• 제목/요약/키워드: digestive disease

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소아 다기관 염증 증후군 (Multisystem Inflammatory Syndrome in Children (MIS-C))

  • 이준기;조은영;이현주
    • Pediatric Infection and Vaccine
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    • 제28권2호
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    • pp.66-81
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    • 2021
  • 코로나바이러스감염증-19는 전 세계적으로 유행하고 있으며, 2021년 7월 15일 기준으로 1.88억명 이상의 확진자와 406만명 이상의 사망자가 발생하였다. 소아청소년에서는 성인에 비해 비교적 중증 감염 발생이 낮으나, 일부에서는 SARS-CoV-2 감염 약 2-6주후소아다기관염증증후군(multisystem inflammatory syndrome in children, MIS-C)라는 합병증이 발생할 수 있다. MIS-C는 어린영아부터 청소년까지 다양한 연령에서 발생할 수 있으며, 발열을 포함하여 다양한 장기와 관련된 증상을 보일 수 있다. 소화기 및 신경계 증상이 흔하며, 많은 경우 가와사키병과 유사한 피부점막증상 등이 나타난다. 특히 심장관련 증상으로 좌심실 기능저하, 심근염 등이 나타날 수 있으며, 관상동맥확장 및 관상동맥류가 나타날 수 있다. 경우에 따라 저혈압, 쇼크를 동반하며, 중환자실 치료 및 기계환기요법을 요하나, 적절한 치료 후 대체로 회복을 보이는 것으로 보고된다. 이와 같이 MIS-C는 소아청소년에서 SARS-CoV-2 이후 드물게 발생하는 중요한 합병증으로, 임상증상을 잘 인지하고 조기에 적절한 치료를 하는 것이 중요하다. 이에 본 종설에서는 MIS-C의 역학 및 임상 증상, 추정되는 병태생리, 진단적 접근 및 치료에 대해 다루고자 한다.

위식도역류질환 변증도구의 신뢰도 및 타당도 평가 (A Study of the Reliability and Validity of Standard Tools for the Pattern Identification of Gastroesophageal Reflux Disease)

  • 조윤재;하나연;고석재;박재우;김진성
    • 대한한방내과학회지
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    • 제43권1호
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    • pp.1-21
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    • 2022
  • Purpose: The standard tool for the pattern identification is used for identifying patterns in patients using a questionnaire. The purpose of this study is to reorganize the standard tool for the pattern identification of gastroesophageal reflux disease (GERD) developed in 2017 and to analyze the reliability and validity of the standard tool for pattern identification by applying it to GERD patients. Methods: To reorganize the standard tool for the pattern identification of GERD developed in the previous study, we searched the literature in the main databases, OASIS (Oriental Medicine Advanced Searching Integrated System) and CNKI (China National Knowledge Infrastructure). We added the search results to the data used in the previous study and went through the reorganizing courses, such as evaluating the validity of the translation, the Delphi technique, and a small survey. After reorganization, the patients who visited the Kyunghee University Korean Medicine Center for GERD symptoms were provided the questionnaire, including the reorganized standard tool for pattern identification. We analyzed the survey results to evaluate their reliability and validity. Results: Fifty patients completed the questionnaire. Reliability analysis results showed a pattern identification match rate of 86%, Cronbach's α coefficient of 0.834, and intraclass correlation coefficient of 0.907. The Mann - Whitney U test and logistic regression were implemented to check the relations between the survey questions and pattern identification results; the Pearson correlation, compared with other scales, showed a moderate score. Conclusion: We reorganized the standard tool for the pattern identification of GERD to be updated on current issues and so that it is easily used. The analysis results of the questionnaire showed that the reorganized standard tool had high reliability and moderate validity.

의약분업 실시 전후 보건소 내소환자 진료내용 변화 (The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center)

