• Title/Summary/Keyword: inborn

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The Role and Treatment Mind of Sasang Constitutional Medicine in Human Genome Age (Human Genome 시대에 부응하는 사상체질의학(四象體質醫學)의 역할과 치료정신)

  • Song, Il-Byung
    • Journal of Sasang Constitutional Medicine
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    • v.15 no.2
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    • pp.1-8
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    • 2003
  • 1. Objects of Research This research is purposed to find role and treatment mind of Sasang constitutional medicine in human genome age, through summarizing recognition of human and etiology. treatment on diseases proposed in Sasang constitutional medicine 2. Methods of Research It was researched as bibliologically with Dong-mu's chief medical writings such as ${\ulcorner}Dongyi$ Soose Bowon(東醫壽世保元)${\lrcorner}$, ${\ulcorner}$Dongyi Soose Bowon Sasang Chongyun(東醫壽世保元四象草本卷${\lrcorner}$. 3. Results and Conclusions 1. The outlook on human of Sasang Constitutional Medicine was completed in the base on Confusianism and it recognized that human is consisted with congenital element based on 'Human nature-shape' and acquired element based on Knowledge-Acting. Dong-mu emphasised acquired element than inborn element. 2. Sasang Constitutional Medicine is thought that we ran overcome inborn limitation of each constitution through moral culture of aposteriori Knowledge-Acting. and that self-correction is methods which is applied to treatment of disease recovering Essential Qi of each constitution with moral culture of personality 3. Sasang Constitutional Medicine is recognizing Essential Qi by main standard that foretell prognosis of disease and emphasize recovery of Essential Qi through self-correction than way of 'Assisting-Good Qi' and 'Removig-Bad Qi' in treatment of disease. 4. Self-correction can be divided into non-herbal self-correction and herbal self-correction. Non-herbal self-correction is to control greed by aposteriori Knowledge-Acting and herbal self-correction is to recover Essential Qi by herb. 5. It is thought that the present constitutional disease is consisted by accumulating life habit nature of a disease of ordinary times, and Sasang Constitutional Medicine that present constitutional disease is treated through administration of life habit nature of a disease of ordinary times in Sasang Constitutional Medicine. 6. Treatment mind to correct oneself into Golden Mean through controlling Knowledge-Acting in Sasang Constitutional Medicine may get into important treatment guide of gene medicine age.

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Cost-benefit Analysis of Massive Screening for Inborn Errors of Metabolism in Korea (선천성대사이상검사 사업의 비용편익 분석)

  • Kim, Sun-Mean;Hwang, Na-Mi;Kim, Chang-Yup
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.317-324
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    • 1999
  • Objectives: Since 1991, nationwide massive neonatal screening program for phenylketonuria (PKU) and congenital hypothyroidism have been performed in Korea. As in many other countries, efficiency of this program has not been definitely concluded. For the purpose of evaluation of this program, from the perspective of efficiency, a cost-benefit analysis was carried out. Methods: Costs of the detection and the treatment program were compared with the projected benefit(avoided costs) that results from the prevention of the mental retardation associated with the disorders due to PKU and hypothyroidism. Costs and benefits were discounted at an annual rate of 5%, and duration of life-long labor was assumed to be 30 years. Cost and benefit were estimated based on the detection rates of one case of PKU per 5,572 and one case of congenital hypothyroidism per 32,554 babies screened during 1991-1997. Results: The benefit-cost ratio was 0.418. The sensitivity analysis for the discount rates and labor durations showed that most cost-benefit ratios were lower than one(1.0) except when discount rate was changed to 3% and detection rate to two- or threefold and/or labor duration to 40 years. Conclusion: The result of this study suggested that present program of mass screening for PKU and congenital hypothyroidism could not be justified in terms of efficiency. It doesn't coincide with the results of previous studies in major developed countries, presumably because of difference in detection rates and welfare cost for the disabled.

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Hereditary Tyrosinemia Type I (Hereditary Tyrosinemia Type I 환아의 NTBC 치료 경험)

  • Kang, Hyun-Young;Kim, Sook Za;Song, Wung Joo;Chang, Mi-Young
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.4 no.1
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    • pp.13-17
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    • 2004
  • Hereditary tyrosinemia type I (fiunarylacetoacetate hydrolase deficiency) is an autosomal recessive inborn error of tyrosine metabolism that results in liver failure in infancy or chronic liver disease with cirrhosis, frequently complicated by hepatocellular carcinoma in childhood or early adolescence. Early detection of this condition is very important to early intervention for better prognosis of patients. Neonatal screening test using tandem mass spectrometry (MS-MS) is performed, and this method facilitates detection of the inborn error of tyrosine. For early treatment of tyrosinemia type I, phenylalanine and tyrosine restricted diet and NTBC (2-nitro-4-trifluoromethylbenzoyl-1,3-cyclohexanedione) for inhibition of succinylacetone production are recommended. We studied a 10-month-old Korean boy with tyrosinemia type I whose condition was not discovered earlier through conventional neonatal screening testing available in Korea. The patient presented hyperbilirubinemia, liver failure, bleeding tendency, colicky pain and skin melanin pigmentation in neonatal period. MS-MS made it possible to detect tyrosinemia type I and allowed immediate treatment of the patient. This was the first successful NTBC trial on tyrosinemia type I patient in Korea.

