• Title/Summary/Keyword: Gastrointestinal involvement

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A case of esophagitis and perinatal cytomegalovirus infection (주산기 거대세포 (Cytomegalovirus) 식도염 1례)

  • Song, Yoon Jung;Lee, Kil Sang;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.14 no.1
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    • pp.120-123
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    • 2007
  • Congenital and perinatal CMV infection is the most common congenital/perinatal viral infection. Only 5 to 10% of affected patients has symptoms, and outcomes are highly vari-able. Gastrointestinal involvement is not usually a manifestation of congenital and perinatal CMV infection. We describe an infant with vomiting and poor weight gain caused by eso-phagitis attributed to perinatally acquired CMV infection.

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SCHWANNOMA DEVELOPED FROM TRIGEMINAL NERVE (삼차신경에 발생한 신경초종)

  • Lee, Deok-Won;Jee, Yu-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.5
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    • pp.578-581
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    • 2008
  • Schwannoma named neurinoma, peripheral glioma, perineural fibriblastoma and Neurilemmoma is a ectodermal benign neoplasm which originates from schwann cell or neuro axons. It usually develops in peripheral systems of sensory nerves of gastrointestinal tract, oral cavity, and bone. It occurs more frequently in soft tissue than hard tissue, and is extremely rare in intraoral area. We report a case of Schwannoma that showed large mass on buccal cheek with Rt. midfacial swelling, pain, tenderness to palpation and involvement with maxillary branch of trigeminal nerve. We present this case and review the literature.

A Case of Acute Pancreatitis Complicated with Allergic Purpura (Allergic Purpura에 합병된 Acute Pancreatitis 1례)

  • Lee, Sung-Chul;Kim, Hwa-Ja;Tchah, Hann;Park, Ho-Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.1
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    • pp.116-122
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    • 1999
  • Allergic (Henoch-Schonlein) purpura is a nonthrombocytopenic purpura that affects small nonmuscular vessels with involvement of skin, gastrointestinal tract, joint, and kidney. Pancreatitis has rarely been reported as a complication of H-S purpura. In 1965, hemorrhagic pancreatitis as a complication of H-S purpura was reported by Toskin. We experienced one case of pancreatitis complicated with H-S purpura: pancreatic head enlargement was noted in small bowel series and abdominal sonogram with increased serum amylase level (160 U/dL) in a 6-year-old female child who complained of abdominal pain, vomiting, bloody stool, and petechiae on lower extremities.

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Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura (Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견)

  • Choi, Eun Jung;Lee, Chang Woo;Choi, Du Young
    • Clinical and Experimental Pediatrics
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    • v.48 no.1
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    • pp.63-67
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    • 2005
  • Purpose : Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications. Methods : One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(-), GI-Sx(+)) for statistical analysis. Results : The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(+) group had an increased risk of renal involvement and relapse than the GI-Sx(-) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%). Conclusion : GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients.

Experimental Studies on the Effect of Gamibaegi-eum

  • Kim Won-Ill
    • The Journal of Korean Medicine
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    • v.25 no.4
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    • pp.61-78
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    • 2004
  • Objective : This study was undertaken to determine whether Gamibaegi-eum (BGU) in vitro and in vivo exerts a beneficial effect against cell injury induced by reactive oxygen species (ROS) in the human intestine. Methods : Effects of BGU in vitro on cell injury were examined using Caco-2 cells, cultured human intestinal cell line. Exposure of cells to H₂O₂ induced increases in the loss of cell viability in a time and dose-dependent fashion. Results : BGU prevented H₂O₂-induced cell death and its effect was dose-dependent over a concentration range of 0.05­1%. H₂O₂-induced cell death was prevented by catalase, the hydrogen peroxide scavenger enzyme, and deferoxamine, the iron chelator. However, the potent antioxidant DPPD did not affect H₂O₂-induced cell death. H₂O₂ increased lipid peroxidation, which was inhibited by BGU and DPPD. H₂O₂ caused DNA damage in a dose-dependent manner, which was prevented by BGU, catalase, and deferoxamine, but not DPPD. BGU restored ATP depletion induced by H₂O₂. BGU inhibited generation of superoxide and H₂O₂ and scavenged directly H₂O₂. Oral administration of mepirizole in vivo at a dose of 200mg/kg resulted in ulcer lesions in the stomach and the proximal duodenum. Pretreatment of BGU(0.1%/kg, orally) and catalase (800Units/kg, i.v.) significantly decreased the size of ulcers. Mepirizole increased lipid peroxidation in the mucosa of the duodenum, suggesting an involvement of ROS. Pretreatment of BGU and catalase significantly inhibited lipid peroxidation induced by mepirizole. Morphological studies showed that mepirizole treatment causes duodenal injury and its effect is prevented by BGU. Conclusion : These results indicate that BGU exerts a protective effect against cell injury in vitro and in vivo through antioxidant action. The present study suggests that BGU may playa therapeutic role in the treatment of human gastrointestinal diseases mediated by ROS.

