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Study on Development a Personal Health Record Application of Atopic Dermatitis in Korean Medicine (아토피피부염 개인건강기록 앱 개발에 관한 연구)

  • Seo, Jin-Soon;Kim, Young-Eun;Lee, Seung-Ho;Kim, An-Na;Nam, Bo-Ryeong;Jang, Hyun-Chul
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.1
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    • pp.32-41
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    • 2019
  • Objective : The purpose of this study is to develop a personal health record(PHR) application of atopic dermatitis in Korean Medicine(KM). Methods : We have identified the items necessary to provide an PHR application that helps to record and manage the symptoms of an atopic dermatitis in KM. We also derived the symptom collection process and method and applied it to the application. Results : In this study, the types of symptoms collected for atopic dermatitis were derived. Symptoms include daily check, stool/urine/sleep, daily emotion, meal management, symptom photographs, SCORAD, quality of life, progress check, original symptom, pediatric health check, weakness check, and subjective symptoms. The recording cycle can be divided into the first, daily, weekly, specific day, and subjective. We developed the PHR application of atopic dermatitis in KM by deriving the type of symptoms and symptom recording process. The app organized menus into dashboards, checklists, daily checks, and health records. Conclusions : We developed a PHR application for atopic dermatitis by deriving symptom collection items of atopic dermatitis and developing symptom collection process and collection technique. The app does not make an accurate diagnosis of atopic dermatitis symptoms, but it helps facilitate symptom collection and helps to identify or predict a person's health condition. It can also be used for medical treatment through sharing symptoms with Korean medicine. Patients are able to communicate in both directions on a daily, weekly, self-aware basis, at the request of a doctor, to record their symptoms and use them for medical purposes. If the doctor asks for a progress check to refer to the next examination, it can be written through the system. This manages atopic dermatitis in daily life and can be used in the clinical field.

Current Status of Clinical Practice for Gout in Korean Medicine - On-line (Web-Based) Survey (통풍의 한의임상진료현황 - 온라인(웹기반) 설문조사)

  • Hwang, Ji Hye;Lee, Kwang Ho;Nam, Dong Woo;Yook, Tae-han;Song, Ho Sueb
    • Korean Journal of Acupuncture
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    • v.38 no.1
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    • pp.16-31
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    • 2021
  • Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

A Case of Propionic Acidemia Presenting with Dilated Cardiomyopathy (확장성 심근병증으로 발현된 프로피온산혈증 1례)

  • Son, Jisoo;Choi, Yoon-Ha;Seo, Go Hun;Kang, Minji;Lee, Beom Hee
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.21 no.1
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    • pp.22-27
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    • 2021
  • Propionic acidemia (PA) is an inherited autosomal recessive disorder, due to the deficiency of propionyl-CoA carboxylase (PCC). PCC is the enzyme which catalyzes the conversion of propionyl-CoA to D-methylmalonyl-CoA, and it is critical for the metabolism of amino acids, odd-chain fatty acids, and side chains of cholesterol. The clinical manifestations present mostly at the neonatal period with life-threatening metabolic acidosis and hyperammonemia. Here, we described a case of a 16-year-old Korean boy with late-onset PA who presented with embolic cerebral infarction due to dilated cardiomyopathy (DCMP) with left ventricular noncompaction. And he has family history of sudden cardiac death, so we performed metabolic screening and genetic tests. Elevated levels of 3-hydroxypropionic acid, methylcitric acid and propionylglycerine were detected in urine. Plasma acylcarnitine profile showed elevated propionylcarnitine (C3). Diagnosis of PA was confirmed by genetic analysis, which revealed compound heterozygous mutations, c.[1151T>G] (p.[Phe384Cys]) and c.[1228C>T] (p.[Arg410Trp]) in PCCB gene. His heart function is in improving state and the results of biochemical analysis are stable with heart failure medication and metabolic managements. We present a case of patient without episodes of metabolic decompensation who manifests DCMP as the first symptom of PA.

Transition of Rice Culture Practices during Chosun Dynasty through Old References. Ⅵ Fertilizing Practices (주요 고농서를 통한 조선시대의 도작기술 전개 과정 연구 Ⅵ. 시비기술)

