• Title/Summary/Keyword: bowel function.

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FREE JEJUNAL FLAP FOR INTRAORAL RECONSTRUCTION CASES REPORT & LITERATURE REVIEW (유리 소장이식을 이용한 구강내 결손부위의 수복 증례보고 및 문헌 고찰)

  • Kang, Bo-Won;Kim, Sung-Moon;Lim, Jae-Suk;Kwon, Jong-Jin;Choi, Sung-Weon;Lee, Dong-Keun;Min, Seung-Ki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.113-121
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    • 1994
  • Large oral defects following tumor resection pose formidable challenge for the reconstructive surgeon. Ideally, wound closure should utilize like tissue in providing expedient, single-stage closure, returning maximum function while minimizing deformity. Recent methods have reported and utilize variable mucocutaneous flaps. However, the ideal reconstruction has yet to defined. The small bowel serves as a readily available donor site for satisfying reconstructive needs in oropharyngeoesophageal defects. Segments of jejunum may be opened along the antimesenteric border and transferred to oral defect as free tissue transfers. Some of the benefits of this technique have included a one-stage procedure, abundant donor tissue with characteristics similar to oral mucosa, near normal facial appearance, preservation of maximum tongue function and relief of annoying xerostomia by jejunal mucous secretion. Three cases re presented in which two cases show successful use of this flap. The other one patient developed total necrosis of this flap. We report cases of reconstruction using free jejunal flap transfer in oral reconstruction.

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Contributions of HO-1-Dependent MAPK to Regulating Intestinal Barrier Disruption

  • Zhang, Zhenling;Zhang, Qiuping;Li, Fang;Xin, Yi;Duan, Zhijun
    • Biomolecules & Therapeutics
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    • v.29 no.2
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    • pp.175-183
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    • 2021
  • The mitogen-activated protein kinase (MAPK) pathway controls intestinal epithelial barrier permeability by regulating tight junctions (TJs) and epithelial cells damage. Heme oxygenase-1 (HO-1) and carbon monoxide (CO) protect the intestinal epithelial barrier function, but the molecular mechanism is not yet clarified. MAPK activation and barrier permeability were studied using monolayers of Caco-2 cells treated with tissue necrosis factor α (TNF-α) transfected with FUGW-HO-1 or pLKO.1-sh-HO-1 plasmid. Intestinal mucosal barrier permeability and MAPK activation were also investigated using carbon tetrachloride (CCl4) administration with CoPP (a HO-1 inducer), ZnPP (a HO-1 inhibitor), CO releasing molecule 2 (CORM-2), or inactived-CORM-2-treated wild-type mice and mice with HO-1 deficiency in intestinal epithelial cells. TNF-α increased epithelial TJ disruption and cleaved caspase-3 expression, induced ERK, p38, and JNK phosphorylation. In addition, HO-1 blocked TNF-α-induced increase in epithelial TJs disruption, cleaved caspase-3 expression, as well as ERK, p38, and JNK phosphorylation in an HO-1-dependent manner. CoPP and CORM-2 directly ameliorated intestinal mucosal injury, attenuated TJ disruption and cleaved caspase-3 expression, and inhibited epithelial ERK, p38, and JNK phosphorylation after chronic CCl4 injection. Conversely, ZnPP completely reversed these effects. Furthermore, mice with intestinal epithelial HO-1 deficient exhibited a robust increase in mucosal TJs disruption, cleaved caspase-3 expression, and MAPKs activation as compared to the control group mice. These data demonstrated that HO-1-dependent MAPK signaling inhibition preserves the intestinal mucosal barrier integrity by abrogating TJ dysregulation and epithelial cell damage. The differential targeting of gut HO-1-MAPK axis leads to improved intestinal disease therapy.

