• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.41-49
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• 2019

Recent studies on pediatric inflammatory bowel disease (IBD) have revealed that early-onset IBD has distinct phenotypic differences compared with adult-onset IBD. In particular, very early-onset IBD (VEO-IBD) differs in many aspects, including the disease type, location of the lesions, disease behavior, and genetically attributable risks. Several genetic defects that disturb intestinal epithelial barrier function or affect immune function have been noted in these patients from the young age groups. In incidence of pediatric IBD in Korea has been increasing since the early 2000s. Neonatal or infantile-onset IBD develops in less than 1% of pediatric patients. Children with "neonatal IBD" or "infantile-onset IBD" have higher rates of affected first-degree relatives, severe disease course, and a high rate of resistance to immunosuppressive treatment. The suspicion of a monogenic cause of VEO-IBD was first confirmed by the discovery of mutations in the genes encoding the interleukin 10 (IL-10) receptors that cause impaired IL-10 signaling. Patients with such mutations typically presented with perianal fistulae, shows a poor response to medical management, and require early surgical interventions in the first year of life. To date, 60 monogenic defects have been identified in children with IBD-like phenotypes. The majority of monogenic defects presents before 6 years of age, and many present before 1 year of age. Next generation sequencing could become an important diagnostic tool in children with suspected genetic defects especially in children with VEO-IBD with severe disease phenotypes. VEO-IBD is a phenotypically and genetically distinct disease entity from adult-onset or older pediatric IBD.

• 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.

• IMMUNE NETWORK
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• 제22권6호
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• pp.46.1-46.25
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• 2022

T-helper-17 (Th17) cells and related IL-17-producing (type17) lymphocytes are abundant at the epithelial barrier. In response to bacterial and fungal infection, the signature cytokines IL-17A/F and IL-22 mediate the antimicrobial immune response and contribute to wound healing of injured tissues. Despite their protective function, type17 lymphocytes are also responsible for various chronic inflammatory disorders, including inflammatory bowel disease (IBD) and colitis associated cancer (CAC). A deeper understanding of type17 regulatory mechanisms could ultimately lead to the discovery of therapeutic strategies for the treatment of chronic inflammatory disorders and the prevention of cancer. In this review, we discuss the current understanding of the development and function of type17 immune cells at the intestinal barrier, focusing on the impact of microbiota-immune interactions on intestinal barrier homeostasis and disease etiology.

• Advances in pediatric surgery
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• 제13권1호
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• pp.23-29
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• 2007

Tapering enteroplasty was first described by Thomas in 1969 as one method of intestinal anastomosis. The advantages of tapering enteroplasty in the intestinal atresia are: First, it makes end-to-end anastomosis possible between the atretic bowel ends with considerable differences in diameters. Second, it promotes the recover of the postoperative bowel function. Third, it prevents the possibility of the short bowel syndrome by eliminating the need of resecting the dilated bowel. A total of 22 patients with intestinal atresia who underwent tapering enteroplasty from January 1988 to December 2005 at our institute were reviewed. In 3 of 22 cases, tapering enteroplasty was the $2^{nd}$ operation after an initial end-to-oblique anastomosis. We reviewed the following items: age, sex, type and location of intestinal atresia, initial feeding and total enteral feeding start day, the length of hospital stay and complications. The average age of the patients was 7 days. Male to female ratio was 1 to 1.2 (10 cases: 12 cases). We performed the tapering enteroplasty on all types and locations of the intestinal atresia from the duodenum to the colon: type I (n=3), type II (n=4), type IIIA (n=7), type IIIB (n=5), type IIIB and IV (n=1), type IV (n=1) and type C (duodenum) and type IIIB and IV (jejunum). On the average, the oral feeds were started on the postoperative $8.8^{th}$ day, and full caloric intake via the enteric route was achieved on postoperative $13.3^{th}$ day. The average length of hospital stay was 19.6 days. There were 1 case (4.5 %) of anastomotic complication and 2 cases (9 %) of adhesive ileus among 22 patients. The tapering enteroplasty on all types of intestinal atresia is a usefull operative method when there are considerable diameter differences between the atretic bowel ends.

• 대한한방내과학회지
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• 제30권1호
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• pp.191-199
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• 2009

목 적 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에서 전침 및 한약의 복합처치 치료가 이 두가지 면에서 각각 어떤 영향을 미치는지를 살펴보았다. 방 법 : 장음검사상 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 환자 10명을 대상으로 치료 전후의 장음 지표 변화를 비교하였다. 장음지표는 % of bowel sound (%BS)와 주 주파수(dominant frequency, DF)를 사용하였으며, %BS(6인 경우를 위 미주신경 활성저하 DF ratio(식후/식 전)<1를 유문부 기능장애로 평가하였다. 환자들에게 2주간 족삼리전 침과 체침이 매일 시술되었으며 평위산 전탕액이 하루 3회 투여되었다. 결 과 : 2주간의 치료 후 DF ratio는 $0.93\pm0.06$에서 $1.06\pm0.04$으로 유의성있게 증가했으며, 10명 중 9명의 환자가 DF ratio>1의 정상치로 회복되었다. %BS 역시 $2.97\pm1.17%$에서 4.27%로 증가했지만 통계적 유의성은 없었으며, 3명의 환자에서 %BS가 6이상으로 정상회복되었다. 결 론 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에 대한 족삼리 전침과 일반 체침, 평위산의 치료는 미주신경 활성 저하보다는 유문부 기능 장애에 더 유의한 효과를 보였다.

