Cho, Jin Min;Lee, Beom Hee;Kim, Gu-Hwan;Kim, Yoo-Mi;Choi, Jin-Ho;Yoo, Han-Wook
Clinical and Experimental Pediatrics
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v.56
no.8
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pp.351-354
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2013
Isovaleric aciduria (IVA) is caused by an autosomal recessive deficiency of isovaleryl-CoA dehydrogenase (IVD). IVA presents either in the neonatal period as an acute episode of fulminant metabolic acidosis, which may lead to coma or death, or later as a "chronic intermittent form" that is associated with developmental delays, with or without recurrent acidotic episodes during periods of stress, such as infections. Here, we report the case of a 2-year old boy with IVA who presented with the chronic intermittent form. He was admitted to Asan Medical Center Children's Hospital with recurrent vomiting. Metabolic acidosis, hyperammonemia, elevated serum lactate and isovalerylcarnitine levels, and markedly increased urine isovalerylglycine concentration were noted. Sequence analysis of the IVD gene in the patient revealed the novel compound mutations-a missense mutation, c.986T>C (p.Met329Thr) and a frameshift mutation, c.1083del (p.Ile361fs$^*11$). Following stabilization during the acute phase, the patient has remained in a stable condition on a low-leucine diet.
Pain disorder is a category of somatoform disorder that be diagnosed when the pain is starting and getting worse associated with psychological factors. At the recent study, it revealed that stress might be more strong factor in occurring and sustaining the somatoform disorder. In this case, a 42 years old female patient had a chronic pain disorder 3 years ago, suddenly complained of an eyeball pain due to retina rupture induced by severe stress. In the view of oriental medicine, pain disorder belongs to GuQiJakTongJung. So, we diagnosed her state as GuQiJakTongJung and treated her such as herbal medicine, acupuncture and phlebotomy therapy. In result, the chronic pain of the patient was improved, and also general condition was getting better.
This review has focused on important but less visible aspects of fibromyalgia (FM) with respect to the high impact of this disorder on patients and societies. FM is a common but challengeable illness. It is characterized by chronic widespread pain, which can be accompanied by other symptoms including fatigue, sleep disturbances, cognitive dysfunction, anxiety and depressive episodes. While our understanding of this debilitating disorder is limited, diagnosis and treatment of this condition is very difficult, even in the hands of experts. Due to the nature of disease, where patients experience invalidation by medical services, their families and societies regarding the recognition and management of disease, direct, indirect and immeasurable costs are considerable. These clinical and economic costs are comparable with other common diseases, such as diabetes, hypertension and osteoarthritis, but the latter usually receives much more attention from healthcare and non-healthcare resources. Present alarming data shows the grave and "iceberg-like" burden of FM despite the benign appearance of this disorder and highlights the urgent need both for greater awareness of the disease among medical services and societies, as well as for more research focused on easily used diagnostic methods and target specific treatment.
This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.
The purpose of this study was to identify the differences of the static and the dynamic balance reactions in the flexion syndrome (FS) and the extension syndrome (ES) group of the patients with chronic lowback pain (LBP) and healthy subjects. Twenty subjects were included in each group. By using EquiTest 5.02, the static balance was measured by the equilibrium score and the strategy score of sensory organization test (SOT), while the dynamic balance was measured by the latency of motor control test (MCT) and the sway energy of adaptation test (ADT). Oswestry Disability Index (OSI) was used to measure level of the disability in patients with chronic LBP. The equilibrium scores, the strategies of SOT, and thelatencies of MCT of three groups were compared with one way ANOVA, while the sway energy of ADT was compared with repeated measures one way ANOVA. The results of this study showed that the equilibrium scores and the strategy scores of SOT were significantly lower in patients with chronic LBP than in healthy subjects. The equilibrium scores and the strategy scores of SOT were significantly differences between the FS and ES groups in condition 5 (support surface was sway-referenced and visual information waseliminated by eye closure), and 6 (support surface was sway-referenced and visual information was altered by sway-referencing). The FS group showed delayed average reaction time at large posterior translation, however, the ES group showed delayed average reaction time at large anterior translation, Even though the sway energy of the patients with chronic LBP were greater than that of healthy subjects during the toe down (plantar flexion rotation), the values between the FS and ES groups didn't show any significant difference. The disability level showed highly correlation with the equilibrium score of the condition 5. As the results, the FS and ES groups divided by the their symptoms and signs in patients with chronic LBP showed different balance reaction. Therefore, more accurate evaluation and balance treatments are needed to focus on their symptoms and signs in patients with chronic LBP.
Objective: To know the recurrence rate of paranasal sinusitis in adults using follow-up investigations. Method: Data was collected from 37 patients who were treated in the Department of Ophthalmology & Otolaryngology & Dermatology, Kangnam Oriental Medical Hospital from 2001-10-01 to 2005-05-31 for chronic paranasal sinusitis in adults over 21 years of age. Results & conclusions: 1. The males made up 51.4% and females made up 48.6%. The recurrence rate was 78.4%. 2. By residence, 78.4% lived in apartments; 21.6% lived in houses. 3. Of the main symptoms, nasal obstruction was the most common. 4. The duration of the disease was within 1 month to 40 years; the group with difficulties within the last 5 years made up the largest group. 5. The patients who had chronic nasal family histories made up 40.5%; Patients who didn't have chronic nasal family histories made up 59.5%. 6. In regards to the period of Tx distribution. the group treated within 4 weeks made up the largest group at 54.1%. 7. As far as methods of Tx distribution, the group of patients treated with herbal medicine and acupuncture were larger (62.2%) than the group treated with only herbal medicine (37.8%). 8. The most common nasal condition symptom in patient histories was chronic rhinitis. 9. The most frequent areas affected by paranasal sinusitis on PNS images were the lateral maxillary sinus, the unilateral maxillary sinus and the ethmoidal sinus. 10. The number of patients who drank little was larger (75.7%) than the number of drinking patients(24.3%); There were more non-smoking patients (78.4%) than smoking patients(16.2%). 11. The patients who slept for 6-7 hours made up the larger group (40.5%). 12. The number of patients who preferred warm water was larger making up 54.1 %; the number of patients that preferred cool water made up 21.6%. 13. The patients who had a common cold 3-5 times a year was the largest group at 54.1%.
