Irritable bowel syndrome (IBS) is a complex disorder characterized by abdominal symptoms including chronic abdominal pain or discomfort and altered bowel habits. The etiology of IBS is multifactorial, as abnormal gut motility, visceral hypersensitivity, disturbed neural function of the brain-gut axis and an abnormal autonomic nervous system are all implicated in disease progression. Based on recent experimental and clinical studies, it has been suggested that additional etiological factors including low-grade inflammation, altered gut microbiota and alteration in the gut immune system play important roles in the pathogenesis of IBS. Therefore, therapeutic restoration of altered intestinal microbiota may be an ideal treatment for IBS. Probiotics are live organisms that are believed to cause no harm and result in health benefits for the host. Clinical efficacy of probiotics has been shown in the treatment or prevention of some gastrointestinal inflammation-associated disorders including traveler's diarrhea, antibiotics-associated diarrhea, pouchitis of the restorative ileal pouch and necrotizing enterocolitis. The molecular mechanisms, as cause of IBS pathogenesis, affected by altered gut microbiota and gut inflammation-immunity are reviewed. The effect of probiotics on the gut inflammation-immune systems and the results from clinical trials of probiotics for the treatment of IBS are also summarized.
Abdominal Pain ; Autonomic Nervous System ; Axis, Cervical Vertebra ; Diarrhea ; Disease Progression ; Enterocolitis, Necrotizing ; Hypersensitivity ; Immune System ; Inflammation ; Insurance Benefits ; Irritable Bowel Syndrome ; Metagenome ; Pouchitis ; Probiotics

OBJECTIVE: To investigate dose-related effects of repeated intraarticular steroid injection on the experimental arthritis. METHOD: Twenty-four adult male rabbits received Zymosan A into their right knee joint for experimental arthritis. After a week, they were injected with 2 mg (group I; n=9), 10 mg (group II; n=7) or 20 mg (group III; n=8) triamcinolone acetonide into their right knee weekly interval for 4 weeks. We measured weekly changes of the weight and the mediolateral diameter of both knees for the calculation of edema index. 99mTechnetium pertechnate (99mTc) uptake measurement were performed before the first steroid injection and a week after the final steroid injection. All rabbits were sacrificed and histologic examinations of their proximal tibia were performed. RESULTS: A progressive weight loss and changes of edema index were evident for all rabbits (p<0.05) and difference among the groups was not found (p<0.05). 99mTc uptake significantly decreased after the steroid injection in group I (p<0.05) but it was not profound in others (p>0.05). In the histological findings, fibrillation-frayings and fissures of the surface were similar in all rabbits, but loss of nuclear stains and cyst formations were increased prominently in group III than group I (p<0.05). CONCLUSION: Low-dose repeated steroid intraarticular injections are safe and effective treatment in arthritis though no definite evidence of chondroprotection, and high-dose steroid injections accelerate degeneration of the arthritic cartilage.
Adult ; Arthritis* ; Cartilage ; Coloring Agents ; Edema ; Humans ; Injections, Intra-Articular ; Knee ; Knee Joint ; Male ; Rabbits* ; Tibia ; Triamcinolone Acetonide ; Weight Loss ; Zymosan

Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.
Achilles Tendon* ; Athletes ; Child* ; Hand ; Heel ; Humans ; Racquet Sports ; Rupture* ; Sutures

No abstract available.

