• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.72-79
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• 2019

Purpose: The efficacy of exclusive enteral nutrition (EEN) with a polymeric diet has not been confirmed in Korean pediatric patients with Crohn's disease (CD). This study aimed to compare the effectiveness of EEN with a specific polymeric diet ($Encover^{(R)}$) and corticosteroids (CSs) for the induction of remission in Korean pediatric CD patients. Methods: We retrospectively compared data from 51 pediatric CD patients who underwent induction therapy with EEN (n=19) or CSs (n=32) at Severance Children's Hospital or Incheon St. Mary's Hospital in Korea. The primary endpoint of this study was the rate of clinical remission, defined as a Pediatric Crohn's Disease Activity Index (PCDAI) score <10, after 8 weeks of induction treatment. Clinical, laboratory, and growth data at post-induction as well as their changes from baseline were also compared between groups. Results: After 8 weeks of induction therapy, clinical remission rates were 78.9% (15/19) and 65.6% (21/32) in the EEN and CS groups, respectively (p=0.313). No significant differences in PCDAI scores, laboratory variables, and growth parameters were noted between the two groups at post-induction. However, significant changes in albumin levels at post-induction were observed in the EEN group compared to the CS group (p=0.038). Conclusion: Our results suggest that the effectiveness of EEN with a polymeric diet and CSs for induction therapy did not differ in Korean pediatric CD patients. EEN with a polymeric diet is a good first-line treatment option for the induction of remission in these patients.

• Journal of Periodontal and Implant Science
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• 제27권4호
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• pp.701-722
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• 1997

It was reported that low dose doxycycline(LDD) regimen could inhibit pathologically elevated collagenase activity in the gingival crevicular fluid of petients with adult periodontitis without producing typical antibiotic side effects. The purpose of this study was to evaluate the effects of LDD regimen(20mg) administered during non-surgical therapy on clinical index and gingival crevicular fluid enzyme activity in diabetics who are at high risk for periodontal disease. Forty-nine subjects having at least two sites with probing pocket depths greater than 4mm were selected. In this double-blind, placebo-controlled study, the patients were administered 20 mg doxycycline capsule or placebo capsule b.i.d. for 2 weeks. Clinical parameters of dental plaque, gingival inflammation, probing pocket depth and probing attachment level were assessed at week 0, 2, 4, and 8. Gingival crevicular fluid samples were collected at the same time to evaluate the activities of collagenase and elastase. Clinical parameters and elastase activity were significantly reduced in all groups compared to the baseline value after treatment. Significantly greater reduction in pocket depth and gain in attachment level was shown in the LDD-administered group compared to placebo group in both adult periodontitis and diabetic patients. Total collagenase activity was also reduced significantly in all groups after treatment, but the greater reduction was seen in the LDD-administered diabetics group compared to relevant placebo group(at 4, 8week). Significantly greater reduction in active collagenase activity was also seen in the LDD-administered group compared to placebo group in diabetic patients(at 2, 4, 8week). These results indicated that use of low dose doxycycline could be aueseful adjunct to instrumentation therapy in the management of diabetic patient with periodontitis as well as adult periodontitis patient.

• 대한본초학회지
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• 제23권1호
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• pp.103-108
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• 2008

Objective: Atopic dermatitis is the most common chronic inflammatory skin disease in childhood. Phellinus linteus, an orange color mushroom, has been used as a traditional herb medicine for years. Recent preliminary animal experiments suggest that Phellinus linteus grown on germinated brown rice is effective in chronic inflammatory disease. The aim of this study was to evaluate the efficacy of Phellinus linteus grown on germinated brown rice in the treatment of atopic dermatitis(AD). Methods: 35 patients, 2 to 14 years of age, with mild to moderate AD were treated with Phellinus linteus grown on germinated brown rice powder per oral, $6{\sim}12g$/day adjusted by the body weight, divided three for up to 12 weeks without other treatment. The mean age of patients was 7.3 years. The disease activity has been monitored by objective SCORAD index. The symptom score of the pruritus was measured by using a traditional visual analogue scale (VAS). In addition, the global assessments of clinical response were also monitored by patients or their parents. Results: After 12 weeks of the study, significant reductions in mean severity scores and mean symptom scores were observed. The mean objective SCORAD indices of 35 patients decreased from 25.31${\pm}$8.96 to 18.73${\pm}$13.89(p<0.05). And the mean symptom score of pruritus assessment decreased from 7.37${\pm}$1.33 to 4.6${\pm}$2.3(p<0.05). The patient's global assessment of clinical response were also improved through the period of treatment(p<0.05). Conclusions: Phellinus linteusgrown on germinated brown rice may play a role in the treatment of mild and moderate AD in Children.

