• Title/Summary/Keyword: 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.

A Case of Eventration of the Diaphragm (횡경막성 내장탈출증: 1례 보고)

  • 박광훈;최인환
    • Journal of Chest Surgery
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    • v.6 no.2
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    • pp.243-248
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    • 1973
  • Eventration of the diaphragm is, by definition, abnormally high or elevated position of diaphragm as a result of paralysis, aplasia or atrophy of varing degrees of muscle fibers, and the cause of which may be congenital or acquired. The unbroken continuity of the diaphragm differentiates it from diaphragmatic hernia. The clinical manifestations of the condition, if present, are usually due to the interference of the ventilatory function of the lung and digesive dysfunction due to gastrointestinal distorsion. Treatment consists of surgical repair of the relaxed diaphragm to it`s normal position. A ease of left sided eventuration of the diaphragm, 31 year old officer, was found by chance after traffic accident with chief complaints of hemoptysis and multiple superficial contusions. Routine chest roentgenogram and barium study of the colon revealed moderately elevated left hemidiaphragm with displacement of the splenic flexure of the colon into the left chest. Past history revealed frequent attack of upper respiratory infection and some abnormal condition on his left chest announced by screen cheek of chest X-ray at the time of entrance for his army service 3 years before. Plication of the relaxed diaphragm through left thoracotomy was done and result was excellent as seen on Fig. 5. Cause of eventration of the left hemidiaphragm was due to paralysis of the left phrenic nerve which was tested during thoracotomy.

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Effect of Baekyeum on Intestinal Motility

  • Lim Jong Won;Cho Jung Hyo;Son Chang Gue;Shin Jang Woo;Lee Yeon Weol;Yoo Hwa Seung;Lee Nam Hun;Yun Dam Hee;Cho Chong Kwan
    • The Journal of Korean Medicine
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    • v.26 no.4
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    • pp.56-61
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    • 2005
  • Objectives: The purpose of this study was to evaluate the effects of Baekyeum (BKE) on intestinal motility. Methods: The effects of BKE on intestinal motility at the physiological state were evaluated by determination of intestinal motility after administration of a charcoal meal. The effects of BKE on intestinal motility at cabachol-induced activated state and loperamide induced suppressed state were also evaluated by determination of intestinal motility after administration of charcoal meal. Results: BKE didn't affect the intestinal motility in physiological state, and BKE didn't affect the intestinal motility at the carbachol-induced activated state. BKE activated significantly the intestinal motility at the loperamide-induced suppressed state. Conclusions: It can be concluded that BKE is an effective herbal prescription for cancer-patients with gastrointestinal dysfunction, especially intestinal stasis.

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A Study for Safe Dose and Clinical Use of Glycyrrhizae Radix in Shanghanlun (『상한론(傷寒論)』 처방에서 감초(甘草) 용량의 안전성 및 임상 사용에 대한 문헌 고찰)

  • Kim, Hyeong-Seop;Lee, Soong-In
    • 대한상한금궤의학회지
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    • v.8 no.1
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    • pp.1-23
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    • 2016
  • Objectives : The purpose of this paper is to find out the safe dose and clinical use for administration of Glycyrrhizae Radix in Shanghanlun(傷寒論). Methods : Web-databases(OASIS, NDSL, Pubmed, Google) were searched with keywords including 'Licorice', 'Pseudoaldosteronism', 'Glycyrrhizin', 'Testosterone' on 14/10/2016. The searched about 40 papers and books were reveiwed. Results : Glycyrrhizin(GL) and 3-monoglucuronyl glycyrrhetinic acid(3MGA) in Glycyrrhizae Radix are found to be the main compounds vulnerable for inducing pseudoaldosteronism. The dose range of Glycyrrhizae Radix in Shanghanlun prescriptions is from 0.25 g to 12 g as a daily administration, and this dose satisfies the guidelines of WHO, European Union, ABC etc. And risk factors contributing for personal sensitivities are old age(>60), female sex, liver dysfunction, hypokalemia, prolonged gastrointestinal transit time, anorexia nervosa, decreased 11-${\ss}$-hydroxysteroid dehydrogenase-2 activity and hypertension. Conclusions : As a result, dose of Glycyrrhizae Radix in Shanghanlun(傷寒論) is safe. However, the personal sensitivity and unexpected drug interactions are independent from doses of GL, so doctors should monitor those risk factors and symptoms of pseudoaldosteronism when administering Glycyrrhizae Radix.

