• Title/Summary/Keyword: Small bowel disease

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Synthesis and Evaluation of 5-Aminosalicyl-glycine as a Potential Colon-specific Prodrug of 5-Aminosalicylic Acid

  • Jung, Yun-Jin;Lee, Jeoung-Soo;Kim, Hak-Hyun;Kim, Young-Mi;Han, Suk-Kyu
    • Archives of Pharmacal Research
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    • v.21 no.2
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    • pp.174-178
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    • 1998
  • As a new colon-specific prodrug of 5-aminosalicylic acid (5-ASA), 5-aminosalicyl-glycine (5-ASA-Gly) was prepared by a simple synthetic route in good yield. Apparent partition coefficients of 5-ASA-Gly were lower than those of 5-ASA, which determined in$ CHCl_{3}$/pH 6.8 buffer or n-octanol/pH 6.8 buffer system. Stability of 5-ASA-Gly by peptidases was investigated by incubation of 5-ASA-Gly with the homogenates of tissue and contents of stomach, proximal small intestine or distal small intestine of rats at $37^{\circ}C$. 5-ASA was not detected, indicating that the prodrug was stable in the upper intestine. The amount of 5-ASA liberated from incubation of the prodrug in cecal or colonic contents of rats was about 65% or 27% in 8 hrs, respectively, which indicated that the prodrug activation took place more readily in the rat cecum whose bacterial counts are high like human colon. Results from in vitro experiments suggested 5-ASA-Gly as a promising candidate of a colon-specific prodrug of 5-ASA.

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Intussusception in Neonates: Clinical Characteristics of Eight Cases in a Single Center

  • Ahn, Yong-gi;Lim, Gina;Hwang, Eun Ha;Oh, Ki Won;Cho, Min Jeng
    • Neonatal Medicine
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    • v.28 no.1
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    • pp.29-35
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    • 2021
  • Purpose: Intussusception is the most common cause of bowel obstruction in children; however, it is rarely diagnosed in newborn infants. This study aimed to describe the clinical features of intussusception in newborn infants. Methods: Medical records of eight patients diagnosed with intussusception during the newborn period at Ulsan University Hospital between March 2007 and March 2020 were retrospectively reviewed. Results: Among the eight cases, two occurred in the intrauterine period and six occurred in the postnatal period. Intrauterine intussusception presented with symptoms of bowel obstruction within 1 to 2 days after birth, and ileal atresia was diagnosed simultaneously through exploratory laparotomy. All the postnatal patients were extremely low birth weight infants (median gestational age and birth weight: 25+6 weeks and 745 g, respectively). Four cases were diagnosed preoperatively using abdominal ultrasonography. One patient was diagnosed by exploratory laparotomy because the clinical symptoms were nonspecific and difficult to differentiate from those of necrotizing enterocolitis, a more prevalent complication in preterm infants. The site of intussusception in all six patients was the small bowel. Meckel's diverticulum (one case) and meconium obstruction (two cases) were found to be the lead point. Conclusion: Neonatal intussusception tends to show different clinical features according to its period of occurrence. Intussusception, especially in preterm infants, has nonspecific clinical features; therefore, clinicians should always be cautious of this disease for its early diagnosis.

A Case of Small Bowel Intussusception Caused by Jejunal Hamartoma Confused as Hepatitis A in an Adult (성인에서 급성 A형 간염으로 오인된 과오종에 의한 소장 중첩증 1예)

  • Hur, Joon;Cho, Gu-Min;Eum, Young Ook;Park, Ji Young;Kim, Mi Sung;Ko, Byung Seong;Shin, Hyang Mi;Son, Seung-Myoung
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.110-112
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    • 2012
  • Intussusception in adult is a rare disease and laparotomy is usually considered because of the probability of malignancy. Especially with obstruction symptom or sign, it might be needed emergency operation. This case was a simultaneous development of small bowel intussusception and acute hepatitis A. The patient had abdominal pain and vomiting. Intitial laboratory examination with elevated aminotransferase revealed that the diagnosis was acute hepatitis. As managing acute hepatitis, the abdominal pain was not improved and the patient had tenderness on periumbilical area on physical examination. A jejunal intussusception with a lead point was proved on the abdominal computed tomography scan. Fortunately, symptom of intussusception was relieved while nulli per os (NPO) and intravenous hydration. After recovery of acute hepatitis, laparotomy was done. The lead point was $2.5{\times}3.0cm$ sized hamartoma. This was the case that the symptom of intussusception was confused with that of acute hepatitis.

