The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.37
no.2
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pp.58-73
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2024
Objectives : This study was designed to review and analyze domestic research trends of Korean medicine treatment on otitis media, and present data for further research and treatment of otitis media. Methods : Two researchers used six search engines to search for papers on Korean medicine treatment for otitis media published from January 1, 2000 to December 31, 2023. A total of 16 papers were searched, and bibliographic information, main and accompanying symptoms, treatment period, treatment method, evaluation scale, and treatment results of each study were analyzed. Scottish Intercollegiate Guidelines Network was used to evaluate the evidence level. Results : The most common otitis media symptom was hearing loss (12 times). The most frequently mentioned herbs were Ledebouriella seseloides (22 times) and Angelica gigas (20 times), which are the ingredients of the most commonly used prescriptions, Hyunggyeyungyo-tang (5 times), Takrisodok-yeum (4 times), and Bojungikgi-tang (3 times). All the clinical trial papers were conducted on Kamihyunggyeyungyo-tang, which showed improvement in otitis media-related indicators. The most frequently mentioned meridians were the Triple Energizer (44 times), Clinical trials were conducted on the Triple Energizer, the Gall Bladder, and the Small Intestines meridians. The most frequently used acupoints were SI19 (10 times), TE21 (9 times), TE17 (9 times). In clinical trials, acupuncture treatment with TE05, GB15, TE06, SI05, GB38, and KI02 showed a significant improvement in otitis media symptoms. Conclusions : It is believed that more efficient otitis media treatment and follow-up research can be performed by using the above-mentioned research results.
Purpose : To evaluate the effectiveness and tolerance of patients of external beam radiotherapy for carcinoma of the extrahepatic biliary system (EHBS) including gall bladder (GB) and extrahepatic bile ducts (EHBD) and to define the role of radiotherapy for these tumors. Methods and Materials : We retrospectively analyzed the records of 43 patients with carcinoma of the EHBS treated with external beam radiotherapy at our institution between April, 1986 and Julr, 1994. Twenty three patients had GB cancers and remaining 20 patients did EHBD cancers. Of those 23 GB cancers, 2 had Stage II, 12 did Stage III and 9 did Stage IV disease, respectively. Male to female ratio was 11 to 12. Fifteen patients underwent radical surgery with curative intent and 8 patients did biopsy and bypass surgery alone All of the patients except for 3 patients were treated with 4500 cGy or higher doses postoperatively Follow up periods ranged from 11 to 82 months. Of those 20 EHBD cancers, one had Stage I, 2 did Stage II, 10 did Stage III and 7 did Stage IV disease, respectively. Male to female ratio was 16 to 4 Sixteen patients underwent Whipple's procedure or resection and drainage with curative aim and remaining 4 patients did bypass surgery alone Postoperatively 16 patients were irradiated with 4500 cGy or higher doses and 4 patients with 3180 to 4140 cGy Follow up periods ranged from 8 to 34 months. Results : Overall median survival time of patients with GB cancer was 11 months. Median survival time for Patients with Stage III and IV disease were 14 months and 5 months, respectively. Corresponding two rear survival rates were $36\%$(4/11) and $13\%$(1/8), respectively Those who underwent surgery with curative intent showed significantly better survival at 12 months than those who underwent bypass surgery alone($67\%$ vs $13\%$). None of the patients died of treatment related complications Median survival time for entire group of 20 EHBD patients was 10 months Median survivals of 10 Stage III and 7 Stage IV disease were 10 and 8 months, respectively. Two patients who underwent Whipple's procedure had 11 and 14 month survival and those treated with resection and drainage showed median survival of 10 month. Conclusion : Postoperative external beam radiotherapy for carcinoma of the extrahepatic biliary system is well tolerated and might improve survival of patients, especially those with resectable lesions with microscopic or gross residual disease after surgery.
