• 제목/요약/키워드: Gastrointestinal Motility

검색결과 138건 처리시간 0.025초

Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions

  • Chiusolo, Fabrizio;Capriati, Teresa;Erba, Ilaria;Bianchi, Roberto;Atti, Marta Luisa Ciofi degli;Picardo, Sergio;Diamanti, Antonella
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제23권6호
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    • pp.521-530
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    • 2020
  • Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

Pituitary Adenylate Cyclase-activating Polypeptide Inhibits Pacemaker Activity of Colonic Interstitial Cells of Cajal

  • Wu, Mei Jin;Kee, Keun Hong;Na, Jisun;Kim, Seok Won;Bae, Youin;Shin, Dong Hoon;Choi, Seok;Jun, Jae Yeoul;Jeong, Han-Seong;Park, Jong-Seong
    • The Korean Journal of Physiology and Pharmacology
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    • 제19권5호
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    • pp.435-440
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    • 2015
  • This study aimed to investigate the effect of pituitary adenylate cyclase-activating peptide (PACAP) on the pacemaker activity of interstitial cells of Cajal (ICC) in mouse colon and to identify the underlying mechanisms of PACAP action. Spontaneous pacemaker activity of colonic ICC and the effects of PACAP were studied using electrophysiological recordings. Exogenously applied PACAP induced hyperpolarization of the cell membrane and inhibited pacemaker frequency in a dose-dependent manner (from 0.1 nM to 100 nM). To investigate cyclic AMP (cAMP) involvement in the effects of PACAP on ICC, SQ-22536 (an inhibitor of adenylate cyclase) and cell-permeable 8-bromo-cAMP were used. SQ-22536 decreased the frequency of pacemaker potentials, and cell-permeable 8-bromo-cAMP increased the frequency of pacemaker potentials. The effects of SQ-22536 on pacemaker potential frequency and membrane hyperpolarization were rescued by co-treatment with glibenclamide (an ATP-sensitive $K^+$ channel blocker). However, neither $N^G$-nitro-L-arginine methyl ester (L-NAME, a competitive inhibitor of NO synthase) nor 1H-[1,2,4]oxadiazolo[4,3-${\alpha}$]quinoxalin-1-one (ODQ, an inhibitor of guanylate cyclase) had any effect on PACAP-induced activity. In conclusion, this study describes the effects of PACAP on ICC in the mouse colon. PACAP inhibited the pacemaker activity of ICC by acting through ATP-sensitive $K^+$ channels. These results provide evidence of a physiological role for PACAP in regulating gastrointestinal (GI) motility through the modulation of ICC activity.

어류 병원체 Edwardsiella piscicida의 OmpR은 생육과 병원성과 관련된 유전자의 발현에 필수적 (OmpR Is Essential for Growth and Expression of Virulence-related Genes in the Fish Pathogen Edwardsiella piscicida)

  • 듀르가 레이;김연하;최윤정;강호영
    • 생명과학회지
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    • 제31권1호
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    • pp.28-36
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    • 2021
  • Edwardsiella piscicida는 어류의 출혈성 패혈증 및 사람의 위장 감염의 중요한 원인균이다. 세균이 생존을 하기 위해서는 환경변화에 적응하기 위한 특수한 메커니즘이 필요하다. 따라서 E. piscicida가 삼투압 변화 환경을 감지하고 이에 반응하는 메커니즘을 이해하기 위하여 본 연구에서는 다양한 염도 조건에서 단백질 발현 형태와 세균의 생리적 특성을 분석하였다. EnvZ-OmpR의 two-component 조절 시스템의 일부인 OmpR 단백질은 세균의 염분 스트레스 감지와 관련이 있다. 이 단백질이 E. piscicida에서 어떤 생리적 역할을 하는지는 밝혀지지 않고 있다. 이 연구에서는 염분 스트레스에 대한 OmpR 단백질의 기능을 조사 하였다. OmpR을 발현하지 못하는 돌연변이체를 분석한 결과 구연산염 이용, H2S 생성 및 인돌 생산의 능력이 야생형과 비교했을 때 차이가 나는 것으로 확인되었다. 전체 ompR 유전자를 가지는 플라스미드를 돌연변이 균주에 도입하여 분석한 결과 위의 세가지 표현형은 야생형과 같아졌다. 지연된 성장률도 부분적으로 회복되었음을 볼 수 있었다. 이 연구에서 OmpR이 세포 운동성과의 관련성을 찾아볼 수 없었다. 이 연구의 결과들을 종합하면, 돌연변이 분석, 성장 분석, MALDI-TOF MS, qRT-PCR 및 표현형 연구 결과는 E. piscicida의 OmpR이 삼투압 조절, 생육, 포린 발현, 독성 관련 유전자(eseC, eseD 및 evpC) (ETAE_1826) 및 기능을 알 수 없는 특정 유전자(ETAE_1540 및 ETAE_2706)와 관련이 있다고 사료된다.