Weight Variation in Term Newborns Hospitalized during Early Postnatal Period (고위험만삭아의 생후 초기 체중변이)

  • Ahn, Youngmee;Kim, Namhee;Lee, Eunyoung;Kwak, Miyoung
    • Child Health Nursing Research
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    • v.21 no.4
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    • pp.339-346
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    • 2015
  • Purpose: This study was performed to explore the weight variations in high-risk term newborns hospitalized during the early postnatal period. Methods: A retrospective explorative study was performed with 64 term newborns who were hospitalized in the NICU after birth. Data on daily weight, birth information, and clinical features such as phototherapy, placements, nutritional status were reviewed through medical records for 14 days of life. General Linear Model, GLM was applied to analyze the weight variation by clinical features of these high-risk term newborns for 14 days of life. Results: Newborns at 40 weeks of gestation showed little weight loss during the few days after birth then steadily gained weight to 7.6% at the 14th day. Infants born at 37-39 gestation showed little weight gain for 14 days though the weight loss itself was not apparent. As well, return to birthweight was not observed in newborns with phototherapy, infants placed on a warmer or infants having gastrointestinal dysfunction for 14 days of life. Conclusion: Even for term newborns, physiologic weight loss may not be warranted even if newborn is born at less than 40 week of gestation, or with high-risk conditions that warrant admission to NICU.

Evaluation of Hemostatic Function with Thromboelastography in Dogs with Hypercoagulable Diseases

  • Kim, Ja-Won;Nam, Aryung;Lee, Kyu-Pil;Song, Kun-Ho;Youn, Hwa-Young;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.65-69
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    • 2017
  • Thromboembolic complications are increasing in veterinary medicine. Thromboelastography (TEG) is a more comprehensive method for assessing the clotting process than standard plasma-based coagulation tests. This study compared the ability of TEG and standard coagulation tests to analyze the overall hemostatic state of dogs. The study involved 40 dogs with underlying diseases that predispose to hypercoagulability, including neoplasia, hyperadrenocorticism, immune-mediated diseases, gastrointestinal diseases, and protein-losing nephropathies and enteropathies, and 20 healthy dogs. Their overall hemostatic functional state was evaluated by TEG and routine coagulation assays, including activated partial thromboplastin time, prothrombin time, platelet count, and D-dimer concentration. TEG analysis showed significant differences in clot formation time, ${\alpha}$ angle, and maximum amplitude (MA) between diseased and control dogs (P < 0.001 each). Increased MA was the most frequent abnormality on TEG and was indicative of hypercoagulability. TEG was useful in detecting hemostatic dysfunction in dogs with diseases associated with hypercoagulability. Dogs with TEG tracings indicative of hypercoagulability are likely to be in procoagulant states. Future prospective studies are needed to evaluate whether TEG tracings indicative of hypercoagulability are predictive of thrombosis in dogs.

Review of Chuna Manual Therapy for Adult Digestive System Disease (추나 치료가 성인 소화기계 질환에 미치는 영향에 대한 문헌 고찰)

  • Kim, Kyu-Jin;Choo, Su-Cheol;Lee, Jae-Won;Hwang, Eui-Hyoung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.35-46
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    • 2018
  • Objectives : To determine the effectiveness of Chuna manual therapy(CMT) for Adult Visceral Diseases. Methods : To find evidence of CMT for adult digestive system disease, we used 9 electronic databases(Pubmed, CAJ, EMBASE, Cochrane Library, Web of Science, KISS, KISTI, NDSL, RISS) up to April 2018. We reviewed randomized control trials(RCTs) using Chuna for Digestive system disease. To assess the methodological quality of each RCT, we used the Cochrane risk of bias tool. Results : We identified 11 RCTs about irritable bowel syndrome, chronic ulcerative colitis, gastritis, gastroptosis, spleen entropathy, gastrointestinal dysfunction after stroke in 356 studies. All studies used total efficiency rate for main outcome. In all studies, CMT was effective for digestive system disease. Conclusions : CMT was effective for Digestive system disease. Risk of bias was high and the difference between the experimental group and the control group was not great. Considering that there were no reports of side effects, it seems possible to apply CMT to the treatment of adult digestive system disease.

Development of donepezil-induced hypokalemia following treatment of cognitive impairment

  • Kim, Dongryul;Yoon, Hye Eun;Park, Hoon Suk;Shin, Seok Joon;Choi, Bum Soon;Kim, Byung Soo;Ban, Tae Hyun
    • Journal of Yeungnam Medical Science
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    • v.38 no.1
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    • pp.65-69
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    • 2021
  • Donepezil is a cholinesterase inhibitor used extensively to treat Alzheimer disease. The increased cholinergic activity is associated with adverse effects, therefore gastrointestinal symptoms, including nausea, vomiting, and diarrhea, are common. Hypokalemia is a rare adverse event that occurs in less than 1% of donepezil-treated patients. Although hypokalemia of mild and moderate grade does not present serious signs and symptoms, severe hypokalemia often results in prolonged hospitalization and mortality. Herein, we report a case of hypokalemia developed after the initiation of donepezil therapy for cognitive impairment.