• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.303-329
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• 2019

Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting "nutritional failure" which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.

• Journal of Clinical Nutrition
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• v.10 no.2
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• pp.45-50
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• 2018

Purpose: Intense multidisciplinary team effort is required for the intestinal rehabilitation of patients afflicted with the short bowel syndrome (SBS). These include enteral and parenteral nutrition (PN) support, monitoring of complications related to treatment, and considering further medical or surgical options for intestinal adaptation. Methods: In the Intestinal Rehabilitation Team (IRT) at the Samsung Medical Center, we have experienced 20 cases of adult SBS requiring multidisciplinary intestinal rehabilitation. This study is a retrospective review of the collected medical records. Results: Of the 20 subjects treated, 12 patients were male and 8 patients were female. At the time of referral to the IRT, the mean age was 51.5 years, and the mean body weight was 50.1 kg, which was 90% of the usual body weight. The diseases or operative managements preceding massive bowel resection were malignancy in 11 cases, cardiac surgery in 2 cases, trauma in 2 cases and one case, each of tuberculosis, corrosive esophagitis, atrial fibrillation, simultaneous pancreas and kidney transplantation, and perforated appendicitis. Of these, there were 14 survivals and 6 mortalities. The fatalities were attributed to progression of disease, intestinal failure-associated liver disease, and sepsis (unrelated to intestinal failure) (2 cases each). Among the 14 surviving patients, 8 patients have been weaned off PN, whereas 6 are still dependent on PN (mean PN dependence 36%). Conclusion: This paper reports the results of multidisciplinary intestinal rehabilitation of adult short bowel patients treated at the Samsung Medical Center. Further studies are required to improve survival and enteral tolerance of these patients.

• Journal of the Korean Society of Food Science and Nutrition
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• v.41 no.7
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• pp.881-887
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• 2012

This study was designed to examine influence of bacteria and herbal applications of Lonicerae Flos on the permeability of intestinal epithelial cells. The HCT-116 human intestinal cell was used as an in vivo model of "leaky gut". Dextran sodium sulphate (DSS) was used to induce an increase in the permeability of epithelial cell tight junctions. Probiotics including Lactobacillus acidophilus, Lactobacillus plantarum, Salomonella spp. and Staphylococcus aureus were used to evaluate bacterial influence on the intestinal epithelial cells. Herbal extract Lonicerae Flos was also assessed to find out what kind of effects it has when used alone or fermented with Lactobacillus plantarum. The permeability of intestinal cell lines was assessed using transepithelial electrical resistance (TEER) and horseradish peroxide (HRP) assessments. This data provides evidence for the probiotic benefits of intestinal permeability. The data also provides promising evidence of herbal effects on reducing intestinal permeability, especially when fermented with probiotics.

• Journal of Korean Medicine for Obesity Research
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• v.13 no.1
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• pp.24-32
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• 2013

Objectives: The aim of this study is to investigate anti-imflammatory and protective effect for intestinal epithelial cells with Atractylodes macrocephae (AM), a traditional Korean Herbal medicine and fermented Atractylodes macrocephae (FAM) with Lactobacillus plantarum. Methods: HCT-116 and Raw 264.7 cells were used in this study. Using NO assay, we measured lipopolysaccharide (LPS)-induced anti-inflammatory effect. We measured permeability of intestinal epithelial cells with transepithelial electrical resistance and horseradish peroxide flux assay. Water soluble tetrazolium salt assay was used to see cell proliferation. All the results were presented in mean and standard deviation. We used Student's t-test for analyzing significance of results. Results: In Raw 264.7 cells NO production decreased 22.4% with pre-treatment of AM and FAM, especially with FAM in high concentration. In HCT-116 cells LPS-induced intestinal permeability had a protective effect with both AM and FAM, which was also tend to be proportional to the concentration. Cell viability increased up to 135.52% after treatment of high concentration of FAM in HCT-116, while there was no significant change in Raw 264.7 cells with herb treatments. Conclusions: These results show evidence that AM, especially fermented ones, significantly reduced intestinal membrane permeability. They also had a protective effect as well as an anti-inflammation effect for HCT-116 and Raw 264.7 cells. This suggest that FAM may be a therapeutic agent for Leaky gut syndrome by reducing intestinal permeability.

