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Current and Future Role of the Gastroenterologist in GI Cancer Management

  • John M. Carethers
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.78-81
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    • 2013
  • With advances in technology, advances in the understanding of biology of cancer, and the advent of improved and novel therapies, the role of the gastroenterologist has been modified greatly over the past 2 decades, and continues to be shaped by the knowledge, skill, and opportunity to capitalize on the unique position that gastroenterologists hold in the patient care continuum. The gastroenterologist is evolving from a "pure" diagnostician to an endoscopic surgeon, a geneticist, a nutritionist, an immunologist and chemotherapist, and palliative care physician.

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Review of Clinical Research about Herbal Medicine Treatment on Chronic Pancreatitis - Research on CNKI (만성 췌장염의 한약치료에 대한 최신 임상연구 동향 - CNKI검색을 중심으로)

  • Hwang, Yun-kyeong;Kim, Gang-san;Kim, Won-ill
    • The Journal of Internal Korean Medicine
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    • v.38 no.1
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    • pp.48-63
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    • 2017
  • Objectives: This study was performed to review the recent clinical research trends of the effects of herbal medicine treatment on chronic pancreatitis in China. Methods: We searched for clinical studies about chronic pancreatitis from the China Academic Journal (CAJ) of the China National Knowledge Infrastructure (CNKI) from January 1, 2005, to August 1, 2016. Results: Thirty-seven papers were selected from 126 studies. The most commonly used herbal prescriptions included Bupleuri Radix (柴胡), Paeoniae Radix Alba (白芍藥), Glycyrrhizae Radix (甘草), Scutellariae Radix (黃芩), Aucklandiae Radix (木香), and Rhei Rhizoma (大黃). Qingyi-tang (淸胰湯) was the most frequently used herbal prescription. Clinical symptoms, physicochemical examination, radiological examination, and relapse were used to evaluate the treatments. The effective treatment rate was 77.5-100%, and effectiveness in the experimental group was significantly higher than in the control group in 15 papers (p<0.05). Conclusions: Herbal medicine treatment has been shown as an effective treatment for chronic pancreatitis. In the future, more scientifically designed clinical studies should be performed to prove the effectiveness of herbal medicine treatment on chronic pancreatitis. These research results can be utilized in other clinical studies and in the treatment of chronic pancreatitis.

A Literature Review of Management on Radiodermatitis (방사선 피부염 치료법에 대한 문헌고찰)

  • Kwon, Mi Hye;Yoon, Jee-Hyun;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.25 no.1
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    • pp.11-24
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    • 2020
  • Objective : Radiodermatitis is a common sequelae in 95% of patients receiving radiation therapy, which is important to be well managed as it can affect the patient's quality of life as well as the cancer treatment schedule. The aim of this study is to review and summarize the interventions available for the treatment of acute radiodermatitis, including traditional Korean medicine, and to propose treatment algorithms for clinicians. Methods : To collect studies about managements for radiodermatitis, domestic and foreign database were used such as Korean journal of traditional knowledge portal (KTKP), Korean studies information service system (KISS), national discovery or science leaders (NDSL), and oriental medicine advance searching integrated system (OASIS), Pubmed, Google scholar and Scopus. Results : Thirty-two studies were selected. There were nine studies on usual care and dressing, eleven studies on chemical agents, two studies on biological preparations, and ten studies on herbal medicines. Conclusion : Hygienic options and dressings have proved to be useful in the management of radiodermatitis. Chemical agents such as corticosteroid, statin, and topical antibiotic agent have proved to alleviate symptoms and severity, regenerate damaged skin, and prevent secondary infection. In biological preparations, EGF (epidermal growth factor) and GM-CSF (granulocyte-macrophage colony-stimulating factor) could be used to protect skin and prevent radiodermatitis. For herbal medicines, Calendula, catechin, β-sitosterol, and Jaungo (紫雲膏) may be effective for symptoms including pain, itching, and burning sensation induced by radiation therapy. Because of some research with conflicting results, further studies are needed to propose an algorithm for more optimal treatments.