  • 천재경;감신;한창현
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.75-86
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    • 2002
  • 의약분업실시 전후 보건소 투약환자의 특성변화, 질병양상변화 그리고 진료내용변화를 알아보기 위해 의약분업 전인 2000년 3월과 의약분업 후인 2001년 3월 각각 한 달 동안 경상남북도에 소재한 4개 보건소(도농복합형 시보건소 2개소, 군보건소 2개소)를 의약분업 전과 후에 이용한 투약환자 5,890명(의약분업 전)과 3,496명(의약분업 후)을 대상으로 건강 보험 및 의료급여 청구서를 이용하여 투약환자의 성, 연령, 주 진단명, 의료보장종류, 내소일수, 투약일수를 조사하였다. 또한 의약품 처방의 변화를 알기 위해 급성 호홉기질환 및 근골격계 질환자에 처방한 약제 종류수, 주사제 사용률, 항생제 사용률, 고가소염제 사용률를 조사하였다. 투약환자의 질환별로는 분업 전에 비해 급성호흡기 질환자는 49.7%, 고혈압환자는 18.1%, 근골격계질환자는 70.5%, 당뇨병환자는 8.5%, 소화기계질환자는 71.2%, 만성호흡기질환자는 76.4% 감소하였으며, 요도감염질환자는 의약분업 전에 비해 66.7% 증가하였다. 의약분업 전후 평균 내소일수의 변화는, 성별로는 남녀 모두 의약분업 전 보다 후가 유의하게 감소하였고(p<0.01), 의료보장형태별도는 건강보험은 유의하게 감소하였으나(p<0.01), 의료급여는 유의한 변화가 없었다. 질환별로는 고혈압, 당뇨병, 근골격계질환에서 유의하게 감소하였다(p<0.01). 의약분업 전후 평균 투약일수는 유의하게 증가하였다(p<0.01). 질환별로는 요도감염을 제외한 다른 질환들은 유의하게 증가하였으며(p<0.01), 요도감염은 증가는 하였으나 통계적으로 유의하지는 않았다. 의약분업 전후 급성호흡기질환자에 대한 평균 처방 약제 종류수는 4.9개에서 4.7개로 유의하게 감소하였고, 주사제 사용률은 63.8%에서 7.7%로 유의하게 감소하였으며, 항생제 사용률은 33.7%에서 19.1%로 유의하게 감소하였 다(p<0.01). 의약분업 전후 근골격계질환자에 대한 평균 처방약제 종류수는 3.7개에서 3.2개로 유의하게 감소하였으며, 주사제 사용률은 64.9%에서 1.7%로 유의하게 감소하였고, 고가 소염제 사용률은 29.1%에서 39.7%로 유의하게 증가하였다(p<0.01). 이상의 결과 의약분업 후 내소환자의 평균 내소일수는 감소한 반면 평균 투약일수는 증가하였다. 의사의 처방형태의 변화로는 평균 약재 종류수는 감소하였고 주사제나 항생제 처방률은 급격히 감소하였으나, 고가 소염제의 처방률은 증가하였다.

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Use of Prebiotics, Probiotics and Synbiotics in Clinical Immunonutrition

  • Bengmark, Stig
    • Preventive Nutrition and Food Science
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    • 제7권3호
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    • pp.332-345
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    • 2002
  • It is a recent observation that about 80 per cent of the body's immune system is localized in the gastrointestinal tract. This explains to a large extent why eating right is important for the modulation the immune response and prevention of disease. In addition it is increasingly recognized that the body has an important digestive system also in the lower gastrointestinal tract where numerous important substances are released by microbial enzymes and absorbed. Among these substances are short chain fatty acids, amino acids, various carbohydrates, poly-amines, growth factors, coagulation factors, and many thousands of antioxidants, not only traditional vitamins but numerous flavonoids, carotenoids and similar plant- and vegetable produced antioxidants. Also consumption of health-promoting bacteria (probiotics) and vegetable fibres (prebiotics) from numerous sources are known to have strong health-promoting influence. It has been calculated that the intestine harbours about 300,000 genes, which is much more than the calculated about 60,000 for the rest of the human body, indicating a till today totally unexpected metabolic activity in this part of the GI tract. There are seemingly several times more active enzymes in the intestine than in the rest of the body, ready to release hundred thousand or more of substances important for our health and well-being. In addition do the microbial cells produce signal molecules similar to cytokines but called bacteriokines and nitric oxide, with provide modulatory effects both on the mucosal cells, the mucosa- associated lymphoid system (MALT) and the rest of the immune system. Identification of various fermentation products, and often referred to as synbiotics, studies of their role in maintaining health and well-being should be a priority issue during the years to come.

혈관 긴장성 조절에 미치는 반하백출천마탕 (Effects of BanhabackchulChunma-tang on the Vascular Relaxation and its mechanism)

  • 김윤태;채종구;김길훤;신흥묵
    • 동의생리병리학회지
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    • 제16권1호
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    • pp.62-66
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    • 2002
  • Hypertension is not only a well-established cardiovascular risk factor but also increase the risk of atherosclerosis. Most studies conducted to investigate the effectiveness of treatment for cardiovascular disease such as hypertension have focused primarily on conventional drug and physiotherapeutic treatments. BanhabackchulChunma-tang(半夏白朮天麻湯:BCT) is popular herbal medicine used in clinic for the treatment of various symptoms of drulatory disorders and weakness of digestive system, including anorexa and nausea with vertigo, severe headache, vomiting and so on. However, the mechanisms underlying its efficacy are unknown. This study investigated the effects of BCT as an alternative medication on the contraction induced by phenylephrine and KCI in rat thoratic aorta. BCT revealed siginificant relaxation on phenylephrine-induced arterial contraction, but revealed noncompetitive effect on concentration responses of phenylephrine-induced contraction. Treatment of N-L/sup ω/ -argine methyl ester(L-NAME) and methylene blue(MB)(10/sup -5/M) reduced the relaxation of BCT. BCT also increased in vitro NO production. It suggest that the relaxation effect of BBT is related with NO pathway, becausse the effect of L-NAME and MB are due to inhibition of NO synthesis from endothelial cells. These results indicate that BCT would be effective in hypertension treatment and its mechanism of relaxtion on arterial contraction is likely to be related with NO production, blocking of α-receptor and signal transduction after receptor activation.

