• Title/Summary/Keyword: bowel disorders

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Evaluation of the Children with Chronic Abdominal Pain (소아 만성 복통의 진단적 평가 -기능성 복통과의 감별점을 중심으로-)

  • Jeong, Su Jin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.sup2
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    • pp.19-28
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    • 2008
  • Chronic abdominal pain, defined as long-lasting intermittent or constant abdominal pain, is a common pediatric problem encountered by primary care physicians and medical subspecialists. Chronic abdominal pain in children is usually functional, i.e., without objective evidence of an underlying organic disorder. Functional abdominal pain is categorized as functional dyspepsia, irritable bowel syndrome, functional abdominal pain, abdominal migraine, and aerophagia according to the Rome II criteria for pediatric functional gastrointestinal disorders. There is insufficient evidence to state that the nature of abdominal pain or the presence of associated symptoms can discriminate between functional and organic disorders. The presence of alarming symptoms or signs, such as weight loss, gastrointestinal bleeding, persistent fever, and chronic severe diarrhea, is associated with a higher prevalence of organic disease. Most children with chronic abdominal pain are unlikely to require diagnostic testing; such children often need pharmacologic and behavioral therapy.

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The Emerging Role of Eosinophils as Multifunctional Leukocytes in Health and Disease

  • Hyung Jin Kim;YunJae Jung
    • IMMUNE NETWORK
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    • v.20 no.3
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    • pp.24.1-24.14
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    • 2020
  • Eosinophils are terminally differentiated cytotoxic effector cells that have a role in parasitic infections and allergy by releasing their granule-derived cytotoxic proteins. However, an increasing number of recent observations indicate that eosinophils are not only associated with the pathogenesis of a wide range of diseases, but also contribute to the maintenance of homeostatic responses in previously underappreciated diverse tissues, such as the gastrointestinal (GI) tract and adipose tissue. In this review, we describe biological characteristics of eosinophils, as their developmental properties, permissive proliferation and survival, degranulation activity, and migration properties enable them to distribute to both homeostatic and inflamed tissues. We describe pathologic aspects of eosinophils with a role in asthma and in various GI diseases, including eosinophilic GI disorders, inflammatory bowel disease, and radiation-induced enteropathy. Finally, we discuss the beneficial role of eosinophils, which contribute to the resolution of pathogenic conditions and to the modulation of homeostatic biologic responses.

Economic Impact according to Health Problems of Workers (근로자의 건강문제에 따른 경제적 손실정도)

  • Lee, Young-Mi;Jung, Moon-Hee
    • Journal of Korean Academy of Nursing
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    • v.38 no.4
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    • pp.612-619
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    • 2008
  • Purpose: The purpose of this study was to examine health problems and to estimate economic impact based on health problems of workers. Methods: The subjects of this study consisted of 301 workers who received a group occupational health service. Data was collected from February 1 to March 30, 2006. The questionnaire contained questions based on general characteristics and the Stanford Presenteeism Scale. Data was analyzed with descriptive statistics, t-test using SPSS program. Results: The primary health conditions as reported by workers were ranked in order as stomach or bowel disorders, back or neck disorders, or liver function disorders. The reason of absenteeism per worker was ranked in order as asthma, or a breathing disorder. The reason of presenteeism was ranked in order as asthma, insomnia or a sleep disorder. The cost of the total economic impact on the workplace in this study was 8,851,838 won. The cost of absenteeism per worker was 8,390 won. The cost of presenteeism per worker was 941,732 won. Conclusion: Presenteeism had a strong correlation to health conditions of the workers. Therefore, improving the work conditions of the workers is very important. If employers improve the health condition of workers, they will benefit from improved productivity in their business.

