코로나19 유행에 따른 한방소아청소년과 외래 환자의 진단명 변화

서혜선,박소현,박슬기,이선행,이진용,Seo, Hae Sun,Park, So Hyun,Park, Sul Gi,Lee, Sun Haeng,Lee, Jin Yong 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.4

Objectives This study aims to provide directions for future Korean pediatric medicine treatment and researches by analyzing the characteristics of diseases of Korean pediatric outpatients before and after the COVID-19 epidemic. Methods We analyzed the medical records of 10,868 new patients aged 0-18 who visited the Korean pediatrics at Kyung Hee university hospital from January 1, 2019 to June 30, 2021. All patients were divided into 2 groups; patients who visited from January 1, 2019 to December 31, 2019, before the coronavirus epidemic, and patients who visited from January 1, 2020 to June 30, 2021, after the coronavirus epidemic. Within the two groups, the diagnosis distribution was performed for the entire population, by gender and by age group. Diagnoses were classified as allergy, growth, gastrointestinal, respiratory, general body supplementation, neuropsychiatric, skin, urogenital, musculoskeletal, and other systems. Results According to the comparative analysis results of before and after the COVID epidemic, there was a decreasing trend of diagnoses in relates to allergy, respiratory, urogenital, musculoskeletal system. On the other side, there was an increasing trend in gastrointestinal, general body supplementation, growth, neuropsychiatric, skin and other system. Changes in diagnosis based on gender and age group will be described below. Conclusions This study analyzed the characteristics of diseases of Korean pediatric outpatients before and after the COVID-19 epidemic, and suggested the direction of future Korean medicine treatment and researches for pediatrics. Also, this study aimed to propose proper treatments for children by showing the role of Korean pediatric medicine related to growth and development of children during the epidemic. However, this study has limitations such as failure to track the long-term impact of COVID-19. Thus, long term follow-up studies are needed to show the effect of COVID-19 on Korean pediatric medicine.

한의학적 치료를 받은 자폐 스펙트럼 장애 환아 63례에 대한 후향적 차트리뷰

박소현,김예지,박슬기,이선행,이지홍,박용석,김재현,장규태,이진용,Park, So Hyun,Kim, Ye Ji,Park, Sul Gi,Lee, Sun Haeng,Lee, Jihong,Park, Yong Seok,Kim, Jae Hyun,Chang, Gyu Tae,Lee, Jin Yong 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.3

Objectives This study aimed to analyze the clinical characteristics of 63 patients with autism spectrum disorder (ASD) who received Korean medicine treatment. Methods This study identified and retrospectively reviewed the first visit records and clinical characteristics of all of the patients who visited the Kyung Hee University Korean Medicine Hospital and Kyung Hee University Korean Medicine Hospital at Gangdong in South Korea with ASD as their chief complaints. The herbal medicines that were prescribed according to the patient's symptoms were analyzed by separating them into categories. Results The data of 83 children with ASD were collected. Among them, the primary medical record charts of 63 patients were reviewed. Additional analysis was performed for 56 patients who were treated with herbal medicine. Through a retrospective chart review, the patients' clinical characteristics and the tendency of the prescribed herbal medicine was identified. Conclusions This study was conducted to provide preliminary data that proposes Korean medicine as a new alternative medical treatment. Our study is meaningful as it used the demographic and clinical records of 63 patients with ASD in Korea who visited an Korean medicine hospital in the last 11 years to identify tendencies and analyzed the prescriptions of two or more Korean medicine pediatricians.

소아 알레르기 결막염의 한의학적 병인, 변증, 치법 및 한약재 선택에 대한 문헌적 고찰

김예지,서혜선,박용석,박슬기,이선행,이진용,Kim, Ye Ji,Seo, Hae Sun,Park, Yong Seok,Park, Sul Gi,Lee, Sun Haeng,Lee, Jin Yong 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.2

Objectives We aimed to understand etiology, pattern differentiation, treatment principle, and the role of selected herbs in the treatment of Korean herbal medicine for allergic conjunctivitis (AC) in children. Methods We searched relevant literature published up to February 20, 2021 through CNKI, using search formula of (SU= '結膜炎'+'conjunctivitis') AND (SU='儿童'+'小儿'+'少儿'+'幼年') AND (SU='治療'+'中医治療'+'中藥'+'中医藥'+'顆粒'+'胶囊'+'自擬'+'湯'+'丸'+'散'+'方'). Results Among 81 searched studies, 9 randomized controlled trials and 1 case report were selected and analyzed. In all studies included, the efficacy of herbal treatment for AC was confirmed, and there was no evidence that herbal medicine treatment has higher risk of developing side effects compared to conventional eye drop treatment. As an etiology, wind (風邪) was observed the most frequently, and Saposhnikoviae Radix (防風) and Schizonepetae Spica (荊芥) were in frequent use to dispel wind (祛風). As visceral pattern identification, spleen (脾) and lung (肺) were two important keywords, and spleen deficiency (脾虛), dampness-heat in the spleen and stomach (脾胃濕熱), lung qi deficiency (肺氣虛) were main pathologic mechanisms. Else, treatments related to liver (肝) and removing dampness-heat (濕熱) were mentioned next. Conclusions This study is significant in that AC in children, which has a lack of research compared to other allergic diseases, has been studied in the contents of Korean medicine and laid foundation that can be used as basic data in the actual clinical field. Based on this study, it is hoped that clinical data of Korean herbal medicine treatment for childhood AC will be further accumulated.

