• 제목/요약/키워드: Hematochezia

검색결과 76건 처리시간 0.028초

헤노호-쉔라인 자반증 (Henoch-Schoenlein purpura)에 합병된 미만성 폐포출혈 1예 (A case of diffuse alveolar hemorrhage associated with Henoch-Schoenlein purpura)

  • 조원경;임채만;이상도;고윤석;김우성;유은실;김동순;김원동
    • Tuberculosis and Respiratory Diseases
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    • 제43권3호
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    • pp.461-466
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    • 1996
  • Diffuse alveolar hemorrhage is a very rare manifestation in Henoch-Schoenlein purpura. Recently we experience a case of diffuse alveolar hemorrhage associated with Henoch-Schoenlein purpura which was diagnosed by typical clinical manifestation and renal biopsy. A 25 year old male was admitted due to hemoptysis and dyspnea. Chest X-ray, HRCT and BAL revealed diffuse alveolar hemorrhage. He also had a history of skin rash, polyarthralgia, and hematochezia with abdominal pain. Renal biopsy which was taken for the evaluation of microscopic hematuria showed IgA nephropathy. Under the diagnosis of Henoch-Schoenlein purpura, we treated him with solumedrol pulse therapy, plasma-pheresis and prednisolone with cytoxan. After then he showed marked improvement in clinical manifestation and was discharged with prednisolone and cytoxan.

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시멘트 경화제 중독으로 인한 급성 신손상 1례 (A Case of Cement Hardening Agent Intoxication with Acute Kidney Injury)

  • 서영우;장태창;김균무;고승현
    • 대한임상독성학회지
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    • 제16권2호
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    • pp.157-160
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    • 2018
  • Chronic silica nephropathy has been associated with tubulointerstitial disease, immune-mediated multisystem disease, chronic kidney disease, and end-stage renal disease. On the other hand, acute intentional exposure is extremely rare. The authors' experienced a 44-year-old man who took rapid cement hardener (sodium silicate) in a suicide attempt whilst in a drunken state. He visited the emergency department approximately 1 hour after ingestion. Information on the material was obtained after 3 L gastric lavage. The patient complained of a sore throat, epigastric pain, and swollen to blood tinged vomitus. Proton pump inhibitors, hemostats, steroid, and fluids were administered. Nine hours after ingestion, he was administered 200 mL hematochezia. Immediately after, a gas-troenterologist performed an endoscopic procedure that revealed diffuse hyperemic mucosa with a color change and variable sized ulceration in the esophagus, whole stomach, and duodenal $2^{nd}$ portion. Approximately 35 hours later, persistent oligouria and progressive worsening of the renal function parameters (BUN/Cr from 12.2/1.2 to 67.5/6.6 mg/dL) occurred requiring hemodialysis. The patient underwent 8 sessions of hemodialysis for 1 month and the BUN/Cr level increased to 143.2/11.2 mg/dL and decreased to 7.6/1.5 mg/dL. He was discharged safely from the hospital. Follow up endoscopy revealed a severe esophageal stricture and he underwent endoscopic bougie dilatation. Acute cement hardener (sodium silicate) intoxication can cause renal failure and strong caustic mucosal injury. Therefore, it is important to consider early hemodialysis and treatment to prevent gastrointestinal injury and remote esophageal stricture.

Anti-inflammatory Effect of the Hedgehog Skin Extracts on LPS-Stimulated RAW 264.7 Cells

