• Title/Summary/Keyword: 임상증상 약물치료

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Clinical Applications and Efficacy of Korean Ginseng (고려인삼의 주요 효능과 그 임상적 응용)

  • Nam, Ki-Yeul
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.111-131
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    • 2002
  • Korean ginseng (Panax ginseng C.A. Meyer) received a great deal of attention from the Orient and West as a tonic agent, health food and/or alternative herbal therapeutic agent. However, controversy with respect to scientific evidence on pharmacological effects especially, evaluation of clinical efficacy and the methodological approach still remains to be solved. Author reviewed those articles published since 1980 when pharmacodynamic studies on ginseng have intensively started. Special concern was paid on metabolic disorders including diabetes mellitus, circulatory disorders, malignant tumor, sexual dysfunction, and physical and mental performance to give clear information to those who are interested in pharmacological study of ginseng and to promote its clinical use. With respect to chronic diseases such as diabetes mellitus, atherosclerosis, high blood pressure, malignant disorders, and sexual disorders, it seems that ginseng plays preventive and restorative role rather than therapeutics. Particularly, ginseng plays a significant role in ameliorating subjective symptoms and preventing quality of life from deteriorating by long term exposure of chemical therapeutic agents. Also it seems that the potency of ginseng is mild, therefore it could be more effective when used concomitantly with conventional therapy. Clinical studies on the tonic effect of ginseng on work performance demonstrated that physical and mental dysfunction induced by various stresses are improved by increasing adaptability of physical condition. However, the results obtained from clinical studies cannot be mentioned in the indication, which are variable upon the scientist who performed those studies. In this respect, standardized ginseng product and providing planning of the systematic clinical research in double-blind randomized controlled trials are needed to assess the real efficacy for proposing ginseng indication. Pharmacological mode of action of ginseng has not yet been fully elucidated. Pharmacodynamic and pharmacokinetic researches reveal that the role of ginseng not seem to be confined to a given single organ. It has been known that ginseng plays a beneficial role in such general organs as central nervous, endocrine, metabolic, immune systems, which means ginseng improves general physical and mental conditons. Such multivalent effect of ginseng can be attributed to the main active component of ginseng,ginsenosides or non-saponin compounds which are also recently suggested to be another active ingredients. As is generally the similar case with other herbal medicines, effects of ginseng cannot be attributed as a given single compound or group of components. Diversified ingredients play synergistic or antagonistic role each other and act in harmonized manner. A few cases of adverse effect in clinical uses are reported, however, it is not observed when standardized ginseng products are used and recommended dose was administered. Unfavorable interaction with other drugs has also been suggested, which the information on the products and administered dosage are not available. However, efficacy, safety, interaction or contraindication with other medicines has to be more intensively investigated in order to promote clinical application of ginseng. For example, daily recommended doses per day are not agreement as 1-2g in the West and 3-6 g in the Orient. Duration of administration also seems variable according to the purpose. Two to three months are generally recommended to feel the benefit but time- and dose-dependent effects of ginseng still need to be solved from now on. Furthermore, the effect of ginsenosides transformed by the intestinal microflora, and differential effect associated with ginsenosides content and its composition also should be clinically evaluated in the future. In conclusion, the more wide-spread use of ginseng as a herbal medicine or nutraceutical supplement warrants the more rigorous investigations to assess its effacy and safety. In addition, a careful quality control of ginseng preparations should be done to ensure an acceptable standardization of commercial products.

Diagnosis and Management of Articular Gout in a Red-eared Slider (Trachemys Scripta Elegans) (붉은귀 거북이(red-eared slider, Trachemys scripta elegans)에서 관절 통풍의 진단 및 치료 증례)

  • Lee, So-Young;Kim, Ju-Won;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.28 no.4
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    • pp.449-451
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    • 2011
  • An 1.28 kg, male, thirteen years of age, red-eared slider (Trachemys scripta elegans) was presented with one month history of anorexia, decreased mobility, and swelling and erythema of forelimbs. Hyperuricemia and tophaceous gout such as osteolysis at the digit, carpal and metacarpal bones with radiopaque densities around the lesion were detected. Allopurinol (20 mg/kg, PO, once a day) and u/d (Hill's diet) were selected for treatment and other antibiotics or anti-inflammatory drugs were not administered. One month after initial presentation, clinical signs and radiographic findings were improved. According to the medical response, the turtle was presumptively diagnosed as articular gout and allopurinol revealed effective response to the articular gout in turtles.