• Journal of Dairy Science and Biotechnology
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• 제28권2호
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• pp.25-30
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• 2010

For centuries, probiotics have been known to promote health and prevent diseases. In recent times, modulation of diseases related to the immune function by probiotics has been recognized as very important to the health of the host's gut. Inflammatory bowel diseases (IBDs) are the most frequently studied diseases in which probiotic administration has been tested as a potential therapy. Various in vitro and in vivo studies have been performed. The studies discussed in this review suggest several mechanisms: probiotics could modulate the gut microflora by competing with disease-causing pathogenic bacteria and could directly regulate the mucosal immune system, which activates the innate and adaptive immune systems. In addition, human clinical trials have shown alleviation of disease symptoms of ulcerative colitis (UC), Crohn's disease, etc. This study aimed to understand the molecular mechanisms underlying immune modulation by probiotics and review studies on the functional aspect of IBD alleviation by probiotics. With more scientific studies confirming the effect of probiotics, this therapy holds promise for use in alternative medicine and/or pharmaceutical preparations, given the long history of safe consumption of probiotics.

• Child Health Nursing Research
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• 제29권3호
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• pp.218-228
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• 2023

Purpose: This study aimed to identify clinical characteristics of South Korean pediatric inflammatory bowel disease (IBD) in a children's hospital over the past 5 years, with a specific focus on comparing the features observed between Crohn's disease (CD) and ulcerative colitis (UC). Additionally, it aimed to examine the nursing diagnoses given to patients. Methods: This retrospective study analyzed the medical records of Korean pediatric patients under 18 years of age who were diagnosed with IBD and hospitalized at a children's hospital in Seoul, South Korea, from January 2017 to December 2021. Results: The number of pediatric patients diagnosed with IBD steadily increased. This finding was particularly prominent for CD patients, the majority of whom were male. Pediatric patients with CD had significantly higher rates of abdominal pain and perianal lesions, while pediatric patients with UC had a higher rate of bloody stool. Laboratory findings indicated that CD patients had higher levels of inflammatory markers and lower albumin levels than UC patients. The nursing diagnoses given during hospitalization mostly related to safety and protection, physical comfort, and gastrointestinal function. Conclusion: This study provides insights into Korean pediatric IBD patients, enabling early detection and the development of nursing intervention strategies. From a comprehensive perspective, nursing care should not only address patients' physical needs but also their psychosocial needs.

• Journal of Nutrition and Health
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• 제28권9호
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• pp.825-833
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• 1995

This study was performed to investigate the influence of dietary fiber, which from whole food on the serum lipid level and bowel function in rats. The fiber sources of experimental diets were prepared by drying and milling of small water dropwort(WD), mugwort(MW), butterbur(BB) and apple(AP). Each fiber sources was mixed at the 15% level of the diet. The level of dietary fiber in WD, MW, BB diets was similar but that in AP diet was slightly low. Male rats of Sprague-Dawley strain were blocked into 5 groups ; WD, MW, BB, AP, FF(fiber free). The animals were fed ad libitum each of experimental diets for 37 days. Food intake of AP and FF groups were than other groups, FF group was lower than other grous in food efficiency ratio. MW group showed highest level in fecal weight and fecal water content and group has the longest transit time compare to other groups. Serum triglyceride level was not significantly different among groups. BB group showed the lowest level in the serum total cholesterol. WD and MW groups showed slightly higher level in the serum HDL cholesterol than other groups. Mucosa weight was not significantly different among groups. The activity of maltase in mucosa of small intestine was highest in FF groups. Absorption rates of calcium were not significantly different among groups. Absorption rate of magnesium was higher in FF group compare to others. And, absorption rates of phosphorus in MW and FF groups were slightly lower than other groups.

• Journal of Ginseng Research
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• 제45권6호
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• pp.706-716
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• 2021

Background: Irritable bowel syndrome (IBS), the most common functional gastrointestinal disorder, is characterized by chronic abdominal pain and bowel habit changes. Although diverse complicated etiologies are involved in its pathogenesis, a dysregulated gut-brain axis may be an important factor. Red ginseng (RG), a traditional herbal medicine, is proven to have anti-inflammatory effects and improve brain function; however, these effects have not been investigated in IBS. Methods: Three-day intracolonic zymosan injections were used to induce post-infectious human IBS-like symptoms in mice. The animals were randomized to receive either phosphate-buffered saline (CG) or RG (30/100/300 mg/kg) for 10 days. Amitriptyline and sulfasalazine were used as positive controls. Macroscopic scoring was performed on day 4. Visceral pain and anxiety-like behaviors were assessed by colorectal distension and elevated plus maze and open field tests, respectively, on day 10. Next-generation sequencing of gut microbiota was performed, and biomarkers involved in gut-brain axis responses were analyzed. Results: Compared to CG, RG significantly decreased the macroscopic score, frequency of visceral pain, and anxiety-like behavior in the IBS mice. These effects were comparable to those after sulfasalazine and amitriptyline treatments. Moreover, RG significantly increased the proliferation of beneficial microbes, including Lactobacillus johnsonii, Lactobacillus reuteri, and Parabacteroides goldsteinii. RG significantly suppressed expression of IL-1β and c-fos in the gut and prefrontal cortex, respectively. Further, it restored the plasma levels of corticosterone to within the normal range, accompanied by an increase in adrenocorticotropic hormone. Conclusion: RG may be a potential therapeutic option for the management of human IBS.

• 대한핵의학회지
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• 제37권2호
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• pp.135-136
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• 2003

A 43-year-old woman with diabetic nephropathy underwent a Tc-99m MAG3 renal scintigraphy for the evaluation of renal function. Posterior images at 60 minutes demonstrated a migration of radiotracer activity beyond the lower pole of the left kidney, which might be incorrectly interpreted as urine leaks. However, the increased activities were moving along the bowel lumens over time. Another ring-like radioactivity was also seen in the suprasplenic region, and increased with time. These radioactivities were in the gastric fundus and gastrointestinal tract and caused by free Tc-99m pertechnetate.