• Title/Summary/Keyword: gastrointestinal system

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A large and pedunculated inflammatory pseudotumor with pseudosarcomatous change of the cecum mimicking a malignant polyp: a case report and literature review

  • Jong Suk Oh;Hyung Wook Kim;Su Bum Park;Dae Hwan Kang;Cheol Woong Choi;Su Jin Kim;Hyeong Seok Nam;Dae Gon Ryu
    • Clinical Endoscopy
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    • 제56권1호
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    • pp.119-124
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    • 2023
  • Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.

약제의 신규등재 절차와 급여기준 관리 (New Drug Listing Process and Reimbursement Standard Management)

  • 배윤경;유미영
    • Journal of Digestive Cancer Research
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    • 제11권2호
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    • pp.104-107
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    • 2023
  • The Ministry of Health and Welfare of Korea has implemented various social security programs to ensure a basic standard of living and raise overall quality of life for all citizens. The Korean social security system provides social insurance, public assistance, and social welfare services. To achieve adequate drug benefits, the Drug Management Department of Health Insurance Review and Assessment Service (HIRA) implement drug management duties including drug listing, upper price limit setting, scope of benefits, and post-factum management. When a manufacturer or an importer wants to apply for National Health Insurance (NHI) coverage of the drug that has obtained safety and efficacy approval, the pharmaceutical benefit assessment committee of HIRA evaluates the drug's clinical efficacy and cost-effectiveness to determine whether or not to include the drug into the benefit package. The benefit standards for a listed drug (ingredient) are set either for the whole permitted range or a part of range with conditions. To increase the coverage rate for new drugs, the listed drugs are regularly reviewed for their value. The status of listed drugs can be adjusted or eliminated from the benefit package if the clinical efficacy turns out to be insignificant. Therefore, through these pharmaceutical management procedures, high-quality drugs are provided at reasonable prices, which save healthcare expenditure by price determination and selective coverage in consideration of economic evaluation.

Constipation anti-aging effects by dairy-based lactic acid bacteria

  • Mohamad Hafis Jaafar;Pei Xu;Uma-Mageswary Mageswaran;Shandra-Devi Balasubramaniam;Maheswaran Solayappan;Jia-Jie Woon;Cindy Shuan-Ju Teh;Svetoslav Dimitrov Todorov;Yong-Ha Park;Guoxia Liu;Min-Tze Liong
    • Journal of Animal Science and Technology
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    • 제66권1호
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    • pp.178-203
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    • 2024
  • Constipation, which refers to difficulties in defecation and infrequent bowel movement in emptying the gastrointestinal system that ultimately produces hardened fecal matters, is a health concern in livestock and aging animals. The present study aimed to evaluate the potential effects of dairy-isolated lactic acid bacteria (LAB) strains to alleviate constipation as an alternative therapeutic intervention for constipation treatment in the aging model. Rats were aged via daily subcutaneous injection of D-galactose (600 mg/body weight [kg]), prior to induction of constipation via oral administration of loperamide hydrochloride (5 mg/body weight [kg]). LAB strains (L. fermentum USM 4189 or L. plantarum USM 4187) were administered daily via oral gavage (1 × 10 Log CFU/day) while the control group received sterile saline. Aged rats as shown with shorter telomere lengths exhibited increased fecal bulk and soften fecal upon administration of LAB strains amid constipation as observed using the Bristol Stool Chart, accompanied by a higher fecal moisture content as compared to the control (p < 0.05). Fecal water-soluble metabolite profiles showed a reduced concentration of threonine upon administration of LAB strains compared to the control (p < 0.05). Histopathological analysis also showed that the administration of LAB strains contributed to a higher colonic goblet cell count as compared to the control (p < 0.05). The present study illustrates the potential of dairy-sourced LAB strains as probiotics to ameliorate the adverse effect of constipation amid aging, and as a potential dietary intervention strategy for dairy foods including yogurt and cheese.

Investigation of the impact of multi-strain probiotics containing Saccharomyces cerevisiae on porcine production

  • Sheena Kim;Jinho Cho;Gi Beom Keum;Jinok Kwak;Hyunok Doo;Yejin Choi;Juyoun Kang;Haram Kim;Yeongjae Chae;Eun Sol Kim;Minho Song;Hyeun Bum Kim
    • Journal of Animal Science and Technology
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    • 제66권5호
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    • pp.876-890
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    • 2024
  • A balanced intestinal microbiome controls intestinal bacterial diseases, helps regulate immunity, and digests and utilizes nutrients, ultimately having a positive effect on the productivity of industrial animals. Yeasts help in the digestion process by breaking down indigestible fibers and producing organic acids, vitamins, and minerals. In particular, polysaccharides such as beta-glucan and mannan-oligosaccharides, which are present in the cell wall of yeast, inhibit the adhesion of pathogens to the surface of the gastrointestinal tract and increase resistance to disease to help maintain and improve intestinal health. Among the yeast additives used in animal feed, Saccharomyces cerevisiae is one of the most commonly used probiotics. However, it does not naturally reside in the intestine, so if it is supplied in combination with other species of probiotics that can compensate for it, many benefits and synergies can be expected for pigs in terms of maintaining intestinal health such as supplementing the immune system and improving digestion. A number of previous studies have demonstrated that dietary complex probiotic supplementation has growth-promoting effects in pigs, suggesting that multiple strains of probiotics may be more effective than single strain probiotics due to their additive and synergistic effects. In practice, however, the effects of complex probiotics are not always consistent, and can be influenced by a variety of factors. Therefore, this review comprehensively examines and discusses the literature related to the effects of complex probiotics using Saccharomyces cerevisiae in pig production.

