• Title/Summary/Keyword: bowel function.

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The Effectiveness of Traditional Korean Medicine for Treating Postoperative Ileus in Gastric Cancer Patients: A Systematic Review and Meta-Analysis (위암 수술 후 장마비에 대한 한의학적 치료의 효과 : 체계적 문헌 고찰 및 메타분석)

  • Bae, Hye-ri;Kim, Eun-ji;Seo, Hyun-sik;Lee, Nam-hun
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.625-642
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    • 2022
  • Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.

Antistress effect of Gagamsanzointang on rat chronic stress model (가감산조인탕(加減酸棗仁湯)이 만성 스트레스 모델 쥐에 대한 항스트레스 효과)

  • Kwon, Hyuk-Jin;Kim, Kyeng-Sub;Kang, Su-Kueng;Park, Pil-Sang;Yu, Ji-Yeon;Lim, Ji-Min;Cho, Yong-Sik;Choi, Yoon-Hee;Park, Shin-Young
    • The Korea Journal of Herbology
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    • v.27 no.6
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    • pp.29-35
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    • 2012
  • Objectives : To observe the effect of 4 kinds of Korean medicine and complex extracts on the anti-stress of chronic mild stress Rat model, so as to find out the machanism of its pharmacological effects. Methods : 64 healthy SD Rats were randomly divided into 8 groups. Model Design by chronic stress(CSM), and carried out the forced swimming test. We investigated the body weight, feed and water intake, feed conversion ratio and measured parameters to changes in swimming time, immobility time, 2 and 24 hours of feces, corticosterone hormone and blood glucose level. Results : In this experiments, body weight gain and feed intake were higher in all korean medicinal herb group. Swimming time were increased by Zizyphus jujuba and Gagamsanzointang(SZT) groups and immobility time was significantly lower by Zizyphus jujuba and Fluoxetine(FLX) groups. The result of corticosterone hormone level were significantly lower in Fluoxetine(FLX) and Gagamsanzointang(SZT) but blood glucose was not significantly difference. In 2 hours after fecal frequency result were significantly lower in Zizyphus jujuba group. but SZT group were increased. This result caused by acute stress but 24 hours of feces were restored to normal. Conclusions : 5 kind of Korean Medicinal Herbs extracts has good anti-stress effects, and also to clear the circulatory system and regulate blood glucose and improve bowel function. We suggest that use a single Korean medicine rather than the combination to relieve stress.

Early and Midterm Results of Coronary Artery Bypass Grafting in Patients with Ischemic Cardiomyopathy ${(LVEF{\leq}35%)}$ (허혈성 심근질환(좌심실박출지수${\leq}$35%) 환자에서 관상동맥우회술의 조기와 중기 결과)

  • Cho Sung-Woo;Lee Young-Tak;Choi Jin-Ho;Kim Si-Wook;Park Kay-Hyun;Park Pyo-Won;Sung Ki-Ick
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.604-610
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    • 2006
  • Background: Recent improvements in interventional procedure and medical therapy for congestive heart failure result in an increase of number of patients with ischemic cardiomyopathy considered for coronary artery bypass grafting. We retrospectively review the results of CABG in these patients with decreased LV function to know the early and mid-term follow-up results. Material and Method: Between January 2001 and June 2005, 1,143 patients underwent coronary artery bypass grafting and 144 of these patients had preoperative left ventricular function of equal to or less than 35% ${(LVEF{\leq}\;35%)}$. There were off-pump coronary artery bypass grafting (OPCAB) in 66 cases (45.8%), on-pump beating heart coronary artery bypass grafting in 34 cases (23.6%) and conventional coronary artery bypass grafting in 44 cases (30.6%). The combined operations including mitral annuloplasty were 48 cases in thirty five patients (24.3%). Result: The mean number of dstal anastomosis were $3.5{\pm}1.3$. The median postoperative duration of stay in intensive care unit and hospital was 2 days and 8 days, respectively. There were 6 early death (4.2%) and causes of deaths were ventricular tachycardia in 5 patients, small bowel infarction in one patient. Mean follow-up time was $21{\pm}14$ months $(4{\sim}54\;months)$. The 1-year was $95{\pm}2%$ and 3-year survival rate was $83{\pm}7%$, the 1-year and 3-year cardiac event-free survival were ${88{\pm}3%\;and\;69{\pm}7%}$, respectively. Conclusion: Based on satisfactory early and mid-term results in our study, CABG should be carried out as actively as possible in patients with ischemic cardiomyopathy. Postoperative aggressive management for ventricular arrhythmia would be helpful for better results.

