• The Journal of Korean Medicine
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• v.29 no.1
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• pp.1-6
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• 2008

Objective : To investigate the therapeutic effect of manual acupuncture at Siguan (four gates, bilateral LI4 and LR3) on suppression of gastrointestinal motility. Methods : A single blind, randomized, sham-acupuncture controlled, crossover study was conducted. Twenty healthy male subjects were admitted at hospital, and gastrointestinal motility suppression was induced by loperamide administration. Just after intake of 20 radio-markers, four gates or sham acupoint treatments were administered every 12 hours, 4 times over 48 hours. Gastrointestinal motility was evaluated by radiographic distribution of the radiomarkers at stomach or ileum, ascending, transverse, descending colon, sigmoid/rectum, and outside body at serial time points (0, 6, 12, 24, and 48 h). Results : Four gates acupuncture activated gastrointestinal movement as evidenced by significantly changed distributionof radio-makers at 6, 12, and 48 hours (P < 0.0001, P = 0.001, and P = 0.03, respectively) in Cochran-Mantel-Haenszel statistics. No serious adverse events occurred in either group. Conclusions : This study showed a scientific clinical relevance of four gates acupuncture to gastrointestinal disorders.

• Journal of Pharmacopuncture
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• v.13 no.3
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• pp.47-62
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• 2010

Objectives: Colitis is an inflammatory bowel disease characterized by colonic mucosal inflammation and chronic relapsing events represents. The purpose of this study is to evaluate effects of pharmacopuncture of anti-inflammatory herbal compound (AiC) applied to the different acupoints in the acute colitis induced by trinitrobenzenesulphonic acid (TNBS) intracolonic injection in rats. Methods: In Male Sprague - Dawley rats, weighing 250~400g, TNBS (5 mg/kg) was infused intrarectally through a silicon rubber catheter into the anus under isoflurane anaesthesia. Acupoints of LI4 (Hapkok), ST25 (Cheonchu), ST36 (Joksamni), and BL25 (Daejangsu) were intramuscularly injected by AiC, respectively (injection volume & times: 0.2 ml / acupoint, twice times on the 2nd & 3rd day). Expressions of cFos protein in the periaqueductal gray (PAG), locus coeruleus (LC), nucleus of solitary tract (Sol), and the 6th lumbar spinal cord (L6 s.c.) were observed at 24 hr after TNBS induced colitis by immunohistochemistry. Results: The expression of c-Fos protein in the L6 s.c., Sol, LC and PAG increased 24 hr after TNBS injection into colorectum as compared to normal and 50% ethanol treated group. AiC to LI4 inhibited the expression of c-Fos protein in Sol and PAG but not L6 s.c. and LC. AiC to ST36 showed significant inhibition the c-Fos expression in L6 s.c., Sol and PAG. AiC to ST25 only showed the effects in L6 s.c. and PAG. AiC to BL25 inhibited significantly the expression of c-Fos protein all over the areas. To investigate whether or not endogenous opioids are involved, intrathecal injection of naltrexone (30ug/30ul) was applied before the 2nd pharmacopuncture treatment 24 hr after TNBS-induced colitis in rat. Naltrexone reversed the inhibition of c-Fos protein expression in the spinal cord and brainstem. Conclusions: These data show that pharmacopuncture of Aic potently inhibits signal pathways ascending hypersensitivity of colorectum after TNBS induced colitis and depends on the endogenous opioids according to acupoints.

• Journal of Yeungnam Medical Science
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• v.6 no.2
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• pp.207-215
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• 1989

The authors studied ED50 of bethanechol on the contractilities of the smooth muscles isolated from various organs of rat under the presence of atropine(a classical competitive blocker of cholinergic muscarinic receptor) or minaprine(a newly developed antidepressant drug) to investigate the pheripheral anticholinergic effect of minaprine. The results were as follows ; 1) There was no significant difference between ED50 of bethanechol in the control group and that under the presence of minaprine $10^{-8}M$ and $10^{-7}M$ in the smooth muscles isolated from the duodenum. 2) There was no significant difference between ED50 of bethanechol in the control group and that under the presence of minaprine $10^{-8}M$ and $10^{-7}M$ in the smooth muscles isolated from the ascending colon. 3) There was significant difference between ED50 of bethanechol in the control group and that under the presence of minaprine $10^{-8}M$ and $10^{-7}M$ in the smooth muscles isolated from the urinary bladder(P<0.01). 4) There was significant difference between ED50 of the atropine $10^{-8}M$ and minaprine ($10^{-8}M$) in the smooth muscles isolated from the urinary bladder(P<0.05).

• Clinical and Experimental Pediatrics
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• v.49 no.1
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• pp.107-111
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• 2006

Crohn disease (CD) is rare, but the incidence of CD has been increasing over the past ten years. We found two cases of CD, associated with myelodysplastic syndrome (MDS), for the first time in children. In the first patient, MDS was diagnosed at three years of age and CD developed later at eight years of age. The patient presented with recurrent abdominal pain, diarrhea, bloody stools and failure to thrive. Colonoscopy revealed cobble stone like mucosa and mass like lesions with superficial ulceration and inflammatory exudates, observed from the cecum to ascending colon. Ileo-cecal biopsy samples showed ulcers with skipped areas and lymphoid infiltrations. The patient was started on treatment with mesalazine and deflazacort, and symptoms remitted. In the second patient, MDS was diagnosed at nine years of age and CD developed at 13 years of age. This patient has recurrent hematochezia, abdominal pain, vomiting and fever. Colonoscopy revealed a large, deep indurative ulceration on the cecal side of the ileo-cecal valve. Ileocecectomy was done, and histology revealed ulceration with transmural inflammation and lymphoid aggregates. Symptoms improved after ileocecectomy.