Treatment of Refractory Lateral Epicondylitis with Platelet-Rich Plasma (불응성 주관절 외상과염에 대한 혈소판 풍부 혈장 주입 치료의 임상적 결과)

  • Ko, Sang-Hoon;Lee, Chae-Chil;Kang, Byeong-Seong;Lee, Ki-Jae;Lee, Seon-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.58-63
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    • 2010
  • Purpose: To evaluate clinical results of a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis. Materials and Methods: Between Jan and Dec 2009, fifteen patients (5 male, 10 female) received a diagnosis of lateral epicondylitis of the elbow and were evaluated in this study. Their average age was 43.5 years. All patients were initially given a variety of non-surgical treatments for more than 1year. All patients were considering surgery. These patients were given a single percutaneous injection of 3cc of platelet-rich plasma. To assess pain, we used a visual analogue scale (VAS) at rest and during work & the Patient-Rated Tennis Elbow Evaluation (PRTEE) score. We compared the score before treatment with scores 4 and 12 weeks after treatment. Results: Average VAS scores at rest improved from 4.6 before treatment to 2.5 at week 4, and 1.8 at week 12. The average VAS score while working also improved from 7.8 before treatment to 6.2 at week 4, and 4.25 at week 12. The average PRTEE score improved from 60.13 before treatment to 46.12 at week 4 and 24.6 at week 12. Conclusion: Treatment using a single percutaneous injection of platelet-rich plasma in patients with refractory lateral epicondylitis appears to be an effective treatment modality. Platelet-rich plasma should be considered before surgical intervention.

The Clinical Study on Chronic Conjunctivitis or Xerophthalmia treated with The Hwangryunhaedock-tang Herbal Acupuncture Therapy (황련해독탕(黃連解毒湯) 약침요법을 통한 만성(慢性) 결막염(結膜炎) 또는 안구건조증(眼球乾燥證) 환자 1례에 대한 보고)

  • Lee Chae-Woo;Park In-Beohm;Kim Sang-Woo;Ahn Chang-Beohm;Song Choon-Ho;Jang Kyung-Jeon;Kim Cheol-Hong;Youn Hyoun-Min
    • Korean Journal of Acupuncture
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    • v.20 no.4
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    • pp.77-84
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    • 2003
  • Objective : This study was designed to investigate the effect of the Hwangryunhaedock-tang Herbal Acupuncture Therapy on Chronic Conjunctivitis or Xerophthalmia Methods : We injected distillation of the Hwangryunhaedock-tang(0.2cc) on both B-15(Shinsu-心兪), B-18(Kansu-肝兪) of patient and dropped it(0.6cc) in both eyes. We examined therapeutic value of Chronic Conjunctivitis or Xerophthalmia Results & Conclusions : The Hwangryunhaedock-tang Herbal Acupuncture Therapy was effective on reducing the symptoms. But further studies are required to concretely prove the effectiveness of the Hwangryunhaedock-tang Herbal Acupuncture Therapy for treating Chronic Conjunctivitis or Xerophthalmia.

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Clinical Considerations of Trigeminal Neuralgia (삼차신경통 진단 및 치료의 중요 고려사항)

  • Jeon, Young-Mi;Tae, Il-Ho;Choi, Jong-Hoon;Ahn, Hyung-Joon;Shim, Woo-Hyun;Kwon, Jeong-Seung
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.449-453
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    • 2007
  • Trigeminal neuralgia is defined as "a sudden, usually unilateral, brief stabbing recurrent pain in the distribution of one or more branches of the fifth cranial nerve" by the International Association for the Study of Pain(IASP). Trigeminal neuralgia is classified as an idiopathic trigeminal neuralgia with no apparent cause and a symptomatic trigeminal neuralgia which is caused by a structural lesion such as brain tumor. Over 80% of the tumors are meningioma, acoustic neuroma, and epidermoid tumors. Symptomatic trigeminal neuralgia can not be excluded even if old-aged patient does not have abnormal neurologic sign and symptom, and good response to pharmacotherapy. Therefore, initial examinations such as MRI or CT are essential to exclude symptomatic trigeminal neuralgia. When compared with CT, MRI, especially gadolinium enhanced MRI, has an increased sensitivity in the detection of intracranial lesions. The most effective medical treatment of trigeminal neuralgia is carbamazepine. The most common side effects of carbamazepine include drowsiness, dizziness, unsteadiness, nausea, anorexia. Hepatotoxicity, bone marrow depression are the most feared side effect of carbamazepine therapy but occurs rarely. It require periodic complete blood cell counts as well as hepatic and renal function tests. It has been recommended that complete blood cell counts is done every 2 weeks for the first 2months and then quaterly thereafter. Oxcarbazepine can be used if neutropenia occurs.

