• Title/Summary/Keyword: 임상증상 약물치료

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A Case with Tyrosinemia Type I Detected by Neonatal Screening Test (신생아 대사이상 선별검사 이상으로 진단된 I형 타이로신혈증)

  • Sohn, Young Bae;Lee, Hae-Sang;Lee, Jang Hoon;Hwang, Jin Soon
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.12 no.2
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    • pp.99-103
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    • 2012
  • Tyrosinemia type I is an autosomal recessive inborn error of tyrosine metabolism that caused a mutation. Clinical symptoms include progressive liver damage with liver failure, coagulopathy, hypophosphataemic rickets, renal tubular dysfunction and a high risk of hepatocellular carcinoma. If left untreated, the affected infants may die from liver failure within the first year of life. PharmacoloIcal therapy with 2-(2-nitro-4-trifluoromethylbenzoyl)-1,3-cyclohexanedione (NTBC) has offered an effective therapeutic option in addition to dietary restriction of tyrosine and phenylalanine. As prognosis of tyrosinemia type I is improving with early diagnosis and early treatments, it meets the criteria for a condition that would benefit from newborn screening. We report a case of tyrosinemia type I diagnosed by newborn screening and successive biochemical analysis of plasma and urine, treated by dietary restriction and NTBC.

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Effect of Clinical Improvement of Schizophrenic Symptoms on $^{99m}Tc$-HMPAO Brain SPECT (정신분열병 환자의 임상적 증세 호전에 따른 $^{99m}Tc$-HMPAO 뇌 SPECT 소견의 변화)

  • Shin, Chul-Jin;Koong, Sung-Soo;Chung, In-Won
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.310-319
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    • 1997
  • This study investigated regional blood flow changes of frontal, temporal, and basal ganglia in eleven schizophrenic patients on DSM-IV criteria to examine the relationship between rCBF and clinical improvement of symptoms. Single-photon emission computed tomography imaging with $^{99m}Tc$-HMPAO was peformed in baseline and sixth weeks after the treatment, and concurrently psychopathology was assessed by PANSS. Antipsychotics wash-out period was more than 2 weeks, and three patient were drug naive. All patients were finally divided into two groups, the improved or not improved. We examined the difference of the amount of rCBF changes between two groups. Finally, frontal activity shows no significant difference between two groups but both groups show decreased frontal blood flow after antipsychotic treatment. However, the change of right temporal rCBF had positive correlation with the change of the total PANSS score, and the change of left temporal lobe activity was greater in the improved group than in the not improved group. Our results suggest that the temporal lobe activity has relation to the underlying schizophrenic symptoms.

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Effects of Cigarette Smoking on Clinical Symptoms and Level of Serum Prolactin in Schizophrenic Patients (흡연이 정신분열병 환자의 임상 증상 및 혈청 Prolactin에 미치는 영향)

  • Woo, Haing-Won;Lim, Weon-Jeong;Yun, Kyu-Wol
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.143-150
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    • 1997
  • This study was performed to evaluate the characteristics of smoking behavior and the effects of smoking on clinical symptoms and level of serum prolactin in schizophrenic patients. Methods : 76 male schizophrenic patients answered the questionnaire about the characteristics of smoking patterns. And patients were assessed by brief psychiatric rating scale(BPRS), positive and negative syndrome scle(PANSS), Hamilton rating scale for depression(HAM-D), assessment for involuntary movement scale(AIMS) and symptom checklist 90 R(SCL-90-R). Serum prolactin levels were measured by enzymeimmunoassay. Results: 1) The frequences of drinking coffee were significantly higher in smokers. The reasons for smoking were to relieve tension, to avoid boredom, due to habit and to do with friends. 80.1% of smokers tried quitting, but smoking was relapsed due to craving and withdrawal symptoms. 2) No significant difference was seen in mean neuropeltic doses, scores of PANSS and AIMS. But as for BPRS, scores of anxiety/depression subscale were significanly lower in smokers. Scores of HAM-D and scores of interpersonal sensitivity and phobia among SCL-90-R were significantly lower. 3) Levels of serum prolactin were significanlty lower in smokers. Conclusion : These findings suggest that in schisophrenia smoking relieves anxiety and depression subjectively But decreased prolactin levels may suggest that the possibility of increased dopamine in CNS.