• Journal of Physiology & Pathology in Korean Medicine
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• v.28 no.2
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• pp.238-242
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• 2014

Here we described 2 cancer patients treated by acupuncture for abdominal pain as a complication of bowel obstruction. The patient 1, 43-year-old man was treated with surgery, radiotherapy and chemotherapy for rectal cancer. Two years after surgery, he complained of acute abdominal pain due to small bowel adhesion band. Bowel obstruction and symptoms were not improved by conservative therapy like as fasting, keeping Levin tube, and fluid therapy. 4 months later, he could eat a little rice water, but ileus and abdominal pain persisted despite of applying opiod drug and patch. Got started on acupuncture, electroacupuncture(ST-36) and moxa treatment, pain was relived gradually. He could stop opioids 1 month later and ileus was improved after acupuncture therapy for 2 months. The patient 2, 65-year-old woman got hepatectomy, cholecystectomy, and chemotherapy with cholangiocarcinoma. 6 months after surgery, she got laparotomy again for biopsy of new mass around ascending colon. She started eating after gas passing, but felt abdominal distension. Diffuse paralytic ileus was diagnosed by abdominal X-ray, and she got started conservative therapy. During ST-36 electroacupuncture therapy, symptoms like abdominal pain and distension were improved and could stop opiod patch. But eating aggravated ileus again and clinical finding of mechanical bowel obstruction was appeared. Based on these cases, acupuncture and moxa therapy could be helpful for improving abdominal pain and ileus, but possibility of malignant bowel obstruction should be considered especially in cancer patients.

• Journal of the Korean Society of Radiology
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• v.83 no.2
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• pp.432-438
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• 2022

Colonic angiosarcoma is an extremely rare and aggressive malignant tumor with poor prognosis. We report a case of colonic epithelioid angiosarcoma with colonic obstruction and rapidly progressive hepatic metastasis in a 44-year-old female. Abdominal CT revealed a heterogeneously enhancing irregular mass in the ascending colon, causing proximal bowel distension. The patient underwent surgery, and histopathological examination revealed a poorly differentiated carcinoma. A follow-up liver dynamic MRI after 4 months revealed newly developed diffusely scattered numerous small nodules in both hepatic lobes with peripheral and nodular marked arterial hyperenhancement, raising the suspicion of hepatic angiosarcoma. A pathologic second opinion was obtained, and additional immunohistochemistry revealed colonic epithelioid angiosarcoma. The patient showed progressive hepatic metastasis on follow-up abdominal CT after 6 months and died 8 months after initial diagnosis. We describe an educational case of colonic angiosarcoma, a rare malignant tumor, with rapidly progressive hepatic metastasis that showed radiologic findings suggestive of angiosarcoma and enabled a re-diagnosis for proper treatment and prognosis prediction.

• Investigative Magnetic Resonance Imaging
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• v.10 no.2
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• pp.81-88
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• 2006

Purpose : To evaluate the MR imaging findings of bowel wall thickening in patients with minimal to moderate cirrhosis, and analyze their clinical significances comparing with laboratory findings. Materials and Methods : We assessed retrospectively the MRI findings of 123 patients with minimal to moderate cirrhosis, and compared these with the clinical laboratory findings. We evaluated the involved sites and MR image findings of thickened bowel wall, as well as the presence of collateral vessels, ascites, and splenic size. These were compared with serum albumin and bilirubin levels, and prothrombin time. Results : Gastrointestinal wall thickening was detected at 37 sites in 25 patients (20%), and more frequently detected in moderate cirrhosis (29%) than in minimal cirrhosis (17%). Jejunum and ascending colon were the most common sites of bowel wall thickening; each was involved at 22 and 9 sites, respectively. Ascending colonic wall thickening was more commonly detected in moderate cirrhosis than in minimal cirrhosis. The thickened bowel wall showed symmetric contour, high signal intensity on T2-weighted images, mixed iso- and low signal intensity on T1-weighted images, and homogeneous or target-like enhancement. Serum albumin level was significantly lower in patients with bowel wall thickening ($3.3{\pm}0.9$ g/dl vs. $3.9{\pm}0.7$ g/dl; p=0.0024). Serum bilirubin level was significantly higher in patients with bowel wall thickening ($1.7{\pm}1.0$ mg/dl vs. $1.4{\pm}1.2$ mg/dl; p=0.0160). Bowel wall thickening did not significantly correlate with the presence of collateral vessels, ascites, splenic size, and prolongation of prothrombin time. Conclusion : In minimal to moderate cirrhosis, the MR imaging evaluation of bowel wall thickening was useful for estimating the severity of cirrhosis and laboratory findings.