• Title/Summary/Keyword: 임상증상 약물치료

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Tracheobronchial Foreign Body in a Shih-tzu Dog; Diagnostic and Therapeutic Trial Using Bronchoscopy (시츄견에서 발생한 기관기관지 이물의 기관지경을 통한 진단적 및 치료적 적용 증례)

  • Park, Chul;Yoo, Jong-Hyun;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.26 no.4
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    • pp.336-339
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    • 2009
  • A 4-year-old, neutered male Shih-tzu dog weighing 5.4 kg was referred due to anorexia and chronic coughing. Based on history, physical examination, laboratory tests, radiographic findings, echocardiography, and bronchoscopic examination, the dog was diagnosed as tracheobronchial foreign body. The foreign body was steamed rice debris, which was removed by bronchoalveolar lavage (BAL) with vacuum suction of bronchoscopy. Bacterial and fungal culture of collected BAL fluid was negative. Baermann test for lungs parasites also was negative. The dog was treated with bronchodilator, antibiotics, anti-inflammatory agent, and mucolytics for 7 days. Appetite increased and coughing sign was clearly improved after removal of foreign body and medical therapy. This case report describes that bronchoscopic techniques are available for the evaluation and management of airway foreign bodies.

급성 정신분열병 환자에 대한 Risperidone(R 64766)의 임상 효과 및 안정성 연구

  • 우종인;권준수;김성윤
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1993.04a
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    • pp.165-165
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    • 1993
  • 목적:지금까지 Risperidone의 치료 효능과 안전성에 대한 연구들이 모두 만성 정신분열병 환자들만을 대상으로 이루어졌고, 효율적인 약물 요법의 중요한 지침이 되는 유효치료용량(effective therapeutic dosage)에 대한 연구가 이루어지지 않고 있는 바, 본 연구에서는 초발인 급성 정신분열병 환자들을 대상으로 첫째, Risperidone의 항정신병 효과(antipsychotic effect)와 추체외로계증상(extrapyramidal symptoms)을 평가하고 둘째, Risperidone의 항정신병 효과와 혈장 Risperidone 및 9-hydroxyrisperidone 농도와의 상관관계를 분석하여 유효혈장농도(therapeutic dose range)와 유효치료용량(effective therapeutic dosage)의 존재 여부를 검토코자 한다. 방법: DSM-III-R 진단기준(APA 1987)예 의해 정신분열병형 장애로 진단된 환자 11명(남자 5, 여자 6)을 대상으로 Risperidone을 이중맹검법(double blind design)으로 6주간 투약하였다. 정신병리의 평가는 PANSS(Kay 1988)를 이용하였고 추체외로계 부작용의 평가는 ESRS(Chouinard 1980)를 이용하였다. 혈장 Risperidone 농도와 혈장 9-hydroxyrisperidone 농도는 Jansen사의 Radioimmunoassay Kit를 이용하여 3회 측정하였다. 결과: PANSS 점수는 Risperidone 투여 후 1주째부터 통계적으로 유의하게 감소하였다. Parkinsonism과 dyskinesa에 대한 physician's examination 점수는 전체 연구 기간 동안 유의한 변화를 보이지 않았다. Dystonia에 대한 physician's examination 점수는 Risperidone 투여 후 1주째에는 평균 5.96점으로 높았으나 2주째부터 통계적으로 유의하게 감소되어 6주째에는 유지되었다. 혈장 Risperidone 농도와 혈장 9-hydroxyrisperidone 농도는 PANSS 점수와 유의한 상관관계를 보이지 않았다.

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A CASE OF LETHAL CATATONIA IN A 11-YEAR-OLD BOY (11세 남아에서 발생된 치사성 긴장증 1례)

  • Cho, In-Hee;Hong, Sung-Do;Joung, Yoo-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.121-133
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    • 1999
  • Lethal catatonia is one of catatonic spectrum, but it differentiates itself to a separate entity as a syndrome because of its severity and lethality. The prevalence of this disorder may have declined worldwide, coinciding with the advent of modern psychopharmacologic agents and other advances in medical treatment. The patient reported here was an 11-year old boy, showing catatonic excitement and stuporous condition with high fever, autonomic dysfunction and several catatonic symptoms. This is a case of successful treatment by using intensive medical monitoring and conservative treatment in an intensive care unit, combined with pharmacological treatment and electroconvulsive therapy during the early phase of lethal catatonia with mild symptoms.