A Case of Pulmonary Trichomoniasis in a Young Healthy Male (건강한 젊은 남성에서 발생한 폐트리코모나스증 1예)

  • La, Sung Soo;Kong, Jae Hwan;Bang, Chang Seok;Hahn, Sung Hwhan;Myong, Na-Hye;Kim, Doh Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.5
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    • pp.387-391
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    • 2008
  • Bronchopulmonary infections caused by trichomonads have been reported principally in patients with pre-existing pulmonary diseases, such as bronchial carcinoma, lung abscess, or bronchiectasis. Pulmonary trichomoniasis is most often caused by Trichomonas tenax, which is usually regarded as a harmless commensal organism of the human mouth. However, pulmonary infection may rarely be caused by other trichomonas species, including Trichomonas vaginalis from the genitourinary tract and Trichomonas hominis from the intestines. Because of the rarity of trichomonas pulmonary infection, and because of its close association with underlying lung and systemic disease, pulmonary trichomoniasis is considered an opportunistic infection. We recently treated a case of pulmonary trichomoniasis occurring in a young, healthy male without obvious underlying pulmonary or systemic illness. To our knowledge, there has been only one reported case of pulmonary trichomoniasis in Korea, and there have been only two reported cases of pulmonary trichomoniasis occurring in normal lung worldwide.

Clinical Effectiveness of Traditional Herbal Medicine in the Treatment of Central Post-Stroke Pain and Thalamic Syndrome: a Systemic Review and Meta-analysis of Randomized Clinical Trials Based on Traditional Chinese Medicine Journals (뇌졸중 후 중추성 통증 및 시상증후군에 대한 한약치료의 효과 : 체계적 고찰 및 메타분석 - 중의학 저널을 중심으로)

  • Jung, Yu-jin;Kang, Eun-jin;Hong, Sang-hoon
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.295-311
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    • 2019
  • Objectives: This research aimed to investigate Chinese clinical studies on the treatment of central post-stroke pain (CPSP) and thalamic syndrome after stroke with traditional herbal medicine (THM). Methods: Randomized controlled trials verifying the effects of herbal medicine on treating CPSP and thalamic syndrome after stroke were included in the study. Electrical and hand search were conducted in the China National Knowledge Infrastructure (CNKI), National Discovery for Science Leaders (NDSL), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (Oasis) for CPSP and thalamic syndrome after stroke. A literature search was performed in the Chinese and Korean databases for papers published from January 1, 2010 to October 1, 2018. The selected literature was assessed by Cochrane's risk of bias. Results: Twelve reports on randomized controlled trials met the inclusion criteria from the 227 identified reports. Effective rate, comparison of visual analogy scale, present pain intensity, pain grading index, recurrence rate, follow-up, and a 36-item short form survey instrument were used to evaluate the treatments. The effective rate of the treatment group was significantly higher than that of the control group in all papers. Side effects occurred less frequently in the treatment group than in the western medicine control group. Conclusions: The treatment of CPSP and thalamic syndrome after stroke with THM was shown to be highly effective. Additional well-designed clinical trials are needed. This study can be used as a basis for further research on the treatment of CPSP and thalamic syndrome after stroke.

Review of Clinical Research about the Treatment of Aphasia after Cerebrovascular Disease (뇌혈관질환 후 실어증의 한의학적 치료에 대한 국내 임상연구에 대한 고찰)

