• The Journal of Korean Medicine
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• v.22 no.3
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• pp.179-188
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• 2001

Diarrhea is the frequent passage of loose, watery stool (frequency: ${\geq}4/day$, weight: ${\geq}250g/day$) Most antibiotics can cause inflammatory change of the colon or Pseudomembranous colitis (PMC). Typical presentations of PMC are watery diarrhea, abdominal pain, fever, leukocytosis ($12,000~20,000/\textrm{mm}^3$), hypoalbuminemia, hypovolemia and recent or concurrent use of antibiotics. Diagnostic methods of PMC are stool assay, sigmoid scopy, abdominal CT, abdominal US, etc. The age-related susceptibility noted with PMC is impressive but unexplained. Two stroke patients had diarrhea, abdominal pain, fever hypoalbuminemia and a history of recent or concurrent use of antibiotics. By use of Shirhyung- Tang, we could improve clinical symptoms (diarrhea, abdominal pain, fever hypoalbuminemia, etc.) and so report clinical course of two stroke patients with antibiotics-associated PMC.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.6
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• pp.517-522
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• 2015

The objective of this study is to report the clinical application of Korean and Western medicine on chronic diarrhea and Clostridium difficile associated diarrhea. Clostridium difficile associated diarrhea is usually triggered by using antibiotics. This patient also took some antibiotics and she started to suffer diarrhea diagnosed as chronic and Clostridium difficile associated diarrhea. She had suffered from diarrhea over 10 times per day. We checked changes of numbers, total volume of defecations and stool form. We treated the patient with acupuncture, moxibustion, herbal medicine and metronidazole. After treatment, diarrhea was stopped and the patient defecated normal form stool. According to this study, acupuncture, moxibustion, herbal medicine and metronidazole was effective for 1 case of stroke patient with chronic and Clostridium difficile associated diarrhea.

• Korean Journal of Clinical Pharmacy
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• v.27 no.2
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• pp.77-82
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• 2017

Background: Clostridium difficile associated diarrhea (CDAD) is a leading cause of hospital-associated gastrointestinal illness. Risk factors for CDAD include advanced age, long-term admission, antibiotics, proton-pump inhibitor or $H_2$ blocker use and immunosuppression. The practice guideline of American Journal of Gastroenterology (2013) suggests metronidazole for the first-line therapy of mild-moderate CDAD as well as vancomycin for severe CDAD. MICU inpatients receiving stress ulcer prophylaxis and antibiotics are susceptible to nosocomial CDAD. Therefore, this study aimed to evaluate occurrence and treatment of CDAD in MICU. Methods: Patients who were admitted to the MICU and had CDAD from August 2012 to August 2015 were analyzed retrospectively. Results: Of the 90 patients with CDAD, 20 patients (2.22%) had mild-moderate CDAD (16 received metronidazole and 4 received vancomycin therapy) and 70 patients (77.8%) had severe CDAD(54 received metronidazole and 16 received vancomycin therapy). Among the patients with mild- moderate CDAD, treatment with metronidazole or vancomycin resulted in same clinical cure in 50% of the patients (p=1.00). Among the patients with severe CDAD, treatment with metronidazole or vancomycin resulted in clinical cure in 40.7% and 50.0% of the patients, respectively (p=0.511). Clinical symptoms recurred in 7.4% of the severe CDAD patients treated with metronidazole and 6.3% of those treated with vancomycin(p=0.875). Conclusion: Our findings suggest that metronidazole and vancomycin are equally effective for the treatment of mild-moderate CDAD; however, vancomycin demonstrated higher clinical cure rate and lower recurrence rate for severe CDAD, although the difference was not statistically significant. For better clinical outcomes, appropriate medication use by disease severity is needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.369-376
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• 2019