소아 추나에 대한 국내·외 연구 동향 (Domestic and Foreign Research Trend on the Pediatric Chuna Treatment)

  • 이진화;한재경;김윤희
    • 대한한방소아과학회지
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    • 제29권4호
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    • pp.67-76
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    • 2015
  • Objectives The purpose of this review is to investigate the domestic and foreign studies of pediatric Chuna treatment and propose the directions of future studies and clinical applications. Methods We searched for the study at RISS, KISS, DBPIA, Pubmed, CNKI by keywords, '추나', 'Osteopathic', 'Chiropractic', 'Manipulation', '推拿', '導引', '按摩', After 2010. Results 1. Selected 3 domestic studies were categorized as 1 survey study and 2 case reports. Selected 41 foreign studies from Pubmed were categorized as 15 systemic reviews, 8 survey studies, 12 case reports and 6 control studies. Selected 82 foreign studies from CNKI were categorized as 10 systemic reviews, 22 case reports and 50 control studies. 2. 2 clinical domestic studies researched on idiopathic Scoliosis. The foreign clinical studies from Pubmed are 18 cases, and those studies were categorized into Premature baby care (3), Infant colic (2), ADHD (2), Congenital talipes equinovarus (1), Somatic dysfuntion (1), Nonsynostotic occipital plagiocephaly (1), Conversion disorder (1), Lower back pain (1), Chronic bilateral dorsal foot pain and stiffness (1), plantar fasciitis (1), Migraine headaches (1), Cyclic vomiting syndrome (1), Acute otitis media (1) and Cerebral palsy (1). The other 72 foreign clinical studies were from CNKI, and they studied 39 different diseases. Systematically, they studied about digestive diseases (25), respiratory diseases (20), fever (6), musculoskeletal diseases (5), nervous system diseases (5), dermatology diseases (2) and other disease states. The Chuna treatment was used in variety of studies. 3. 2 clinical domestic studies adopted techniques of Osteopathy Chuna. The foreign clinical studies from Pubmed adopted techniques of Osteopathic manipulation (10) and Chiropractic manipulation (8). The other foreign clinical studies from CNKI adopted techniques of Acupressure (69), Abdominal manipulation (23), Spinal manipulation (21), Thoracic manipulation (11), Traction manipulation (2), Muscular manipulation (2), Squeezing Sha manipulation (1), Spine correction (1), Joint manipulation (1) and Fascia manipulation (1). Conclusions In addition to musculoskeletal disorders, variety of pediatric diseases could be treated with Chuna treatment instead of acupuncture.

Genomic analysis reveals selection signatures of the Wannan Black pig during domestication and breeding

  • Zhang, Wei;Yang, Min;Wang, Yuanlang;Wu, Xudong;Zhang, Xiaodong;Ding, Yueyun;Yin, Zongjun
    • Asian-Australasian Journal of Animal Sciences
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    • 제33권5호
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    • pp.712-721
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    • 2020
  • Objective: The Wannan Black pig is a typical Chinese indigenous, disease-resistant pig breed with high fertility, and a crude-feed tolerance that has been bred by artificial selection in the south of Anhui province for a long time. However, genome variation, genetic relationships with other pig breeds, and domestication, remain poorly understood. Here, we focus on elucidating the genetic characteristics of the Wannan Black pig and identifying selection signatures during domestication and breeding. Methods: We identified the whole-genome variation in the Wannan Black pig and performed population admixture analyses to determine genetic relationships with other domesticated pig breeds and wild boars. Then, we identified the selection signatures between the Wannan Black pig and Asian wild boars in 100-kb windows sliding in 10 kb steps by using two approaches: the fixation index (FST) and π ratios. Results: Resequencing the Wannan Black pig genome yielded 501.52 G of raw data. After calling single-nucleotide variants (SNVs) and insertions/deletions (InDels), we identified 21,316,754 SNVs and 5,067,206 InDels (2,898,582 inserts and 2,168,624 deletions). Additionally, we found genes associated with growth, immunity, and digestive functions. Conclusion: Our findings help in explaining the unique genetic and phenotypic characteristics of Wannan Black pigs, which in turn can be informative for future breeding programs of Wannan Black pigs.