• Journal of Periodontal and Implant Science
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• 제23권1호
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• pp.109-126
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• 1993

Refractory periodontitis manifest progressive attachment loss in a rapid and unrelenting manner regardless of the type or frequency of therapy applied. The purpose of this study was ta evaluate the relation between the level of cytokines in GCF and periodontopathic microflora with disease activity of refractory periodontitis. Selection of patients with refractory periodontitis (7 males, 3 females) were made by long term clinical observation including conventional clinical history and parameters. Teeth that showed pocket depth greater than 6mm were selected as sample teeth. Subjects were examined at baseline and after 3 months. Prior to baseline test, individual acrylic stent was fabricated. Reference grooves were made on each sample tooth site. Pocket depth and attachment loss were measured by Florida Probe. Gingival index was measured at 4 sites each sample teeth. Disease activity was defined as attachment loss of ${\ge}$ 2.1mm, as determined by sequential probing and tolerance method. The pattern and amount of alveolar bone resorption was observed with quantitative digital subtraction image processing radiography. Morphological analysis of subgingival bacteria was taken by phase contrast microscopy. Predominant cultivable bacterial distribution and frequency were compared between disease-active and disease-inactive site using immunofluorescence microscopy and selective microbial culturing. Levels of $interleukin-l{\beta}$, 2, 4, 6 and $TNF-{\alpha}$ in GCF and blood serum sample were quantified by ELISA. In active sites, P. intermedia was significantly increased to compare with inactive site. $IL-1{\beta}$, IL-2, IL-6 and $TNF-{\alpha}$ in GCF were increased in active sites and IL-2 in serum was increased in active patients significantly. Alveolar bone loss in active site was correlated with $IL-1{\beta}$, IL-2 in GCF. And loss of attachment in active site was correlated with IL-2 in GCF. These results demonstrate that IL-2 in serum, $IL-1{\beta}$, IL-2, IL-6 and $TNF-{\alpha}$ in GCF, P, intermedia might be used as possible predictors of disease activity in refractory periodontitis before it is clinically expressed as attachment loss and quantitative alveolar bone change.

• 한국자원식물학회지
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• 제31권4호
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• pp.275-282
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• 2018

염증성 대장질환에 대한 작약의 효능 연구가 미비하여 본 연구에서는 dextran sulfate sodium로 유도된 궤양성 대장염의 임상증상인 체중감소, 결장단축, 질병활성화 정도에 대한 작약의 효과를 관찰하였다. 또한 대장 조직 내 염증매개인자인 interleukin-6 및 cyclooxygenase-2의 생성에 대한 작약의 효과를 측정하여 다음과 같은 결과를 얻었다. 첫째 dextran sulfate sodium로 유도된 궤양성 대장염에서 체중 감소에 대한 작약의 효과를 관찰한 결과 유의적으로 억제함을 확인하였다. 둘째 DSS로 유도된 궤양성 대장염에서 결장 단축에 대하여 작약의 억제 효과가 유의성 있게 나타났다. 셋째 dextran sulfate sodium로 유도된 궤양성 대장염에서 임상증상인 설사, 잠혈 및 출혈 등의 질병활성화 정도에 대한 작약의 효과를 관찰한 결과 유의적으로 질병활성화 정도를 억제하였다. 넷째 대장 조직내 염증매개인자인 interleukin-6 및 cyclooxygenase-2의 생성증가에 대한 작약의 억제효과를 확인 하였다. 본 연구는 작약의 효능을 과학적으로 입증한 결과로, 작약의 궤양성 대장염의 치료제 개발의 소재로서의 가능성을 시사한다.

• Journal of Periodontal and Implant Science
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• 제40권4호
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• pp.164-171
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• 2010

Purpose: This study compared the total antioxidant status (TAS) and superoxide dismutase (SOD) activity in the saliva of periodontally compromised patients before and after scaling and root planing (SRP) to assess their diagnostic utility. Methods: Severe chronic periodontitis patient (test group) and subjects with no attachment loss, sites showing a 3 mm or more probing depth and a sulcus bleeding index < 10% (control group) were enrolled in this study. Saliva sampling and clinical examination were performed at one week, one month and 3 months after SRP. The TAS and SOD activity in each patient's saliva was measured for the comparative analysis between the groups. Results: In the test group, the TAS decreased directly after SRP. With time, it increased slightly and was relatively unchanged compared to the baseline. In the control group, the TAS also decreased immediately after SRP but increased gradually with time until 3 months. The SOD activity in the test and control subjects decreased immediately after SRP until 1 month. At 3 months, the SOD activity had increased. Both groups had a similar profile of SOD activity. However, the SOD activity of the control group was significantly higher than that of the test group at each point in time (P < 0.05). Conclusions: There was a significant difference in the total salivary antioxidant level between the periodontitis and healthy or gingivitis (control) group during the experiment period. The total antioxidant level in the saliva was higher in the patients with severe chronic periodontitis than the healthy or gingivitis control before SRP. The SOD activity of the periodontitis patients was lower than the control at each time point. These findings conclusively reveal the possible use of saliva as a diagnostic tool for periodontal health.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권5호
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• pp.396-405
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• 2022