• Journal of Korean Medicine for Obesity Research
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• v.12 no.1
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• pp.33-47
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• 2012

Objectives This study was designed to investigate the effects of fermented soybean upon anti-inflammation, cytotoxicity, antioxidant and intestinal mucous membrane permeability by measuring the cell viability, NO (nitric oxide) production, DPPH, Polyphenol, HRP and TEER in cells like Raw 264.7 and HCT 116 using fermented soybean. Methods Raw 264.7 cell and HCT 166 cell were used in this study. And fermented soybean powders were used for the experimental group and soybean powders for the control group. There was inflammation response upon using lipopolysaccharide(LPS). Fermented soybean powders and soybean powders were in a respectively different dose added to the cells with LPS. MTT assay, NO, DPPH and Polyphenol measurement, TEER, HRP were conducted for each cell. The results of this study were presented in mean and standard deviation. Results 1. In Raw 254.7 cells added with $100{\mu}l/ml$ unfermented soybean powders, 104.95% higher than 62.59% was measured. In Raw 254.7 cells added with $100{\mu}l/ml$ fermented soybean powders, there was 74.90% measured higher than 62.59%, which was a significant result. 2. By a gradual increase of unfermented soybean powders like $0.1{\mu}l/ml$, $1.0{\mu}l/ml$, $10{\mu}l/ml$, $100{\mu}l/ml$, the measured NO were also gradually decreased $53.12{\mu}M$, $47.57{\mu}M$, $37.02{\mu}M$, $28.16{\mu}M$. In case of cells added with fermented soybean powders, $43.95{\mu}M$ NO was measured in $0.1{\mu}l/ml$ which is significant, and in other cases, mostly measured over$ 56.72{\mu}M$. 3. It was inferred that fermented soybean powders have anti-inflammatory effects of maintaining intestinal mucous membrane permeability because the measured values of cells in both groups were all higher than $133.62{\Omega}$ measured of cells added with only LPS. And measured values of cells in both groups were all lower than 2.26 measured of cells added with only LPS. 4. In case of experiment DPPH and polyphenol measurement, fermented group was all higher than unfermented group. Conclusion From the results of conducting MTT assay, NO measurement, and TEER, HRP by using cells Raw 264.7 and HCT-116, even though there was no significance in the correlation between cytotoxicity, anti-inflammatory effects, both unfermented soybean powders and fermented soybean powders were shown to have intestinal mucous membrane permeability improvement effects. This effects could be applicable for autoimmune diseases, chronic inflammatory diseases and so additional studies are expected in the future. From the results of conducting DPPH, Polyphenol measurement, Fermented soybean may be useful as potential antioxidant.

• Journal of Korean Physical Therapy Science
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• v.4 no.3
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• pp.475-489
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• 1997

Connective tissue massage(CTM, Bindegewebs massage) are developed and named by Mrs. Elizabeth Dicke, a German physical therapist. The CTM is used primarily for internal disorder such as myocarditis, coronary insufficiency, high blood pressure, functional stomach and intestinal disorders, inflamma-tion of the gallbladder, and hepatitis, arterial circulatory problems, venous disorders, headache, particularly trauma to the head, and some gynecologic disorder, etc. Which is performed with special stroking technique of the subcutaneous tissue of the trunk, extremities, and face. The mechanism of effectiveness of CTM is based on a viscerocutaneous reflex. The stroking stimulates the nerve end-ings of the autonomic nervous system. The impulses activated by stroking travel to the sympathetic trunk and the spinal cord and brain, which causes a change in reaction susceptibility. The most important for apply CTM is necessary to know the reflex zone (Head's zone, Mackenzie's zone and Dicke's connective tissue zone). Dicke's connective tissue zones are only found by the special dia-gnostic stroking. Because the connective tissue zones no discomfort when unmanipulated, and thus the patient is unaware of them. It is characterized by diagnostic stroking that causes a sharp pain in the tissue. As a general rule, all treatment are preceded by the basic stroke from the level of the coccyx to the first lumbar vertebra and each stroke is done three times. The right side is done first, then the left side.

