We found seventeen dairy cattle with the abnormal signs in cardiovascular and gastrointestinal systems after feeding of the yew foilage. Among them three cattle were dead due to yew poisoning. Among the remaining fourteen dairy cattle, four cattle showed similar symptoms as did dead cattle. Although the remaining ten dairy cattle did not show any abnormal signs, we conducted a therapy of forced magnesium sulfate infusion because the yew consumption might have been occurred in all cattle. As a result of the therapy, we could not found further signs of yew poisoning. The performance of the therapy and the treatment procedures adapted by the therapy could be concluded as follows: The cardioselective toxicity and inhibition of peristaltic activity by the taxine in yew foilage might be involved in the symptoms of acute poisoning as anorexia, dullness, muscle tremor, dyspnea, and sudden death. We also performed the dose response relationship of taxine to the range of clinical symptoms and examined recovery performances. Through the autopsy of the cattle, we could confirm the presence of yew foilages that might have caused the poisoning in the gastrointestinal tract. However, we could not identify further abnormalities in other organs. In this case report, we demonstrated that practice of the forced magnesium sulfate infusion in yew poisoning was helpful for the attenuating the taxine poisoning by blocking the further proceeding of the toxic effect.
Purpose: Familial Mediterranean fever (FMF) is an auto inflammatory disease characterized by periodic fever, synovitis and serositis. Patients may be admitted to gastroenterology units due to gastrointestinal symptoms. In this study; we aimed to analyze endoscopic findings and diagnostic utility of endoscopic procedure in children with FMF. Methods: Patient with FMF that was performed endoscopy for the gastrointestinal symptoms were included to the study (39 of 164 patients, 53 procedure). A control group was randomly designed as age and gender matched four endoscopic procedures per one endoscopic procedure of patients with FMF (n=212). Results: No different was found between the patients and control group in esophagogastroscopy findings. However, the diagnosis of gastrointestinal pathology was made by esophagogastroscopy in 46.2% patients. Colonoscopic examination revealed that the frequency of inflammatory bowel disease (IBD) was higher in undiagnosed patients compared to both the control group (50.0% vs. 6.9%, p<0.05, odds ratio [OR]:13.4 and 95% confidence inteval [95% CI]: 2.1-84.3) and the patients under colchicine treatment (50.0% vs. 8.3%, p<0.05, OR: 11 and 95% CI: 0.8-147.8). Colonoscopic procedure that was made after the diagnosis was found to provide contribution by 16.7% in determining the etiology of the additional symptoms. Conclusion: Patients with FMF may be admitted to pediatric gastroenterology outpatient clinic prior to diagnosis or during the follow-up period. The frequency of IBD is high in undiagnosed patients with FMF. Endoscopic procedures may be helpful in these patients for the diagnosis accompanying mucosal lesions.
Purpose: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study. Methods: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset. Results: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24). Conclusion: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.
Objectives : Functional dyspepsia (FD) is one of the most common gastrointestinal diseases. Nevertheless, there are many unknown mechanisms of autonomic functioning in FD patients. This study was designed to investigate the relationship between FD and biosignals from heart rate variability (HRV) and Yangdorak diagnosis. Methods : 32 patients (22 female, 10 male; mean age 40) and 32 healthy volunteers (21 female, 11 malemean; age 38) participated in this study. First gastrointestinal symptoms rating scale (GSRS) was assessed by questionnaires in both groups to evaluate the types of gastrointestinal symptoms. Second, HRV and Yangdorak diagnosis were measured in both groups. Results : 1. The FD group in this study mainly had the complaint of 'bloating' symptoms. 2. There was statistically no significant difference between Yangdorak (total average and 24 acupoints) and HRV values except logarithmic low-frequency band (lnLF) and total power (TP) in frequency domain. 3. There was statistically no significant relationship between HRV and Yangdorak in either group. However, most Yangdorak values were positively related with some HRV values (low-frequency, low-frequency/high-frequency ratio and high-frequency, etc) in the control group. Conclusions : FD patients had relatively lesser sympathetic domain than healthy subjects, indicated by decreased lnLF and TP. Particularly, there were positive relationships and significant differences between Yangdorak and HRV in young healthy subjects. This suggests that biosignals from HRV may be a useful method that can differentiate FD from healthy state in those of young age.
Gastrointestinal duplications are rare congenital malformation that may require surgical intervention in the neonate, infant, and occasionally the older child. Symptoms produced by duplications vary according to their location, size, type and histology. We report the clinical characteristics and the surgical results of 9 cases of the gastrointestinal duplications treated at at Asan Medical Center between 1989 and 2000. Five patients were boys and four were girls; age of patients ranged from 5 days to 10 years. Eight duplications were cystic and one was tubular. One involved the stomach; five were in the ileum, and two in the cecum. The most common presentation was intestinal obstruction. There was associated anomaly in one patient, pulmonary sequestration and double ureter. Ectopic gastric mucosa was found in two. All patients underwent surgical resection. There was no perioperative mortality or morbidity. Although gastrointestinal duplication is a rare entity. consideration of associated anomalies and being familiar with the anatomy and clinical features are required for adequate management. In cystic form. complete excision is recommended but planned surgery is required for long segment tubular lesion.
The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.
