• Title/Summary/Keyword: deficiency syndrome

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Determination of N-nitrosodimethylamine in zidovudine using high performance liquid chromatography-tandem mass spectrometry

  • Yujin Lim;Aelim Kim;Yong-Moon Lee;Hwangeui Cho
    • Analytical Science and Technology
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    • v.36 no.6
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    • pp.281-290
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    • 2023
  • Zidovudine is an antiretroviral agent prescribed for the prevention and treatment of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). It is typically recommended to be used in combination with other antiretroviral drugs. Zidovudine has the potential to generate N-nitrosodimethylamine (NDMA) in the presence of dimethylamine and nitrite salt under acidic reaction conditions during the drug manufacturing process. NDMA is a potent human carcinogen that may be detected in drug substances or drug products. An analytical method was developed to determine NDMA in pharmaceuticals including zidovudine using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The analysis involved reversed-phase chromatography on a Kinetex F5 column with a mobile phase comprising water-acetonitrile mixtures. The detection of positively charged ions was conducted using atmospheric pressure chemical ionization (APCI). The calibration curve demonstrated excellent linearity (r = 0.9997) across the range of 1-50 ng/mL with a highly sensitive limit of detection (LOD) at 0.3 ng/mL. The developed method underwent thorough validation for specificity, linearity, accuracy, precision, robustness, and system suitability. This sensitive and specific analytical method was applied for detecting NDMA in zidovudine drug substance and its formulation currently available in the market, indicating its suitability for drug quality management purposes.

Study on The Drug Processing of of the Roots of Aconitum carmichaeli (바꽃(烏頭)의 포제(抱製)에 관한 연구)

  • Seong, Man-Jun;Lee, Kye-Suk;Cho, Sun-Hee;Lee, Go-Hoon;Kang, OK-Hwa;Kwon, Dong-Yeul
    • Herbal Formula Science
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    • v.13 no.2
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    • pp.141-151
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    • 2005
  • From the tuberous root of Aconitum carmichaeli Debx.(Ranunculaceae), the main root is called as common monkhood mother root and the later root is called as the prepared aconite root. From the prepared aconite root. Looking at the processing method of the prepared aconite root, it is divided into Yeombuja (prepared aconite root processed in salt) and heuksoonpyeon (baekbupyeon) following the processing method after removing the soil and this is a way of processing the prepared aconite root without damage it. The recently produced raw prepared aconite root is easily damaged, thus it shall be preserved in salt to have the crystal shape on the surface of the prepared aconite root and store and transport in firmly solidified yeombuja condition. Therefore, yeombuja shall remove the salt before use and requires processing for use but heuksoonpyeon or baekbupyeon may use immediately. For the succession of the unique processing techniques of our ancestors, there has to be studies on the techniques. Prepared aconite root is generally used as holy medicines to cure the yang depletion syndrome, kidney-yang deficiency syndrome, and obstruction of qi in the chest syndrome. However, they are the substances with toxicity. It is contemplated that the contents of processing are broadly understood through the document on the processing method, and based on such foundation, the systematic set and proof on the documents are made along with the addition of the contemporary scientific theory and technology to develop the traditional processing technology to maximize the treatment effect and safety of prepared aconite root. In this study, the historic data and records on the processing method of latteral root of aconitum carmichaeli Debx will be rearranged to contribute to the standardization of medicinal herbs, maximization of efficacy and minimization of the side effects.

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Current Status of Systems Biology in Traditional Chinese medicine - in regards to influences to Korean Medicine (최근 중의학에서 시스템생물학의 발전 현황 - 한의학에 미치는 영향 및 시사점을 중심으로 -)

