• Childhood Kidney Diseases
• /
• v.26 no.2
• /
• pp.80-85
• /
• 2022

Purpose: To determine the prevalence, clinical manifestations, and outcomes of renal involvements in pediatric Alagille syndrome (ALGS). Methods: A total of 21 patients diagnosed with ALGS at age under 18 years who visited Samsung Medical Center from March 1999 to March 2022 were enrolled. ALGS was diagnosed either by clinical manifestations, targeted JAG1 sequencing, and/or liver biopsy. Medical records including sex, age, renal manifestations, urinalysis, serum creatinine, JAG1 sequencing, and ultrasonography were retrospectively reviewed. Results: The male to female ratio was 9:12. The mean age of patients at confirmative diagnosis of ALGS was 18.4 months. Sanger sequencing was performed for 17 patients. Sixteen of 21 patients (76.1%) showed JAG1 mutations. Renal involvement was found in 10 patients (47.6%). The most common type of anomaly was renal dysplasia (40%). One patient having renal dysplasia was pathologically confirmed with glomerular lipid deposition. Two patients (20%) manifested nephrocalcinosis/nephrolithiasis. Among eight renal-involved patients who survived, four (50%) progressed to chronic kidney disease stage 3. Two of these chronic kidney disease patients were diagnosed with hepatorenal syndrome. The other four patients had renal functions preserved, including two without any interventions and two who underwent urological interventions. Conclusions: The current study revealed a high prevalence of renal involvement in Korean pediatric ALGS with diverse phenotypes.

• Journal of Oriental Neuropsychiatry
• /
• v.16 no.2
• /
• pp.1-11
• /
• 2005

Objective : This study was to evaluate the clinical improvement of Panic attack and Anticipatory anxiety on Panic Disorder patients after Oriental medical treatment. Methods : We compared post-treatment with pre-treatment on Panic attack and Anticipatory anxiety with Thirty eight Panic Disorder patientsafter Oriental medical treatment - acupunture, herbal medicine, oriental psychotherapy. Results and Conclusions : 1. Foremost herbal medicines were Siwuanshentang(四物安神揚)(39.47%), Qingxinwendantang(情心溫膽揚)(13.16%). Types of demonstration weredeficiency of the heart blood(心血不足)(39.47%), deficiency of qi and blood in the heart and spleen(心脾兩虛)(28.95%), timidity die to insufficiency of qi and deficiency of blood of the heart(心脫虛法)(15.79%), stagnation of phlegm(痰獨阻滯)(13.16%), deficiency of liver-yin and kidney-yin(肝腎陰虛)(2.63%) in order. 2. The physical constitutions in Thirty eight Panic Disorder patients weretwenty nine of Taiyinren(76.3%),six of Shaoyinren(15.8%), three of Shaoyangren(7.9%) in order. 3. This oriental medical treatment was effective in Panic attack from $7.68{\pm}0.87$ to $2.68{\pm}1.613$ and in Anticipatory anxiety from $7.47{\pm}1.006$ to $2.47{\pm}1.841$ in comparison post-treatment with pre-treatment. 4. A percentage of subjective improvement was 72.6%. There were 18.4% in the same, 15.8% in slight improvement, 18.4% in medium improvement, 47.4% in remarkable improvement.

• Journal of Korean Medical classics
• /
• v.33 no.4
• /
• pp.107-130
• /
• 2020

Objectives : This paper aims to lay out the meaning of Gongjindan, its indications and mechanisms based on relevant contents in the 『Donguibogam』, for better clinical application. Methods : First, Gongjindan related contents were searched in the medical classics database. Next, contents from the 『Shizhaibaiyixuanfang』 and the 『Donguibogam』 were analyzed. Finally, the properties of the Gongjindan ingredients were examined based on the 『Donguibogam』 and the 『Zhongyaodacidian』. Results & Conclusions : Examination of its indications according to the 『Donguibogam』 in terms of applicable age and viscera/bowels, Gongjindan could be applied to children with constitutional insufficiency and elder generations, but it could not be said to be most appropriate for older generations. In regards to viscera/bowels, Gongjindan sends water upwards into fire in the water-rising-fire-descending mechanism, which makes it applicable to symptoms of anxiety and fear by tonifying the consumed Jing and Blood caused by Liver deficiency. To summarize, those who would most benefit from Gongjindan are young adults in weak, fearful and lethargic conditions.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.3
• /
• pp.1597-1599
• /
• 2013

