• 대한핵의학회지
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• 제35권1호
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• pp.1-11
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• 2001

Current scintigraphic tests of gastrointestinal motor function provides relevant pathophysiologic information, but their clinical utility is controversial. Many scintigraphic methods are developed to investigate gastrointestinal motility from oral cavity to colon. These are esophageal transit scintigraphy, oropharyngeal transit study, gastric emptying test, small bowel transit time measurement, colon transit study and gastroesopahgeal reflux scintigraphy. Scintigraphy of gastrointestinal tract is the most physiologic and noninvasive method to evaluate gastrointestinal motility disorders. Stomach emptying test is regarded as a gold standard in motility study. Gastrointestinal transit scintigraphy also has a certain role in assessment of drug effect to GI motility and changes alter therapy of motility disorders. Scintigraphy provides noninvasive and quantitative assessment of physiological transit throughout the gastrointestinal tract, and it is extremely useful for diagnosing gastrointestinal motor dysfunction. This article reviews the current procedures, indications, significance and guidelines for gastrointestinal motility measurements by scintigraphy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제20권1호
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• pp.47-54
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• 2017

Purpose: Clinical symptoms associated with Clostridium difficile infection (CDI) can vary widely. Carrier state without apparent symptoms is relatively common during infancy. The objective of this study was to determine the association of C. difficile colonization with bowel habit change and the effect of C. difficile colonization treatment on restoration of normal bowel habit. Methods: Between 2006 and 2014, infants at 1 to 12 months of age with diarrhea for more than 2 weeks who did not improve with conservative care were recruited from Gachon University Gil Medical Center. Infants who were followed up for at least 7 days were included. The presence or absence of C. difficile colonization, effect of metronidazole, and other medical records were reviewed. To determine the association between CDI and bowel habit change, logistic regression analysis was used. Results: Of a total of 126 infants, 74 (58.7%) were male patients. Of the 126 patients, 27 (21.4%) had C. difficile colonization. Significant (p<0.05) risk factors for C. difficile colonization included artificial milk feeding (odds ratio [OR], 4.310; 95% confidence interval [CI], 1.564-11.878), prior rotavirus vaccination (OR, 4.322; 95% CI, 1.018-18.349), and antibiotic use (OR, 4.798; 95% CI, 1.430-16.101). There was improvement in bowel habit after metronidazole therapy (OR, 0.34; 95% CI, 0.15-0.79; p<0.05), regardless of the presence or absence of C. difficile colonization, Conclusion: There was no significant correlation between bowel habit change and C. difficile colonization during infancy. However, metronidazole can be used as an optional method to manage functional gastrointestinal disorders.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권5호
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• pp.447-452
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• 2019

Purpose: Few studies have reported non-acute long-term morbidity rates in children with intestinal malrotation. The aim of this study was to investigate the rate of constipation in children undergoing Ladd's procedure for isolated intestinal malrotation. Methods: This retrospective study included children aged <15 years who underwent Ladd's procedure for intestinal malrotation between 2001 and 2016. Demographics, presence of volvulus perioperatively, need for bowel resection, short term (<30 days) and long-term complications, including mortality were recorded. Constipation was defined as treatment with laxatives at 1-year follow-up. Results: Of the 43 children included in the study, 49% were boys. The median age at surgery was 28 days (0-5, 293 days). Volvulus occurred in 26 children (60.5%), and bowel resection was required in 4 children (9.3%). Short-term complications categorized as grades II-V according to the Clavien-Dindo classification occurred in 13 children (30.2%). Of these, 5 children (11.6%) required re-operation. Constipation was observed in 9 children (23.7%) at the 1-year follow-up. No difference was observed in the rate of perioperative volvulus between children with and without constipation (44% vs. 65%, p=0.45). Excluding re-operations performed within 30 days after surgery, 3 children (6%) underwent surgery for intestinal obstruction during the study period. Conclusion: Many children undergoing Ladd's procedure require bowel management even at long-term follow-up, probably secondary to constipation. It is important to thoroughly evaluate bowel function at the time of follow-up to verify or exclude constipation, and if treatment of constipation is unsuccessful, these children require evaluation for dysmotility disorders and/or intestinal neuronal dysplasia.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.264-270
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• 2018

