• 제목/요약/키워드: Gastrointestinal diseases

검색결과 578건 처리시간 0.019초

R을 이용한 결과 변수에 따른 최적의 Cut-off Point 결정 (Determining the Optimal Cut-off Point According to the Outcome Variables Using R)

  • 양주연;이혜선
    • Journal of Digestive Cancer Research
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    • 제10권2호
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    • pp.99-106
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    • 2022
  • Clinical research ultimately aimed to promptly diagnose and prevent diseases through precise biomarker development. Finding the optimal cut-off point of a regularly measured biomarker can help its interpretation and ultimately help in disease investigation and diagnosis, more specifically in determining the presence of diseases. Therefore, this study aimed to use the characteristics of outcome variables in clinical research to explain how to determine the optimal cutoff point. The outcome variables can be divided into dichotomous, ordinal, and survival types. The optimal cut-off point can be determined by finding points that maximize the Youden index, extended Youden index, and log-rank statistics. This study will enable clinical researchers to accurately determine the optimal cut-off points for regularly measured biomarkers, thereby enabling prompt disease diagnosis for effective treatment.

Usefulness of the double-guidewire technique for endoscopic procedures in the field of biliary and pancreatic diseases

  • Mamoru Takenaka;Masatoshi Kudo
    • Clinical Endoscopy
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    • 제55권5호
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    • pp.605-614
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    • 2022
  • The double-guidewire method has been increasingly used in endoscopic procedures for biliary and pancreatic diseases in recent years, including endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography-related procedures. In addition, double-lumen catheters with uneven distal and proximal lumen openings have been introduced, making it possible to easily create a double-guidewire situation, and the usefulness of the double-guidewire technique using uneven double-lumen cannulas has been widely reported. Although the advantages of using two guidewires depend on the particular situation and the appropriate use of the two guidewires, deepening the knowledge of the double-guidewire method will contribute greatly to troubleshooting in daily practice. In this review, the usefulness of the double-guidewire technique is discussed with respect to two main areas: selective insertion of guidewires and devices and biliary cannulation.

The Prostaglandin Synthase 2/cyclooxygenase 2 (PTGS2/COX2) rs5277 Polymorphism Does not Influence Risk of Colorectal Cancer in an Iranian Population

  • Khorshidi, Fatemeh;Haghighi, Mahdi Montazer;Mojarad, Ehsan Nazemalhosseini;Azimzadeh, Pedram;Damavand, Behzad;Vahedi, Mohsen;Almasi, Shohreh;Aghdaei, Hamid Asadzadeh;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3507-3511
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    • 2014
  • Background: The prostaglandin-endoperoxide synthase 2 [PTGS2, commonly known as cyclooxygenase-2 (COX-2)] is an enzyme induced by proinflammatory stimuli that is often overexpressed in malignant tissue and involved in the synthesis of prostaglandins and thromboxanes, regulators of processes such as inflammation, cell proliferation, and angiogenesis, all relevant for cancer development. We investigated whether a functional genetic polymorphism, rs5277, in COX-2 may have a risk-modifying effect on sporadic colorectal cancer in an Iranian population. Materials and Methods: We conducted a case-control study on 167 patients with colorectal cancer and 197 cancer-free controls in Taleghani Hospital in Tehran, Iran, between 2007 and 2011. Peripheral blood samples of both groups were processed for DNA extraction and genotyping of the COX-2 gene polymorphism (rs5277) using PCR-RFLP. RFLP results were confirmed by direct sequencing. Logistic regression analysis was performed to calculate the adjusted odds ratio (OR) and 95% confidence interval (95% CI). Results: There was no significant difference in the distribution of COX-2 gene rs5277 polymorphism genotype and the allelic form, among CRC patients compared with the healthy control group (p: 0.867). Conclusions: Our results suggest that rs5277 polymorphism in COX2 could not be a good prognostic indicator for patients with CRC.

내과 환자의 입원후 영양상태 변화 연구 (Changes in Nutritional Status of General Medical Patients During Hospitalization)

  • 양영희;최스미;김은경
    • 대한간호학회지
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    • 제27권1호
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    • pp.49-60
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    • 1997
  • The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular. renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment : patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of days of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements. including weight body mass index, lean body mass, body fat. and skin fold thickness. were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization, almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia. Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

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Sulfoquinovosylmonoacylglycerols regulating intestinal inflammation in co-culture system from the brown alga Turbinaria ornata