The pathophysiology of functional gastrointestinal disorder(FGID) is not completely understood, but the importance of the 'Brain-Gut Axis(BGA)' model in FGID is being increasingly recognized. The BGA model is a bidirectional, hard-wired and homeostatic relationship between the central nervous system(CNS) and the enteric nervous system(ENS) via neural, neurohormonal and neuroimmunological pathways. In addition, the BGA model would provide a rationale for the use of psychotropics on FGID. The authors experienced two cases in which duloxetine, a serotonin-norepinephrine reuptake inhibitor, was effective in relieving FGID symptoms as well as psychiatric symptoms such as depression and hypochondriacal anxiety. Therefore we discuss the vignettes from the perspective of BGA theory. Duloxetine showed efficacy in these two patients by reducing visceral hypersensivity (bottom-up regulation) and by relieving depression and anxiety(top-down regulation).
Yu, Yun Mi;Choi, Soo An;Lee, Mo Se;Youn, So Jung;Kim, Mi Hye;Choi, Kwang Hoon;Shin, Wan Gyoon
Korean Journal of Clinical Pharmacy
/
v.24
no.1
/
pp.45-52
/
2014
Objective: To evaluate the clinical manifestations and causative drugs of the outpatient adverse drug reactions (ADRs) reported by community pharmacy. Methods: From April 2013 to September 2013, all outpatient ADRs reported by community pharmacy to Regional Pharmacovigilance Center of Korean Pharmaceutical Association were included. The causality of ADRs was assessed by the criteria of WHO-Uppsala Monitoring Centre. The clinical features and the offending drugs were analyzed using the WHO-Adverse Reaction Terminology and the classification of American Hospital Formulary Service Drug Information, respectively. Results: 2,826 (97.0%) of the total 2,912 ADRs had causal relationship. The 1,923 patients with mean age of 55.1 years and female fraction of 66.5% were included in the ADRs. Gastrointestinal (33.6%), nervous system (14.9%), and skin (13.5%) symptoms were common in ADRs. Analgesic drugs (19.7%), gastrointestinal drugs (17.7%), and central nervous system drugs (11.0%) were prevalent offending drugs. The leading causative generic drug was the complex of acetaminophen and tramadol. Among 203 ADRs by the nonprescription drugs, the most common clinical features were skin (37.4%) and gastrointestinal (23.6%) symptoms and the most prevalent offending drugs were analgesic drugs (40.0%) and mucocutaneous system drugs (16.3%). The combination of acetaminophen and chlorzoxazone was the leading causative generic in nonprescription drugs. Conclusion: In this study, gastrointestinal symptom was the most common manifestation and analgesic drug was the most common causative drug in outpatient ADRs reported by community pharmacy.
Choi, Eunsoo;Lee, Hyo Gyun;Choi, Soo Jin Na;Chung, Sang Young
Advances in pediatric surgery
/
v.20
no.1
/
pp.12-16
/
2014
Foreign body ingestion is a common problem among paediatric populations. Most of the ingested foreign bodies spontaneously pass through the gastrointestinal tract, but approximately less then 10% of them remain without being discharged, and trigger complications. Therefore, proper evaluation and treatment according to the situation is required. In this study, clinical progress and complications were analyzed according to the clinical features and treatment in children who ingested foreign bodies. Among pediatric patients under 18 who were admitted to Chonnam National University Hospital after ingesting foreign bodies between January 2008 to June 2012, only the patients who had their foreign body in the gastrointestinal tract were included in this study. Based on medical records, age, type of foreign body, time spent till admission, and whether the endoscopy was done or not, complication were researched retrospectively. According to symptoms and plain abdomen X-ray findings, treatment was chosen and conducted among endoscopy, observation and emergency operation. Among 273 patients, 9 (3.3%) of them had surgical removal. Seven (2.6%) of them had an emergency operation on the day of admission, and the rest 2 (0.7%) had operation during observation. Removal through initial endoscopic approach was tried in 157 (57.5%) patients. Eleven (70.8%) of them had their foreign body removed at the initial trial, and 5 (4.9%) of them at the second trial. Among 109, who were on observation status, 9 (8.3%) of them needed endoscopic removal, and 2 (1.8%) of them suffered from surgical removal. It is thought to be better to approach slowly considering the type, size and symptoms in foreign body ingestion of pediatric patients, rather than immediate and invasive removal.
Objectives : Prevalence of night eating habit associated with substance use and obesity is increasing rapidly in children and adolescents. Further, staying up late and eating snacks late at night were known as leading health risk behaviors for children, suggesting the potential adverse effect of night-eating habit on children. However, only few reports had been issued on the effect of night-eating habit on gastrointestinal symptom and SUI-TAI(水滯) symptom of children. Therefore, we aimed to investigate clinical characteristics of children by night-eating symptom status. Methods : Parents were asked to give a detailed answer to a systemized medical history questionnaire concerning night-eating habit, gastrointestinal symptom and SUI-TAI symptom of their children. Medical records of 28 children treated in the Department of Pediatrics, Hospital of Oriental Medicine, were the subject of this study. Clinical characteristics of two groups of children who with no night-eating habit and frequent night-eating group(eating at night more than 3 times per week) were analysed. In addition, the correlation analysis between clinical characteristics were performed. Results : Children with frequent night-eating habit(n=7, more than 3 days of night-eating a week) were observed to have more aggravated gastrointestinal symptom and SUI-TAI symptom compared with those without night-eating habit(n=13). In parallel, the association of gastrointestinal symptom and SUI-TAI symptom was demonstrated(n=28). Conclusions : It is notable that deranged gastrointestinal function and aggravated SUI-TAI symptom were observed among children generally regarded as healthy. Therefore, endeavors to correct night-eating habit as well as to treat aggravated gastrointestinal and SUI-TAI symptoms are needed for the promotion of health of children.
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