• Title/Summary/Keyword: gastrointestinal dysfunction

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Clinical Experiences of Multiple Organ Failure after Surgery for Acquired Cardiovascular Disease

  • 김병열
    • Journal of Chest Surgery
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    • v.23 no.2
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    • pp.275-284
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    • 1990
  • A serious problem after cardiovascular surgery known as Multiple Organ Failure[MOF] whereby several vital organs successively demonstrate dysfunction in spite of intensive postoperative treatment has recently arisen. We have made a retrospective study of the clinical records of 137 patients who underwent cardiovascular surgery during past two years [1987-1988]. Fourteen patients [10%] developed multi-organ failure postoperatively with the results of seven death [50%]. In fatal group, preoperative poor cardiac function [Cardiac Index<2.0L/min/m2] was considered important prognostic factor and infection 5 disseminated intravascular coagulation complicating gastrointestinal bleeding were the leading cause of death. In conclusion, evaluation of multiple factors concerning multi-organ failure demonstrates preoperative poor functional preservation of vital organs is the main factor. So early diagnosis k management for each of the failing organs & prevention of infection are mandatory of the treatment of these critically ill patients.

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The Effect of Long Coronavirus Disease on Obesity and the Role of Korean Medicine (롱코비드가 비만에 미치는 영향과 그에 대한 한의학의 역할)

  • Han, Kyungsun;Kim, Myung-Ho
    • Journal of Korean Medicine for Obesity Research
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    • v.22 no.1
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    • pp.77-85
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    • 2022
  • While the Coronavirus disease 2019 (COVID-19) pandemic is gradually turning into an endemic disease, concerns about post COVID-19 conditions (Long COVID) are emerging. Obesity is a major risk factor for severe complications of COVID-19, and COVID-19 has a wide range of effects on obesity and metabolic function. This paper aims to examine the interaction between COVID-19 and obesity, the effects and mechanisms of long COVID on obesity, and the role of Korean medicine on long COVID-related obesity. Obesity may worsen with cardiometabolic damage and psychosocial insecurity during COVID-19 and long COVID-induced neuroinflammation, systemic inflammation, mitochondrial dysfunction, and hypoxia also may aggravate obesity. Korean Medicine treatments, which have been widely used to treat obesity, have the potential to improve obesity in the era of long COVID by intervening in these mechanisms.

Review on Clinical Studies of Traditional Herbal Medicine and Acupuncture Treatments for Colorectal Cancer Patients (대장암 환자의 한약 및 침치료에 대한 국내외 임상연구 결과에 대한 고찰 - Pubmed를 중심으로)

  • Kang, Yun Hwan;Hong, Mi-na;Han, Chang Woo;Choi, Jun Yong;Park, Seong Ha;Kim, So Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.30 no.4
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    • pp.219-228
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    • 2016
  • The aim of this study was to collect and analyze the clinical studies of traditional herbal medicine and acupuncture treatments for colorectal cancer patients searched in Pubmed and Cochrane library in English. We collected the clinical studies, including randomized controlled trial, case control study and cohort study, in the PubMed and Cochrane library using keywords 'Colorectal Cancer', 'Korean Medicine', 'Traditional Chinese Medicine', 'Kampo' and 'Acupuncture'. Then we analyzed them according to the objective of the therapy, i.e. improving therapy prognosis, reducing chemotherapy's adverse event and reducing operational adverse event. In case RCT, we evaluate the quality of the study with jadad scale. Total 18 studies were selected. There were 3 studies about improving therapy prognosis, 6 studies about reducing chemotherapy's adverse event and 9 studies about reducing operational adverse event. Traditional medicine might improve therapy prognosis in terms of the survival rate, relapse/metastasis rate, quality of life and immune function. The specific herbal formula, 'Goshajinkigan' might not be successful about reducing chemotherapy's adverse event, peripheral neurotoxicity. 'Hangeshanshinto' might reduce the duration of oral mucositis but it is not clear to reduce the incidence of that. 'PHY906' might reduce the incidence of diarrhea. Acupuncture might reduce operational adverse event such as gastrointestinal dysfunction and pain. And 'Daikenchuto' might not be successful in reducing operational adverse event, gastrointestinal dysfunction. Further studies are needed to clarify the efficacy of traditional herbal medicine and acupuncture for colorectal cancer patients.