  • Koh, Ji-yoon;Son, Ah-hyun;Shin, Hyeon-su
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1105-1115
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    • 2018
  • Objectives: The aim of this review is to investigate clinical studies on Oriental medicine treatment for aphasia after cerebrovascular disease. Methods: Using the keywords 'Aphasia', 'Oriental medicine', 'Stroke' 'Cerebral infarction', 'Cerebral hemorrhage', and 'Clinic', we searched domestic databases, including "NDSL (National Discovery for Science Leaders)", "Korean Traditional Knowledge Portal", "OASIS (Oriental Medicine Advanced Searching Integrated System)", and "RISS (Research Information Sharing Service)". Each keyword was not searched individually, but combined in various ways. To investigate recent trends, we limited our search to papers published after 2000. Papers that did not include a specific treatment method or did not match the subject "Aphasia after stroke" were excluded. Results: Using the searching method, 13 studies were found. Of these, 12 studies were in the form of case reports, while one was in the form of a non-randomized controlled trial. These studies showed positive results for the use of Oriental medicine in terms of the Korean version of the Western Aphasia Battery (K-WAB), the evaluation form on functional performance capability and accuracy of articulatory organs developed by Lee, aphasia screening test refered in 'Assessment in Speech-Language Pathology' and adapted properly to Korean, the Communicative Ability in Daily Living Test (CADLT), the Korean Version-Boston Naming Test (K-BNT), and language assessment items included in CNS, and NIHSS. Conclusions: Of the 12 case reports, 11 studies showed positive results of the use of Oriental medicine for treatment of aphasia after cerebrovascular disease. However, more sophisticated and large-scale clinical research on aphasia should be conducted.

Recent Trends in Clinical Research on Herbal Medicine Based on Pinellia Ternata for Treatment of Gastroesophageal Reflux Disease (위식도역류질환의 한약 치료에 대한 최신 임상 연구 동향 - 반하(半夏)를 중심으로 -)

  • Jang, Hye-yeon;Kim, Young-kwang;Jeong, Seo-yun;Kim, Do-hyeong;Kim, Kyeong-ok;Lee, Young-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1119-1140
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    • 2020
  • Objective: The purpose of this study was to review Chinese clinical studies of the treatment of gastroesophageal reflux disease (GERD) with herbal medicine including Pinellia ternata. Methods: We searched the China National Knowledge Infrastructure (CNKI) database for clinical studies on herbal treatments including Pinellia ternata for GERD, from January 1st, 2015 to September 30th, 2019. We evaluated the risk of bias using Cochrane's risk of bias to confirm the quality of the 37 selected documents. Results: The 37 papers included high-dose and middle-dose Pinellia ternata groups. The outcome measures included treatment effectiveness rate, symptom comparisons, and endoscopy effectiveness rates or scores. In both groups, most studies showed significant improvement in the treatment group compared with the control group. The meta-analysis revealed a higher treatment effectiveness rate and a lower recurrence rate in the treatment group than in the control group. Conclusions: Comparing the treatment effect between the two groups was difficult due to the low quality of most studies. However, the results suggest that herbal remedies including Pinellia ternata showed statistically significant improvement in GERD compared to control groups.

A Review of Clinical Studies for Chinese Medicine Treatment of Post-concussion Syndrome Using the CNKI Database (뇌진탕 후 증후군의 중의치료에 대한 임상연구 동향 - CNKI검색을 중심으로)

  • Park, Mi-so;Ju, Ah-ra;Choi, Yo-sup;Baek, Hye-kyung;Hwang, Bo-kyung;Shin, Dong-guk;Jang, Seung-won
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1184-1198
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    • 2021
  • Objectives: The aim of this study was to investigate the latest clinical studies on Korean medicine treatment of post-concussion syndrome (PCS) in the Chinese National Knowledge Infrastructure Database (CNKI). Methods: We searched the last 10 years of clinical studies discussing Oriental medicine-based treatments for PCS in the CNKI database. The search focused on the authors, publication year, type of study, purpose of the study, method and duration of treatment, evaluation criteria, and results of each article. Results: Of the 22 selected studies, 1 was a non-randomized controlled trial (nRCT), 2 were case series, and 19 were randomized controlled trials (RCTs). Treatments included oral herbal medicine in 16 studies, oriental medicine through external use in 2 studies, acupuncture in 3 studies, and traditional Chinese medicine injection in 2 studies. The most frequently used herb was Cnidii Rhizoma (川芎). All 22 studies confirmed the efficacy of Oriental medicine treatments. Conclusion: More varied and scientifically designed clinical studies are required to develop treatments for PCS. The results of this study could be used as basic data for further PCS studies.

