• 대한영상의학회지
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• 제84권6호
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• pp.1309-1323
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• 2023

목적 크론병 환자의 자기공명영상 장운동기록(MR enterography; 이하 MRE)에서 단발 고속 스핀 에코기법(single-shot fast spin-echo; 이하 SSFSE)을 이용한 단일호흡영상(singlebreath-hold; 이하 SBH)과 다호흡영상(multiple-breath-hold; 이하 MBH)을 딥러닝 기반 재구성(deep-learning based reconstruction; 이하 DLR)의 유무에 따라 네 개의 영상에서 품질을 비교했다. 대상과 방법 이 연구는 후향적 연구로서, 크론병으로 MRE를 시행한 61명의 환자가 포함되었다. SBH와 MBH SSFSE 영상에서 각각 DLR과 고식적 재구성(conventional reconstruction; 이하 CR)을 시행한 영상을 획득했다. 두 명의 영상의학과 전문의가 네 가지 영상을 분석하여 전반적인 영상의 품질, 인공물, 선명도와 움직임 관련 신호 손실에 대하여 각각 5점 척도를 이용해 점수를 부여했다. 회장과 말단 회장, 결장에서 염증을 시사하는 세 가지 소견을 평가했다. 각 영상에 대해서 공간적 불일치 여부를 확인했고, 네 가지 영상에서 각각 다른 두 위치에서 신호 대 잡음비(signal-to-noise ratio; 이하 SNR)를 계산했다. 결과 SBH SSFSE 영상에서 DLR을 적용한 경우 CR보다 영상의 품질, 인공물, 선명도가 통계학적으로 유의하게 개선되었다. 네 가지 영상 중 SBH-DLR 영상에서 SNR이 가장 높게 나타났다(p < 0.001). 염증 소견에 대한 판독자 간 일치율은 좋음에서 매우 좋음으로 나타났고(κ = 0.76-0.95) 시퀀스 간 일치율은 매우 좋음으로 측정되었다(κ = 0.92-0.94). 공간적 불일치는 SBH 영상보다 MBH 영상에서 통계학적으로 유의하게 빈도가 높았다(p < 0.001). 결론 SBH-DLR 영상은 MBH-CR 영상과 비교했을 때 동등한 영상 품질과 성능을 보여주었다. 또한, MBH 영상에 비해 절반 이하의 시간과 단일 호흡만으로 영상을 획득할 수 있으며 공간 불일치를 줄일 수 있는 대체제로 사용할 수 있다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권4호
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• pp.181-192
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• 2023

Purpose: The development of assistive devices has allowed for the performance of capsule endoscopy in children. Anticipating the capsule's transit time could affect the efficacy of the investigation and potentially minimize the fasting period. This study determined the predictors of small bowel transit time for small-bowel capsule endoscopy in children and adolescents with inflammatory bowel disease. Methods: We retrospectively examined children and adolescents with inflammatory bowel disease who underwent capsule endoscopy by the age 18 at a Japanese tertiary care children's hospital. Small bowel transit time predictors were analyzed using multiple regression with explanatory variables. Results: Overall, 92 patients, aged 1-17 years, with inflammatory bowel disease (63 Crohn's disease and 29 ulcerative colitis cases) were examined for factors affecting small bowel transit time. In the simple regression analysis, diagnosis, age, height, weight, serum albumin, general anesthesia, and small intestine lesions were significantly associated with small bowel transit time. In the multiple regression analyses, serum albumin (partial regression coefficient: -58.9, p=0.008), general anesthesia (partial regression coefficient: 127, p<0.001), and small intestine lesions (partial regression coefficient: 30.1, p=0.037) showed significant associations with small bowel transit time. Conclusion: Hypoalbuminemia, the use of general anesthesia for endoscopic delivery of the capsule, and small intestine lesions appeared to be predictors of prolonged small bowel transit time in children and adolescents with inflammatory bowel disease. Expecting the finishing time may improve examination with a fasting period reduction, which benefits both patients and caregivers.

• Korean Journal of Acupuncture
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• 제24권1호
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• pp.79-94
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• 2007