  • Lee, Seungeun;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.2
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    • pp.1-13
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    • 2017
  • Objectives : This paper serves to explore current trends of systems biology in Traditional Chinese Medicine (TCM) and examine how it may influence the Traditional Korean medicine. Methods : Literature review method was collectively used to classify Introduction to systems biology, diagnosis and syndrome classification of systems biology in TCM perspective, physiotherapy including acupuncture, herbs and formula functions, TCM systems biology, and directions of academic development. Results : The term 'Systems biology' is coined as a combination of systems science and biology. It is a field of study that tries to understand living organism by establishing a theory based on an ideal model that analyzes and predicts the desired output with understanding of interrelationships and dynamics between variables. Systems biology has an integrated and multi-dimensional nature that observes the interaction among the elements constructing the network. The current state of systems biology in TCM is categorized into 4 parts: diagnosis and syndrome, physical therapy, herbs and formulas and academic development of TCM systems biology and its technology. Diagnosis and syndrome field is focusing on developing TCM into personalized medicine by clarifying Kidney yin deficiency patterns and metabolic differences among five patterns of diabetes and analyzing plasma metabolism and biomarkers of coronary heart disease patients. In the field of physical therapy such as acupuncture and moxibustion, researchers discovered the effect of stimulating acupoint ST40 on gene expression and the effects of acupuncture on treating functional dyspepsia and acute ischemic stroke. Herbs and formulas were analyzed with TCM network pharmacology. The therapeutic mechanisms of Si Wu Tang and its series formulas are explained by identifying potential active substances, targets and mechanism of action, including metabolic pathways of amino acid and fatty acid. For the academic development of TCM systems biology and its technology, it is necessary to integrate massive database, integrate pharmacokinetics and pharmacodynamics, as well as systems biology. It is also essential to establish a platform to maximize herbal treatment through accumulation of research data and diseases-specific, or drug-specific network combined with clinical experiences, and identify functions and roles of molecules in herbs and conduct animal-based studies within TCM frame. So far, few literature reviews exist for systems biology in traditional Korean medicine and they merely re-examine known efficacies of simple substances, herbs and formulas. For the future, it is necessary to identify specific mechanisms of working agents and targets to maximize the effects of traditional medicine modalities. Conclusions : Systems biology is widely accepted and studied in TCM and already advanced into a field known as 'TCM systems biology', which calls for the study of incorporating TCM and systems biology. It is time for traditional Korean medicine to acknowledge the importance of systems biology and present scientific basis of traditional medicine and establish the principles of diagnosis, prevention and treatment of diseases. By doing so, traditional Korean medicine would be innovated and further developed into a personalized medicine.

A Comparative Study on Soumin Bojungyikgitang and Bojungyikgitang in the View of Constitution Medicine (소음인(少陰人) 보중익기탕(補中益氣湯)과 보중익기탕(補中益氣湯)에 대한 사상의학적(四象醫學的) 비교(比較) 연구(硏究))

  • Kim, Ilwhan;Kim, kyungyo
    • Journal of Sasang Constitutional Medicine
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    • v.8 no.2
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    • pp.69-94
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    • 1996
  • The main purpose of this work is comparing the difference between Soumin Bojungyikgitang of constitutional medicine and Li Dongyuan's Bojungyikgitang Bojungyikgitang, the prescription originated from the Pi-Wei theory(脾胃論) of Li Dongyuan who was a medical man in the Jin Yuan dynasty, had been used widely for many kinds of disease caused by the singking of the qi of middle energizer due to the weakness of the spleen and stomach. But in the singking of the qi of middle energizer due to the weakness of the spleen and stomach. But in the end of Choseon dynasty Li Je Ma, the creator of the constitutional medicine, modified the Bojungyikgitang and applied to Soumin's disease. In this paper, the difference between the two prescription were investigated from the viewpoint of chinese herb pharmacology and purpose of prescription. Additionally the problems which could be brought out by applying Bojungyikgitang to the Soyangin and the Taeumin were studied. And the conclusion could be summarized as follows: 1. The prescription of the Li Dongyuan's Bojungyikgitang is based on the deficiency of vital energy due to internal damage and the Soumin Bojungyikgitang is useful to only a certain stage of progressing disease on the basis of Shanghanlun(傷寒論). 2. In the Li Dongyuan's Bojungyikgitang, Cimicifugae Rhizoma and Bupleuri Radix were used for emphasizing the ascending action and have the antipyretic action and the effect of elavating of yangqi as they are bitter in taste and cold in nature. 3. In the Soumin Bojungyikgitang, Pogostemonis Herba and Perillae Folium have the ascending-descending action and strengthen the stomach with the effect of mild sweating by pungent taste and warm nature. 4. The effect of elavating of yangqi in the Li Dongyuan's Bojungyikgitang offers the pathway where vital qi go up by eleminating the pathogenic fire with the action of Cimicifugae Rhizoma and Bupleuri Radix in the triple energizer and yangming muscular striae. On the other hand, the Soumin Bojungyikgitang depends on the effect of reinforcing qi and elavating yangqi by Astrgalli Radix entirely and supply vital qi by reinforcing yangqi with Ginseng Rsdix. 5. The exahausion of yin(亡陰證) in the Soyangin exterior syndrome and cold limbs(寒厥證) in Taeumin exterior syndrome are similar to the indication of Li Dongyuan's Bojungyikgitang. As the causes of the disease are fundamentally different in the view of constitutional medicine, the diseases could be aggravated by applying Li's Bojungyikgitang. These results suggest that Li Dongyuan's Bojungyikgitang is proper to the exterior syndrome of Soumin and Soumin Bojungyikgitang seems to be appropriate to the Soumin's disease.

