• Advances in pediatric surgery
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• v.11 no.2
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• pp.131-140
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• 2005

The purpose of this study is to review the operative management and outcome of operation for Crohn's disease. The medical records of 17 patients who underwent operations for Crohn's disease at Seoul National University Children's Hospital from January of 1988 to June of 2005 were reviewed. The male-to -female ratio was 1.8: 1. The median age at the onset of symptoms and the time of diagnosis was 9 years 6 months and 11 years 6 months respectively. The median time interval from diagnosis to operation was 2 years and 1 month (0 month~8 years). The ileocolic or ileocecal region was the most common site of involvement. The indications for operation were intractable symptoms (8 cases) and obstruction or stricture (7 cases). The median postoperative hospitalized days were 14.4 days (8~35 days). Five patients (29 %) experienced postoperative complications. Symptom free state or symptom relief was observed in 11 cases after surgery and 6 cases had intermittent episodes of remissions and recurrences. In pediatric Crohn's disease patients who present with intractable symptoms despite medical treatment or develop surgical complications, symptom free state or symptom relief can be achieved by minimal resection of the diseased segment.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.38C no.9
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• pp.802-812
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• 2013

Recently, Capsule Endoscope(CE) system is receiving great attention as a innovative convergence technology that allows doctors to examine the digestive tract of a human body in the minimum invasive way. Once patients swallow the vitamin pill-sized capsule, doctors can detect disease such as blood-based abnormalities, polyps, ulcers, and Crohn's disease through the image information delivered by wireless or human body communication module in CE. Although CE is really a innovative technology, it still suffers from some drawbacks in terms of correct diagnosis of lesion and analysis required time. Due to the massive images approximately 60~120 thousand frames taken by miniature camera in the CE, doctors spend too much time examining the images and analyzing the lesions. Therefore, to lighten the burden of doctors, software tools for fast diagnosis and medical image processing techniques for correct diagnosis of lesion are essential in CE system. In this paper, we investigate the latest trends of diagnosis tools and image processing techniques based on major makers of CE systems, which are hardly known to the general public.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.4
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• pp.56-74
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• 2021

Objectives The purpose of this study is to analyze the trend of herbal medicine treatment, treatment's effect and stability for Crohn's disease by reviewing clinical studies published over the past 5 years. Methods 22 articles which were published from 2017 to August, 2021 were obtained from the ScienceON, Research information sharing service (RISS), Koreanstudies Information Service System (KISS), Oriental medicine advanced searching integrated system (OASIS), China national knowledge infrastructure (CNKI), Pubmed. We analyzed the literature in regards to the treatment methods and results. Results There were 6 case reports, 1 controlled clinical trial, and 15 randomized controlled trial and in most cases, herbal medicines and Western medicines were administered in combination. The pathology of damp-heat due to spleen deficiency was the most common, and Sijunzi-tang and Shenling Baishu san were the most commonly used. As a result of the treatment, it was found that the combined administration of the herbal medicine and the Western medicine was more effective than the administration of the Western medicine alone. Conclusions Herbal treatment of Crohn's disease induced high cure rate safely than when only western treatment was applied. Future studies on safety and studies that can suggest specific guidelines for the combined administration of western and herbal medicines are needed.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.853-862
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• 2021

Objectives: This case study examined the effectiveness of Korean medical treatment for pediatric Crohn's disease. Methods: A 15-year-old female Korean patient with Crohn's disease received acupuncture, electroacupuncture, herbal medicine, moxibustion, and aromatherapy treatment for 1 month in a hospital. Results: Decreases in the Pediatric Crohn's Disease Activity Index score (from 22.5 to 7.5) and the size of two abscesses (from 39.97 mm to 33.36 mm, and from 28.14 mm to 18.71 mm) according to an abdominal CT were observed following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Nausea and vomiting disappeared, stool condition improved, and weight increased (from 30 kg to 33 kg) following treatment. Conclusion: It would be worth examining the long-term effectiveness of Korean medical treatment for pediatric Crohn's disease.

