• Title/Summary/Keyword: Gastrointestinal symptoms

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Current Research Trend on the Acupuncture and Moxibustion Treatment for Pancreatitis (국내외 췌장염 관련 침구치료 연구 현황)

  • Kang, Ha Ra;Lee, Yeon Sun;Kim, Hye Ryeon;Kim, Eun Jung;Kim, Kyung Ho;Kim, Kap Sung;Jung, Chan Yung;Lee, Jun Kyu
    • Korean Journal of Acupuncture
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    • v.35 no.2
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    • pp.56-69
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    • 2018
  • Objectives : The aim of this study is to review the current research trend on the acupuncture and moxibustion treatment for pancreatitis. Methods : Through nine search engines, articles were collected, which had involved the use of acupuncture and moxibustion treatment for pancreatitis. Data were extracted from the selected articles regarding the year, country, type of pancreatitis, study design, evaluation variable, intervention, point for acupuncture and moxibustion, and effectiveness of treatment. Results : Total 56 articles were reviewed. The number of studies increased gradually every ten years. Fifty-one studies(91%) were conducted in China. Most of clinical studies and animal experimentations reported on acute pancreatitis. Thirty-nine studies were randomized controlled trials(RCTs), but most of them were assessed as uncertain in the risk of bias evaluation. The degree of overall improvement(79%) was used mainly as evaluation variable of clinical studies. In animal experimentations, the examination of pancreatitis tissue(77%) and blood test(77%) were used the most. Most of studies were conducted with the acupuncture, one with moxibustion. Among them, electroacupuncture was the most common intervention of treatment group. ST36 was the most frequently used acupuncture point in the included studies. Effective rate increased and serum amylase, clinical symptoms, recovery time of gastrointestinal function decreased statistically significantly in the treatment group of clinical studies. Conclusions : The result of this study could be used for the future practice and research about the acupuncture and moxibustion treatment for pancreatitis.

Toxicologic Features and Management in Aconitine Intoxication Following Ingestion of Herbal Tablets Containing Aconitum Species (한방환약 복용 후 발생한 Aconitine 중독의 임상독성학적 특성과 환자관리)

  • Cho, Wool-Lim;Jin, Young-Ho;Jeong, Tae-Oh;Lee, Jae-Baek;Kang, Ji-Hun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.104-109
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    • 2008
  • Purpose: Unrefined tablets prepared from Aconitum tubers are occasionally used in Korean folk medicine. This study defines the potential sources, clinical toxicology, and treatment of aconitine poisoning. Methods: A retrospective survey was conducted in 63 patients in the ED of a tertiary University Hospital with suspected toxicity from an unrefined tablet prepared from Aconitum tubers from 1999 to 2007. Results: A total of 63 cases enrolled included 26 men and 37 women, aged 30 to 86 years. Forty-eight patients ingested aconitine tablets as digestives, 26 tablets on average. After a latent period of 30 to 450 minutes, patients developed a combination of neurologic (87.3%), gastrointestinal (82.5%), cardiopulmonary (41.3%), and other (28.6%) features typical of aconitine poisoning. Initial ECG abnormalities revealed dysrhythmia (61.9%), conduction disturbance (42.9%), and abnormal waveforms (39.7%), with 28.6% of patients having normal ECGs. All patients received supportive treatment or close observation regardless of ingestion amounts. Patients with hypotension or ventricular arrhythmia were treated with inotropic agents or amiodarone. Conclusion: Toxicologic signs and symptoms can occur after the consumption of aconitine tablets, regardless of ingestion amount. The risk occurs because of inadequately processed aconitine roots. This study will provide important data for public education and distribution regulations for Aconitum sp. in Korea.

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The Epidemiological Characteristics of Health Problems of Middle School Students Based on School Health Clinic Service (보건실 이용을 중심으로 본 중학생 건강문제의 역학적 특성)

