• Title/Summary/Keyword: Differentiation of Syndromes

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Study on Development of Assessment Guideline and Endpoints for Clinical Trial with Antitumor Natural Products (천연물 항암제제 임상시험 평가지표 개발연구)

  • Namgung, Mi-Ae;Chang, Yoo-Sung;Jeong, Seung-Gi;Kim, Jin-Seung;Yoon, Sung-Woo;Jang, Ki-Young;Yoo, Hwa-Seung;Jung, Myeon-Woo;Lee, Sung-Ho;Kim, Sung-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.6
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    • pp.1678-1727
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    • 2006
  • This study was perfromed to develop the assessment guideline and endpoints for clinical trial with anticancer herbal medicine. The botanical products used to humans for long time may be applied to phase 3 clinical trial after submitting the evidences for safety and efficacy of them or completion of basic requirement of phase 1 and phase 2 for safety confirmation and dose determination. Syndrome improvement was chiefly evaluated by Zubrod and karnofsky(%) methods. We suggest the general clinical trial assessment with botanical products, by following assessment points, that is, tumor size for 50 points, survival fate for 10 points, major syndromes for 40 points. It is recommendable that the each symptom of Qi deficiency syndrome, blood deficiency syndrome and Qi stagnation syndrome was allocated by assessment points, Similarly, the each symptom was given the assessment points according to the severity of symptom, for example, slight for 3 points, moderate for 2 points and severe for 1 point in hepatocelluar carcinoma and lung cancer. Then, the efficacy of botanical products was evaluated by the difference between pre-treatment and post-treatment. Asking the neoplastic patients of questionnaire on physical, emotional, cognitive, social and role subjects availability, three more syndromes (Fatigue, Pain and Nausea/Vomit), quality of life(QOL) will be evaluated by GLM statistics. In addition, in case of lung cancer, 13 questions will be asked by the EORTC QLQ-C13 forms. As the assessment of endpoints for efficacy to reduce side effects induced by chemotherapy and radiotherapy, the data of image scanning and hemato-urinalysis can be usefully applied on immune response, weight loss, indigestion, hemopoietic damage and injury of liver and kidney, while the changes of syndromes of side effect can be evaluated by differentiation methods of Qi and blood and five viscera. However, it is still necessary to determine the ratio between scientific analytical method and Oriental differentiation method as well as confirm the Oriental assessment endpoints by clinical trial. In addition, we suggest the continuous development of assessment endpoints on other carcinomas except of hepatocelluar carcinoma and lung cancer in future.

Discriminant Model V for Syndrome Differentiation Diagnosis based on Sex in Stroke Patients (성별을 고려한 중풍 변증진단 판별모형개발(V))

  • Kang, Byoung-Kab;Lee, Jung-Sup;Ko, Mi-Mi;Kwon, Se-Hyug;Bang, Ok-Sun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.138-143
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    • 2011
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.

A study on the Transmutation among Six-channels in Shanghanlun (『상한론(傷寒論)』 육경병(六經病) 전변(傳變)에 관한 연구(硏究))

  • Lee, Sang-Hyup;Kim, Hoon
    • Journal of Korean Medical classics
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    • v.28 no.3
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    • pp.27-43
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    • 2015
  • Objectives : Zhang Zhong-jing's Shanghanlun is based on Six-channels system to classified a disease. This paper is planning to describe the Transmutation among Six-channels system. Six-channels change not fixed in either direction and each is relative to each other. Methods : I will try to describe the Transmutation among Six channels system, through the letter of the Shanghanlun. First, I will find letters related to a disease transmission. Second, It will be described through the analysis of the past medical scientists. Results : Six-Meridian Pattern is the categorization of syndromes according to the theory of the six meridians, applied to the diagnosis of acute febrile diseases at different stages, but also useful for the pattern syndrome differentiation of other diseases. Transmutation among Six channels system is not fixed in a certain order and it each affects one another. Conclusions : We can see that Zhong-jing's medical treatment from syndrome differentiation is associated with a Mutual transmission(相互傳變).