• Journal of Physiology & Pathology in Korean Medicine
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• v.35 no.6
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• pp.255-260
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• 2021

Crohn's disease (CD) is an idiopathic inflammatory bowel disease (IBD) with unknown etiopathogenesis. Currently there are no definitive treatment modalities for CD. This case report presents clinical remission and its maintenance of CD induced by Korean herbal medicine treatment. A 56-year-old male patient diagnosed as CD by capsule endoscopy presented to a Korean Medicine clinic with severe abdominal pain as a chief complaint. Despite taking 5-aminosalicylic acid and immunosuppressant for 2 years, his abdominal pain was worsening at the time of visit. Treatment was initiated with Jinmoo-tang based on pattern identification and continued for approximately a year with some modifications according to patient's symptom changes. He was mainly given Jinmoo-Tang for a year and clinical remission was achieved; he could stop taking western medications. For 6 years since then, he took Korean medicine from time to time when he felt his condition went down and he is still maintaining remission. There were no adverse events reported. This case report suggests that individualized Korean herbal medicine treatment may have the potential for induction and maintenance of clinical remission of CD. Further research is warranted to establish an evidence-base for such approach.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.520-535
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• 2023

Gastrointestinal (GI) bleeding is not a single disease but a symptom and clinical manifestation of a broad spectrum of conditions in the GI tract. According to its clinical presentation, GI bleeding can be classified into overt, occult, and obscure types. Additionally, it can be divided into upper and lower GI bleeding based on the Treitz ligament. Variable disease entities, including vascular lesions, polyps, neoplasms, inflammation such as Crohn's disease, and heterotopic pancreatic or gastric tissue, can cause GI bleeding. CT and conventional angiographies and nuclear scintigraphy are all radiologic imaging modalities that can be used to evaluate overt bleeding. For the work-up of occult GI bleeding, CT enterography (CTE) can be the first imaging modality. For CTE, an adequate bowel distention is critical for obtaining acceptable diagnostic performance as well as minimizing false positives and negatives. Meckel's scintigraphy can be complementarily useful in cases where the diagnosis of CTE is suboptimal. For the evaluation of obscured GI bleeding, various imaging modalities can be used based on clinical status and providers' preferences.

• Korean Journal of Acupuncture
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• v.25 no.2
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• pp.159-177
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• 2008

Objectives : Crohn's disease is a severe chronic inflammation that is treated mainly by immunosuppression, which often has serious side effects. There is need to develop new therapeutic methods or drugs that have few side effects in order to treat this disease. Acupuncture with Moxi-tar at Cheonchu (ST25) has anti-inflammatory properties, but the mechanism of its anti-inflammatory actions is unclear. We investigated the protective effects and speculated the mechanisms of acupuncture with Moxi-tar at ST25 on trinitrobenzene sulfonic acid (TNBS) induced colitis in mice which is a well known Crohn's disease animal model. Methods : 5 % TNBS was treated at day 1 and day 7 into rectum of mice. To investigate therapeutic effects of acupuncture with Moxi-tar at ST25, acupuncture was carried out on day 3, and day 6. For the data analysis, we observed macroscopic and microscopic findings of the colon. Weight and width of the colon, degree of damage, changes of body weight, and myeloperoxygenase (MPO) activity were checked. For analysing protein expression, we carried out immunohistochemical staining and Western blot. For analysing mRNA expression, RT-PCR was carried out. Results : TNBS induced damages on the colon of mice, while acupuncture of Moxi-tar at ST25 suppressed TNBS mediated damages similar to those on the colons of mice in the control (not treated with TNBS) group. The average body weight of TNBS treated mice (77.4%) was decreased compared with that of the control mice (105%), and acupuncture with Moxi-tar at ST25 suppressed the loss of body weight caused by TNBS (from 77.4% to 95.3%). TNBS induced infiltration of immune cells in all layers of the colon while acupuncture with Moxi-tar at ST25 suppressed infiltration of immune cells caused by TNBS. Furthermore, acupunctured with Moxi-tar at ST25 suppressed macro-, micro- colonic damages caused by TNBS. Acupunctured with Moxi-tar at ST25 dramatically improved the clinical and histopathological symptoms such as the increase in weight of the distal colon and the MPO activity in TNBS-induced colitis. Acupuncture with Moxi-tar at ST25 down-regulated the nuclear transcription factor kappa B ($NF-{\kappa}B$) activity and suppressed tumor necrosis factor-a (TNF-${\alpha}$), interleukin-$1{\beta}$ (IL-1${\beta}$), and intracellular adhesion molecule-1 (ICAM-1) expressions caused by TNBS. Conclusions : Acupuncture with Moxi-tar at ST25 helps recovery from the TNBS-induced colonic damage by down-regulation of $NF-{\kappa}B$ activity and suppressing of TNF-${\alpha}$, IL-1${\beta}$, and ICAM-1 expressions. This may be an important method for the treatment of Crohn's disease.