• Journal of Korean Medicine for Obesity Research
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• v.9 no.1
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• pp.1-14
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• 2009

Complex microbial communities play an important role in the human health and co-evolved with human in the form of symbiosis. Many literatures provide new evidences that the increased prevalence of obesity cannot be attributed solely to changes in the human genome, nutritional habits, or reduction of physical activity in our daily lives. The intestinal flora was recently proposed as an environmental factor responsible for the control of body weight and energy metabolism. A number of studies suggest that the modulation of gut microbiota affects host metabolism and has an impact on energy storage and demonstrated a role for the gut microbiota in weight gain, fat increase, and insulin resistance. Variations in microbiota composition are found in obese humans and mice and the microbiota from an obese mouse confers an obese phenotype when transferred to an axenic mouse. As well, the gut microbial flora plays a role in converting nutrients into calories. Specific strategies for modifying gut microbiota may be a useful means to treat or prevent obesity. Dietary modulations of gut microbiota with a view to increasing bifidobacteria have demonstrated to reduce endotoxemia and improve metabolic diseases such as obesity. The fermentation of medicinal herbs is intended to exert a favorable influence on digestability, bioavailability and pharmacological activity of herbal extract. Therefore we also expect that the fermented herbal extracts may open up a new area to treat obesity through modulating gut microbiota.

• Journal of Veterinary Clinics
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• v.26 no.6
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• pp.659-662
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• 2009

The Korea Institute of Oriental White Stork Rehabilitation Research (KIOWSRR) is breeding oriental white storks for residential rehabilitation in South Korea. Three oriental white storks were referred with anorexia and depression. Two storks were died before examinations and one stork was died after 1 day of fluid therapy. On necropsy, salmon-colored subcutaneous and visceral fats were examined in all storks. Multiple focal necroses on liver surface were also examined. In gizzards, many gravels and grasses were severely tangled; therefore, it produced a large mass that blocked digestive system of the storks. Small intestinal segments of the stork, which was dead after the fluid therapy, were severely adhesive. On histopathology, diffuse necroses with/without inflammation were examined in the liver, gizzard and intestine in all storks. Bile stasis was additionally examined in the liver. According to the results of the examinations, all storks were diagnosed as gizzard impaction caused by parorexia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.6
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• pp.594-600
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• 2019

With improving survival of children with complex congenital heart disease (CCHD), postoperative complications, like protein-losing enteropathy (PLE) are increasingly encountered. A 3-year-old girl with surgically corrected CCHD (ventricular inversion/L-transposition of the great arteries, ventricular septal defect, pulmonary atresia, postdouble switch procedure [Rastelli and Glenn]) developed chylothoraces. She was treated with pleurodesis, thoracic duct ligation and subsequently developed chylous ascites and PLE (serum albumin ${\leq}0.9g/dL$) and was malnourished, despite nutritional rehabilitation. Lymphangioscintigraphy/single-photon emission computed tomography showed lymphatic obstruction at the cisterna chyli level. A segmental chyle leak and chylous lymphangiectasia were confirmed by gastrointestinal endoscopy, magnetic resonance (MR) enterography, and MR lymphangiography. Selective glue embolization of leaking intestinal lymphatic trunks led to prompt reversal of PLE. Serum albumin level and weight gain markedly improved and have been maintained for over 3 years. Selective interventional embolization reversed this devastating lymphatic complication of surgically corrected CCHD.

• Journal of Veterinary Clinics
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• v.28 no.5
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• pp.516-518
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• 2011

A survey was conducted to examine the normal intestinal bacterial flora of captive Oriental white storks (Ciconia boyciana) maintained at the Korea Institute of Oriental White Stork Rehabilitation Research, Cheongwon, South Korea. From the cloaca of 44 healthy storks, 44 fecal samples were collected and cultured under aerobic and anaerobic conditions. The 16S ribosomal RNA gene sequences and the heat shock protein 60 gene were cloned and sequenced for bacterial identification. Under aerobic conditions, Enterococcus faecalis, Escherichia coli, Bacillus spp., Enterococcus avium, Enterococcus gallinarum, Pseudomonas spp., Alcaligenes spp., Enterobacter spp., Corynebacterium spp., and Proteus mirabilis were identified. Under anaerobic conditions, E. coli, Clostridium tertium, En. faecalis, and P. mirabilis were identified. E. coli, En. faecalis, or both were isolated from all samples. These results will add to the information available on this stork species and help for the interpretation of fecal culture results.