Therapeutic and Prophylactic Effects of Zostera Marina on Dextran Sulfate Sodium-induced Colitis (해대(海帶) 추출물이 Dextran Sulfate Sodium로 유발된 대장염 동물모델에 미치는 치료 및 예방적 효과)

  • Jeon, Woo-Hyeon;Ko, Seok-Jae;Ryu, Bongha;Park, Jae-Woo
    • The Journal of Korean Medicine
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    • v.37 no.3
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    • pp.13-26
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    • 2016
  • Objectives: Inflammatory bowel disease (IBD) is chronic inflammatory disorders of the intestines. Due to limitation of conventional treatment including steroids, herbal medicines have emerged as possible therapeutic options for IBD. The purpose of the current study was to investigate the therapeutic and prophylactic effects and mechanisms of Zostera Marina water extract (ZME) on DSS-induced colitis. Methods: Colitis was induced by DSS in Balb/c mice. In pre-treatment setting, ZME was administered 7 days before DSS treatment and in co-treatment setting, ZME was simultaneously administrated with DSS treatment. In both settings, ZME 100, 300 and 1000 mg/kg were orally administered twice a day, respectively. Mice weight and clinical findings were measured daily. Colon length, macroscopic findings and histological damages of colon mucosa were assessed at the end of experiments. The levels of cytokines including TNF-${\alpha}$, IFN-${\gamma}$, IL-$1{\beta}$, IL-6, IL-10 and IL-17 were measured by Biometric Multiplex Cytokine Profiling method. Results: In a dose dependent manner, ZME significantly inhibited the colon shortening, and improved macroscopic score and histological score. However, there were insignificant changes on inhibition of weight loss and improvement of clinical score. There were no significant differences of effects between co-treatment and pre-treatment settings. ZME 300 and 1000 mg/kg groups significantly inhibited IFN-${\gamma}$. Only ZME 1000 mg/kg group significantly inhibited TNF-${\alpha}$, IL-$1{\beta}$ and IL-6. Conclusions: The current results show the possibility of therapeutic use and its prophylactic application of ZME on inflammatory bowel diseases. Future studies for targeted mechanisms of ZME are needed.

Studies on the Treatment of Irritable Bowel Syndrome(IBS) in Oriental Medicine (하부위장관 기능장애 치료의 한의학적 접근방법에 관한 연구)

  • Lee, Gun-Up;Won, Jin-Hee;Moon, Gu;Moon, Seok-Jae;Ryu, Su-Taek
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.162-168
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    • 2000
  • Irritable Bowel Syndrome(IBS) is the most common disease in the western male, and it is founded in $70{\sim}80%$ patient who has Gastrointestinal trouble. It is characterized by the formation of disorders of Gastrointestinal tract, for example, constipation, diarrhea, abdominal pain& discomfort, stool urgency, and so on. The etiology of IBS is uncertain, but the majority of patients has emotional problems. The aims of this study are to investigate and summarize the current trends of treatment for IBS so as to suggest the effective and available way to treat this disease. In Oriental Medicine, the IBS is recognized as Stagnation of the Iiver-qi(肝氣鬱結), Incoordination between the liver and the stomach(肝胃不和). So the point of treatment of IBS is Invigorating the spleen and relieving the depression of Iiver-qi(疏肝健脾), Regulating the function of the liver and the flow of qi(調肝理氣), Regulating the stomach and lowering the adverse flow(和胃降逆), and the treatment can be approached in several ways through herb drugs, acupuncture. Some of the herb drugs have substances which promote gastric and small intestinal emptying. Acupuncture and moxibustion therapies stimulate the meridian points of LR(足厥陰肝經), ST(足陽明胃經), LI(手陽明腸經), SI(手太陽小腸經) and is reported to be effective for releafing syndromes. Anal therapy, attachment of herb drug to umbilicus are annunced as the effective treatments. So, this study of the approach and application of these treatments on IBS would be necessary.

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Clinical Experiences of Stellate Ganglion Block Therapy (성상신경절차단요법에 대한 임상경험)

  • Cheon, Im-Soon;Kim, Jeng-Il;Ban, Jong-Seuk;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.6 no.2
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    • pp.204-207
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    • 1993
  • Stellate ganglion block therapy is widely practiced in pain clinics for a wide variety of diseases(numbering over 150). The precise mechanisms are unknown, but it has been said that the systemic effect of the stellate ganglion block may improve the hypothalamic circulation and thus restoring the homeostasis of the body. We have administered stellate ganglion block for the treatment and cure of the following examples of ailments idiopathic hypertension, allergic rhinitis, constipation, insomnia, irritable bowel syndrome. The causes of these diseases are unclear except that they are recognized as nervous disorders. However in clinical field, the effect of stellate ganglion block appears clearly. In this study 13 patients were treated only with stellate ganglion block; once daily for l5 days. The outcome of the treatments were as follows: 6 patients had excellent results, 5 patients had good results and the remaining 3 with poor results. We conclude that stellate ganglion block appears to be a good choice as the treatment for a number of nervous disorders.

