• The Journal of Internal Korean Medicine
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• v.23 no.1
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• pp.141-145
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• 2002

Diabetic Ketoacidosis(DKA), one of acute complications of diabetes mellitus(DM) occurs mostly in insulin dependent diabetes mellitus (IDDM) patients. Its clinical symptoms are hyperglycemia, ketonemia or ketonuria, metabolic acidosis, etc. The interaction of lack of insulin, excessive secretion of insulin antagonic hormone and dehydration cause body fluid loss and electrolyte, typical symptom of DKA as polyuria, polydipsia, nausea, vomiting, abdominal pain occur. As a result, prompt supply of fluid and insulin by intravenous injection should be conducted for treatment. It is still an emergent disorder whose mortality is still 10 to 15%, though is has decreased compared to the past. We treated a female patient who has DKA, had withdrawn insulin pump therapy. We report a case of DKA with a brief review of related literatures.

• Journal of Korean Medical classics
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• v.20 no.1
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• pp.151-164
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• 2007

In "Sanghanlon(傷寒論)", there are several articles to explain about Oryeongsan's syndrome. Most important articles of them are No. 72 and No. 75. Oryeongsan is explained by many doctors as a prescription to control exterior and interior, because they considered that symptoms of 72 and 75 articles were caused by exterior and interior's syndrome. Accordingly, they explained that RAMULUS CINNAMOMI(桂枝) and warm water remove exterior pathogens, and PORIA(茯笭) and others remove interior fluid retention. But considering the origin of a fluid retention, RAMULUS CINNAMOMI's effects are rather activating Yang(通陽) and warming Yang(溫陽) than removing exterior pathogens. The fluid retention is cauesd by insufficiency of Yang energy, because body fluid's spreading depends on Ynag energy. RAMULUS CINNAMOMI's effects of activating Yang and warming Yang improve the fluid retention and spread body fluid to the whole body. Some doctors use CORTEX CINNAMOMI(肉桂) instead of RAMULUS CINNAMOMI, because CORTEX CINNAMOMI's effects of activating Yang and warming Yang are better than RAMULUS CINNAMOMI's. There are many opinions about what is the main symptom of Oryeongsan's syndrome, but the difficulty in urination is understood by most doctors as the main symptom of Oryeongsan's syndrome. From the viewpoint of that, they understand that Oryeongsan's main effect is the induce diuresis. But the induce diuresis does not only mean a urination. The induce diuresis must be understood as the removing fluid retention by sweat and urine through the spreading body fluid.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.99-102
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• 2014

Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.

• The Journal of Internal Korean Medicine
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• v.40 no.3
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• pp.541-550
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• 2019

Objective: The aim of this clinical study was to describe the case of a patient who experienced chronic diarrhea related to seasonal changes that improved with herbal medicine treatment. Methods: A patient with diarrhea and globus hystericus was treated following treatment with Hoehyangbanchong-san-hap-Ukgan-san and Gamisachil-tang. A defecation and urination diary, the Bristol Stool Form Scale, and the Visual Analog Scale (VAS) were used to evaluate the effectiveness of this treatment. Results: During treatment, the patient's Bristol Stool Form Scale score changed from Type 7 to Type 4, and the VAS score was significantly decreased. The symptoms of diarrhea and globus hystericus almost subsided. Conclusion: In this case, Korean traditional herbal medicine reduced the clinical symptoms of diarrhea and globus hystericus.

• Journal of Sasang Constitutional Medicine
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• v.32 no.4
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• pp.96-106
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• 2020

Objectives The purpose of this case study was to report that San-syndrome patient was treated by diagnosing as Greater Yang Disease Reverting Yin Pattern. Methods The patient was administered with Insamosuyu-tang. Numeral Rating Scale (NRS) and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to assess the improvements of symptoms. Results and Conclusions The perineal region discomfort was reduced from NRS 4 to NRS 1. NIH-CPSI score was reduced from 23 to 11, which means symptom relief. Nocturia and sleep disorder were resolved, and general weakness was relieved accordingly.

• The Journal of Internal Korean Medicine
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• v.43 no.2
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• pp.283-293
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• 2022

A 42-year-old male patient with prolonged throat pain and discomfort, dry mouth, and general weakness and recently diagnosed with tonsillitis, pulmonary embolism, and venous thrombosis was admitted to the internal Korean medicine department. A sudden onset of diabetic ketoacidosis with hyperammonemia was diagnosed on the second day of treatment. During admission, the patient received insulin therapy, hydration, and traditional Korean medicine treatment, including herbal medicine. Subjective symptom change was evaluated daily and blood glucose level checked five times per day. At discharge, the patient's fasting and postprandial blood sugar levels were adequate. After an additional two weeks of herbal treatment, the symptoms were significantly ameliorated. Thus, having been admitted with dysregulated glucose metabolism leading to a hyperglycemic crisis after a series of inflammatory events, the patient showed symptomatic improvements and decreased blood glucose after 18 days of hospitalization and treatment.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.2
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• pp.249-255
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• 2001

Methylmalonic acidemia is a rare congenital autosomal recessive metabolic disease. It is caused by blocking in the pathways of isoleucine, valine, threonine, methionine, cholesterol and odd-chain fatty acids to succinyl CoA, resulting in the increase of L-methylmalonyl CoA and methylmalonic acid. In most cases, there are symptoms such as recurrent vomitings, lethargy and laboratory abnormalities including metabolic acidosis and hyperammonemia from the neonatal period. We had a 6-month-old infant with methylmalonyl acidemia who presented with recurrent vomiting episodes since 3 months of age, failure to thrive and developmental delay. The laboratory findings showed hyperammoninemia and ketotic metabolic acidosis. Plasma amino acid analysis showed nonspecific finding. Urine organic acid ananysis by gas chromatography and mass spectrometry detected large amount of methylmalonic acid excreted in the urine. We restrained the supply of protein in the amount of 1~1.5 g/kg of body weight a day using leucine, isoleucine and valine-r-estrained milk and administered vitamine $B_{12}$, in the amount of 1mg per day. During the follow-up in the outpatient clinic, He could control his head and showed increased muscle strength.

