• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권1호
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• pp.1-6
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• 2010

The small bowel is the most difficult intestinal segment to examine. Radiologic tests are mostly insensitive and double-balloon enteroscopy is unsuitable for the younger child. Capsule endoscopy is a novel wireless method of investigation of the small bowel. The primary indications for capsule endoscopy include evaluation of obscure gastrointestinal bleeding, small bowel Crohn's disease, and polyposis syndromes. Capsule endoscopy offers an accurate and effective means of investigating the small bowel in children. Capsule retention is a potential complication of capsule endoscopy. This review provides the indications, safety, and limitations of wireless capsule endoscopy in children.

• Journal of Oral Medicine and Pain
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• 제43권4호
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• pp.153-153
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• 2018

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권4호
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• pp.227-235
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• 2017

Purpose: Crohn's disease (CD) can involve any site of the gastrointestinal tract (GIT). However, the characteristics of upper GIT involvement in CD are unclear, especially in the Eastern pediatric population. This study aimed to estimate the prevalence of upper GIT involvement and identify the clinical features of Korean children with CD. Methods: This was a retrospective multicenter cohort study that included 52 pediatric patients with CD who underwent esophagogastroduodenoscopy and biopsy. The clinical symptoms and endoscopic and histologic features of the upper GIT were identified according to the presence or absence of upper gastrointestinal symptoms. Results: Among the 52 patients, upper GIT involvement was noted in 50.0% (26/52). The mean age at CD diagnosis was $14.1{\pm}2.1$ years. Gastric ulcer was the most common lesion (19.2%) found on upper GIT endoscopy, followed by duodenal ulcers (15.4%). Chronic inflammation was the most common histopathologic feature (75.0%), followed by gastric erosion (17.3%). Granuloma was found in 9.6% of patients. Helicobacter pylori infection was identified in 5.8% of patients. Endoscopic and histologic findings were not significantly different, but the mean values of erythrocyte sedimentation rate ($60.7{\pm}27.1$ vs. $43.0{\pm}27.6mm/h$, p=0.037) and C-reactive protein ($16.5{\pm}28.2$ vs. $6.62{\pm}13.4mg/dL$, p=0.014) were significantly different between patients with and without upper gastrointestinal CD symptoms. Conclusion: Upper GIT involvement was relatively common in pediatric patients with CD irrespective of upper gastrointestinal symptoms, and H. pylori infection was relatively uncommon. The results of this study should aid the establishment of regional guidelines for upper GIT examination.

• 미생물학회지
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• 제50권3호
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• pp.261-263
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• 2014

암, 류마티스, 크론병 등은 만성염증과 관련되어 있다. Interleukin-6 (IL-6)는 염증의 주요 매개인자이다. 청국장은 콩 발효식품으로 대두단백질이 분해되어 다양한 peptide가 생성되면서, 생리활성물질이 될 수 있다. 본 연구에서는 청국장에서 분리한 peptide (Gly-Val-Tyr-Tyr-Met-Tyr)를 가공한 6mer H, [(Glu-Val-Tyr-Tyr-Met-Tyr(EVYYMY)]가 유방암세포 MDA-MB-231에서 IL-6 발현을 억제할 수 있는지 여부를 결정하였다. MDA-MB-231 세포에 peptide H를 처리해 주면, IL-6 발현은 peptide를 처리하지 않은 control에 비해, 크게 억제되었으며, 세포의 성장은 농도의존적으로 억제되었다. 암 이외에, 류마티스, 크론병 등 만성염증 질환에서 IL-6 신호의 차단은 염증개선에 유효한 것으로 알려져 있다. Peptide H는 염증과 관련된 IL-6 발현의 감소효과가 있으므로, IL-6 관련 암, 류마티스, 크론병 등의 치료제 개발로 응용, 연결될 수 있을 것이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권4호
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• pp.357-365
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• 2021

Purpose: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). Conclusion: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.

• 대한암한의학회지
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• 제10권1호
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• pp.75-86
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• 2005

Disease associated with microorganisms are far from resolved by current therapeutics. One of effective approach to health maintenance and disease control is the use of dietary bacterial and carbohydrate supplements. This comprises use of probiotics and prebiotics. Probiotics mean the live microorganisms, which when administered in adequate amounts confer a health benefit on the host. Prebiotics mean a nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria that can Improve the host health. Especially, probiotics has the relation which is close with innate immunity and adaptive immunity. And probiotics has the clinical value with many disease like lactose intolerance, constipation, acute gastroenteritis, food hypersensitivity and allergy, atopic dermatitis, crohn's disease, rheumatoid arthritis, pelvic radiotherapy, intestinal inflammation and chemical exposure, colon cancer, inhibitory effect of Helicobacter pylori and lowering the level of cholesterol. We use jointly korean medicine and probiotics and it has the more therapeutic effect in the many disease.

