• Title/Summary/Keyword: Symptom severity

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Herbal Medicine for Premenstrual Syndrome: A Systematic Review and Meta-analysis (월경전증후군에 대한 한약 치료의 효과 : 체계적 문헌 고찰과 메타 분석)

  • Ji-In Seo;Yun-Jae Lee;Seo-Lim Ko;Nu-Ree Kim;Jeong-Hun Kim;Mi-Ju Son;Young-Eun Kim;An-Na Kim;Eun-Hee Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.4
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    • pp.96-120
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    • 2023
  • Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

Epidemiology of Coronavirus Disease 2019 in Infants and Toddlers, Seoul, South Korea (서울시 5세 미만 영유아 코로나19 감염의 역학적 특성)

  • JiWoo Sim;Euncheol Son;Young June Choe
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.94-101
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    • 2024
  • Purpose: Coronavirus disease 2019 (COVID-19) has posed a significant burden to infant and toddler's care globally, while the disease severity is generally mild in this age group. In this study, we aimed to assess epidemiological and clinical aspects of COVID-19 in infants and toddlers in Seoul, South Korea. Methods: We used Seoul Metropolitan Government's epidemiological investigation database to describe the epidemiological and clinical characteristics of COVID-19 in infants and toddlers, between March 2020 to December 2021. Results: A total of 5,025 infants and toddlers aged <5 years was diagnosed between the observed period. 2,720 (54.1%) had symptoms, and fever was the most common symptom in 1,941 (74.1%). Of the diagnosed cases, 96.4% did not have underlying diseases. In a district level, extended opening of childcare facility was associated with increased risk of COVID-19 in infants and toddlers. Conclusions: An efficient monitoring system, resembling routine clinical care, is crucial, considering the low rates of severe progression and fatality among infants and toddlers. Moreover, a well-grounded intervention based on scientific evidence, rather than unconditional closures, is necessary to establish a suitable childcare policy that ensures safety from infectious diseases while not overlooking the developmental aspects of social skills.

Ultrasound-Guided Radiofrequency Ablation in Tertiary Hyperparathyroidism: A Prospective Study

  • Erya Deng;Tingting Jiang;Huihui Chai;Ning Weng;Hongfeng He;Zhengxian Zhang;Chengzhong Peng;Wenwen Yue;Huixiong Xu
    • Korean Journal of Radiology
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    • v.25 no.3
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    • pp.289-300
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    • 2024
  • Objective: To prospectively evaluate the outcomes of ultrasound (US)-guided radiofrequency ablation (RFA) in tertiary hyperparathyroidism (THPT). Materials and Methods: Patients with THPT underwent RFA between September 2017 and January 2022. Laboratory parameters, including serum intact parathyroid hormone (iPTH) levels, were monitored for 48 months after RFA and compared with the levels at baseline. Complications related to RFA and changes in hyperparathyroidism-related clinical symptoms were recorded before and after RFA. Results: A total of 42 patients with THPT were recruited for this study. Ultimately, 36 patients with renal failure and 2 patients who underwent successful renal transplantation (male:female, 17:21; median age, 54.5 years) were enrolled. The follow-up time was 21.5 ± 19.0 months in the 36 patients with renal failure. In these 36 patients, iPTH levels were significantly decreased to 261.1 pg/mL at 48 months compared with the baseline value of 1284.9 pg/mL (P = 0.012). Persistent hyperparathyroidism, defined as iPTH levels maintained at > 585.0 pg/mL for 6 months after treatment, occurred in 4.0% of patients (1/25). Recurrent hyperparathyroidism, defined as iPTH levels > 585.0 pg/mL after 6 months, were 4.0% (1/25) and 0.0% (0/9) at 6 months and 4 years after treatment, respectively. In two patients with THPT after successful renal transplantation, iPTH decreased from the baseline value of 242.5 and 115.9 pg/mL to 171.0 and 62.0 pg/mL at 6 months after treatment. All complications resolved within 6 months of ablation without medical intervention, except in 10.5% (4/38) patients with permanent hypocalcemia. The overall symptom recovery rate was 58.8% (10/17). The severity scores for bone pain, arthralgia, and itchy skin associated with hyperparathyroidism improved after treatment (P < 0.05). Conclusion: US-guided RFA is an effective and safe alternative to surgery in the treatment of patients with TPTH and improves hyperparathyroidism-related clinical symptoms.

