• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권4호
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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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• 제10권2호
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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.

• 한국식품영양과학회지
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• 제41권7호
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• pp.881-887
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• 2012

유산균과 금은화, 발효 금은화는 장누수 증후군과 연관된 장 상피세포 점막 투과성 감소에 대하여 유의한 효과를 나타내었다. 따라서 유산균을 단독으로 사용하는 방법과 유산균을 이용해 발효시킨 금은화를 증가된 장 투과성 및 장내미생물 불균형으로 인한 장누수 증후군과 관련된 일련의 증상들을 치료하고 면역관련 질환 및 만성 염증성 질환에도 응용할 수 있을 것으로 예상되며 이에 대한 앞으로의 추가 연구가 필요할 것으로 사료된다.

• 한방비만학회지
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• 제13권1호
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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.

• 한방비만학회지
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• 제12권1호
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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.

• 대한물리치료과학회지
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• 제4권3호
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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.

• 한방비만학회지
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• 제9권1호
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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.

• 한국임상수의학회지
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• 제26권6호
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• pp.659-662
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• 2009

한국교원대학교 황새복원센터에서는 한국내 야생 황새 복원을 위해 인공적인 황새 사육을 진행중이다. 세 마리의 황새가 식욕부진과 침울을 보여 충북대학교 동물의료센터에 진료 의뢰되었다. 두 마리는 내원 전 사망하였으며, 한 마리는 내원 후 수액요법을 실시하였으나 1일 후 사망하였다. 부검시 salmon-color의 피하 및 내장지방이 전체 황새에서 관찰되었다. 간 표면의 다발성 국소 괴사병소도 확인되었다. 근육위 내강에는 많은 양의 풀과 자갈이 뭉쳐져 큰 덩어리를 형성하고 있었으며, 유문부는 이것에 의해 폐색되어 있었다. 수액요법을 받은 황새의 소장 분절은 유착되어 있었다. 조직병리학적 검사상 염증을 동반하지 않은 괴사병변이 전체 황새의 간, 근육위, 장에서 관찰되었다. 간에서는 담즙정체도 관찰되었다. 이 검사 결과들에 기초하여 황새들은 이식증에 의한 사낭 경색증으로 최종 진단되었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권6호
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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.

• 한국임상수의학회지
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• 제28권5호
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• pp.516-518
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• 2011

한국 황새복원센터에서 사육중인 황새의 정상 장내 세균총을 검사하기 위한 조사를 실시하였다. 44마리의 건강한 황새의 총배설강으로부터 44개의 분변시료를 채취하여 호기 및 혐기조건에서 배양하였다. 배양된 미생물의 16Sribosomal RNA 및 heat shock protein 60 유전자의 염기서열을 조사하였다. 호기조건 하에서는 Enterococcus faecalis, Escherichia coli, Bacillus spp., Enterococcus avium, Enterococcus gallinarum, Pseudomonas spp., Alcaligenes spp., Enterobacter spp., Corynebacterium spp., Proteus mirabilis가 동정되었다. 혐기조건 하에서는 E. coli, Clostridium tertium, En. faecalis, P. mirabilis가 동정되었다. 모든 시료에서 E. coli, En. faecalis 혹은 두 가지 모두가 분리되었다. 이러한 정상 황새의 장내 미생물 정보는 향후 분변 배양 결과의 해석에 도움이 될 것으로 판단된다.