• 제목/요약/키워드: Gastrointestinal involvement

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The Medical Treatments of Intestinal Behçet's Disease: An Update

  • Lee, Hye Won;Kim, Won Ho;Cheon, Jae Hee
    • Intestinal research
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    • 제11권3호
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    • pp.155-160
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    • 2013
  • Behçet's disease (BD) is a systemic immunological disorder characterized by recurrent mucosal ulcerative lesions including oral and genital ulcerations in association with skin and ocular involvements. BD also can involve the gastrointestinal tract. Gastrointestinal involvement of BD is one of the major causes of morbidity and mortality for this disease. However, clinical data are quite limited because of the rarity of intestinal BD. Therefore, the management of intestinal BD is heavily dependent on expert opinions and standardized medical treatments of intestinal BD are yet to be established. In this brief review, the authors summarized the currently available medical treatments such as 5-aminosalicylic acids, corticosteroids, immuno-modulators, and anti-TNF agents. Moreover, we sought to suggest a treatment algorithm for intestinal BD based on the recently published and updated data.

Evaluation and Treatment of Malnutrition and Associated Gastrointestinal Complications in Children with Cerebral Palsy

  • Trivic, Ivana;Hojsak, Iva
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권2호
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    • pp.122-131
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    • 2019
  • The majority of children with cerebral palsy (CP) have feeding difficulties and are especially prone to malnutrition. The early involvement of a multidisciplinary team should aim to prevent malnutrition and provide adequate nutritional support. Thorough nutritional assessment, including body composition, should be a prerequisite for the nutritional intervention. As in typically-developed children nutritional support should start with dietary advice and the modification of oral feeding, if safe and acceptable. However, for prolonged feeding, in the presence of unsafe swallowing and inadequate oral intake, enteral nutrition should be promptly initiated and early gastrostomy placement should be evaluated and discussed with parents/caregivers. Gastrointestinal problems (oropharyngeal dysfunction, gastroesophageal disease, and constipation) in children with CP are frequent and should be actively detected and adequately treated as they can further worsen the feeding process and nutritional status.

소아 베체트 병에서 발생된 복부 천공 1예 (Multiple Intestinal Perforations in a Child with Behcet's Disease)

  • 최금옥;고홍;정기섭
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제11권1호
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    • pp.80-83
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    • 2008
  • 소아 베체트병은 상당히 드문 질환으로 전체 베체트병의 약 2~3%에 해당한다. 이 중 장 점막과 관련된 경우는 2~50%까지 다양하게 보고되나, 대부분이 40~50대 성인에서 보고되는 내용이며 소아 베체트병 환자에서 장 천공이 보고된 증례는 극히 드물다. 본 증례는 4년 9개월된 남아로, 베체트병을 진단받은 후 약물 치료하며 추적 관찰 중, 지속되는 복통이 있어 시행한 대장 내시경상에 다발성 장점막 궤양이 관찰되었고, 이후 스테로이드 용량 감량하며 경과 관찰하던 중 장 천공이 발생하여 수술한 1예를 경험하였기에 보고하는 바이다.

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간문 주위 림프절병증으로 발현된 아밀로이드증 1예 (A Case of Amyloidosis Presenting as Lymphadenopathy at the Porta Hepatis)

  • 이자인;김준성;김병욱
    • 대한상부위장관⦁헬리코박터학회지
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    • 제18권3호
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    • pp.209-212
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    • 2018
  • We report a rare case of systemic amyloidosis with gastrointestinal and lymph node involvement. A 64-year-old woman was admitted to our hospital with dyspepsia and weight loss. Initial esophagogastroduodenoscopy (EGD) revealed nonspecific findings, and abdominal computed tomography showed necrotizing lymphadenopathy at the porta hepatis. Laparoscopic lymph node biopsy was performed under suspicion of tuberculous lymphadenopathy, but a definite diagnosis was not established. Follow-up EGD performed 6 months later revealed multiple telangiectasia-like lesions at the gastric body, and endoscopic biopsy revealed amyloid deposition. Through additional blood and urine protein electrophoresis, the patient was finally diagnosed with systemic amyloidosis associated with multiple myeloma. She was treated with dexamethasone, thalidomide, and bortezomib; however, she died 3 months after diagnosis because of pneumonia and multiple organ failure.

