• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.1015-1021
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• 2014

This study aimed at summarizing published study findings on the diagnostic value of rectal bleeding (RB) and informing clinical practice, preventive interventions and future research areas. We searched Medline and Embase for studies published by September 13, 2013 examining the risk of colorectal cancer in patients with RB using highly inclusive algorithms. Data for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive predictive value (PPV) of RB were extracted by two researchers and analyzed applying Meta-Disc (version 1.4) and Stata (version 11.0). Methodological quality of studies was assessed according to QUADAS. A total of 38 studies containing 5,626 colorectal cancer patients and 73,174 participants with RB were included. The pooled sensitivity and specificity were 0.47 (95% CI: 0.45-0.48) and 0.96 (95% CI: 0.96-0.96) respectively. The overall PPVs ranged from 0.01 to 0.21 with a pooled value of 0.06 (95% CI: 0.05-0.08). Being over the age of 60 years, change in bowel habit, weight loss, anaemia, colorectal cancer among first-degree relatives and feeling of incomplete evacuation of rectum appeared to increase the predictive value of RB. Although RB greatly increases the probability of diagnosing colorectal cancer, it alone may not be sufficient for proposing further sophisticated investigations. However, given the high specificity, subjects without RB may be ruled out of further investigations. Future studies should focus on strategies using RB as an "alarm" symptom and finding additional indications to justify whether there is a need for further investigations.

• Korean Journal of Adult Nursing
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• v.28 no.6
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• pp.637-645
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• 2016

Purpose: The purpose of this study was to identify the occurrences and the factors contributing to constipation in the post surgical period following major orthopedic surgery. Methods: The sample included 133 patients who had surgery of the hip, knee, or spine. Patients were excluded from the study if there was a history of bowel surgery or constipation from chart review. Data were collected using questionnaires such as Korean version of Modified Barthel index (K-MBI), Hospital Anxiety and Depression Scale, and Constipation Assessment Scale (CAS) before surgery and on the third postoperative day. Results: Reports of constipation occurred in 77 instances (57.9%). The first reported defecation was within $4.0{\pm}2.2days$ following surgery. Mean days of first defecation of constipation group vs. non-constipation group was $5.5{\pm}1.7days$ vs. $2.1{\pm}1.0days$. There were statistically significant differences between patients who reported than those who did not in terms of age, length of NPO period, postoperative ADL, and the reported incidents of preoperative and postoperative depressive symptoms. Postoperative ADL, age, and NPO period were significant influencing factors of constipation and explained 52.4% of the variance. Conclusion: Constipation is a very common symptom for patients undergoing orthopedic surgery. These results indicate a need for improving patient's ADL after surgery to prevent constipation.

• Korean Journal of Veterinary Research
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• v.47 no.1
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• pp.19-24
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• 2007

The cause and pathogenesis of inflammatory bowel disease remain unknown and no definitetherapy exists until now. The present study was conducted to investigate the anti-inflammatory effectsof a herbal preparation (HemoHIM) in colitis induced by 30 mg of trinitrobenzene sulfonic acid (TNBS)in rats. Sprague-Dawley rats were divided into 5 groups. Each group was treated with 1 mg ofHemoHIM/ml of drinking water, 4 mg of HemoHIM/ml of drinking water, 50 mg of HemoHIM/kgof body weight (i.p. once every other day) or 10 mg/kg of HemoHIMof body weight (i.p. onceevery other day) from the next day. After 2 weeks, rats were sacrificed and morphologic featuresof colons were examined. Ulceration, adhesion, thickening and dilatation were noticed in the colonicmucosa after TNBS instillation. Intraperitoneal injection of HemoHIM (50 and 100 mg/kg of bodyweight) showed the anti-inflammatory effect on adhesion, thickening, dilatation, ulceration, and theinhibition effect on damage score by 72.7% and 90.9%, respectively. Histologically, the colon of TNBS-treated rat showed inflammatory cell infiltration by polymorphonuclear cells, multiple erosive lesionsignificant improvement in these symptoms. The results obtained suggest marked anti-inflamatoryactivity of the HemoHIM at the dose levels examined.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.104-107
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• 2001

