• Title/Summary/Keyword: Chronic fatigue

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Clinical Characteristics, Histology and Prognosis of Autoimmune Hepatitis in Korean Children (소아 자가면역성 간염: 임상적 특성, 조직 소견 및 예후)

  • Chung, Dae-Lim;Seo, Jeong Kee;Yang, Hye Ran;Ko, Jae Sung;Park, Sung Hye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.2
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    • pp.186-196
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    • 2004
  • Purpose: Autoimmune hepatitis is a chronic inflammatory liver disease with unknown cause that is characterized by liver histology, circulating autoantibodies and increased levels of immunoglobulin G. Only sporadic reports are available on autoimmune hepatitis in children. The aim of this study was to evaluate the clinical, biochemical, and histological features, and the long-term outcome of autoimmune hepatitis in Korean children. Methods: We reviewed the medical records of 14 children diagnosed as having autoimmune hepatitis at Seoul National University Children's Hospital from 1990 to 2004, and analyzed clinical, biochemical, and histological features, and clinical outcomes. Results: Mean age at diagnosis was 9 years and 11 of the 14 children were female. Six children presented with acute hepatitis-like manifestations. Jaundice and fatigue were the most common symptoms. Other autoimmune diseases accompanied in 6 children. Anti-nuclear antibody was detected in 13 patients and anti-smooth muscle antibody was positive in 8. All 14 patients were type 1 autoimmune hepatitis. The main histologic findings were interface hepatitis, rosette formation, and cirrhosis. Clinical and biochemical features were improved in six patients treated with ursodeoxycholic acid. Eight patients were treated with corticosteroid alone or in combination with azathioprine and five of them are in biochemical remission. Conclusion: Autoimmune hepatitis is an inflammatory liver disease, which has a favorable long-term outcome if it is diagnosed and treated promptly. Therefore, autoimmune hepatitis should be suspected in children with chronic hepatitis of unknown etiology, especially in female patients who show hypergammaglobulinemia or some clinical features of autoimmune disease.

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The Diagnostic Significances of D.I.T.I. on the Patients of Cold-limbs (수족냉증(手足冷症) 환자(患者)에 대(對)한 컴퓨터 적외선(赤外線) 체열촬영(體熱撮影)의 의의(意義))

  • Cho, Yu-Kyung;Oh, Su-Wan;Cho, Nam-Hee;Kim, Dong-Mook;Kim, Jin-Seong;Ryu, Bong-Ha;Park, Dong-Won;Ryu, Ki-Won
    • The Journal of Internal Korean Medicine
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    • v.19 no.2
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    • pp.37-49
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    • 1998
  • To make a objective diagnosis of the syndrome of cold-limbs, We investigated the 20 patients with cold limbs and GI trouble and 20 normal people as a control group. And we compared the thermal difference between Chon-jung(CV17) and Chung-wan(CV12 中脘), Chon-jung(CV17) and Ki-hae(氣海 CV6) and we compared the thermal differences of No-gung(PE8 勞宮) and Yong-chon(湧泉 KI1), too. The results were as follows. 1. All 20 patients had GI trouble and cold limbs. They had the symptom-Indigestion(16 cases-80%) with heart burn, tympanites, abdominal distention, hiccup, belching. Beside that symptom they also had constipation(6 cases-30%), diarrhea(3 cases-15%), headache & dizziness(6 cases-30%). And some had the menstrual syndrome, chronic fatigue, palpitation, insomnia, edema, arthralgia. 2. The thermal difference of the palms between the patients group and the control group were $25.70^{\circ}C,\;25.82^{\circ}C$, but they were not significant. 3. The thermal difference of the soles between the patients group and the control group were $23.58^{\circ}C,\;24.42^{\circ}C$ and the significancy was P=0.020 so it was significant(P<0.05). 4. The thermal difference of the palms and Chon-jung(CV17) between the patients group and the control group were $1.08^{\circ}C,\;0.76^{\circ}C$, but they were not significant. 5. The thermal difference of the sales and Chon-jung(CV17) between the patients group and the control group were $3.01^{\circ}C,\;1.90^{\circ}C$ and the significancy was P=0.003 so it was significant(P<0.05). 6. The thermal difference of Chon-jung(CV17) and Chung-wan(CV12 中脘) between the patients group and the control group was $0.30^{\circ}C,\;0.62^{\circ}C$ and the significancy was P=0.793 so it was significant(P<0.05). 7. The thermal difference of Chon-jung(CV17) and Ki-hae(CV6 氣海) between the patients group and the control group was $0.53^{\circ}C,\;0.68^{\circ}C$, but they were not significant. From the above, I could find the significance of D.I.T.I to diagnose the cold-feet not the cold-hands and the thermal difference between the trunk and limbs was more significant on cold-feet than on cold-hand, either.