Purpose: The aim of this study was to evaluate the clinical significance of inflammatory biomarkers in acute infectious diarrhea among children. Methods: Clinical parameters including fever, bacterial and viral etiology based on stool culture and multiplex polymerase chain reaction, and nine biomarkers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and leukocytes in blood and calprotectin, lactoferrin, myeloperoxidase, polymorphonuclear elastase, leukocytes, and occult blood in feces were evaluated in children who were hospitalized due to acute diarrhea without underlying disease. Results: A total of 62 patients were included. Among these patients, 33 had fever, 18 showed bacterial infections, and 40 patients were infected with 43 viruses. Of all the biomarkers, CRP was significantly correlated with fever (p<0.001). CRP, ESR, calprotectin, lactoferrin, myeloperoxidase, fecal leukocytes, and occult blood were significantly associated with infection with bacterial pathogens (p<0.001, p=0.04, p=0.03, p=0.003, p=0.02, p=0.03, p=0.002, respectively). The combination of CRP and fecal lactoferrin at their best cut-off values (13.7 mg/L and $22.8{\mu}g/mL$, respectively) yielded a sensitivity of 72.2%, and a specificity of 95.5% for bacterial etiology compared with their individual use. Conclusion: Blood CRP is a useful diagnostic marker for both fever and bacterial etiology in acute pediatric diarrhea. The combination of CRP and fecal lactoferrin yields better diagnostic capability for bacterial etiology than their use alone for acute diarrhea in children without underlying gastrointestinal disease.

• The Journal of Internal Korean Medicine
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• v.41 no.5
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• pp.868-876
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• 2020

The purpose of this study was to report the clinical effects of Korean medicine on a patient who suffered from Early Dumping Syndrome with diarrhea, abdominal pain, anorexia, and insomnia after gastrectomy. The patient was treated with herbal medicine, acupuncture and moxibustion use in combination with Western medicine for 4 weeks. Though anorexia was maintained at a similar level, other clinical symptoms (diarrhea, abdominal pain, and insomnia) were improved after Korean medicine treatment. Therefore, Korean medicine may be effective for treatment of Early Dumping Syndrome after gastrectomy.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.1
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• pp.1-6
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• 2004

The enterobacterial repetitive intergenic consensus (ERIC)-PCR is a recently described DNA fingerprinting technique based on amplification of repetitive element distributed in bacteria. We applied of ERIC-PCR to clinical isolates of Vibrio parahaemolyticus and other bacteria associated diarrhea. Twenty isolates of V. parahaemolyticus were used for intragenic genotyping, which were isolated from 2001 to 2002 in Chungbuk National University hospital. For interspecies genotyping, V. vulnificus, V. alginolyticus, V. parahaemolyticus, Escherichia coli, Salmonella and Shigella spp. were used. The genotyping were analyzed by ERIC-PCR. The genotyping of V. parahaemolyticus were grouped two major pattern (A, B) and were subdivided into 10 subtypes (A1, A2, B1-B8) by ERIC-PCR. These method distinctly differentiated bacterial species associated diarrhea. Those results show that ERIC-PCR can be reliable and efficient method for genotyping of V. parahaemolyticus and bacteria associated diarrhea.

• Journal of Sasang Constitutional Medicine
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• v.26 no.3
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• pp.251-261
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• 2014

Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Yin-Depletion (Mangeum) Symptomatology. The CPG was developed by the national-wide experts committee consisting of SCM professors. Methods The CPG was developed by the national-wide experts committee considering of the society of Sasang Constitutional Medicine. It was performed by search and collection of literature related SCM, opinion of SCM experts and journal search and it was followed by CPG's guideline. Results & Conclusions The CPG of Yin-Depletion (Mangeum) Symptomatology in Soyangin Disease include classification, definition and standard symptoms of each pattern. Yin-Depletion (Mangeum) Symptomatology is classified into severe and critical pattern by severity. The severe pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum) and the advanced pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum). The critical pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Cold-related diarrhea accompanied by the abdominal pain (Sinhan-bocktong Mangeum) and the advanced pattern of Cold-related diarrhea accompanied by abdominal pain (Sinhan-bocktong Mangeum).

• Journal of Sasang Constitutional Medicine
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• v.26 no.1
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• pp.55-63
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• 2014