The natural history and prognostic factors of Graves' disease in Korean children and adolescents (한국 소아 및 청소년 Graves병의 자연 경과 및 예후 인자)

  • Song, Seung-Min;Youn, Ji-Seok;Ko, Jung-Min;Cheon, Chong-Kun;Choi, Jin-Ho;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.585-591
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    • 2010
  • Purpose : Graves' disease is the most common cause of hyperthyroidism in children and adolescents. In this study, we investigated the natural course and the prognostic factors of Graves' disease in Korean children and adolescents. Methods : One-hundred thirteen (88 girls and 25 boys) patients were included in this study. A retrospective analysis was made of all patients who were diagnosed with Graves' disease. The following parameters were recorded and analyzed: patient's sex, age at diagnosis, duration of disease, laboratory findings, symptoms and signs, and family history of autoimmune thyroid disease. Results : All patients were initially treated with antithyroid drugs, either methimazole (93.8%) or propylthiouracil (6.2%). Antithyroid drugs had been discontinued in 75 (66.4%) of 113 patients. Of these 75 patients, 23 (20.4%) relapsed after $25.5{\pm}33.7$ months. Thirteen (11.5%) of 23 patients, who experienced the first relapse, showed a second remission. However, 2 (1.8%) of 13 patients relapsed again. Euthyroid state could not be achieved by antithyroid drugs in 1 patient, and radioactive iodine therapy was performed. The older the patient at diagnosis, the greater the likelihood of remission ($P$=0.034). Conclusion : Age at diagnosis seems to be a prognostic factor in Korean children and adolescents with Graves' disease, and should be taken into account in treatment plan determination.

Treatment of dental erosion caused by intrinsic and extrinsic etiology: a case report (외인성 및 내인성 요인에 의한 치아부식에 대한 치료 증례)

  • Lee, Gyeong-Je;Jin, Soo-Yoon;Kim, Hee-Jung;Min, Jeong-Bum
    • Journal of Dental Rehabilitation and Applied Science
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    • v.33 no.1
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    • pp.42-46
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    • 2017
  • Dental erosion is defined as tooth structure loss by acidic chemical substance. It is caused by extrinsic factors such as acidic foods, drugs, and working environments, and also intrinsic factors such as gastric acid regurgitation in gastro-esophageal disorder or intensive vomiting in bulimia nervosa. These lesions can be treated with direct resin filling, laminate or full contour crown depending on the intensity of clinical problem. This is a case report about treatment of rare clinical case: labial erosion of anterior tooth caused by frequent intake of acidic fruit and palatal erosion of anterior tooth caused by intensive vomiting in bulimia nervosa.

Study for Treatment Effects and Prognostic Factors of Bronchial Asthma -Follow Up Over 2 Years- (2년 이상 관찰중인 성안 기관지 천식환자의 치료 효과 및 예후인자에 관한 연구)

  • Choung, Bo-Young;Park, Jung-Won;Kim, Sung-Kyu;Hong, Chein-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.3
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    • pp.559-573
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    • 1997
  • Background : Asthma causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough. These symptoms are usually associated with widespread but variable airflow limitation that is partly reversible either spontaneously or with treatment. The inflammation also causes an associated increase in airway responsiveness to a variety of stimuli. Method : Of the 403 adult bronchial asthma patients enrolled from March 1992 to March 1994 in Allergy Clinics of Severance Hospital in Yonsei University, this study reviewed the 97 cases to evaluate the treatment effects and to analyse prognostic factors. The patients were classified to five groups according to treatment responses ; group 1 (non control group) : patients who were not controlled during following up, group 2 (high step treatment group) : patients who were controlled longer than 3 months by step 3 or 4 treatment of "Global initiative for asthma, Global strategy for asthma management and prevention" (NHLBI/WHO) with PFR(%) larger than 80%, group 3 (short term control group) : patients who were controlled less than 1 year by step 1 or 2 treatment of NHLBI/WHO, group 4 (intermediate term control group) : patients who were controlled for more than 1 year but less than 2 years by step 1 or 2 treatment of NHLBI/WHO, group 5 (long term control group) : patients who were controlled for more than 2 years by step 1 or 2 treatment of NHLBI/WHO. Especially the patients who were controlled more than 1 year with negatively converted methacholine test and no eosinophil in sputum were classified to methacholine negative conversion group. We reviewed patients' history, atopy score, total IgE, specific IgE, methacholine PC20 and peripheral blood eosinophil count, pulmonary function test, steroid doses and aggrevation numbers after treatment. Results : On analysis of 98 patients, 20 cases(20.6%) were classified to group 1, 26 cases(26.8%) to group 2, 23 cases(23.7%) to group 3, 15 cases(15.5%) to group 4, and 13 cases(13.4%) to groups 5. There were no differences of sex, asthma type, family history, smoking history, allergic rhinitis and aspirin allergy among the groups. In long term control group, asthma onset age was younger, symptom duration was shorter, and initial pulmonary function was better. The long term control group required lower amounts of oral steroid. had less aggrevation during first 3months after starting treatment and shorter duration from enrollment to control Atopy, allergic skin test, sputum and blood eosinophil, total IgE, nonspecific bronchial responsiveness was not significantly different among the groups. Seven out of 28 patients who were controlled more than 1 years showed negatively converted methachloine test and no eosinophils in the sputum. The mean control duration was $20.3{\pm}9.7$ months and relapse did not occur. Conclusion : Patients who had asthma of onset age younger, shorter symptom duration, better PFT, lower treatment initial steps, lower amounts of steroid needs and less aggravation numbers after starting treatment were classified in the long term control groups compared to the others.