Since renal failure causes decrease in tumor marker excretion, use of these markers in cancer care and treatment in patients with renal insufficiency or hemodialysis is controversial. The aim of this study was to investigate differences of serum levels of tumor markers CA15-3, AFP, CA19-9 and CEA in patients with impaired renal function. A total of 100 patients referred to the Tabriz Immam Reza and Amiralmomenin hospital from June 2010 to November 2011 were selected for study. Subjects were divided to 3 groups of healthy, dialysis and renal failure but non hemodialysis cases, the last category being re-grouped based on creatinine clearance. No significant relationship between different groups in serum levels of CEA (P=0.99) and CA19-9 (P=0.29) tumor markers was found. A significant correlation was observed between serum levels of AFP (P<0.001) and CA15-3 (P<0.001) and also a tendency between creatinine clearance and CEA (r=0.05, P=0.625). Creatinine clearance significantly correlated with AFP (P<0.001, r=0.53) and CA15-3 (p=0.00, r=-0.412), but not CA19-9 (P=0.089, r=-0.171). According to results of this study it appears that use of tumor markers in patients with impaired renal function should be performed with special precautions.

• Journal of Oriental Neuropsychiatry
• /
• v.21 no.4
• /
• pp.99-112
• /
• 2010

Objectives : This study was to investigate the associations of Parent Stress Index(PS]). Way of Coping Checklist(WCC). and Diagnostic System of Oriental Medicine(DSOM) in mothers of elementary school children. Methods: In the study. K-PSI-SF. WCC. and DSOM were carried out on 202 mothers of O Oelementary school children during June. 2010. Cross tabulation analysis was used to verify the association of PSI. WCC and DSOM. Results: 1. The most common pathogenic factor was Dampness(濕) in total subjects. 2. The score of problem-focused coping methods showed significant difference in PSI grades. 3. The zp and sc10 of Qi deficiency(氣虛), Blood deficiency(血虛), Qi-Stagnation(氣滯), Insufficiency of Yang(陽虛), Heat(熱), Dampness(濕), Dryness(燥), Liver(肝), Heart(心), and Kidney(腎) showed significant difference in PSI grades. 4. The score of total PSI and PSI subscale had negative correlations with problem-focused coping methods 5. The score of total PSI had positive correlations with Qi-Stagnation (氣滯), Dampness(濕), Dryness(燥), Heart(心), and Kidney(腎) in total subjects. Conclusions : This study provides insights on associations of parenting stress coping methods and diagnostic system in Oriental Medicine. Furthermore, the study shows positive correlations among Qi-Stagnation (氣滯), Dampness(濕), Dryness(燥), Heart(心), Kidney(腎) and PSI, and negative correlations between PSI and Problem-focused coping methods, all with statistical significance.

