• Clinical Endoscopy
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• v.56 no.5
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• pp.563-577
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• 2023

In inflammatory bowel disease (IBD), chronic inflammation leads to unfavorable clinical outcomes and increases the risk of developing colorectal neoplasm (CRN); thereby highlighting the importance of endoscopically evaluating disease activity as well as detecting and characterizing CRN in patients with IBD. With recent advances in image-enhanced endoscopic (IEE) technologies, especially virtual chromoendoscopy (VCE) platforms, this review discusses state-of-the-art IEE techniques and their applicability in assessing disease activity and surveillance colonoscopy in patients with IBD. Among various IEE, VCE demonstrated the capacity to identify quiescent disease activity. And endoscopic remission defined by the new scoring system using VCE platform better predicted clinical outcomes, which may benefit the tailoring of therapeutic strategies in patients with IBD. High-definition dye-chromoendoscopy (HD-DCE) is numerically superior to high-definition white light endoscopy (HD-WLE) in detecting CRN in IBD; however, discrepancy is observed in the statistical significance. VCE showed comparable performance in detecting dysplasia to HD-WLE or DCE and potential for optical diagnosis to differentiate neoplastic from nonneoplastic lesions during surveillance colonoscopy. Applying these novel advanced IEE technologies would provide opportunities for personalized medicine in IBD and optimal treatment of CRN in patients with IBD.

• Journal of Bone Metabolism
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• v.25 no.4
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• pp.213-217
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• 2018

Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the postgastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.

• Korean Journal of Microbiology
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• v.50 no.4
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• pp.265-274
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• 2014

Gut microbiota is a group of microorganisms that resides in the intestine and serves many important functions in human health. Using 16S ribosomal RNA sequencing analysis, a wide variety of bacteria in human gastrointestinal tract has been identified along with intriguing findings that there is a different bacterial composition among individuals. Fecal microbiota transplantation (FMT) is a procedure of stool transplantation from healthy donors to patients suffering from various diseases. Specifically, FMT is able to alter the composition of gut microbiota of recipients and therefore could be an effective treatment for the patients with gastrointestinal diseases including recurrent Clostridium difficile infection, inflammatory bowel disease, and irritable bowel syndrome. Here we review a list of human diseases related to gut microbiota disturbance and the case studies of FMT. We also summarize medicines and diagnostic tools that are under development. Therefore, gut microbiota can be a next generation's biotherapy for promotion of health and treatment of chronic diseases.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.1
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• pp.11-19
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• 2018

The gut microbiome has been studied extensively over the past decade with most scientific reports focused on the adverse role of the gut microbiome on gastrointestinal diseases. For example, the altered gut microbiome exacerbates the development of immune system-mediated damage in many diseases. The most studied pathologies include irritable bowel syndrome, inflammatory bowel diseases, and colitis-associated cancer. On the other hand, intestinal microflora is also beneficial and contributes to the intestinal physiology by the synthesis of vitamins, production of short chain fatty acids and bile acid metabolism, thereby maintaining gut homeostasis. Therefore, the balance between commensal and pathogenic bacteria populations influences mainly the maintenance of intestinal health. Changes in the intestinal microflora have been suspected to be the underlying causes of multiple diseases. Despite the immense amount of published data, the optimal gut microbiome composition is still controversial. This review briefly outlines the connection between the gut microbiome and critical gastrointestinal diseases focusing on three prominent intestinal disorders: irritable bowel syndrome, inflammatory bowel diseases, and colitis-associated cancer disorders. Finally, intervention strategies using natural products for the alleviation of these diseases and the maintenance of a health gut microbiome are suggested.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.5
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• pp.439-446
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• 2020