Ergostane-Type Steroids from Korean Wild Mushroom Xerula furfuracea that Control Adipocyte and Osteoblast Differentiation

  • Lee, Seoung Rak;Choi, Jin Hee;Ryoo, Rhim;Kim, Jin-Chul;Pang, Changhyun;Kim, Seon-Hee;Kim, Ki Hyun
    • Journal of Microbiology and Biotechnology
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    • v.30 no.11
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    • pp.1769-1776
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    • 2020
  • As part of our current work to discover structurally and/or biologically novel compounds from Korean wild mushrooms, we isolated five ergostane-type steroids (1-5) from the fruiting bodies of Xerula furfuracea via repeated column chromatographic separations and HPLC purification. The chemical structures of the isolated steroids were shown to be (22E,24R)-24-methylcholesta-4,22-diene-3,6-dione (1), ergosta-7,22-diene-3β,5α,6β-triol (2), ergosta-7,22-diene-3β,5α,6β,9α-tetraol (3), (22E,24R)-5α,8α-epidioxyergosta-6,22-diene-3β-ol-3-O-β-D-glucopyranoside (4), and (22E,24R)-5α,8α-epidioxyergosta-6,9,22-triene-3β-ol-3-O-β-D-glucopyranoside (5)based on comparison of the data regarding their spectroscopic and physical properties with those of previous studies. Notably, this is the first report on the presence of the identified steroids (1-5) in this mushroom. We tested compounds 1-5 to determine their effects on adipogenesis and osteogenesis in the mouse mesenchymal stem cell line C3H10T1/2 and found that compounds 4 and 5 suppressed the differentiation of stem cells into adipocytes. Notably, in addition to its suppressive effect on adipogenesis, compound 5 was also shown to promote the osteogenic differentiation of stem cells. These findings demonstrate that the bioactive compounds isolated might be effective for the treatment of menopause-associated syndromes, such as osteoporosis and obesity, as the isolated compounds were shown to suppress adipogenesis and/or promote osteogenesis of stem cells.

A Case Report on Cardiac Asthma due to Congestive Heart Failure (울혈성 심부전으로 인한 심장성 천식환자 치험 1례)

  • Jung Wun-Suk;Shin Jeong-In;Sea Un-Kyo
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1093-1102
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    • 2003
  • Congestive heart failure is a cardiac dysfunction that can't supply sufficient amount of blood. The disorder usually causes hypertension, ischemic cardiac disease and give rise to pulmonary congestion and pulmonary epileptic edema. The symptoms of the disease are dyspnea, palpitation, edema, etc. We treated a 82 year-old female patient who had severe dyspnea, nausea, and dizziness. At the point of differentiation of syndromes(辨證), the case was diagnosed as Su-Cheon(水喘) induced by Yang-deficiency of Both Spleen and Kidney(脾腎陽虛) and was administered Yerunpang(胃?湯). After two weeks of the treatment, we witnessed improvement in the symptoms of CHF and general depressed condition. This report describes the process and contents about the way the patient was treated.

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Relationship between the Severity of Stenosis and Stroke Pattern-identification in 18 Acute Stroke Patients (Brain MRA상 stenosis정도와 중풍변증모형을 비교한 18례)

  • 곽미애;정우상;박정미
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.51-56
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    • 2000
  • To assess the relationship between the severity of stenosis in MCA territory and the differentiation of syndromes in oriental medical aspects, the general characteristics, the scores of stroke-pattern identification, and the findings of MRA were compared in 18 acute cerebral infarction patientshospitalized in Dept. of Internal Medicine, Pundang CHA Oriental Medicine Hospital from 1998 sep. 1 to 1999 sep. 31. We compared the scores of stroke-pattern identification with the severity of stenosis by Kruskall-Wallis test, and analyzed the relationship by Pearson correlation test. The P value under 0.05 was regarded as significant. The results are as follows: The incidence of stenosis(mild to complete occlusion) was 83.3%. There were significant difference of the mean scores according to the severity of stenosis in Yin deficiency pattern. We could also observe a strong relationship between the severity of stenosis and Yin deficiency pattern, whose Pearson correlation coefficient was 0.655 (P<0.05). These results showed that Yin deficiency pattern could be a major cause of cerebral infarction.

