• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.181-190
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• 2001

Purpose: The aim of this study is to investigate the usefulness of intestinal ultrasonography (US) and upper gastrointestinal endoscopy in the early diagnosis of Henoch-Sch$\"{o}$nlein purpura (HSP) with the gastrointestinal (GI) symptoms preceding the emergence of the skin lesion. Methods: The clinical, intestinal US and upper gastrointestinal endoscopic records of 85 patients (88 cases) with GI symptoms relating to HSP presenting between January 1999 and April 2001 were reviewed. Results: 1) GI symptoms were observed in 52 cases (59%) and skin, joint, renal and scrotal manifestations were observed in 88 (100%), 64 (73%), 15 (17%), 3 cases (3%) respectively. 2) Out of 52 cases with GI symptoms, abdominal pain was observed in all cases (100%). Positive stool occult blood, nausea and vomiting, abdominal tenderness, melena or tarry stool, diarrhea, hematemesis, rebound tenderness and rigidity were observed in 28 (50%), 17 (33%), 17 (33%), 12 (23%), 6 (12%), 4 (8%), 1 (2%) and 1 case (2%) respectively in order of frequency. 3) Intestinal US examination was performed in 27 cases with HSP and GI symptoms (52 cases). Out of 27 sonographic examinations 22 showed abnormal findings. Thickening of the duodeno-jejunal wall was observed in 16 cases (73%). Free peritoneal fluid, enlarged mesenteric lymph node, ileus and abnormal gall bladder were seen in 8 (36%), 8 (36%), 4 (18%) and 1 case (5%) respectively. In three cases of HSP without GI symptoms, those changes were absent. 4) In all of five cases with HSP and GI symptoms, endoscopic study showed mucosal edema and multiple hemorrhagic erosions especially at the second portion of the duodenum. Biopsy specimens from the duodenum of 2 cases out of 5 endoscopic examinations showed acute inflammatory infiltrates in the mucosa with hemorrhage. 5) Both intestinal US and endoscopic studies were performed in 4 cases with HSP and GI symptoms simultaneously. Out of 4 those cases, 3 cases showed the thickened duodeno-jejunal wall on the intestinal US, which suggested erosive hemorrhagic duodenitis by endoscopic findings. Conclusion: The typical but nonpathognomonic intestinal US findings including the thickening of the duodeno-jejunal wall and upper gastrointestinal endoscopic findings including hemorrhagicerosive duodenitis, in children with GI symptoms, should be considered a manifestation of HSP, even in the absence of skin lesion.

• Clinical and Experimental Pediatrics
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• v.46 no.6
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• pp.576-584
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• 2003

Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

• Journal of Yeungnam Medical Science
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• v.22 no.1
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• pp.113-118
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• 2005

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.6
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• pp.459-461
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• 2009

Polycythemia vera is one type of myeloproliferative disorder which occurs due to the clonal proliferation of hematopoietic stem cell related to the production of leukocyte and megakaryocyte which produces a little less than erythrocyte. Polycythemia vera has a peak incidence in the sixth decade of life with males affected slightly more frequently than females. Vasquez first described polycythemia vera as an autonomous erythrocytosis in 1892, and a further description, delineation of the disease process and a complete course outline were made in 1899, 1903 and 1938, respectively. Symptoms include pruritus, tinnitus, vertigo, gastrointestinal (GI) pain, and bleeding gums. Hyperuricemia and hyperuricosuria are present in about 40% of these patients. Complications are hemorrhage, thrombosis, post-polycythemic myeloid metaplasia, and leukemic transformation. In case of surgery, complications such as hemorrahge and thrombosis are highly likable to happen. We report a case of preoperative and postoperative of a 63-year-old male, who was diagnosed as oral cavity cancer in the mouth floor, with known history of hypertension and polycythemia vera. We considered that conservative management would be an advisable treatment for patients with uncontrolled systemic disease.