Objectives : Ulcerative colitis and Crohn's disease are chronic inflammatory disease of the gastrointestinal tract was identified mainly for diarrhea, stomachache, hemafecia. The source and pathologic mechanism about ulcerative colitis and crohn's disease are still unknown but stress, infection, a genetic factor, environmental factors etc. may be the cause of chronic inflammatory disease of the gastrointestinal tract recently. The purpose of the present study is to evaluate the effects of herbal acupuncture with Artemisiae Argyi for the treatment to intestinal disease in the rat with 2, 4, 6 - trinitrobenzenesulfonic acid (TNBS) induced colitis. Methods : Artemisiae Argyi Herbal acupunctures were infected in HapGok (LI4) which is used to treat for intestinal disease in clinic. All animals were subjected to the injection of saline (300 ${\mu}l$, 500 ${\mu}l$) for a study control and TNBS (300 ${\mu}l$, 500 ${\mu}l$) into the lumen of the colon, 8cm proximal to the anus through the intestine. Artemisiae Agryi' Herbal (20 mg/ml, 0.4 ml) acupunctures were injected to the LI4 (both hands) at the secondary injection time of TNBS in rats. And body weight, RBC count, WBC count, total protein, Paw edema rate, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels were observed to study the effects of Artemisiae Argyi' Herbal acupuncture in HapGok (Ll4). Results : Artemisiae Argyi' Herbal acupuncture in HapGok (Ll4) on TNBS-induced colitis inhibit the body weight lose rate but not RBC and WBC count. Furthermore, it inhibited the reduction of total protein concentration, paw edema, rate of protein leakage into CMC-pouch fluid, IgG levels and IgM levels. Conclusions : Herbal acupuncture with Artemisiae Argyi helps recover the TNBS-induced colonic damage and may be an important method for treatment of the colitis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권1호
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• pp.19-29
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• 2021

Purpose: To assess parent perspectives of the current and potential future tests for their child with inflammatory bowel disease (IBD). Methods: New Zealand parents of a child with IBD were invited to complete an anonymous online survey. Experiences relating to their child's blood or faecal tests, medical imaging (abdominal ultrasound [US], abdominal computerised tomography [CT] and magnetic resonance enterography) and colonoscopy were collected. Perceived attitudes to potential future testing of urine, saliva, and breath, were sought. Results: Twenty-eight parents, 93% female completed the survey, and 86% were aged between 35 and 54 years. Baseline information was provided by parents for 27 of 28 children, 70.3% had Crohn's disease with a mean disease duration of 2.67 years. Blood tests were the most requested and completed tests, while CT was the least ordered and most refused test. Colonoscopy was rated as the least comfortable and generated the most worry. Explanation of test significantly improved parent's levels of understanding when their child had blood, faecal, imaging (US) or colonoscopy tests. Providing an explanation, test invasiveness and the impact of the blood results may have on their child's treatment significantly improved parents' comfort levels. However, explanation of colonoscopy generated a significant parental concerns. Saliva, urine and blood tests were chosen as the most preferred disease monitoring tests. Conclusion: Parents preferred any tests less invasive than colonoscopy for monitoring their child's IBD. Although providing explanation of their child's tests enhanced parents' understanding, it can also affect parents' levels of concern and comfort.

• 한국식품위생안전성학회지
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• 제33권4호
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• pp.221-228
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• 2018

19세기말 Mycobacterium avium subsp. paratuberculosis(Map)이 요네병(Johne's disease)의 원인균임이 밝혀진 이후, 불현성 감염된 동물들의 국제적 이동은 요네병을 전세계로 퍼뜨리기 시작하였다. 이러한 요네병이 축산분야에 나타남과 동시에 새로운 형태의 대장염으로서 요네병과 같은 증상을 나타내는 질병(크론병)이 사람에게서도 나타나기 시작하였다. 그러나 Map이 이러한 새로운 대장염의 원인균이며 인수공통전염병의 원인체라는 인식은 20세기 후반 이러한 질병을 앓고 있는 사람의 조직으로부터 Map을 검출할 수 있게 되고서야 나타나기 시작했다. 본 총설은 어떻게 Map이 축산분야와 사람의 공중보건 측면에서 심각한 문제를 야기시키게 되었고, Map 감염에 의한 대장염 환자의 치료가 어떻게 발전되어 왔는지 간단히 요약하고, 축산에서 Map의 통제를 위한 새로운 백신개발 전략에 대하여 소개한다.

• Biomolecules & Therapeutics
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• 제25권1호
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• pp.80-90
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• 2017

Initial discovery on sphingosine 1-phosphate (S1P) as an intracellular second messenger was faced unexpectedly with roles of S1P as a first messenger, which subsequently resulted in cloning of its G protein-coupled receptors, $S1P_{1-5}$. The molecular identification of S1P receptors opened up a new avenue for pathophysiological research on this lipid mediator. Cellular and molecular in vitro studies and in vivo studies on gene deficient mice have elucidated cellular signaling pathways and the pathophysiological meanings of S1P receptors. Another unexpected finding that fingolimod (FTY720) modulates S1P receptors accelerated drug discovery in this field. Fingolimod was approved as a first-in-class, orally active drug for relapsing multiple sclerosis in 2010, and its applications in other disease conditions are currently under clinical trials. In addition, more selective S1P receptor modulators with better pharmacokinetic profiles and fewer side effects are under development. Some of them are being clinically tested in the contexts of multiple sclerosis and other autoimmune and inflammatory disorders, such as, psoriasis, Crohn's disease, ulcerative colitis, polymyositis, dermatomyositis, liver failure, renal failure, acute stroke, and transplant rejection. In this review, the authors discuss the state of the art regarding the status of drug discovery efforts targeting S1P receptors and place emphasis on potential clinical applications.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.28-40
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• 2019

