• Title/Summary/Keyword: Gastrointestinal Motility

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Management of Enteral Nutrition in the Pediatric Intensive Care Unit: Prokinetic Effects of Amoxicillin/Clavulanate in Real Life Conditions

  • Chiusolo, Fabrizio;Capriati, Teresa;Erba, Ilaria;Bianchi, Roberto;Atti, Marta Luisa Ciofi degli;Picardo, Sergio;Diamanti, Antonella
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.6
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    • pp.521-530
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    • 2020
  • Purpose: Malnutrition is a common feature in critically ill children. Enteral nutrition (EN) is the main strategy to nutritionally support critical ill children, but its use can be hindered by the development of intolerance. The study aimed to assess the effectiveness and safety of amoxicillin/clavulanate (A/C) to treat EN intolerance. Methods: We retrospectively evaluated patients admitted to the pediatric intensive care unit from October 2018 to October 2019. We conducted a case-control study: in the first 6 months (October 2018-April 2019) we implemented the nutritional protocol of our Institution with no drug, whereas in the second half (May 2019-October 2019) we employed A/C for 1 week at a dose of 10 mg/kg twice daily. Results: Twelve cases were compared with 12 controls. At the final evaluation, enteral intake was significantly higher than that at baseline in the cases (from 2.1±3.7 to 66.1±27.4% of requirement, p=0.0001 by Wilcoxon matched-pairs signed rank test) but not in the controls (from 0.2±0.8 to 6.0±14.1% of the requirement, p=NS). Final gastric residual volume at the end of the observation was significantly lower in the cases than in the controls (p=0.0398). The drug was well tolerated as shown by the similar safety outcomes in both cases and controls. Conclusion: Malnutrition exposes critically ill children to several complications that affect the severity of disease course, length of stay, and mortality; all may be prevented by early EN. The development of intolerance to EN could be addressed with the use of A/C. Future prospective clinical trials are needed to confirm these conclusions.

Pituitary Adenylate Cyclase-activating Polypeptide Inhibits Pacemaker Activity of Colonic Interstitial Cells of Cajal

  • Wu, Mei Jin;Kee, Keun Hong;Na, Jisun;Kim, Seok Won;Bae, Youin;Shin, Dong Hoon;Choi, Seok;Jun, Jae Yeoul;Jeong, Han-Seong;Park, Jong-Seong
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.5
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    • pp.435-440
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    • 2015
  • This study aimed to investigate the effect of pituitary adenylate cyclase-activating peptide (PACAP) on the pacemaker activity of interstitial cells of Cajal (ICC) in mouse colon and to identify the underlying mechanisms of PACAP action. Spontaneous pacemaker activity of colonic ICC and the effects of PACAP were studied using electrophysiological recordings. Exogenously applied PACAP induced hyperpolarization of the cell membrane and inhibited pacemaker frequency in a dose-dependent manner (from 0.1 nM to 100 nM). To investigate cyclic AMP (cAMP) involvement in the effects of PACAP on ICC, SQ-22536 (an inhibitor of adenylate cyclase) and cell-permeable 8-bromo-cAMP were used. SQ-22536 decreased the frequency of pacemaker potentials, and cell-permeable 8-bromo-cAMP increased the frequency of pacemaker potentials. The effects of SQ-22536 on pacemaker potential frequency and membrane hyperpolarization were rescued by co-treatment with glibenclamide (an ATP-sensitive $K^+$ channel blocker). However, neither $N^G$-nitro-L-arginine methyl ester (L-NAME, a competitive inhibitor of NO synthase) nor 1H-[1,2,4]oxadiazolo[4,3-${\alpha}$]quinoxalin-1-one (ODQ, an inhibitor of guanylate cyclase) had any effect on PACAP-induced activity. In conclusion, this study describes the effects of PACAP on ICC in the mouse colon. PACAP inhibited the pacemaker activity of ICC by acting through ATP-sensitive $K^+$ channels. These results provide evidence of a physiological role for PACAP in regulating gastrointestinal (GI) motility through the modulation of ICC activity.

