Do-Eun Lee

Chijasi-tang (Zhizichi decoction), a classical two-herb formula used for neuropsychiatric symptoms, combines an iridoid-rich fruit with a fermented and steamed soybean preparation, and no validated single-run assay covering the markers of both herbs, or data on the variability in commercial raw materials, has been reported. Geniposide (from Gardenia jasminoides) and four isoflavones (daidzin, genistin, daidzein, and genistein; from fermented Glycine max) were selected as markers and identified by Q-TOF MS and UV spectra. A UPLC-PDA method (254 nm) using an HSS C18 column (1.8 µm, 2.1 × 100 mm) separated the five reference standards within 12 min (resolution between adjacent markers ≥ 12.37; 25-min total run time) and was validated according to ICH Q2(R2); in the extracts, the closest marker-to-matrix pair was daidzin and an adjacent matrix peak (retention-time difference, 0.17 min). Six commercial raw materials were analyzed, and water, 30% ethanol, and 70% ethanol extracts (one per Gardeniae Fructus lot; three per solvent) were characterized by marker content and a 14-peak fingerprint. The method showed r² ≥ 0.9995, mean spike recoveries of 85.54–109.30%, intra- and inter-day precision RSD ≤ 4.18%, and test-solution stability for 156 h. One Korean Gardeniae Fructus lot contained 2.40% geniposide, below the Korean Pharmacopoeia limit (≥ 3.0%), and no isoflavones were detected in one Chinese Dandouchi lot. Provisional marker specifications were proposed for each solvent. Fingerprint correlations were r ≥ 0.954 within each solvent system but did not reflect lot-level differences in geniposide content. The method is suitable for the routine quality control of Chijasi-tang, and the results indicate that raw material qualification, fingerprint-based identity testing, and quantitative marker assays should be combined. These exploratory, laboratory-scale data may inform the future CMC development of Chijasi-tang preparations.

Background/Objectives: Recognizing the types and intensity of everyday emotions helps people articulate distress and seek support. Community assessment therefore needs to describe coexisting emotions alongside specific symptoms. The Core Seven-Emotions Inventory–Short Form (CSEI-s), developed and initially validated in Korea, draws on traditional Korean medicine’s Seven Emotions framework. However, references for interpreting scores across adult age groups remain limited. This study explored sample-based references for multidimensional emotional profiles. Methods: A cross-sectional online survey included 1,769 adults aged 20–65 years recruited through non-probability sampling across 17 Korean regions. Subscale percentile ranks, linear T scores, and measurement-error estimates were derived. Internal consistency, factor structure, and demographic differences were examined. Results: Subscale Cronbach’s α ranged from 0.736 to 0.900. A score of 12 corresponded to percentile ranks of 48.8 for Rumination/Pensiveness and 82.5 for Anger. Older groups generally reported lower scores. Factor-model misfit and differential item functioning constrained interpretation. Conclusions: These references enable subscale scores to be interpreted within a defined sample, providing a basis for describing everyday emotional profiles. They offer groundwork for developing and evaluating applications that support emotional self-understanding and communication in community mental-health education and primary care. The values are sample-based, non-diagnostic resources, rather than population norms or clinical thresholds.

Background: Trauma-focused psychotherapies are recommended first-line treatments for post-traumatic stress disorder (PTSD). Emotion-to-Emotion Therapy (ETE) is a psychotherapy derived from traditional Korean medicine that regulates excessive emotional responses using theoretically opposing emotions. Virtual reality (VR) may support standardized and immersive delivery of the meditation component of ETE. This trial will evaluate the efficacy, safety, and cost-effectiveness of VR-based ETE for PTSD. Methods: This multicenter, randomized, waitlist-controlled, assessor-blinded trial will enroll 72 adults with PTSD and allocate them 1:1:1 to VR-based ETE, standard ETE, or a waitlist control group. Both active groups will receive 16 sessions over 8 weeks; waitlist participants will continue usual activities with scheduled monitoring. The primary endpoint is the between-group difference in the week-8 Korean version of the PTSD Checklist for DSM-5 (PCL-5-K) total score, adjusted for the baseline PCL-5-K score and study site. A week-12 follow-up assessment will examine the durability of treatment effects. Secondary outcomes, assessed at baseline and weeks 8 and 12, include the Core Seven-Emotions Inventory–Short Form, Korean Posttraumatic Growth Inventory, Five Facet Mindfulness Questionnaire–Short Form, Patient Health Questionnaire-15, Hospital Anxiety and Depression Scale, Korean Insomnia Severity Index, Hwa-Byung Scale, Clinical Global Impression scales, quantitative electroencephalography, and heart rate variability. Health-related quality of life and cost data will be collected for a within-trial economic evaluation. Discussion: This trial will provide preliminary randomized evidence on the efficacy, safety, and cost-effectiveness of standard and VR-based ETE for PTSD, and on whether adding VR to the meditation component of ETE offers clinical value beyond standard ETE. Interpretation will need to consider the modest sample size, the absence of participant blinding, and the use of a waitlist rather than an active control condition. Trial registration: Clinical Research Information Service of the Republic of Korea, KCT0007845 . Registered on October 18, 2022.