Natural orifice transluminal endoscopic surgery is a newly emerging technique recently, with its many potential advantages in clinical practice. Cholecystectomy by Hybrid NOTES in this work, performed with single working channel endoscope in conjunction with a laparoscopic grasping forceps in dogs, is a "bridge" between laparoscopic procedure and pure NOTES. Three different approaches for cholecystectomy were carried out; transgastric, transcolonic and transvaginal. In all three approaches, abdominal opening was made by a 5 mm trocar, followed by making pneumoperitoneum of 4 mmHg with $CO_2$ insufflator. Transgastric cholecystectomy, single working channel endoscope was advanced to the peritoneal cavity through gastric incision in antral region made by endoscopic needle knife. Endoscope was retroflexed to visualize the gall bladder. Transcolonic access, incision for endoscopic entry was done at right ventral wall of descending colon, 15 cm inside from the anus. Incision in transvaginal access was made at right-ventral region, just caudal to the caudal tubercle. With the simple traction by the laparoscopic grasping forceps, good visualization of surgical field was obtained in all three groups. Cystic duct and artery were ligated with endoclips; for complete gall bladder dissection from liver, L-knife was used. Closure of incision sites were done in transgastric and transcolonic cholecystectomy by endoclips, not in transvaginal approach.
For the first time, the theory of ChonKwanChuk(寸關尺) and the examination method of KyungJung(輕重法) of KiGu(氣口) were formed in "NanKyung(難經)". After that, the vicera assignment theory at left and right hands(左右守藏府記屬理論) was established in "MaekKyung(脈經)" After Reserching the theoretical relevance of the two books, theories between the doctors who understood the examination method of ChukBu(尺部診法) of "Somun MaekYoJungMiRon(素問 脈要精微論)" as the examination method of KyungJung(輕重法) and the doctors who understood that method as the method of ChonKwanChuk(寸關尺) were compared and researched. The results were as follows : 1. The posit ion of ChonKwanChuk(寸關尺) of the examination method of ChonKwanChuk(寸關尺法) is explained at 2nd Nan(二難) of "NanKyung" as follows. Chuk(尺) is the position which is 1Chon(1寸, unit) distant from Kwan(關) to the direction of ChukTaek acupuncture point(尺澤穴) and Chon(寸) is the position which is 9Pun(9分, unit) distant from Kwan(關) to the direction of EoJe acupuncture point(魚際穴). And the six vessels(六經) were assined to ChonKwanChuk(寸關尺) on the basis of OHangJaMoSnagSaeng(五行子母相生) at 18th Nan(18難) of NanKyung. After that Yang Hyun-Jo(楊玄操) at Dang Dynasty, Jung Deok-Yong(丁德用), Woo Seo(廬庶) at Song dynasty explaind the examination method of ChonKwanChuk(寸關尺法) of NanKyung as the method of ChonKwanChuk of two hands(兩手寸關尺法) from the viewpoint of "MaekKyung(脈經)". 2. From the viewpoint of MaeKyung, the vicera assignment of the two hand ChonKwanChuk method is as follows. At Chuk of left hand, the Heart and Small intestine are assigned. At Kwan of left hand, the Liver and Gall Bladder are assigned. At Chuk of left hand, the Kidney and Bladder are assigned. At Chuk of right hand, the Lung and Large in testine are assigned. At Kwan of right hand, the Spleen and Stomach are assigned. At Chuk of Right hand, the Vital Gate(命門) and Bladder are assigned. 3. For the first time, HwalSu(滑壽) at Won dynasty said that the paragraph "尺內兩傍${\cdots}{\cdots}$" of "Somun MaekYoJungMiRon" is the first of the examination method of KiGu(氣口診脈法). After that Ma Shi(馬蒔), Jang Gae-Bin(張介賓) of Myung Dynasty, Jang Ji-Chong(張志聰), Seo Dae-Chun(徐大椿) of Chung Dynasty who were influenced by him explained that paragraph as the method of KiGuChonKwanChuk(氣口寸關尺法). 4. Lee Kyu-Jun(李圭晙) explained the paragraph "尺內兩傍${\cdots}{\cdots}$" of "Somun MaekYoJungMiRon" as the method of KyungJung(輕重法) and explained Chok(尺) as the paragraph 'Chuk is low position of Kigu, and it means the depth(氣口之下位也, 言其深也)' and explained that 'the Left and the Right is layers(左右者層數). And he revised that the Jang(臟) must be examined at the inner part and the Bu(府) must be examined at the outer part. By this, he settled the theoratical basis of the method of KyungJung(輕重法). 5. The doctors who used the examination method of ChonKwanChok(寸關尺診法) settled their logical justification of the two hand examination method of ChonKwanChuk(兩手寸關尺診法) by connecting with "Somon MaekYoJungMi-Ron" from the viewpoint of 2nd Nan(難) and 18th Nan(難) of NanKyung and MaekKyung. On the contrary, the doctors who used the examination method of KyungJung(輕重診法) settled their logical justification of the examination method of KyungJung(輕重診法) by connecting with "Somun MaekYoJungMiRon" from the viewpoint of 4th Nan(四難) and 5th Nan(五難).