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A Study on the Collateral Vessel Pathology(絡脈病機) of Blood Disease(血證) in Onbyeong(溫病) with focus on Ju-Gaek-Gyo(主客交, guest-host minglement) and Dry Blood(乾血) (온병(溫病) 혈증(血證)의 낙맥병기(絡脈病機)에 대한 고찰 -주객교(主客交)와 건혈(乾血)을 중심으로-)

  • Kim, Dong-Hui;Jeong, Chang-Hyun;Jang, Woo-Chang;Lyu, Jeong-Ah;Baik, You-Sang
    • Journal of Korean Medical classics
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    • v.25 no.1
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    • pp.89-115
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    • 2012
  • Objective : Blood disease is common these days due to modern man's excessiveness in Yang heat (陽熱) and vulnerability of the Eum blood(陰血). This exposes them to warmheat/ dampness-heat diseases, where pathogenic heat easily penetrates the blood dimension(血分) creating stagnated blood(瘀血). Consequently, pathogenic symptoms in the collateral vessels increase, making it crucial to understand the pathogenic mechanism of the disease. Method : This paper examines the condition and region of the collateral vessel diseases(CVD) according to the blood diseases of Onbyeong, by analyzing each prescription's matching symptom. The disease in question in this paper is 'stagnated blood fixated in the collateral vessels'. Therefore diseases with stagnated blood in the Yang collaterals and Viscera collaterals or viscera themselves from the chapter of "On-Yeok-Ron(溫疫論)", and < Dry Blood-DaeWhangJaChungWhan(大黃蟅蟲丸) > chapter of "Geum-Gue-Yo-Rak(金匱要略)", were examined respectively. Result & Conclusion : The process of CVD according to the blood diseases of Onbyeong can be summarized as follows. First, bleeding in the Yang and Bowel collaterals, then stagnation in the Yang and Bowel collaterals, and finally stagnation in the viscera collaterals or Liver itself. The refractory nature of blood stagnation symptoms of the collateral vessels is mainly due to the characteristics of the collateral vessel itself. In structure, they are very narrow and small, situated at the most terminal part of the body where it is difficult for the Jeong Gi(精氣) to reach. Also, as they are symptomatic of degeneration of Jeong Gi, the root of the disease is very deep. Therefore to resolve blood stagnation in the cases of Ju-Gaek-Gyo and Dry Blood, general approaches using 'Gi communication(行氣)' or 'Blood vitalizing(活血)' medicinals will not suffice. Special medicinals such as crustacean and insects need to be appropriately applied.

Successful treatment of fungal central thrombophlebitis by surgical thrombectomy in Korea: a case report

  • Eun Ji Lee;Jihoon T. Kim
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.276-280
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    • 2023
  • Fungal thrombophlebitis of the central vein is a rare, life-threatening disease associated with significant morbidity and mortality. It requires immediate central venous catheter removal and intravenous antifungal therapy, combined in some cases with either anticoagulation or aggressive surgical debridement. A 70-year-old male patient injured by a falling object weighing 1,000 kg was transferred to our hospital. A contained rupture of the abdominal aorta with retroperitoneal hematoma was treated with primary aortic repair, and a small bowel perforation with mesenteric laceration was treated with resection and anastomosis. After a computed tomography scan, the patient was diagnosed with thrombophlebitis of the left internal jugular vein and brachiocephalic vein. Despite antifungal treatment, fever and candidemia persisted. Therefore, emergency debridement and thrombectomy were performed. After the operation, the patient was treated with an oral antifungal agent and direct oral anticoagulants. During a 1-year follow-up, no signs of candidemia relapse were observed. There is no optimal timing of surgical treatment for relapsed fungal central thrombophlebitis. Surgical treatment should be considered for early recovery.

Post-operative Adjuvant Chemotherapy in Patients with Stage II Colon Cancer (2기 대장암 환자에서의 수술 후 보조 항암화학요법)

  • Jae Jun Park
    • Journal of Digestive Cancer Research
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    • v.3 no.2
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    • pp.89-94
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    • 2015
  • The role of adjuvant chemotherapy in patients with stage II colon cancer remains a controversial issue. Adjuvant chemotherapy aims to eliminate any micrometastatic disease that may have been missed, at the time of surgery. Although one prospective study showed a small but statistically significant benefit with respect to the overall survival for those who received adjuvant chemotherapy, multiple pooled data did not demonstrate any benefit of this therapy in patients with stage II colon cancer. Current national and international guidelines for the adjuvant treatment of stage II colon dose not advise routine implementation of adjuvant chemotherapy, but rather recommend selective use of this therapy for patients with high risk of recurrence. High risk features for recurrence include T4 disease, poorly differentiated histology, presence of lymphovascular invasion, presence of perineural invasion, inadequate retrieval of lymph nodes, bowel obstruction, localized perforation, or positive margins. More recently, prediction tools using gene expression cancer profiles are proposed to identify patients who are most likely to have recurrence and therefore may benefit from postoperative chemotherapy in stage II colon cancer. These novel methods together with conventional prognosticators, will allow us to implement more optimized personalizing adjuvant therapy in these patients.