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that can last until adulthood and the diagnosis is often delayed in women due to internalizing symptoms, masking, and compensation strategies. The stigma of the disease and its cultural characteristics can make it difficult to diagnose and accept mental disorders, particularly in the Korean society. Hence, this study aims to explore how the expectations and norms of social roles in the Korean society affect the recognition of symptoms, diagnosis processes, and daily life experiences of women with ADHD. In particular, role conflicts, coping strategies, self-care practices, and unmet needs that appear during the process of delayed diagnosis will be analyzed. To this end, semi-structured, in-depth interviews will be conducted according to Strauss and Corbin’s grounded theory, and core categories and mechanisms will be derived through open, axial, and selective coding. Identifying the unique experiences of ADHD in adult women in Korean society will provide basic data for early diagnosis and intervention strategies and further contribute to discussions on improving international diagnostic guidelines, including those in Asian countries.

Objectives: Team-based learning (TBL) expands in healthcare education to enhance students’ competency in self-directed learning, effective communication, collaboration, clinical reasoning, and problem-solving in clinical settings. This study investigated students’ perspectives in Korean Medicine (KM) regarding their clinical experience with a real patient in a pilot TBL module using a mixed-methods approach.Methods: A 3-hour TBL session was conducted with 36 final-year KM students divided into eight groups of 4–5 students each. The students conducted a medical interview and performed physical examinations and clinical reasoning for the patient with neck pain. Students were then surveyed regarding their satisfaction with TBL, relevance of the program’s objectives and content, and suggestions for program improvement. Four students from different teams were interviewed to explore their experiences in the TBL class, and a qualitative thematic analysis was conducted.Results: Eleven students (31%) completed questionnaires. All students found TBL to be beneficial and satisfactory and considered it highly pertinent to their future duties. Interacting with a real patient facilitated learning, as students identified their weaknesses. Through team-based care, students actively engaged in discussions about clinical reasoning and treatment plans, thereby expanding their perspectives on patient care through their peers. The group activities reflected the characteristics of traditional medical practice, in which diagnosis and treatment might be timely completed in primary care, with multiple therapeutic approaches available for the same diagnosis. The students proposed promoting pre-learning, modifying group composition methods, extending class time, and modifying feedback methods using post-it notes to improve the TBL module.Conclusion: Group practice with a real patient facilitates self-directed learning and expands students’ understanding of clinical reasoning and perspectives on patient care through live discussions. The pilot TBL module should be included in KM curricula to ensure students’ sufficient experience in decision-making and communication before practicing individually as licensed healthcare providers.

Major depressive disorder (MDD) is a widespread psychiatric condition with substantial socioeconomic impacts, yet single-target pharmacotherapies often yield responses. To address its multifactorial nature, this study employed a multiscale network analysis of herbs, their active components, and MDD-associated protein targets. Using a biased random walk with restart, we calculated interactions between disease-related and herb-derived targets, identifying herbs highly correlated with MDD. Enrichment analysis further revealed key signaling pathways, including oxidative stress, neuroinflammation, and hormone metabolism, underlying these herbs’ therapeutic effects. We identified Ephedrae herba, Glehniae radix, Euryales semen, and Campsitis flos as promising candidates, each containing multiple bioactive compounds (such as ephedrine, psoralen, xanthine, and ursolic acid) that modulate critical processes like oxidation–reduction, inflammatory cytokine regulation, and transcriptional control. Network visualization showed how these herbs collectively target both shared and distinct pathways, supporting a synergistic, multi-target therapeutic strategy. This approach underscores the significance of network-based methodologies in addressing complex disorders such as MDD, where focusing on a single target may overlook synergistic interactions. By integrating diverse molecular data, this study provides a systematic framework for identifying novel interventions. Future experimental validation will be crucial to confirm these predictions and facilitate the translation of findings into effective MDD therapies.

