• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.172-176
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• 1991

Lyme disease, or Lyme borreliosis. is an infection caused by spirohete Borrellia burgdorferi. This disease was recognized in Lyme, Conneticut U.S.A. in 1975. The onset of the disease is usually heralded by the appearance of a pathognomic skin lesion, known as erythema chronicum migrans, and accompanied by flue like or meningitis like symptoms. Unless treatment is initiated early, the disease usually disseminated, often resulting carduac, neurologic, or joint manifestations. All stages of the disease are usually curable by appropriate antibiotic therapy, and can prevent severe late cardiac, neurologic, and joint complications. Lyme disease is typically defined by clinical evidence supported by serologic test. The diagnosis require serologic confirmantion of erythema chronicum migrans, occurring in patient in nonendemic countries. Determination of antibody titer against B. burgdorferi by enzyme linked immunosorbent assay(ELISA) currently the most practical diagnostic test. Currently Lyme disease occurs in U.S.A. Europe, and Australia. It has recently recognized in China, Japan, and Soviet Union also. In United States, Lyme disease is most common vector borne infection. There is no reported case of patients with this disease in Korea. But the vector of this disease, -Ixodes ticks- had been identified in Korea. And Korea is geographically closely related to China and Japan where Lyme disease is already reported. We expect first case of Lyme disease could he reported in near future. We review the clinical manifestations and diagnostic method of Lyme disease.

• 대한한방내과학회지
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• 제40권2호
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• pp.173-180
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• 2019

Objective: In this case report, we address the case of a 47-year-old man with anemia due to chronic kidney disease. Methods: A patient was treated with Korean medicine including an herbal medication, Shipjeondaebo-tang. We evaluated the improvement of symptoms by biochemical examination of blood, complete blood cell count and total score of Fatigue Severity Scale (FSS). Results: After 15 days of Korean medicine treatment, there was an increase in hemoglobin states, even after intervention ended, for over 30 days with improvement of the patient's fatigue. Conclusions: This study suggested that Shipjeondaebo-tang might be effective in patient's renal anemia and fatigue recovery.

• 대한한방내과학회지
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• 제39권1호
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• pp.9-21
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• 2018

Objective: Graves' disease, the most common cause of primary hyperthyroidism, is a thyroid specific autoimmune disorder. When resistance to medication is shown in spite of long term therapy with anti-thyroid drugs, radioactive iodine therapy would be chosen in Western medicine. However, this therapy has often been reported to cause patients have hypothyroidism, thus requiring them to take levothyroxine for the rest of their lives. In this study, we evaluate the clinical efficacy and safety of Ahnjeonbaekho-tang (AJBHT) on patients with Graves' disease. Methods: We prescribed AJBHT for 3 months to two groups: patients who had been taking antithyroid drugs were administered AJBHT after discontinuing the antithyroid drugs ($Com-Tx{\rightarrow}Single-Tx$), and patients who had not been taking antithyroid drugs were started with AJBHT (Single-Tx) immediately. We evaluated the thyroidal function test (TFT) and visual analogue scale (VAS) for clinical symptoms for 3 months. Results: Serum T3 and fT4 were significantly decreased in both groups and remission rate of thyroidal hormones were significantly improved in the Single-Tx group. The clinical symptoms of palpitation, fatigue, and heat intolerance were significantly improved in both groups. In the safety analysis, all patients were in normal range of liver, renal function blood test and common blood count. Conclusion: From these results, we suggested that AJBHT was effective on TFT and clinical symptoms of Graves' disease. The study supports that AJBHT may be a useful agent for patients with Graves' disease who are resistant to antithyroid medication or radioactive iodine therapy, and for patients at first diagnosis.

• Annals of Clinical Neurophysiology
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• 제17권1호
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• pp.17-23
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• 2015

Background: Sleep-related disturbances and sleep disorders are common in Parkinson's disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age $60.6{\pm}6.4$, Hoehn and Yahr (HY) stage $2.7{\pm}1.0$) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.

• 기본간호학회지
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• 제13권2호
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• pp.249-256
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• 2006

Purpose: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. Method: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. Results: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. Conclusion: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.

• 한국임상약학회지
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• 제33권4호
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• pp.290-304
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• 2023

Background: Innovative Alzheimer's disease drugs received approval in the United States in 2021 and 2023. This study aims to assess the safety and efficacy of these novel treatments, elucidate their mechanisms of action, and compare their impact on cognitive function improvement with approved drugs. Methods: We conducted a comprehensive search of pivotal clinical studies related to Alzheimer's disease treatments in PubMed/Medline, Embase, and the Cochrane Library databases from January 1st, 2020 to December 31st, 2022. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 14 studies were included in this systematic review. When compared to the placebo, the new drugs did not exhibit a statistically significant effect on MMSE (Mini-Mental State Examination) (mean difference= -0.04, 95% confidence intervals [CIs]: -0.31, 0.23, N=3662, I²=0%). However, they demonstrated a significant impact on ADAS-cog (Alzheimer's Disease Assessment Scale-Cognitive Subscale) (standardized mean difference= -0.15, 95% CIs: -0.2, -0.1, N=6710, I²=17%). When compared to the approved drugs, the new drugs showed a statistically significantly lower effect on MMSE (test for subgroup difference Chi²=23.13, N = 5870, p<0.00001) but showed only a trend of decreased efficacy on ADAS-cog (Chi²=1.16, N = 8670, p=0.28). Conclusion: New drugs yielded diverse clinical endpoint results compared to the placebo, and in comparison to existing approved drugs, they exhibited lower efficacy in improving cognitive function. The safety profile of these new drugs, as reported in clinical trials, was generally well-tolerated.