A Case Report of Korean Medical Treatment for an Adult with Cyclic Vomiting Syndrome Analyzed by Electrogastrography and Subjective Evaluation Scale (위전도 검사와 주관적 평가척도를 통해 분석한 성인 주기성 구토 증후군 환자의 한의 치료 증례보고)

  • Dahee Jeong;Chae-Rim Yoon;Su-Hyun Choi;Nahyun Jeong;Yoohyun Sim;Hae-in Jeong;Na-Yeon Ha;Jinsung Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.519-531
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    • 2024
  • Objectives: This case study reports the effectiveness of Korean medical treatment in a patient with cyclic vomiting syndrome. Methods: A 29-year-old female Korean patient with cyclic vomiting syndrome received acupuncture, electroacupuncture, herbal medicine, and moxibustion for 2 weeks in hospital. Changes in symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS), Visual Analog Scale (VAS), Index for Nausea, Vomiting, and Retching (INVR), Nausea Severity Scale (NSS), Nepean Dyspepsia Index-Korean version (NDI-K), quality of life using the Functional Dyspepsia Related Quality of Life questionnaire (FD-QoL), and gastric motility using electrogastrography (EGG). Results: Post-treatment, the patient showed high satisfaction and improvement in symptoms of nausea and vomiting. The following changes were observed in scores: GSRS: 23 to 19; VAS of nausea: 88 to 95; VAS of dyspepsia: 95 to 12; INVR: 13 to 1; NSS: 17 to 5; NDI-K: 107 to 78; and FD-QoL 84 to 27. We also found positive results in Channel 3 of EGG parameters, implying the improvement of gastric motility disorder. Conclusion: Korean medical treatment can be a therapeutic option for cyclic vomiting syndrome.

A Pilot Study of Evaluating the Reliability and Validity of Pattern Identification Tool for Insomnia and Analyzing Correlation with Psychological Tests (불면증 변증도구 신뢰도와 타당도 평가 및 심리검사와의 상관성에 대한 초기연구)

  • Jeong, Jin-Hyung;Lee, Ji-Yoon;Kim, Ju-Yeon;Kim, Si-Yeon;Kang, Wee-Chang;Lim, Jung Hwa;Kim, Bo Kyung;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.1
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    • pp.1-12
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    • 2020
  • Objectives: The purpose of this study was to evaluate the reliability and validity of the instrument on pattern identification for insomnia (PIT-Insomnia) and verify the correlation between PIT-Insomnia and psychological tests. Methods: Two evaluators examined the pattern identification of the participants who met insomnia disorder diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition (DSM-5) and took the Insomnia Severity Index (ISI) score over 15 once manually and twice using the PIT-Insomnia to measure the inter-rater and test-retest reliability. We also conducted the following surveys: the Pittsburgh Sleep Quality Index (PSQI), the Korean version of Beck's depression inventory (K-BDI), the Korean version of the State-Trait Anxiety Inventory (STAI-K), the Korean Symptom checklist-95 (KSCL-95), and the EuroQol-5 dimension (EQ-5D), to measure concurrent validity and correlation between the PTI-Insomnia and psychological tests. Results: 1. The test-retest reliability analysis of the pattern identification results showed moderate agreement, and test-retest reliability analysis of each pattern identification score showed agreements from poor to moderate. 2. The inter-rater reliability analysis of the pattern identification results via manual showed slight agreement, when analysis was performed with calibration, the inter-rater reliability analysis of the pattern identification results via manual showed fair agreement. 3. The concordance analysis between results via manual and the PIT-Insomnia showed poor agreement, when the analysis was performed with calibration, concordance analysis showed fair agreement. 4. The concordance analysis between the PIT-Insomnia and the PSQI showed positive linear correlation. 5. The concordance analysis between the PIT-Insomnia and the PSQI, K-BDI, STAI-K, KSCL-95, and EQ-5D showed that non-interaction between the heart and kidney have positive linear correlation with the K-BDI, anxiety item of KSCL-95, dual deficiency of the heart-spleen have positive linear correlation with somatization item of KSCL-95, paranoia item of KSCL-95, heart deficiency with timidity have positive linear correlation with stress vulnerability item of KSCL-95, parania item of KSCL-95, phlegm-fire harassing the heart have positive linear correlation with K-BDI, paranoia item of KSCL-95, depressed liver qi transforming into fire have positive linear correlation with the anxiety item of KSCL-95, parania item of KSCL-95, all pattern identification have negative linear correlation with EQ-5D. Conclusions: The PIT-Insomnia has moderate agreement of reliability and reflects the severity of insomnia since it has some concurrent validity with the PSQI. There are some correlations between the PTI-Insomnia with specific psychological tests, so we could suggest it can be used appropriately in the clinical situation.

