Purpose This study was to develop and study 'Diagnostic Index for the Ordinary Symptom of Soyangin'. Methods The main diagnosis and evaluation index symptoms of Soyangin were extracted based on 『Donguisusebowon』 and Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology; CPG for soyangin. The selected ordinary symptoms were divided into 4 categories such as Exterior-Cold ordinary symptom (表寒素證), Exterior-Disease unfavorable's ordinary symptom (表病逆證素證), Interior-Heat ordinary symptom (裏熱素證), Interior-Disease unfavorable's ordinary symptom (裏病逆證素證) of Soyangin and translated into Korean. And the inclusion, importance and translation validity of major diagnosis and assessment indicators of Soyangin were surveyed online by a group of Sasang constitutional experts. Results & Conclusions 29 ordinary symptoms and pathological mechanism were selected from references and translated into 51 Korean symptoms. After inclusion yes or no survey by expert group, 45 symptoms were selected. The importance survey showed that 'Have a soft stool' of Exterior-Cold ordinary symptom indication, '(If you're stressed, if you're not in good health) Have a soft stool or diarrhea' of Exterior-Disease unfavorable's ordinary symptom, 'The feces harden easily' of Interior-Heat ordinary symptom and '(If you're stressed, if you're not in good health) Have an upset stomach' of Interior-Disease unfavorable's ordinary symptom were the most important. Finally, [Diagnostic Index for the Ordinary Symptom of Soyangin] was completed after survey of translation validity, reflection of individual opinions by the expert committee, and application of weighted value calculated from the importance survey.
The authors, over the last 6 months, have treated 2 patients with perforated typhlitis complicating acute lymphocytic leukemia (ALL) with good outcome. The first patient was a 13-year-old male who developed intermittent high fever, abdominal pain, abdominal distention and diarrhea during the course of maintenance chemotherapy. The peripheral leukocyte ranged from 230-470/$mm^3$. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal and ascending colonic walls and subsequent ragged perforation of the posterior wall of the cecum. He survived after treatment by right hemicolectomy and aggressive supportive measures. The patient case was a 3 year-old female who developed intermittent high fever, right lower abdominal pain, a mass, and watery diarrhea during the course of maintenance chemotherapy. Serial ultra sonograms and CT scans demonstrated irregular thickening of the cecal wall (6-15mm in thickness) and subsequent small perforation of the posterior wall of the cecum with thick-walled localized abscess. She has recovered completely after aggressive medical management. We learned two lessons from our experience treating these patients:1) early diagnosis provided by a high index of suspicion and the use of ultra sonogram or CT scan is essential. And 2) although perforation is one of the surgical indications for the treatment of typhlitis, it is possible to manage the perforation nonoperatively in selected cases with localized abscess.
The effect of meal service for home-staying, urban elderly with low income on their mineral status and prevalence of clinical symptoms was evaluated. One hundred. One hundred and eighty three subjects were assigned to meal-served(served) and non-served(non-served)groups. A meal containing approximately one half of the RDA for energy, protein, calcium and iron was served as lunch every day to served group at a welfare center. Dietary, biochemical and clinical data were collected before and after 6 months of meal service and the changes of parameters were analyzed with paired t-test. served female showed significantly increased intake of calcium. The mean hemoglobin, serum iron, TIBC and serum copper of female were significantly increase with meal service. The proportion of anemic female compared to reference data on hemoglobin, hematocrit and serum iron were 45.5$\%$, 29.1$\%$ and 16.4$\%$ respectively, but were lowered to 18.2$\%$, 7.3$\%$, and 5.5$\%$ after 6 months of meal service. served male showed significant increase in MCHC, serum copper, and urinary Na. The urinary Ca/Creatinine, which is often used as an index of bone resorption, was decreased significantly in served group. The decrease in the proportion of served women suffering from edema of ankle and diarrhea was most apparent and less women reported feeling clinical symptoms of dizziness, constipation, difficulty in hearing, and coughing after meal service. The symptoms of benumbness of hands and feet and coughing was lowered most among men after meal service. Clinical symptoms of non-served elderly did not show improvement in feeling clinical symptoms except slightly decreased frequency in coughing of female and buzzing sound in the ears and diarrhea of male.
