• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권4호
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• pp.224-229
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• 2023

Gastrointestinal (GI) bleeding is a rare adverse event of dasatinib, which is known to be caused by dasatinib-induced colitis, severe thrombocytopenia, and platelet dysfunction. We present two cases of pediatric patients who developed hematochezia during treatment with dasatinib after hematopoietic stem cell transplantation (HSCT). A colonic tissue biopsy was performed to differentiate the cause of GI bleeding. Both patients were diagnosed with proven cytomegalovirus (CMV) colitis, but only one was treated with ganciclovir. The patient who did not receive antiviral therapy experienced recurrent GI bleeding during dasatinib administration, leading to multiple treatment interruptions. During dasatinib therapy after HSCT, patients with GI bleeding and confirmed CMV colitis may benefit from antiviral therapy to reduce interruptions in dasatinib therapy.

• Clinical Endoscopy
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• 제57권4호
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• pp.542-546
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• 2024

Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) through ducts B2 or B3 is effective in most patients with biliary obstruction, because B2 and B3 commonly join together. However, in some patients, B2 and B3 do not join each other due to invasive hilar tumors; therefore, single-route drainage is insufficient. Here, we investigated the feasibility and efficacy of EUS-HGS through both B2 and B3 simultaneously in seven patients. We decided to perform EUS-HGS through both B2 and B3 to achieve adequate biliary drainage because these two ducts were separate from each other. Here, we report a 100% technical and overall clinical success rate. Early adverse effects were closely monitored. Minimal bleeding was reported in one patient (1/7) and mild peritonitis in one patient (1/7). None of the patients experienced stent dysfunction, fever, or bile leakage after the procedure. EUS-HGS through both B2 and B3 simultaneously is safe, feasible, and effective for biliary drainage in patients with separated ducts.

• 생명과학회지
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• 제24권3호
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• pp.260-265
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• 2014

귤나무(Citrus unshiu)의 과피를 말린 한약재인 진피(Aurantii Nobilis Pericarpium; ANP)는 오래 전부터 대한민국을 비롯한 동아시아에서 위장관 운동 관련 질환의 치료에 전통적으로 쓰여 왔다. 본 연구에서는 진피 주정 추출물(ANP-E)을 제조하여 실험하였는데, 우선 ANP-E는 5 g/kg의 고용량을 mouse에 경구 투여하였을 때에도 급성독성을 나타내지 않았다. ANP-E가 위장관 운동 기능에 미치는 영향을 파악하고 이를 cisapride의 효과와 비교하기 위하여, mouse를 대상으로 위장관 이송률을 측정하는 실험을 수행하였다. Cisapride는 20세기 말까지 다양한 위장관 운동 저해 상황에서 임상적으로 광범위하게 적용되었던 최고의 위장관 운동 촉진제였으나, 치명적인 부작용으로 인하여 2000년 이후 시장에서 철수된 약물이다. 실험 결과, ANP-E는 정상 및 위장관 운동 저해 상황에서 모두 용량 의존적으로 위장관 운동을 촉진시키는 것으로 나타났다. ANP-E의 위장관 운동 촉진 효과를 cisapride와 비교해 보면, 정상 mouse에서는 cisapride와 거의 대등한 위장관 이송률 수치를 나타내었으며, 특히 위장관 운동 저해 상황에서는 cisapride보다 약효 및 안전성 측면에서 모두 비교 우위를 점하는 강력한 위장관 운동 기능개선 효과를 보였다. 이상과 같은 결과들은, ANP-E가 인간의 위장관 운동 기능 저해 상황을 개선할 수 있는 새롭고 강력한 신약 후보 물질이자, 아직 시장에 출현하지 않고 있는 cisapride의 대체 의약품으로서 개발 가능함을 시사하고 있다.