Endoscopic submucosal dissection in colorectal neoplasia performed with a waterjet system-assisted knife: higher en-bloc resection rate than conventional technique

  • Paolo Cecinato;Matteo Lucarini;Francesco Azzolini;Mariachiara Campanale;Fabio Bassi;Annalisa Cippitelli;Romano Sassatelli
    • Clinical Endoscopy
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    • 제55권6호
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    • pp.775-783
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    • 2022
  • Background/Aims: Colorectal endoscopic submucosal dissection (ESD) is burdened by its associated high risk of adverse events and long procedure time. Recently, a waterjet-assisted knife was introduced to simplify and speed up the procedure. The aim of this study was to evaluate the efficacy and safety of waterjet-assisted ESD (WESD) compared to that of the conventional ESD (CESD) technique. Methods: The charts of 254 consecutive patients who underwent colorectal ESD between January 2014 and February 2021 for colorectal neoplasms were analyzed. The primary outcome was the en-bloc resection rate. Secondary outcomes were complete and curative resection rates, the need to switch to a hybrid ESD, procedure speed, the adverse event rates, and the recurrence rates. Results: Approximately 174 neoplasias were considered, of which, 123 were removed by WESD and 51 by CESD. The en-bloc resection rate was higher in the WESD group (94.3% vs. 84.3%). Complete resection rates and curative resection rates were similar. The need to switch to a hybrid ESD was greater during CESD (39.2% vs. 13.8%). Procedure speed and adverse event rates were similar. During follow-up, one recurrence occurred after a WESD. Conclusions: WESD allows a high rate of en-bloc resections and less frequently requires a rescue switch to the hybrid ESD compared to CESD.

비가역적 전기 천공술을 시행한 국소 진행형 췌장암 환자 2례 (Irreversible Electroporation in Patients with Pancreatic Cancer :Angel and Devil)

  • 금지영;이희승;강화평;조중현;정문재;박정엽;박승우;송시영;방승민
    • Journal of Digestive Cancer Research
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    • 제7권1호
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    • pp.26-30
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    • 2019
  • Pancreatic cancer has a very poor prognosis. Complete surgical resection remains the only current curative treatment. Locally advanced pancreatic cancer (LAPC) is considered as unresectable because of involvement of celiac and/or mesenteric vessels. The treatment of LAPC is a challenge. Current guidelines suggest systemic therapy. However, the majority of patients will never experience conversion to surgical resection. Thus, in these patients, ablation is an alternative therapy for local control, which causes local destruction while ideally avoiding injury to surrounding healthy tissue. Irreversible electroporation (IRE) is an energy delivery system, effective in ablating tumors by inducing irreversible membrane destruction of cells. IRE demonstrated to be safe in previous studies. However, it is not free from complications, even serious. Here, we reported two cases of the IRE in LAPC patients.

Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis

  • Shivanand Bomman;Munish Ashat;Navroop Nagra;Mahendran Jayaraj;Shruti Chandra;Richard A Kozarek;Andrew Ross;Rajesh Krishnamoorthi
    • Clinical Endoscopy
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    • 제55권1호
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    • pp.33-40
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    • 2022
  • Background/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates. Methods: A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model. Results: A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%-10.8%, inconsistency index [I2]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%-2.7%, I2=94.96). Conclusions: While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

Laser-cut-type versus braided-type covered self-expandable metallic stents for distal biliary obstruction caused by pancreatic carcinoma: a retrospective comparative cohort study