Purpose: This study evaluated the predictive role of fecal calprotectin (FC) measured at an early stage of treatment for monitoring clinical remission (CR) after six months and endoscopic remission (ER) after one year of treatment in pediatric Crohn's disease (CD). Methods: This retrospective study included 45 patients who simultaneously underwent ileocolonoscopy and FC testing during follow-up. FC levels were measured before and after six weeks of treatment. CR was assessed after six months of treatment using Pediatric Crohn' s Disease Activity Index and acute-phase reactants. ER was assessed after one year using the Simple Endoscopic Score for Crohn's Disease. Results: Twenty-nine (64.4%) patients used oral prednisolone for remission induction and 16 (35.6%) patients used anti-tumor necrosis factor-alpha. Thirty (66.7%) patients achieved CR, while 24 (53.3%) achieved ER. The FC level measured after six weeks of treatment could predict CR (χ²=9.15, p=0.0025) and ER (χ²=12.31, p=0.0004). The δFC could predict CR (χ²=7.91, p=0.0049), but not ER (χ²=1.85, p=0.1738). With a threshold of ≤950.4 ㎍/g, FC at week six could predict CR with 76.7% sensitivity and 73.3% specificity. The area under the curve (AUC) was 0.769 (standard error 0.0773, p=0.0005). The same threshold predicted ER with 87.5% sensitivity and 71.4% specificity. The AUC was 0.774 (standard error 0.074, p=0.0002). Conclusion: FC assay at an early stage of treatment can be used as a surrogate marker to predict CR and mucosal healing in pediatric CD.

• 생약학회지
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• 제43권1호
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• pp.22-26
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• 2012

The aim of this study was to evaluate the anti-inlfammatory effect of the extract of Zanthoxylum schinifolium on ulcerative colitis induced by 3% dextran sulfate sodium in the rat. The experiment animals were divided into six groups: control (normal), DDS-induced colitis, 1 mg/kg, 15 mg/kg and 150 mg/kg of the extract of Z. schinifolium and 150 mg/kg of 5-aminosalicylic acid (5-ASA) as comparative drug. Anti-ulcerative colitis effect was evaluated pathologically by disease activity index (DAI), the change of weight and myeloperoxidase (MPO) in colon mucosa. Treatment with 15 mg/kg and 150 mg/kg of the extract of Z. schinifolium significantly improved the gain of body weight and DAI as clinical symptoms, and reduced MPO and $PGE_2$ level as biochemical index. Especially, 150 mg/kg of the extract of Z. schinifolium showed markedly more improvement than the same dose of 5-ASA in all kind of index such as MPO, $PGE_2$ and DAI. These results suggest that Z. schinifolium mediated anti-inflammatory action on colorectal sites may be a useful therapeutic approach to ulcerative colitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.473-480
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• 2022

Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

• Journal of Periodontal and Implant Science
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• 제25권2호
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• pp.397-406
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• 1995

The purpose of this study was to evaluate the changes of interproximal bone density by means of videodensitometer and to examine the clinical applicability of videodentitometer to assess the periodontal disease activity.Twelve interproximal sites, with periodontal pockets deeper than 5mm and vertical loss of bone on standard dental radiograph, were treated by subgingival curettage. The papilla bleeding index, the plaque index, the degree of mobility, the depth of pockets, and the level of attachment were measured. Standardized reproducible radiographs were taken by using the occlusal stent with parallelling film holder. The density of the interdental bone was measured on the radiographs by a videodensitometer at three levels: the most 'superficial' level; the 'deep' level, arbitrarily 1.5mm below: and the 'apical' level, where no bony changes were to be expected. The clinical parameter and the radiographical change were measured at initial, and 1 month, 3 months, and 6 months after treatment.The results were as follows :1. The papilla bleeding index and the degree of mobility decreased significantly until 3 months after subgingival curettage and showed the Same level in the remaining experimental periods. 2. The pocket depth mainly decreased due to the gingival recession until 1 month after treatment, but to the attachment gain after 1 month. 3. The density of the interdental bone did not show a significance increase until 1 month after treatment, but showed a steady increase throughout the 6 months of observation. 4. The close relationships were shown between the decrease in pocket depth and the gain of attachment and the improvement of bone density at 6 months after treatment.