  • Kim, Tae Yeon;Jo, Na Young;Leem, Kang Hyun
    • 대한본초학회지
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    • 제33권3호
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    • pp.19-24
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    • 2018
  • Objectives : Hedgehog skin is one of the animal medicines in Traditional Korean Medicine for hematochezia and hemorrhoids. In this study, we examined cytotoxicity and anti-inflammatory effects. Methods : Cytotoxicity of hedgehog skin extracts was measured by MTT assay in vitro. We investigated the inhibition of lipopolysaccharide (LPS) stimulated nitric oxide (NO) production in RAW 264.7 cells. The phosphorylation of mitogen-activated protein kinases (MAPKs) was measured by western blot. And we observed the effect of hedgehog skin extracts on the expression of IL-6 genes using real time PCR. Results : As a result of MTT assay for cytotoxicity, there were no significant differences between non-treatment group and hedgehog skin extracts treatment groups. $500{\mu}g/m{\ell}$ of hedgehog skin extracts treatment significantly decreased nitric oxide production in comparison with non-treatment in LPS-induced RAW 264.7 cells. In measurement of the phosphorylation of MAPKs using western blot analysis, LPS stimulation increased the phosphorylation of MAPKs and $500{\mu}g/m{\ell}$ of hedgehog skin extracts treatment decreased the phosphorylation of ERK1, ERK2 and p38 significantly. But there were no significant differences the phosphorylation of JNK1 and JNK2. As a result of confirmation of the IL-6 mRNA gene expression using real time PCR, IL-6 mRNA gene expressions were significantly decreased in $50{\mu}g/m{\ell}$, $100{\mu}g/m{\ell}$ and $500{\mu}g/m{\ell}$ hedgehog skin extracts treated groups by comparison with non-treatment group. Conclusion : These results could provide a mechanistic explanation for the anti-inflammatory effects of the hedgehog skin.

식품 단백질 유발성 직결장염의 임상 소견과 식이 조절에 관한 연구 (Clinical Features and the Natural History of Dietary Protein Induced Proctocolitis: a Study on the Elimination of Offending Foods from the Maternal Diet)

  • 최선윤;박문호;최원정;강유나;오훈규;감신;황진복
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권1호
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    • pp.21-30
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    • 2005
  • 목 적: 식품 단백질 유발성 직결장염(dietary protein induced proctocolitis, DPIPC)의 임상적 특성과 장기 추적 관찰에 따른 자연 경과 과정을 알아보고, 모유 수유아에서의 어머니 식이 조절에 관한 새로운 방안을 모색하여 보고자 본 연구를 시행하였다. 방 법: 2003년 3월에서 2004년 7월까지 계명의대소아과 외래와 병동을 방문하여 DPIPC로 진단되고 6개월 이상 추적 관찰된 30명을 대상으로 후향적으로 조사되었다. 모유 수유아는 진단 직후 우유를 포함한 유제품, 계란, 견과류 및 콩류, 어패류, 밀가루 및 메밀의 5가지 음식을 어머니의 식단에서 7일간 제거 한 후 혈변의 소실을 관찰하였으며, 분유 수유아, 모유 부족의 경우는 단백가수분해물을 이용하였다. 결 과: 1) DPIPC의 발병 당시 모유 수유아는 28례(93.3%)이었으며, 2례(6.7%)는 분유 수유아였다. 2) 발병 연령은 생후 $11.5{\pm}5.1$ (5~24)주, 진단 연령은 $17.8{\pm}9.5$ (8~56)주이었다. 발병에서 진단까지 $6.3{\pm}6.7$ (0~36)주가 소요되었다. 3) 진단 당시의 말초 혈액 검사상 호산구수가 $250/mm^3$ 이상 증가된 경우가 27례(90.0%)로 $478{\pm}320$ (40~1,790)/$mm^3$으로 관찰되었고, 혈중 IgE가 증가된 경우는 없었다. 알레르기 MAST 검사를 시행한 26례 중 13례(50.0%)에서 양성 반응을 보였다. 4) S상 결장경을 시행한 15례 중 14례(93.3%)가 결절성 비후(nodular hyperplasia)와 미란에 의한 점막 출혈이 함께 관찰되었으며, 1례(6.7%)에서 국소적 발적만 관찰되었다. 5) 어머니 식단에서 5가지 음식을 배제한 27례 중 20례(74.1%)가 혈변이 소실되었으며, 7례(25.9%)에서 지속되었다. 혈변이 사라진 20례에서 5가지 음식을 선호도에 따라 하나씩 식단에 추가하였을 때 18례(90.0%)에서 혈변을 보였으며, 혈변을 보인 식품은 40건으로 중복 관찰되어, 우유 37.5%, 밀가루 27.5%, 어패류 20.0%, 견과류와 계란이 각각 7.5%로 관찰되었다. 6) 어머니 식단이 혈변없이 완전히 자유로워진 때는 관찰된 27례에서 환자 생후 $29.4{\pm}8.7$ (9~44)주이었다. 7) 환자의 식단이 혈변없이 완전히 자유로워진 시기는 관찰된 25례에서 생후 $37.5{\pm}9.7$ (12~56)주였다. 결 론: DPIPC는 일반적으로 알려진 바와 달리 모유 수유아에 집중되고, 호산구의 증가가 높게 관찰되었다. 어머니의 식단 중 5가지 식품을 제거하여 높은 혈변 소실률을 보였으므로 식이 조절의 방안으로 활용될 수 있을 것으로 판단된다. DPIPC는 생후 12개월까지 96.0%에서 완전한 소실이 관찰되었다.