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Colon Perforation in Hyperimmunoglobulin E Syndrome - A Case Report - (Hyperimmunoglobulin E 증후군에서의 결장천공 - 증례보고 -)

  • Oh, Jung-Tak;Kim, In-Gyu;Han, Seok-Joo;Kim, Ho-Guen;Hwang, Eui-Ho
    • Advances in pediatric surgery
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    • v.2 no.2
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    • pp.151-155
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    • 1996
  • Hyperimmunoglobulin E syndrome is a relatively rare primary immunodeficiency syndrome characterized by recurrent infection, abscess formation and marked elevation of serum IgE level. The common infectious organism is Staphylococcus aureus and recurrent infection indicates some defects in the immunologic system. Although the infection can affect various organs, gastrointestinal tract involvement is rare and only one case of colon perforation has been previously reproted. Herein we report another one case of colon perforation which ocurred in an 8-year-old girl with hyper immunoglobulin E syndrome. The patient was admitted to the hospital due to an abscess on right neck. The diagnosis of hyper immunoglobulin E syndrome was made because she had eczematoid dermatitis on the face, pneumatocele on left upper lung field and markedly elevated serum IgE level(>15,000 IU/ml) with a past histories of frequent scalp abscesses and otitis media. Abdominal pain developed on the 13th day of admission and abdominal plain X-ray revealed free air. An exploratory laparatomy was performed and two free perforations of the transverse colon were noted. Segmental resection and double barrel colostomy were performed. Colostomy closure was done 4 month later and she had no gastrointestinal problem during a follow up period of 15 months.

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A Case of Protein-losing Enteropathy Treated with High Dose Intravenous Glucocorticoid Therapy in Systemic Lupus Erythematosus (전신성 홍반성 루푸스에서 고용량 경정맥 당질코르티코이드로 치료된 단백질 소실성 장질환 1예)

  • Lee, Kyu-Hyung;Kwon, Chang-Mo;Kim, Hyun-Do;Yun, Dae-Young;Lee, Jae-Yoong;Hong, Yeong-Hoon;Lee, Choong-Ki
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.253-258
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    • 2005
  • Generalized edema and hypoalbuminemia are relatively common presenting manifestations in many clinical situations. The differential diagnosis of hypoalbuminemia include: Kwashiorkor, synthetic dysfunction of the liver, and excessive protein loss as in nephrotic syndrome. In systemic lupus erythematosus (SLE), hypoalbuminemia and generalized edema are most commonly due to protein loss associated with lupus nephritis; gastrointestinal involvement is uncommon, and therefore protein loss through the gastrointestinal tract is quite rare. We report a case of a protein losing enteropathy (PLE) associated with SLE. The patient was referred to our hospital for generalized edema, arthralgia and facial rash. After clinical evaluation, the patient met the criteria for the SLE diagnosis; hypoalbuminemia with general edema was consistent with a protein losing enteropathy. After two weeks of therapy with parenteral high dose glucocorticoid, the patients was improved in laboratory findings as well as clinical symptoms.

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The Mechanism of Action of Ghrelin and Motilin in the Pacemaker Potentials of Interstitial Cells of Cajal from the Murine Small Intestine