Effect of Youngkaechulgam-tang and Bojoongikki-tang on Gastric Contractility, Body Weight, and Gastric Morphology in Rats with Non-obstructive Antral Dilation (비폐색성 위 전정부 확장이 있는 흰쥐의 위 수축력, 체중 및 위 형태 복원에 대한 영계출감탕과 보중익기탕(補中益氣湯)의 효능)

  • Jung, Yong-Jae;Yoon, Sang-Hyub
    • The Journal of Internal Korean Medicine
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    • v.31 no.4
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    • pp.857-869
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    • 2010
  • Objectives : The aim of this study was to evaluate whether rats with non-obstructive antral dilation could be a useful tool resembling functional dyspeptic patients. We also investigated the effect of Bojoongikki-tang (BJ), and Youngkaechulgam-tang (YK) in antral dilated rats. Methods : Non-obstructive antral dilation was performed by first wrapping a non-absorbable rubber ring (D:6mm, W:4mm, T:1mm) around the 1st portion of the duodenum causing pyloric obstruction (PO). After 12 weeks, except for some PO group rats used for the control, the rubber ring was removed by performing another operation. The antral dilated rats (AD) were then divided into three groups, a non-treatment group (AD-NT), and two herbal medicine groups each given an extract solution containing 125 mg/kg of Youngkaechulgam-tang (AD-YK) or Bojoongikki-tang (AD-BJ) for 4 weeks. Then gastric contractility was evaluated by bowel sound measurement, and afterwards the changes of the weight, and morphologic changes of the stomach were evaluated for each group including the normal intact group (NI). Results : Loss of weight and enlargement of the stomach surface area was seen in the PO group. Decrease of gastric motility index was observed in the AD-NT group, while the increased surface area of the stomach was not significantly different from the PO group. Youngkaechulgam-tang seemed to increase gastric contraction, whereas Bojoongikki-tang showed no effect. Weight gain of rats was observed in both the AD-YK and AD-BJ groups, but there seemed to be no change of the dilated stomach surface area. Conclusions : The non-obstructive antral dilated rat seems to be an experimental pathologic model that reflects the gastric dysmotility similar to functional dyspeptic patients with antral dilation. Therefore patients with dysmotility-like dyspepsia with antral function disorders should be treated efficiently. As Youngkaechulgam-tang is shown to increase both gastric contraction and weight in antral dilated rats, it may be used for treating functional dyspepsia. However, Bojoongikki-tang should be used with caution in patients with gastric dysmotility.

Use of Cellulose and Recent Research into Butyrate (섬유소의 이용과 butyrate의 최근 연구)

  • Yeo, Tae Jong;Choi, In Soon;Cho, Kwang Keun
    • Journal of Life Science
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    • v.22 no.11
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    • pp.1571-1586
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    • 2012
  • On earth, there are about 5,400 kinds of mammals, of which about 1,000 kinds are herbivores. Among herbivores, about 250 kinds are known to be ruminants. As for cattle and sheep, which are ruminants, fermentation takes places mainly in their rumen; in contrast, for pigs and men, which are non-ruminants, fermentation takes place mainly in their caecum, colon, and rectum. As for the kind and dominance of rumen microorganisms, Bacteroidetes account for 51% and Firmicutes for 43%. As for the dominance of the large intestine microorganisms in men, Firmicutes account for 65% and Bacteroidetes for 25%. Cell wall components are decomposed by microorganisms, and short chain fatty acids (SCFAs) are generated through fermentation; the ratio of acetate, propionate, and butyrate generate is 60:25:15. Butyrate absorbed through the primary butyrate transporter MCT1 (mono carboxylate transports-1) in the intestines activates such SCFA receptors as GPR43 and GPR41. Butyrate has a strong anti-tumorigenic function. Butyrate is characterized by the fact that it has an effect on many cancer cells, contributes to the coordination of functions in the cells, and induces cancer apoptosis. Butyrate activates caspase but inhibits the activity of HDAC (histone deacetylase), so as to induce apoptosis. In addition, it increases p53 expression, so as to induce cell cycle arrest and apoptosis. Anti-inflammation actions of SCFA include the reduction of IL-8 expression in intestinal epithelial cells, the inhibition of NO synthesis, and the restraint of the activity of NF-${\kappa}B$ (nuclear factor ${\kappa}B$), so as to suppress the occurrence of cancers caused by inflammation. Butyrate plays an important role in maintaining physiological functions of intestinal mucous membranes and is used as a cure for inflammatory bowel disease (IBD).

