• Title/Summary/Keyword: Intestinal failure

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A Bone-like Small Intestinal Wooden Foreign Body in a Dog (개의 소장에서 관찰된 뼈와 같은 형태의 나무 이물)

  • Jeoung, Seok-Young;Kim, Doo;Ahn, So-Jeo;Park, In-Chul;Woo, Heung-Myong;Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.23 no.3
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    • pp.375-379
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    • 2006
  • Detection of wooden foreign body represents a clinical challenge. Wood is typically radiolucent, so wooden foreign bodies are generally cannot be seen on survey radiography. Failure to locate and remove foreign bodies can lead the patient to the long-term secondary inflammatory reactions or infections. The dog described in the present report ingested a wooden foreign body(cotton swab stick) a year ago. The foreign body remained in the intestinal tracts which were attached to each other due to the prior abdominal operation. The wooden piece in the intestine functioned as a nidus and inorganic matters were gathered forming calculus on the outer layer of foreign body. In the radiograph, the foreign body appeared to be a chicken bone which of it's inner area was more radiolucent than the outer layer. Because the wooden foreign bodies that have remained for long time in the intestinal tract can be seen like a bone by mineralization, the diagnosis of the wooden foreign bodies should be done prudently.

Homozygous Missense Epithelial Cell Adhesion Molecule Variant in a Patient with Congenital Tufting Enteropathy and Literature Review

  • Guvenoglu, Merve;Simsek-Kiper, Pelin Ozlem;Kosukcu, Can;Taskiran, Ekim Z.;Saltik-Temizel, Inci Nur;Gucer, Safak;Utine, Eda;Boduroglu, Koray
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.6
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    • pp.441-452
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    • 2022
  • Congenital diarrheal disorders (CDDs) with genetic etiology are uncommon hereditary intestinal diseases characterized by chronic, life-threatening, intractable watery diarrhea that starts in infancy. CDDs can be mechanistically divided into osmotic and secretory diarrhea. Congenital tufting enteropathy (CTE), also known as intestinal epithelial dysplasia, is a type of secretory CDD. CTE is a rare autosomal recessive enteropathy that presents with intractable neonatal-onset diarrhea, intestinal failure, severe malnutrition, and parenteral nutrition dependence. Villous atrophy of the intestinal epithelium, crypt hyperplasia, and irregularity of surface enterocytes are the specific pathological findings of CTE. The small intestine and occasionally the colonic mucosa include focal epithelial tufts. In 2008, Sivagnanam et al. discovered that mutations in the epithelial cell adhesion molecule (EpCAM, MIM# 185535) were the genetic cause of CTE (MIM# 613217). More than a hundred mutations have been reported to date. Furthermore, mutations in the serine peptidase inhibitor Kunitz type 2 (SPINT2, MIM# 605124) have been linked to syndromic CTE. In this study, we report the case of a 17-month-old male infant with congenital diarrhea. Despite extensive etiological workup, no etiology could be established before admission to our center. The patient died 15 hours after being admitted to our center in a metabolically decompensated state, probably due to a delay in admission and diagnosis. Molecular autopsy with exome sequencing revealed a previously reported homozygous missense variant, c.757G>A, in EpCAM, which was confirmed by histopathological examination.

Angiodysplasia in a Child with Chronic Renal Failure: Endoscopic Hemostatic Therapy (소아 만성 신부전 환자에서 발생한 위혈관 이형성증의 Hemoclipping에 의한 지혈 치료 1례)

  • Lee, Yun-Jin;Kim, Young-Mi;Kim, Su-Young;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.192-196
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    • 2003
  • Angiodysplasia is the most common vascular abnormality of the gastrointestinal tract and probably the most frequent cause of recurrent lower intestinal bleeding in otherwise healthy elderly patients. Also, it is an important cause of hemorrhage in chronic renal failure observed in up to 19~32% of patients. Bleeding due to gastric angiodysplasia is treated by various endoscopic approaches, including argon and Nd : YAG laser photocoagulation, monopolar or bipolar electrocoagulation, heater probe, injection sclerotherapy, band ligation or hemoclipping. A 15-year-old boy, who had undergone hemodialysis for chronic renal failure for about 10 years, was admitted due to melena and progressive anemia. A gastroduodenoscopy revealed a cherry red and fern-like lesion with oozing on the posterior wall at junction of gastric body and fundus. Endoscopic hemoclipping therapy was performed. However, melena recurred four days later. Argon plasma coagulation and hemoclipping therapy were performed again. Since then, no recurrence of bleeding has been observed.