Background : Cell adhesion molecules knave been Implicated In the various stages of tumor progression and metastasis. ICAM-1 plays a important roles in cell-cell interactions in inflammatory and immune response of several diseases. Recently, elevated levels of sICAM-1 in circulation was reported as association with liver metastasis in gastric, Colonic, gall bladder and pancreatic cancer, with reduced survival in malignant melanoma. This study was performed to measure the sICAM-1 in patients with lung cancer and to evaluate the relations between staging of lung cancer and level of sICAM-1. Methods : Serum sICAM-1 was measured in 36 patients with lung cancer according to the pathologic types and clinical staging before therapy and in 8 controls with ICAM-1 ELISA kit. Results : Serum sICAM-1 levels were elevated in patients with lung cancer except small cell type. Also progression and metastasis of lung cancer associated with elevation of sICAM-1 levels. Conclusion : These results suggest that higher levels of serum ICAM-1 reflect the progression and metastasis of lung cancer and it may be used as a marker with diagnostic and prognostic significance.
Choi Hyun;Bae Hyun su;Hong Moo chang;Shin Hyun Dae;Shin Min Kyu
Journal of Physiology & Pathology in Korean Medicine
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v.18
no.5
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pp.1426-1436
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2004
There have been several reports on the relationship between G protein β3 subunit gene (GNB3), angiotensin converting enzyme gene (ACE), β3-adrenergic receptor gene (ADRB3), and β2-adrenergic receptor gene (ADRB2) genotype and obesity or obesity related disease. The objective of this study was to examine the relationship between the combinations of these four genes' polymorphism and probability of obesity related disease in Korean female subjects. The experimental group was consisted of 85 obese Korean female subjects (body mass index, BMI≥27㎏/㎡). To determine the polymorphism, genomic DNA was isolated, and PCR was performed. Serological examinations (fasting plasma glucose, FPG; aspartate aminotranferase, AST; alanine aminotransferase, ALT; total cholesterol, TC; triglyceride, TG; high density lipoprotein-cholesterol, HDL; low density lipoprotein-choles terol, LDL) were carried by an autoanalyzer and serological methods. BMI, waist circumference (WC), hip circumference and waist hip ratio (WHR) were measured. Consequencely in the analysis with grouping of general genotyping and variant allele carrier/non-carrier, the result was not significantly different within all gene combinations and polymorphic pairings except higher waist circumference in Arg16Arg group of ADRB2 codon16 (P=0.024). And there was no significantly contrast result about age, height, weight, AST and ALT that are index feature of liver and gall bladder disease in polymorphic pairings of gene combinations. However, the statistical analysis of waist-hip ratio and waist circumference that could be recognized as the physical type of obesity showed T-Arg16 pairing carrier in GNB3-ADRB2 codon16 combination had increased WHR and WC significantly (P=0.046 and P=0.015 respectively). Futhermore, the levels of total cholesterol (TC) and low density lipoprotein choresteral (LDL) were significantly lower in C-I pairing of GNB3-ACE combination (P=0.032 and P=0.005). These results suggest that the T-Arg16 pairing carrier in GNB3-ADRB2 codon16 gene might have increased waist circumference and C-I pairing carrier in GNB3-ACE combination have lower possibility of contraction of cardiovascular disease related cholesterol and LDL despite of obese state.