  • Lee, Sung-Kyum;Guh, Ja-Ok;Lee, Eun-Woong;Lee, Hong-Suk
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.37 no.2
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    • pp.209-215
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    • 1992
  • Different from 'Seyokwiryang' (歲易爲良 : fallowing as the best method) which was an agricultural technique of ancient China, fertilization of rice fields was already practiced in the end of Koryo age in Korea. 'Bunjongbeob'(糞種法 : fertilizer applicating method on seed) or 'Bunkwabeob' (糞科法 : fertilizer applicating method on each plant) was practiced before green manure of bean crops and 'Bunjeonbeob'(糞田法 : fertilizer practicing method on fields) were done. In the 15th century 'Dojeonbunjeonbeob'(稻田糞田法 : fertilizer applicating method on paddy) in 'Jikseol' was divided the materials to be used into the soil brought from another place, trees, grasses, and the manure. Also, it discribed the fertilization between first plowing and the second, and proper fertilization for particular soil conditions. In case of transplanting techniques, the fertilization practices were specified into nursery and rice fields, and restoration of organic matter was systemized by plowing for cultivation in the reclaimed areas. In the 17th century, through 'Jikseolbo'($\ulcorner$直說補$\lrcorner$), the habitual practice of Kyungsang province was systemized and 'Bunyangsool'(糞壤術 : technique of fertilization) of 'Jodoangkicheo' (早稻秧基處 : rearing fields of early-ripening rice) was completed. Specific things was the manufacturing and utilizing techniques of 'Bunhoe'(糞灰 : mixture of manure and ash), 'Yohoe'(尿灰 : mixture of urine and ash), and additional fertilizers. In the 18 to 19th century, the materials of fertilization were greatly enlarged to recover the waste lands and to support the reinforcement of soil fertility for increasing the system of two cropping a year. Also, 'Jeobunbeob'(貯糞法 : method of manure storage) and additional fertilization were emphasized, and use of wagons for it was emphasized to improve the theory of fertilization and working efficiency. As mentioned above, limitation of fertilizing materials was conquered by 'Dojeonbunyang'(稻田糞壤 : techniques of practicing fertilizers in paddy) and the system of additional fertilization was established. The fertilization methods were improved with 'Jeobunbeob' due to the theory and recognition necessary for high rates of fertilizers.

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Analysis of a Compound-Target Network of Oryeong-san (오령산 구성성분-타겟 네트워크 분석)

  • Kim, Sang-Kyun
    • Journal of the Korea Knowledge Information Technology Society
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    • v.13 no.5
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    • pp.607-614
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    • 2018
  • Oryeong-san is a prescription widely used for diseases where water is stagnant because it has the effect of circulating the water in the body and releasing it into the urine. In order to investigate the mechanisms of oryeong-san, we in this paper construct and analysis the compound-target network of medicinal materials constituting oryeong-san based on a systems pharmacology approach. First, the targets related to the 475 chemical compounds of oryeong-san were searched in the STITCH database, and the search results for the interactions between compounds and targets were downloaded as XML files. The compound-target network of oryeong-san is visualized and explored using Gephi 0.8.2, which is an open-source software for graphs and networks. In the network, nodes are compounds and targets, and edges are interactions between the nodes. The edge is weighted according to the reliability of the interaction. In order to analysis the compound-target network, it is clustered using MCL algorithm, which is able to cluster the weighted network. A total of 130 clusters were created, and the number of nodes in the cluster with the largest number of nodes was 32. In the clustered network, it was revealed that the active compounds of medicinal materials were associated with the targets for regulating the blood pressure in the kidney. In the future, we will clarify the mechanisms of oryeong-san by linking the information on disease databases and the network of this research.

Therapeutic Effect of Anti-Rotavirus Chicken Egg Yolk Immunoglobulin(IgY) on Diarrhea by Infection of Rotavirus (로타바이러스 감염성 설사에 대한 항-로타바이러스 난황항체의 치료 효과)

  • Lim, In Seok;Lee, Ho Seok;Kim, Wonyong;Choi, Eung Sang;Jung, Dong Hyuk;Jung, Hoo Kil;Yun, Sung Seob;Chun, Ho Nam
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1354-1361
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    • 2005
  • Purpose : Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of antirotavirus IgY in the treatment of infants and children with gastroenteritis. Methods : First, the amount of viral particle in the stools of thirteen patients(seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT-PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups(an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. Results : First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. Conclusion : Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.

Clinical Analysis of Children with Transitory Minimal Change Nephrotic Syndrome (MCNS) to Focal Segmental Glomerulosclerosis (FSCS) (미세변화형 신증후군(MCNS)으로부터 국소성 분절성 사구체 경화증(FSGS)으로 이행된 환아의 임상양상)