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Toxicological Profiles of Poisonous, Edible, and Medicinal Mushrooms

  • Jo, Woo-Sik;Hossain, Md. Akil;Park, Seung-Chun
    • Mycobiology
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    • v.42 no.3
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    • pp.215-220
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    • 2014
  • Mushrooms are a recognized component of the human diet, with versatile medicinal properties. Some mushrooms are popular worldwide for their nutritional and therapeutic properties. However, some species are dangerous because they cause toxicity. There are many reports explaining the medicinal and/or toxic effects of these fungal species. Cases of serious human poisoning generally caused by the improper identification of toxic mushroom species are reported every year. Different substances responsible for the fatal signs and symptoms of mushroom toxicity have been identified from various poisonous mushrooms. Toxicity studies of mushroom species have demonstrated that mushroom poisoning can cause adverse effects such as liver failure, bradycardia, chest pain, seizures, gastroenteritis, intestinal fibrosis, renal failure, erythromelalgia, and rhabdomyolysis. Correct categorization and better understanding are essential for the safe and healthy consumption of mushrooms as functional foods as well as for their medicinal use.

Laparoscopic Surgery for Intussusception in Children (소아 장중첩증에 대한 복강경 수술의 경험)

  • Yoon, Doo Hwan;Nam, So-Hyun
    • Advances in pediatric surgery
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    • v.19 no.2
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    • pp.66-72
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    • 2013
  • Intussusception is common cause of intestinal obstruction in children. Most of intussusceptions can be treated with non-operative reduction using air or barium. However, about 10% patients need operative treatment due to failure of reduction, peritonitis, and recurrence after reduction. We introduce our experience of laparoscopic surgery for intussusception. From April 2010 to March 2013, we reviewed 57 children who diagnosed intussusception. Twelve patients underwent an operation. The cause of operation was 7 of failure of air reduction and 5 of recurrence after air reduction. Median age was 21.5 months (range: 5.0~57.7 months) and 11 children (91.7%) underwent successful laparoscopic reduction. Median operating time was 50 minutes (range: 30~20 minutes) and median hospital days was 4.5 days (range: 3~8 days). One patient had a leading point as a heterotopic pancreas and underwent bowel resection through conversion. There was neither intra-operative nor postoperative complication. Laparoscopic reduction for intussusception can bring an excellent cosmetic effect with high success rate.

Incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis patient

  • Jeong, Yo-Han;Do, Jun-Young;Hwang, Mun-Ju;Kim, Min-Jung;Gu, Min Geun;Park, Byung-Sam;Choi, Jung-Eun;Kim, Tae-Woo
    • Journal of Yeungnam Medical Science
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    • v.31 no.1
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    • pp.25-27
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    • 2014
  • Patients treated with peritoneal dialysis have increased intra-abdominal pressure and a high prevalence of abdominal wall complications. Hernias can lead to significant morbidity in patients on peritoneal dialysis. Hernias are clinically important because of the risk of incarceration, strangulation and subsequent bowel obstruction, rupture, and peritonitis. In this paper, a case of incarcerated umbilical hernia with small bowel obstruction in a continuous ambulatory peritoneal dialysis (CAPD) patient is reported. The small bowel obstruction improved after herniorrhaphy, and the peritoneal dialysis was resumed 2 weeks after the herniorrhaphy. The patient had been undergoing CAPD without technical failure until the 2 months follow-up after the herniorrhaphy. This case shows that early detection of incarcerated umbilical hernia and herniorrhaphy can prevent resection of a strangulated small bowel so that it can remain on CAPD without post-operative technical failure. Umbilical hernias should be carefully observed and intestinal obstruction should be considered when a CAPD patient with an umbilical hernia has abdominal pain.

Treatment of Esophagojejunostomy Leakage with Expanding Stent (식도-공장 문합루에 대한 Stent 삽관치료)

  • 박재길;이선희;이성호;곽문섭;김세화
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.77-81
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    • 1998
  • It would be possible to manage the intestinal anastomotic failure with intraluminal stenting, but its reports are very rare. We experienced a effective and dramatic improvement of esophago-jejunal anastomotic leak in a esophageal and gastric double cancer patient with intraluminal stenting. The intraluminal stenting was tried at the 28th postoperative day and the anastomotic leak and inflammatory signs were disappeared about 3 weeks later. Postoperative 11th months now, the stent was moved about 1 cm downward but not changed further, and he enjoys regular diet without any problems. And we think the stenting would be helful with some limitations in the intestinal anastomotic leak patient.