Although primary application of radioisotope scanning technics to the liver has been of use in the detection of the intra-hepatic space occupying lesion from the normal functioning liver parenchyme, there has been on increasing awareness of its use in evalution of Liver function. In this study, the diseases of the liver were classified into group A,B,C and D by the liver scanning findings, conventional liver function tests and clinical findings. Following were the results: 1. The colloidal radiogold liver scan appeared normal in the group A, also the albumin in serum, alkaline phosphatase activity and prothrombin time were within normal levels in this group. 2. In the group B, there were acute hepatitis 24(48%), chronic hepatitis 5(10%), toxic hepatitis 3(6%), subacute hepatic necrosis 3(6%), typhoid liver 4(8%), hepatic tuberculosis 2(4%), diabetes mellitus 3(6%) and others 3(6%). In this group, SGOT and SGPT were increased predominantly as compared with group A, and the liver scan showed small amount of mottling of activity and faintly visualized spleen. 3. In the group C, there were postnecrotic liver cirrhosis 30(60%), Laennec cirrhosis 10(20%), cardiac cirrhosis 1(2%), cholangiocarcinoma 1(2%), chronic active hepatitis 6(12%), hepatic milliary tuberculosis 1(2%) and gall bladder cancer 1(2%). In this group, the albumin in serum and prothrombin time were lowered significantly and the liver scan showed severe mottling of activity with extra-hepatic uptake in the spleen and bone marrow along the vertebral column. 4. In the group D, there were primary hepatoma 26(52%), hepatoma with liver cirrhosis 7(14%), metastatic liver cancer 5(10%), liver abscess 10(20%), multiple liver cyst 1(2%) and cystic duct adenoma 1(2%), In this group, the alkaline phosphatase activity was elevated with single or multiple intrahepatic space occupying lesion in the radiogold colloid liver scan.
The cocktails of two $^{131}I$ labeled Monoclonal antibody (MCAB) (Anti CA 19-9 F$(ab')_2$ + Anti CEA $F(ab')_2$ fragment), which react specially, with human gastrointestinal cancers, were administered to 10 patients with colorectal (7), stomach(2) and pancreas(1) cancer for scintigraphic detection. All patients were known or postoperatively recurrent cases, and serum tumor markers, CA 19-9 and CEA, were measured with immunoradiometric assay, just before immunoscintigraphy (ISG). The tumor marker's level in serum is not correlated with positive tumor uptake in ISG. The sensitivity and specificity of ISG in detection of 21 tumor sites, based on surgery, CT, ultrasonography and pathology, were 90.5% and 100% One case of colon cancer showed gall bladder metastasis, which was neglected on CT study. Tumor/non tumor uptake ratio of radiolabelled antibody were progressively increased from day 3 to day 7 during study. We summerized as follows 1) The use of cocktails of CEA and CA 19-9 MCAB $F(at')_2$ increased sensitivity and specificity in ISG. 2) Delayed imaging (later than 5 days) increases sensitivitv and specificity due to exclusion of nonspecific iodine accumulation in stomach and lung. 3) Second tracer technique is essential for anatomical landmark by use of a double isotope scan, but subtraction technique, a possible source of artifacts, is no longer necessory when delayed imaging is performed. 4) It may be possible to use two MCAB cocktails of CA 19-9 and CEA in Radioimmunodetection of stomach and pancreas cancer. In conclusion, ISG using MCAB cocktails, $F(ab')_2$ fragment of anti CA 19-9 and Anti CEA, provide additional opportunity for tumor localization and detection of colorectal and other G-I cancer, such as stomach and pancreas.