  • Lee, Seon Min;Kim, Na-Hyun;Ji, Yeong Kwang;Kim, Yun Na;Jeon, You-Jin;Heo, Jeong Doo;Jeong, Eun Ju;Rho, Jung-Rae
    • ALGAE
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    • 제35권2호
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    • pp.201-212
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    • 2020
  • The inflammatory bowel diseases (IBD) including ulcerative colitis and Crohn disease are characterized by chronic inflammation throughout the gastrointestinal tract. The prevalence of IBD has been increasing worldwide, and has sometimes led to irreversible impairment of gastrointestinal structure and functions. In the present study, we identified a new sulfoquinovosylmonoacylglycerols (SQMG) (1) together with two known SQMGs (2 and 3) regulating intestinal inflammation from the brown alga Turbinaria ornata. The anti-inflammatory properties of two bioactive SQMGs, 1 and 2 were evaluated using an in vitro co-culture system consisting of human epithelial Caco-2 cells and PMA (phorbol 12-myristate 12-acetate)-differentiated THP-1 macrophages. Treatment with 1 or 2 inhibited the production nitric oxide and prostaglandin E2 induced by lipopolysaccharide and interferon γ challenge. The expressions of inducible nitric oxide synthase and cyclooxygenase 2 were markedly down-regulated in response to inhibition of nuclear factor κB translocation to nucleus. These findings suggest the potential use of the brown alga T. ornata and its biologically active metabolites SQMGs as pharmaceutical adjuvants in the treatment of inflammation-related diseases, including IBD.

Physiological Characteristics of Lactobacillus casei Strains and Their Alleviation Effects against Inflammatory Bowel Disease

  • Liu, Yang;Li, Yifeng;Yu, Xinjie;Yu, Leilei;Tian, Fengwei;Zhao, Jianxin;Zhang, Hao;Zhai, Qixiao;Chen, Wei
    • Journal of Microbiology and Biotechnology
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    • 제31권1호
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    • pp.92-103
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    • 2021
  • Lactobacillus casei, one of the most widely used probiotics, has been reported to alleviate multiple diseases. However, the effects of this species on intestinal diseases are strain-specific. Here, we aimed to screen L. casei strains with inflammatory bowel disease (IBD)-alleviating effects based on in vitro physiological characteristics. Therefore, the physiological characteristics of 29 L. casei strains were determined, including gastrointestinal transit tolerance, oligosaccharide fermentation, HT-29 cell adhesion, generation time, exopolysaccharide production, acetic acid production, and conjugated linoleic acid synthesis. The effects of five candidate strains on mice with induced colitis were also evaluated. The results showed that among all tested L. casei strains, only Lactobacillus casei M2S01 effectively relieved colitis. This strain recovered body weight, restored disease activity index score, and promoted anti-inflammatory cytokine expression. Gut microbiota sequencing showed that L. casei M2S01 restored a healthy gut microbiome composition. The western blotting showed that the alleviating effects of L. casei M2S01 on IBD were related to the inhibition of the NF-κB pathway. A good gastrointestinal tolerance ability may be one of the prerequisites for the IBD-alleviating effects of L. casei. Our results verified the efficacy of L. casei in alleviating IBD and lay the foundation for the rapid screening of L. casei strain with IBD-alleviating effects.

Eosinophilic Esophagitis and Eosinophilic Gastroenteritis: Similarities and Differences

  • Yoshikazu Kinoshita;Norihisa Ishimura;Shunji Ishihara
    • Journal of Digestive Cancer Research
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    • 제6권1호
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    • pp.1-5
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    • 2018
  • Eosinophilic gastrointestinal disease (EGID), a chronic allergic condition characterized by dense infiltration of eosinophils in the digestive tract, is classified into two types, eosinophilic esophagitis (EoE), which features dense infiltration of eosinophils in the esophageal epithelial layer, and eosinophilic gastroenteritis (EGE), in which the entire digestive tract including the esophagus may be involved. Patients with EoE only have esophageal symptoms, since the other parts of the digestive tract are not involved. On the other hand, 80% of EGE patients have lesions in the small intestine. The esophageal epithelial layer in healthy individuals has no or negligible infiltration by eosinophils, while the small intestinal mucosal layer, especially the distal small intestinal mucosa, can show dense eosinophil infiltration even in the absence of disease. Therefore, histological changes observed in cases of EGE are not qualitative but rather quantitative, as compared to EoE, which has qualitative histopathological changes, indicating important pathogenetic differences between the types. Comparisons of clinical, laboratory, and morphological characteristics between EoE and EGE have revealed several interesting differences. Both EoE and EGE patients are frequently affected by atopic diseases, such as bronchial asthma and allergic rhinitis, and elevated plasma levels of Th2 type cytokines and chemokines are also similarly seen in both. On the other hand, age at diagnosis differs, as the former is generally found in individuals from 30 to 50 years old, while the latter appears in all age groups. Additionally, 80% of patients with EoE are male as compared to only 50% of those with EGE. Furthermore, approximately 60% of patients with EoE respond favorably to proton pump inhibitor (PPI) administration, whereas EGE patients rarely show a response to PPIs. Nevertheless, both diseases show a similarly favorable response to a six foods elimination diet and glucocorticoid administration. These similarities and differences of EoE and EGE provide important clues for understanding the pathogenesis of these EGID types.