Bae, Joon Yeol;Lee, Dong Hyuk;Ko, Kyung Ok;Lim, Jae Woo;Cheon, Eun Jeong;Song, Young Hwa;Yoon, Jung Min
Clinical and Experimental Pediatrics
/
v.61
no.3
/
pp.84-89
/
2018
Purpose: Timely antibiotic therapy in selected cases of diarrhea associated with bacterial infections can reduce the duration and severity of illness and prevent complications. The availability of a predictive index before identification of causative bacteria would aid in the choice of a therapeutic agent. Methods: The study included patients admitted to the pediatrics unit at Konyang University Hospital for acute inflammatory diarrhea from August 1, 2015 to July 31, 2016 who underwent multiplex polymerase chain reaction testing. Of 248 patients, 83 had positive results. The clinical symptoms and blood test results were examined in 61 patients with Campylobacter spp. (25 patients), Salmonella spp. (18 patients), and Clostridium perfringens (18 patients) infections. The mean age of the 61 patients (male:femal=31:30) was $84.0{\pm}54.8months$, and the mean hospital stay was $4.6{\pm}1.7days$. Results: There were no statistical differences in sex, age, clinical symptoms, or signs. Patients with Campylobacter infection were significantly older (P=0.00). C-reactive protein (CRP) levels in patients with Campylobacter infection were higher than those in the other 2 groups, at $9.6{\pm}6.1mg/dL$. The results of receiver-operating characteristic curve analysis showed that the cutoff age was ${\geq}103.5months$ (sensitivity, 72%; specificity, 86%) and the CRP cutoff level was ${\geq}4.55mg/dL$ (sensitivity, 80%; specificity, 69%). Conclusion: Age (${\geq}103.5months$) and higher CRP level (${\geq}4.55mg/dL$) were good predictors of Campylobacter enterocolitis. If neither criterion was met, Campylobacter enterocolitis was unlikely (negative predictive value 97.2%). When both criteria were met, Campylobacter enterocolitis was highly likely.
The Journal of the Korean Society for Microbiology
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v.18
no.1
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pp.53-58
/
1983
Enterotoxigenic E. coli is one of causative agents of the infantile diarrhea and traveler's diarrhea. A modified infant mouse assay(IMA) was developed for the detection of heat stable enterotoxin (ST) of E. coli isolated from diarrheal and control infants and assay system was established with using enterotoxin producing reference strains. The supernatant of the 24 hour-shaking culture of E. coli in Casamino Acid Yeast Extract Salt Broth(CYES-2) was ingested orally into the 2-4 day old ICR mice. After the mice were kept at $25^{\circ}C$ for 4 hours, they were sacrificed and the gut weight body weight ratio(GW/BW) was taken as the index of fluid accumulation induced by heat stable enterotoxin of E. coli. The results obtained were as follows; 1. The GW/BW responses of IMA tested with enterotoxin reference strains of E. coli(E. coli O148H28:$ST^+LT^+$, E. coli $O78H^-:ST^+LT^+$, E. coli O15H11:$ST^-LT^+$, E. coli O1H7:$ST^-LT^-$) appeared ta be ST dose-dependent, and not LT-dependent. From the dose-response curve, $25{\mu}l$ of culture supernatant was determined as test amount of the IMA. 2. Frequency distribution of IMA result from 643 strain of E. coli showed normal distribution at low GW/BW ratio and dispersed pattern at high GW/BW ratio. The GW/BW ratios of $0.056{\pm}0.004(mean{\pm}SD)$ of normal distribution which distributed from 0.044 to 0.068(P<0.01) was considered as ST negative. Thus the GW/BW ratio above 0.069 could be regarded as ST positive.
To assess the clinical efficacy of Chungpyesagan-tang on acute stroke, we prescribed this medicine to 88 acute stroke patients without thrombolytic treatment. The rate of progressive stroke type was 2.3%, remarkably lower than in previous reports. 1.1 % felt an itching sensation, and 17.0% complaxined of loose stool and diarrhea. Chungpyesagan-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale (NIHSS), and increased Modified Barthel Index (MBI). Thus, we could suggest that this medicine has a desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, ALT had anupward tendency and increased over normal value in 16 cases (18.2%). However, the mean serum level 2 weeks later was within the normal value and the other hepatic enzymes did not increase.
Objective : To assess the clinical efficacy of Yangkyuksanwha-tang on acute stroke Methods : We prescribed Yangkyuksanwha-tang to 83 acute stroke patients without thrombolytic treatment. Results : The rate of progressive stroke type was 1.2%, it was remarkably lower than previous reports. 3.6% felt an itching sensation, 3.6% complained headache, dizziness and powerless, 2.4% complained indigestion and diarrhea, 1.2% appeared hematuria and G-I bleeding. Yangkyuksanwha-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale(NIHSS), and increased Modified Barthel Index(MBI). So we could suggest that this medicine have desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, all results were within the normal value, which showed no hepatic or renal toxicity. Conclusion : We could suggest that Yangkyuksanwha-tang is a useful medicine which has clinical efficacy for acute stroke, but further investigation for an administration of more than 2 weeks is necessary.