Quantitative analysis of gallbladder emptying is important in diagnosis of motility disorder of gallbladder and in studies of biliary physiology. However, the normal range of gallbladder ejection fraction (GBEF) has not been determined yet and the best method for stimulating the gallbladder to contract has not been elucidated adequately. The purpose of this study was to compare the gallbladder emptying effect of the fatty meal ingestion with that of the continuous infusion of cholecystokinin (CCK) and to establish the normal GBSF values of normal subjects. Quantitative hepatobiliary scan with $^{99m}Tc-DISIDA$ after a fatty meal was performed for 22 normal healthy volunteers. Among them, 10 subjects repeated the test with a fatty meal. Again, for 7 subjects quantitative heaptobiliary scan with an infusion of CCK (sincalide) at a rate of 20 ng/kg/hr for 45 minutes was performed repeatedly. The results were as follows. 1) With a fatty meal, the mean GBEF was $89.6{\pm}8.2%$ in 22 normal subjects, and there was no difference between subjects. 2) With a continuous infusion of CCK, the mean GBEF was $62.4{\pm}16.6%$ in 7 normal subjects, and there was a significant difference between subjects(p<0.05). 3) The reproducibility of GBEF by a fatty meal was significantly higher than by an infusion of CCK (p < 0.05). 4) The mean GBEF by a fatty meal was significantly higher than that by an infusion of CCK (p < 0.05). We concluded that a fatty meal is superior to a continuous infusion of CCK for inducing gall-bladder contraction because that induces more complete emptying and the response is more reproducible and constant.
Lee Young Su;Kwack Jeong Jin;Lee Gang Nyoung;Choi Chang Won;Kim Hee Chul
Journal of Physiology & Pathology in Korean Medicine
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v.16
no.4
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pp.630-636
/
2002
After The Yellow Emperor's Canon of Internal Medicine, The text researches of pathologic change to the liver disease concluded the next, 1, The category of liver-disease(肝病) include the Symptoms of abnormality due to vital energy and blood motion, emotion and intention, muscular and reproductive function, and legions around descending liver channel. 2. In the theory that Liver-Yang energy(肝陽氣) is always overproducing, Liver-Yin blood(肝陰血) is always lacking, pathologic characteristics for liver disease is functional change of malfunction of the use of body(體用失調), So nourishing the liver and kidney is used for the principal aspects of a disease. regulating and calm the liver is used for the secondary aspects of a disease as the treatment plan, 3. If malfunctioning of the functions of dispersion and discharge(疏泄), Iiver-energy(肝氣) is becoming degected, So overproduct and overflow of ascent and exhalation of liver-yang(肝陽) is becoming blood are ascending following energy. complete usage of Yin-blood(陰血) is responsible for some kinds of mass formed by blood stasis in the early stage of pathogenesis of liver disease syndrome of the energy system as the progession of disease extravasated blood is forming. the pathologic characteristics is appeared loss of control of the vital energy and blood(體用失調) at the liver disease. 4. Sthenia-syndrome of liver(肝實證) and liver-heat syndrome(肝熱證) is appered that overproducing and overflow of dispersion(疏泄太過) and discharge is responsible for overfunctioning of liver disease or some kinds of heat syndrome such as liver fire(肝火), Sthenia of liver-yang(肝陽上亢), the syndromes of sthenic liver heat(肝實熱) are appered. deficiency of the liver(肝虛證) and cold syndrome of liver(肝寒證) is classified pathologic characteristics of cold and heat, deficiency and excess that regression of sensory, motor, mental due to lack of dispersion and discharge(疏泄不及), or intruding of the cold miasma, are degected. 5. The liver is close relation of physiologic function and internal organ such as spleen, stomach, lung, heart, kidney, gall bladder by the meridian channels, because of property of wind Zang, rapid progession is classified by phthologic charateristics.
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