Interferon-γ-mediated secretion of tryptophanyl-tRNA synthetases has a role in protection of human umbilical cord blood-derived mesenchymal stem cells against experimental colitis

  • Kang, Insung;Lee, Byung-Chul;Lee, Jin Young;Kim, Jae-Jun;Lee, Seung-Eun;Shin, Nari;Choi, Soon Won;Kang, Kyung-Sun
    • BMB Reports
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    • v.52 no.5
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    • pp.318-323
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    • 2019
  • Mesenchymal stem cells (MSCs) are multipotent adult stem cells that present immunosuppressive effects in experimental and clinical trials targeting various rare diseases including inflammatory bowel disease (IBD). In addition, recent studies have reported tryptophanyl-tRNA synthetase (WRS) possesses uncanonical roles such as angiostatic and anti-inflammatory effects. However, little is known about the function of WRS in MSC-based therapy. In this study, we investigated if a novel factor, WRS, secreted from MSCs has a role in amelioration of IBD symptoms and determined a specific mechanism underlying MSC therapy. Experimental colitis was induced by administration of 3% DSS solution to 8-week-old mice and human umbilical cord blood-derived MSCs (hUCB-MSCs) were injected intraperitoneally. Secretion of WRS from hUCB-MSCs and direct effect of WRS on isolated $CD4^+$ T cells was determined via in vitro experiments and hUCB-MSCs showed significant therapeutic rescue against experimental colitis. Importantly, WRS level in serum of colitis induced mice decreased and recovered by administration of MSCs. Through in vitro examination, WRS expression of hUCB-MSCs increased when cells were treated with interferon-${\gamma}$ ($IFN-{\gamma}$). WRS was evaluated and revealed to have a role in inhibiting activated T cells by inducing apoptosis. In summary, $IFN-{\gamma}$-mediated secretion of WRS from MSCs has a role in suppressive effect on excessive inflammation and disease progression of IBD and brings new highlights in the immunomodulatory potency of hUCB-MSCs.

Effects of Alginic Acid, Cellulose and Pectin Level on Bowel Function in Rats (알긴산과 셀룰로오스 및 펙틴 수준이 흰쥐의 대장기능에 미치는 영향)

  • 이형자
    • Journal of Nutrition and Health
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    • v.30 no.5
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    • pp.465-477
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    • 1997
  • The purpose of this article is to know the effects on bowel function of the kind of fiber and the amount of fiber in SD-rats. To do this experiment, we select of $\alpha$-cellulose as n insoluble cellulose source and alginic acid and pectin as soluble cellulose source. The rats diets contained callolose camcentrations of 1.0%, 3.6%, 6.0% and 10.0%. After that, we raised the SD-rats for 4weeks and measured the amount of food intake, body weight, the food effciency ratio, the length of liver and stomach the weight of the intestines, the transit time through the intestines, pH in feces, and the amount of bile acid and Ca, Mg, pp. 1) The amount of food intake was 15.75-31.00g/day. It was highest in the 10.0% cellulose group and the lowest in the 3.6% and 6.0% alginic acid group (p<0.05). The body weights of rats were 277.50-349.809. It was highest in the 1.0% pectin group and lowest in the 3.6% alginic acid group, 6.0% cellulose group, and 10.0% pectin group. It had differences according to the content fiber and the kind of dietary(p<0.01). The food efficiency ratio was (p<0.01). The higher the content of dietary fiber, the lower the calory and the food efficiency ratio. 2) Transit time was 446.0-775.0 minutes and it showed signidicant ifferences according to the content and kind of dietary fiber(p<0.01). It was long in the 1.0% cellulose group and 1.0% pectin group but short in the 10.0% alginic acid group. As the content of dietary fiber increased, the transit time through the intestines was shortened. The length of small intestine was 101.03-120.40cm and there were no difference cegardloss of the content and kind of fiber. The length of the large intestine was 20.92-25.42cm and there were significant differences according to the content and kind of the fiber. High-fiber diets resulted in increases in the length of the large intestine. 3) The weight of the liver was 8.68-10.96g and there were no differences according to the content and kind of fiber. The weight of stomach was 1.28-1.74g and there were no differences resulting from the kind of dietary fiber, but it was highest in the 10.0% alginic acid group. The weight of the small intestine was 5.52-8.04g with no difference resulting from to the kind of fiber. It was highest in the 10.0% the alginic acid group and lowest in the 1.0% alginic acid group(p<0.05). The weight of large intestine was 2.50-3.30g with no differences related to the kind of dietary fiber. It was heaviest in the 6.0% and 10.0% alginic acid groups and in the 10.0% pectin group with differences related to the content of fiber(p<0.05). 4) The pH of the feces was 5.82-6.86 according to the kind of dietary fiber, alginic acid group was high at 6.66, the cellulose group was 6.26. but the pectin group was low at 6.30. There were difference according to the content of fiber, but no consistency. The content of bile acid was 6.25-34.77umol per 1g of dry feces. According to the kind of dietary fiber, the alginic acid group was low at 12.91umol, cellulose group was 18.64umol and, the pectin group was the highest at 27.78umol(p<0.001). Based on the content of dietary fiber, alginic acid group was low at 1.0%, but high at 3.6% pectin group(p<0.001). 5) The amount of feces was 1.00-5.10g/day. The weight of rat feces was 2.23g/day in the alginic acid goup, 2.75g/day in the cellulose group, and 1.82g/day in the pectin group. According to the content of fiber, cellulose group was high at 10.0% but alginic acid group was 1.0%, and there were significant difference according to the dietary fiber. The more the content of fiber, the more increase the content of feces in alginic acid, cellulose and pectin group. The content of Ca in the feces was 80.10-207.82mg/1g of dry feces. In the dietary fiber, alginic acid group was 193.08mg, cellulose group was 87.5mg, pectin group was 138.16mg. In the content of fiber, alginic acid group was high at 1.0% and 3.6% but low at 10.0% of Pectin group. The content of Mg was 19.15-44.72mg/1g of dry feces. According to the kind of dietary fiber, alginic acid group was 35.33mg, cellulose group was 23.60mg, and pectin was 36.93mg. According to the content of fiber, pectin group was high at 1.0% and low at 10.0% of cellulose group. The content of P was 1.65-4.65mg/1g of dry feces. According to the kind of dietary fiber, alginic acid group 2.23mg/g dry feces, cellulose group was 2.29mg/g, pectin group wa 4.08mg/g dry feces. In the content of fiber, pectin group was high at 6.0% and low at 6.0% alginic acid group, but there were significant difference among the analysis value. The conetnt of Ca and MG was higher in soluble alginic acid group and pectin group than in insoluble cellulose group. The high the content of the dietary fiber, the lower the food efficiency ratio and the short the transit time through intestine with the increase of the length of large intestin as well as the higher level of the stomach, the small intestine and the large intestine. According to the content of the dietary fiber, the amount of the feces, Ca, Mg and P was increased but the length the small intestin, the weight of liver, pH of the feces and the amount of bile acid showed no differences and consistency.

