• The Journal of Internal Korean Medicine
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• v.45 no.3
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• pp.444-455
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• 2024

Objectives: This study aimed to report a case of alcoholic hepatitis with megaloblastic anemia that improved with Korean medicine treatment. Methods: A 27-year-old woman with alcoholic hepatitis and megaloblastic anemia was treated with herbal medicine, acupuncture, and moxibustion. The responses before and after treatment were evaluated using blood tests, ultrasound imaging, the Checklist Individual Strength (CIS), and the numerical rating scale (NRS). Results: Post-treatment, blood tests showed improved liver function test, lipid test, and anemia work-up. Ultrasound imaging showed improvement in the superoinferior diameter of right lobe, from 13.02 to 11.09, and the fatty liver improved. The CIS score decreased from 107 to 55. Fatigue diminished from NRS 10 to NRS 3, and dizziness dropped from NRS 5 to NRS 1. The abdominal distension slightly decreased, from NRS 7 to NRS 5. Conclusion: Korean medicine treatment might be effective for treating alcoholic hepatitis with megaloblastic anemia.

• Parasites, Hosts and Diseases
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• v.62 no.2
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• pp.238-242
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• 2024

Strongyloidiasis is a chronic infection caused by the intestinal nematode parasite Strongyloides stercoralis and is characterized by a diverse spectrum of nonspecific clinical manifestations. This report describe a case of disseminated strongyloidiasis with urination difficulty, generalized weakness, and chronic alcoholism diagnosed through the presence of worms in the urinary sediment. A 53-year-old man was hospitalized for severe abdominal distension and urinary difficulties that started 7-10 days prior. The patient also presented with generalized weakness that had persisted for 3 years, passed loose stools without diarrhea, and complained of dyspnea. In the emergency room, approximately 7 L of urine was collected, in which several free-living female adult and rhabditiform larvae of S. stercoralis, identified through their morphological characteristics and size measurements, were detected via microscopic examination. Rhabditiform larvae of S. stercoralis were also found in the patient's stool. During hospitalization, the patient received treatment for strongyloidiasis, chronic alcoholism, peripheral neurosis, neurogenic bladder, and megaloblastic anemia, and was subsequently discharged with improved generalized conditions. Overall, this report presents a rare case of disseminated strongyloidiasis in which worms were detected in the urinary sediment of a patient with urination difficulties and generalized weakness combined with chronic alcoholism, neurogenic bladder, and megaloblastic anemia.

• Journal of Oral Medicine and Pain
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• v.44 no.1
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• pp.40-44
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• 2019

Third molar extraction, one of the important surgical treatments commonly practiced in dentistry, presents various symptoms after surgery ranging from temporary or mild symptoms to permanent or severe complications. However, oral burning pain, dysesthesia, parageusia, dry mouth, headache and pain in multiple teeth are not the common symptoms that patients often complain after dental extraction. Here, the authors report two cases who presented acute neuropathic symptoms mentioned above in the orofacial regions following third molar extraction. At the initial examination, the healing of the tooth sockets of two patients was normal. One patient was diagnosed as megaloblastic anemia associated with Vitamin $B_{12}$ deficiency and was referred to the Department of Hematology for assessing the underlying etiology of anemia. The laboratory test for the other patient revealed microcytic anemia related to iron deficiency. The patient with iron deficiency anemia was successfully treated with iron supplement. These two cases suggest that anemia, as an underlying systemic disease, may be a rare etiology explaining acute onset of peripheral neuropathy in the orofacial regions after third molar extraction and should be considered in the assessment of patients who report neuropathic symptoms after dental extraction.

• The Korean Journal of Nuclear Medicine
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• v.5 no.2
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• pp.41-56
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• 1971

The pathogenetic mechanisms of anemia in patients with chronic liver disease were observed. Seventeen patients with moderate to advanced hepatic diseass were studied by various methods. Only patients without previous blood loss were included: 14 had cirrhosis, 2 had active chronic hepatitis, and one had inferior vena cava obstruction with associated liver cirrhosis. The followings were the results: 1. The anemia based on red blood cell count, Hb., and Ht. was found in 76.5-78.6% of the patients. 2. Red cell indices indicated that normo-macrocytic and normochromic anemia was present is the majority of the patients. 3. No evidence of megaloblastic anemia was found on the basis of the morphological examinations. 4. Serum iron, TIBC, % saturation and iron content in the bone marrow indicated that iron deficiency anemia was present in about half of the patients. 5. In the view of the erythrocyte dynamics, primary increase in the red cell destruction was ascribed to the cause of the anemia. 6. Decrease in the red cell survival time was not correlated with MCV, % saturation and S.L. ratio. Also, hemoglobin level was not correlated with MCV, % saturation and $T_{50}Cr$. Therefore, multiple causes may be involved in the pathogenesis of the anemia. 7. Anemia as determined by the red cell volume was found in only 60% of the patients. It may be possible that hemodilutional anemia is present.