  • Um, Jeong-Im;Lee, Sung-Eun
    • Journal of the Korean Society of School Health
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    • v.20 no.1
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    • pp.25-35
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    • 2007
  • Purpose: This study was to identify the types and characteristics of health problems of middle school students in Gangwondo. Methods: The subjects of the study were 11 middle schools from 47 schools with nurse teachers in Gangwondo. The anecdotal records of the school health clinics were collected from March to December in 1998 with the agreement of nurse teachers of the schools. Results: 71.0% of the middle students visited the school health care clinics once or more than once. The mean frequency of health problems was 2.03 times per one year. The rate of health problems did not show any statistical differences by sex, school location, age, the day of the week and weather. However, there were statistical differences of the rate by month. The highest rate was showed in September, followed by June and April (F=2.52, p=0.01). Health problems were classified into 11 types. Gastrointestinal illness showed the largest proportion (60.6%). The oral illness showed statistical differences among the location of school, between municipal and rural area (t=-2.97, p=0.016). There were 411 types of signs and symptoms recorded. Among them, headache was showed the highest proportion with 2,122 cases (11.2%). Conclusion : The incidence rate of health problems was higher than that of earlier studies. It showed that the incidence rates and the types of diseasps in middle school students were different by school locations, characteristics of students, and months. To improve the qualities of primary cares in school health services, the reformed and unified anecdotal record system and the standardized guidelines for primary care are necessary.

Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit

  • Bae, Eunjoo;Kim, Jiyoon;Jang, Jinyoung;Kim, Junghyun;Kim, Suyeon;Chang, Youngeun;KIM, MI YEON;Jeon, Mira;Kang, Seongsuk;Lee, Jung Keun;Kim, Tae Gon
    • Nutrition Research and Practice
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    • v.15 no.6
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    • pp.703-714
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    • 2021
  • BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.

Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital

  • Balagurunathan, Muruganantham;Natarajan, Thrilok;Karthikeyan, Jothilakshmi;Palanisamy, Venkateshwaran
    • Clinical and Experimental Pediatrics
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    • v.64 no.10
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    • pp.531-537
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    • 2021
  • Background: Multisystem inflammatory syndrome in children (MIS-C) is a new hyperinflammatory variant that evolved during the coronavirus disease 2019 pandemic. Although the precise pathophysiology of MIS-C is uncertain, it is thought to be due to immune dysregulation occurring after recovery from acute infection. Purpose: Our study aimed to analyze the clinical spectrum, laboratory parameters, imaging characteristics, treatment strategies, and short-term outcomes of children with a diagnosis of MIS-C. Methods: This retrospective and prospective observational study included children less than 16 years of age who were admitted to the pediatric unit of a tertiary care teaching hospital in south India between August 2020 to January 2021 with a diagnosis of MIS-C according to World Health Organization criteria. Results: Twenty-one children were included in the analysis; all had fever with variable combinations of other symptoms. The mean age was 6.9 years; 71.4% were male. Gastrointestinal (80.9%) and cardiovascular (80.9%) systems were the most commonly affected. The majority of children had elevated inflammatory markers, and 16 (76.2%) had echocardiographic abnormalities mimicking Kawasaki disease. Eleven children (52.4%) required intensive care admission, 3 (14.3%) required supplemental oxygen, and 4 (19%) required inotropes. Nine (42.9%) were treated with intravenous immunoglobulin alone, 6 (28.6%) with steroids alone, and 3 (14.3%) with steroids and immunoglobulin. The median hospital stay was 6 days; there were no fatalities. Overweight/obesity, elevated ferritin, and mucocutaneous involvement were significantly associated with a prolonged hospital stay (≥7 days). Sixteen children (76.2%) were followed up till now and all of them had no clinical concerns. Conclusion: MIS-C is an emerging disease with variable presentation. A high index of suspicion is necessary for its early identification and appropriate management. Further research is essential for developing optimal treatment strategies.

Effects of red ginseng on gut, microbiota, and brain in a mouse model of post-infectious irritable bowel syndrome

  • Yu, Seonhye;Chun, Eunho;Ji, Yeounjung;Lee, Young Joo;Jin, Mirim
    • Journal of Ginseng Research
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    • v.45 no.6
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    • pp.706-716
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    • 2021
  • Background: Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut-brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods: Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut-brain axis responses were analyzed. Results: Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion: RG may be a potential therapeutic option for the management of human IBS.

