• Title/Summary/Keyword: Clinical diarrhea

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Prevalence and molecular characterization of novel recombinant enterovirus G isolates in Jeju Province of South Korea

  • Jeon, Ji Hyun;Lee, Changhee
    • Korean Journal of Veterinary Research
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    • v.59 no.2
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    • pp.89-96
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    • 2019
  • Enterovirus species G (EV-G) is highly diverse, and is ubiquitous in pig populations, usually without diarrhea. The present study aimed to investigate the presence of novel EV-G recombinants with the torovirus papain-like cysteine protease (PLCP) in Jeju pig herds. EV-G1-PLCP mono-infections were most prevalent in diarrheic weaned piglets. The PLCP genes of the Jeju isolates varied in size and junction sequences, and were greatly heterogeneous, with 77.0-90.7% homology amongst all recombinants. Our results suggest that the exogenous PLCP gene has undergone continuous rapid mutation in the individual EV-G genomes following cross-order recombination, thereby causing clinical disease in swine.

Clinical Study on 1 Case of Soyangyin Patient Diagnosed as Crohn's Disease (크론씨병으로 진단된 소양인 환자 치험 1 례)

  • Lee, Seung-Hyun;Park, Darn-Seo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.5
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    • pp.1346-1351
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    • 2007
  • Crohn' disease is an auto-immune disease characterized by intermittent chronic diarrhea, high fever, weight loss, abdominal spastic pain or abdominal discomfort which is followed by granulomatous necrosis and cicatrical inflammation. It is also called segmental enteritis or granulomatous enteritis. In western medicine the exact cause is undefined, however it is presumed as an immunological unbalance in alimentary tract commoonly occured in ileum portion of small intestitine or ascending colon and therefore immuno suppressive agents(usually steroids) and anti-inflammatory drugs are prescribed. In case of emergency such as ileus, perforation of intestinal wall surgical methods are considered. In oriental medicine this falls under the category of diarrhea(泄瀉), dysentery(痢疾), splenic diarrhea(脾泄). As to the pathological mechanism the abnormal ascending and descending circulation of stomach and splenic energy(脾不升淸, 胃不下降) the hepatic stagnation(肝鬱氣滯) and dysfunction of small intestine in expelling urine and feces(小陽淸獨不利) all together causes such condition. Main treatments are inducing diuresis(利小便), warming kindey to reinforce yang(溫賢助陽), nourishing the middle energy to invigorate spleen(補中健脾), elimination of the dampness by cooling(淸熱燥濕). In this case the patient was diagnosed as soyangyin(少陽人) constitution and herb medicine soyangyin Hyongbangjihwan-tang(少陽人 荊防地黃湯), Sa-am acupuncture Sojangjeonggyeok(小腸政格) was applied. There was an significant improve in chief complaints and general conditions.

Isospora belli Infection with Chronic Diarrhea in an Alcoholic Patient

  • Kim, Min Jae;Kim, Woo Ho;Jung, Hyun-Chae;Chai, Jee-Won;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • v.51 no.2
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    • pp.207-212
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    • 2013
  • Chronic diarrhea with a 35 kg weight loss (75 kg to 40 kg) occurred during 2 years in an alcoholic patient was diagnosed with Isospora belli infection in the Republic of Korea. The patient, a 70-year old Korean male, had been a heavy drinker for more than 30 years. He was admitted to the Seoul National University Hospital because of long-standing diarrhea and severe weight loss. He had an increased white blood cell (WBC) count with high peripheral blood eosinophilia (36.8-39.9%) and lowered protein and albumin levels but without any evidence of immunosuppression. A parasitic infection was suspected and fecal examination was repeated 3 times with negative results. Peroral endoscopy with mural biopsy was performed in the upper jejunum. The biopsy specimens revealed villous atrophy with loss of villi together with various life cycle stages of I. belli, including trophozoites, schizonts, merozoites, macrogamonts, and microgamonts. The patient was treated successfully with oral doses of trimethoprim 160-320 mg and sulfamethoxazole 800-1,600 mg daily for 4 weeks. A follow-up evaluation at 2.5 years later revealed marked improvement of body weight (68 kg), increased protein and albumin levels, and normal WBC count with low eosinophils (3.1%). This is the first clinical case of isoporiasis with demonstration of various parasitic stages in the Republic of Korea.