Purpose: The evidence for an association between inflammatory bowel disease (IBD) and obesity is conflicting. Therefore, we set out to review the body mass index (BMI) at presentation of IBD to understand if the rise of the obesity rate in the general population, lead to an increase of obesity in patients with IBD at the time of diagnosis. Methods: Retrospective review of all patients with IBD seen at Children's Hospital and Medical Center from January 1st 2010 to December 31st 2014. From the initial visit and endoscopy, we obtained: age; sex; BMI; disease phenotype; disease severity. Results: We had a total of 95 patients, 35 patients were excluded due to incomplete data or referral being made after diagnosis was made. 28 were males and 32 were females, Age range was 2-17 years. A 37 had Crohn's disease, 19 ulcerative colitis, and 4 indeterminate colitis. Disease severity in 19 cases was mild, 29 moderate and 12 severe. BMI distribution was as follows-obese (5.0%), overweight (6.7%), normal weight (65.0%), mild malnutrition (8.3%), moderate malnutrition (15.0%), severe malnutrition (1.7%). Conclusion: Our data is consistent with other series. Showing most children had a normal BMI, regardless of disease severity or phenotypes. One confounding factor is the possibility of delay in referral to GI. This could mean some obese children may fall in the normal BMI range at the time of diagnosis due to ongoing weight loss. Future studies should include prospective cohort studies, comparing incidence of IBD in obese and non-obese patients, severity at presentation, duration of symptoms, and clinical outcomes.

• Pediatric Infection and Vaccine
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• v.29 no.2
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• pp.96-104
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• 2022

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory bone disorder presenting with sterile osteomyelitis, most often presenting in childhood. Although the etiology is understood incompletely, its association with other auto-inflammatory diseases including inflammatory bowel disease (IBD); psoriasis; Wegener's disease; arthritis; and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome suggests that dysregulated innate immunity may play an important role in the pathogenesis. We report a case of a 13-year-old boy with CRMO associated with Crohn's disease (CD) successfully treated with infliximab after failure of non-steroidal anti-inflammatory drug (NSAID) treatment. He initially was diagnosed with CRMO based on symmetric and aseptic bone lesions with no fever, lack of response to antibiotic treatment, vertebral involvement, and normal blood cell counts. Despite five months of NSAID treatment, his musculoskeletal symptoms were aggravated, and he developed gastrointestinal symptoms. Finally, he was diagnosed with CRMO associated with CD. Due to the severity of symptoms, infliximab was initiated and produced symptom improvement. This case supports infliximab as another choice for treatment of bowel symptoms in addition to the bone and joint symptoms of CRMO when other first-line treatments are ineffective.

• CELLMED
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• v.6 no.3
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• pp.16.1-16.5
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• 2016

Thymic stromal lymphopoietin (TSLP) is a novel interleukin (IL)-7-like cytokine and was originally discovered in the supernatant of a murine thymic stromal cell line. TSLP signal initiates via complex of the TSLP receptor and the IL-7 receptor α chain. TSLP expression is closely connected with many diseases such as atopic dermatitis, allergic rhinitis, asthma, inflammatory arthritis, eosinophilic esophagitis, rheumatoid arthritis, inflammatory bowel diseases, and cancer. In this review, I discussed biological roles of TSLP on mast cell-mediated allergic responses. In addition, this review summarizes the effective drugs in allergic-inflammatory reactions induced by TSLP on mast cells.

• Journal of Korean Medical classics
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• v.36 no.4
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• pp.69-91
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• 2023

Objectives : This study investigates the association between disease behind the Beijing Epidemic of 1232 and fever causing internal damages as mentioned in the Neiwaishang Bianhuolun. Methods : In order to narrow the fever causing diseases in the Neiwaishang Bianhuolun, the retrospective diagnostic method was used in analysis. Disease behind the 1232 Beijing Epidemic and the fever causing internal damages were categorized. Results : Fever causing diseases in the Neiwaishang Bianhuolun could be categorized as infectious disease, inflammatory disease, irritable bowel syndrome, and fever of unknown origin. The Beijing Epidemic was limited in scale with high fatality, of which possible diseases include infectious disease and inflammatory disease with epidemic medium. Fever from internal damage has a mild prognosis, is non-epidemic, and lacks accompanying symptoms such as acute stomachache, even when it happens with external damage. This narrows the possible diseases to IBS and fever of unknown origin. Conclusions : Among internal damage fever cases treated by Li Dongyuan, there were infectious diseases from the 1232 epidemic and inflammatory diseases with mild prognosis.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.286-291
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• 2015

Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.1
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• pp.14-21
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• 2017

Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients. Surgery can affect a patient's clinical course, especially for pediatric CD patient who are growing physically and mentally, so the decision should be made by careful consideration of several factors. The complex and diverse clinical conditions hinder development of a systemized treatment algorithm. Therefore, timing of surgery in pediatric CD patients should be determined with individualized approach by an experienced and well organized multidisciplinary inflammatory bowel disease team. Best long-term outcomes will require proactive post-operative monitoring and therapeutic modifications according to the conditions.