BACKGROUND: The dominant innervation of airway smooth muscle is parasympathetic fibers which are carried in the vagus nerve. Activation of these cholinergic nerves releases acetylcholine which binds to M3 muscarinic receptors on the smooth muscle causing bronchocontraction. Acetylcholine also feeds back onto neuronal M2 muscarinic receptors located on the postganglionic cholinergic nerves. Stimulation of these receptors further inhibits acetylcholine release, so these M2 muscarinic receptors act as autoreceptors. Loss of function of these M2 receptors, as it occres in animal models of hyperresponsiveness, leads to an increase in vagally mediated hyperresponsiveness. However, there are limited data pertaining to whether there are dysfunctions of these receptors in patients with asthma. The aim of this study is to determine whether there are dysfunction of M2 muscarinic receptors in asthmatic patients and difference of function of these receptors according to severity of asthma. METHODS: We studied twenty-seven patients with asthma who were registered at Pulmonology Division of Korea University Hospital. They all met asthma criteria of ATS. Of these patients, eleven patients were categorized as having mild asthma, eight patients moderate asthma and eight patients severe asthma according to severity by NAEPP Expert Panel Report 2(1997). All subjects were free of recent upper respiratory tract infection within 2 weeks and showed positive methacholine challenge test(PC 20<16mg/ml). Methacholine provocation tests performed twice on separate days allowing for an interval of one week. In the second test, pre-treatment with the M2 muscarinic receptor agonist pilocarpine(180µg) through inhalation was performed before the routine procedures. RESULTS: Eleven subjects with mild asthma and eight aubjects with moderate asthma showed significant increase of PC20 from 5.30±5.23mg/ml(mean±SD) to 20.82±22.56mg/ml(p=0.004) and from 2.79±1.5mg/ml to 4.67±3.53mg/ml(p=0.012) after pilocarpine inhalation, respectively. However, in the eight subjects with severe asthma significant increase of PC20 from 1.76±1.50mg/ml to 3.18±4.03mg/ml(p=0.161) after pilocarpine inhalation was not found. CONCLUSION: In subjects with mild and moderate asthma, function of M2 muscarinic receptors was normal, but there was a dysfunction of these receptors in subjects with severe asthma. These results suggest that function of M2 muscarinic receptors is different according to severity of asthma.
Acetylcholine ; Asthma ; Autoreceptors ; Humans ; Inhalation ; Korea ; Methacholine Chloride ; Models, Animal ; Muscle, Smooth ; Neurons* ; Pilocarpine ; Pulmonary Medicine ; Receptors, Muscarinic* ; Respiratory Tract Infections ; Vagus Nerve

BACKGROUND: Pulmonary thromboembolism is relatively frequent and potentially fatal. However, it is commonly misdiagnosed. The incidence of pulmonary thromboembolism is not decreasing despite advances in diagnosis and effective prophylatic measures. Its potential for significant sequela necessitates a prompt diagnosis and treatment. Unfortunately, there are many difficulties and problems regarding accurate diagnosis. There is a low prevalence of deep vein thrombosis and pulmonary thromboembolism in Korea and only few reports on this subject are available. METHOD: The clinical features of 36 patients, who were diagnosed with pulmonary thromboembolism at the Korea University medical center, were reviewed. RESULTS: 1) There was no significant difference in prevalence between men an women, and the mean age was 50.9 years in men 59.2 years in women. 2) The frequent causes of pulmonary thromboembolism were malignancies (22.2%), surgery (22.2%), and heart disease(8.2%). Specific causes were not identified in 33.3%. 3) The most common symptom was dyspnea(72.2%), and the most common sign was tachypnea(61.1%). 4) The EKG findings were normal in 28.6%, and S1Q3T3 pulmonale pattern in 25.7%, ST or QRS changes in others. 5) The chest X-ray findings indicated pulmonary infiltation in 37.5%, cardiomegaly in 15.6%, pleural effusion in 12.5%, and normal in 27.8%. The perfusion lung scan showed a high probability in 66.7%, and intermediate or low probability in 33.3%. 6) The pulmonary arterial pressure(PAP) in the high probability groups was 57.9mmHg with a higher mortality rate(35%). CONCLUSION: Pulmonary thromboembolism is not uncommon in Korea and its clinical features do not differ greatly from those reported in the literature. When pulmonary thromboemblism of unknown causes are diagnosed, a search for an occult malignancy is recommended. Rapid diagnosis and treatment are achieved when thromboemblism is suspected.
Academic Medical Centers ; Cardiomegaly ; Diagnosis ; Electrocardiography ; Female ; Heart ; Humans ; Incidence ; Korea ; Lung ; Male ; Mortality ; Perfusion ; Pleural Effusion ; Prevalence ; Pulmonary Embolism* ; Thorax ; Tomography, Spiral Computed ; Venous Thrombosis

Collagenous colitis is an uncommon condition charaeterized clinically by diarrhea and weight loss and histologically by thickening of the subepithelial collagen band with chromic inflammation. Laboratory tests of blood, urine and stool, and colonscopic findings are usually normal. The etiology of collagenous colitis is unknown. We report a case of collagenous colitis improved after treatment with sulfasalazine with review of literatures.
Colitis, Collagenous* ; Collagen* ; Diarrhea ; Inflammation ; Sulfasalazine ; Weight Loss

Inflammatory fibroid polyps are rare benign tumors of the GI tract, that commonly present with intestinal obstruction as a result of intussusceptions in the small bowel. A 39-year old man visited our clinic with an asymptomatic polypoid mass in the distal ileum that was identified on abdominal computed tomography for postoperative surveillance after total gastrectomy due to previously diagnosed early gastric cancer. Retrograde double-balloon enteroscopy was performed to diagnose the ileal mass and a complete resection of the polyp was performed using snare for polypectomy without complications. The final histological finding was an ileal inflammatory polyp. Balloon-assisted enteroscopy is a valuable modality to diagnose and treat small bowel lesions in lieu of surgical procedures in selected cases.
Double-Balloon Enteroscopy ; Gastrectomy ; Gastrointestinal Tract ; Ileum ; Intestinal Obstruction ; Intussusception ; Leiomyoma ; Polyps ; SNARE Proteins ; Stomach Neoplasms