OmpR Is Essential for Growth and Expression of Virulence-related Genes in the Fish Pathogen Edwardsiella piscicida (어류 병원체 Edwardsiella piscicida의 OmpR은 생육과 병원성과 관련된 유전자의 발현에 필수적)

  • Ray, Durga;Kim, Yeon Ha;Choe, unjeong;Kang, Ho Young
    • Journal of Life Science
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    • v.31 no.1
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    • pp.28-36
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    • 2021
  • Edwardsiella piscicida is a significant cause of hemorrhagic septicemia in fish and gastrointestinal infections in humans. Survival bacteria require specialized mechanisms to adapt to environmental fluctuations. Hence, to understand the mechanism through which E. piscicida senses and responds to environmental osmolarity changes, we determined the protein expression profile and physiological properties under various salinity conditions in this study. The OmpR protein is a part of the Env-ZOmpR two-component system that has been implicated in sensing salt stress in bacteria. However, the physiological role played by this protein in E. piscicida remains to be elucidated. Therefore, in this work, the function of the OmpR protein in response to salt stress was investigated. Phenotypic analysis revealed that, in the mutant, three of the biochemical phenotypes were different from the wild type, including, citrate utilization, hydrogen sulfide, and indole production. Introduction of the plasmid containing the entire ompR gene to the mutant strain returned it to its parental phenotype. The retarded growth rate also partially recovered. Furthermore, in our studies, OmpR was not found to be related to cell motility. Taken together, our results from the mutational analysis, the growth assay, MALDI-TOF MS, qRT-PCR, and the phenotype studies suggest that the OmpR of E. piscicida is implicated in osmoregulation, growth, expression of porins (ETAE_1826), virulence-related genes (EseC, EseD and EvpC), and certain genes of unknown function (ETAE_1540 and ETAE_2706).

The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis (위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Bae, Hye-ri;Kim, Eun-ji;Seo, Hyun-sik;Lee, Nam-hun
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.625-642
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    • 2022
  • Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.

Recent Studies on Natural Products that Improve Browning (Browning 촉진에 관여하는 최근 천연물의 동향)

  • Lee, Eunbi;Nam, Ju-Ock
    • Journal of Life Science
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    • v.31 no.11
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    • pp.1037-1045
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    • 2021
  • The prevalence of obesity is increasing worldwide, and since obesity is associated with dietary factors and sedentary lifestyles, it is a disease that is readily developing in the modern population. Because obesity is accompanied by serious complications such as diabetes and cardiovascular disease, prevention and treatment are important. Currently, drugs such as liraglutide and phentermine are used to treat obesity by suppressing appetite and inducing gastrointestinal motility delay. However, various side effects may occur, including thyroid cancer, cardiovascular problems, and central nervous system disorders. Therefore, to explore an obesity treatment method with relatively few side effects, a method known as "fat browning" was introduced to change white adipose tissue into brown adipose tissue to increase energy consumption. Ongoing studies are attempting to find effective natural substances to safely induce browning. Many natural substances have been identified. The induction of browning by treatment with natural substances generally involves three mechanisms: positive control of browning-inducing factors, inhibition of differentiation into white adipose tissue, and the activation of mechanisms related to browning. In this study, we describe plant extracts with known browning-inducing effects, such as strawberry, black raspberry, cinnamomum cassia, and Ecklonia stolonifera extracts. We also summarize the underlying mechanisms of action identified thus far, including the signaling pathway mediated by these extracts to induce browning. Furthermore, the effects of brown adipose tissue generated through browning on heart disease as an endocrine organ disruptor are discussed.