• Journal of Chest Surgery
• /
• v.11 no.4
• /
• pp.516-522
• /
• 1978

In spite of recent improvement of the medical and surgical treatments, there are many significant problems in the management of thoracic empyema. This is a clinical analysis of 49 cases of thoracic empyema who underwent lung decortication for a period of 6 years and 5 months extending from May, 1972 to Aug. 1975. The following results were obtained: Male to female ratio was 2. S to 1. The age ranged between Sand 69, bnt was mostly 2r.d and 5th decade. The underlying diseases were pulmonary tuberculosis (30 cases, 61. 1 SO, , ), posttraumatic hemothorax (7 cases, 14.396). pneumonia (6 cases, 12.2%), lung abscess (2 cases, 4.2%), paragonimiasis (2 cases, 4.2%). spontaneous pneumothorax (1 case, 2.1%), and unknown origin (1 case, 2.1%). In 13 cases (26.5%), positive bacterial growth on culture was reported. There were single infection in 11 cases and mixed infection in 2 cases. The organisms grown were Staphylococcus, alpha-hemolytIc Streptococcus, Alkaligenes fecalis, Escherichia coli, Pseudomonas, SerratIa, Enterobacter agglomerans, and Enterococcus in order of frequency. Staphylococcus, Streptococcus, and Serratia were sensitive to several different kinds of antibiotics. But Pseudomonas, Escherichia co:i, and Enterococcus were sensitive to only one or two antibiotics. Leukocytosis was observed In acute empyema, but not in chronic empyema. Hemoglobin and hematocrit were all within normal limits. Preoperative liver function tests were within normal limits in most of the cases. In 49 cases, lung decortication alone was performed in 40 cases (S1. 696), and for the remaining 9 cases (1S. 4%), additional surgical procedures were necessary, i. e., lobectomy (6cases). partial thoracoplasty (2 cases), and lobectomy & partial thoracoplasty (1 cases). The results of lung decortication in thoracic empyema were goed. 38 cases (77.5%) healed with no complication, and 10 cases (20.4%) were complicated by bleeding, wownd infection, pleural infection, chondritis, and psychosis. These complications resolved ultimately leaving no sequelae. One death was recorded (2.1%), and the causes of death were postoperative pleural infection, sepsis and hepatic insufficiency.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.24 no.6
• /
• pp.1094-1098
• /
• 2010

With the high prevalence of functional dyspepsia in the world, it was difficult to get objective diagnosis, treatment and assessment for the reason that there were many different symptoms and signs. The purpose of this study is to develop a standard instrument of pattern identification for functional dyspepsia which will be applied to clinical research. The items and structure of the instrument were based on review of published literature. The advisor committee on this study was organized by 11 oriental division of gastroenterology professors of oriental medical colleges nationwide. The experts discussed developing the instrument, and we also took professional advices by e-mail. We divided the symptoms and signs of functional dyspepsia into 6 pattern identification, such as disharmony of liver and stomach, retention of undigested food, damp-heat in the spleen and stomach, simultaneous occurrence of cold and heat syndromes, deficiency and cold of the spleen and the stomach, and insufficiency of stomach eum. We got the mean weights to each symptom of six pattern identification which had been scored on a 5-point scale ranging from 1 to 5 by the 11 experts. We made out the Korean instrument of the pattern identification composed of 45 questions for functional dyspepsia. Although there are some limitations in our study, the instrument is meaningful and certain worth of its own. We hope to improve the instrument through the further clinical studies and discussions.

• Korean Journal of Hospice Care
• /
• v.7 no.2
• /
• pp.6-14
• /
• 2007

Purpose: Hepatocellular carcinoma is the 3rd leading cause of cancer death in Korea and its prognosis is very poor. We aimed to investigate the clinical characteristics of terminal patients with hepatocellular carcinoma on admission into a hospice unit, and to know if they had received appropriate hospice and palliative care. Methods: We retrospectively reviewed the medical records in 62 patients with hepatocellular carcinoma who had admitted, received palliative care, and died in a hospice unit between January 2003 and December 2005. Results: The median age of patients was 56.5 years with 50 men(80.65%) and 12 women(19.35%) and gender ratio(male to female) was 417. Child-Pugh class A, B, and C were 6(9.68%), 22(35.38%), and 34(58.84%) respectively. We divided the patients into two groups and compared, the terminal HCC patients with class C as group I and those with class A & B as group 2. The median time from hospice referral to death was significantly short in group 1 with 15.5 days compared to group 2 with 53 days. Statistically more prevalent symptoms in group I were ascites, dyspnea, peripheral edema, and hepatic encephalopathy with abnormal laboratory findings (jaundice, hypoalbuminemia, or renal insufficiency). There, however, was no significant difference in complications and managements during admission between group 1 and 2. Conclusion: Most terminal HCC patients were often accompanied with chronic liver disease. The length of hospice and palliative care for above patients was not enough to attend them. Therefore, we suggest that proper education and information should be provided to physicians, patients, and their family members for effective hospice and palliative care.