The Effects of 120 Hz High Frequency Electroacupuncture on the Gastric Mucosa in Cold-Restraint Stressed Rats (고빈도 120 Hz 전침이 Cold-Restraint 스트레스 유발 흰쥐의 위점막에 미치는 영향(影響))

  • Jo, Mee-Hyeong;Ahn, Chang-Beohm;Song, Choon-Ho;Yoon, Hyoun-Min;Kim, Cheol-Hong;Jang, Kyung-Jeon
    • Korean Journal of Acupuncture
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    • v.21 no.4
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    • pp.101-115
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    • 2004
  • Objective : The present studies investigated the effects of 120 Hz high frequency electroacupuncture (EA) on the stress-induced stomach dysfunction in relation to its effect on the level of stress hormones and gastric mucosal damages. The gastric mucosal injury was induced by cold-restraint stress and two acupoints corresponding to Zusanli and Sanyinjiao in man were used. Methods : Cold-restraint stress produced typical gastric lesions in all rats of the stressed groups, but the number of ulcers as well as the mean ulcer diameter were reduced by 120 Hz EA pre-treatment. Results : The degranulation value of gastric mast cell was significantly higher in cold-restrained rats than in control ones. However, with the significant reduction of degranulation values of gastric mast cells in EA pre-treated rats compared with cold-restrained rats. Cold-restarint stress induced an elevated mRNA expression of pro-inflammatory gene such as cyclooxygenases-2 and tumor necrosis factor $(TNF)-{\alpha}$, but these expression were down-regulated in EA pre-treated rats. Immunohistochemical analysis showed that while the $inhibitory-{\kappa}B{\alpha}$ and $TNF-{\alpha}$ immunorection in the surface epithelium of the stomach tended to increase, both reactions in the EA pre-treated rats showed similar pattern as observed in controls. Conclusion : These results suggest that 120 Hz EA may act as a therapeutical means for gastric mucosal damages through an activation of pituitary adrenal system. It could be concluded that 120 Hz high frequency electroaucupuncture affords a good protective potential against stress-induced gastrointestinal dysfunction.

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Does the Oral-Anal Transit Test Correlate with Colonic Manometry Findings in Children with Refractory Constipation?

  • Dranove, Jason;Fleishman, Nathan;Reddy, Saigopala;Teich, Steven
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.2
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    • pp.137-145
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    • 2020
  • Purpose: The Oral-anal Transit Test (OTT) is a simple method of obtaining information about colonic transit. We aim to assess the correlation of OTT with the neuromuscular integrity of the colon determined by colonic manometry (CM). Methods: All patients who had OTT followed by CM were evaluated. Less than 6 of 24 markers remaining on OTT was considered normal. CM was performed per previously published guidelines. A normal CM was defined as at least one High Amplitude Propagating Contraction progressing from the most proximal sensor through the sigmoid colon. Results: A total of 34 patients underwent both OTT and CM (44% male, age 4-18 years, mean 11.5 years, 97% functional constipation +/- soiling, Hirschsprung's Disease). Of normal and abnormal OTT patients, 85.7% (6/7) and 18.5% (5/27) respectively had normal CM. When all markers progressed to at least the sigmoid colon, this was 100% predictive against colonic inertia. Greater than 50% of patients with manometric isolated sigmoid dysfunction had markers proximal to the recto-sigmoid. Conclusion: OTT and CM are both valuable studies that assess different aspects of colonic function. OTT can be used as a screening test to rule out colonic inertia. However, the most proximal extent of remaining markers does not predict the anatomical extent of the manometric abnormality, particularly in isolated sigmoid dysfunction.