위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석 (The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis)

  • 배혜리;김은지;서현식;이남헌
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.625-642
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    • 2022
  • 목적: 본 연구는 위암 수술 후 장마비의 한의학적 치료 효과를 평가하기 위해 수행하였다. 방법: 2007년 1월 1일부터 2022년 5월 11일까지 출판된 연구들을 6개의 데이터베이스를 통해 수집하였다. 수술 후 한의학적 치료를 받은 위암 환자를 장마비 관련 지표들을 통해 관찰한 연구들을 선정하였다. 결과: 한약, 침, 뜸, 전기혈위자극, 이혈요법, 족삼리혈의 약물 주입을 수술 후 장마비 치료법으로 사용한 27편의 연구를 선정하였다. 한약, 한약과 침 병용요법, 침, 뜸, 전기혈위자극, 이혈요법, 족삼리혈의 네오스티그민 주입 치료군에서 수술 후 첫 가스 배출까지의 시간이 감소하였고 (p<0.00001), 수술 후 첫 배변까지의 시간이 한약. 한약과 침 병용요법, 침, 뜸, 전기혈위자극, 이혈요법, 족삼리혈의 네오스티그민 주입 치료군에서 유의미하게 감소하였다 (p<0.00001). 심각한 이상반응은 나타나지 않았다. 결론: 한의학적 치료는 위절제술 후 위암 환자에게 수술 후 장마비의 예방과 치료법으로 활용될 수 있으며 수술 후 장마비 치료의 임상적 효과를 명확히 하기 위해 후속 연구가 필요하다.

Browning 촉진에 관여하는 최근 천연물의 동향 (Recent Studies on Natural Products that Improve Browning)

  • 이은비;남주옥
    • 생명과학회지
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    • 제31권11호
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    • pp.1037-1045
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    • 2021
  • 전세계적으로 비만의 유병률은 증가하고 있으며 비만 유행은 식이요인과 좌식 생활 방식과 관련이 있기 때문에 현대인에게 발병하기 쉬운 질병이다. 또한 비만은 당뇨병, 심혈관계 질환과 같이 심각한 합병증을 동반하기 때문에 비만을 예방하고 치료하는 것이 중요해지고 있다. 현재 Liraglutide와 phentermine과 같은 의약품이 식욕억제 및 위장관 운동 지연을 유도해 비만 치료를 하고자 사용되고 있지만 갑상선암, 심혈관계 부작용, 중추 신경계 부작용 등 다양한 부작용이 발생하는 것으로 알려져있다. 따라서 상대적으로 부작용이 적은 비만 치료 방법을 탐색하기 위해 백색 지방조직을 갈색조직지방으로 바꾸어 에너지 소비를 증가시켜 비만을 치료하는 "Fat browning"이라는 방법이 도입되었다. 임상적으로 안전하게 "browning"을 유도하기 위해 효과 있는 천연 물질을 탐색하기 위한 연구가 진행중이며 현재 많은 천연물 소재가 연구되었다. 천연 물질 치료를 통한 "Browning" 유도는 일반적으로 "Browning" 유도 인자의 긍정적인 제어, 백색지방조직으로의 분화 억제, "Browning"과 관련된 메커니즘의 활성화의 세 가지를 포함한다. 따라서 Strawberry, Black raspberry, Cinnamomum cassia, Ecklonia stolonifera와 같은 "Browning" 유도 효과가 알려진 식물 추출물에 대한 연구를 설명한다. 우리는 또한 이러한 추출물이 "Browning"을 유도하고 그들이 매개하는 신호 경로를 통해 지금까지 확인된 메커니즘을 요약한다. 나아가 Browning을 통해 생성된 갈색지방조직이 내분비 기관으로써 심장 질환에 미치는 영향까지 확인해본 후 정리했다.