Cytokine Inductions and Intracellular Signal Profiles by Stimulation of dsRNA and SEB in the Macrophages and Epithelial Cells

  • Jun-Pyo Choi;Purevsuren Losol;Ghazal Ayoub;Mihong Ji;Sae-Hoon Kim;Sang-Heon Cho;Yoon-Seok Chang
    • IMMUNE NETWORK
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    • v.22 no.2
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    • pp.15.1-15.16
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    • 2022
  • Foreign molecules, including viruses and bacteria-derived toxins, can also induce airway inflammation. However, to the best of our knowledge, the roles of these molecules in the development of airway inflammation have not been fully elucidated. Herein, we investigated the precise role and synergistic effect of virus-mimicking double-stranded RNA (dsRNA) and staphylococcal enterotoxin B (SEB) in macrophages and epithelial cells. To identify cytokine expression profiles, both the THP-1-derived macrophages and BEAS-2B epithelial cells were stimulated with dsRNA or SEB. A total of 21 cytokines were evaluated in the culture supernatants. We observed that stimulation with dsRNA induced cytokine production in both cell types. However, cytokine production was not induced in SEB-stimulated epithelial cells, compared to the macrophages. The synergistic effect of dsRNA and SEB was evaluated observing cytokine level and intracellular phospho-signaling. Fifteen different types were detected in high-dose dsRNA-stimulated epithelial cells, and 12 distinct types were detected in macrophages; those found in macrophages lacked interferon production compared to the epithelial cells. Notably, a synergistic effect of cytokine induction by co-stimulation of dsRNA and SEB was observed mainly in epithelial cells, via activation of most intracellular phosphor-signaling. However, macrophages only showed an accumulative effect. This study showed that the type and severity of cytokine productions from the epithelium or macrophages could be affected by different intensities and a combination of dsRNA and SEB. Further studies with this approach may improve our understanding of the development and exacerbation of airway inflammation and asthma.

Systematic Review of Korean Medicine for the Treatment of Sixth Cranial Nerve Palsy (외전신경마비의 한의학 치료에 대한 체계적 문헌 고찰)

  • Won, Seo-young;Kim, Min-ji;Cha, Ji-yun;Jung, Eun-sun;Cho, Hyun-kyoung;Yoo, Ho-ryong;Seol, In-chan;Kim, Yoon-sik
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.409-424
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    • 2019
  • Objectives: This research aimed to confirm the efficacy of oriental medicine in sixth cranial nerve palsy and to evaluate the quality of the studies. Methods: Using the medical subject heading (MeSH) keywords "abducens nerve palsy", "abducens nerve paralysis", "sixth nerve palsy", "herbal medicine", "Chinese medicine", "oriental medicine" and "acupuncture", we collected the research papers through an electronic database search in Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leaders (NDSL), PubMed, Cochran Library, and China National Knowledge Infrastructure (CNKI). Results: A total of 136 papers were searched from the databases. Among these, 15 case reports and 8 randomized controlled trials (RCTs) met our criteria. 17 articles were found on the use of acupuncture as the main intervention, 11 on the use of herbal medicine as the main intervention, and 9 on the use of electroacupuncture as the main intervention. The frequently used acupoints were LI4, EX-HN5, GB1, BL2, TE23, LR3, BL1, ST2, GB20, and ST36. All 23 studies confirmed the efficacy of Korean medicine. According to the assessment using the risk of bias, the overall quality of the RCTs was low. Conclusions: Twenty-three papers suggested that Korean medicine treatment for abducens nerve palsy was effective in many cases. Analyzing the potential bias was difficult.