Two Cases of Cryptosporidiosis in Children Confirmed by Electron Microscopy (소아에서 전자현미경으로 확진된 Cryptosporidiosis 2례)

  • Chung, Ju-Young;Bae, Sun-Hwan;Ko, Jae-Sung;Cho, Hui-Seung;Seo, Jeong-Kee;Chi, Je-Geun;Chai, Jong-Yil;Lee, Soon-Hyung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.85-92
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    • 1999
  • Cryptosporidiosis is an intestinal disease caused by the protozoan Cryptosporidium parvum. The most common manifestation in human is enteric symptoms, which in immunocompetent hosts are self-limiting but can be life threatening in immunocompromised hosts, characterized by profuse watery diarrhea, abdominal pain, severe weight loss. It's prevalence rate in immunocompetent host is variable by geographic locations (3~11%) but up to 15~40% in AIDS patients. Now it is considered as one of the important enteropathogens causing diarrhea not only in immunocompromised but also in immunocompetent hosts, especially in children. We experienced two cases of cryptosporidiosis in a 15 year old boy who was admitted due to diarrhea, abdominal pain and fever and in a 8 year old boy who was admitted due to watery diarrhea and vomiting. These are the first clinical cases of cryptosporidiosis confirmed by electron microscopy of the colonic mucosa among immunocompetent children in Korea.

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The oriental-western literal study of Crohn's disease (크론씨병(극한성(局限性) 장염(腸炎))에 관(關)한 한의학적(韓醫學的) 고찰(考察))

  • Choi, Chang-Woo;Son, Chang-Gyu;Cho, Chong-kwan
    • Journal of Haehwa Medicine
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    • v.9 no.2
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    • pp.251-268
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    • 2001
  • We arrived at the following conclusion after we have studied crohn's disease through the literatures of western and oriental medicine. 1. Crohn's disease has a characteristic of granulomatous necrosis and cicatricial inflammation which is called by segmental enteritis, granulomatous enteritis. This falls under the category of "Diarrhea", "Dysentery" and is similar to "small intestinal diarrhea", "acute temesmus", "splenic diarrhea" in oriental medicine. 2. In western medicine, the cause of crohn's disease indefinites, but it is presumed immunological unbalance of alimentary canal. In oriental medicine, it is summarized as the abnormal ascending and descending circulation of stomach and splenic energies, the hepatic stagnation, being the lower part of cleaning qi by exogenous disease, dyspeptic convulsion. 3. The presenting symptoms of crohn's disease are intermittent chronic diarrhea, fever, weight loss, abdominal spastic pain or abdominal discomfort. When anyone has a abdominal mass, a rectal abcess, and a rectal constriction by physical examination, we can doubt crohn's disease. 4. The methods of western medical treatment are a suppression of intestinal toxic contents and inflammatory mediator, a supply of nutritive substanceus to intestinal epithelial cell. Oriental medical treatments of these are "inducing diuresis", "warming kidney to reinforce yang", "nourishing qi to invigorate spleen", "eliminatin dampness by cooling" according to syndrome differentiations. As mentioned above, we can confirm possibility of oriental medical treatment that induces recovery of immunologic control function and we need advanced experiment, study, and clinical approach.

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Effects of a low-FODMAP enteral formula on diarrhea on patients in the intensive care unit

  • Bae, Eunjoo;Kim, Jiyoon;Jang, Jinyoung;Kim, Junghyun;Kim, Suyeon;Chang, Youngeun;KIM, MI YEON;Jeon, Mira;Kang, Seongsuk;Lee, Jung Keun;Kim, Tae Gon
    • 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.