Bevacizumab Concomitant with Chemotherapy is Effective in Treating Chinese Patients with Advanced Non-Squamous Non-Small Cell Lung Cancer

  • Sun, Jing;Hu, Yi;Wu, Bai-Shou;Wang, Jin-Liang;Tao, Hai-Tao;Zhang, Su-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5945-5950
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    • 2014
  • Objectives: To retrospectively review the safety and clinical efficacy of bevacizumab concomitant with chemotherapy in Chinese patients with advanced non-squamous non-small cell lung cancer (NSNSCLC). Methods: Clinical data for 79 patients with NSNSCLC who received bevacizumab concomitant with chemotherapy in Chinese PLA General Hospital from April 28th 2009 to May 5th 2013 were retrospectively reviewed to analyze the clinical efficacy including disease control rate (DCR), overall response rate (ORR), progression-free survival (PFS), overall survival (OS), the Eastern Cooperative Oncology Group (ECOG) score and the safety. Results: The Eastern Cooperative Oncology Group (ECOG) score was 0-2. By the final cutoff date (June 9, 2013), 54 (68.4%) patients had disease progression and 37 (46.8%) died. The ORR was 32.9% and the DCR was 83.5%. The ORR of the first-, second-, and third- or later-line treatments were 51.4%, 25.0% and 12.5%, while the DCR were 94.3%, 80.0% and 70.8%, respectively. The median OS (mOS) and PFS (mPFS) were 13.5 and 5.83 months, respectively. The mOS of patients with the first-, second-, and third- or later- line treatments were 16.2, 10.9 and 8.30 months, while the mPFS were 7.27, 5.90 and 5.17 months, respectively. Chemotherapy-related adverse events included myelosuppression, vomiting, hepatic dysfunction and renal dysfunction, while the common serious bevacizumab-related adverse events were thromboembolic problems, gastrointestinal perforation and reversible posterior leukoencephalopathy syndrome, which could be well managed. Conclusions: Bevacizumab concomitant with chemotherapy is effective and the related toxicity can be well tolerated in Chinese patients with NSNSCLC.

The Effects of 120Hz High Frequency Electroacupuncture on the Cold-Restraint-Induced Gastric Mucosal Damages (Cold-Restraint 스트레스 유발 위점막손상에 미치는 고빈도 120Hz 전침의 효과)

  • Jo, Mee-hyeong;Choi, Byung-tae;Jang, Kyung-jeon
    • Journal of Acupuncture Research
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    • v.20 no.3
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    • pp.177-193
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    • 2003
  • Objective : The present studies investigated the effects of 120Hz high frequency electroacupunctue(EA) on the stress-induced stomach dysfunction in relation to its effect on the level of stress hormone and gastric mucosal damages. The gastric mucosal injury was induced by cold-restraint stress and two acupoints corresponding to Zusanli and Sanyinjiao in man were used. Methods: Cold-restraint stress produced typical gastric lesions in all rats of the stressed groups, but he number of ulcers as well as the mean ulcer diameter were reduced by 120 Hz EA pre-treatment. The cold-restraint stress also induced an increase in catecholamine response involving epinephrine, norepinephrine and dopamine, but an slight decline were observed in EA pre-treated rats compared with cold-restrained rats. Results: The degranulation value of gastric mast cell was significantly higher in cold-restrained rats than in control ones. However, with the significant reduction of degranulation values of gastric mast cells in EA pre-treated rats compared with cold-restrained ones, $PGE_2$ content in the gastric mucosa of EA pre-treated rats was also different from that observed in cold-restrained rats. Cold-restraint stress induced an elevated mRNA expression of pro-inflammatory gene such as cyclooxygenases-2 and tumor necrosis factor(TNF)-${\alpha}$, but these expression were down-regulated in EA pre-treated rats. Immunohistochemecal analysis showed that while the inhibitory-${\kappa}B{\alpha}$ an TNF-${\alpha}$ immunoreaction in the surface epithelium of the stomach tended to increase, both reactions in the EA pre-treated rats showed similar pattern as observed in controls. Conclusions : These results suggest that 120 Hz EA may act as a therapeutical means for gastric mucosal damages through a activation of pituitary adrenal system. it could be concluded that 120 hz high frequency electroacupuncture affords a good protective potential against stress-induce gastrointestinal dysfunction.