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A Case Report of the Agitation(Byun-jo) Caused by Cerebral Infarction Treated with Hwangryunhaedok-tang Herbal-Acupuncture Therapy (뇌경색 후 발생한 번조증에 대한 황련해독탕 약침의 병행 치험 1례)

  • Lee, Yu-Jin;Park, Se-Jin
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.118-125
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    • 2012
  • Object : The purpose of this study is to evaluate the effect of Hwangryunhaedok-tang herbal-acupuncture therapy for Agitation(Byun-jo) caused by cerebral infarction. Methods : One patient was admitted who was suffering from insomnia, chest discomfort, anxiety, palpitation of Agitation(Byun-jo), after cerebral infarction. In the point of Differentiation of Syndromes(辨證), we diagnosed this patient as Excessive heat-fire syndrome of stroke(中風火熱證) and treated with Hwangryunhaedok-tang herbal-acupuncture therapy at CV17, BL15, GB20. Results : After Hwangryunhaedok-tang herbal-acupuncture therapy, symtoms of Agitation(Byun-jo) were improved remarkably, and the score of State-Trait Anxiety Inventory(STAI), Pittsburgh Sleep Quality Index(PSQI) were decreased. Conclusions : Hwangryunhaedok-tang herbal-acupuncture therapy has meaningful effect on the symptoms of Agitation(Byun-jo) caused by cerebral infarction and more researches should be followed.

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Clinical Management of Gastric Neuroendocrine Tumors

  • In Kyung Yoo;Bora Keum
    • Journal of Digestive Cancer Research
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    • v.3 no.1
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    • pp.21-25
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    • 2015
  • Gastric neuroendocrine tumors (GNETs, also known as gastric carcinoids) are rare form of hormone-secreting neoplasms that present with varied clinical syndromes. There are four types of GNETs based on size, proliferation, localization, differentiation, and hormone production. Type I GNET is related to autoimmune atrophic gastritis and hypergastrinemia. Type II GNETs are related to multiple endocrine neoplasia (MEN)-1, Zollinger-Ellison syndrome and hypergastrinemia. Type 3 GNETs are not associated with any background pathology, and type 4 GNETs are poorly differentiated tumors. The most useful diagnostic and prognostic marker for gastrointestinal NETs is plasma chromogranin A (CgA) levels. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. For optimal management, the type, biology, and stage of the tumor must be considered. Here, we provide a comprehensive and up-to-date review of GNETs.

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Study on the Seop-Gye's constitution theory for the connection with 'the differentiation of syndromes' and the general body form diagnosis (전신형태 진단과 변증시치의 연계를 위한 엽계의 형태체질론 연구)

  • Kim Gyeong Cheol;Lee Yono Tae;Shin Soon Shik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.1
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    • pp.22-27
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    • 2004
  • Seop-Gye divided up the constitution's strength and weakness, and so he cured disease by the 'cold and heat'. 'deficiency and excessiveness' means on the basis of the YINㆍYANG of constitution. He classified constitution with pathogenesis grounding in body formal distinction, flesh hardness and softness, face color and form, skin color. Therefore he grasped the rule of constitution connected with physiological function and pathological distinction, applied the rule of constitution in the diagnosis and cure of the chronic & epidemic febrile disease.

Study on The Rhythmical Rules of The Circulation of Yeong(營) and Wi(衛) during Sleep (시론영위주야절률성재수면활동중적작용(试论营卫昼夜节律性在睡眠活动中的作用))

  • Lu, Ying
    • Journal of Korean Medical classics
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    • v.22 no.4
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    • pp.47-50
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    • 2009
  • This paper according to the sleep theory of Yeonggi(營氣) and Wigi(衛氣)'s circulation in "Naegyeong(內經)", explains that Yeonggi and Wigi's circulation is the internal basic for human's sleep-wake rhythm, and it's relationship with other sleep theories, such as mental activity sleep theory, soul sleep theory, Jangbu(臟腑) organs sleep theory etc. It can be seen that the circulation law of Yeonggi and Wigi for day and night is the key of sleep activities, and Yeonggi and Wigi's circulation disorder is the key of insomnia, so we should use coordination of Yeonggi and Wigi as basic method for treating insomnia, based on treatment after differentiation of syndromes.

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