ASSOCIATION BETWEEN TOURETTE DISORDER AND CATECHOL-O-METHYL TRANSFERASE(COMT) GENE IN KOREAN SUBJECTS (한국인에 있어서의 뚜렛 장애와 COMT유전자간의 상관 관계에 대한 연구)

  • Kim, Boong-Nyun;Lim, Jae-In;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.178-184
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    • 2004
  • Objectives : This study was conducted to investigate the association of the COMT polymorphism with the TD in Korean sample of families with TD probands. The relationship between risk alleles and specific clinical features (tic severity, comorbidity, drug response) was also explored. Method : Patients were recruited from the Tic Disorder clinic at the Child & Adolescent Psychiatric Division of Seoul National University Hospital and assessed through 2 stage evaluation. Firstly, all the patients and parents received semistructured interview using Korean version of K-SADS-PL. Secondly all the patients received clinical interview and tic severity assessment with Korean version of YGTSS. The subjects in control group were recruited from the health promotion center in out hospital and were evaluated by SCL-90 and SCID-IV. Through these process, total of 42 children and adolescents with TD, their 84 parents and 86 control subjects were finally recruited. Genotyping for The Val158Met polymorphism of the COMT gene was done by standardized method. After collection of genetic data of all the patients, parents and control subjects, case-control comparison and tranmission dysequilibrium test was executed by SPSS version 11. Result : From the case-control comparison, the frequency of L-allele and LL genotype was significantly higher in TD group. However, no differences were found from the TDT. No significant differences were found in in family history of tic, ADHD, OCD, drug response and comorbid conditions among the three different genotypes in patients with TD. Conclusion : Though this study results should be interpreted cautiously due to small sample size and negative finding in TDT test, this study is the first report that there is positive association between the functional polymorphism of COMT gene the TD.

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Lower Extremity Edema in Terminal Cancer Patients (말기 암 환자에서의 하지 부종)

  • Shim, Byoung-Yong;Hong, Seok-In;Park, Ji-Chan;Hong, Sug-Hui;Choi, Gang-Heun;Cho, Hong-Joo;Kim, Seon-Young;Han, Sun-Ae;Lee, Ok-Kyung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.152-155
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    • 2005
  • Purpose: The lower extremity edema (LEE) is a common distressful symptom in advanced cancer patients and is hard to manage. We analyze the characteristics of LEE in patients with advanced cancer to provide the basic information of causes and adequate management. Methods: Physical examination, assessment of the location and severity of edema, blood chemistry (albumin, creatinine), Doppler Sono for patients with suspecting deep vein thrombosis (DVT), and abdomen CT scan for patient with suspecting lymph edema were performed. Severity of edema was classified according to NCI lymph edema scaling and improvement was defined as lowering at least 1 grade of edema after management. Results: Among 154 patient who had been admitted to Hospice Ward from Mar 2003 to Jan 2004, 33 had LEE, and 6 had both upper extremity edema and LEE except generalized edema. Their underlying cancers were stomach (7), lung (6), biliary tract (5), liver (5), colorectal (5), pancreas (2), and others (9). There were 12 patient with grade I, 20 patients with grade II, and 7 patients with grade III edema. The causes were hypoalbuminemia (11), lymph edema (10), DVT (7), obstruction of inferior vena cava (IVC) or portal vein (6), and dependent edema (5). The common managements were including leg elevation and diuretics. Elastic stocking was applied for patients with DVT and leg massage and pneumatic compression was used for lymph edema. The 2/3 patients were improved after management. Conclusion: The incidence of LEE in terminal cancer pts was high (25.3%) and their causes were variable including lymph edema, DVT, hypoalbuminemia and dependent edema. Active noninvasive management according to causes could result in good palliation.