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Blockade of Ganglion Impar and Superior Hypogastric Plexus Block for Perineal Cancer Pain -Case report- (회음부 암성통증에 대한 외톨이 신경절 블록과 상 하복 신경총 블록 -증례 보고-)

  • Han, Seung-Yeon;Yoon, Duck-Mi
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.238-241
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    • 1999
  • Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1; metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.

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Study on Clinical Diseases of Yang Deficiency Pattern (양허증(陽虛證)의 임상적 질환 범위에 대한 고찰)

  • Park, Mi Sun;Ki, Yeong Mok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.2
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    • pp.153-166
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    • 2013
  • Yang deficiency pattern is a representative syndrome differentiation. This article is a study on to which categories of modern diseases yang deficiency is assigned by reference to modern clinical papers and the meaning of yang deficiency interpreted with a perspective of Korean Medicine and a modern perspective. Yang deficiency, yang qi deficiency, lack of yang qi and yang qi debilitation are the words found in "Nei Ching" and yang qi can be interpreted as something to warm, drive and arouse. Zhangzhongjing considered recovery or loss of Yang as the key to life in "Shanghanlun". Danxi proposed "Yang being liable to hyperactivity, Yin being insufficient" and emphasized pathological ministerial fire of Yang exuberance rather than physiological ministerial fire of Yang deficiency. Zhangjingyue proposed "Yang not being in excess, Yin being often deficient" and understood growth and decline of yin qi are all led by yang qi and put emphasis on true yin in addition to yang qi. Diseases of yang deficiency pattern are related with decline of metabolic level, hypofunction of internal secretion, disorder of immune function, disorder of automatic nerve system, sympathetic nerve inhibition, metabolic disorder of microelements, increase of cGMP, change of microcirculation, low speed of blood stream, kidney malfunction. Diseases related with kidney are sterility, polycystic ovary syndrome, spinal stenosis, edema, renal failure, IgA nephropathy, erectile dysfunction, nephritis, prostatitis, benign prostatic hyperplasia, decrease of adrenal cortical hormone by nephrotic syndrome, myelodysplastic syndrome. Disease related with heart are heart failure, arrhythmia, cardiomyopathy, atherosclerosis heart disease, hypertension, hyperlipidemia, pulmonary heart disease. Diseases related with spleen are irritable bowel syndrome, ulcerative colitis. Diseases related with liver are hypothyroidism, liver cirrhosis ascites, hepatitis B, chronic hepatitis, hepatic diabetes. Diseases related with lung are allergic rhinitis, cough variant asthma, bronchial asthma, pulmonary emphysema. And diabetes mellitus, metabolic syndrome, aplastic anemia, headache, encephalatrophy, Alzheimer's disease are also related with yang deficiency.