Phellinus linteus Extract Regulates Macrophage Polarization in Human THP-1 Cells

Sang-Yull Lee(이상률),Sul-Gi Park(박슬기),Sun-Nyoung Yu(유선녕),Ji-Won Kim(김지원),You-Lim Hwang(황유림),Dong-Seob Kim(김동섭),Soon-Cheol Ahn(안순철) 한국생명과학회 2020 생명과학회지 Vol.30 No.2

대식세포는 특성에 따라 크게 classically activated macrophages (M1-phenotype macrophages)와 alternatively activated macrophages (M2-phenotype macrophages) 두 가지의 형태로 나눌 수 있다. M1 대식세포의 경우 직·간접적으로 병원체, 감염된 조직 및 암세포 등을 제거하는 능력을 가진 반면, M2 대식세포의 경우 항염증 반응을 동반한 손상된 세포 조직의 복구 및 세포외기질의 생성에 관여하고 있다. 본 연구에서는 상황버섯 열수추출물을 합성 흡착제인 Diaion HP-20에 통과시켜 소수성 물질을 제거한 시료(PLEP)을 이용하여 인간 유래 THP-1 단핵구 세포주의 염증성 혹은 항염증성 분극화 특성을 알아보았다. 먼저 PLEP 자체의 단핵구 세포에 대한 세포독성을 확인한 결과, 고농도의 300 μg/ml에서 세포독성이 확인되지 않았다. 한편 세포의 형태학적 변화를 확인한 결과, PLEP의 농도가 증가함에 따라 M1- phenotype 대식세포와 유사한 flatted and branched 형태가 증가하였다. 대식세포로 분화시킨 THP-1 세포주에 PLEP를 처리한 후, M1 대식세포 분극화 관련 유전자인 TNFα, IL-1β, IL-6, IL-8, CXCL10, CCR7과 M2-분극화 관련 유전자인 MRC-1, DC-SIGN, CCL17, CCL22의 유전자 발현량을 조사하여 분극화 양상을 알아보았다. 그 결과, M1-분극화 관련 유전자들은 PLEP 농도 의존적으로 증가하였지만, M2-분극화 관련 유전자들은 반대로 감소하였다. 또한 ELISA assay를 통하여 M1 분극화 관련 cytokine인 TNFα, IL-1β, IL-6의 발현량이 유전자의 발현량과 동일하게 증가하였다. 이러한 cytokine들의 분비를 촉진시키는 MAPK signaling 또한 PLEP의 농도가 증가함에 따라 촉진되었고 염증성 cytokine과 관련된 전사인자 NF-κB의 활성화도 증가하였다. 따라서 PLEP는 인간 유래 THP-1 세포주에서의 M1 대식세포 분극화를 통해 염증 반응을 유발하는 것으로 확인되어 염증을 촉진하는 천연물질로 이용할 수 있을 것으로 전망된다. Macrophages are initiators for regulating a host’s defenses to eliminate pathogens and trigger tissue repair. Macrophages are classified into two types: classically (M1) activated macrophages and alternatively (M2) activated macrophages. M1-phenotype macrophages directly or indirectly kill infectious organisms and tumor cells via pro-inflammatory responses, whereas M2-phenotype macrophages remodel wounded tissue through anti-inflammatory responses. In this paper, we investigated how Phellinus linteus hot water extract passed from Diaion HP-20 resin (PLEP) regulates polarization of M1-like or M2-like macrophages in human THP-1 cells. PLEP did not have cytotoxicity at a high concentration of 300 μg/ml. We observed morphological alteration of the THP-1 cells, which are stimulated by PLEP, LPS/INF-γ (M1 stimulators) or IL-4/IL13 (M2 stimulators). PLEP exposure induced morphology contiguous with LPS/INF-γ. qPCR was also performed to determine whether PLEP influences M1 or M2 polarization-related genes. M1-phenotype macrophage–specific genes, such as TNF-α, IL-1β, IL-6, IL-8, CXCL10 and CCR7, were enhanced by PLEP in a dose-dependent manner similar to LPS/INF-γ. Conversely, M2-phenotype–specific genes, such as MRC-1, DC-SIGN, CCL17 and CCL22, were suppressed by PLEP. PLEP also significantly up-regulated secretory inflammation cytokines related to M1 polarization of macrophages, including TNFα, IL-1β and IL-6, which was similar to the gene expression. Further, MAPK and NF-κB signaling were increased by treatment with PLEP, resulting in enhancement of cytokine secretion. PLEP might therefore be used as a promising booster of pro-inflammatory responses through M1 polarization of human THP-1 cells.