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Evaluation of Potential of Mandarin Hybrid 'Shiranuhi' against inoculation of Bacterial Canker Disease Pathogen (Xanthomonas axonopodis pv. citri) in Citrus Field in Jeju Island

  • Hyun, Jae-Wook;Myung, Inn-Shik;Lee, Seong-Chan;Kim, Kwang-Sik;Lim, Han-Cheol
    • The Plant Pathology Journal
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    • v.19 no.5
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    • pp.248-252
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    • 2003
  • This study was carried out to evaluate potential of Shiranuhi cultivar against inoculation of causal pathogen of citrus canker, Xanthomonas axonopodis pv. citri in Jeju Island by comparing degree of susceptibility of fruits and leaves/twigs, and analysis of incidence of canker disease. Progression of symptom, disease incidence, and percent area of lesion were surveyed for evaluation of resistance. In greenhouse condition, symptoms of bacterial citrus canker progressed more rapidly in sweet orange, a moderately susceptible cultivar, than in other four cultivars (satsuma mandarin, 'Kiyomi', 'Shiranuhi' and 'Yuzu'). At 20 days after inoculation, disease severity was the highest in sweet orange (5.0$\pm$0.0), and all tested leaves were distorted or had dropped. On the other hand, 'Yuzu' showed the lowest disease severity (2.6$\pm$0.47), followed by 'Kiyomi' (4.0$\pm$0.0), 'Shiranuhi' (4.0$\pm$0.82), and satsuma mandarin (4.3$\pm$0.47). Percent area of lesion per leaf 30 days after inoculation was the highest in sweet orange (8.31$\pm$1.78), followed by satsuma mandarin (1.51$\pm$1.25), 'Shiranuhi' (1.39$\pm$0.94), and 'Kiyomi' (1.1$\pm$0.9), while the lowest was in 'Yuzu' (0.26$\pm$0.17). Infield condition, percentage of diseased leaf in 'Shiranuhi' was very low, 5.2$\pm$2.9, compared with sweet orange, 71.0$\pm$ 11.5, while that of satsuma mandarin and 'Kiyomi' were 6.9$\pm$7.0 and 4.3$\pm$2.0, respectively. Percentages of diseased leaf was higher (17.4$\pm$7.1) than that of diseased fruit (3.2$\pm$2.5) in severely diseased trees of Shiranuhi cultivar, and the disease was not observed on twig in open field condition. Lesion sizes on leaves and fruits in open field condition were 4.1$\pm$2.2 mm2 and 5.1$\pm$5.6 mm2, respectively, while those in greenhouse condition were 8.7$\pm$5.7 mm2, 10.4$\pm$9.2 mm2 and 5.6$\pm$2.6 mm2 on leaves, fruits and twigs, respectively. The disease was observed in 5.6% out of total 107 farmers Shiranuhi fields under polyethylene film house, and average percentages of diseased tree in 31 fields of Shiranuhi cultivar and adjacent satsuma mandarin fields were 0.02% and 14.8%, respectively. Average percentage of diseased fruit was 1.6% in satsuma mandarin which was not observed in anyone of all the 31 Shiranuhi farmers fields. Therefore, it was concluded that 'Shiranuhi' cultivar is not potential against causal pathogen of citrus canker disease in Jeju Island because the cultivar has similar resistance as satsuma mandarin which occupies over 95% of total 25,000 ha in Jeju Island in polyethylene film houses protected from outside.