• Journal of Ginseng Research
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• 제39권4호
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• pp.314-321
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• 2015

Background: Ginseng belongs to the genus Panax. Its main active ingredients are the ginsenosides. Interstitial cells of Cajal (ICCs) are the pacemaker cells of the gastrointestinal (GI) tract. To understand the effects of ginsenoside Re (GRe) on GI motility, the authors investigated its effects on the pacemaker activity of ICCs of the murine small intestine. Methods: Interstitial cells of Cajal were dissociated from mouse small intestines by enzymatic digestion. The whole-cell patch clamp configuration was used to record pacemaker potentials in cultured ICCs. Changes in cyclic guanosine monophosphate (cGMP) content induced by GRe were investigated. Results: Ginsenoside Re ($20-40{\mu}M$) decreased the amplitude and frequency of ICC pacemaker activity in a concentration-dependent manner. This action was blocked by guanosine 50-[${\beta}-thio$]diphosphate [a guanosine-5'-triphosphate (GTP)-binding protein inhibitor] and by glibenclamide [an adenosine triphosphate (ATP)-sensitive $K^{+}$ channel blocker]. To study the GRe-induced signaling pathway in ICCs, the effects of 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one (a guanylate cyclase inhibitor) and RP-8-CPT-cGMPS (a protein kinase G inhibitor) were examined. Both inhibitors blocked the inhibitory effect of GRe on ICC pacemaker activity. L-NG-nitroarginine methyl ester ($100{\mu}M$), which is a nonselective nitric oxide synthase (NOS) inhibitor, blocked the effects of GRe on ICC pacemaker activity and GRe-stimulated cGMP production in ICCs. Conclusion: In cultured murine ICCs, GRe inhibits the pacemaker activity of ICCs via the ATP-sensitive potassium ($K^{+}$) channel and the cGMP/NO-dependent pathway. Ginsenoside Re may be a basis for developing novel spasmolytic agents to prevent or alleviate GI motility dysfunction.

• 대한한방내과학회지
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• 제26권4호
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• pp.761-766
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• 2005

Objectives : 본 연구는 암환자의 위장관 기능장애를 개선시킬수 있는 보다 효과적인 약물개발의 일환으로 곽향 추출물의 장운동에 미치는 영향을 평가하기 위해 수행되어졌다. Methods : 생리적인 상태에서 곽향추출물이 장운동에 미치는 영향을 알아보기 위해 장운동촉진제인 carbachol과 곽향추출물을 실험쥐들에게 투여후 15분후 charcoal meal을 먹여서 charcoal meal의 소장내 통과 정도를 비교 측정하였다. 또, loperamide, scopolamine, nicotine으로 장운동을 억제시켜 놓은 실험쥐들에 15분 간격으로 곽향 추출물과 charcoal meal을 먹인 후 역시 charcoal meal의 소장내 통과 정도를 비교 측정하였다. Results : 곽향 추출물은 생리상태에서는 장운동에 영향을 미치지 않았다. 곽향추출물은 loperamide와 scopolamine으로 유발된 장운동 억제상태에 대하여 부분적으로 영향을 끼쳤다. 그러나 nicotine으로 유발된 상태에 대해서는 영항을 끼치지 않았다. Conclusion : 곽향 추출물은 소화관 기능부전 완화에 효과적으로 작용하는 천연물이라 추론할 수 있다.

• The Korean Journal of Physiology and Pharmacology
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• 제6권6호
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• pp.311-317
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• 2002

This study was performed to investigate the pancreatic exocrine dysfunction in streptozotocin- induced diabetic rats. Changes in pancreatic enzymes secretion and in pancreatic enzymes content were observed. The output and the tissue content of amylase were significantly reduced in diabetic rats, while the output and the content of lipase were increased. Plasma secretin and cholecystokinin (CCK) concentrations of diabetic rats were significantly increased compared to those of normal rats. The altered pancreatic exocrine function was abolished by the exogenous insulin administration. The exogenous insulin also restored the increased plasma secretin and CCK concentrations. From the above results, it is suggested that, in streptozotocin-induced diabetic rats, anticoordinated changes in pancreatic enzymes secretion as well as pancreatic enzymes content are attributable to insulin deficiency and that the insulin deficiency is responsible for the increased plasma concentrations of both secretin and CCK. However, it is not clear whether the elevated plasma secretin and CCK concentrations played a direct role in changes of pancreatic exocrine function.