• The Journal of the Society of Korean Medicine Diagnostics
• /
• v.15 no.2
• /
• pp.175-190
• /
• 2011

Objectives: Even though there has been no consensus on the concept of viscera organ between the oriental and western medicine, we tried to investigate the correlation between clinical biomarkers of five Jang and chronological age and develop the models for predicting five Jang biological ages by statistical analysis. Methods: We obtained data from about 120,000 subjects who visited health promotion centers for health promotion and disease prevention from January 2004 to June 2009. Participants were included if they were over 20 years old, and excluded if reported to have cardiovascular disease or other serious medical illness such as cancer, malignant hypertension, uncontrolled diabetes, cardiopulmonary insufficiency, liver disease, pancreatic disease or renal disease. Among the clinical biomarkers obtained, we selected the biomarkers which were associated with the function of 5 Jang in previous studies, or showed statistically significant correlation with age. Multiple regression models were used for building prediction models of biological age after adjusting for potential confounders for men and women, respectively. Pearson correlation coefficient was calculated to examine the linear relationship between age and various biomarkers, and multiple regression analysis was used for building the prediction models of five Jang biological ages for men and women, respectively. All statistical data analysis was performed by using SPSS Version 12.0 software and statistical significance was obtained if p<0.05. Results: For males, the best models were developed using 12, 2, 8, 3, and 4 biomarkers for predicting biological ages of heart, lung, liver, pancreas, and kidney, respectively (R2 = 0.57, 0.43, 0.11, 0.24, and 0.93, respectively). Similar to males, for the females, 10, 2, 8, 3, and 4 biomarkers were selected as the models respectively (R2 = 0.76, 0.44, 0.14, 0.38, and 0.89, respectively). Conclusions: As we have developed for the first time the models for predicting five Jang biological ages with common clinical biomarkers, it is expected that these models may be used as clinical supplementary tools in the evaluation of aging status and functional decline of five Jang according to age in health promotion centers and private clinics. At the same time, it is considered that the use as objective tools to evaluate aging status and functional decline of each Jang.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.14 no.2
• /
• pp.134-145
• /
• 2001

Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($23.5\%$) and phlegm-fire, 7($20.6\%$), 9. The efficacy of treatments showed: an improvement in 17cases($50.0\%$); no real improvement or changes in 13 cases($38.2\%$); and some worsening in 4 cases($11.8\%$). In the group with deficiency in Qi, 4($57.1\%$) improved, 1($14.3\%$) showed no change and 2($28.6\%$) were aggravated. In the cases of deficiency in Xue, 6($75.0\%$) improved, 2($25.0\%$) showed no change. In the cases of insufficiency of Kidney Yin & Yang, 3($75.0\%$) showed no change and 1($25.0\%$) were aggravated. In the group of flare of Liver fire, 4($50.0\%$) improved, 3($37.5\%$) no change and 1($12.5\%$) were aggravated. In the cases of phlegm-fire, 3($42.9\%$) improved, 4($57.1\%$) showed no change. Conclusion: We would recommend that any further studies of tinnitus utilize trial treatments of longer than 2 months duration, as any positive effects observed in our study showed that improvement occurred fairly slowly. And we suggest that this study could be utilized as a reference for clinical Oriental Medical treatment of tinnitus. If we try to apply music or sound therapy treatment properly combined with ours, we expect it to provide psycological stability in addition to inducing masking effects, even though it may not directly decrease or completely remove tinnitus.