보중익기탕(補中益氣湯)이 streptozotocin 유발 당뇨병성 위부전마비 백서에 미치는 영향 (The Effects of Bojungikgi-tang on Streptozotocin-induced Diabetic Gastroparesis Rat Model)

  • 강윤미;김효정;박윤범;정찬문;함성호;양웅모;안효진
    • 대한본초학회지
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    • 제34권6호
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    • pp.45-55
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    • 2019
  • Objective : Diabetic gastroparesis is a complication that is defined as delayed gastric emptying and upper gastrointestinal symptoms and often occurs in long-standing diabetic patients. Bojungikgi-tang (BJT) is a traditional oriental herbal formula that has long been used for the treatment of digestive disorders. The purpose of this study was to investigate the effects of BJT on streptozotocin (STZ)-induced diabetic gastroparesis rat model. Methods : Sprague-Dawley (SD) male rats (250-270g) were divided into 13 groups including normal group, STZ-induced diabetic control group, BJT diet (7 various concentrations), and insulin-, glibenclamide-, metformin-treated group were used for the experiments for the comparison. Diabetic gastroparesis was induced by intraperitoneal injection of STZ. The water intake, food intake, body weights and fasting blood glucose levels were measured. After 4 weeks the animals were sacrificed and gastrin, leptin, insulin, hemoglobin A1C (HbA1c), lactate, lactate dehydrogenase (LDH), bilirubin, creatinine, albumin and lipid levels were evaluated. Results : Intraperitoneal injection of BJT for 4 weeks resulted in increased levels of gastrin in blood and decreased leptin and lactate concentration in STZ-induced diabetic gastroparesis rat model. BJT did not affect insulin, fasting glucose, HbA1c, and lipid levels in STZ-induced diabetic gastroparesis rat model. Conclusion : These results indicated that BJT would have protect effect on diabetic gastroparesis through the improvement effect of gastric motility and fatigue syndrome in STZ-induced diabetic rats. This study shows that BJT might be effective for treatment of diabetes and its complications such as gastroparesis.

생쥐 대장 카할세포의 자발적 탈분극에서 한약의 효과에 관한 비교연구 (Effects of Herbal medicines in Pacemaker Potential of Colonic Intestinal Interstitial cells of Cajal in mice)

  • 최나리;정해정;최우균;김병주
    • 대한한의학방제학회지
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    • 제31권1호
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    • pp.11-19
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    • 2023
  • Objectives : The purpose of this study was to examine the effects of herbal medicines on pacemaker potentials of large intestinal interstitial Cells of Cajal (ICC) in mice. Methods : We made the ICC culture in large intestine in mice and used the electrophysiological method to record pacemaker potentials. Also we used MTT assay to check cell viability and examined the ICC protein expression by western blot. Results : 1.Glycyrrhiza uralensis Fischer (GF) (50-150 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 58.95 ㎍/ml. Angelica gigas (AG) (50-200 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 77.22 ㎍/ml. Poncirus fructus (PF) (10-100 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 13.39 ㎍/ml. Citrus unshiu S. Marcov. (CU) (10-500 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 139.80 ㎍/ml. Gardenia jasminoides J. Ellis (GJ) (100-500 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 78.70 ㎍/ml. Coptis chinensis (CC) (100-1000 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 138.10 ㎍/ml. Scutellaria baicalensis (SB) (10-100 ㎍/ml) had no effects on pacemaker potentials and decreased frequency with concentration-dependent manners. IC50 is 18.34 ㎍/ml. Atractylodes macrocephala koidzumi (AM) (10-100 ㎍/ml) induced pacemaker hyperpolarizations and decreased frequency with concentration-dependent manners. IC50 is 18.54 ㎍/ml. 2. PF, SB and AM had no effects on cell death in large ICC. 3. PF increased the ANO1 and c-kit protein expression and SB and AM increased the c-kit protein expression in large ICC. Conclusions : These results suggest that PF, SB, and AM are likely to be the optimal combination of herbal medicines that can be used to treat diseases such as gastrointestinal motility disorders such as irritable bowel syndrome.