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소아의 장회전이상과 중장염전: 진단적 접근, 영상 소견 및 함정들 (Malrotation and Midgut Volvulus in Children: Diagnostic Approach, Imaging Findings, and Pitfalls)

  • 김정주;유소영;전태연;김지혜
    • 대한영상의학회지
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    • 제85권1호
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    • pp.124-137
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    • 2024
  • 장회전이상과 이로 인한 중장염전은 생후 1개월 이내에 호발하는 외과적 응급 질환이다. 전형적인 증상은 급성 담즙성 구토이며, 유아기 이후에는 반복적인 복통과 같은 비특이적인 증상을 호소할 수 있다. 장간막 띠로 인한 십이지장 폐쇄나 고리췌장, 십이지장 전방 문맥과 같은 기형을 동반하기도 한다. 중장염전은 장의 괴사를 일으켜 생명을 위협할 수 있으므로 정확하고 빠른 진단이 중요하다. 상부 위장관 조영술, 초음파 및 CT로 진단할 수 있으며, 초음파는 소아에서 방사선 피폭 없이 빠르고 정확하게 진단할 수 있어 선별검사로 대두되고 있다. 본 임상화보에서는 장회전이상과 중장염전의 핵심적인 영상 소견 및 진단적 접근법에 대해 알아보고, 실제 증례에서 경험한 진단적 오류와 주의할 점에 대하여 살펴보고자 한다.

Capsule enteroscopy versus small-bowel ultrasonography for the detection and differential diagnosis of intestinal diseases

  • Luca Elli;Erica Centorrino;Andrea Costantino;Maurizio Vecchi;Stefania Orlando;Mirella Fraquelli
    • Clinical Endoscopy
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    • 제55권4호
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    • pp.532-539
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    • 2022
  • Background/Aims: Capsule enteroscopy (CE) and intestinal ultrasonography (IUS) are techniques that are currently used for investigating small-bowel (SB) diseases. The aim of this study was to compare the main imaging findings and the lesion detection rate (LDR) of CE and IUS in different clinical scenarios involving the SB. Methods: We retrospectively enrolled patients who underwent CE and IUS for obscure gastrointestinal bleeding (OGIB), complicated celiac disease (CeD), and suspected or known inflammatory bowel disease (IBD). We evaluated the LDR of both techniques. The accuracy of IUS was determined using CE as the reference standard. Results: A total of 159 patients (113 female; mean age, 49±19 years) were enrolled. The LDR was 55% and 33% for CE and IUS (p<0.05), respectively. Subgroup analysis showed that the LDR of CE was significantly higher than that of IUS in patients with OGIB (62% vs. 14%, p<0.05) and CeD (55% vs. 35%, p<0.05). IUS showed a similar LDR to CE in patients with suspected or known IBD (51% vs. 46%, p=0.83). Conclusions: CE should be preferred in cases of OGIB and CeD, whereas IUS should be considered an early step in the diagnosis and follow-up of IBD even in patients with a proximal SB localization of the disease.

만성질환자의 산림치유 프로그램에 대한 요구도 및 선호도 분석 (An Analysis of Needs and Preferences of Forest Healing Programs in patients with Chronic Diseases)

  • 채영란;강소연;조영미;이선희;박수연;천인선
    • 농촌계획
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    • 제27권1호
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    • pp.29-41
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    • 2021
  • This study was conducted to identify the interest, needs, and preferences for forest healing programs of patients with chronic diseases. A total of 227 individuals with chronic diseases who were admitted to a university hospital were surveyed on the needs and preferences of forest healing programs. The participants of this study were 111 patients (48.9%) with cardiovascular disease, 88 patients (38.8%) with gastrointestinal diseases, 39 patients with musculoskeletal disease (17.2%), and 78 patients (34.3%) with other diseases. About 51% of all participants had heard of the forest healing programs, but 94.3% of the participants said they had no experience in participating. The frequency of forest visits was the most often once a month or not, and the reason for not being able to participate in forest healing programs was "because there was no time to spare." The participants generally preferred a small group programs with family members or their friends for one day or two days. The preferred seasons were spring and autumn, and the preferred time zones were morning and weekend, and the participants preferred outdoor programs rather than indoors. An important factors of the programs were dense forests, trees, landscape, sound, and fresh air. These preferences can be applied when developing forest healing programs for patients with chronic diseases.