Intussusception is a frequent cause of bowel obstruction in the first five years of life and it is one of the most common surgical emergencies in infancy and early childhood. The age of five months child was administered in Department of Pediatrics of Chunchon Sacred Heart Hospital. His main symptoms were vomiting and high fever for three days. Abdominal sonography, air reduction and abdominal computerized tomography (CT) were performed and the conclusion of these study was intussusception due to cyst mass lesion; duplication cyst, mesenteric cyst or Meckel's diverticulum. He was transferred for operation. We had performed laparotomy for reduction of the intussusception. Operative findings revealed ileocolic type of intussusception due to cystic tumor on ileocecal valve that was invaginated into the cecum, and hyperplasia of the Peyer's patch were seen. But we failed manual reduction because of the tumor in the ileocecal area. So we had performed partial resection of the ileocecum. Diverticulum of the ileum was confirmed by pathologic examination. We experienced unusual cause of the intussusception. So we report this case with a review of the literatures.

• Advances in pediatric surgery
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• v.11 no.2
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• pp.141-149
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• 2005

Ulcerative colitis, an inflammatory bowel disease, is primarily managed medically with a combination of 5-ASA and steroids. However, this chronic disease requires surgical management if symptoms persist or complications develop despite medical management. The clinical course, indications and outcome of surgical management of 21 patients under the age of 15 who were endoscopically diagnosed with ulcerative colitis at the Seoul National University Children's Hospital between January, 1988 and January, 2003 were reviewed. Mean follow up period was 3 years and 10 months. The mean age was 10.3 years old. All patients received medical management after diagnosis and 8 patients (38 %) eventually required surgical management. Of 13 patients who received medical management only, 7 patients (53 %) showed remission, 4 patients are still on medical management, and 2 patients expired due to congenital immune deficiency and hepatic failure as a result of sclerosing cholangitis. In 8 patients who received surgical management, the indications for operation were, 1 patient sigmoid colon perforation and 7 patients intractability despite medical management. The perforated case had a segmental colon resection and the other 7 patients underwent total colectomy with ileal pouch-anal anastomosis. One patient expired postoperatively due to pneumonia and sepsis. and 1 is still on medical management because of mild persistent hematochezia after surgery. Six other operated patients are doing well without medical therapy. Pediatric ulcerative colitis patients can be surgically managed if the patient is intractable to medical management or if complications such as perforation are present. Total colectomy & ileal pouch-anal anastomosis is thought to be the adequate surgical method.

• Journal of Acupuncture Research
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• v.25 no.5
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• pp.127-137
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• 2008

Objectives : These days, herbal acupuncture therapy is widely applied to many diseases and symptoms by Korean medical doctors in Korea. The aim of this study was to demonstrate the effect of Carthami-Semen herbal acupuncture(CSHA) on chronic constipation. Methods : This single-blind placebo-controlled randomized parellel study enrolled 24 adults with chronic constipation. After one week's run-in period, they were randomly assigned to receive CSHA therapy, or placebo therapy for 4 weeks by 2 times per week. After completing 4 week's therapy, 2 week's follow-up period was continued. During study, defecation frequency, consistency and ease of evacuation were checked before study, every week and follow-up periods. Also, the VAS of constipation, quality of life(QoL) and heart rate variability(HRV : low frequency, high frequency) were checked 3 times totally. Finally, 21 subjects completed the protocol and 20 subjects were analyzed.(1 subject is excluded for analysis because of not following the protocol.) Results : In CSHA group, defecation frequency(continued after 1 week), consistency and ease of evacuation(at 1 week after and follow-up) were increased significantly. The VAS of constipation in CSHA group was significantly decreased. There was no significant change at QoL and HRV. Conclusions : CSHA therapy was effective in treating adults with chronic constipation. Study that have larger case number and longer follow up will be needed in the future.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.31 no.1
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• pp.12-21
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• 2018