• Journal of Dairy Science and Biotechnology
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• 제28권2호
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• pp.25-30
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• 2010

For centuries, probiotics have been known to promote health and prevent diseases. In recent times, modulation of diseases related to the immune function by probiotics has been recognized as very important to the health of the host's gut. Inflammatory bowel diseases (IBDs) are the most frequently studied diseases in which probiotic administration has been tested as a potential therapy. Various in vitro and in vivo studies have been performed. The studies discussed in this review suggest several mechanisms: probiotics could modulate the gut microflora by competing with disease-causing pathogenic bacteria and could directly regulate the mucosal immune system, which activates the innate and adaptive immune systems. In addition, human clinical trials have shown alleviation of disease symptoms of ulcerative colitis (UC), Crohn's disease, etc. This study aimed to understand the molecular mechanisms underlying immune modulation by probiotics and review studies on the functional aspect of IBD alleviation by probiotics. With more scientific studies confirming the effect of probiotics, this therapy holds promise for use in alternative medicine and/or pharmaceutical preparations, given the long history of safe consumption of probiotics.

• Pediatric Infection and Vaccine
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• 제29권2호
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• pp.96-104
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• 2022

Chronic recurrent multifocal osteomyelitis (CRMO)는 소아에서 호발하는 비감염성 염증성 골질환으로 염증성장질환, 건선, 베게너 육아종, SAPHO 증후군 등의 다른 자가 면역 질환이 병발하기도 한다. 13세 중앙아시아 인종의 남자환자가 18개월 동안 반복되는 하지 관절 통증과 연조직 염증 증상을 주소로 내원하여 CRMO로 진단 하 비스테로이드성소염제 치료를 시작하였다. 5개월 간 약물 복용하였으나 근골격계 증상 악화, 새롭게 발생한 위장관 증상에 대해 CRMO에 크론병이 병발한 것으로 진단되었으며, 이에 대해 infliximab을 투여하였다. 본 증례에서는 크론병이 병발한 CRMO 환자에서 비스테로이드성 소염제 치료에 실패한 후 infliximab을 이용하여 효과적으로 치료된 증례를 보고하는 바이다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제17권3호
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• pp.147-154
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• 2014

Purpose: Gender differences in paediatric patients with inflammatory bowel disease (IBD) are frequently reported as a secondary outcome and the results are divergent. To assess gender differences by analysing data collected within the Swiss IBD cohort study database since 2008, related to children with IBD, using the Montreal classification for a systematic approach. Methods: Data on gender, age, anthropometrics, disease location at diagnosis, disease behaviour, and therapy of 196 patients, 105 with Crohn's disease (CD) and 91 with ulcerative or indeterminate colitis (UC/IC) were retrieved and analysed. Results: The crude gender ratio (male : female) of patients with CD diagnosed at <10 years of age was 2.57, the adjusted ratio was 2.42, and in patients with UC/IC it was 0.68 and 0.64 respectively. The non-adjusted gender ratio of patients diagnosed at ${\geq}10$ years was 1.58 for CD and 0.88 for UC/IC. Boys with UC/IC diagnosed <10 years of age had a longer diagnostic delay, and in girls diagnosed with UC/IC >10 years a more important use of azathioprine was observed. No other gender difference was found after analysis of age, disease location and behaviour at diagnosis, duration of disease, familial occurrence of IBD, prevalence of extra-intestinal manifestations, complications, and requirement for surgery. Conclusion: CD in children <10 years affects predominantly boys with a sex ratio of 2.57; the impact of sex-hormones on the development of CD in pre-pubertal male patients should be investigated.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.218-227
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• 2022

Purpose: To analyze the characteristics of pediatric inflammatory bowel disease (IBD) over the past three decades in Argentina and determine if there are differences between the first two decades and the past decade. Methods: We conducted a retrospective multicenter analytical study in children with IBD between 0 and 18 years of age diagnosed between 1987 and 2017 in three tertiary health centers in Argentina. The evaluation included clinical characterization, endoscopy, histology, and imaging data together with therapeutic strategies. The patients were divided into two groups: Group 1, diagnosed between 1987 and 2007, and Group 2, diagnosed between 2008 and 2017. Results: Of the 756 patients included, 409 (54%) had ulcerative colitis (UC), 250 (33%) had Crohn's disease (CD), and 97 (13%) had IBD-unclassified (IBD-U). The positive family history was 3.8%, which was more frequent among children under two years of age (6.7%). There were no significant differences in clinical presentation and extraintestinal manifestations between periods, with hepatic manifestations being the most frequent. In the last decade, we found an upward trend in CD, a downward trend in UC/IBD-U, even after adjustment for socioeconomic status, and a decrease of 50% in surgical treatments coinciding with the advent of biological therapy. Conclusion: This is the first multicenter cohort study in a Latin American country to describe clinical, endoscopic, and therapeutic data across the past 30-year period. Although CD was responsible for the overall increase in incidence, UC was still prevalent in this region.