• Journal of Chest Surgery
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• 제49권3호
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• pp.151-156
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• 2016

Background: Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods: Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results: Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients' diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion: ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.

• 한국축산식품학회지
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• 제37권6호
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• pp.931-939
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• 2017

Alcoholic liver disease (ALD) is a complex multifaceted disease that involves oxidative stress and inflammation as the key mediators. Despite decades of intensive research, there are no FDA-approved therapies, and/or no effective cure is yet available. Probiotics have received increasing attention in the past few years due to their well-documented gastrointestinal health-promoting effects. Interestingly, emerging studies have suggested that certain probiotics may offer benefits beyond the gut. Lactobacillus fermentum LA12 has been previously demonstrated to play a role in inflammatory-related disease. However, the possible protective effect of L. fermentum LA12 on ALD still remain to be explored. Thus, the aim of this study was to evaluate the possible protective effect of L. fermentum LA12 on alcohol-induced gut barrier dysfunction and liver damage in a rat model of alcoholic steatohepatitis (ASH). Daily oral administration of L. fermentum LA12 in rat model of ASH for four weeks was shown to significantly reduced intestinal nitric oxide production and hyperpermeability. Moreover, small intestinal histological- and qRT-PCR analysis further revealed that L. fermentum LA12 treatment was capable of up-regulating the mRNA expression levels of tight junction proteins, thereby stimulating the restitution of barrier structure and function. Serum and hepatic analyses also revealed that the restoration of epithelial barrier function may prevent the leakage of endotoxin into the blood, subsequently improve liver function and hepatic steatosis in the L. fermentum LA12-treated rats. Altogether, results in this study suggest that L. fermentum LA12 may be used as a dietary adjunct for the prevention and treatment of ASH.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1140-1146
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• 2008

Nocturnal enuresis is a heterogeneous disorder with various underlying pathophysiological mechanisms and causes a mismatch between the nocturnal bladder capacity and the amount of urine produced during sleep at night. It is associated with a simultaneous failure of conscious arousal in response to the sensation of bladder fullness. Generally, a complete history and physical examination, with a specific focus on the genitourinary, gastrointestinal, and neurologic systems, is sufficient to evaluate a patient with enuresis. The therapeutic focus is directed toward a differential approach based on the underlying mechanism and toward combination therapies such as alarm devices and desmopressin as well as anticholinergic agents and desmopressin. Children with increased nocturnal urine production usually have a good response to desmopressin therapy. Patients with a small bladder generally show a poor response to desmopressin treatment, but they would benefit more from combination therapy with enuretic alarm, urotherapy, and antimuscarinic agents in addition to desmopressin. Different types of bladder dysfunction, which result in a small nocturnal bladder capacity, probably contribute significantly to the pathogenesis of nocturnal enuresis, particularly in those with treatment failure and refractory symptoms. Because different clinical subgroups may show different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made.

• 동의생리병리학회지
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• 제21권2호
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• pp.462-467
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• 2007

The radix of Pueraria thunbergiana BENTHAM (Leguminosae) is traditionally prescribed to attenuate the clinical manifestations of inner ear dysfunction and various clinical situations including fever, gastrointestinal disorders, skin problems, migraine headaches, lowering cholesterol and treating chronic alcoholism in Oriental Medicine. In the present study, we examined the effect of ethanol extract of P. thunbergiana radix (EPR) on cisplatin-mediated HEI-OC1 auditory cell death. In addition, to investingate the protection mechanism of EPR on free radicals. Treatment of EPR protected cells from cisplatin and reduced lipid peroxidation in a dose-dependent manner. Furthermore, EPR demonstrated significant scavenging activity against various free radicals, including superoxide radical, hydroxyl radical, hydrogen peroxide, and DPPH radical. These results indicate that EPR protects cisplatin-induced damages of HEI-OC1 cells through inhibition of lipid peroxidation and augmenting scavenging activities against free radials.