기능성(機能性) 두통(頭痛)에 대한 이침요법(耳鍼療法)의 임상적(臨床的) 연구(硏究) (Clinical Study on the Auricular Acupuncture Therapy for the Functional Headache)

  • 류영수;박진성;황시영
    • 동의신경정신과학회지
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    • 제8권2호
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    • pp.85-95
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    • 1997
  • After performing the auricular acupuncture therapy for the functional headache, we came to gain the following therapy effects. 1. In the whole of the patients of the functional headache, housewives of forties were most of all. 2. In the classification of mordern medicine on the patients of the functional headache, muscular contractional headache was most of all and in the classification of oriental differentiation of symtoms and signs(辨證), headache due to deficiency of blood(血虛頭痛) was most of all. 3. In the regional auricular acupuncture therapy for the functonal headache, Taiyang of auricular point(太陽點) had an effect on the lateral headache around the area of Taiyang of auricular point(太陽點) though the actions of sedation, analgesia, Neck of auricular point(頸點) had an effect on the muscular contractional headache of the occipital region, and Stomach of auricular point(胃點) had an effect on the headache of stagnation of phlegm(痰濁頭痛) of anterior region with a chronic digestive disease. 4. The average treatment times of the auricular acupuncture therapy in the patients of the functional headache was 4.08 times, if we have them take auricular acupuncture therapy about 4 times it could be thought to take excellent effect of treatment. 5. The effect of auricular acupuncture therapy for functional headache was turned out to be effective in the following orders ; lateral region(Group A), occipital region(Group B), anterior region(group C). Through the clinical consequences of therapy mentioned above, we came to confirm regular therapeuric effects and hereafter, it is considered that a clinical comparative study on oriental cure and auricular acupuncture therapy for headache has to be more progressed than now.

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Pancreatic lesions of pigs with post-weaning multisystemic wasting syndrome

  • Jung, Ji-Youl;Kang, Sang-Chul;Park, Bong-Kyun;Hwang, Eui-Kyung;Kim, Dae-Yong;Kim, Jae-Hoon
    • 대한수의학회지
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    • 제50권4호
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    • pp.265-271
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    • 2010
  • Post-weaning multisystemic wasting syndrome (PMWS) is a new emerging disease affecting nursery and growing pigs in worldwide. Porcine circovirus type 2 (PCV-2) is a most important pathogen associated with PMWS. This study was carried out to investigate the pathological changes in the pancreas of pigs diagnosed as PMWS. To detect the PCV-2 antigen and nucleic acid in the tissue, immunohistochemistry and polymerase chain reaction (PCR) was conducted, respectively. 24 pigs of 4-10 weeks old showed clinical signs of PMWS such as chronic wasting, respiratory distress and diarrhea were examined. Histopathologically, interstitial and periductular mononuclear cells infiltration were observed in pancreas. Multifocal to diffuse necrosis of acinar tissues or necrotizing to granulomatous pancreastitis with numerous syncytial cells infiltration were examined in severe cases. PCV-2 nucleic acid was detected from all tested pancreas using PCR. The PCV-2 antigen in 12 pancreas sections was detected by immunohistochemical staining. PCV-2 has a tropism for vascular endothelial cells and infiltrated macrophages. Although gross lesions are uncommon in the pancreas of pigs with PMWS, histopathological changes and the presence of PCV-2 in this tissue may be related to clinical signs associated with digestive disorders.

상한론 증상에 근거한 진료기록부 작성에 대한 제언 (Suggestions for writing the medical records based on the symptoms in Sanghanron("傷寒論"))

  • 김상운;이홍규;정현종
    • 대한한의진단학회지
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    • 제18권2호
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    • pp.85-110
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    • 2014
  • Objectives This study intends to present the writing of standardized medical records based on Korean medicine on the basis of the Sanghanron symptoms. Methods 1. Excluding the sentences unrelated to the Sanghanron symptoms, the symptoms in the rest of sentences were extracted. 2. Classifying the extracted symptoms as per the review of system, the similar symptoms were integrated. 3. Calculating the frequencies of each symptom, each strain rate was calculated. Results & Conclusion: 1. Resulting from the analysis on 378 sentences in Sanghanron, a total of 1566 different symptoms were extracted. 2. As results out of total, the symptom related to the temperature sensation accounted for 17.9%, that related to sweat did 6.5%, that related to pulse did 12.4%, that related to eye and nose and mouth and tongue and throat as well as thirst did 7.7%, that related to stool did 11.6%, that related to urination and urinary organs did 4.9%, that related to language and mind and sleep and agitation as well as heart did 10.0%, and that related to vomiting and abdomen as well as digestive organs did 15.4%. 3. There were found many symptoms were described in accordance with the severity of basic expressions. For examples, in case of fever, there were mild fever and high fever, and in case of sweat, there were profuse sweating and slightly sweating. 4. To create the medical records for cold damage disease, it may necessary to consider the factors to be recorded as per each symptom and write the detail of each symptom.