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Differences in Clinical and Laboratory Findings between Group D and Non-Group D Non-Typhoidal Salmonella Gastroenteritis in Children

  • Park, Heung Keun;Rhie, Kyuyol;Yeom, Jung Sook;Park, Ji Sook;Park, Eun Sil;Seo, Ji-Hyun;Lim, Jae Young;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang;Kang, Ki Ryeon;Park, Jung Je
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제18권2호
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    • pp.85-93
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    • 2015
  • Purpose: To investigate the differences in clinical features and laboratory findings between group D and non-group D non-typhoidal Salmonella (NTS) gastroenteritis in children. Methods: A retrospective chart review of children diagnosed with NTS confirmed by culture study was performed. The clinical features and laboratory findings of group D and non-group D NTS were compared. Results: From 2003 to 2012, 75 cases were diagnosed as NTS at our center. The number of group D and non-group D patients was 45 and 30, respectively. The mean age was higher in group D than in non-group D patients (5.1 years vs. 3.4 years, p=0.038). Headaches were more frequently observed (p=0.046) and hematochezia was less frequently observed (p=0.017) in group D than in non-group D NTS gastroenteritis patients. A positive Widal test result was observed in 53.3% of group D and 6.7% of non-group D NTS cases (O-titer, p=0.030; H-titer, p=0.039). There were no differences in white blood cell counts, level of C-reactive protein and rate of antimicrobial resistance between group D and non-group D cases. Conclusion: The more severe clinical features such as headache, fever, and higher Widal titers were found to be indicative of group D NTS gastroenteritis. Additionally, group D NTS gastroenteritis was more commonly found in older patients. Therefore, old age, fever, headache, and a positive Widal test are more indicative of group D NTS than non-group D NTS gastroenteritis. Pathophysiological mechanisms may differ across serologic groups.

대장암(大腸癌)의 동서의(東西醫) 결합(結合) 진치근황(診治近況) (An Outlook of the Oriental and Western Medical Diagnosis and Treatment on Large Bowel Cancer)

  • 김병주;문구
    • 대한한방종양학회지
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    • 제5권1호
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    • pp.1-17
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    • 1999
  • Large bowel cancer shows the 4-5th frequency in cancers that occurs in Korea. The western medicine cures the Large bowel cancer by radiation, surgery and chemotherapy. While, Oriental medicine cures the Large bowel cancer by Herb-drugs, acupuncture, moxa and et al. With just one way of treating Large bowel cancer can't be effective remedy. Because each medicine has a strength and weakness, it is effective treatment when two medicine combines and supplement each other. We got the following result about a trend of oriental and western combination treatment for Large bowel cancer through studding records. 1. In Large bowel cancer, colon cancer is referred hematochezia(腸風下血), rectal cancer is refereed enterotoxin(腸毒), and anal cancer is accumulation of pathogens in yin(結陰). 2. The western medicine treats Large bowel cancer patient with surgery first. They need on assembly treatment such as chemical, radiation and immune treatment. In oriental medicine, they treats Large bowel cancer patients with differentiation of symptom and signs and treatment(辨證施治) for example, insufficiency of spleen and stomach(脾胃虛弱), collapse of the spleen-ql(脾氣下陷), stagnation of blood stasis and toxic agent(瘀毒內結), reinforcing both qi and blood(脾血下陷), stagnation of damp-phlegm(痰濕凝結) and cure for them by acupuncture and moxa too. 3. In combination with oriental and western medical treatment princple of Large bowel cancer by each stage is as follows. First stage is cured with radical surgery and herb-drugs without chemotherapy. The intermediate and terminal stage patients is used radiation before surgery, or after palliative surgery cour with chemotherapy, radiation and Herb-drugs. In terminal stage patients, unable for surgery, is used combination between chemotherapy, palliative radiation and Herb-drugs. 4. After radiation surgery, the terminal stage patients who have extensively lymph node metastasis or local contraindication is able to undergo combination of Herb-durgs and chemotherapy. 5. The cure-effect with oriental and western medicine combination treatment was better than that just with oriental or western medical treatment. 6. The merits of oriental and western medicine combination treatment lengthen one's life and diminish the bad effect of chemotherapy and complete radiation treatment, prevent from relapsing, maintain the balance in their environment of body and improve immunity.