Journal of the Korean Institute of Oriental Medical Informatics
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v.16
no.2
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pp.9-49
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2010
Byun Jeung Ok Ham, written by Jin Sa Tak is composed of four books. This book is estimated of being written after A.D 1688 and composed of internal medicine, obstetrics and gynecology, ophthalmology, dental surgery and so on, total 36 parts of clinical medicine. This is the last book of that four studying about definition on true and false of 15 diseases. 15 subjects follow, tumo, heat, faint, hematemesis and nosebleeding, insanity, great vomiting, great diarrhea, great thirst, scrotal hernea, uterus attacked by heat, dysentery, congestion, great swelling, malaria, attack by cold. This treatise is the last book of four which deals with jin ga translating into korean and studying about medical theories. In every parts, author's unique clinical theory appears affluently and in that periods his study developed a lot in those days' medical methods. The first book deals with eum yang. second book is weakness and strongness, third upper and low, fourth truth and untruth. First book, Jin Sa Tak says studying on eum yang is oriental medical basic theory and on incurable diseases or chronic symptoms, doctor must go back to that eumyang demonstration after can cure patients. Second parts are on weakness and strongness demonstration, that weakness is weakness of patients' energy and strongness is prosperous condition of diseases' attack. Third parts are on upper and low, that upper is upper parts of human body of painful parts and low is human low parts of pain, that is parts of under waist. And this treaties fourth parts are truth and untruth, true symptoms and untrue symptoms, that is the real reaction of human condition and the other way. Every prescriptions are author's creations. This book provides new viewpoints which surpasses original ancient medical theories. Author suggests new opinions about chronic and incurable diseases.
Background: Chronic obstructive pulmonary disease (COPD) is a serious chronic condition with a global impact. Symptoms of COPD include progressive dyspnea, breathlessness, cough, and sputum production, which have a considerable impact on the lives of patients. In addition to the human cost of living with COPD and the resulting death, COPD entails a huge economic burden on the Chinese population, with patients spending up to one-third of the average family income on COPD management in some regions is clinically beneficial to adopt preventable measures via prudent COPD care utilization, monetary costs, and hospitalizations. Methods: Toward this end, this study compared the relative effectiveness of six indices in predicting patient healthcare utilization, cost of care, and patient health outcome. The six assessment systems evaluated included the three multidimensional Body mass index, Obstruction, Dyspnea, Exercise capacity index, Dyspnea, Obstruction, Smoking, Exacerbation (DOSE) index, and COPD Assessment Test index, or the unidimensional measures that best predict the future of patient healthcare utilization, cost of care, and patient health outcome among Chinese COPD patients. Results: Multiple linear regression models were created for each healthcare utilization, cost, and outcome including a single COPD index and the same group of demographic variables for each of the outcomes. Conclusion: We conclude that the DOSE index facilitates the prediction of patient healthcare utilization, disease expenditure, and negative clinical outcomes. Our study indicates that the DOSE index has a potential role beyond clinical predictions.
Background: Prostatitis, one of the most common diseases of the prostate, is a complex disease with various clinical features. This study aims to analyze the utilization and prescribing patterns of antibiotics in Korean patients with prostatitis between 2008 and 2015. Methods: We used the National Health Insurance Database complied from the Health Insurance Review and Assessment Service (HIRA). The outcomes included the number of claims, number of patients, medical cost, and length of stay for each year. In addition, the prescribing patterns of antibiotics, including fluoroquinolone, and low-dose use of ciprofloxacin and levofloxacin were investigated. Results: The total number of patients and medical cost increased by 9.5% and 51.7% from 2008 to 2015, respectively. Most prostatitis patients were classified as chronic prostatitis patients. The prescribing proportion of antibiotics for chronic prostatitis outpatients decreased from 71.0% to 66.9% from 2008 to 2015, and fluoroquinolone accounted for more than half of the total antibiotics. Over 80% of prescription of levofloxacin and ciprofloxacin was identified to be for low-dose use. Conclusion: Most of the patients with prostatitis experienced pain relief and condition improvement after antibiotic treatment; however, chronic prostatitis and chronic pelvic pain syndrome recur easily. Therefore, active disease management and further studies are needed to enhance our understanding of effective treatment for prostatitis.
This study examined a rarely seen benign heart tumor that was found incidentally on a chest X-ray. Radiological images were taken of a 42-year-old patient with no symptoms of a heart condition, showing a thick-walled left lung cavity that appeared after prior inflammation and concomitant enlargement of the cardiac shadow. A large subepicardial lipoma in combination with a chronic abscess on the left lung was revealed on chest computed tomography. The treatment consisted of simultaneous surgical removal of both the lung and heart lesions using video-assisted thoracoscopic surgery.
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