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중의치료소아효천임상관찰(中醫治療小兒哮喘臨床觀察) -소아천식에 대한 중약치료의 임상관찰-

  • Yun Hye-Min;Yang Yeon;Jang Ryeo-Yeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.267-270
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    • 2001
  • 소아천식은 기도의 만성 염증 및 과민반응을 특징으로 나타내고 있어 염증을 일으키거나 알레르기 반응을 일으키는 물질로부터 차단하는 방법이 효과적임을 현대의학에서 이미 밝히고 있다. 한의학에서는 천증(喘證)에 본디 뿌리 깊은 근원(천유숙근(喘有夙根))이 있다고 간주하여 허약한 체질은 내적인 요인이고, 풍한침습(風寒侵襲)은 유발요인이며, 담음복폐(痰飮伏肺)와 신기휴허(腎氣虧虛)는 재발의 근본이라고 하였다. 본 연구에서는 소아 천식에 구마황(灸麻黃), 은행(銀杏), 건강(乾薑), 오미자(五味子), 백전(白前), 구백부(灸百部), 소자(蘇子) 등을 사용하였고, 경우에 따라 황기(黃?) 혹은 선령비(仙靈脾)를 추가하여 正氣(正氣)를 강화시키는 목적으로 사용하였다. 약리학적 연구에 따르면 마황과 건강, 오미자 등은 모두 기도의 염증세포 침윤(浸潤)를 억제하고 항알레르기 효과가 있으며, 건강과 오미자는 또한 히스타민에 대한 길항효과(拮抗效果)도 있는 것으로 알려져 있다. 은행 추출물은 혈소판 활성화 수용체에 대한 길항작용을 갖고 있으므로 이러한 물질들로 인한 기관지의 경련을 방지하여 천식증상을 왕화시킨다. 구백부(灸百部)는 지해(止咳)효과가 뛰어나다. 소아천식에 대한 치료는 표본동치(標本同治)의 원칙을 지키며, 증상이 완화된 단계에서도 중약 투여를 1-2개월 지속시키는 것이 중요하다. 소아에게 있어서 천식증상이 완화된 후 어혈(瘀血) 상태가 성인에 비해 심하지는 않지만, "구병필어(久病必瘀)"의 결과에 유의할 필요가 있다. 천식이 장기간 지속되면 필히 혈액순환 장애가 수반되므로 천궁(川芎)이나 단삼(丹蔘) 등의 활혈제(活血劑)를 가미하여 사용하면 효과를 높일 수 있다. 결론적으로 소아의 천식은 항염증, 평천(平喘), 화담(火痰), 지해(止咳)와 더불어 보신익기화어(補腎益氣化瘀)의 약물을 병행하여 사용하는 것이 바람직하며, 단순한 중약 투여는 일부 양약에 의한 소아성장에 미치는 영향을 피할 수 있어 더 많은 임상연구가 이어져야 한다.

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A Clinical Analysis of Surgically Treated Myasthenia Gravid (중증 근무력증환자에서 흉선절제술의 효과 및 임상적 고찰)

  • 민경석;조유원
    • Journal of Chest Surgery
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    • v.29 no.1
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    • pp.73-78
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    • 1996
  • From June 1989 to May 1994, 23 patients with myasthenia gravis underwent thymectomy in the Department of Thoracic Surgery, Asan Medical Center. For the evaluation of the effect of thymectomy, clinical analysis including age and sex distribution, preoperative disease severity, duration of the symptoms, thymic pathology, and postoperative clinical improvement was performed. The mean follow-up period was 15 mon hs(range : 5∼60mon1hs). The effectiveness of thymectomy according to the postoperative symptoms and drug dose was graded as follow : a) complete remission in 5 cases (21.7%), b) clinical improvement with dose reduction in II cases (47.9%), c) clinical improvement without dose reduction in 3 cases(13.0%), 4) unchanged in 2 cases (8.8%), e) early death in 1 case(4.3%) and f) recurrence in 1 case(4.3%). According to the preoperative disease stage by Modified Osserman classification, 6(66.7%) of the 9 patients in stage I and 13 (92.9%) of 14 patients in stage II were clinically improved after thymectomy. although there was no significant statistical differences between these two groups (p> 0.05). According to the thymic pathology, 4 (100%) of 4 cases with normal thymus were clinically improved. Ten (90.9%) of 11 cases with thymic hyperplasia and 5 (62.5%) of 8 cases with thymoma were clinically improved, but there was no significant statistical differences in these three groups (p> 0.05 . The thymectomy resulted in dramatic clinical improvement in 19 (82.5%) out of 23 patients. According to the preoperative disease stage by Modified Osserman classification or the thymic pathology, there was no significant statistical differeneces in the effect of thyinectomy (p> 0.05).