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A CASE OF PERVASIVE DEVELOPMENTAL DISORDER NOS WITH REPETATIVE SELF-INJURIOUS BEHAVIOR (반복적으로 머리를 때리는 전반성발달장애 환아 1례)

  • Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.244-251
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    • 1999
  • Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

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A Case Report on The Relieving Effect of Herbal Medicine on Clinical Symptoms in Patients with Hyperthyroidism Taking Methimazole (메티마졸 투여 중인 갑상선기능항진증 환자에서 한약의 임상증상 완화효과에 대한 증례보고)

  • Henja Yun
    • Herbal Formula Science
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    • v.31 no.3
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    • pp.203-213
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    • 2023
  • Objectives : The purpose of this study is to report the symptomatic relief effect of a herbal prescription combined with methimazole for hyperthyroidism caused by Graves' disease. Methods : After diagnosis of hyperthyroidism, methimazole was initially administered alone. As the clinical symptoms continued, a herbal medicine combining Gamiondam-tang and Cheongsimyeonja-eum was administered together with methimazole. Blood concentrations of hormones were measured, and the degree of clinical symptoms was measured using the NRS scale. The effect of herbal medicine on heat intolerance was analyzed by Wilcoxon rank sum test, and the relationship between thyroid hormone and heat intolerance was analyzed by Pearson's correlation coefficient. Results : Heat intolerance symptoms were significantly reduced when the herbal prescription was administered in parallel than when methimazole was administered alone (w=296, p=0.001). The decrease in heat intolerance was not related to thyroid hormone levels (p=0.27, 0.37). Conclusions : It was found that the herbal medicine combining Gamiondam-tang and Cheongsimyeonja-eum was effective in treating hyperthyroidism symptoms including heat intolerance.

Two Cases of Spasmodic Torticollis Managed by Yinyang balance appliance of FCST for the Meridian and Neurologic Balance (FCST의 음양균형장치를 활용한 경련성 사경증 증례보고)

  • Shon In-Cheol;Ahn Kyu-Suk;Sohn Kyung-Seok;Koh Gi-Wan;Yin Chang-Shik;Ha Sung-Joon;Lee Young-Jun
    • Korean Journal of Acupuncture
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    • v.23 no.4
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    • pp.111-122
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    • 2006
  • Objectives : Therapeutic effect of Balance Appliance of functional crebrospinal technique (FCST for meridian and neurologic yinyang balance was observed in two refractory torticollis cases. Methods : A unidentified severe torticollis two cases with several months of duration was managed by the Balance Appliance on temporomandibular joint (TMJ), combined with acupuncture and manual medicine. Results : Assessment was made by self assessment of subjective symptoms and clinical observation. The patient reported over-90% remission and returned to ordinary daily life after $3{\sim}5$ months of therapy, which effect was reported to maintain for 6 months. Conclusions : An impressive effect was observed and further clinical and biological research on FCST is expected.

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Depressive Symptoms in Patients with Parkinson's Disease (파킨슨병 환자에서의 우울증상)

  • Lee, Moon-Sook;Yang, Chang-Kook;Hah, Hong-Moo;Kim, Jae-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.1
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    • pp.25-35
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    • 2003
  • Objectives: The aim of this study was to investigate 1) the prevalence of depressive symptoms, 2) the severity of depressive symptoms, 3) the correlation of depressive symptoms with clinical variables, and 4) factors that contribute to depressive symptoms in patients with Parkinson's disease. Methods: One hundred eighteen patients with Parkinson's disease referred from the Parkinson's Disease Clinic of Dong-A University Hospital, Busan, Korea, completed a self-administered questionnaire package, which included basic demographic data, the Beck Depression Inventory, the Parkinson's disease quality of life questionnaire, the Symptom Checklist-90-Revision(SCL-90-R), and the Spielberger's State-Trait Anxiety Inventory. In addition, a structured interview and a complete neurological examination, including the Hoehn and Yahr stage, the motor part of the Unified Parkinson's Disease Rating Scale(some selected scales of UPDRS part III), the Schwab and England Activities of Daily Living scale(ADL), and the Korean version of Mini-Mental State Examination were performed. Results: 1) Based on BDI score, subjects were divided into four groups:severely(40.7%), moderately(13.6%) and mildly(12.7%) depressive and non-depressive(33.1%). 2) The severity of depressive symptom in Parkinson's disease was positively correlated with Hoehn and Yahr(H & Y) stage(r=0.34, p<0.0001), the severity of motor symptom(r=0.35, p<0.0001), and trait anxiety inventory(r=0.33, p<0.001). On the other hand, the severity of depressive symptom was negatively correlated with educational level(r=-0.34, p<0.001), ADL(r=-0.37, p<0.0001) and Parkinson's disease quality of life (PDQL)(r=-0.69, p<0.0001). Among several clinical variables, the PDQL was the most influential factor predicting whether the depressive symptom was present or not. Conclusion: This study suggests that depressive symptom is very prevalent among patients with Parkinson's disease. Data from this study indicate that medical staffs who take care of patients with Parkinson's disease should pay attention to finding and treating depressive symptom among their patients. With appropriate psychiatric intervention, patient's depressive symptom can be minimized or alleviated and thus, the quality of life in these patients is likely enhanced.