Objectives : Inflammation is one of the self-protective abilities against tissue injury, and it has clinical symptoms like redness, heat, swelling, pain, and loss of function. The purpose of this study is to examine inhibitory effects of Naetakchunkeum-san (NTCKS) on nitric oxide (NO), Prostaglandin E2 (PGE2), inducible NOS (iNOS), cyclooxygenase-2 (COX-2), and phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2), which play a major role in inflammatory response. Methods : The experiment was performed using Raw 264.7 cells pretreated with NTCKS extracts. Cell viability was determined by MTT assay. To evaluate anti-inflammatory effects of NTCKS, we examined NO and $PGE_2$ production in LPS-induced macrophages. We also investigated effects of NTCKS on iNOS, Cox-2, and ERK1/2 expression using western blot. Results : In MTT assay, no cytotoxicity of NTCKS (50, 100, 150, $200{\mu}g/ml$) on RAW 264.7 cell was found. LPS-induced NO production was decreased after treatment with NTCKS (150, $200{\mu}g/ml$)(p<0.05). $PGE_2$ was decreased after treatment with NTCKS (150, $200{\mu}g/ml$)(p<0.05). NTCKS inhibited LPS-induced expressions of iNOS and COX-2 in a dose-dependent manner. Increased phosphorylation of ERK1/2 by LPS was decreased by NTCKS in a dose-dependent manner. Conclusions : According to above experiments, NTCKS may be applied to inflammatory diseases such as atopic dermatitis, rheumatoid arthritis, and inflammatory bowel disease.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.3
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• pp.67-88
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• 2021

Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

• 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.

• Nutrition Research and Practice
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• v.13 no.2
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• pp.95-104
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• 2019

BACKGROUND/OBJECTIVES: Inflammatory Bowel Disease (IBD) has rapidly escalated in Asia (including Korea) due to increasing westernized diet patterns subsequent to industrialization. Factors associated with endoplasmic reticulum (ER) stress are demonstrated to be one of the major causes of IBD. This study was conducted to investigate the effect of Lycium barbarum (L. barbarum) on ER stress. MATERIALS/METHODS: Mouse embryonic fibroblast (MEF) cell line and polarized Caco-2 human intestinal epithelial cells were treated with crude extract of the L. chinense fruit (LF). Paracellular permeability was measured to examine the effect of tight junction (TJ) integrity. The regulatory pathways of ER stress were evaluated in MEF knockout (KO) cell lines by qPCR for interleukin (IL) 6, IL8 and XBP1 spliced form (XBP1s). Immunoglobulin binding protein (BiP), XBP1s and CCAAT/enhancer-binding homologous protein (CHOP) expressions were measured by RT-PCR. Scanning Ion Conductance Microscopy (SICM) at high resolution was applied to observe morphological changes after treatments. RESULTS: Exposure to LF extract strengthened the TJ, both in the presence and absence of inflammation. In polarized Caco-2 pretreated with LF, induction in the expression of proinflammatory marker IL8 was not significant, whereas ER stress marker XBP1s expression was significantly increased. In wild type (wt) MEF cells, IL6, CHOP and XBP1 spliced form were dose-dependently induced when exposed to $12.5-50{\mu}g/mL$ extract. However, absence of XBP1 or $IRE1{\alpha}$ in MEF cells abolished this effect. CONCLUSION: Results of this study show that LF treatment enhances the barrier function and reduces inflammation and ER stress in an $IRE1{\alpha}$-XBP1-dependent manner. These results suggest the preventive effect of LF on healthy intestine, and the possibility of reducing the degree of inflammatory symptoms in IBD patients.