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A Case of Mesodiverticular Band Causing Small Intestinal Obstruction (소장 폐쇄의 원인이 된 게실 간막 띠(Mesodiverticular band) 1례)

  • Na, Hyun Jung;Lee, Gyeong Hoon
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.278-283
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    • 2004
  • Meckel's diverticulum is found in about 3% of the population, often incidentally during laparotomy or at autopsy. Over 50% of patients who develop symptoms from this anomaly are younger than 2 years of age. The most common symptom of this lesion is intestinal obstruction. Rarely Meckel's diverticulum is complicated by a mesodiverticular band, which is believed to be a remnant of a vitelline artery. We report a 11-year-old girl with small bowel obstruction because of an intestinal hernia beneath the mesodiverticular band. The causative factor was a stenotic area in the terminal ileum caused by a ringlike lipovascular mesenteric band encroaching externally on the lumen. Although the incidence of mesodiverticular bands complicating Meckel's diverticulum is quite low, the rapid clinical course and the associated high mortality rate make this an important disease.

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Double Intussusception in a Jindo Puppy : Triple-circle Sign

  • Kim, Hyun-su;Jeon, Soo-hee;Hwang, Tae-sung;Yoon, Young-min;Yeon, Seong-chan;Lee, Hee-Chun
    • Journal of Veterinary Clinics
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    • v.33 no.3
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    • pp.176-178
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    • 2016
  • Here we report a case of a 7-month-old Jindo puppy with a double intussusception. On survey radiography, a soft tissue opacity mass was identified in the mid-abdomen. Abdominal ultrasonography revealed a triple-circle sign. Double intussusception was diagnosed based on these findings. Exploratory laparotomy confirmed it to be a double intussusception in the small intestine. Small intestine involving the double intussusception was surgically resected followed by anastomosis. The dog had good prognosis without any complication. To the best of our knowledge, double intussusception is an extremely rare form of intestinal disease in dogs. It may cause blood supply to that section to be greatly reduced, thus causing ischemia and necrosis of the bowel tissue. Timely diagnosis with ultrasonographic findings and immediate surgical intervention are important to improve the prognosis of such cases.

Protein-losing Enteropathy Induced by 4 Different Etiologies (4가지 다른 병인들에 의해 유발된 단백소실성 장병증 증례)

  • Cho, Kyu-Woan;Moon, Jong-Hyun;Lee, Hee-Chun;Kwon, Do-Hyung;Kang, Byeong-Teck;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.93-97
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    • 2012
  • Four dogs (case 1; 2-year-old spayed female Schnauzer, case 2; 3-year-old spayed female Cocker Spaniel, case 3; 9-year-old castrated male Yorkshire Terrier, and case 4; 9-year-old intact female Shih-tzu) were referred to us with gastrointestinal signs such as diarrhea, vomiting, and anorexia. Results of blood analysis revealed hypoproteinemia and hypoalbuminemia in all dogs. Case 4 showed large circular mass which is connected with small intestine on abdominal ultrasonography and other 3 cases showed no remarkable findings on abdominal radiography and ultrasonography. We performed enterectomy in case 4 and gastrointestinal endoscopic examination with biopsy in other 3 patients. Finally, 4 patients diagnosed to protein losing enteropathy with 4 different etiologies.

[$^{18}F$]-FDG PET/CT Images of Appendiceal Adenocarcinoma ($^{18}F$-FDG PET/CT로 진단된 충수 선암종)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Chun, Kyung-Ah;Won, Kyu-Chang;Lee, Hyung-Woo;Kim, Hong-Jin
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.3
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    • pp.188-189
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    • 2006
  • A 53-year -old man underwent $^{18}F$-FDG whole body PET/CT because of the detected liver mass on abdominal CT. The PET/CT showed a huge liver mass ($9{\times}9cm$, SUV: 12.12 ) in the right lobe and a focally hypermetabolic lesion in the right lower quadrant of abdomen (SUV: 9.12). At first, we suspected that the focal hypermetabolic lesion in RLQ was the physiologic uptake of ureter or a metastatic lesion of small bowel. We repeated the abdominal PET/CT next day. The focally hypermetabolic lesion was identified as the appendiceal mass. He underwent right hemicolectomy and right lobectomy of the liver. It was confirmed that the lesion was appendiceal adenocarcinoma with liver metastasis. Cancer of the appendix is an uncommon disease that is rarely suspected before surgery. But, we suggest that PET/CT is useful to identify the small lesion like appendiceal malignant mass.