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The Diagnosis and Assessment of 3-methylglutaconic Acidurias (3-Methylglutaconic aciduria의 진단 및 평가)

  • Kim, Ja Hye
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.10-17
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    • 2016
  • The 3-methylglutaconic aciduria (3-MGA-uria) is a heterogeneous group of several inborn errors of metabolism characterized by increased urinary excretion of 3-methylglutaconic acid. In most cases, 3-MGA is only slightly increased and combined with other metabolites. However, repeated and significant excretion of 3-MGA (40->1,000 mmol/mol creatinine) is a hallmark of the disorders of 3-MGA-urias. There have identified five distinct types of disorders: inborn errors of leucine metabolism and four disorders of mitochondrial dysfunction through different mechanism. The range of clinical and biochemical findings in this condition is variable. In the patients with 3-methylglutaconyl-CoA hydratase deficiency, increased 3-hydroxyisovaleric acid is useful in the differential diagnosis. Other forms of 3-MGA-urias are welldefined clinically such as Barth syndrome, Costeff syndrome, TMEM 70 defect, MEGDEL syndrome, and DCMA syndrome. We provide an overview of the expanding clinical spectrum and differential diagnosis of the 3-MGA-urias.

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Compound heterozygous mutations of ACADS gene in newborn with short chain acyl-CoA dehydrogenase deficiency: case report and literatures review

  • An, Se Jin;Kim, Sook Za;Kim, Gu Hwan;Yoo, Han Wook;Lim, Han Hyuk
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.45-48
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    • 2016
  • Short-chain acyl-CoA dehydrogenase deficiency (SCADD) is a rare autosomal recessive mitochondrial disorder of fatty acid ${\beta}$-oxidation, and is associated with mutations in the acyl-CoA dehydrogenase (ACADS) gene. Recent advances in spectrometric screening for inborn errors of metabolism have helped detect several metabolic disorders, including SCADD, without symptoms in the neonate period. This allows immediate initiation of treatment and monitoring, so they remain largely symptomless metabolic disease. Here, we report a 15-month-old asymptomatic male, who was diagnosed with SCADD by newborn screening. Spectrometric screening for inborn errors of metabolism 72 hours after birth revealed an elevated butyrylcarnitine (C4) concentration of $2.25{\mu}mol/L$ (normal, < $0.99{\mu}mol/L$). Urinary excretion of ethylmalonic acid was also elevated, as detected by urine organic acid analysis. To confirm the diagnosis of SCADD, direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Subsequent sequence analysis revealed compound heterozygous missense mutations c.164C>T (p.Pro55Leu) and c.1031A>G (p.Glu344Gly) on exons 2 and 9, respectively. The patient is now growing up, unretarded by symptoms such as seizure and developmental delay.

The Past, Present, Future of Newborn Screening in Korea (한국 신생아 집단검사의 과거, 현재, 미래)

  • Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.1-9
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    • 2014
  • Many inborn errors of metabolism can be completely cured with early detection and early treatment. This is why neonatal screening on inborn errors of metabolism is implemented worldwide. In 1991, the Ministry of Health & Social affairs adopted a nationwide service program for neonatal screening of phenylketonuria, galactosemia, maple syrup urine disease, homocystinuria, histidinemia and congenital hypothyroidism for newborns delivered from low class pregnant women registered in health centers. Government decreased the test items from six to two, PKU and congenital hypothyroidism to increase test numbers with same budget from 1995. 78 laboratories wanted to participate for neonatal screening test in 1999. Government decided to screen six items of PKU, congenital hypothyroidism, maple syrup urine disease, homocystinuria, galactosemia and congenital adrenal hyperplasia from 2006. In 2014, thirteen laboratories are participating. Inter laboratory quality control was started 6 times a year from 1994. In case a patient with an inherited metabolic disease is diagnosed by screening of government program, special milk is provided at government's expense. According to the government project, from 1997 to 2013, 7,080,569 newborns were screened. 144 PKU, 2.451 congenital hypothyroidism were detected. So incidence of PKU is 1/49,170 and congenital hypothyroidism is 1/2,888. The cost benefit of performing screening procedures coupled with treatment has been estimated to be as high as 1.77 times in PKU, 11.11 times in congenital hypothyroidism than cost without screening. By January 2007, many European countries had expanded of their newborn screening programs by inclusion of Tandem mass spectrometry. We are trying to increase the budget to test all newborns for Tandem mass spectrometry from 2016. We are considering four to five central laboratories which cover all newborns and are equipped with tandem mass spectrometer & enzyme immunoassay for TSH, 17OHP & enzyme colorimetric assay for galactose. And I hope to expand test including Wilson disease screening test and lysosomal storage diseases.