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A Study on Aadjustment of the Patterns, and the Correlation between the Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (CaPSP) and Korean Medicine Doctors' Diagnosis (갱년기장애 및 폐경기 후 증후군 변증진단 도구의 변증분류 조정과 진단의 간의 진단일치도 연구)

  • Lee, In-Seon;Kim, Jong-Won;Jeon, Soo-Hyung;Chi, Gyoo-Yong;Kang, Chang-Wan
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.1-14
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    • 2021
  • Objectives: We studied for the adjustment of the patterns of 'The Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (hereinafter CaPSPI)' (studyI) and the correlation between CaPSPI and Korean medicine doctors' diagnosis which was carried out without knowing the results of CaPSPI (studyII). Methods: The studyI followed the previous study method in 2018 (2018-3). The studyII was conducted from June 1, 2019 to July 10, 2020 with ◯◯ University Korean Medicine Hospital IRB's approval (2019-4). Doctors' diagnosis was conducted face-to-face with the subjects. Doctors' diagnosis was carried out based on the Kupperman's questionnaire, 'Diagnosis System of Oriental Medicine (hereinafter DSOM)' and four examinations (四診) records. The diagnosis was marked with 0 for 'no', 1 for 'somewhat', 2 for 'yes' and 3 for 'very yes'. The correlation between CaPSPI and the mean of doctors diagnostic scores were investigated statistically. Results: The studyI showed that heart-heat (心火) pattern was added. The Factor loading coefficient for heart-heat was 0.551 to 0.789, and the Cronbach's coefficient was 0.896. The studyII showed that the diagnosis (Kappa statistic) of two doctors showed statistically significant concordance (all eight patterns), with correlation of them were 0.3 or higher. And the correlation between the CaPSPI score and the mean of doctors' diagnostic score showed a statistically significant correlation, with liver qi depression (肝鬱) being the highest at 0.552 and dual deficiency of the heart-spleen (心脾兩虛) being the lowest at 0.301. Conclusions: Since the diagnosis results of CaPSPI showed a significant correlation with the diagnosis of Korean traditional medicine experts, it was believed that the CaPSPI results can be trusted and used for clinical purposes.