여뀌섭취가 반추수에 비치는 임상병리학적 영향 (Clinicopathological Effects of Waterpepper (Persicaria hydropiper) on Ruminants)

  • 조명래;한홍율
    • 한국임상수의학회지
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    • 제6권2호
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    • pp.227-259
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    • 1989
  • Waterpepper is a weed which grows on damp soil. especially near swamps, and in shallow water of ponds and ditches. It Is widespread throughout the country In abundant colonies. In the present experiments, possible toxic effects of waterpepper were investigated in ruminants. Pour cows were fed waterpepper ad libitum or by force in the from of green forage, hay and/or powder, 8 goats were administered in the form of methanol extract, and 4 goats, crude juice, into the lumen. Clinical signs were examined as well as urinalysis, hematology, serum chemical analysis, pH/blood gas analysis and chclinesterase activities following administration of waterpepper. Six goats which were administered the methanol extract or crude juice were sacrificed for pathological examinations., In addition to the clini copathological examinations, the chemical constituents of waterpepper were qualitively analyzed from the methanol extract and the Effects of the waterpepper crude juice were examined on the motility of rabbit duodenum and uterus. It is revealed that waterpepper contains steroids, terpenoids, flavonoids, tannin and essential oils in the methanol extract and nitrates in the crude juice. The crude juice of waterpepper relaxed the rabbit uterine and duodenal smooth muscles. The constraction of duodenum by acetylcholine or BaCl$_2$ were partially inhibited by pretreatment of the crude juice. However, the relaxation of duodenum by the crude juice was not blocked by the pretreatments of phenoxybenzamlne, propranolol, cocaine, reserpine and tetrodotoxin. The constituents of waterpepper to evoke elaxation of duodenal smooth muscle were stable to heat. The cows administered waterpepper showed common clinical symptoms such as acrid expression, restlessness, dullness, inappetence, anorexia, severe diarrhea, mild bloat and left displacement of abomasum, while bloody feces was shown in a cow. The goats administered the mothanol extract showed common clinical signs such as acrid expression, restlessness, dullness, inappetence and soft feces, while bloody feces was shown in a goat, A goat adminstered the crude juice showde bloody feces and diarrhea. Respiratory rates and heart beats were increased along with diarrhea in the experimental cows. The erythrocyte counts and MCHC were decreased whereas PCV, MCV and neutrophils were increased in the cows administered waterpepper. In goats administered methanol extract, there were decreases in erythrocytes, PCV and hemoglobin content, and an increase in MCHC. The goats ingester with the crude juice showed negligible changes in hematologic values compared with control group which was administered the same amount of water instead of the crude juice. The contents of serum calcium, Inorganic phosphorus, magnesium, Iron, glucose, cholesterol, total protein, triglycerides and phospholipids were tended to decrease in cows. In goats serum iron, glucose, triglycerides, cholesterol, BUN and phospholipids content were decreased while the content of sodium and chloride were increased after administration of the methamol extract The goats ingested with the crude juice did not show significant changes in serum chemical analysis. Even though there were some pathological findings such as hyperemia in the small intestines and kidneys and swelling of liver parenchymal cells, the values of serum AST, ALT, LDH, alkaline phosphatase, total bilirubin and creatinine did not change significantly. While proteins, hemoglobin and blood were detected in the urine of cows, urine pH, ketone bodies, glucose, bilirubin and urobilinogen content were normal or undetected. There were no significant changes in pH/bolld gas analysis data of cows and cholinesterase activities of plasma and erythrocytes of cows and goats ingested with waterpepper or the methanol extract. It is concluded that waterpepper irritates the gatrointestinal system, causes abdominal pain, relaxes the gastrointestinal smooth muscle and dilatates blood vessels supplied to the system. The irritation and relaxation may lead to abnormal fermentation, maldigestion and malabsorption of nutrients and result in diarrhea, body feces, mild bloat and left displacement of abomasum.

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