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Shiga toxin-associated hemolytic uremic syndrome complicated by intestinal perforation in a child with typical hemolytic uremic syndrome

  • Chang, Hye Jin;Kim, Hwa Young;Choi, Jae Hong;Choi, Hyun Jin;Ko, Jae Sung;Ha, Il Soo;Cheong, Hae Il;Choi, Yong;Kang, Hee Gyung
    • Clinical and Experimental Pediatrics
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    • v.57 no.2
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    • pp.96-99
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    • 2014
  • Hemolytic uremic syndrome (HUS) is one of the most common causes of acute renal failure in childhood and is primarily diagnosed in up to 4.5% of children who undergo chronic renal replacement therapy. Escherichia coli serotype O157:H7 is the predominant bacterial strain identified in patients with HUS; more than 100 types of Shiga toxin-producing enterohemorrhagic E. coli (EHEC) subtypes have also been isolated. The typical HUS manifestations are microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. In typical HUS cases, more serious EHEC manifestations include severe hemorrhagic colitis, bowel necrosis and perforation, rectal prolapse, peritonitis, and intussusceptions. Colonic perforation, which has an incidence of 1%-2%, can be a fatal complication. In this study, we report a typical Shiga toxin-associated HUS case complicated by small intestinal perforation with refractory peritonitis that was possibly because of ischemic enteritis. Although the degree of renal damage is the main concern in HUS, extrarenal complications should also be considered in severe cases, as presented in our case.

Flagellin-Stimulated Production of Interferon-β Promotes Anti-Flagellin IgG2c and IgA Responses

  • Kang, Wondae;Park, Areum;Huh, Ji-Won;You, Gihoon;Jung, Da-Jung;Song, Manki;Lee, Heung Kyu;Kim, You-Me
    • Molecules and Cells
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    • v.43 no.3
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    • pp.251-263
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    • 2020
  • Flagellin, a major structural protein of the flagellum found in all motile bacteria, activates the TLR5- or NLRC4 inflammasome-dependent signaling pathway to induce innate immune responses. Flagellin can also serve as a specific antigen for the adaptive immune system and stimulate anti-flagellin antibody responses. Failure to recognize commensal-derived flagellin in TLR5-deficient mice leads to the reduction in anti-flagellin IgA antibodies at steady state and causes microbial dysbiosis and mucosal barrier breach by flagellated bacteria to promote chronic intestinal inflammation. Despite the important role of anti-flagellin antibodies in maintaining the intestinal homeostasis, regulatory mechanisms underlying the flagellin-specific antibody responses are not well understood. In this study, we show that flagellin induces interferon-β (IFN-β) production and subsequently activates type I IFN receptor signaling in a TLR5- and MyD88-dependent manner in vitro and in vivo. Internalization of TLR5 from the plasma membrane to the acidic environment of endolysosomes was required for the production of IFN-β, but not for other pro-inflammatory cytokines. In addition, we found that anti-flagellin IgG2c and IgA responses were severely impaired in interferon-alpha receptor 1 (IFNAR1)-deficient mice, suggesting that IFN-β produced by the flagellin stimulation regulates anti-flagellin antibody class switching. Our findings shed a new light on the regulation of flagellin-mediated immune activation and may help find new strategies to promote the intestinal health and develop mucosal vaccines.

Blood Pressure and the Risk of Death From Non-cardiovascular Diseases: A Population-based Cohort Study of Korean Adults

  • Choi, Jeoungbin;Jang, Jieun;An, Yoonsuk;Park, Sue K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.6
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    • pp.298-309
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    • 2018
  • Objectives: The objective of this study was to assess the relationship between systolic and diastolic blood pressure (SBP, DBP) and the risk of death from specific causes other than cardiovascular diseases. Methods: We calculated the risk of specific death by SBP and DBP categories for 506 508 health examinees in 2002-2003 using hazard ratios (HRs) and 95% confidence intervals (CIs) in a Cox proportional hazards model. Results: Compared to normal levels (SBP <120 or DBP <90 mmHg), stage I systolic and diastolic hypertension (SBP 140-159, DBP 85-89 mmHg, respectively) were associated with an increased risk of death from diabetes mellitus, alcoholic liver disease, and renal failure (HR, 1.83; 95% CI, 1.51 to 2.22; HR, 1.24; 95% CI, 1.06 to 1.46; HR, 2.30; 95% CI, 1.64 to 3.21; HR, 1.67; 95% CI, 1.27 to 2.20; HR, 1.99; 95% CI, 1.41 to 2.81; HR, 1.31; 95% CI, 0.99 to 1.73, respectively), but a decreased risk of death from intestinal pneumonia (HR, 0.64; 95% CI, 0.42 to 0.98; HR, 0.59; 95% CI, 0.39 to 0.91). Only stage II systolic hypertension (SBP ${\geq}160mmHg$) was associated with an increased risk of death from pneumonia, liver cirrhosis, and intestinal ischemia (HR, 1.54; 95% CI, 1.19 to 1.98; HR, 1.46; 95% CI, 1.00 to 2.15; HR, 3.77; 95% CI, 1.24 to 11.40, respectively), and stage I and II diastolic hypertension (SBP 140-159 and ${\geq}160mmHg$) were associated with an increased risk of death from intestinal ischemia (HR, 3.07; 95% CI, 1.27 to 7.38; HR, 4.39; 95% CI, 1.62 to 11.88, respectively). Conclusions: An increase in blood pressure levels may alter the risk of death from certain causes other than cardiovascular diseases, a well-known outcome of hypertension, although the mechanism of these associations is not well documented.