A study for diagnosis and pattern identification of Hwa-Byung (화병의 진단 및 변증유형에 관한 연구)

  • Lee, Hui-Young;Park, Jong-Hoon;Whang, Wei-Wan;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.16 no.1
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    • pp.1-17
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    • 2005
  • Objective : This empirical research is performed to recognize diagnostic concept, pattern identification, and clinical features of Hwa-byung. In other words, the aims of this research are to examine the differences of the diagnosis between Hwa-Byung and the other psychiatric disorders, and to find out pattern identification, and clinical characteristics of Hwa-Byung for prescriptions of this syndrome. Method : In the experiment, there were participated 30 patients who were met for our criterions according to HBDIS (Hwa-Byung Diagnostic interview Schedule). These patients were diagnosed as Axis1 according to criterions of DSM-IV with administering SCID-I. OMS-prime was utilized for finding out pattern identification of oriental medicine. Symptom Check List-90-Revision(SCL-90-R), Hemilton rating Scale for Depression(HRSD), Heart Rate Variability(HRV), and Digital Infrared Thermographic imaging(D.I.T.I.) were also utilized to discover clinical characteristics of Hwa-Byung Patients. Results : 1. Regarding Sex-ratio, male subjects were 3(10%), and female subjects are 27(90%). The age of subjects ranged from 22 year old to 75 $(51.87{\pm}11.04;\:Mean{\pm}SD)$ 2. In the results of diagnosis on the basis of DSM-IV, the 17(56.67%) patients were MOD (Major Depressive Disorder), the 5(16.67%) patients were USD (Undifferentiated Somatoform Disorder), the 4(13.33%) patients were Dysthymic Disorder, the 3(10%) patients were GAD (Generalized Anxiety Disorder), and the 1(3.33%) was Panic Disorder. Two of the patients who diagnosed as MOD were diagnosed as Panic Disorder too, and one of them was diagnosed as Pain Disorder too. 3. Regarding pattern identification, Hwa-Byung is positively correlated to deficiency of Heart(心). and then to stagnancy of Liver-Gall bladder. Hwa-Byung is correlated deficiency symptom-complex rather than excessiveness symptom-complex. That is also correlated positively to Pathological heat and fire. 4. In SCL90-R, the mean of PSDI was $(75.3{\pm}10.7;\:Mean{\pm}SD)$. The each mean of the other 11 factors was distributed between50-70. 5. The mean of HRSD was $(17.9{\pm}5.6;\:Mean{\pm}SD)$ in the entire subject's group. Then the group of MDD was $20.9{\pm}4.4$ and the group of USD was $12.0{\pm}4.8$ 6. In the results of HRV. the mean of TP is $972.4{\pm}1174(Mean{\pm}SD)$, this is lower than normal range 1000-200. The other factors were within normal range. Then, there were no significant differences between them (p<0.05). 7. The temperatures of each acupoint have significant differences between HNl(印堂) and PC6(內關), between CV17(顫中) and PC6(內關), between HN1(印堂) and CV8(神闕), between CV17(顫中) and CV8(神闕) in comparison with the average of body temperature in the use of D.I.T.I. (p<0.01) 8. In the analysis of correlation between SCL-90-R, HRSD, HRV. and D.I.T.I. there were no significant results. According to results that the correlation was analyzed with only the MDD group as subjects, there was negative correlation between RMSSD of HRV and HRSD, between LF of HRV and PDSIof SCL-90-R, and between LF/HF of HRV and ANX, PSY, and PDSI of SCL-90-R. Conclusion : In the observation of clinical features of 30 cases of Hwa-Byung patients by using diverse structured tests, there could make diverse diagnosis as depressive disorder, anxiety disorder, and Somatoform Disorder. Particularly. MDD was highly distributed. Considering oriental medicine's pattern identification of Hwa-Byung, this syndrome is related strongly to Heart, and there were demonstrated deficiency symptom-complex, and Pathological heat and fire. One of the limits of this study is lack of control subject's group, therefore, in the future study, it requires reexamination through a comparative research with these data to complete this study.

