• Title/Summary/Keyword: Intestinal disease

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Anti-Tumor Necrosis Factor Therapy in Intestinal Behçet's Disease

  • Park, Jihye;Cheon, Jae Hee
    • Gut and Liver
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    • v.12 no.6
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    • pp.623-632
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    • 2018
  • Intestinal Behçet's disease is a rare, immune-mediated chronic intestinal inflammatory disease; therefore, clinical trials to optimize the management and treatment of patients are scarce. Moreover, intestinal Behçet's disease is difficult to treat and often requires surgery because of the failure of conventional medical treatment. Administration of anti-tumor necrosis factor-${\alpha}$, a potential therapeutic strategy, is currently under active clinical investigation, and evidence of its effectiveness for both intestinal Behçet's disease and inflammatory bowel diseases has been accumulating. Here, we review updated data on current experiences and outcomes after the administration of anti-tumor necrosis factor-${\alpha}$ for the treatment of intestinal Behçet's disease. In addition to infliximab and adalimumab, which are the most commonly used agents, we describe agents such as golimumab, etanercept, and certolizumab pegol, which have recently been shown to be effective in refractory intestinal Behçet's disease. This review also discusses safety issues associated with anti-tumor necrosis factor-${\alpha}$, including vulnerability to infections and malignancy.

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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    • v.11 no.3
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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.

Hirschsprung's Disease Associated with Neonatal Intestinal Perforation (장 천공을 동반한 Hirschsprung씨 병 3예 보고)

  • Kim, Seong-Chul;Sea, Byong-Sun;Liu, Shan King;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.1 no.2
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    • pp.186-189
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    • 1995
  • Neonatal intestinal perforation is mainly caused by necrotizing enterocolitis, intestinal atresia, meconium ileus or unknown etiology. Occasionally, Hirschsprung's disease presents with neonatal intestinal perforation, of which, it is known that total colonic aganglionosis is common. Therefore, Hirschsprung's disease should be considered as a cause of neonatal intestinal perforation. The authors have experienced 3 cases of neonatal Hirschsprung's disease associated with colonic perforations. Cecal perforations were noted in 2 cases with aganglionosis from descending colon and sigmoid perforation in a case with aganglionosis in rectum. These cases will be discussed with literature review.

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Evaluation of porcine intestinal organoids as an in vitro model for mammalian orthoreovirus 3 infection

  • Se-A Lee;Hye Jeong Lee;Na-Yeon Gu;Yu-Ri Park;Eun-Ju Kim;Seok-Jin Kang;Bang-Hun Hyun;Dong-Kun Yang
    • Journal of Veterinary Science
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    • v.24 no.4
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    • pp.53.1-53.12
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    • 2023
  • Background: Mammalian orthoreovirus type 3 (MRV3), which is responsible for gastroenteritis in many mammalian species including pigs, has been isolated from piglets with severe diarrhea. However, the use of pig-derived cells as an infection model for swine-MRV3 has rarely been studied. Objectives: This study aims to establish porcine intestinal organoids (PIOs) and examine their susceptibility as an in vitro model for intestinal MRV3 infection. Methods: PIOs were isolated and established from the jejunum of a miniature pig. Established PIOs were characterized using polymerase chain reaction (PCR) and immunofluorescence assays (IFAs) to confirm the expression of small intestine-specific genes and proteins, such as Lgr5, LYZI, Mucin-2, ChgA, and Villin. The monolayered PIOs and three-dimensional (3D) PIOs, obtained through their distribution to expose the apical surface, were infected with MRV3 for 2 h, washed with Dulbecco's phosphate-buffered saline, and observed. Viral infection was confirmed using PCR and IFA. We performed quantitative real-time reverse transcription-PCR to assess changes in viral copy numbers and gene expressions linked to intestinal epithelial genes and antiviral activity. Results: The established PIOs have molecular characteristics of intestinal organoids. Infected PIOs showed delayed proliferation with disruption of structures. In addition, infection with MRV3 altered the gene expression linked to intestinal epithelial cells and antiviral activity, and these effects were observed in both 2D and 3D models. Furthermore, viral copy numbers in the supernatant of both models increased in a time-dependent manner. Conclusions: We suggest that PIOs can be an in vitro model to study the infection mechanism of MRV3 in detail, facilitating pharmaceutical development.