The Effects of Bojungikgi-tang on Streptozotocin-induced Diabetic Gastroparesis Rat Model (보중익기탕(補中益氣湯)이 streptozotocin 유발 당뇨병성 위부전마비 백서에 미치는 영향)

  • Kang, Yun-Mi;Kim, Hyo-Jung;Park, Yun-Beom;Jeong, Chan-Mun;Ham, Seong-Ho;Yang, Woong-Mo;An, Hyo-Jin
    • The Korea Journal of Herbology
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    • v.34 no.6
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    • pp.45-55
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    • 2019
  • Objective : Diabetic gastroparesis is a complication that is defined as delayed gastric emptying and upper gastrointestinal symptoms and often occurs in long-standing diabetic patients. Bojungikgi-tang (BJT) is a traditional oriental herbal formula that has long been used for the treatment of digestive disorders. The purpose of this study was to investigate the effects of BJT on streptozotocin (STZ)-induced diabetic gastroparesis rat model. Methods : Sprague-Dawley (SD) male rats (250-270g) were divided into 13 groups including normal group, STZ-induced diabetic control group, BJT diet (7 various concentrations), and insulin-, glibenclamide-, metformin-treated group were used for the experiments for the comparison. Diabetic gastroparesis was induced by intraperitoneal injection of STZ. The water intake, food intake, body weights and fasting blood glucose levels were measured. After 4 weeks the animals were sacrificed and gastrin, leptin, insulin, hemoglobin A1C (HbA1c), lactate, lactate dehydrogenase (LDH), bilirubin, creatinine, albumin and lipid levels were evaluated. Results : Intraperitoneal injection of BJT for 4 weeks resulted in increased levels of gastrin in blood and decreased leptin and lactate concentration in STZ-induced diabetic gastroparesis rat model. BJT did not affect insulin, fasting glucose, HbA1c, and lipid levels in STZ-induced diabetic gastroparesis rat model. Conclusion : These results indicated that BJT would have protect effect on diabetic gastroparesis through the improvement effect of gastric motility and fatigue syndrome in STZ-induced diabetic rats. This study shows that BJT might be effective for treatment of diabetes and its complications such as gastroparesis.

Effects of Herbal medicines in Pacemaker Potential of Colonic Intestinal Interstitial cells of Cajal in mice (생쥐 대장 카할세포의 자발적 탈분극에서 한약의 효과에 관한 비교연구)

  • Na Ri, Choi;Haejeong, Jeong;Woo-gyun, Choi;Byung Joo, Kim
    • Herbal Formula Science
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    • v.31 no.1
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    • pp.11-19
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    • 2023
  • Objectives : The purpose of this study was to examine the effects of herbal medicines on pacemaker potentials of large intestinal interstitial Cells of Cajal (ICC) in mice. Methods : We made the ICC culture in large intestine in mice and used the electrophysiological method to record pacemaker potentials. Also we used MTT assay to check cell viability and examined the ICC protein expression by western blot. Results : 1.Glycyrrhiza uralensis Fischer (GF) (50-150 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 58.95 ㎍/ml. Angelica gigas (AG) (50-200 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 77.22 ㎍/ml. Poncirus fructus (PF) (10-100 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 13.39 ㎍/ml. Citrus unshiu S. Marcov. (CU) (10-500 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 139.80 ㎍/ml. Gardenia jasminoides J. Ellis (GJ) (100-500 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 78.70 ㎍/ml. Coptis chinensis (CC) (100-1000 ㎍/ml) induced pacemaker depolarization and decreased frequency with concentration-dependent manners. EC50 is 138.10 ㎍/ml. Scutellaria baicalensis (SB) (10-100 ㎍/ml) had no effects on pacemaker potentials and decreased frequency with concentration-dependent manners. IC50 is 18.34 ㎍/ml. Atractylodes macrocephala koidzumi (AM) (10-100 ㎍/ml) induced pacemaker hyperpolarizations and decreased frequency with concentration-dependent manners. IC50 is 18.54 ㎍/ml. 2. PF, SB and AM had no effects on cell death in large ICC. 3. PF increased the ANO1 and c-kit protein expression and SB and AM increased the c-kit protein expression in large ICC. Conclusions : These results suggest that PF, SB, and AM are likely to be the optimal combination of herbal medicines that can be used to treat diseases such as gastrointestinal motility disorders such as irritable bowel syndrome.