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Characterization of B Cells of Lymph Nodes and Peripheral Blood in a Patient with Hyper IgM Syndrome (Hyper IgM Syndrome 환자에서 얻은 림프절 및 말초혈액 B세포의 특성)

  • Kim, Dong Soo;Shin, Kyuong Mi;Yang, Woo Ick;Shin, Jeon-Soo;Song, Chang Hwa;Jo, Eun Kyeong
    • Clinical and Experimental Pediatrics
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    • v.46 no.2
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    • pp.128-136
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    • 2003
  • Purpose : Hyper IgM syndrome(HIGM) is characterized by severe recurrent bacterial infections with decreased serum levels of IgG, IgA, and IgE but elevated IgM levels. Recently, it has been classified into three groups; HIGM1, HIGM2 and a rare form of HIGM. HIGM1 is a X-linked form of HIGM and has now been identified as a T-cell deficiency in which mutations occur in the gene that encodes the CD40 ligand molecule. HIGM2 is an autosomal recessive form of HIGM. Molecular studies have shown that the mutation of HIGM2 is in the gene that encodes activation-induced cytidine deaminase(AID). Recently, another rare form of X-linked HIGM syndrome associated with hypohydrotic ectodermal dysplasia has been identified. We encountered a patient with a varient form of HIGM2. To clarify the cause of this form of HIGM, we evaluated the peripheral B cells of this patient. Methods : The lymphocytes of the patient were prepared from peripheral blood. B cells were immortalized with the infection of EBV. Cell cycle analysis was done with the immortalized B cells of the patient. Peripheral mononuclear cells were stained with monoclonal anti-CD40L antibody. Total RNA was extracted from the peripheral mononuclear cells. After RT-PCR, direct sequencing for CD40L gene and HuAID gene were done. Immunostainings of a lymph node for CD3, CD23, CD40, Fas-L, bcl-2, BAX were done. Results : The peripheral B cells of this patient showed normal expression of CD40L molecule and normal sequencing of CD40L gene, and also normal sequencing of AID gene. Interestingly, the peripheral B cells of this patient showed a decreased population of G2/mitosis phase in cell cycles which recovered to normal with the stimulation of IL-4. Conclusion : We suspect that the cause of increased serum IgM in this patient may be from a decrease of G2/mitosis phase of the peripheral B cells, which may be from the decreased production or secretion of IL-4. Therefore, this may be a new form of HIGM.

The spectrum of 5p deletion in Korean 20 patients with Cri du chat syndrome (한국인 묘성증후군 20명 환자에서의 5p 결실 양상 분석)

  • Park, Sang-Jin;Kim, Sook-Ryung;Baek, Kum-Nyeo;Yoon, Joon-No;Jeong, Eun-Jeong;Kown, Ji-Eun;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.4 no.2
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    • pp.133-141
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    • 2007
  • Purpose : Cri-du-Chat syndrome (CdCs) is a rare but clinically recongnizable condition with an estimated incidence of 1:50,000 live births. The clinical characteristics of the syndrome include severe psychomotor and mental retardation, microcephaly, hypertelorism, hypotonia, and slow growth. Also the size of the chromosome 5p deletion ranges were known from the region 5p13 to the terminal region. In this study, we report the spectrum of 5p deletion in Korean 20 pts. with CdCs and genotype-phenotype associations in CdCs. Methods : In order to delineate genotype-phenotype correlation, molecular cytogenetic studies including GTG banding and clinical characterization were performed on Korean 20 pts with CdCs including parents. CGH array and Fluorescence in situ hybridization (FISH) analysis were used to confirm a terminal deletion karyotype and map more precisely the location of the deletion breakpoint. Results : Molecular analysis of the spectrum of 5p deletion revealed 9 pts (45%) with a del (5)(p14), 7 pts. (35%) a del (5)(p13), 3 pts. (15%) a del (5)(p15.1) and 1 pt. (5%) a del (5)(p15.2) in 20 pts with CdCs. 4(20%)pts were identified to have additional chromosome abnormalites of deficiency and duplication involving chromosomes of 6, 8, 18, & 22. Parental study identified 3 familial case (2 paternal and 1 maternal origin) showing parents being a balanced translocation carrier. And the comparison study of the deletion break points among these 20 pts. with their phenotype has showed the varying clinical pheno-types in the CdCs critical region. Conclusion : The characterization of 5p deletion including parental study may help to delineate the genotypephenotype correlation in CdCs. Also these molecular cytogenetic analyses will be able to offer better information for accurate genetic diagnosis in CdCs and further make possible useful genetic counseling in pts. and family.