Objectives: This study utilized a network pharmacology approach to investigate the potential therapeutic effects and underlying mechanisms of Daehwangmokdanpi-tang (DHMDPT) in diabetic cognitive disorder (DCD).Methods: The compounds of DHMDPT and their target genes were obtained from the OASIS and PubChem databases. These putative target genes were compared with known targets of DCD to identify potential correlations. Using Cytoscape 3.10.2, a network was constructed to highlight key target genes. To further elucidate the underlying mechanisms, functional enrichment analysis was performed using Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. Finally, CB-DOCK was used to assess binding affinities and confirm the interactions.Results: The results showed that a total of 27 compounds and 439 related genes were identified from DHMDPT. Among these, 373 genes interacted with the DCD gene set, indicating a close relationship between the effects of DHMDPT and DCD. Through GO enrichment analysis and KEGG pathways, ‘Regulation of Apoptotic Process’, ‘Cytokine-Mediated signaling pathway’, and ‘AGE-RAGE signaling pathway in diabetic complications’ were identified as the functional pathways of the 18 key target genes of DHMDPT on DCD. Additionally, molecular docking was performed to assess the binding affinities of the six most highly associated key target genes of DCD with active compounds.Conclusions: Using a network pharmacology approach, which included molecular docking, DHMDPT was found to be highly relevant to DCD. This study could serve as a foundation for further research on the cognitive enhancement effects of DHMDPT in DCD.

Background: Insufficient postpartum care can negatively affect mothers’ health. The aim of the Korean Medicine-based Postnatal Healthcare Program (KMPHP) is to prevent and treat Sanhupung by rapid intervention in postpartum care.Methods: A retrospective study was conducted using data from 37 postpartum women who participated in the KMPHP between April 2019 and April 2020. The women had received at least one type of Korean medicine treatment (herbal medicine, acupuncture, electroacupuncture, pharmacoacupuncture, or Chuna manual therapy) for at least one session. General characteristics were collected from the medical records, and postpartum symptoms (taken from a questionnaire) were investigated. Outcome measures included pain intensity, quality of life (QoL), and postpartum depression.Results: The effectiveness of the KMPHP was determined using the paired-sample Wilcoxon test and significant improvements in the scores were observed using the Korean version of the Edinburgh Postnatal Depression Scale (from 8 to 5, p < 0.01), EuroQol-5 Dimension-5L (from 0.82 to 0.83, p = 0.02), and EuroQol Visual Analog Scale (from 70 to 80, p < 0.01). The womens’ pain scores (Numeric Rating Scale) reduced from 4 to 3 after treatment, but the difference was not significant. As a result of analyzing the effects of each intervention, herbal medicine show a significant effect on womens’ depression, QoL and pain, and non-pharmacological intervention showed synergistic effects with herbal medicine.Conclusion: Korean medicine-based interventions may be effective in the management of postpartum health by improving mothers’ emotional status, QoL, as well as reducing pain.

Background: The postpartum period is the most critical period in the mother’s and child’s lives, and integrative medical approaches, including Korean medicine, are preferred for promoting postpartum recovery and managing postpartum symptoms. The socially disadvantaged class is known to be more vulnerable to postpartum depression, obesity, and bleeding, and the National Medical Center is undertaking Korean medicine-based postpartum health management projects for the socially disadvantaged mothers. However, clinical evidence and research data on integrative medicine-based postpartum care to expand the scope of these postpartum programs to help these women are lacking. Aim: To investigate the barriers, benefits, and limitations of integrative medical postpartum health management programs for the socially disadvantaged mothers and investigate the experiences of this population. Methods: A qualitative research methodology is used, and a semi-structured, open-ended interview will be conducted. The interview will be conducted among 10 or fewer participants, with each interview session lasting for 60–120 min. Data will be analyzed using grounded theory framework proposed by Strauss and Corbin. Significance: This study will shed light on the users’ experiences and benefits, unmet needs, and limitations of Korean medicine-based postpartum management programs for the socially disadvantaged mothers. The findings will be useful for the improvement of postpartum care programs and used as foundational data for the protocols of quantitative studies in the future.