  • Kim, Jeong Nam;Kim, Byung Joo
    • Molecules and Cells
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    • v.42 no.6
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    • pp.470-479
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    • 2019
  • Interstitial cells of Cajal (ICCs) are pacemaker cells that exhibit periodic spontaneous depolarization in the gastrointestinal (GI) tract and generate pacemaker potentials. In this study, we investigated the effects of ghrelin and motilin on the pacemaker potentials of ICCs isolated from the mouse small intestine. Using the whole-cell patch-clamp configuration, we demonstrated that ghrelin depolarized pacemaker potentials of cultured ICCs in a dose-dependent manner. The ghrelin receptor antagonist [D-Lys] GHRP-6 completely inhibited this ghrelin-induced depolarization. Intracellular guanosine 5'-diphosphate-${\beta}$-S and pre-treatment with $Ca^{2+}$-free solution or thapsigargin also blocked the ghrelin-induced depolarization. To investigate the involvement of inositol triphosphate ($IP_3$), Rho kinase, and protein kinase C (PKC) in ghrelin-mediated pacemaker potential depolarization of ICCs, we used the $IP_3$ receptor inhibitors 2-aminoethoxydiphenyl borate and xestospongin C, the Rho kinase inhibitor Y-27632, and the PKC inhibitors staurosporine, Go6976, and rottlerin. All inhibitors except rottlerin blocked the ghrelin-induced pacemaker potential depolarization of ICCs. In addition, motilin depolarized the pacemaker potentials of ICCs in a similar dose-dependent manner as ghrelin, and this was also completely inhibited by [D-Lys] GHRP-6. These results suggest that ghrelin induced the pacemaker potential depolarization through the ghrelin receptor in a G protein-, $IP_3$-, Rho kinase-, and PKC-dependent manner via intracellular and extracellular $Ca^{2+}$ regulation. In addition, motilin was able to depolarize the pacemaker potentials of ICCs through the ghrelin receptor. Therefore, ghrelin and its receptor may modulate GI motility by acting on ICCs in the murine small intestine.

MALT Lymphoma of Ocular Adnexa: A Case Report (안구 부속기의 점막연관 림프조직형 림프종의 증례보고)

  • Cho, Jeong Nam;Kim, Yoong Soo;Chung, Chan Min;Suh, In Suck;Cho, Ji Woong;Park, Hye Rim;Choi, Jae Gu
    • Archives of Plastic Surgery
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    • v.35 no.3
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    • pp.321-324
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    • 2008
  • Purpose: Lymphoma originated from mucosa associated lymphoid tissue(MALT) is most common in gastrointestinal system, and rarely found in salivary gland, thyroid, bronchus or orbit. We experienced a case of MALT lymphoma which was originated from conjunctiva and involving lower eyelid without metastasis. Methods: A 40-year-old man suffered palpable mass on right lower eyelid without pain. Orbital computed tomographic and ultrasonographic findings showed a conical mass($1.9{\times}1.2{\times}0.9cm$ size) inside lower eyelid. The mass was completely excised under local anesthesia and histopathological examination was followed. Results: Microscopic finding showed a multiple follicular colonization. In the follicle, small lymphocytes and plasma cells differentiated to centrocyte-like cell, monocyte B cell, plasma cell were diffusely infiltrated. Immunophenotyping was preformed on fixed section. The majority of the small cells were immunoreactive for the B cell marker CD20. Based on the typical histological findings supported by immunostaining, the mass was defined as MALT lymphoma. After excision, SPECT, abdominal CT was carried out and there were no evidence of extraorbital disease. Conclusion: Biopsy and pathological examination should be performed in patients who complain palpable mass on lower eyelid because of possibility of MALT lymphoma. Although MALT lymphoma is rarely metastasized, it is necessary to evaluate the extraorbital involvement using SPECT or other radiologic exams. For detecting extraorbital involvement, periodic follow-up examination is need.

Treatment of Severe Small Bowel Involvement in Henoch-Schönlein Purpura: Two Cases Report (심한 소장침범을 보인 Henoch-Schönlein Purpura의 치료 2례)

  • Kim, Hyung Tae;Moon, Jin Soo;Jang, Hyun Oh;Jo, Heui Seung;Lee, Jong Guk;Kim, Ki Hong;Seo, Jung Wook;Kim, Min Kyung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.78-82
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    • 2004
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a vasculitis of the small vessels in skin, joints, gastrointestinal (GI) tract and kidney. GI symptoms occur in up to 85% of patients and may lead to severe problems such as intussusception, obstruction, and perforation. GI symptoms may not be easily controlled, showing refractoriness to the conventional corticosteroid therapy. Although GI involvements of HSP are acute, and self-limited in most instances, they may cause fatal results in some unusual cases. In such conditions all the possible therapeutic modalities should be considered. We report two cases of severe small bowel involvement of HSP. One case presented with severe abdominal pain showing refractoriness to corticosteroid, but improved with IV immunoglobulin therapy. In the second case, HSP with transmural infarction in the small bowel could be cured with surgical intervention.

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