  • Lee Ji Eun;Yook Jinwon;Lee Eui Seong;Kim Ji Hong;Kim Pyung-Kil;Chung Hyun Joo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.17-24
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    • 2000
  • Purpose: MCNS is found in approximately $85\%$ of the idiopathic nephrotic syndrome in children and shows good prognosis with initial steroid therapy. However in FSGS, there is poor prognosis with initial therapy and shows higher rate of progression to chronic renal failure and relapse after kindney transplantation. We have experienced 8 patients who were diagnosed as MCNS on initial renal biopsy and then progressed to FSGS on follow-up biopsy. So we have investigated their clinical course and risk factors for transition of MCNS to FSGS. Methods: We conducted a retrospective study with a review of histopathologic findings and clinical manifestations of 296 cases of MCNS and FSGS that were diagnosed from January 1988 to May 1999. We classified them into 3 groups according to the histopathologic finding; MCNS, FSGS, MCNS progressed to FSGS in follow-up biopsy. Results: The number of children was 296 cases comprising 241 cases($81.4\%$) showing MCNS, 8 cases($2.7\%$) transition group, 47 cases($15.9\%$) FSGS. The mean onset age was $6.0{\pm}2.6$years in MCNS, transition group $8.3{\pm}2.3$years, FSGS $7.2{\pm4.3$years, and the gender (M:F) ratio was 3.7:1 in MCNS, 3:1 in transition group, 1.8:1 in FSGS. Comparing the presence of initial hematuria, hypertension,24 hour urine protein, serum albumin, serum creatinine, there were significant difference between the transition group and the FSGS group in the following points; 24hour urine protein $684:342mg/m^2/hr$(P<0.05), serum albumin 1.92: 2.47g/dL(P<0.05), serum cholesterol 494:343mg/dL(P<0.05). Refractoriness to steroid therapy was 13.3$\%$ in MCNS. $12.5\%$ in transition group, $29.6\%$ in FSGS; significantly higher in FSGS(P<0.05). Immunosuppressant therapy was performed in $58.5\%$ of MCNS, $100\%$ in transition group, $80.8\%$ in FSGS; transition group showed significantly higher .ate(P<0.05) comparing with MCNS. Mean number of relapse and duration from onset to first relapse showed no significance difference between these groups. Conclusion: 249 patients with MCNS have been followed and $3.2\%$ (8 patients) of them has shown change in pathologic diagnosis from MCNS to FSCS. The risk factor for transition could not be found. Our results point to the need for a follow-up biopsy to certify the possibility of transition to FSCS in some MCNS cases with refractory cases to steroid therepy, frequent relapsing cases, or in case of no remission in spite of vigorous immunosuppressant therapy.

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The Effect of Human Albumin Infusion on the Clinical Course of Steroid Sensitive Nephrotic Syndrome (인알부민 투여가 스테로이드 반응성 신증후군의 임상경과에 미치는 영향)

  • Lee Soo Jin;Jeong Ji A;Hwang Soo Ja;Lee Seung Joo
    • Childhood Kidney Diseases
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    • v.4 no.2
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    • pp.102-110
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    • 2000
  • Purpose : Intravenous infusion of albumin has been widely und to relieve severe nephrotic edema in spite of beneficial or harmful effects. The purpose of this study is to examine the harmful effect of albumin on the clinical course of steroid sensitive nephrotic syndrome(SSNS). Method : We prospectively randomized the patients with nephrotic syndrome(biopsy proven or clinically compatible to minimal change nephrotic syndrome) into the albumin group(20$\%$ albumin 1 g/kg) or control group(5$\%$ D/W) between March 1997 and September 1999 at Ewha University Mokdong Hospital. We compared the clinical course of the albumin group(n=13) with the control group(n=13). Results : 1. The duration of steroid therapy until complete remission in the albumin group was significantly longer than the control group($13.7{\pm}6.4\;days\;vs\;7.5{\pm}2.8\;days$)(P<0.05). 2. The remission duration to the first relapse was significantly shorter in the albumin group ($94{\pm}63.5$ days) than the control group($190{\pm}106.4$ days)(P< 0.05). There was no significant difference in the relapse rate within 1 year after complete remission[77$\%$ (10/13) vs 46$\%$ (6/13)](P>0.05) and the relapse frequency per year($1.9{\pm}0.8\;vs\;1.5{\pm}0.5$) between the albumin and control groups. 3. Spot urine protein/creatinine ratio significantly increased in the albumin group at post-albumin 2, 4 days(P<0.05). There was no significant difference in the change of the daily percent weight loss, blood pressure, serum Na, K concentration between the albumin and control groups. Conclusion : Albumin infusion in SSNS delayed the response to steroid and shortened the remission duration to the first relapse. Albumin should be carefully used in nephrotic edema.

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Clinical Characteristics and Renal Outcomes of Acute Focal Bacterial Nephritis in Children (소아 급성 세균성 신엽염의 임상상 및 신장 예후)

  • Lee Dong-Ki;Kwon Duck-Geun;Lim Yun-Ju;Shin Yun-Hye;Yun Suk-Nam;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.229-238
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    • 2004
  • Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.

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Factors Related to the Resolution of Primary Vesicoureteral Reflux (요로감염 영아에서 일차성 방광요관역류)

  • Jung, Jae-Won;Woo, Mi-Kyoung;Koo, Ja-Wook
    • Childhood Kidney Diseases
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    • v.13 no.1
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    • pp.40-48
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    • 2009
  • Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants. Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR. Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001). Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.