The incidence of pediatric-onset inflammatory bowel disease (IBD) is on the rise, accounting for up to 25% of IBD cases. Pediatric IBD often has extensive bowel involvement with aggressive and rapidly progressing behavior compared to adult IBD. Because IBD has a high morbidity rate and can have a lifelong impact, successful transition from pediatric to adult care is important to maintain the continuity of care. Furthermore, successful transition facilitates appropriate development and psychosocial well-being among patients, as well as comprehensive and harmonious healthcare delivery amongst stakeholders. However, there are various obstacles related to patients, family, providers, and organizations that interfere with successful transition. Successful transition requires a flexible and tailored plan that is made according to the patient's developmental abilities and situation. This plan should be established through periodic interviews with the patient and family and through close collaboration with other care providers. Through a stepwise approach to the transition process, patients' knowledge and self-management skills can be improved. After preparation for the transition is completed and the obstacles are overcome, patients can be gradually moved to adult care. Finally, successful transition can increase patients' adherence to therapy, maintain the appropriate health status, improve patients' self-management, and promote self-reliance among patients.

• 한양메디칼리뷰
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• 제33권1호
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• pp.27-32
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• 2013

Inflammatory bowel diseases(IBD), including Crohn's disease and ulcerative colitis, are chronic inflammatory states of the intestinal tract. While the exact mechanisms inducing chronic inflammation are still unclear, it is hypothesized that the inflammation is caused in part by an inappropriate immune response to the intestinal microflora. Although inflammatory diseases are not directly linked to patient survival, symptoms of these diseases significantly decrease quality of life. The incidence rate is higher in western people than eastern people, but the incidence rate of IBD in eastern people, including Korean, is increasing. Recently, it has been reported that IL-17 is an important factor that appears to be involved in IBD induction and progression. This report reviews many recent papers reporting the relationship between IBD and IL-17, which may provide an understanding leading to new means of prevention and treatment for IBD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.180-193
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• 2022

Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

• Korean Journal of Acupuncture
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• 제25권3호
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• pp.147-166
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• 2008

Objectives : Crohn's disease (CD) is characterized by a chronic relapsing inflammation of the bowel in which proinflammatory cytokines play an important perpetuating role. Methods : Mice (preventive animal model of gliotoxin) were treated with 5 % 2,4,6-trinitrobenzenesulfonic acid (TNBS) at day 1 and day 7. To investigate preventive effects of acupuncture with Gujin at $LI_{11}$, acupuncture was carried out at day -1, day 1, day 3. And, to investigate therapeutic effects, acupuncture with Gujin was carried out at day 3, day 5, day 7. For the data analysis, we checked weight and width of colon, diarrhea, edema, survival rate, changes of body weight, and myeloperoxygenase (MPO) activity. For analysing protein expression, we carried out immunohistochemical staining and Western blot and we analyzed mRNA expression by RT-PCR. Results : Colon of TNBS treated mice was erosive and shortening compared with the colon of control mice and induced damages of colon epithelial cell layer and induced infiltration of immune cells in all layer of colon. Acupuncture of gujin at $LI_{11}$ in preventive mode suppressed macorscopic damages such as erosive and shortening of colon by TNBS and damages of intestinal epithelial cells and infiltration of immune cells in the colon. The average weight of 5 cm distal colon was increased in TNBS treated mice (758${\mu}g$) compared with in control mice (112${\mu}g$) and width of distal colon was also increased in TNBS treated mice (4.9mm) compared with in control mice (1.3mm). Acupuncture with Gujin at $LI_{11}$ in preventive and therapeutic mode suppressed increase of colon weight and width by TNBS. TNBS induced edema of colon and diarrhea and Acupunctured with Gujin at $LI_{11}$ in preventive and therapeutic mode ameliorated these symptom by TNBS. In preventive and therapeutic mode, the effects of acupuncture with Gujin at $LI_{11}$ were increasing the motility, suppressing body weight decreasing, suppressing MPO activity, reducing expressing of TNF-${\alpha}$, IL-1b, and ICAM-1 in colon compared with that by TNBS Conclusions : This study demonstrates that acupuncture with Gujin at $LI_{11}$ represents a potential therapeutic method of Crohn's disease.