Extranodal Malignant Lymphoma Concurrent Involving Female Urethra and Cervix: a Case Report

  • Kim, Dong Chan;Kim, You Me
    • Investigative Magnetic Resonance Imaging
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    • 제24권3호
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    • pp.168-173
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    • 2020
  • Extranodal lymphoma presents in almost one-third of all non-Hodgkin lymphoma cases. The gastrointestinal tract, skin, and central nervous system are common sites of involvement, whereas the urethra and cervix are very rare. To the best of our knowledge, this is the first report on concurrent extranodal involvement of the uterine cervix and urethra. We report imaging findings of malignant lymphoma involving urethra and cervix concurrently in a 79-year-old female patient with literature review. The magnetic resonance imaging showed huge intermediate to high signal intensity mass on T2 weighted images and strong homogeneous enhancement in uterine cervix and periurethral area, but no surrounding architectural disruption.

Diffuse large B-cell lymphoma presenting as transverse myelitis

  • Zukhriddin, Urchiyev;Kang, Jin-Ju;Jeong, Myoung-Ja;Oh, Sun-Young
    • Annals of Clinical Neurophysiology
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    • 제24권2호
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    • pp.79-83
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    • 2022
  • Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma. Although progressive lymphadenopathy is a typical feature, extranodal involvement may also occur, including the gastrointestinal tract, skin, bone, thyroid, and testes. Central nervous system invasion is rare, so differentiating it from diseases such as inflammatory demyelinating disorder or infection is essential. DLBCL is therefore a challenge to diagnose, especially when the first findings are neurological symptoms. We report an unusual case of DLBCL that presented as transverse myelitis.

Gallstone Etiopathogenesis, Lith and Mucin Genes and New Treatment Approaches

  • Goral, Vedat
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.467-471
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    • 2016
  • Gallstones constitute one of the more common and relatively costly conditions of the gastrointestinal system and are a major risk factor for gallbladder cancer. Most gallstone cases involve individuals younger than 60 years of age, those older representing 9% of the total in one series. There are many risk factors for gallstones and Lith and Mucin genes, for example, play important roles in their formation. Surgery is one therapeutic approach but in the future it is to be expected that drugs for prevention of gallstones will be developed in the future. This will have clear implications for gallbladder cancer control.

제2기 위암에서 3 Subgroup간의 비교 분석 (Comparative Analysis of Three Subgroups in Stage II Stomach Cancer)

  • 서병선;김병식;김용호;육정환;오성태;김완수;박건춘
    • Journal of Gastric Cancer
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    • 제1권1호
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    • pp.32-37
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    • 2001
  • Purpose: Three subgroups of stage II stomach cancer (T1N2M0, T2N1M0, T3N0M0) by UICC-TNM staging system show obvious survival difference to each other, which becomes the pitfall of the current staging system. We analyzed the survival and relapse pattern of stage II stomach cancer patients in three subgroups retrospectively to prove the need for change in staging system. Materials and Methods: From July 1989 to December 1995, curative gastric resection was performed in 1,037 patients with gastric adenocarcinoma, and among them 268 patients ($26\%$) were in stage II. The number in each of subgroups (T1N2M0, T2N1M0, and T3N0M0) were 17, 139 and 112 respectively. Survival and relapse pattern were analyzed and median follow up period was 46 months. Results: The 3-year cumulative survival rates of T1N2M0, T2N1M0, and T3N0M0 were $50\%,\;80\%,\;and\;76\%$ respectively (p=0.001). And the 3-year cumulative survival rates of T1N2M0 was comparable to those of 2 subgroups of stage IIIa (T2N2M0, T3N1M0), $47\%\;and\;45\%$ (p>0.05). Peritoneal recurrence was the most frequent in T3N0M0. And hematogenous spread was more frequent in T2N1M0 while nodal spread was more frequent in T1N2M0. Ten out of 17 cases of T1N2M0 died of recurrence. Most of them showed submucosal tumor with depressed lesion and mean tumor size was 3.3 cm. Conclusions: Up-staging of T1N2M0 should be considered because it has the lowest survival rate and the worst prognosis among the three subgroups of Stage II stomach cancer patients. In early gastric cancer patients with high-risk factors (large tumor size, invasion into the submucosal layer, and lymphatic vessel involvement), lymph node dissection and postoperative adjuvant therapy is recommended in an attempt to prevent recurrence in the form of lymph node metastasis.