한약재 약욕요법이 소아 발열기간에 미치는 영향 : 체계적 문헌고찰 및 메타분석

김예지,박소현,서혜선,박슬기,이선행,이진용,Kim, Ye Ji,Park, So Hyun,Seo, Hae Sun,Park, Sul Gi,Lee, Sun Haeng,Lee, Jin Yong 대한한방소아과학회 2021 대한한방소아과학회지 Vol.35 No.3

Objective The purpose of this study is to evaluate whether herbal bath shortens the duration of pediatric fever. Methods Databases, such as Medline, EMBASE, Cochrane library, OASIS, KISS, KMBASE, CNKI, Wanfang Med Online were used to search randomized controlled trials. Those trials that included children younger than 18-year-old were evaluated for the clinical efficacy of herbal bath in fever by analyzing 'body temperature (BT) drop start time' and 'time to return to normal BT'. Results 12 studies or 1306 participants were analyzed in the study. When applying herbal bath in combination with the controlled treatment, 'BT drop start time' was decreased by 0.11 hours, and 'time to return to normal BT' was decreased by 10.94 hours compared to the controlled group. When comparing herbal bath with tepid bath, 'time to return to normal BT' was reduced by 8.19 hours in herbal bath group. In regards to safety, 3 studies out of 12 studies mentioned about its adverse events: 2 studies did not have any adverse events, and a minor needle-shaped bleeding had occurred in one of the studies. Conclusion Use of herbal bath as a treatment of fever in children was associated with shortened duration of fever. However, cautious interpretation is necessary due to its limited safety data.

Conditioned Media of RAW 264.7 Cells Stimulated with Phellinus linteus Extract Regulates the Epithelial-mesenchymal Transition in Prostate Cancer Cells

Taewoo Kang(강태우),Hyun-Hee An(안현희),Sul-Gi Park(박슬기),Sun-Nyoung Yu(유선녕),You-Lim Hwang(황유림),Ji-Won Kim(김지원),Soon-Cheol Ahn(안순철) 한국생명과학회 2019 생명과학회지 Vol.29 No.8

전립선암은 전이성 종양 중의 하나로 치료를 위해 호르몬 요법이나 외과 적 거세 방법이 주로 수행되지만 많은 부작용을 나타내었다. 최근 많은 연구자들이 이러한 상황을 해결하기 위해 종양 미세 환경을 연구하고 있으며 그 중 면역 세포, 특히 대식세포는 종양 미세 환경의 중요한 구성요소이다. 정상적인 조건에서 대식세포는 여러 암세포에 대해 약한 종양 살균 활성을 갖으나 interferon-γ 또는 lipopolysaccharide에 의해 활성화되면, 염증성 사이토카인 및 케모카인을 분비함으로써 암세포를 직접 또는 간접적으로 사멸 시키게 된다. 본 연구에서는, 마우스 대식세포인 RAW 264.7 세포에 Phellinus linteus 추출물을 처리하여 산화질소의 방출과 pro-inflammatory cytokine들을 real-time PCR과 ELISA 방법으로 분석하였다. RAW 264.7의 조정 배지는 48시간 동안 전립선 암세포처리하여 상피간엽세포전이 관련 유전자의 발현을 측정 하였다. 그 때에 mesenchymal 관련 유전자들인 N-cadherin, snail, twist, slug 및 cadherin 11이 감소했을 뿐만 아니라 epithelial 관련 유전자인 E-cadherin은 증가하였다. 또한 암 전이 및 신생 혈관 형성에 관여하는 vimentin, ccl2 및 vegfa가 감소되었는데, 이는 EMT가 암세포의 이동과 침범에 밀접한 관련이 있기 때문이다. 따라서 Phellinus linteu에 의해 자극된 RAW 264.7 세포의 조정 배지는 인간 전립선 암세포주인 PC-3 세포의 이동과 전이를 억제하고 EMT 경로를 조절한다는 것을 나타낸다. Prostate cancer (PCa) is one of the most metastatic tumor. Although hormone therapy or surgical castration is mostly conducted to treat PCa, it has a lot of side effects. Recently, many researchers have been exploring the tumor microenvironment to remedy these circumstances. Immune cells, especially macrophages, are an important composition of the tumor microenvironment. Under normal conditions, macrophages exhibit mild tumoricidal activity against tumors. However, once activated by interferon gamma or lipopolysaccharides, macrophages can kill cancer cells directly or indirectly by secreting cytokines and chemokines. In this study, murine macrophage RAW 264.7 cells were treated with Phellinus linteus extract. To analyze their pro-inflammatory phenotype, we were used several assays such as a real-time polymerase chain reaction, an enzyme-linked immunosorbent and nitric oxide assay. Prostate cancer cells were treated with the RAW 264.7-conditioned media, which was identified as a pro-inflammatory nature, for 48 h, and the expression of epithelial-mesenchymal transition (EMT)-related genes was determined. Not only N-cadherin, Snail, Twist, Slug, and Cadherin 11, which are mechenchymal-related proteins, were decrease, but epithelial marker of E-cadherin was increased. In addition, the mRNA level of vimentin, ccl2, and vegfa were decreased, as the EMT is closely related to the migration and invasion of cancer cells. In conclusion, the RAW 264.7-conditioned media stimulated with P. linteus extract inhibited migration and invasion and regulated the EMT pathway in human prostate cancer cells.