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Long-term Clinical Consequences in Patients with Urea Cycle Disorders in Korea: A Single-center Experience (요소회로대사 질환 환자들의 장기적인 임상 경과에 대한 단일 기관 경험)

  • Lee, Jun;Kim, Min-ji;Yoo, Sukdong;Yoon, Ju Young;Kim, Yoo-Mi;Cheon, Chong Kun
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.15-21
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    • 2021
  • Purpose: Urea cycle disorder (UCD) is an inherited inborn error of metabolism, acting on each step of urea cycle that cause various phenotypes. The purpose of the study was to investigate the long-term clinical consequences in different groups of UCD to characterize it. Methods: Twenty-two patients with UCD genetically confirmed were enrolled at Pusan National University Children's hospital and reviewed clinical features, biochemical and genetic features retrospectively. Results: UCD diagnosed in the present study included ornithine transcarbamylase deficiency (OTCD) (n=10, 45.5%), argininosuccinate synthase 1 deficiency (ASSD) (n=6, 27.3%), carbamoyl-phosphate synthetase 1 deficiency (CPS1D) (n=3, 13.6%), hyperornithinemia-hyperammonemia-homocitrullinuria syndrome (HHHS) (n=2, 9.1%), and arginase-1 deficiency (ARG1D) (n=1, 4.5%). The age at the diagnosis was 32.7±66.2 months old (range 0.1 to 228.0 months). Eight (36.4%) patients with UCD displayed short stature. Neurologic sequelae were observed in eleven (50%) patients with UCD. Molecular analysis identified 37 different mutation types (14 missense, 6 nonsense, 6 deletion, 6 splicing, 3 delins, 1 insertion, and 1 duplication) including 14 novel variants. Progressive growth impairment and poor neurological outcomes were associated with plasma isoleucine and leucine concentrations, respectively. Conclusion: Although combinations of treatments such as nutritional restriction of proteins and use of alternative pathways for discarding excessive nitrogen are extensively employed, the prognosis of UCD remains unsatisfactory. Prospective clinical trials are necessary to evaluate whether supplementation with BCAAs might improve growth or neurological outcomes and decrease metabolic crisis episodes in patients with UCD.

Observational Study of Glossodynia (설통에 대한 관찰연구)

  • Shim, So-Ra;Kim, Min-Kyung;Lee, Ji-Hyun;Lu, Hsu-Yuan;Cho, Seung-Yeon;Park, Seong-Uk;Park, Jung-Mi;Bae, Hyung-Sup;Ko, Chang-Nam
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.476-484
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    • 2012
  • Objectives : The purpose of this study was to report the clinical characteristics of glossodynia patients and effects of traditional Korean treatment on glossodynia and to gather data in order to carry out future study. Methods : We surveyed 40 glossodynia patients visiting the Department of Korean Internal Medicine of Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong and analyzed their glossodynia questionnaires, examination results, and progression of symptoms. Results : In Glossodynia patients the average age was 62.4 years old. Glossodynia was more prevalent in females than males (5.67:1). Red tongue color, white fur, and fissured tongue were observed most often. The average glossodynia duration was 36.1 months and the average glossodynia degree was VAS 5.6. The most commonly appearing symptom was burning sense, and dryness of tongue. In Korean medicine diagnosis, Yin, deficiency, Tae-eum was most commonly diagnosed. In herbal medicine, Gamichungsim-tang was the most frequently prescribed. In laboratory tests, zinc deficiency was the most common result. In heart rate variability (HRV), average SDNN was 34.03 and average LF/HF ratio was 2.11. Of 40 patients, 23 completed treatment and their pain was relieved from average VAS 5.52 to VAS 3.63. Pre-and post-treatment results showed a significant difference. The average duration of treatment was 34.91 days. Conclusions : The results of this study suggest that Korean medical approach and treatment for glossodynia could be effective. Further study should be conducted for more valuable information.