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Hypersensitive Large Intestine Syndrome in Hyungsang Medicine (과민성대장증후군의 형상의학적 고찰 -동의보감(東醫寶鑑)을 중심으로-)

  • Choi Byung-Tae;Choi Yung-Hyun;Han Jin-Soo;Lee Yong-Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.19 no.5
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    • pp.1129-1136
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    • 2005
  • The writer reports the conclusions gained from study about the cause of the hypersensitive large intestine syndrome with Dongeuibogam as the central figure through researching the disharmony among Body Essence, Vital Energy, Mentality, and Blood, mutual action of five viscera and six bowels, and external shapes. The hypersensitive large intestine syndrome is generally chronic and recurred in many cases, so it is more efficacious than symptomatic to treat according to find the contradictions of individual shapes. The shapes and cases suffering frequently the hypersensitive large intestine syndrome are Gi-kwa and Sin-kwa, having a long nose, having a bruised spot on Triple warmer, man with inclined mouth, Taeeum type, man with congested fluids, man with colic symptoms. The hypersensitive large intestine syndrome in Oriental medicine is recognized of diarrhea, constipation, abdominal pain, abdominal distention and fullness caused by seven emotions. In Dongeuibogam it can be found out the similarity in depressive symptoms due to disorder of Gi, stagnation of Gi, dysphasia due to disorder of Gi, diarrhea due to disorder of Gi, fullness of due to Gi, diarrhea due to phlegm-retention, retention of undigested food, immoderate drinking, hypo-function of the spleen, or deficiency, abdominal pain from colic symptom, and difficulty in defecation and urination, internal injury, diarrhea due to weakness and fatigue. If the Jung, Gi, Sin, and Hyul composed the human body is broken harmony, the function of large intestinal transmission would be fallen, so similar symptoms like the hypersensitive large intestine syndrome are gotten. Especially Gi-kwa suffers diarrhea, constipation abdominal pain, and abdominal distention and fullness due to depressive symptoms from disorder of Seven emotions or Seven Gi. And Sin-kwa suffers from the hypersensitive large intestine syndrome due to emotional restlessness having an influence on rhythmic movement of abdomen. Examining between five viscera and six bowels and the hypersensitive large intestine syndrome, Liver cannot disperse well having influence on mutual relation of Liver-Large intestine, Heart reduces the function of defecation and urination not to control the seven emotions, Lung having exterior and interior relation with intestine has an influence on primordial energy and let the main symptoms occur, Spleen circulating the body fluid let the main symptoms occur due to malfunction of circulation, Kidney locating in lower part of the body has deep connection with intestine, so let the disorder. Urinary bladder is connected with intestine in moisture metabolism, Stomach is connected in receive and transmission, Small intestine is connected in absorption and excretion, from small intestine pain disturbing the abdominal movement, Samcho managing the catharsis of lower heater if declined its function causes the hypersensitive large intestine syndrome. The colic symptoms of Front private parts which disorder in lower abdomen give rise to abdominal pains, difficulty in defecation and urination due to Cold are similar to the hypersensitive large intestine syndrome. The treatments of applying the shapes of colic syndrome advocated by Master Park can be efficacious cure in clinic. Researching after the clinical cases of Master Park advocating Hyungsang medicine, we came to know that plenty of prescriptions of internal injury are applied and take good effects.

Applications of Prescriptions Including Astragali Radix and Angelicae gigantis Radix in Dongeuibogam (동의보감(東醫寶鑑) 중(中) 황기(黃芪)와 당귀(當歸)가 배오(配伍)된 방제(方劑)의 활용(活用)에 대한 고찰(考察))