Objectives This research was performed to establish the clinical practice guideline(CPG) for Lesser Yin Symptomatology of Soeumin disease. Methods Dongeui suse bowon(sinchuk edition), textbook for Sasang constitutional medicine, Clinical guidebook for Sasang constitutional medicine, and standardization reports on Sasang constitutional medicine and papers concerning symptomatology of Soeumin Disease, especially Lesser Yin Symptomatology was collected and classified. Additionally experts' conference was held to make agreement on the conflicting issues on a regular basis. Results & Conclusions There was no concerning paper on Lesser Yin Symptomatology. Experts' agreement was needed to establish the CPG. Lesser Yin pattern can be classified into 2 groups; Lesser Yin severe pattern and Lesser Yin critical pattern. There are Lesser Yin pattern accompanied abdominal pain and bowel irritability pattern and Lesser Yin pattern accompanied green tinged watery diarrhea pattern in Lesser Yin severe pattern. There are Visceral syncope pattern and Exuberant yin repelling yang pattern in Lesser Yin critical pattern. Lesser Yin symptomatology has several symptoms like abdominal pain and diarrhea, thirst, oral discomfort, chest discomfort, whole body pain, articular pain and coldness of hands and feet. Additionally there are abdominal pain and diarrhea in Lesser Yin symptomatology accompanied abdominal pain and bowel irritability pattern, there is green tinged watery diarrhea in Lesser Yin pattern accompanied green tinged watery diarrhea pattern and if this symptoms exacerbate, delirious speech and constipation can occur. There are restlessness and coldness on hands and feet in Visceral syncope pattern and severe restlessness and coldness on hands and feet and symptom which the patient cannot drink water in Exuberant yin repelling yang.

• Korean Journal of Clinical Pharmacy
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• v.20 no.1
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• pp.78-84
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• 2010

Background: Clostridium difficile is the primary reason of the nosocomial diarrhea. The antimicrobial therapy plays a central role in the pathogenesis of Clostridium difficile associated diarrhea (CDAD). Although nearly all classes of antimicrobial agents have been associated with CDAD, clindamycin and the third-generation cephalosporins have traditionally been considered to the greatest risk factor. Recent studies have also implicated fluoroquinolones as high-risk agents due to increasing use of the agents. This study was to determine the incidence and the risk factors of CDAD related to the administered antibiotics and to assess the therapeutic regimen of metronidazole or vancomycin based on the C. difficile toxin assay Methods: A retrospective study was performed in patients with Clostridium difficile toxin assay at I Hospital (Incheon, South Korea) during the period from January 2007 through December 2007. Administrative, laboratory, and pharmacy data were collected from Electronic Medical Databases. Results: The analysis included 129 reported C.difficile toxin assay results, with 42 positive cases and 87 negative cases. Significant antibiotic risk factors for CDAD included the use of the fourth-generation cephalosporinse (OR=5.97, 95% CI 1.37-25.98, P=0.017). Administration of metronidazole was protective against CDAD (OR=0.30, 95% CI 0.12-0.74, P=0.009). Prolonged antimicrobial therapy has been associated with an increased risk of CDAD. The third-generation cephalosporins (OR=3.81, 95% CI 1.08-13.41, P=0.037) and aminoglycoside (OR=5.50, 95% CI 1.43-21.10, P=0.013) demonstrated greater risk for CDAD over 15 days than 8days or less days of treatment duration. Conclusions: The fourth and third generation cephalosporin, aminglycoside were the significant risk factors compared with other antibiotics, whereas metronidazole appears to be protective. The longer duration of antiobiotic use increased CDAD.

• Journal of Veterinary Science
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• v.21 no.2
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• pp.17.1-17.11
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• 2020

Dehydration, electrolyte disturbance, and acid-base imbalance are the most significant consequences of diarrhea in calves. We aimed to determine blood gas, hematological, electrolyte, and biochemical values and investigate the relationship between the physical status and blood parameters in Korean native calves (KNCs) with diarrhea. One hundred eighty KNCs with diarrhea (age < 75 days) were investigated. Blood samples were collected from the external jugular vein and analyzed using a portable clinical blood gas analyzer. The measured parameters were statistically compared according to the status of physical activity, dehydration, or prognosis. The mean values of parameters in the Calves with diarrhea showed metabolic acidosis, hyponatremia, and azotemia. The mean values of potassium, chloride, hematocrit, and hemoglobin were in the upper limit of their reference ranges. More than 75% of the calves had metabolic acidosis caused by bicarbonate loss, and 63.6% had high blood urea nitrogen (BUN) values. Moreover, BUN showed the highest correlation with the physical activity status and dehydration. pH, base excess of the extracellular fluid (BE), anion gap, potassium, hematocrit, bicarbonate, and hemoglobin were closely correlated with physical deterioration and dehydration (p < 0.001). BUN, pH, BE, and anion gap were closely correlated with physical deterioration and dehydration. These correlations between clinical symptoms and blood gas parameters can be clinically relevant in predicting the status of parameters according to clinical symptoms.