• Korean Journal of Pharmacognosy
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• v.37 no.4 s.147
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• pp.266-271
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• 2006

Sophorae Radix, the dried roots of Sophora flavescens Aiton (Leguminosae), has been used in oriental traditional medicine for treatment of skin and mucosal ulcers, sores, gastrointestinal hemorrhage, diarrhea, inflammation and arrhythmia. Present study was carried out for the gastroprotective effect of trifolirhizin from Sophora flavescens. This reports were evaluated antibacterial activity against Helicobacter pylori and HCl ethanol-induced gastric lesion in rats and showed the significant effectiveness. In pylorus ligated rats, the treatments of trifolirhizin showed decrease in the volume of gastric secretion and acid output. Also we evaluated the antibacterial activity against H. pylori treated with methanol extract and trifolirhizin from Sophora flavescens had a equivalent antibacterial activity with ampicillin against H. pylori at the dose of $100{\mu}g/mL$. It may be regarded that the antigastritic effects and antibacterial activity of trifolirhizin from Sophora flavescens are originated from reduction of total acid output identified by gastric secretion reduce, free radical scavenging effects and the antibacterial activity against H. pylori.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.2
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• pp.460-466
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• 2006

We wondered whether the mechanisms of antiplatelet aggregation of DJS-WE were through multiple pathways. Danggijakyak-san(DJS) consisting of 6 herbes of Paeoniae Radix, Poria Cocos, Angelicae Sinensis Radix, Cnidii Rhizoma, Atractylodis Macrocephalae Rhizoma and Alismatis Rhizoma, is a crude mixture of a commonly used Korean herbal medicine. The water extract (DJS-WE) of DJS has been known to have an anti-platelet aggregation activity. We have reported that DJS-WE inhibited ADP-induced aggregation as well as arachidonic acid-induced aggregation of human platelet. Clinical studies on the cardiovascular effects of DJS-WE have been done in Korea. The DJS has been used as a remedy for gastrointestinal disorders (abdominal pain, dysentery), headache, amenorrhea, and postpartum hemorrhage. It has also been claimed to have a remarkable central stimulant effect, a transient hypertensive effect, and positive inotropic and chronotropic effects. In this paper, we evaluated the possible mechanisms of the antiplatelet activity of DJS-WE using human platelets. On the other hand, the role of DJS-ethanol extract on the inhibition of platelet aggregation and hemolytic effect have not yet been investigated in detail. We also used the method of activated partial thromboplastin times (APTT) for the first time to study the inhibition on platelet aggregation activity of DJS-ethanol extract. The effect of DJS-WE on hemolysis was also investigated. DJS-WE showed a high hemolysis ability on human blood.

• Korean Journal of Veterinary Research
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• v.40 no.1
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• pp.153-165
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• 2000

To identify, the effects of acua-acupuncture of Bletillae rhizoma extract on the duodenal ulcer induced by HCl-aspirin in rats, the changes of histological profiles, number of mucous-producing goblet cells (PAS-positive cells), and morphology and/or number of chole-cystokinin (CCK)-8 and serotonin-immunoreactive (IR) cells in the gastrointestinal tract were observed after acua-acupuncture of Bletillae rhizoma extract on Ganshu locus ($BL_{14}$). Samples were collected at 1, 3 and 5 days after treatment. Histologically, very severe injury, atrophy of villus, necrosis of epithelial cell and hemorrhage, to the duodenal mucosa including epithelium were observed in HCl-aspirin administrated control groups, and these injuries were increased with time intervals. But in acua-acupuncture groups and nontreated normal groups, no gross lesion of ulcer was demonstrated and histologically minor injury to the apex of villas epithelium was observed. Compared to the PAS-positive cells of the control groups, those of the acua-acupuncture groups were increased. Severe degranulation of CCK-8- and serotonin-IR cells were observed in the control groups but these phenomena seldom occur in the acua-acupuncture groups. Serotonin-IR cells were significantly decreased in control groups but increased in the acua-acupuncture groups compared to control groups. However, these degranulation of IR cells of the aqua-acupuncture groups were less severe than those of normal groups, and number of serotonin-IR cells were lower than those of normal groups but these phenomena were decreased with time intervals and in 5 days after treatment, they were observed like those of normal groups. These result indicated that acua-acupuncture of Bletillae rhizoma extract would be accelerated the healing of the duodenal ulcer but the functional mechanisms were unknown.