Comprehensive Geriatric Assessment for Community Living Elderly in a Rural Area (일부 농촌지역 거주 노인들에 대한 포괄적 노인평가)

  • Rhee, Jung-Ae;Shin, Hee-Young;Chung, Eun-Kyung;Shin, Jun-Ho
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.21-31
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    • 2002
  • The aim of this study was to analyse and conduct the comprehensive geriatric assessment for the elderly in rural area. The subjects were 388 older people aged 65 years or older living in the community. Data for comprehensive assessment such as physical, mental, functional, social and environmental conditions were collected from January to February, 2001 through a person-to-person interview. Of the total 388 olders, 169(43.6%) were men and 219(56.4%) were women. Mean ages of men and women were $73.5{\pm}6.4$ and $74.0{\pm}6.2$ years respectively. Three common diseases of the elderly were arthralgia(51.6%), chronic back pain(33.2%) and hypertension(18.6%), and higher in women than in men. Impairment rate of vision, hearing and bowel or bladder control was 59.0%, 20.1%, and 28.4% respectively. But that of lover extremities 3.4%. In terms of cognitive function, short term memory loss was found in 33.7% of males and 44.7% of females. The percentage of fully independent in the six ADL items was 72.2% in men and 58.9% in women. In the social supportive system, 49.5% of the elderly were living with spouse, and 22.9% living alone, 26.3% having care giver. These results will provide basic data for the development of community-based health program, which gives appropriate health service for the elderly living in the community.

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The Ability of Anti-tumor Necrosis Factor Alpha(TNF-${\alpha}$) Antibodies Produced in Sheep Colostrums

  • Yun, Sung-Seob
    • 한국유가공학회:학술대회논문집
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    • 2007.09a
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    • pp.49-58
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    • 2007
  • Inflammatory process leads to the well-known mucosal damage and therefore a further disturbance of the epithelial barrier function, resulting abnormal intestinal wall function, even further accelerating the inflammatory process[1]. Despite of the records, etiology and pathogenesis of IBD remain rather unclear. There are many studies over the past couple of years have led to great advanced in understanding the inflammatory bowel disease(IBD) and their underlying pathophysiologic mechanisms. From the current understanding, it is likely that chronic inflammation in IBD is due to aggressive cellular immune responses including increased serum concentrations of different cytokines. Therefore, targeted molecules can be specifically eliminated in their expression directly on the transcriptional level. Interesting therapeutic trials are expected against adhesion molecules and pro-inflammatory cytokines such as TNF-${\alpha}$. The future development of immune therapies in IBD therefore holds great promises for better treatment modalities of IBD but will also open important new insights into a further understanding of inflammation pathophysiology. Treatment of cytokine inhibitors such as Immunex(Enbrel) and J&J/Centocor(Remicade) which are mouse-derived monoclonal antibodies have been shown in several studies to modulate the symptoms of patients, however, theses TNF inhibitors also have an adverse effect immune-related problems and also are costly and must be administered by injection. Because of the eventual development of unwanted side effects, these two products are used in only a select patient population. The present study was performed to elucidate the ability of TNF-${\alpha}$ antibodies produced in sheep colostrums to neutralize TNF-${\alpha}$ action in a cell-based bioassay and in a small animal model of intestinal inflammation. In vitro study, inhibitory effect of anti-TNF-${\alpha}$ antibody from the sheep was determined by cell bioassay. The antibody from the sheep at 1 in 10,000 dilution was able to completely inhibit TNF-${\alpha}$ activity in the cell bioassay. The antibodies from the same sheep, but different milkings, exhibited some variability in inhibition of TNF-${\alpha}$ activity, but were all greater than the control sample. In vivo study, the degree of inflammation was severe to experiment, despite of the initial pilot trial, main trial 1 was unable to figure out of any effect of antibody to reduce the impact of PAF and LPS. Main rat trial 2 resulted no significant symptoms like characteristic acute diarrhea and weight loss of colitis. This study suggested that colostrums from sheep immunized against TNF-${\alpha}$ significantly inhibited TNF-${\alpha}$ bioactivity in the cell based assay. And the higher than anticipated variability in the two animal models precluded assessment of the ability of antibody to prevent TNF-${\alpha}$ induced intestinal damage in the intact animal. Further study will require to find out an alternative animal model, which is more acceptable to test anti-TNF-${\alpha}$ IgA therapy for reducing the impact of inflammation on gut dysfunction. And subsequent pre-clinical and clinical testing also need generation of more antibody as current supplies are low.

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