• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.53-57
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• 2011

Purpose: Pyoderma gangrenosum is a rare inflammatory, reactive dermatosis marked by painful cutaneous ulcer. The causes of pyoderma gangrenosum remain unclear. Gastrointestinal, hematological, rheumatological, and immmune disorders may be associated with pyoderma gangrenosum. The appearance of this disease may range from mild skin ulcers to life-threatening conditions. Generalized multiple ulcerative pyoderma gangrenosum is very rare. Here we report our experience with a case of multiple ulcerative pyoderma gangrenosum accompanied by ulcerative colitis. Methods: A 67-year-old man had cutaneous ulcers at multiple sites including the scalp, face, chest, abdomen, hands, and buttocks. He also developed gastrointestinal symptoms such as intermittent dyspepsia and bloody excrement. Debridement and irritation aggravated the disease progress. We gave a diagnosis of pyoderma gangrenosum with ulcerative colitis based on the clinical appearance and biopsy. The patient was treated with systemic intravenous steroid therapies and careful wound cares. Ulcers of the scalp and buttocks were treated with split thickness skin grafts. Results: Most of the multiple cutaneous ulcers were treated by systemic intravenous steroid therapies and wound cares. The rest of the ulcers were treated with skin grafts. Systemic intravenous steroid therapy was used to treat the ulcerative colitis. Conclusion: Generalized multiple ulcerative pyoderma gangrenosum is very rare. Without making an accurate diagnosis, hasty surgical treatments could aggravate the progression of the disease. Additionally, care should be taken to systemically treat underlying disease as well as administrating local treatments for the skin lesions. Intravenous systemic steroid therapy and skin grafts are useful treatments for generalized pyoderma gangrenosum.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.3
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• pp.67-88
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• 2021

Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

• Herbal Formula Science
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• v.29 no.4
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• pp.285-295
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• 2021

Objective : This systematic review was conducted to investigate the effect of herbal medicine on Helicobacter pylori(H. pylori) infection compared to amoxicillin included synthetic drugs. Methods : Relevant randomized controlled trials(RCTs) which were published prior to December 26, 2020, were collected using PubMED database. Risk of bias evaluation and data extraction were done independently by two reviewers, and the third reviewer reassessed mismatching parts. Results : Two RCTs testing two different herbal medicines against synthetic drugs solitary treatment or synthetic drugs with placebo for herbal medicine were included. One study reported that there was no significant difference between the eradication rate of synthetic drugs and the herbal medicine. The other study did not report the eradication rate of the herbal medicine. One study reported histologic severity, the other reported dyspepsia score as efficacy indicators. There was no adverse event reported in all studies. However, the number of included RCTs was too small, the quality of reported data was not enough to verify efficacy of herbal medicine, and there were some methodological problems. Conclusion : It was difficult to conclude that solitary treatment of herbal medicine was as effective as amoxicillin included synthetic drugs for H. pylori infection.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.512-527
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• 2018

This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.669-675
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• 2018

Background/Aims Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are common gastrointestinal (GI) disorders and these patients frequently overlap. Trimebutine has been known to be effective in controlling FD co-existing diarrhea-dominant IBS, however its effect on overlap syndrome (OS) patients has not been reported. Therefore, we investigated the effect of trimebutine on the model of OS in guinea pigs. Methods Male guinea pigs were used to evaluate the effects of trimebutine in corticotropin-releasing factor (CRF) induced OS model. Different doses (3, 10, and 30 mg/kg) of trimebutine were administered orally and incubated for 1 hour. The next treatment of $10{\mu}g/kg$ of CRF was intraperitoneally injected and stabilized for 30 minutes. Subsequently, intragastric 3 mL charcoal mix was administered, incubated for 10 minutes and the upper GI transit analyzed. Colonic transits were assessed after the same order and concentrations of trimebutine and CRF treatment by fecal pellet output assay. Results Different concentrations (1, 3, and $10{\mu}g/kg$) of rat/human CRF peptides was tested to establish the OS model in guinea pigs. CRF $10{\mu}g/kg$ was the most effective dose in the experimental OS model of guinea pigs. Trimebutine (3, 10, and 30 mg/kg) treatment significantly reversed the upper and lower GI transit of CRF induced OS model. Trimebutine significantly increased upper GI transit while it reduced fecal pellet output in the CRF induced OS model. Conclusions Trimebutine has been demonstrated to be effective on both upper and lower GI motor function in peripheral CRF induced OS model. Therefore, trimebutine might be an effective drug for the treatment of OS between FD and IBS patients.

• Herbal Formula Science
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• v.26 no.4
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• pp.329-340
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• 2018

Objectives : In Traditional Korean medicine, Daucus carota L. has been used for treating dyspepsia, diarrhea, dysentery and cough. Recent pharmacognosic evidence showed D. carota has anti-oxidant, anti-cancer, anti-fungal, and hypotensive effects. Present study investigated hepato-protective effect of D. carota ethanol extract (DCE) against oxidative stress in HepG2 cells. Methods : After HepG2 cells were pretreated with different concentrations of DCE, the cells were exposed to tert-butyl hydroperoxide (tBHP) for inducing oxidative stress. Cell viability, hydrogen peroxide production, glutathione concentration, and mitochondrial membrane potentials were measured to explore hepato-protective effect of DCE. Phosphorylation of AMP-activated protein kinase (AMPK) and effect of compound C on cell viability were determined to investigate the role of AMPK on DCE-mediated cytoprotection. Results : DCE significantly decreased the tBHP-mediated cytotoxicity in a concentration dependent manner and reduced the changes on apoptosis-related proteins by tBHP in HepG2 cells. In addition, DCE significantly prevented hydrogen peroxide production, glutathione depletion, and mitochondrial membrane impairment induced by tBHP. Treatment with DCE increased phosphorylation of AMPK, and the DCE-mediated cytoprotection was abolished by pretreatment with compound C. Conclusions : These results demonstrate that DCE can protect hepatocytes from oxidative stress through activation of AMPK.