• Journal of Haehwa Medicine
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• v.15 no.2
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• pp.135-148
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• 2006

Sophorae Radix (SFR) is known as a therapeutic drug that has been used in Oriental traditional medicine for the treatment of skin and mucosal ulcers, gastrointestinal hemorrhage, diarrhea, inflammation and arrhythmia. In the present study, we examined the effects of the aqueous extract of SFR on anti-inflammation, anti-allergic and anti-oxidant effect in various cell lines; they include mouse lung fibroblast cells (hFCs), human mast cells (HMC-1), human monocytic cells (THP-1), and RAW 264.7 cells. Treatment with SFR extract at a concentration of 250 ${\mu}g$/ml for 24h showed no significant decrease in the survival rate of the hFCs. SFR decreased the mRNA expression of IL-8, TNF-$\alpha$, and IL-6 in HMC-1 cells. SFR extract treatment significantly inhi-bited the protein expression of IL-6 and, IL-8 induced by mite in THP-1 cells and it also did MCP-1 expression. We examined the alternation of histamine release in HMC-1 cells for investigating anti-allergic effect of SFR. Histamine secretion decreased after the treatment with SFR. In addition, SFR extract treatment at a concentration of 10 ${\mu}g$/ml, 100 ${\mu}g$ /ml, and 200 ${\mu}g$/ml lowered the $\beta$-hexosaminidase to 10.3%, 21.7%, and 50.8%, respectively. IC50 of SFR extract in RBL-2H3 cells was 196.85 ${\mu}g$/ml. Both activity of NF-$\kappa$B promoter in RBL-2H3 cells significantly diminished after the dose-dependent treatment of SFR. Therefore, our results indicate that SFR has anti-inflammatory and it may be useful for treating allergic diseases such as atopic dermatitis.

• YAKHAK HOEJI
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• v.40 no.5
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• pp.591-598
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• 1996

The water extracts of ten crude drugs were tested for the spasmolytic and anti-peptic ulcer activities on rat ileum smooth muscle contraction and aspirin-induced acute hemorrhag ic erosive gastritis respectively. The water extract of Aurantii immaturi pericarpium(AIP)($IC_{50}=1.5{\times}1O^{-2}$g/l), Aurantii nobilis pericarpium(ANP)($IC_{50}=2.5{\times}1O^{-2}$g/l), Cyperi rhizoma(CR)($IC_{50}=3.3{\times}1O^{-2}$g/l). Linderae radix(LR) ($IC_{50}=6.8{\times}1O^{-2}$), Aurantii fructus immaturus(AFI)($IC_{50}=11.8{\times}1O^{-2}$), Saussureae radix(SR)($IC_{50}=13.2{\times}1O^{-2}$g/l) and Ponciri fructus(PF)($IC_{50}=23.3{\times}1O^{-2}$g/l) showed inhibitory activity on the isometric contraction of rat ileum smooth muscle induced by electrical stimulation in a concentration-dependent manner, whereas the water extracts of Arecae pericarpium(AP), Agastachis herba(AH) and Magnoliae cortex(MC) potentiated the isometric contraction. In the aspirin-induced acute gastritis, the water extracts of MC, AP and CR reduced significantly the gastric juice secretion, gastric juice acidity and pepsin activity. They also showed protective activity of gastric mucosal layer from erosion and petichial hemorrhage in gross and histological examination.

• Journal of Gastric Cancer
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• v.22 no.1
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• pp.47-55
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• 2022

Purpose: The use of direct oral Xa inhibitors (DXaIs) to prevent venothrombotic events is increasing. However, gastrointestinal bleeding, including that related to endoscopic resection, is a concern. In this study, we evaluated bleeding and coagulation times during the perioperative period of gastric endoscopic submucosal dissection (ESD). Materials and Methods: Patients who consecutively underwent gastric ESD from August 2016 to December 2018 were analyzed. Bleeding rates were compared among the 3 groups (antiplatelet, DXaIs, and control). DXaI administration was discontinued on the day of the procedure. Prothrombin time (PT), activated partial thromboplastin time, and the ratio of inhibited thrombin generation (RITG), which was based on dilute PT, were determined before and after ESD. Results: During the study period, 265 gastric ESDs were performed in 239 patients, where 23 and 50 patients received DXaIs and antiplatelets, respectively. Delayed bleeding occurred in 17 patients (7.4%) and 21 lesions (7.1%). The bleeding rate in the DXaI group was significantly higher than that in the other groups (30.4%, P<0.01), and the adjusted odds ratio of bleeding was 5.7 (95% confidence interval, 1.4-23.7; P=0.016). In patients using DXaIs, there was a significant (P=0.046) difference in the median RITG between bleeding cases (18.6%) and non-bleeding cases (3.8%). Conclusions: A one-day cessation of DXaIs was related to a high incidence of bleeding after gastric ESD, and monitoring of residual coagulation activity at trough levels might enable the predicted risk of delayed bleeding in patients using DXaIs.