Enterotoxigenic Bacteroides fragilis-Associated Diseases and Detection (Enterotoxigenic Bacteroides fragilis에 의한 질환과 검출)

  • Gwon, Sun-Yeong;Jang, In-Ho;Rhee, Ki-Jong
    • Korean Journal of Clinical Laboratory Science
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    • v.47 no.4
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    • pp.161-167
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    • 2015
  • These commensal intestinal bacteria can enhance the immune system and aid in nutrient absorption but can also act as opportunistic pathogens. Among these intestinal bacteria, the anaerobic Bacteroides fragilis are divided into enterotoxigenic B. fragilis (ETBF) which secrete the B. fragilis toxin (BFT) and non-enterotoxigenic B. fragilis (NTBF) which do not secrete BFT. ETBF can cause diarrhea and colitis in both humans and livestock but can also be found in asymptomatic individuals. ETBF is predominantly found in patients with inflammatory diarrheal diseases and traveller's diarrhea. Several clinical studies have also reported an increased prevalence of ETBF in human patients with inflammatory bowel disease (IBD), colitis and colorectal cancer. In small animal models (C57BL/6 wild-type mice, germ-free mice, multiple intestinal neoplasia (Min) mice, rabbits and Mongolian gerbils), ETBF have been found to initiate and/or aggravate IBD, colitis and colorectal cancer. BFT induces E-cadherin cleavage in intestinal epithelial cells resulting in loss of epithelial cell integrity. Subsequent activation of the ${\beta}$-catenin pathway leads to increased cellular proliferation. In addition, ETBF causes acute and chronic colitis in wild-type mice as well as enhances tumorigenesis in Min mice via activation of the Stat3/Th17 pathway. Currently, ETBF can be detected using a BFT toxin bioassay and by PCR. Advances in molecular biological techniques such as real-time PCR have allowed both researchers as well as clinicians to rapidly detect ETBF in clinical samples. The emergence of more sensitive techniques will likely advance molecular insight into the role of ETBF in colitis and cancer.

Dysentery Caused by Balantidium coli in China

  • Yu, Peixia;Rong, JianRong;Zhang, Yan;Du, Jingjing
    • Parasites, Hosts and Diseases
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    • v.58 no.1
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    • pp.47-49
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    • 2020
  • Balantidium coli human infection predominantly occurs in tropical and subtropical regions in the world. Human case is extremely rare in China. This report details a case of B. coli infection in a 68-year-old man in China, who presented with history of abdominal pain, tenesmus, diarrhea with blood and was diagnosed as B. coli-caused dysentery. Our case indicates possible occurrence of Balantidium coli-related disease in cooler climates. This case is presented not only because of its rarity but also for future references.

Clinical Spectrum of Norovirus Gastroenteritis Compared to Rotavirus Gastroenteritis at a Single Center in Gwangju, Korea during 2005-2006 (2005-2006년 광주 지역에서 소아 Norovirus 장염의 임상적 고찰; Rotavirus 장염과 비교)