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.3
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• pp.142-161
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• 2019

Objectives: The purpose of this study is to report the effect and safety of traditional Korean medicine (TKM) for enhanced recovery after surgery (ERAS) after gynecological surgery. Methods: The study is conducted by analyzing the medical records of the hospitalized patients in TKM hospital. Eighty-six patients were enrolled who received TKM for ERAS after gynecological surgery from January 2015 to April 2018. We performed statistical analysis by using SPSS ver. 25.0. To prove the effect and safety of TKM for ERAS, we analyzed symptoms and Hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and serum creatinine (Cr) with glomerular filtration rate (GFR). In addition, we checked other adverse reactions that the patients complained to prove the safety of TKM for ERAS. Results: Among symptoms of pain, there was a statistically significant decrease in abdominal pain, lower back pain, and shoulder pain. Other symptoms showed statistically significant improvement in fatigue, abdominal tympanosis, operation-site discomfort, dizziness, urinary discomfort, throat discomfort, constipation, dyspepsia and colporrhagia. Anemia in both ferritin combination treatment group and herbal medicine only group showed significant improvement. There was no liver damage or renal damage by TKM. Conclusions: The result has shown that TKM for ERAS after gynecological surgery is effective and safe. The further study of TKM for ERAS with more patients is needed.

• Archives of Obesity and Metabolism
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• v.1 no.2
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• pp.78-82
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• 2022

Liraglutide (Saxenda^R) is prescribed to induce and sustain weight loss in obese patients. The starting dose of liraglutide is 0.6 mg/day for 1 week, which is increased by 0.6 mg/day every week until the full maintenance dose of 3 mg/day is achieved. Such dose titration is needed to prevent side effects, which primarily include gastrointestinal problems such as nausea, diarrhea, constipation, vomiting, dyspepsia, and abdominal pain. A 35-year-old, reportedly healthy obese man receiving liraglutide treatment for obesity visited the emergency room complaining of generalized weakness and dizziness accompanied by repeated diarrhea and vomiting. He reported over 20 episodes of diarrhea starting the day after liraglutide dose escalation from 1.2 mg/day to 1.8 mg/day. Laboratory findings suggested pre-renal acute kidney injury, including serum creatinine 4.77 mg/dl, blood urea nitrogen (BUN) 37 mg/dl, estimated glomerular filtration rate (eGFR) 15 ml/min/1.73 m², and Fractional excretion of sodium 0.08. After volume repletion therapy, his renal function recovered to a normal range with laboratory values of creatinine 1.08 mg/dl, BUN 14 mg/dl, and eGFR 88 ml/min/1.73 m². This case emphasizes the need for caution when prescribing glucagon-like peptide-1 receptor agonists, including liraglutide, given the risk of serious renal impairments induced by volume depletion and dehydration through severe-grade diarrhea and vomiting.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.184-190
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• 2022

Objectives: This study aims to report the clinical efficacy of Korean medical treatment of a patient with nonalcoholic fatty liver disease accompanied by obesity and dyslipidemia. Methods: A 52-year-old man with nonalcoholic fatty liver disease, obesity, and dyslipidemia was treated with Saenggangunbi-tang extract from November 3, 2021 to January 8, 2022. During the treatment period, the patient also undertook exercise and maintained a hypocaloric diet to reduce body weight. Changes were observed in the patient's symptoms, laboratory findings, such as liver enzymes and lipid profiles, and bioelectrical impedance analyzer results. Results: After taking Saenggangunbi-tang extract for approximately two months, with concomitant adjustments to exercise and diet, the serum levels of liver enzymes and triglyceride were decreased and the patient's body weight, body mass index, hepatic steatosis index, and visceral fat area were also reduced. In addition, symptoms including fatigue and dyspepsia improved. Conclusion: This study suggests that Saenggangunbi-tang extract with exercise and a regulated diet could be a helpful treatment strategy for managing nonalcoholic fatty liver disease with metabolic disorders.

• Journal of Korean Traditional Oncology
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• v.27 no.1
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• pp.1-12
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• 2022

Objectives: To report recurrent pancreatic cancer treated by Korean medicine based-integrated oncology treatment, who is improved quality of life without progression of cancer Method: A 63-year-old female patient diagnosed with recurrent pancreatic cancer in April, 2022 received Chemotherapy with Korean medicine based integrative oncology treatment. Radiologic outcome was assessed by Abdomen Computed Tomography (CT) based on Response Evaluation Criteria In Solid Tumors (RECIST). Clinical outcomes were assessed by National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), Numeric Rating Scale (NRS) Result: During 2months of treatment, Cancer size was stable in Abdominal CT. Chief complaints, Abdominal pain and dyspepsia, were improved and ECOG score was improved from grade 2 to 1. There were no toxicity on laboratory test and no side effects of grade 3 or higher on NCI-CTCAE. Conclusion: This report shows that Korean medicine based integrative oncology treatment might contribute to synergetic effect to Chemotherapy and improvement of quality of life