Objective: The impact of forage feeding strategy on growth performance, ruminal fermentation and nutrient digestibility in post-weaning calves was investigated. Methods: Forty-five female Holstein calves (body weight [BW] = $79.79{\pm}0.38kg$) were enrolled in the 35-d study at one week after weaning and randomly assigned to one of three dietary treatments. All diets were fed as total mixed ration containing 60% (dry matter [DM] basis) of basal starter feed and 40% (DM basis) of forage, but varied in composition of forage source including i) alfalfa (40% DM, AH); ii) alfalfa hay (26.7% DM)+oat hay (13.3% DM; OH); iii) alfalfa hay (26.7% DM)+corn silage (13.3% DM; WS). Results: Dry matter intake was not different among treatment groups (p>0.05). However, BW (p<0.05) and average daily gain (p<0.05) of calves fed AH and OH were greater than WS-fed calves, whereas heart girth was greater in OH-fed calves than those fed AH and WS (p<0.05). Ruminal fermentation parameters including proportion of butyric acid, acetated-to-propionate ratio, concentration of total volatile fatty acid, protozoal protein, bacterial protein, and microbial protein in rumen were the highest in OH (p<0.05) and the lowest in WS. Compared with the AH and WS, feeding oat hay to postweaning calves increased crude protein digestibility (p<0.05), and decreased duration of diarrhea (p<0.05) and fecal index (p<0.05). Conclusion: Our results suggested that partially replacing alfalfa hay with oat hay improved ruminal fermentation, nitrogen utilization, and reduced incidence of diarrhea in post-weaning dairy calves.
Min-Ok Ryu;Soh-Yeon Lee;Se-Hoon Kim;Hwa-Young Youn;Kyoung-Won Seo
Journal of Veterinary Clinics
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v.41
no.3
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pp.150-156
/
2024
This retrospective case series assessed the effectiveness of commercially available oral fecal microbiota transplantation (FMT) for treating chronic enteropathies in eight animals, five dogs, and three cats, between 2020 and 2023 at the Seoul National University Veterinary Medical Teaching Hospital. Chronic enteropathies, often resistant to conventional therapies, present a significant challenge in veterinary medicine. To assess oral capsule FMT's effectiveness (Doggybiome® one capsule daily for dogs and Kittybiome® one capsule daily for cats) as a universal adjunctive therapy for chronic enteropathies across species not responding to traditional treatments. This retrospective case series applied a uniform evaluation of gastrointestinal symptoms and treatment efficacy, utilizing established scoring systems (Canine Inflammatory Bowel Disease Activity Index [CIBDAI] and Canine Chronic Enteropathy Clinical Activity Index [CCECAI] for dogs, Feline Chronic Enteropathy Activity Index [FCEAI] for cats) before and one month after FMT. This approach ensured consistency in hypothesis testing across the study population. Results revealed significant improvements in clinical indices post-FMT, with notable reductions in the CIBDAI, CCECAI, and FCEAI scores (p < 0.05). Additionally, symptoms such as anorexia, lethargy, diarrhea, vomiting, and weight loss showed marked improvement, with normalization of appetite and activity levels observed in most cases. No adverse effects were reported, indicating the safety and tolerability of this treatment. This study highlights the potential of oral capsule FMT as a viable therapeutic option for dogs and cats with chronic enteropathies unresponsive to conventional treatments, providing a new avenue for clinical management. Further research is warranted to expand these findings and explore the microbiome changes associated with FMT in veterinary patients.
Objectives : Two related cases of Hemolytic-Uremic Syndrome (HUS) were reported to the Korea National Institute of Health in May, 2001. Shiga toxin 2 genes were detected in both stool samples. We suspected an enterohemorrhagic Escherichia coli (EHEC) infection as the cause of the HUS, and conducted an investigation to find the source of the infection and its route of transmission. Methods : We peformed case investigations on these two related HUS cases, and obtained interviews and rectal swabs form the family members and other close contacts. Additionally, we peformed rectal swabs on the cattle raised by the household of the index patient. Results : We found a 20 month old index patient and a 6 year-old cousin had developed HUS, where there had been a 2 day history of contact with the index, and bacteriological examinations for these two patients revealed, indistinguishably, the same E. coli O171. The grandmother of the index patient was found to be asymptomatic, but E. coli O26 was isolated. We also found a probable case in the mother of the cousin. She reported a history of contact with the index, and developed bloody diarrhea of 3 days duration. The test results for the cattle revealed E. coli O26 in one cow, and E. coli O26 and O55 in another. E. coli O26, which was isolated in both cows and the grandmother of the index, were indistinguishably the same. Conclusions : We found that the E. coli O26 in the grandmother had originated from the cows, and that the E. coli O171 found in the index patient had been transmitted to the cousin through person-to-person contact.
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