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Current understanding of nociplastic pain

  • Yeong-Min Yoo;Kyung-Hoon Kim
    • The Korean Journal of Pain
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    • v.37 no.2
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    • pp.107-118
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    • 2024
  • Nociplastic pain by the "International Association for the Study of Pain" is defined as pain that arises from altered nociception despite no clear evidence of nociceptive or neuropathic pain. Augmented central nervous system pain and sensory processing with altered pain modulation are suggested to be the mechanism of nociplastic pain. Clinical criteria for possible nociplastic pain affecting somatic structures include chronic regional pain and evoked pain hypersensitivity including allodynia with after-sensation. In addition to possible nociplastic pain, clinical criteria for probable nociplastic pain are pain hypersensitivity in the region of pain to non-noxious stimuli and presence of comorbidity such as generalized symptoms with sleep disturbance, fatigue, or cognitive problems with hypersensitivity of special senses. Criteria for definitive nociplastic pain is not determined yet. Eight specific disorders related to central sensitization are suggested to be restless leg syndrome, chronic fatigue syndrome, fibromyalgia, temporomandibular disorder, migraine or tension headache, irritable bowel syndrome, multiple chemical sensitivities, and whiplash injury; non-specific emotional disorders related to central sensitization include anxiety or panic attack and depression. These central sensitization pain syndromes are overlapped to previous functional pain syndromes which are unlike organic pain syndromes and have emotional components. Therefore, nociplastic pain can be understood as chronic altered nociception related to central sensitization including both sensory components with nociceptive and/or neuropathic pain and emotional components. Nociplastic pain may be developed to explain unexplained chronic pain beyond tissue damage or pathology regardless of its origin from nociceptive, neuropathic, emotional, or mixed pain components.

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management

  • Goulet, Olivier;Nader, Elie Abi;Pigneur, Benedicte;Lambe, Cecile
    • 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.

Trends in Clinical Research of Herbal Medicine Treatment for Functional Gastrointestinal Disorders in Children - Focused on Randomized Controlled Trials in traditional Chinese medicine (소아 기능성 위장 장애의 한약 치료에 대한 임상연구 동향 - 중의학 무작위 대조군 임상시험을 중심으로)

  • Lee, Jihong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.3
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    • pp.67-88
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    • 2021
  • Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

Associations of unspecified pain, idiopathic pain and COVID-19 in South Korea: a nationwide cohort study

  • Kim, Namwoo;Kim, Jeewuan;Yang, Bo Ram;Hahm, Bong-Jin
    • The Korean Journal of Pain
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    • v.35 no.4
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    • pp.458-467
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    • 2022
  • Background: Few studies have investigated unspecified or idiopathic pain associated with COIVD-19. This study aimed to provide the incidence rates of unspecified pain and idiopathic pain in patients with COVID-19 for 90 days after COVID-19 diagnosis. Methods: A propensity score matched cohort was used, including all patients with COVID-19 in South Korea, and analyzed their electronic medical records. The control group consisted of those who had not had tests for COVID-19 at all. Unspecified pain diagnoses consisted of diagnoses related to pain included in the ICD-10 Chapter XVIII. Idiopathic pain disorders included fibromyalgia, temporomandibular joint disorders, headaches, chronic prostatitis, complex regional pain syndrome, atypical facial pain, irritable bowel syndrome, and interstitial cystitis. Results: After matching, the number of participants in each group was 7,911. For most unspecified pain, the incidences were higher in the COVID-19 group (11.7%; 95% confidence interval [CI], 11.0-12.5) than in the control group (6.5%; 95% CI, 6.0-7.1). For idiopathic pain, only the headaches had a significantly higher incidence in the COVID-19 group (6.6%; 95% CI, 6.1-7.2) than in the control group (3.7%; 95% CI, 3.3-4.1). However, using a different control group that included only patients who visited a hospital at least once for any reasons, the incidences of most unspecified and idiopathic pain were higher in the control group than in the COVID-19 group. Conclusions: Patients with COVID-19 might be at a higher risk of experiencing unspecified pain in the acute phase or after recovery compared with individuals who had not had tests for COVID-19.