morbidity respiratory disease for 67.6 percent in urban area and 68.5 percent in rural area and it was followed by gastrointestinal disease and nervous & sensory diseases. The morbid conditions took place at school in 37.5 percent, and at home in 59.8 percent. The absence rate due to morbidity was 4.4 percent out of all morbid students. In addition, 73.5 percent of all morbid student utilized medical treatment, of which the pharmacy accounted for 53.8 percent and 57.5 percent in the urban and rural areas, respectively. The second most common facility utilized was hospital OPD. While there was no student who utilized the school nursing room in the rural area, 1.5 percent of the sick students utilized the school nursing room in the urban area. The most important in selecting medical facility was the distance. By low medical expense was more frequent cited reason for selecting medical facility in rural area (13.6 percent) than in urban area (3.2 percent). Mild illness accounted for 70.3 percent of the reasons for no treatment and 21.8 percent was due to the conflict between school hour and clinic hour. The morbid students mostly suffered from mild respiratory and gastrointestinal disease, and its incidence was the highest rate in the school. Although there was relation between the worry of absence and no-treatment, the school nursing room utilization of students was very insufficient. Therefore, it is required to activate the operation of the high school nursing room by utilizing the specialized personnel.

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A Case of Microscopic Polyangiitis with Pulmonary Hemorrhage and Rapidly Progressive Glomerulonephritis (폐출혈과 급속 진행성 사구체신염을 동반한 현미경적 다발성 동맥염 (Microscopic Polyangiitis) 1례)

  • Kwon Hae Sik;Lee Young-Mock;Kim Ji Hong;Kim Pyung-Kil;Kang Hae Youn;Hong Soon Won;Jeong Hyeon Joo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.213-218
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    • 2001
  • Microscopic Polyangiitis(MPA) belongs to a spectrum of systemic vasculits, and particularly antineutrophil cytoplasmic autoantibodies(ANCA)-associated small-vessel vasculitis which is characterized by involvement of the lung and kidney. The diagnosis of MPA is often difficult to make, and delayed because of the variability of the clinical presentation. Renal biopsies have a very important diagnostic and prognostic value in MPA. We experienced a case of microscopic polyangiits which was confirmed by renal biopsy and positive serum perinuclear ANCA, associated with alveolar hemorrhage and gastrointestinal bleeding. We began methylprednisolone pulse therapy, combined with a low dose of cyclophosphamide and plasmapheresis therapy. ACE inhibitor and Ca channel blocker were used when proteinuria and hypertention developed. On admission, the patient's lab findings showed BUN l17 mg/dL, Cr 2.3 mg/dL, while on the 60th hospital day BUN/Cr values fell to 20.8 mg/dL / 1.6 mg/dL and though proteinuria persisted, the patient's condition was tolerable and is currently under observation on an out-patient basis. The last lab values were BUN 26 mg/dL / Cr 1.6 mg/dL. (J. Korean Soc Pediatr Nephrol 2001 ; 5 : 213-18)

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