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The Improvement Effect of MMSC (DL-Methionine Methylsulfonium Chloride) in Functional Dyspepsia Animal Models (동물모델을 이용한 MMSC(DL-Methionine Methylsulfonium Chloride)의 기능성소화불량증 개선효과)

  • Kim, Jae Min;Cha, Myoung Hee;Lee, Don Haeng;Lee, Woon Kyu
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.12
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    • pp.2076-2081
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    • 2013
  • The objective of this study is to investigate the gastric emptying and gastrointestinal transit improvement effect of DL-methionine methylsulfonium chloride (MMSC) in functional dyspepsia animal models. Cisplatin causes nausea, vomiting, and inhibition of gastric emptying. Rats were divided into four groups: G1 (normal group), G2 (gastric emptying induced by cisplatin), G3 (gastric emptying induced by cisplatin with itopride 30 mg/kg pretreatment), and G4 (gastric emptying induced by cisplatin with MMSC 4 mg/kg pretreatment). Immediately after an oral administration of a liquid meal (phenol red), delayed gastric emptying was induced by cisplatin (10 mg/kg (i.p.)). After 20 min in the cisplatin administration, the animals were sacrificed. In rats treated with cisplatin, the gastric emptying rate was significantly reduced. On the other hand, MMSC reversed the reduction of gastric emptying induced by cisplatin. And also, MMSC caused to travel FITC-dextran more significantly longer distance than the control, which is based on the values of the mean geometric center in the atropine driven delayed gastrointestinal transit animal models. Furthermore, MMSC drastically increased the gastrointestinal transit in rats, considerably increased the values of the mean geometric center (MGC), compared to the control, which was comparable to that of mosapride. These results suggest that MMSC could be an effective component for the treatment of functional dyspepsia.

Utility of Bone SPECT in Temporomandibular Joint Pain (악관절 동통 환자에서 Bone SPECT의 유용성)

  • Yang, Dong-Hunn;Sung, Mi-Sook;Lee, Jung-Whee;Chung, Soo-Kyo;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.388-394
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    • 1997
  • Temporomandibular (TM) joint Pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above the background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients (21%) out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.

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Esophageal Dysmotility in a Young Adult Dog (식도운동성 저하에 대한 진단 및 치료)

  • Kim, Jae-Hoon;Park, Hyung-Jin;Song, Kun-Ho;Choi, Ho-Jung;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.193-195
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    • 2013
  • An 18-month-old intact male Cocker Spaniel dog weighing 7.7 kg was referred with a 2-week history of severe regurgitation. Based on the screening examination and fluoroscopy, this patient was diagnosed as having esophageal dysmotility. Treatment with mosapride and feeding small amounts of canned food frequently in an elevated position resulted in a successful outcome. The severe regurgitation improved, and the esophageal transit time improved from 18 sec to 8 sec. This is the first case report describing the diagnosis and clinical management of esophageal dysmotility in a young dog in Korea.

CLINICAL SUBTYPING AND TREATMENT STRATEGY OF COLLEGE ENTERANCE EXAMINATION STRESS SYNDROME (입시병의 아형과 대처방안)

  • Lee, Young-Sik;Ku, Young-Jin;Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.2 no.1
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    • pp.43-48
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    • 1991
  • The College entrance examination stress syndrome is a kind of anxiety disorder. The underlying cause of this disorder is not a test anxiety itself. One's hidden inner and familial conflicts are more likely attributed to this disorder. Patient's the most common complaints are various psychosomatic symptoms but in severe cases underlying psychopathology may be activated and progress to major psychosis. In a broad sense adolescent's delinguent behavior, drug abuse, school drop-out and sucide are closely related to this syndrome. In clinical management of these patients, considering the special situation of impending examination, the therapist must access to central conflict theme in a short time without severe resistance. The authors classified this syndrome into 5 clinical subtypes ; 'the anxious group', 'the exhaustion group', 'the despair group', 'the emptyness group' and 'the boredome group'. Typical case of each subtype and it's management methods were presented briefly.

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A Clinical Trial of Combined Treatment with Estrogen and Antipsychotics in Females with Chronic Schizophrenia (만성 여성 정신분열병 환자에서 Estrogen 병합투여의 임상시도)

  • Kwon, Ei-Jung;Kim, Jin-Se;Lee, Dong-Woo;Jung, In-Kwa
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.122-128
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    • 1998
  • Objective : This study was a open clinical trial aimed at exploring the effectiveness of combined treatment with estrogen and antipsychotics to the chronic female schizophrenics. Method : 40 female patients who met DSM-VI criteria for schizophrenia who were chronically ill were randomly assigned to estrogen group(EG) and control group(CG). EG patients were received estrogen 1.25mg for 8weeks in addition to their routine antipsychotic regimens. CG patients were received their routine antipsychotic regimens only. Both groups were evaluated by PANSS(Postive and Negative Syndrome Scale), CGI(Clinical Global Impression) at 0, 4, 8 week during the trial period and compaired with each other. Results : 40 female patients have completed the study during 8weeks. EG was significantly improved in PANSS and CGI scores than CG during the 8weeks. In EG patients, all symptom subtypes(positive symptoms, negative symptoms, general psychopathology symptoms) of PANSS were significantly improved and positive symptoms were most significantly improved at 8week. Conclusions : This results support the clinical value of combined estrogen therapy among chronic female schizophrenics.

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