Intestinal Parasite Infections among Inhabitants in Yanbian Prefecture, Jilin Province, China

  • Lee, Myoung-Ro;Shin, Hee-Eun;Chung, Byung-Suk;Lee, Sang-Eun;Ju, Jung-Won;Xu, Liji;Nan, Chen Long;Park, Mi-Yeoun;Cho, Shin-Hyeong
    • Parasites, Hosts and Diseases
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    • v.55 no.5
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    • pp.579-582
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    • 2017
  • To investigate the prevalence of intestinal parasite infections in Yanbian Prefecture, Jilin Province, China, epidemiological surveys were conducted on a collaboration basis between the Korean Centers for Disease Control and Prevention and the Yanbian Center for Disease Control and Prevention. A total of 8,396 (males 3,737 and females 4,659) stool samples were collected from 8 localities and examined with the formalin-ether sedimentation technique, and additionally examined with the cellotape anal swab to detect Enterobius vermicularis eggs. The overall rate of intestinal parasites was 1.57%. The prevalence of Ascaris lumbricoides was the highest (0.80%), followed by Entamoeba spp. (0.23%), heterophyid flukes (0.15%), Clonorchis sinensis (0.08%), Enterobius vermicularis (0.07%), hookworms (0.06%), Trichostrongylus spp. (0.06%), Giardia lamblia (0.04%), Paragonimus spp. (0.02%), Diphyllobothrium spp. (0.02%), Trichuris trichiura (0.02%). The prevalence by sex was similar, 1.58% (n=59) in males and 1.57% (n=73) in females. By the present study, it is partly revealed that the prevalences of intestinal parasite infections are relatively low among the inhabitants of Yanbian Prefecture, Jilin Province, China.

Behcet's Disease with the Left Carotid Artery Aneurysm and Colon Perforation (좌측 경동맥류와 대장천공을 동반한 베체트병)

  • 전준경;장원채;최용선;오봉석
    • Journal of Chest Surgery
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    • v.37 no.3
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    • pp.279-281
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    • 2004
  • Behest's disease is manifested as ulcers present in oral cavity, on external genital organ, orbital area, and skin. This disease could also cause other symptoms by invading the cardiovascular system, respiratory system, gastrointestinal system, central nervous system, and urogenital system. It is very rare for Behcet's disease to be accompanied by carotid artery aneurysm and intestinal perforation. We report a patient with Behcet's disease, who is diagnosed with symptoms and pathological findings as haying carotid artery aneurysm and intestinal perforation at the same time. The patient underwent operation for the aneurysm and the intestinal perforation.

Waardenburg Syndrome Type IV De Novo SOX10 Variant Causing Chronic Intestinal Pseudo-Obstruction

  • Hogan, Anthony R.;Rao, Krishnamurti A.;Thorson, Willa L.;Neville, Holly L.;Sola, Juan E.;Perez, Eduardo A.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.5
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    • pp.487-492
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    • 2019
  • Waardenburg syndrome (WS) type IV is characterized by pigmentary abnormalities, deafness and Hirschsprung's disease. This syndrome can be triggered by dysregulation of the SOX10 gene, which belongs to the SOX (SRY-related high-mobility group-box) family of genes. We discuss the first known case of a SOX10 frameshift mutation variant defined as c.895delC causing WS type IV without Hirschsprung's disease. This female patient of unrelated Kuwaiti parents, who tested negative for cystic fibrosis and Hirschsprung's disease, was born with meconium ileus and malrotation and had multiple surgical complications likely due to chronic intestinal pseudo-obstruction. These complications included small intestinal necrosis requiring resection, development of a spontaneous fistula between the duodenum and jejunum after being left in discontinuity, and short gut syndrome. This case and previously reported cases demonstrate that SOX10 gene sequencing is a consideration in WS patients without aganglionosis but with intestinal dysfunction.