Analysis of online parenting community posts on expanded newborn screening for metabolic disorders using topic modeling: a quantitative content analysis (토픽 모델링을 활용한 광범위 선천성 대사이상 신생아 선별검사 관련 온라인 육아 커뮤니티 게시 글 분석: 계량적 내용분석 연구)

  • Myeong Seon Lee;Hyun-Sook Chung;Jin Sun Kim
    • Women's Health Nursing
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    • v.29 no.1
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    • pp.20-31
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    • 2023
  • Purpose: As more newborns have received expanded newborn screening (NBS) for metabolic disorders, the overall number of false-positive results has increased. The purpose of this study was to explore the psychological impacts experienced by mothers related to the NBS process. Methods: An online parenting community in Korea was selected, and questions regarding NBS were collected using web crawling for the period from October 2018 to August 2021. In total, 634 posts were analyzed. The collected unstructured text data were preprocessed, and keyword analysis, topic modeling, and visualization were performed. Results: Of 1,057 words extracted from posts, the top keyword based on 'term frequency-inverse document frequency' values was "hypothyroidism," followed by "discharge," "close examination," "thyroid-stimulating hormone levels," and "jaundice." The top keyword based on the simple frequency of appearance was "XXX hospital," followed by "close examination," "discharge," "breastfeeding," "hypothyroidism," and "professor." As a result of LDA topic modeling, posts related to inborn errors of metabolism (IEMs) were classified into four main themes: "confirmatory tests of IEMs," "mother and newborn with thyroid function problems," "retests of IEMs," and "feeding related to IEMs." Mothers experienced substantial frustration, stress, and anxiety when they received positive NBS results. Conclusion: The online parenting community played an important role in acquiring and sharing information, as well as psychological support related to NBS in newborn mothers. Nurses can use this study's findings to develop timely and evidence-based information for parents whose children receive positive NBS results to reduce the negative psychological impact.

A Case of Wilson's Disease (Wilson's Disease 환자 1례의 증례 보고)

  • Lee Sang Kwan
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.5
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    • pp.1066-1069
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    • 2002
  • Wilson's disease is a rare inborn error of metabolism inherited as a autosomal recessive trait. The disease has varied mode of manifestations. It is characterized by different neurologic disorder and hepatic disease. I experienced a case of Wilson's disease in 40 year old woman who was suffered from liver cirrhosis, severe anorexia, and classical neurologic symptoms such as tremour, dysarthria and ataxia. The symptoms was not relieved by D-penicillamine, Youngyanggaksan and Samchulgunbi-tang but anorexia was improved significantly by same medication.

Bilateral Pallidotomy for Dystonia with Glutaric Aciduria Type 1

  • Hwang, Hyung-Sik;Salles, Antonio De
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.380-383
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    • 2005
  • Glutaric aciduria type 1 is an inborn error of lysine, hydroxylysine, and tryptophan metabolism caused by deficiency of glutaryl-coenzyme A dehydrogenase. The disease often appears in infancy with encephalopathy episode that results in acute basal ganglia and white matter degeneration. The majority of patients develop a dystonic-dyskinetic syndrome. This reports 6year-old boy who had been done previous gastrostomy due to swallowing difficulty underwent bilateral pallidotomy with intraoperative electromyography[EMG] monitoring for disabling dystonia. Intraoperative EMG was used to assess stimulation thresholds required for capsular responses and muscle tone. Surface EMG electrodes were placed on the face and cricopharyngeal muscles. Exact target were directly modified according to MRI-visualized anatomy. EMG response was consistently seen prior to visual observation of muscle activity. The surgery improved dystonic symptoms without swallowing difficulty.

Study on the Jang-Nam's Constitution Theory for the Connection with 'the Differentiation of Syndromes' and the General Body form Diagnosis (전신형태 진단과 변증시치의 연계를 위한 장남의 형태체질론 연구)

  • Kim Gyeong Cheol;Lee Yang Tae;Shin Soon Shik
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.2
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    • pp.355-358
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    • 2004
  • Jang Nam's opinion is that Yin-Yang of pathogenic factors change following to the Yin and Yang of human body. As the pathogenic factors injure the human body, the conditions of diseases become different to the inborn constitution of human. Therefore the main principles of remedy set up the diagnosis on the YINㆍYANG & the strengthㆍweakness of constitution. This diagnotic points are body formal distinction, flesh hardness and softness, face color and form, skin color. Moreover he arranges the 4 type of the hole-body constitution based on the Seop-Gye's the guide of clinical differentiation of syndromes(臨證指南); Yang-Strength and Yin-weakness(陽盛陰虛), Yin ㆍYang-strength(陰陽具盛), Yin-Strength and Yang-weakness(陰盛陽虛), YinㆍYang-weakness(陰陽兩虛).