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골수이형성 증후군으로 진단받은 소아에서 발생한 크론병 (Development of Crohn disease in patients with myelodysplastic syndrome : report of two children)

  • 심정옥;서정기;양혜란;고재성;신희영;안효섭;김우선;강경훈
    • Clinical and Experimental Pediatrics
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    • 제49권1호
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    • pp.107-111
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    • 2006
  • 크론병은 매우 드문 질환이나 지난 10년간 발생률이 꾸준히 증가하고 있다. 저자들은 골수 이형성 증후군을 가진 환아에서 크론병이 발병한 2례를 소아에서는 최초로 보고하는 바이다. 첫번째 환아는 3세에 골수 이형성 증후군으로 진단받았고, 수 년간 지속된 반복적인 복통 및 설사, 혈변, 성장 부전이 있어 8세에 크론병으로 진단받았다. 대장 내시경 검사에서는 맹장에서 오름 결장에 걸쳐 조약돌상 점막과 표재성 궤양 및 염증성 삼출이 있었으며, 조직 소견은 궤양 사이에 정상 점막을 포함하고 있으면서 림프구 침윤을 보였다. Mesalazine과 deflazacort로 치료 후 증상은 호전을 보였다. 두 번째 환아는 9세에 골수 이형성증후군으로 진단받았으며, 13세에 반복되는 혈변과 복통, 구토, 발열로 크론병으로 진단받았다. 대장 내시경 검사에서 크고 깊은 경화성 궤양이 회맹판에서 맹장 쪽 주위에서 발견되었다. 이 외의 부위에는 병변이 없어 병변을 절제하였고, 조직은 경벽 염증과 림프구 집합을 동반한 궤양 소견을 보였다. 절제술 후 증상은 호전을 보였다.

A novel herbal formulation consisting of red ginseng extract and Epimedium koreanum Nakai-attenuated dextran sulfate sodium-induced colitis in mice

  • Saba, Evelyn;Lee, Yuan Yee;Kim, Minki;Hyun, Sun-Hee;Park, Chae-Kyu;Son, Eunjung;Kim, Dong-Seon;Kim, Sung-Dae;Rhee, Man Hee
    • Journal of Ginseng Research
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    • 제44권6호
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    • pp.833-842
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    • 2020
  • Background: Ulcerative colitis (UC) is a commonly encountered large intestine disease in the contemporary world that terminates into colorectal cancer; therefore, the timely treatment of UC is of major concern. Panax ginseng Meyer is an extensively consumed herbal commodity in South East Asian countries, especially Korea. It exhibits a wide range of biologically beneficial qualities for almost head-to-toe ailments in the body. Epimedium koreanum Nakai (EKN) is also a widely used traditional Korean herbal medicine used for treating infertility, rheumatism, and cardiovascular diseases. Materials and methods: Separately the anti-inflammatory activities of both red ginseng extracts (RGEs) and EKNs had been demonstrated in the past in various inflammatory models; however, we sought to unravel the anti-inflammatory activities of the combination of these two extracts in dextran sulfate sodium (DSS)-induced ulcerative colitis in mice model because the allopathic remedies for UC involve more side effects than benefits. Results: Our results have shown that the combination of RGE + EKN synergistically alleviated the macroscopic lesions in DSS-induced colitic mice such as colon shortening, hematochezia, and weight loss. Moreover, it restored the histopathological lesions in mice and decreased the levels of proinflammatory mediators and cytokines through the repression of nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP-3) expression. In vitro, this combination also reduced the magnitude of nitric acid (NO), proinflammatory mediators and cytokine through NF-κB and mitogen-activated protein kinase (MAPK) pathways in RAW 264.7 mouse macrophage cells. Conclusion: In the light of these findings, we can endorse this combination extract as a functional food for the prophylactic as well as therapeutic treatment of UC in humans together with allopathic remedies.