Purpose: The aim of this study was to describe functional gastrointestinal disorders (FGID) presented in a tertiary medical center, characteristics of patients and results of the diagnostic work-up together with an outcome during the follow up. Methods: This was a retrospective, single center, observational study including all patients who were diagnosed with FGID based on Rome III criteria from January to December 2015 in tertiary medical center. Results: Overall 294 children were included (mean age, 8.9 years [range, 1-18 years]; 165 females). Majority had functional constipation (35.4%), followed by functional abdominal pain (30.6%), irritable bowel syndrome (17.0%), functional dyspepsia (12.6%), functional nausea (3.4%) and abdominal migraine (1.0%). Regression model found that only significant factor associated with improvement of symptoms is the establishment of the functional diagnosis at the first visit (hazard ratio, 2.163; 95% confidence inverval, 1.029-4.544). There was no association between improvement of symptoms and presence of alarm signs/symptoms (weight loss, nocturnal symptoms and severe vomiting) at diagnosis. Furthermore, in pain symptoms (functional abdominal pain, irritable bowel syndrome, dyspepsia) no treatment positively correlated with pain improvement. Conclusion: Regardless of the initial diagnosis of FGID, positive diagnosis at the first visit increases a chance for resolution of symptoms.

• 재활간호학회지
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• 제8권2호
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• pp.129-138
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• 2005

Purpose: Irritable bowel syndrome (IBS) is frequently yet little understood disease. Review was performed to promote understanding on the characteristics, pathophysiology, and risk factors of IBS. Content: IBS is characterized by abdominal discomfort associated with pain and altered bowel function; structural and biochemical abnormalities are absent. Generally IBS is more prevalent in women and people with higher educational and social background, but there are some controversies. IBS is diagnosed by the Rome II or Manning criteria after excluding organic gastrointestinal diseases. The pathophysioloy is explained by abnormal control mechanism of central and enteric nervous system. Mucosal immunity, secretions, and neurotransmitter are also associated with the hypersensitivity and motility change of bowel function. Stress is known as a major triggering factor and contributed to symptoms. Other risk factors are genetic elements, childhood experiences, inflammation, anxiety, depression, diet, and sleep disorders.

• The Korean Journal of Physiology and Pharmacology
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• 제18권4호
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• pp.279-288
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• 2014

Ulcerative colitis and Crohn's disease are a set of chronic, idiopathic, immunological and relapsing inflammatory disorders of the gastrointestinal tract referred to as inflammatory bowel disorder (IBD). Although the etiological factors involved in the perpetuation of IBD remain uncertain, development of various animal models provides new insights to unveil the onset and the progression of IBD. Various chemical-induced colitis models are widely used on laboratory scale. Furthermore, these models closely mimic morphological, histopathological and symptomatical features of human IBD. Among the chemical-induced colitis models, trinitrobenzene sulfonic acid (TNBS)-induced colitis, oxazolone induced-colitis and dextran sulphate sodium (DSS)-induced colitis models are most widely used. TNBS elicits Th-1 driven immune response, whereas oxazolone predominantly exhibits immune response of Th-2 phenotype. DSS-induced colitis model also induces changes in Th-1/Th-2 cytokine profile. The present review discusses the methodology and rationale of using various chemical-induced colitis models for evaluating the pathogenesis of IBD.