  • Koh Kitagawa;Akira Mitoro;Takahiro Ozutsumi;Masanori Furukawa;Yukihisa Fujinaga;Kenichiro Seki;Norihisa Nishimura;Yasuhiko Sawada;Kosuke Kaji;Hideto Kawaratani;Hiroaki Takaya;Kei Moriya;Tadashi Namisaki;Takemi Akahane;Hitoshi Yoshiji
    • Clinical Endoscopy
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    • 제55권3호
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    • pp.434-442
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    • 2022
  • Background/Aims: Covered self-expandable metallic stents (CMSs) are widely used for malignant distal biliary obstructions (MDBOs) caused by pancreatic carcinoma. This study compared the efficacy and safety of the laser-cut-type and braided-type CMSs. Methods: To palliate MDBOs caused by pancreatic carcinoma, the laser-cut-type CMSs was used from April 2014 to March 2017, and the braided-type CMSs was used from April 2017 to March 2019. The tested self-expandable metallic stents were equipped with different anti-migration systems. Results: In total, 47 patients received CMSs for MDBOs (24 laser-cut type, 23 braided-type). The time to recurrent biliary obstruction (TRBO) was significantly longer in the braided-type CMSs (p=0.0008), and the median time to stent dysfunction or patient death was 141 and 265 days in the laser-cut-type CMSs and braided-type CMSs, respectively (p=0.0023). Stent migration was the major cause of stent dysfunction in both groups, which occurred in 37.5% of the laser-cut-type CMSs and 13.0% of the braided-type CMSs. There were no differences in the survival duration between the groups. Conclusions: The TRBO was significantly longer for the braided-type CMSs with an anti-migration system than for the laser-cut-type. Stent migration tended to be less frequent with the braided-type CMSs than with the laser-cut-type CMSs.

Effect of Forage Feeding on Goat Meat Production: Carcass Characteristics and Composition of Creole Kids Reared Either at Pasture or Indoors in the Humid Tropics

  • Alexandre, G.;Limea, L.;Fanchonne, A.;Coppry, O.;Mandonnet, N.;Boval, M.
    • Asian-Australasian Journal of Animal Sciences
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    • 제22권8호
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    • pp.1140-1150
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    • 2009
  • Forage diets provide good quality carcasses in sheep but very little is known in tropical goats. An experiment was designed with Creole male goats using grass-based systems to assess carcass yield, scores, cuts and composition. After weaning (84 d, 9.2 kg LW) two modes of forage feeding were compared with two replicates of each. Feeding groups were: PF for animals reared at pasture (n = 62) and IF when reared indoors (n = 60). Given that forage finishing will result in low ADG it appeared necessary to study different fattening lengths. The kids were equally divided into 4 groups: group A (n = 32), 4mo after weaning; group B (n = 32), 4mo after A; group C (n = 30), 3mo after B and group D (n = 28), 2mo after C. The animals grazed (in two sub-flocks) on irrigated tropical pastures managed in a rotational system (28 d of re-growth) at a mean stocking rate of 1,200 kg/ha/yr LW. The IF groups were reared in collective pens on a slatted floor (2 replicates of 7 or 8 kids each). They were fed the same stand of tropical grass (25% DM, 12% CP) as that of pasture that was cut daily and provided ad libitum. The ADG (-10%), the weights of omental fat (-60%) and fat in shoulder (-18%), the ultimate pH of carcass (-12%), the meat colour score (-24%), the ""parameter accounting for redness (12%) and the DM and lipid contents (-4%) were significantly lower (p<0.05) in PF than in IF, while the liver was heavier (+23%, p<0.05). Feeding conditions seemed to be similar, thus, differences could be related to gastrointestinal parasitism in the PF system and hypotheses are discussed. Increasing the fattening duration, resulted in significant difference (p<0.01) in many traits: the weights at slaughter and of carcass increased by 40% and 60% from groups A to D and consequently the weights of body compartments and carcass cuts (1.5 to 2.0 fold more). When the results were presented as percentage of empty body weight and carcass weight, these preliminary results (carcass weight 9kg and yield 53%, muscle proportion 70%) and qualitative parameters (low fat score 2/5, fat proportion 5%), seem to be a good incentive for the sector to develop a niche market to meet consumer lean meat expectations. The indoors system could be implemented where there was low availability of grazing areas or problems of dog attacks.

개인 휴대 단말기 (PDA)를 기반으로 한 휴대용 E-Nose의 개발 (A portable electronic nose (E-Nose) system using PDA device)

  • 양윤석;김용신;하승철;김용준;조성목;표현봉;최창억
    • 센서학회지
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    • 제14권2호
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    • pp.69-77
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    • 2005
  • The electronic nose (e-nose) has been used in food industry and quality controls in plastic packaging. Recently it finds its applications in medical diagnosis, specifically on detection of diabetes, pulmonary or gastrointestinal problem, or infections by examining odors in the breath or tissues with its odor characterizing ability. Moreover, the use of portable e-nose enables the on-site measurements and analysis of vapors without extra gas-sampling units. This is expected to widen the application of the e-nose in various fields including point-of-care-test or e-health. In this study, a PDA-based portable e-nose was developed using micro-machined gas sensor array and miniaturized electronic interfaces. The rich capacities of the PDA in its computing power and various interfaces are expected to provide the rapid and application specific development of the diagnostic devices, and easy connection to other facilities through information technology (IT) infra. For performance verification of the developed portable e-nose system, Six different vapors were measured using the system. Seven different carbon-black polymer composites were used for the sensor array. The results showed the reproducibility of the measured data and the distinguishable patterns between the vapor species. Additionally, the application of two typical pattern recognition algorithms verified the possibility of the automatic vapor recognition from the portable measurements. These validated the portable e-nose based on PDA developed in this study.