견우자의 생리활성 분석과 추출물로부터 항암 활성물질의 분리

최현덕(Hyeun Deok Choi),유선녕(Sun Nyoung Yu),박슬기(Sul-Gi Park),김영욱(Young Wook Kim),남효원(Hyo Won Nam),안현희(Hyun Hee An),김상헌(Sang Hun Kim),김광연(Kwang-Youn Kim),안순철(Soon Cheol Ahn) 한국생명과학회 2017 생명과학회지 Vol.27 No.2

견우자는 한의학에서 사하 작용 및 이뇨 작용 등의 치료 목적으로 사용되어 왔다. 본 연구에서는 견우자를 methanol로 추출하고(PNM), 이를 기본으로 ethyl acetate 분획물(PNE), butanol 분획물(PNB), water 분획물(PNW)로 나누었으며 각 분획물을 이용하여 mushroom tyrosinase 저해활성, pancreatic lipase 저해활성, DPPH free radical 소거활성 및 암세포주의 증식 저해활성 등을 조사하였다. 특히, 전립선암 세포주 PC-3 세포에서 강력한 세포 증식 저해활성을 보였으며, 용매 분획물 중, butanol 분획에서 가장 높은 암세포의 증식 저해활성을 보였다. 따라서 견우자의 methanol 추출물을 Diaion HP-20 column chromatography, reverse phase column chromatography, Sephadex LH-20 column chromatography를 순차적으로 실시하여 최종적으로 저해활성이 가장 높은 compound PN을 얻었으며 HPLC를 통해 그 순도를 확인하였다. Compound PN을 이용하여 cell cycle arrest과 annexin V/PI를 측정한 결과, 세포의 sub-G1기를 축적되면서 apoptosis가 유발되어 전립선암 세포주 PC-3 세포의 세포사멸이 유도되는 것을 확인하였다. 따라서 본 연구를 통하여 견우자에 대한 항산화 활성, 미백 활성 등의 효과 뿐 만 아니라 항암 활성에도 활용할 수 있을 것으로 사료된다. This study aimed to evaluate several biological activities of Pharbitis nil and to isolate an anticancer agent from its methanol extract. Pharbitis nil seeds were extracted with methanol (PNM). Then, PNM was fractionated into solvent layers such as ethyl acetate fraction (PNE), butanol fraction (PNB), and water fraction (PNW). The biological activities of the fractions were analyzed for tyrosinase inhibition, lipase inhibition, DPPH-free radical scavenging, and cell growth inhibition. PNM showed strong growth inhibition of prostate cancer PC-3 cells. PNM was subjected to Diaion HP-20 and eluted stepwise with 50%, 80%, and 100% methanol. Then, for activity-guided fraction, each fraction was analyzed for growth inhibition of prostate cancer PC-3 cells by using an MTT assay. Because the 100% fraction showed significantly strong inhibitory activity, the fraction was further separated in the reverse phase C18, which was eluted with 80% and 90% methanol. The 90% fraction was further subjected to Sephadex LH-20 using a mobile solvent of 100% methanol. Finally, the compound PN was partially purified for HPLC analysis. PN showed cell growth inhibitory activity and induced the apoptosis and cell cycle arrest of prostate cancer PC-3 cells, as measured by flow cytometry. The results together suggest that Pharbitis nil possesses various biological activities, especially the inhibitory activity for the proliferation of prostate cancer PC-3 cells, suggesting the possibility of its use as an anticancer agent.