Dopamine Transporter Density Assessed with $[^{123}I]IPT$ SPECT Before and After Risperidone Treatment in Children with Tourette's Disorder (뚜렛 장애 아동에서 Risperidone 치료 전후 $[^{123}I]IPT$ SPECT로 측정한 기저 신경절 도파민 운반체 밀도)

  • Kim, Tae-Hoon;Ryu, Won-Gee;Park, Se-Young;Chi, Dae-Yoon;Choi, Tae-Hyun;Lee, Kyung-Yul;Cheon, Keun-Ah;Yun, Mi-Jin;Kim, Jai-Keun;Lee, Jong-Doo;Ryu, Young-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.1
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    • pp.41-51
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    • 2004
  • PURPOSE: Tourette's disorder (TD), which is characterized by multiple waxing and waning motor tics and one or more vocal tics, is known to be associated with abnormalities in the dopaminergic system. To testify our hypothesis that risperidone would improve tic symptoms of TD patients through the change of the dopaminergic system, we measured the dopamine transporter (DAT) densities between drug-naive children with TD and normal children, and investigated the DAT density before and after treatment with risperidone in drug-naive children with TD, using iodine-123 labelled $N-(3-iodopropen-2-yl)-2{\beta}-carbomethoxy-3beta-(4-chlorophenyl)tropane$ ($[^{123}I]IPT$) single photon omission computed tomography (SPECT). MATERIALS and METHODS: $[^{123}I]IPT$ SPECT Imaging and Yale Global Tic Severity Scale-Korean version (YGTSS-K) for assessing the tic symptom severity were carried out before and after treatment with risperidone for 8 weeks in nine drug-naive children with TD. Eleven normal children also underwent SPECT imaging 2 hours after an intravenous administration of $[^{123}I]IPT$. RESULTS: Drug-naive children with TD had a significantly greater increase in the specific/nonspecific DAT binding ratio of both basal ganglia compared with the normal children. However, no significant difference in the specific/nonspecific DAT binding ratio of the basal ganglia before and after treatment with risperidone in children with TD was found, although tic symptoms were significantly improved with risperidone. CONCLUSION: These findings suggest that DAT densities are directly associated with the pathophysiology of TD, however, that the effect of risperidone on tic symptoms in children with TD is not attributed to the change of dopaminergic system.

Post-Exposure Prophylaxis of Varicella in Family Contact by Oral Acyclovir (가족 내 수두 환자와 접촉 후 경구 Acyclovir의 예방효과)

  • Kim, Sang Hee;Kim, Jong Hyun;Oh, Jin Hee;Hur, Jae Kyun;Kang, Jin Han;Koh, Dae Kyun
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.61-66
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    • 2002
  • Purpose : To determine wether varicella can be prevented by administration of oral acyclovir(ACV) during the incubation period of the disease. Methods : Starting 9 days after exposure to the index case in their families, ACV(40 mg/kg/day in four divided doses) was given orally to 20 exposed children for 5 days. Their clinical features was compared with those of 20 control subjects. Antibody titers to VZV were measured in both group 1 week and 4 weeks after finishing the oral ACV administration. Results : The mean age of family members with varicella(51.4 months) were significantly high compared to that of ACV prophylaxis group(28.5 months) and control group(31 months) (P<0.05). Among the 12 children with ACV prophylaxis who completed follow up blood sampling, nine children were diagnosed as VZV infection on the serologic test(75%). Among them six children showed positive VZV IgM on the first blood sample and two children showed serocoversion to positive IgM on the second test after ACV prophylaxis. One child who was negative on both IgM and IgG, showed positive IgG on the second test. The incidence of fever and severity of skin rashes were significantly low in children received oral ACV than in the control group. No or reduced number of maculopapular eruption were observed in the oral ACV group compared to multiple vesicles of the control group. Conclusion : In the present study, we observed that oral ACV prophylaxis to the family contacts is effective in reducing severity of skin lesion. It is likely that oral ACV 9 days after contact prevents or reduces blood dissemination of VZV. Little is known about clinical effect and immunity to the virus in exposed children with no varicella symptom after treatment. We propose the checking up antibody to VZV some period after oral ACV, and considering vaccination to whom with no antibody. But further more studies are needed to practical application of oral ACV for the postexposure prophylaxis of varicella.

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