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황달을 동반한 알코올성 간질환 환자의 한방치료 치험 1례
안재윤,심상송,정솔,신용진,김강산,문병순,윤종민,Ahn, Jae-yoon,Sim, Sang-song,Jeong, Sol,Shin, Yong-jeen,Kim, Kang-san,Moon, Byung-soon,Yun, Jong-min 대한한방내과학회 2021 大韓韓方內科學會誌 Vol.42 No.5
Objective: This study aimed to report a case of alcoholic liver disease with jaundice that was improved with Korean medicine treatment. Methods: A patient who developed jaundice due to continuous drinking was treated with herbal medicine, acupuncture, moxibustion, and cupping. Blood tests were performed to measure the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (γ-GTP), total bilirubin, albumin, and total protein; AST/ALT ratio; and mean corpuscular volume (MCV). Jaundice parameters were subjectively recorded at 3-day intervals. Results: After treatment, the AST, ALT, ALP, γ-GTP, and total bilirubin levels; MCV; and jaundice were decreased. Conclusion: Korean medicine treatment appeared to be an effective method for alcoholic liver disease with jaundice.
제초제 음독 후 발생한 신경학적 후유증으로 사지마비, 인지저하를 호소한 환자의 한의치료 증례보고 1례
심상송,안재윤,진효원,윤종민,문병순,Shim, Sang-song,Ahn, Jae-yoon,Jin, Hyo-won,Yun, Jong-min,Moon, Byung-soon 대한한방내과학회 2021 大韓韓方內科學會誌 Vol.42 No.5
This study is a case report of Korean medicine treatment for a patient with quadriplegia and impaired cognition as neurological sequelae after ingestion of herbicides. A 59-year-old man with toxic encephalopathy and hypoxic encephalopathy after the ingestion of herbicides was treated with acupuncture, Hyulbuchuko-tang mixed with Ondam-tang-gami (血府逐瘀湯合溫膽湯加味), cupping, moxibustion, and rehabilitation. Clinical symptoms were measured with the Manual Muscle Test (MMT), Korean Mini Mental Status Exam (K-MMSE), Functional Independence Measure (FIM), and Modified Barthel Index (MBI). After three months of treatment, clinical symptoms improved. The motor function improved (MMT on both sides, Gr. 3+F/4G→Gr. 4-G~4G/4+G), cognition improved (K-MMSE, 13→21), and ADL (Activities of Daily Living) scores also improved (FIM 41→74; MBI 20→63). Korean medical treatment could effectively treat neurological sequelae after ingestion of herbicides in this case.
성인 중증 중독환자 예측을 위한 새로운 지표 개발: aBIG score for poisoning
최마이클승필 ( Michael Sung Pil Choe ),안재윤 ( Jae Yun Ahn ),강인구 ( In Gu Kang ),이미진 ( Mi Jin Lee ) 대한임상독성학회 2014 대한임상독성학회지 Vol.12 No.1
Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning “aBIG” score [0.28×Age group+0.38×WBC count/103+0.52×Base deficit+0.64×(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.
급성 약물중독에 합병된 일과성 혹은 지속성 고암모니아혈증의 특성
이수형 ( Soo Hyung Lee ),박홍인 ( Hong In Park ),최마이클승필 ( Michael Sung Pil Choe ),제동욱 ( Dong Wook Je ),노우영 ( Woo Young Nho ),김성훈 ( Seong Hun Kim ),이미진 ( Mi Jin Lee ),안재윤 ( Jae Yun Ahn ),문성배 ( Sung Bae Moon 대한임상독성학회 2016 대한임상독성학회지 Vol.14 No.2
Purpose: In patients with altered mentality caused by drugs or unknown causes, ammonia is checked to facilitate differential diagnosis or diagnose hepatic coma. This helps early prevention and treatment of brain damage due to hyperammonemia. This study was conducted to evaluate clinical characteristics of intoxicated adult patients with hyperammonemia. Methods: We evaluated 95 patients with hyperammonemia among intoxicated patients above the age of 15 who visited our ED from January 2013 to December 2015. We analyzed the demographic characteristics and type of poisoning substance, reason for ingestion, toxicological characteristics such as elapsed time from ingestion to hospital visit, lab, clinical progression and complications. Data were evaluated using the student`s t test or Mann-Whitney U test for continuous variables, and Chi-square test and Fisher`s exact test for frequency analysis of categorical variables. Results: When compared to healthy individuals, patients with hyperammonemia showed statistical significance on their SOFA score (p=0.016) and poison severity score (p<0.001). Additionally, patients with hyperammonemia showed significantly different initial serum AST level (p=0.012) and maximum serum AST level during the hospital stay (p=0.026) when compared to healthy individuals. Moreover, individuals with sustained hyperammonemia compared to transient hyperammonemia showed clinically significant SOFA scores (p<0.001), poison severity scores (p=0.007), mortality rates in the ICU (p=0.021), as well as different duration of hospital stay (p=0.037), serum creatinine level (p=0.002), erythrocyte sedimentation rate (p=0.025), and serum myoglobin (p=0.015). Conclusion: Most poisoning-induced hyperammonemia cases were transient and recovered without special treatment. Therefore, hyperammonemia is almost non-specific among poisoning patients.