• Clinical and Experimental Reproductive Medicine
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• 제38권1호
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• pp.42-46
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• 2011

Objective: This study was aimed to investigate endometrial histology and to find predictable clinical factors for endometrial disease (hyperplasia or cancer) in women with polycystic ovary syndrome (PCOS). Methods: We investigated the endometrial histology and analyzed the relationship between endometrial histology and clinical parameters, such as LH, FSH, estradiol, testosterone, fasting and 2 hours postprandial glucose and insulin, insulin resistance, body mass index, endometrial thickness, menstrual status from 117 women with PCOS. Statistical analysis was performed with chi square and t-test, p-value<0.05 was considered as statistically significant. And receiver operating characteristic curve was used to find predictable clinical factors for endometrial disease and to decide the cuff off values. Results: In 117 women with PCOS, endometrial histologic profiles are as follows: proliferative phase in 90 women (76.9%), endometrial hyperplasia in 25 women (21.4%), and endometrial cancer in 2 women (1.7%). Of 25 women with endometrial hyperplasia, simple hyperplasia without atypia, complex hyperplasia without atypia and complex hyperplasia with atypia were diagnosed in 15 (12.8%), 6 (5.1%), 4 (3.4%) women, respectively. Age and endometrial thickness were significantly related with endometrial disease, p=0.013 and p=0.001, respectively. At the cut off level of 25.5 years in age, sensitivity and specificity predicting for endometrial disease were 70.4% and 55.6%, respectively (p=0.023). At the cut off level of 8.5 mm in endometrial thickness, sensitivity and specificity were 77.8% and 56.7%, respectively (p=0.000). Conclusion: In women with PCOS, the incidence of endometrial hyperplasia and cancer were 21.4% and 1.7%. The age and endometrial thickness may be used as clinical determining factors for endometrial biopsy.

• Clinical and Experimental Pediatrics
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• 제62권6호
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• pp.224-234
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• 2019

Purpose: Pompe disease (PD) is an autosomal recessive disorder caused by a deficiency of acid alpha-glucosidase resulting from pathogenic GAA variants. This study describes the clinical features, genotypes, changes before and after enzyme replacement therapy (ERT), and long-term outcomes in patients with infantile-onset PD (IOPD) and late-onset PD (LOPD) at a tertiary medical center. Methods: The medical records of 5 Korean patients (2 male, 3 female patients) diagnosed with PD between 2002 and 2013 at Samsung Medical Center in Seoul, Republic of Korea were retrospectively reviewed for data, including clinical and genetic characteristics at diagnosis and clinical course after ERT. Results: Common initial symptoms included hypotonia, cyanosis, and tachycardia in patients with IOPD and limb girdle weakness in patients with LOPD. Electrocardiography at diagnosis revealed hypertrophic cardiomyopathy in all patients with IOPD who showed a stable disease course during a median follow-up period of 10 years. Patients with LOPD showed improved hepatomegaly and liver transaminase level after ERT. Conclusion: As ERT is effective for treatment of PD, early identification of this disease is very important. Thus, patients with IOPD should be considered candidates for clinical trials of new drugs in the future.

• 대한한의학회지
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• 제21권4호
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• pp.112-121
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• 2000

Objectives : The purpose of this study was to examine the efficacy of Gamichunggan-tang(Jiaweiqinggan-tang) on 57 patients who have suffered from chronic liver disease. Methods : Gamichunggan-tang(Jiaweiqinggan-tang) was administered to patients for over 2 months continuously. We checked improvement of clinical symptoms, changes of Hepatitis B markers and lymphocyte count. Results : Gamichunggan-tang(Jiaweiqinggan-tang) has significant effect on the improvement of clinical symptoms. And the ratio of seroconversion from HBeAg positive to HBeAg negative was 42.9%. Lymphocyte increased in 83.3% of patients converted to HBeAg negative. Conclusions : It is suggested that Gamichunggan-tang(Jiaweiqinggan-tang) has significant effects on the recovery of weakened liver function and immune modulation. This treatment could be recommened as a prescription for Chronic liver disease.

• Clinical and Experimental Pediatrics
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• 제52권5호
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• pp.513-518
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• 2009

In childhood tuberculosis, it is possible to clearly distinguish among three basic stages: exposure, infection, and disease. The incidence of tuberculosis in children is low compared with that in adults, but latent infection is a major concern because children, who are exposed to Mycobacterium tuberculosis especially early in childhood, are at increased risk of developing the disease. Younger children particularly infants have a high relative risk of miliary or meningeal disease. The clinical manifestations of childhood tuberculosis differ noticeably from those of the disease seen in adults. Adolescents with tuberculosis have different demographic and clinical features from those of adults or children. Tuberculosis in adolescents has become relatively more important as the incidence of infection in childhood has decreased.