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Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management

  • Lee, Yong Hee;Kim, Yu Bin;Koo, Ja Wook;Chung, Ju-Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제19권3호
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    • pp.175-185
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    • 2016
  • Purpose: To investigate the epidemiology, clinical manifestations, investigations and management, and prognosis of patients with Henoch-Schonlein purpura (HSP). Methods: We performed a retrospective review of 212 HSP patients under the age of 18 years who were admitted to Inje University Sanggye Paik Hospital between 2004 and 2015. Results: The mean age of the HSP patients was 6.93 years, and the ratio of boys to girls was 1.23:1. HSP occurred most frequently in the winter (33.0%) and least frequently in the summer (11.3%). Palpable purpura spots were found in 208 patients (98.1%), and gastrointestinal (GI) and joint symptoms were observed in 159 (75.0%) and 148 (69.8%) patients, respectively. There were 57 patients (26.9%) with renal involvement and 10 patients (4.7%) with nephrotic syndrome. The incidence of renal involvement and nephrotic syndrome was significantly higher in patients with severe GI symptoms and in those over 7 years old. The majority of patients (88.7%) were treated with steroids. There was no significant difference in the incidence of renal involvement or nephrotic syndrome among patients receiving different doses of steroids. Conclusion: In this study, the epidemiologic features of HSP in children were similar to those described in previous studies, but GI and joint symptoms manifested more frequently. It is essential to carefully monitor renal involvement and progression to chronic renal disease in patients ${\geq}7$ years old and in patients affected by severe GI symptoms. It can be assumed that there is no direct association between early doses of steroids and prognosis.

Involvement of D2 Receptor on Dopamine-induced Action in Interstitial Cells of Cajal from Mouse Colonic Intestine

  • Zuoa, Dong Chuan;Shahia, Pawan Kumar;Choia, Seok;Jun, Jae-Yeoul;Park, Jong-Seong
    • 대한의생명과학회지
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    • 제18권3호
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    • pp.218-226
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    • 2012
  • Dopamine is an enteric neurotransmitter that regulates gastrointestinal motility. This study was done to investigate whether dopamine modulates spontaneous pacemaker activity in cultured interstitial cells of Cajal (ICCs) from mouse using whole cell patch clamp technique, RT-PCR and live $Ca^{2+}$ imaging analysis. ICCs generate pacemaker inward currents at a holding potential of -70 mV and generate pacemaker potentials in current-clamp mode. Dopamine did not change the frequency and amplitude of pacemaker activity in small intestinal ICCs. On the contrary dopamine reduced the frequency and amplitude of pacemaker activity in large intestinal ICCs. RT-PCR analysis revealed that Dopamine2 and 4-receptors are expressed in c-Kit positive ICCs. Dopamine2 and 4 receptor agonists inhibited pacemaker activity in large intestinal ICCs mimicked those of dopamine. Domperidone, dopamine2 receptor antagonist, increased the frequency of pacemaker activity of large intestinal ICCs. In $Ca^{2+}$-imaging, dopamine inhibited spontaneous intracellular $Ca^{2+}$ oscillations of ICCs. These results suggest that dopamine can regulate gastrointestinal motility through modulating pacemaker activity of large intestinal ICCs and dopamine effects on ICCs are mediated by dopamine2 receptor and intracellular $Ca^{2+}$ modulation.