  • Lee, Yang Jin;Jeong, Seong Nam;Yoo, Ju Hee;Cho, Hyoung Min;Yoo, Eun Jung;Kim, Eun Young;Kim, Yong Wook;Kim, Kyoung Sim;Kim, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.16 no.1
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    • pp.61-72
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    • 2009
  • Purpose : We evaluated the clinical features of Norovirus gastroenteritis compared with Rotavirus gastroenteritis in hospitalized children. Methods : We detected causative agents in 3,261 samples of children hospitalized with gastroenteritis symptoms at a single center of pediatrics between 2005 and 2006. Among 266 and 303 samples which tested positive for Norovirus and Rotavirus, we selected 73 and 182 samples of children with relatively pure gastroenteritis symptoms and retrospectively analyzed the corresponding medical records. Results : The male-to-female ratio of the Norovirus (+) and Rotavirus (+) groupswas 1.43:1 and 1.56:1 both groups were predominantly in males. The mean age of the Norovirus (+) and Rotavirus (+) groups was 36.7 and 24.4 months, respectively the children in the former group were older than the children in the latter group. The incidence in the Norovirus (+) group was more concentrated in the winter. The symptoms in the Norovirus (+), in decreasing order, included vomiting, diarrhea, and fever. The duration of vomiting, diarrhea, and fever was 2.1, 1.2, and 1.2 days. The maximum number of episodes of vomiting and diarrhea per day was 3.5 and 4.5, respectively. The severity score was 10.16. The symptoms inthe Rotavirus (+) group, in decreasing order, included diarrhea, vomiting, and fever. The duration of diarrhea, vomiting, and fever was 2.2, 4.3, and 2.2 days, respectively. The maximum number of episodes of vomiting and diarrhea per day was 3.3 and 6.5, respectively. The severity score was 11.9. The severity in the Norovirus (+) group was somewhat lower than the Rotavirus (+) group. The younger the child, the more severe the symptoms in the Norovirus (+) group. There was no difference between mono-and co-infection in severity and between the two groups regarding the hematologic findings. Conclusion : Based on the findings reported herein, additional studies about prophylaxis, as well as the epidemiology and clinical features of pediatric Norovirus gastroenteritis, are required.

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Pathogenesis on enteritis induced by Cryptosporidium parvum alone and combined with porcine rotavirus in piglets (Cryptosporidium parvum 단독 및 돼지 rotavirus와 혼합 감염시킨 자돈 장염의 병원성)

  • Han, Dong-un;Kang, Mun-il;Park, Nam-yong;Wee, Sung-hwan
    • Korean Journal of Veterinary Research
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    • v.35 no.1
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    • pp.149-158
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    • 1995
  • The purpose of the present study was to understand the pathogenesis of infections in piglets inoculated with C parvum isolated from mice alone and combined with porcine rotavirus (S-80). Thirteen 10-day piglets were divided in four groups; Three, A group, were only given by C parvum. Four, B group, were orally administrated with firstly porcine rotavirus and then C patvum. Three, C group, were orally inoculated with porcine rotavirus alone. The rest, D group, were used as controls. During the experiment, there were daily recorded clinical signs including diarrhea to each pig. According to the periodic intervals for necropsy, all pigs were sacrificed from 4 to 12 days after the final inoculation of C parvum. Location and distribution of two pathogens, C parvum and rotavirus, in the intestinal mucosa of piglets tested were examined by pathological and immunohistological means. In addition, parasitological test using the feces of piglets was applied for the detection of cryptosporidial oocysts as well. A group showed diarrhea from 4 to 6 days post-inoculation(PI) and also discharged C parvum oocysts in feces during the day 4 to 7 PI. In tissue sections of jejunum and ileum, cryptosporidial oocysts were observed a few on the top of villi with slightly fusion. B group represented sign of diarrhea and discharge of oocysts from 2 to 11 days PI. There were some cryptosporidial oocysts both in the jejunal lumen and in the lumen of mucosal glands. As progressed, oocysts were most commonly distributed on the tip of villi of jejunum. Histopathologically there were also mild to moderately fused, attenuated focal desquamated, congested villi and mononuclear cell infiltration of varying degrees in the lamina propria of small intestine and colon at the day 4 and 7 PI. C group showed slightly to mildly attenuated and fused top of villi and mildly mucosal congestion. D group as controls was grossly and histopathologically normal in all parts of intestine. The present results indicate that the piglets inoculated with C parvum only are certainly milder in pathogenesis including duration of clinical course and severity of lesion than those in piglets concurrently infected with porcine rotavirus and C parvum. Also the strain (VRI-CN91) of C parvum used in the study has very low pathogenicity to occur enteritis of piglets.

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