Dietary Practices, Addictive Behavior and Bowel Habits and Risk of Early Onset Colorectal Cancer: a Case Control Study

  • Khan, Naveed Ali;Hussain, Mehwish;Rahman, Ata ur;Farooqui, Waqas Ahmed;Rasheed, Abdur;Memon, Amjad Siraj
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권17호
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    • pp.7967-7973
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    • 2015
  • Background: The abrupt rise of colorectal cancer in developing countries is raising concern in healthcare settings. Studies on assessing relationships with modifiable and non-modifiable risk factors in the Pakistani population have been limited. The present investigation was designed to examine associations of dietary practices, addictive behavior and bowel habits in developing colorectal cancer (CRC) among patients in a low-resource setup. Materials and Methods: An age-gender matched case control study was conducted from October 2011 to July 2015 in Karachi, Pakistan. Cases were from the surgical oncology department of a public sector tertiary care hospital, while their two pair-matched controls were recruited from the general population. A structured questionnaire was used which included questions related to demographic characteristics, family history, dietary patterns, addictive behavior and bowel habits. Results: A family history of cancer was associated with a 2.2 fold higher chance of developing CRC. Weight loss reduced the likelihood 7.6 times. Refraining from a high fat diet and consuming more vegetables showed protective effects for CRC. The risk of CRC was more than twice among smokers and those who consumed Asian specific addictive products as compared to those who avoid using these addictions (ORsmoking: 2.12, 95% CI: 1.08 - 4.17, ORpan: 2.92, 95% CI: 1.6 - 5.33, ORgutka: 2.13, 95% CI: 1.14 - 3.97). Use of NSAID attenuated risk of CRC up to 86% (OR: 0.14, 95% CI: 0.07 - 0.31). Conclusions: Most of the findings showed concordance with the literature elucidating protective effects of consuming vegetables and low fat diet while documenting adverse associations with family history, weight loss, constipation and hematochezia. Moreover, this study highlighted Asian specific indigenous addictive products as important factors. Further studies are needed to validate the findings produced by this research.

궤양성 대장염에서 나타난 폐쇄성 세기관지염 기질화 폐렴 1예 (A Case of Bronchilolitis Obliterans Organizing Pneumonia in a Patient with Ulcerative Colitis)

  • 이현정;박병훈;손지영;정지예;황세나;전영은;김은영;임주은;이경종;윤여운;김영삼;김세규;장준;심효섭;조상호;박무석
    • Tuberculosis and Respiratory Diseases
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    • 제68권3호
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    • pp.175-179
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    • 2010
  • The ulcerative colitis is a chronic inflammatory bowel disease with an unknown etiology. The major symptoms of ulcerative colitis are diarrhea, abdominal pain and hematochezia. However, arthritis, skin disorders, hepatobiliary inflammation and uveitis are occasionally recognized as systemic complications. Although there are few reports of coexistent pulmonary and inflammatory bowel disease, the lung is not generally considered to be a target organ in ulcerative colitis. We report a patient with ulcerative colitis-related bronchilolitis obliterans organizing pneumonia confirmed by video-assisted thoracoscopic surgery, who responded to corticosteroid therapy.