• Journal of Yeungnam Medical Science
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• v.10 no.1
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• pp.58-67
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• 1993

The author obtained index of red cell volume distribution width(RDW) and other red cell indices in 210 patients of various hematoncologic conditions and 200 healthy control group using, an automated blood analyzer, Coulter Counter Model S-plus II. This study performed to classify various etiologic anemia based on the MCV and RDW, to evaluate availability to the differential diagnosis in korean anemic distoders somewhat different from etiologies of anemias in foreginers. In the most of cases, the increase or decrease of MCV were always combined the pararell changes of MCH and MCHC. But the values of MCV and RDW were not correlated in control group and patient group. So the terms of heterogenous of homogenous anemia were meaningful morphologic classification than hypochromic or normochromic anemia. The heterogenous microcytic anemia contained iron deficiency anemia. In heterogenous normocytic anemia, myelophthisic anemia, acute leukemia were contained. In heterogenous macrocytic anemia, megaloblastic anemia, hemolytic anemia were contained. The homogenous microcytic anemia was observed in anemia of chronic disorders. In homogenous normocytic anemia, acute blood loss, chronic leukemia, multiple myeloma were contained. The aplastic anemia was belonged to homogenous macrocytic anemia. The diagnostic significance of RDW in hemoglobinopathies is most important. But this study was not contained hemoglobinopathies. Instead RDW was very helpful to differential diagnosis of most common anemias, iron deficiency anemia and anemia due to chronic disorders in Korea.

• Journal of Nutrition and Health
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• v.10 no.4
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• pp.84-91
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• 1977

엽산의 결핍은 대혈구성 빈혈(macrocytic and/or megaloblastic anemia)을 일으킨다. 체내에서 엽산은 합성될 수 없는 것으로 알려져, 식품을 통하여 섭취하여야 한다. 이에, 한국인 식생활의 기본을 이루고 있는 쌀, 콩 및 채소류의 식품에 포함된 엽산치를 미생물학적인 측정방법에 따라 분석하였다. Streptococcus faecalis보다 Lactobacillus casei미생물을 사용하여 측정한 방법이, 인간에게 이용될 수 있는 보다 정확한 엽산치로 밝혀졌다. 산화되기 쉬운 형태로 된 labile folate를 보호하기 위한 ascorbic acid의 첨가는, 각 식품에 포함된 엽산치를 증가 시켰다. 결합형으로 존재하는 polyglutamates를 유리형으로 하기 위하여 conjugase enzyme을 사용하였으며, 식품에 따른 화학적 조성은 주로 polyglutamyl form이나 각 식품에 따라 큰 차이가 있는 것으로 나타났다. Lactobacillus casei을 사용하여 측정된 각 식품의 엽산치는, 배추 34.5, 당근17.8, 오이 25.3, 가지 24.7, 쑥갓 76.5, 마늘 3.1, 파 40.2, 완두콩 68.7, 풋고추 27.1, 강남콩 66.9, 부추 64.1, 상치 39.3, 양파 4.3, 시금치 150.7, 호박 26.1, 무우 40.3, 백미 29.9 ug으로 각기 식품 100g 중에 함유됨을 보였다.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.62-65
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• 2008

Purpose: Vitamin $B_{12}$ and folic acid are type of water-soluble vitamin and those work as a secondary vital enzyme, but especially those are involved in the nuclear DNA synthesis. Those are mainly measured in order to diagnose megaloblastic anemia and to assess the storage of folic acid during pregnancy. It is generally known that the hemolyzed serum is useless for folic acid and vitamin $B_{12}$, but it is not easy to abide by this information because our lab (Samkwang Medical Laboratories) is reference laboratory. We tested how much the extent of hemolyzed serum had influence on the results. Materials and Method: We performed the tests of vitamin $B_{12}$, folic acid. For the hemolysis effect study, we used 40 cases. According to the level of A, B and C groups, each group had 10 samples which were mechanically hemolyzed serum. Results: Hemolysis did not affect the vitamin $B_{12}$ results. However in case of folic acid, the value increased according to the degree of hemolysis. And severe hemolyzed cases had the highest value (greater than 20 ng/ml). Conclusions: Preventing the hemolysis, it has to be informed that blood-collecting, separation and storage are performed more carefully. As you see from the above results, hemolyzed serum is not proper for folic acid test, and hemolysis does not affect the results of vitamin $B_{12}$. However, for the more accurate results, it is necessary to avoid hemolysis.