Comparison of small bowel findings using capsule endoscopy between Crohn's disease and intestinal tuberculosis in Korea

  • Kim, Yong Gil;Kim, Kyung-Jo;Min, Young-Ki
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.98-105
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    • 2020
  • Background: Little is known about capsule endoscopy (CE) findings in patients with intestinal tuberculosis who exhibit small bowel lesions. The aim of the present study was to distinguish between Crohn's disease (CD) and intestinal tuberculosis based on CE findings. Methods: Findings from 55 patients, who underwent CE using PillCam SB CE (Given Imaging, Yoqneam, Israel) between February 2003 and June 2015, were retrospectively analyzed. Results: CE revealed small bowel lesions in 35 of the 55 patients: 19 with CD and 16 with intestinal tuberculosis. The median age at diagnosis for patients with CD was 26 years and 36 years for those with intestinal tuberculosis. On CE, three parameters, ≥10 ulcers, >3 involved segments and aphthous ulcers, were more common in patients with CD than in those intestinal tuberculosis. Cobblestoning was observed in five patients with CD and in none with intestinal tuberculosis. The authors hypothesized that a diagnosis of small bowel CD could be made when the number of parameters in CD patients was higher than that for intestinal tuberculosis. The authors calculated that the diagnosis of either CD or intestinal tuberculosis would have been made in 34 of the 35 patients (97%). Conclusion: The number of ulcers and involved segments, and the presence of aphthous ulcers, were significantly higher and more common, respectively, in patients with CD than in those with intestinal tuberculosis. Cobblestoning in the small bowel may highly favor a diagnosis of CD on CE.

Cathepsin D Expression in Intestinal Ganglion Cells of Neonate (신생아 장 신경절세포에서 cathepsin D 발현)

  • Kim, Dae-Yeon;Lee, Seong-Cheol;Park, Kwi-Won;Kim, Woo-Ki
    • Advances in pediatric surgery
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    • v.5 no.1
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    • pp.39-44
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    • 1999
  • Diagnosing Hirschprung's disease is one of the clinical challenges of this disorder. In the stomach and the intestines, Cathepsin D was readily detected in cytoplasm of the rat gastric and in intestinal ganglion cells of the autonomic nervous system. The objectives of the present study were to examine cathepsin D expression in ganglion cells of the submucosal and myenteric plexuses of the intestine of children and to determine the utility of immunohistochemical staining of cathepsin D for detection of immature ganglion cells. Paraffin blocks of 35 intestinal segments were reviewed for immunohistochemical staining with polyclonal antibody to cathepsin D and hematoxylineosin stainings from the compatible specimens. There were 9 aganglionic segments and 9 ganglionic segments of neonates with Hirschsprung's disease, 8 intestinal segments with non-Hirschsprung's disease in neonates and 9 intestinal segments with non-Hirschsprung's disease infants over the age of 10 months. All ganglion cells showed intense granular cytoplasmic reactivity for cathepsin D regardless of maturity and all aganglionic segments had no expression for cathepsin D in the submucosal and myenteric plexuses of the intestine. However, histiocytes within the laminar propria and submucosa stained positively for cathepsin D. In conclusion, intestinal ganglion cells in children have reactivity for cathepsin D, threrfore immunohistochemical staining for cathepsin D can be used for identification of ganglion cells in neonates.

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

  • Choi, Kum-Ok;Koh, Hong;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.80-83
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    • 2008
  • Behcet's disease (BD) is a multisystem inflammatory disorder dominated clinically by recurrent oral and genital ulceration, uveitis and erythema nodosum. BD is very rare in children, especially those less than 10 years of age, who account for only an estimated 5% of all cases. Gastrointestinal ulcers, in patients with Behcet's disease with intestinal involvement are rare and have been reported in only 1-2% of all cases. The intestinal ulcers of Behcet's disease are usually multiple and scattered and tend to cause perforations associated with significant morbidity. Patients with BD and abdominal symptoms must be evaluated thoroughly for potential perforation of the gastrointestinal tract. Here we report the case of a 4 year 9 month old child with multiple perforations of the gastrointestinal tract associated with BD.

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