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Association of vitamin D deficiency with clinical outcomes in critically ill Korean children

  • Jhang, Won Kyoung;Kim, Da Hyun;Park, Seong Jong
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.12-19
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    • 2020
  • BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

A Case of Protein-losing Enteropathy Treated with High Dose Intravenous Glucocorticoid Therapy in Systemic Lupus Erythematosus (전신성 홍반성 루푸스에서 고용량 경정맥 당질코르티코이드로 치료된 단백질 소실성 장질환 1예)

  • Lee, Kyu-Hyung;Kwon, Chang-Mo;Kim, Hyun-Do;Yun, Dae-Young;Lee, Jae-Yoong;Hong, Yeong-Hoon;Lee, Choong-Ki
    • Journal of Yeungnam Medical Science
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    • v.22 no.2
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    • pp.253-258
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    • 2005
  • Generalized edema and hypoalbuminemia are relatively common presenting manifestations in many clinical situations. The differential diagnosis of hypoalbuminemia include: Kwashiorkor, synthetic dysfunction of the liver, and excessive protein loss as in nephrotic syndrome. In systemic lupus erythematosus (SLE), hypoalbuminemia and generalized edema are most commonly due to protein loss associated with lupus nephritis; gastrointestinal involvement is uncommon, and therefore protein loss through the gastrointestinal tract is quite rare. We report a case of a protein losing enteropathy (PLE) associated with SLE. The patient was referred to our hospital for generalized edema, arthralgia and facial rash. After clinical evaluation, the patient met the criteria for the SLE diagnosis; hypoalbuminemia with general edema was consistent with a protein losing enteropathy. After two weeks of therapy with parenteral high dose glucocorticoid, the patients was improved in laboratory findings as well as clinical symptoms.

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Effects of the Dried Root of Codonopsis pilosula on Gastrointestinal Motor Function in Mice (당삼이 마우스 위장관 운동 기능에 미치는 영향)

  • Kim, Min Woo;Kim, Hyun Jin;Kim, Moon-Moo;Lee, Eun-Woo;Kwon, Hyun Ju;Kim, Byung Woo;Lee, Hyun-Tai
    • Journal of Life Science
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    • v.26 no.11
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    • pp.1253-1258
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    • 2016
  • Although major advances have been achieved in our understanding and treatment of diseases in many areas of medicine, relatively few improvements have been made in the area of gastrointestinal (GI) motor function. The dried root of Codonopsis pilosula (Franch.) Nannf. (CP) has been used as a traditional folk medicine for improving poor GI function in East Asia, including China and Korea. In the present study, neither aqueous (CP-W) nor ethanolic (CP-E) extracts of CP showed significant toxicity, even at an oral dose of 5 g/kg to mice. The effects of CP-W and CP-E on GI motor function were investigated by measuring in vivo the gastric emptying rate (GER) and intestinal transit rate (ITR) in mice. In normal mice, the ITR was significantly increased by CP-W in a dose-dependent manner, whereas the GER was not significantly affected by any CP extracts. The ITR was significantly retarded in the mice with experimental GI motility dysfunction (i.e., peritoneal irritation by acetic acid) compared with that in normal mice. However, the retardation was significantly recovered by the pre-treatment of CP-W in a dose-dependent manner. The above results suggest that CP-W might be a potential prokinetic agent preventing or alleviating GI motility dysfunctions in human patients.