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A Case of End-Stage Renal Disease with Joubert Syndrome due to CEP290 Mutation (CEP290 돌연변이로 인해 발생한 Joubert 증후군 말기 신부전 1례)

  • Kim, Sung Hoon;Lee, Sang Taek;Seong, Moon-Woo;Kim, Man Jin;Lee, Jun Hwa
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.20 no.1
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    • pp.29-35
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    • 2020
  • Joubert syndrome (JS) is a rare genetic disorder that is characterized by ataxia, hypotonia, developmental delay, respiratory abnormalities such as apnea-hyperpnea, and abnormal eye movements. The pathognomonic diagnostic finding is the "molar tooth sign" (MTS) on brain magnetic resonance imaging (MRI), described as cerebellar vermis hypoplasia or dysplasia, thick and horizontally oriented superior cerebellar peduncles, and an abnormally deep interpeduncular fossa. JS is characterized by genetic heterogeneity: pathogenic variants in over 30 genes have been identified to date. The CEP290 protein, which is on chromosome 12q21.3, is most frequently mutated in patients with JS, especially with renal involvement. Here, we report a case of JS in a 14-year-old male patient with end-stage renal disease. To the best of our knowledge, this is the first Korean report of a patient with JS due to CEP290 mutation (c.6012-12T> A) whose diagnosis was confirmed after repetitive MRI. We suggest consultation with an experienced neuro-radiologist and follow-up MRI studies to detect a "hidden" MTS if clinical findings suggest a diagnosis of JS. Furthermore, even in the absence of an MTS, whole exome sequencing should be considered.

Treatment Strategies for Depression during Pregnancy and Lactation (임신과 수유기 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.14 no.2
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    • pp.91-98
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    • 2007
  • Objectives : Considering the impact of depressive illness on physical and mental health of both mother and fetus, specification of a treatment algorithm for depressive disorder during pregnancy is legitimated. This article provides a systemic review of treatments for depressive disorder during pregnancy and lactation. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders during pregnancy and lactation. Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using the PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Pharmacotherapy during pregnancy and lactation requires a comprehensive assessment of the risks and benefits of treatment for both mother and fetus or neonate. Recently, there is growing evidence that the use of tricyclic and selective serotonin reuptake inhibitors during pregnancy and lactation does not result in increased risks of teratogenicity. Treatment strategies are described according to the point of time of pregnancy or lactation. FDA categories for antidepressants during pregnancy and lactation are described. In addition, issues regarding to the electroconvulsive therapy and psychosocial treatment are discussed. Conclusion : The treatment option for depressive disorders during pregnancy and lactation depends on the severity of depressive illnesses of the individual patient. For mild to moderate depression, the non-pharmacological treatment should be considered first. For moderate to severe depression, pharmacotherapy should be administered in addition to the psychosocial treatment. ECT is recommended for depressive disorder of severe intensity. As the research knowledge is limited, the recommendations should based on the best judgement of psychiatrists.

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Duodenal Complication After Open Heart Surgery Report of Three cases (개심술후 발생한 십이지장궤양 합병증 -3례 보고-)

  • Heo, Jae-Park;Kim, Gi-Bong
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1251-1253
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    • 1997
  • Gastrointestinal complications, especially duodenal complication after cardiopulmonary bypass are rare, but often fatal. We experienced 1 case of duodenal ulcer bleeding and 2 cases of duodenal ulcer perforation developing after cardiopulmonary bypass from August 1994 to April 1996. In the case of duodenal ulcer bleeding, palpitation, dizziness, tachycardia and melena were the clues leading to diagnosis, and in the cases of perforation, abdominal distension with pain, tachycardia, hypotension, oliguria were the clues. Duodenal perforations were diagnosed by abdominal paracentesis. The patient with duodenal bleeding was treated by H-2 receptor antagonist, antacids and transfusion. And emergency laparotomy was required for the patients with duodenal perforation. In addition to ulcer prophylaxis including H-2 receptor antagonist and antacids, a high index of suspicion and timely surgery are necessary for early diagnosis and appropriate treatment of duodenal complication developing af er cardiopulmonary bypass.

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