One-stage Repair of Neonatal Hirschsprung's Disease (신생아기 일기식 방법으로 수술한 Hirschsprung병에 대한 고찰)

  • Rhim, Si-Youn;Jung, Poong-Man
    • Advances in pediatric surgery
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    • v.13 no.1
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    • pp.61-65
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    • 2007
  • Conventional treatment of Hirschsprung's disease consists of initial colostomy followed by pull-through operation. But, the treatment of Hirschsprung's disease has been changed along with the development of new surgical technique. Since 1995, endo-GIA has been available at our hospital and one stage Duhamel operation has been performed for neonatal Hirschsprung's disease. Between May 1995 and April 2006, 26 neonates have been treated with one stage pull-through operation by one pediatric surgeon at HanYang University Hospital. The sex ratio was 4.2:1 with male predominance. Clinical findings included abdominal distension (96.2 %), vomiting (50.0 %), delayed passage of meconium (46.2 %), constipation (23.1 %), and enterocolitis (15.4 %). Twenty two cases (84.6 %) were short-segment and 4 cases (15.4 %) were long-segment disease, of which 2 cases were total colon aganglionosis. One of the two patients with total colonic aganglionosis had double transition zones - distal ileum and hepatic flexure of the colon. The average age at operation was $14.56{\pm}8.77$ days and the average weight at operation was $3.26{\pm}0.66kg$. Primary Duhamel operations were performed in 25 patients and Soave-Boley operations was performed in one patient. The endo-GIA 35 (Ethicon, USA) was used from 1995 until 1997, and after that endo-GIA 60 (USSC, USA) was used. The average Duhamel operation time was $88.57{\pm}22.80$ minutes. Wound abscess (n = 2) and septum formation (n =1) occurred after Duhamel operation. Bowel function was normalized in 59 % within 3 months and in 95% within 1 year after operation. There was no mortality after one stage pull-through operation in neonate.

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The Cross-sectional Study on Characteristics between Soyangin Gyolhyungjeung and Soyangin Heat-related Diarrhea Accompanied by Headache in Patients of Indigestion (소화불량을 주소로 내원한 소양인(少陽人) 결흉증(結胸證)과 신열두통망음증(身熱頭痛亡陰證)의 소증(素證) 특성에 관한 단면연구)

  • Lee, Mi-Suk;Hwang, Min-Woo;Kim, Yun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.2
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    • pp.19-30
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    • 2012
  • 1. Objectives : The aim of this study was to survey the Original symptoms of Soyangin's and to compare the tendency of their symptoms between Soyangin Gyolhyungjeung and Soyangin Heat-related diarrhea accompanied by headache in patients of indigestion. 2. Methods : We recruited 76 Soyangin subjects in the Korean Medicine clinic and researched their original symptoms. Subjects were diagnosed by the Sasang Constitutional specialists and Sasang Constitutional Medication. Subjects were two groups, confirmed to Soyangin Gyolhyungjeung and Soyangin Heat-related diarrhea accompanied by headache. All subjects answered the questionnaire about their Original symptoms. We found the differences between 2 groups using the Mann-Whitney U Test. Analysis was conducted using SPSS 18.0 for Korean. 3. Results : In Original symptoms, there was no difference between 2 groups in sleep, appetite, digestion, eating habits, water temperature, function of bowel movement, urination, sweating, sensitivity to coldness and sensitivity to warmness. But there was difference between 2 groups in frequency of defecation & hardness of feces(p=0.027). 4. Conclusions : We found the differences of heat and cold in symptoms between two Soyangin syndromes.