BACKGROUNDS/AIMS: Stem cell therapies for liver disease are being studied by many researchers worldwide, but scientific evidence to demonstrate the endocrinologic effects of implanted cells is insufficient, and it is unknown whether implanted cells can function as liver cells. Achieving angiogenesis, arguably the most important characteristic of the liver, is known to be quite difficult, and no practical attempts have been made to achieve this outcome. We carried out this study to observe the possibility of angiogenesis of implanted bio-artificial liver using scaffolds. METHODS: This study used adipose tissue-derived stem cells that were collected from adult patients with liver diseases with conditions similar to the liver parenchyma. Specifically, microfilaments were used to create an artificial membrane and maintain the structure of an artificial organ. After scratching the stomach surface of severe combined immunocompromised (SCID) mice (n=4), artificial scaffolds with adipose tissue-derived stem cells and type I collagen were implanted. Expression levels of angiogenesis markers including vascular endothelial growth factor (VEGF), CD34, and CD105 were immunohistochemically assessed after 30 days. RESULTS: Grossly, the artificial scaffolds showed adhesion to the stomach and surrounding organs; however, there was no evidence of angiogenesis within the scaffolds; and VEGF, CD34, and CD105 expressions were not detected after 30 days. CONCLUSIONS: Although implantation of cells into artificial scaffolds did not facilitate angiogenesis, the artificial scaffolds made with type I collagen helped maintain implanted cells, and surrounding tissue reactions were rare. Our findings indicate that type I collagen artificial scaffolds can be considered as a possible implantable biomaterial.
Actin Cytoskeleton ; Adult ; Animals ; Artificial Organs ; Biocompatible Materials ; Collagen Type I* ; Humans ; Liver Diseases ; Liver* ; Membranes, Artificial ; Mice ; Stem Cells* ; Stomach ; Tissue Scaffolds ; Vascular Endothelial Growth Factor A

We present a series of 97 patients with spinal cord injury. Those patients were treated at Soonchunhyan University Chonan Hospital during six-year-period(January 1986-December 1992), and followed up for at least 3 months. They were divide into four groups ; complete-surgical, complete-conservative, partial-surgical, and partial-conservative. Male to female ratio was 3.6:1, and the peak age was the fifth decade. Passenger's traffic accident(46%) was the most common cause of injury and fall/slip(39%) followed next. Level of spinal injury was cervical in 51%, thoracic in 29%, lumbar in 13%, and others in 7%. Type of injury was fracture-dislocation in 31%, dislocation in 19%, compression fracture in 19%, burst fracture in 18%, cord injury without bony lesion in 7%, and others in 7%. Cord injury was complete in 36 patients(37%) and partial in 61 patients(63%). Surgery was performed in 20 patients with complete cord injury and 34 patients with partial injury. Majority of operations were performed for spinal stability, and posterior instrumentation was the most commonly used operative method. The mean neurotrauma motor index on admission was 44.1 in the complete-surgical group, 39.5 in complete-conservative group, 70.1 in partial-surgical group, and 63.2 in partial-conservative group. It improved to 52.5, 50.3, 90.4, 80.3 at 3 months, and 53.4, 51.7, 91.8, 82.0 at final examination(mean follow-up period was 182.2 days), respectively. The mean values of the final index were higher in the surgically treated groups than the conservatively treated groups, but these differences were not statistically significant(student t-test p>0.1) The mean recovery rate was 14.2% in the complete-surgical group, 17.7% in complete-conservative group, 66.1% in partial-surgical group, and 46.1% in partial-conservative group at 3 months. It improved to 16.6%, 19.3%, 70.0%, and 48.7% at final examination, respectively. The mean recovery rates were higher in the partially injured groups than the completely injured groups(student t-test, p<0.01), regardless the methods of treatment. The final neurotrauma motor index was significantly(regression analysis, p<0.01) related to the initial index except the partial-surgical group. Neurotrauma motor index was a useful method for assessing the injury severity, comparing the recovery rate and predicting prognosis.
Chungcheongnam-do ; Dislocations ; Female ; Follow-Up Studies ; Fractures, Compression ; Humans ; Male ; Prognosis* ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Injuries