Perinatal Nutrition, Post-Hatch Holding Time and In Ovo Feeding (부화 전후 영양, 부화 후 유지시간, 그리고 In Ovo Feeding)

  • Moon, Yang Soo
    • Korean Journal of Poultry Science
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    • v.46 no.1
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    • pp.1-10
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    • 2019
  • The most important times during the development of young chicks are the days immediately prior to hatching and the days immediately after hatching, known as the perinatal period. A sufficient supply of nutrients during the perinatal period is a crucial during the late stage of embryonic development and the starvation period of the young chicks. The delayed post-hatch holding time can restrict the development of the gastrointestinal tract, reduce final body weight, impair muscle development, and change immunological capacities. These symptoms are deleterious to the development of young chicks. Therefore, the post-hatch holding time and its influence on the fitness of young chicks are major concerns to the poultry industry. The in ovo feeding is a practical technology for perinatal nutrition to optimize poultry production and for attenuating the stress experienced by fasting young chicks. This study will discuss in ovo feeding and its effect on the development of the chick embryo, the establishment of a healthy microbiota, and the improving immune response.

Intraoperative Neurophysiologic Testing of the Perigastric Vagus Nerve Branches to Evaluate Viability and Signals along Nerve Pathways during Gastrectomy

  • Kong, Seong-Ho;Kim, Sung Min;Kim, Dong-Gun;Park, Kee Hong;Suh, Yun-Suhk;Kim, Tae-Han;Kim, Il Jung;Seo, Jeong-Hwa;Lim, Young Jin;Lee, Hyuk-Joon;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.19 no.1
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    • pp.49-61
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    • 2019
  • Purpose: The perigastric vagus nerve may play an important role in preserving function after gastrectomy, and intraoperative neurophysiologic tests might represent a feasible method of evaluating the vagus nerve. The purpose of this study is to assess the feasibility of neurophysiologic evaluations of the function and viability of perigastric vagus nerve branches during gastrectomy. Materials and Methods: Thirteen patients (1 open total gastrectomy, 1 laparoscopic total gastrectomy, and 11 laparoscopic distal gastrectomy) were prospectively enrolled. The hepatic and celiac branches of the vagus nerve were exposed, and grabbing type stimulation electrodes were applied as follows: 10-30 mA intensity, 4 trains, $1,000{\mu}s/train$, and $5{\times}$frequency. Visible myocontractile movement and electrical signals were monitored via needle probes before and after gastrectomy. Gastrointestinal symptoms were evaluated preoperatively and postoperatively at 3 weeks and 3 months, respectively. Results: Responses were observed after stimulating the celiac branch in 10, 9, 10, and 6 patients in the antrum, pylorus, duodenum, and proximal jejunum, respectively. Ten patients responded to hepatic branch stimulation at the duodenum. After vagus-preserving distal gastrectomy, 2 patients lost responses to the celiac branch at the duodenum and jejunum (1 each), and 1 patient lost response to the hepatic branch at the duodenum. Significant procedure-related complications and meaningful postoperative diarrhea were not observed. Conclusions: Intraoperative neurophysiologic testing seems to be a feasible methodology for monitoring the perigastric vagus nerves. Innervation of the duodenum via the celiac branch and postoperative preservation of the function of the vagus nerves were confirmed in most patients.

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.

A Case Report on Opioid-Induced Constipation in a Patient with Cancer Treated by Jowiseunggi-tang (조위승기탕으로 호전된 암 환자의 마약성 진통제로 인한 변비 치험 1례)

  • Yoon, Jee-Hyun;Park, Su Bin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.229-236
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    • 2022
  • Objective: Jowiseunggi-tang (JWSGT) is a traditional herbal medicine commonly used for purgative activity in constipation. This study evaluates JWSGT for the treatment of opioid-induced constipation (OIC), the most common and debilitating gastrointestinal effect of opioid use. Methods: A 64-year-old man with floor of mouth cancer was hospitalized for OIC, and JWSGT was administered orally twice a day for 10 days, along with acupuncture, moxibustion, and cupping. The primary outcome measures were defecation type according to the Bristol Stool Form Scale (BSFS) and the frequency of bowel movements. The Brief Fatigue Inventory (BFI) and the Functional Assessment of Cancer Therapy-General (FACT-G) were used as secondary measures. Results: After three days of JWSGT administration, spontaneous bowel movements were observed two to three times per week with improved BSFS from type 2 to 4. A reduction in BFI score (8.7 to 2.0) and an increase in FACT-G score (44.3 to 59.0) suggested an improvement in fatigue level and quality of life. Conclusion: This is the first report to assess the efficacy of JWSGT for the management of OIC in patients with cancer, and JWSGT may be an effective option to improve symptoms and quality of life in this group.