• Journal of Yeungnam Medical Science
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• v.33 no.1
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• pp.33-36
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• 2016

Metformin, commonly prescribed for type 2 diabetes, is considered safe with minimal side-effect. Acute pancreatitis is rare but potentially fatal adverse side-effect of metformin. We report a patient on hemodialysis with metformin-related acute pancreatitis and lactic acidosis. A 62-year-old woman with diabetic nephropathy and hypertension presented with nausea and vomiting for a few weeks, followed by epigastric pain. At home, the therapy of 500 mg/day metformin and 50 mg/day sitagliptin was continued, despite symptoms. Laboratory investigations showed metabolic acidosis with high levels of lactate, amylase at 520 U/L (range, 30-110 U/L), and lipase at 1,250 U/L (range, 23-300 U/L). Acute pancreatitis was confirmed by computed tomography. No recognized cause of acute pancreatitis was identified. Metformin was discontinued. Treatment with insulin and intravenous fluids resulted in normalized amylase, lipase, and lactate. When she was re-exposed to sitagliptin, no symptoms were reported.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.15 no.2
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• pp.98-100
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• 2015

Short-chain acyl-CoA dehydrogenase (SCAD) deficiency is a rare mitochondrial fatty-acid oxidation disorder that is inherited as an autosomal recessive pattern. SCAD deficiency is caused by mutations in the ACADS gene (Acyl-CoA Dehydrogenase, Short-chain, OMIM #606885), which encodes SCAD, the mitochondrial enzyme that catalyzes the first reaction in the beta-oxidation of fatty acids four to six carbons in length. Here, we describe one Korean pediatric case of SCAD deficiency, which was diagnosed during newborn screening through tandem mass spectrometry. An increased concentration of butyrylcarnitine was detected on the newborn screening test, and the urine organic acid analysis showed increased urinary excretion of ethylmalonic acid. The patient has been asymptomatic and has shown normal growth and development by 8 months of age without any intervention during follow-up period.

• Korean Journal of Clinical Pharmacy
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• v.15 no.2
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• pp.165-172
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• 2005

엑세나타이드는 2005년 4월에 미국 FDA로부터 허가된 새로운 계열의 당뇨병치료제로서 적응증은 멧포르민이나 설포닐유레아계열의 당뇨병치료제로서 치료를 받고 있음에도 불구하고 혈당이 목표치로 저하되지 않는 제2형 당뇨병환자에게 기존의 치료법에 부가적으로 사용하는 것으로 제한되어 있다. 엑세나타이드는 39개의 아미노산으로 구성되어 있으며 미국 캘리포니아주에 자생하는 도마뱀의 타액에서 유래된 물질과 조성과 기능이 유사하도록 합성된 펩타이드 약물이다. 이 약물은 혈중포도당의 농도에 의존적으로 인슐린분비를 촉진하며, 비정상적으로 높은 혈중 글루카곤농도를 저하시키며, 음식물의 위통과시간을 연장하며, 식욕을 저하시키는 등의 여러 가지 기전을 통하여 혈당을 조절하는 것으로 알려져 있다. 멧포르민으로 1일 1500 mg을 사용하고 있는데도 불구하고 당화혈색소가 7%를 초과하는 제2형 당뇨병환자 336명을 대상으로 부가적으로 30주간 엑세나타이드 $5{\mu}g$또는 $10{\mu}g$을 1일 2회 피하주사 한 임상시험결과에 의하면, 당화혈색소가 7% 미만인 환자의 비율은 intent-to-treat 로서 각각 27%와 40%로 나타났다. 이는 기존의 치료법과 위약으로 치료받은 군에서의 13%에 비하여 통계적으로 매우 유의성 있는 결과인 것으로 분석되었다(p<0.01). 또 다른 임상시험에서는 상기 임상시험과 유사한 임상시험계획을 바탕으로 하여 설포닐유레아로 치료받고 있었지만 당화혈색소가 7%를 초과하는 제2형 당뇨병환자를 대상으로 임상시험을 실시하였으며, 그 결과에 의하면 엑세나타이드와 설포닐유레아의 병용치료 시 혈당조절에 매우 유리한 것으로 나타났다. 멧포르민과 설포닐유레아의 병용요법으로 치료받고 있던 당뇨병환자를 대상으로 실시한 임상시험에서도 동일한 결과가 나타났다. 이 약의 부작용은 치료개시 후 나타나는 메스꺼움이 문제로 지적되었으며 저 혈당현상은 큰 문제가 되지 않는 것으로 나타났다. 이 약은 인슐린 대용약물이 될 수 없으며 당뇨병성 케토산증의 치료에 사용할 수 없다. 또한 이 약물은 심한 신부전이 있거나 말기신장질환 환자에게 사용해서는 안 된다.