• Journal of the korean academy of Pediatric Dentistry
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• v.41 no.1
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• pp.80-84
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• 2014

Intractable ulcerating enterocolitis is an uncommon inflammatory bowel disease syndrome of neonatal onset first described in 1991. Intractable ulcerating enterocolitis usually presents in the neonate with a mouth ulceration and the subsequent development of perianal disease and colitis. In this case report, an infant, 18 days from birth, with ulcerative lesion on hard palate for systemic differential diagnosis about oral lesion is referred from the department depiatrics. At that time, there is no abnormality, except oral lesion-like Aphthous ulcer. The patient was discharged from pediatrics, but returned to the hospital 3weeks later with blood diarrhea. As a result of endoscopy, there were large ulcerating lesions and the patient was diagnosed intractable ulcerating enterocolitis. Early recognition of Intractable ulcerating enterocolitis appears to be beneficial because colectomy, as opposed to immunosuppression, appears to be effective in controlling disease symptoms and progression. Most of the infants who were affected intractable ulcerating enterocolitis were normal at birth and oral manifestation appeared earlier than others. So, it is very meaningful for dentists to know about Intractable ulcerating enterocolitis.

• Korean Journal of Plant Resources
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• v.33 no.4
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• pp.287-292
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• 2020

Lathyrus palustris often used as a treatment for inflammation of the kidneys in Korean traditional medication. Generally, drugs for arthritis have anti-inflammatory and antinociceptive properties. However, the validity of the anti-inflammatory effect has not been scientifically investigated so far. Therefore, the purpose of the research was to investigate the latent anti-inflammatory ability of L. palustris using the ethanol extract. To evaluate the anti-inflammatory activities, we examined the inflammatory arbitrators such as a nitric oxide (NO) and prostaglandin E₂ (PGE₂) on RAW 264.7 cells. Our results indicated that ethanol extract significantly inhibited the lipopolysaccharide E (LPS) derived PGE₂ production in RAW 264.7 cell. The inhibitory activity of ethanol extract for PGE₂ tests with inhibition ratio showed in 40 ㎍/mL. Overall, PGE₂ tests had a higher inhibitory effect on inflammation than NO tests. This result anticipated that the ethanol extract from L. palustris is a good candidate for developing the origin of anti-inflammatory agents.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.177-182
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• 2009

Purpose: Colitis is a condition associated with a spectrum of altered morphologic changes and cellular adhesion. E-cadherin plays a key role in the establishment and maintenance of epithelial tissue structure and cell-cell adhesion. The purpose of this study is to evaluate E-cadherin expression in colonic epithelium of various colitis in children. Methods: The expressions of E-cadherin were examined in 39 cases of colonic mucosal biopsy specimen using immunohistochemical staining. When more than 50 percent of cells exhibited uniformly the same intensity and pattern of immunostaining as the adjacent normal mucosa, the antigen expression was considered normal. Abnormal expression was defined when less than 50 percent of cells stained, when cells showed a heterogeneously weak or altered distribution, or when complete absence of staining was observed. Results: Fifteen cases with non-specific colitis (38.5%), 7 cases of with Crohn's disease (17.9%), 5 cases of infectious colitis and milk protein sensitive proctocolitis (12.8%), 3 cases of ulcerative colitis (7.7%), 2 cases of Henoch-Schonlein purpura colitis (5.1%), one case of Behcet's disease and ischemic colitis (2.6%) were included in this study. E-cadherin expression was decreased in all kinds of colitis. Reduced expression of E-cadherin was observed in 77 percent of cases. E-cadherin was weaker or no expression in reparative epithelium and "ulcer associated cell lineage". Conclusion: Altered expression of E-cadherin occurs during mucosal inflammation in any kinds of colitis. These changes may be involved in promoting cell migration during epithelial restitution of the gastrointestinal mucosa.