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The effects of ibuprofen and indomethacin therapy for patent ductus arteriosus in preterm infants (미숙아 동맥관 개존 치료에서 indomethacin과 ibuprofen의 효과)

  • Choi, Wooksun;Shin, Jung-Yeon;Choi, Byung Min;Eun, Baik-Lin;Yoo, Kee Hwan;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.49 no.12
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    • pp.1315-1323
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    • 2006
  • Purpose : This study was conducted to compare the efficacy and safety of ibuprofen and indomethacin in the treatment of patent ductus arteriosus (PDA) in preterm infants and to determine whether ibuprofen can be an alternative drug. Methods : A total of 32 preterm infants with symptomatic PDA were enrolled in the study. Twelve infants received intravenous ibuprofen 10 mg/kg, followed by 5 mg/kg after 24 and 48 hours. As a comparative group, twenty premature infants received three doses of indomethacin 0.1-0.2 mg/kg every 12 hours. Results : PDA was closed in 11 of 12 infants of the ibuprofen group (92 percent) and in 18 of 20 infants of the indomethacin group (90 percent). Serum sodium concentration decreased along with time significantly (P<0.0001) and to its lowest level at 48 hours after administration of the third dose (P=0.0011) in both groups, but showed no significant difference between two groups. Serum BUN and creatinine concentrations were not changed significantly before or after treatment in each group and showed no difference between thetwo groups. The amount of urine output did not change along with time significantly in both groups (P=0.0725), and showed no significant difference between two groups. Conclusion : Ibuprofen has similar effects to indomethacin in the rate of PDA closure and complication when compared. It has similar changes in serum sodium level and complications when compared to indomethacin for the treatment of PDA in preterm infants. Therefore, intravenous ibuprofen may be used as an alternative agent in the treatment of symptomatic PDA in preterm infants.

Total Ear Canal Ablation and Lateral Bulla Osteotomy for Chronic Otitis Externa and Media in Dogs: Postoperative Recovery and Long-Term Follow-up (개에서 만성외이염과 중이염에 대한 전이도 적출술과 외측 고포절골술: 수술 후 회복과정과 장기간 예후)

  • Kim, Joon-Young;Jeong, Soon-Wuk;Jeong, Man-Bok;Han, Hyun-Jung;Kim, Je-Sun
    • Journal of Veterinary Clinics
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    • v.20 no.1
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    • pp.26-32
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    • 2003
  • The clinical results of 10 consecutive total ear canal ablation combined with lateral bulla osteotomy (TECA-LBO) in six dogs with chronic otitis externa and media were evaluated by the postoperative recovery and long-term follow-up. All dogs were selected for TECA-LBO on the basis of following five clinical symptoms. First, medical treatment couldnt improve clinical signs at least for eve. 2 months. Second, tympanic membrane was completely disappeared. Third, radiopacity was increased in tympanic cavity. Forth, petrous temporal bone was sclerosed. Fifth, ear canal calcification was progressed. And all cases were satisfied all five clinical symptoms. At 14. days after operation, the preoperative symptoms of chronic otitis externa and media which were scratching ear, pain, and hardening ear canal were resolved, and postoperative swelling, erythema, head tilt, and exudate from Penrose drainage were not existed In all cases. Loss of eye blink was happened in 4 cases, but these were disappeared between 14 days a(ter operation except one case on 3 months. All dogs were discharged form hospital at 14 days after operation. Between 3.5 and 6.5 months after discharging from hospital, para-aural abscessation was happened only in all Cocker spaniels. But this complication was solved by ventral bulla osteotomy (VBO). The dogs which didn't show para-aural abscessation after TECA-LBO didn't show scratching, pain, hardening of ear and hearing ability was improved, at 7.5 months after TECA-LBO. And the dogs which showed para-aural abscessation after TECA-LBO also didn't show scratching, pain, hardening of ear and hearing ability was also improved, at 7.5 months after VBO. In conclusion, After TECA-LBO, all dogs were recovered well without complication within 2 weeks except Cocker spaniel. And loss of eye blink can be cured naturally within 2 weeks after surgery. And para-aural abscessation can be happened between 4 and 7 months after TECA-LBO, so surgeon must follow-up until 8 months.