Clinicopathological Effects of Waterpepper (Persicaria hydropiper) on Ruminants (여뀌섭취가 반추수에 비치는 임상병리학적 영향)

  • Cho Myoung-Rae;Han Hong-Ryul
    • Journal of Veterinary Clinics
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    • v.6 no.2
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    • pp.227-259
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    • 1989
  • Waterpepper is a weed which grows on damp soil. especially near swamps, and in shallow water of ponds and ditches. It Is widespread throughout the country In abundant colonies. In the present experiments, possible toxic effects of waterpepper were investigated in ruminants. Pour cows were fed waterpepper ad libitum or by force in the from of green forage, hay and/or powder, 8 goats were administered in the form of methanol extract, and 4 goats, crude juice, into the lumen. Clinical signs were examined as well as urinalysis, hematology, serum chemical analysis, pH/blood gas analysis and chclinesterase activities following administration of waterpepper. Six goats which were administered the methanol extract or crude juice were sacrificed for pathological examinations., In addition to the clini copathological examinations, the chemical constituents of waterpepper were qualitively analyzed from the methanol extract and the Effects of the waterpepper crude juice were examined on the motility of rabbit duodenum and uterus. It is revealed that waterpepper contains steroids, terpenoids, flavonoids, tannin and essential oils in the methanol extract and nitrates in the crude juice. The crude juice of waterpepper relaxed the rabbit uterine and duodenal smooth muscles. The constraction of duodenum by acetylcholine or BaCl$_2$ were partially inhibited by pretreatment of the crude juice. However, the relaxation of duodenum by the crude juice was not blocked by the pretreatments of phenoxybenzamlne, propranolol, cocaine, reserpine and tetrodotoxin. The constituents of waterpepper to evoke elaxation of duodenal smooth muscle were stable to heat. The cows administered waterpepper showed common clinical symptoms such as acrid expression, restlessness, dullness, inappetence, anorexia, severe diarrhea, mild bloat and left displacement of abomasum, while bloody feces was shown in a cow. The goats administered the mothanol extract showed common clinical signs such as acrid expression, restlessness, dullness, inappetence and soft feces, while bloody feces was shown in a goat, A goat adminstered the crude juice showde bloody feces and diarrhea. Respiratory rates and heart beats were increased along with diarrhea in the experimental cows. The erythrocyte counts and MCHC were decreased whereas PCV, MCV and neutrophils were increased in the cows administered waterpepper. In goats administered methanol extract, there were decreases in erythrocytes, PCV and hemoglobin content, and an increase in MCHC. The goats ingester with the crude juice showed negligible changes in hematologic values compared with control group which was administered the same amount of water instead of the crude juice. The contents of serum calcium, Inorganic phosphorus, magnesium, Iron, glucose, cholesterol, total protein, triglycerides and phospholipids were tended to decrease in cows. In goats serum iron, glucose, triglycerides, cholesterol, BUN and phospholipids content were decreased while the content of sodium and chloride were increased after administration of the methamol extract The goats ingested with the crude juice did not show significant changes in serum chemical analysis. Even though there were some pathological findings such as hyperemia in the small intestines and kidneys and swelling of liver parenchymal cells, the values of serum AST, ALT, LDH, alkaline phosphatase, total bilirubin and creatinine did not change significantly. While proteins, hemoglobin and blood were detected in the urine of cows, urine pH, ketone bodies, glucose, bilirubin and urobilinogen content were normal or undetected. There were no significant changes in pH/bolld gas analysis data of cows and cholinesterase activities of plasma and erythrocytes of cows and goats ingested with waterpepper or the methanol extract. It is concluded that waterpepper irritates the gatrointestinal system, causes abdominal pain, relaxes the gastrointestinal smooth muscle and dilatates blood vessels supplied to the system. The irritation and relaxation may lead to abnormal fermentation, maldigestion and malabsorption of nutrients and result in diarrhea, body feces, mild bloat and left displacement of abomasum.

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