• Journal of Dairy Science and Biotechnology
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• 제30권2호
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• pp.139-143
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• 2012

For human including newborn baby, the intestinal microbiota can play an important role in the development of the intestinal mucosa and in maintaining the balance of the immune cells. Important functions of the intestinal microbiota include the inhibition of the colonization of the intestine by potentially pathogenic microorganisms. Thus, the research of probiotics have been focused on the prevention and treatment of disorders associated with the gastrointestinal tract (GIT), including pathogen infection, traveler's diarrhea, antibiotic-associated diarrhea, and constipation. Probiotics have also been suggested as therapeutic agents against irritable bowel syndrome and inflammatory bowel diseases. An increasing amount of evidence from clinical studies suggests that they are effective in the prevention of atopic allergies and may have potential anti-carcinogenic effects. Until recent years many scientific research for this use has been based on empirical observations. Therefore, probiotics in the form of fermented milk products have been long part of attempts to maintain good health in world wide.

• 대한임상검사과학회지
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• 제50권1호
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• pp.11-19
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• 2018

본 연구에서는 최근에 연구되어 온 장내 세균총이 특히 주요 장질환의 발병에 있어서, 어떠한 역할을 하는지 보고된 여러 문헌들을 중심으로 연구 결과들을 요약 하였다. 예를 들자면, 면역체계를 매개하여 병이 악화되는 여러 질환에서 정상일 때와 달리 바뀐 장내 세균총을 통해 악화된다고 보고된 바 있다. 장내 세균총의 역할에 대해 많이 연구된 장질환 중에서, 많이 연구된 3개의 질환은 과민성 장 증후군, 염증성 장질환, 대장암이다. 그러나, 사람의 장내에 존재하는 세균총은 몸에 이로우며, 비타민 A 합성, 단사슬지방산의 생산, 담즙산 대사과정과 같은 장내 생리적 기능 매개를 통해 장내 항상성을 유지한다고 알려져 있다. 이와 같이, 장내에 존재하는 이로운 세균 군집과 해로운 세균 군집의 균형은 장내 건강에 주요한 영향을 미친다. 장질환을 포함한 여러 질환의 발병 및 진행에서 장내 세균총의 변화가 주요 원인으로 추측되고 있는 실정이다. 현재까지 보고된 많은 연구 결과에도 불구하고, 어떤 장내 세균총 구성이 몸에 가장 이로운 지학계에서도 의견이 분분한 상태이다. 본 논문에서는, 주요 장질환으로 알려진 과민성 장 증후군, 염증성 장질환, 대장암과 장내 세균총과의 관계에 대해 연구한 논문들에 대해 연결 지어 요약하였다. 마지막으로, 장내 세균총을 매개로 악화되는 장질환을 완화하며, 장내 건강을 지키기 위한 수단으로 천연물을 이용한 치료 전략을 제시하고자 한다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.180-193
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• 2022

Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

• 대한한방소아과학회지
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• 제28권1호
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• pp.32-42
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• 2014

Objectives The purpose of this study is to establish relationship between allergic diseases and functional gastrointestinal disorders in children and adolescents using objective criteria and questionnaires. Methods This study surveyed 237 children and adolescents who visited the department of Pediatrics of ${\bigcirc}{\bigcirc}$ Korean Medicine Hospital from September 23rd, 2013 to December 26th, 2013. The Korean version of International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire and the Korean-translated Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III (QPGS-Rome III) were used. We analyzed the data by using PASW Statistics 18.0 with Chi-square test, Fisher's exact test and Linear by linear association. Results There was no significant difference between prevalence of allergic diseases and functional gastrointestinal disorders. Also, there was no strong relationship between the number of allergic diseases and the functional gastrointestinal disorders. However, some parts showed significant relationships - such as asthma symptoms ever and belch; asthma symptoms last 12 months and belch; allergic rhinitis diagnosis ever and belly aches and abdominal pain around and below the belly button; allergic rhinitis treatment last 12 months and belly aches and abdominal pain around and below the belly button; and atopic dermatitis diagnosis ever and irritable bowel syndrome (respectively; p=0.046, p=0.008, p=0.004, p=0.029, p=0.035). And as the number of allergic diseases increases, the prevalence of functional gastrointestinal disorders are 19.4%, 31.3%, 41.7%, 31.0% respectively. Conclusions Although there was no significant relationship between allergic diseases and functional gastrointestinal disorders, some gastrointestinal symptoms were related to allergic diseases.