  • Kwon, Hyun-Kyong;Kook, Yoon-Bum
    • Herbal Formula Science
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    • v.19 no.1
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    • pp.51-58
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    • 2011
  • Objectives : This study was performed to investigate applications of 171 prescriptions including Astragali Radix and Angelicae gigantis Radix in Dongeuibogam. Methods : 171 prescriptions including Astragali Radix and Angelicae gigantis Radix which have been used separately or concurrently in Oriental Medicine for a long time as a treatment for various disease in Dongeuibogam were studied through order of frequency, symptoms, dosages, etc. Results : 1. 27 times(15.79%) prescriptions are recorded in intumescence chapter, 21 times(12.28%) in fatigue chapter, 11 times(6.43%) in women chapter and 9 times(5.26%) in anus chapter, which are arranged in order of frequency. 2. Yin-yang deficiency treat herbs are ranked top, eliminating intumescence methods, bloody stool, discharging blood from one's vagina, yang deficiency treat herbs are ranked in order of frequency among 107 symptoms in prescriptions including Astragali Radix and Angelicae gigantis Radix. 3. The dosages of Astragali Radix which is more used than Angelicae gigantis Radix are ranged from 3 puns:1 pun ~ 2 nyangs:1.5 nyangs. 1 jeon:5 puns is recorded 8 times(14.29%), 2 jeon:1 jeon is 7 times(12.50%), 1 jeon:3 puns and 1 jeon:7 puns are 24 times(11.2%), 1 nyang is 21 times(9.8%), same amount is 11 times(5.1%), 5 pun is 4 times(7.14%) each, 1.5 jeon:5 puns is 3 times(5.36%) used among 56 prescriptions including Astragali Radix and Angelicae gigantis Radix. 4. The dosages of Astragali Radix which is used same amount Angelicae gigantis Radix are ranged from 2.5 puns each ~ 2 nyangs each, 2.5 chons, same amount each. 1 jeon each is recorded 36 times(38.71%), 1 nyang each is 15 times(16.13%), 0.7 jeon each is recorded 12 times(12.90%), 0.5 jeon each is recorded 6 times(6.45%) used among 93 prescriptions including Astragali Radix and Angelicae gigantis Radix. 5. The dosages of Astragali Radix which is less used than Angelicae gigantis Radix are ranged from 3 puns:7 pun ~ 5 nyangs:12 nyangs. 1 jeon:1.5 jeons is recorded 3 times(13.64%), 0.8 jeon:1 jeon and 1 nyang:2 nyangs are 2 times(9.09%) each, the others are 1 time(4.55%) used among 22 prescriptions including Astragali Radix and Angelicae gigantis Radix. 6. The dosages of (Astragali Radix $\gg$ Angelicae gigantis Radix), (Astragali Radix = Angelicae gigantis Radix) and (Astragali Radix $\ll$ Angelicae gigantis Radix) which are recorded by counts (decoction groups: the other groups) are 52:4(92.86%:7.14%), 70:23(75.27%:24.73%), 13:9 (59.09%:40.91%) respectively. 7. The less using dosage of Astragali Radix and Angelicae gigantis Radix has a more percentage of decoctions groups, The more using dosage of Astragali Radix and Angelicae gigantis Radix has a more percentage of the other groups except decoctions. The less using prescriptions have an effects of controling yin and yang, enhancing blood and chi, etc, as a whole. The more using prescriptions as a form of compound powder have an effects in incurableness disease, chronic diseases, etc. Conclusions : The 171 prescriptions including Astragali Radix and Angelicae gigantis Radix in Dongeuibogam are mainly composed of Dangguibohyul-tang, Samool-tang, Sagoonja-tang and Gobangpoong-tang, Gamri-hwan, etc.

The clinical study of Myasthenia Gravis (중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究))

  • Chae, Byung-Yoon
    • The Journal of Korean Medicine
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    • v.17 no.1 s.31
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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Distress and Associated Factors in Patients with Breast Cancer Surgery : A Cross-Sectional Study (유방암 수술환자의 디스트레스 및 연관인자 : 단면연구)

  • Lee, Sang-Shin;Rim, Hyo-Deog;Woo, Jungmin
    • Korean Journal of Psychosomatic Medicine
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    • v.26 no.2
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    • pp.77-85
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    • 2018
  • Objectives : This study aimed to investigate the level of distress using the distress thermometer (DT) and the factors associated with distress in postoperative breast cancer (BC) patients. Methods : DT and WHOQOL-BREF (World Health Organization Quality of Life Scale Abbreviated Version) along with sociodemographic variables were assessed in patients undergoing surgery for their first treatment of BC within one week postoperatively. The distress group consisted of participants with a DT score ${\geq}4$. The prevalence and associative factors of distress were examined by descriptive, univariable, and logistic regression analysis. Results : Three hundred seven women were recruited, and 264 subjects were finally analyzed. A total of 173 (65.5%) were classified into the distress group. The distress group showed significantly younger age (p=0.045), living without a spouse (p=0.032), and worse quality of life (QOL) as measured by overall QOL (p=0.009), general health (p=0.005), physical health domain (p<0.000), and psychological health domain (p=0.002). The logistic regression analysis showed that patients aged 40-49 years were more likely to experience distress than those aged ${\geq}60years$ (Odds ratios [OR]=2.992, 95% confidence interval [CI] 1.241-7.215). Moreover, the WHOQOL-BREF physical health domain was a predictive factor of distress (OR=0.777, 95% CI 0.692-0.873). Conclusions : A substantial proportion of patients are experiencing significant distress after BC surgery. It would be expected that distress management, especially in the middle-aged patients and in the domain of physical QOL (e.g., pain, insomnia, fatigue), from the early BC treatment stage might reduce chronic distress.