• 제목/요약/키워드: Atypical symptoms

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폐결핵환자에서 비정형항산균의 분리, 동정 및 약제감수성에 관하여 (Studies on Identification and Drug Resistance of Atypical Mycobacteria isolated from Patients with Pulmonary Tuberculosis)

  • 정동현;김성광;김주덕
    • Journal of Yeungnam Medical Science
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    • 제1권1호
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    • pp.49-58
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    • 1984
  • 폐결핵 환자의 객담으로 부터 비정형항산균의 배균여부를 규명하기 위하여 세균학적 시험 및 임상적 조사를 시행하여 다음과 같은 결론을 얻었다. 1. 객담 334예에서 항산균 103주 (30.8%)를 분리 배양하였다. 2. 분리배양된 항산균주에서 비정형항산균으로 감별된 균주는 10주(9.7%)이며 인형결핵균주는 93주(90.3%)이였다. 3. 감별된 비저형항산균주는 Runyon군별로는 암착색균군, 광비발색균군이 각각 3주 (30.0%)씩이며 신속발육균군이 4주(40.0%)였으며 광발색균군은 분리되지 않았다. 4. 생물학석 성상 및 생화학적 특성시험 양상에 의해 암착색균군 3주 중 2주는 Mycobacterium scrofulaceum, 1주는 Mycobacterium szulgai로, 광비발색균 3주 중 2주는 Mycobacterium avium complex, 1주는 Mycobacterium terrae로 동정되였으며, 신속발육균주 4주중 3주는 Mycobacterium fortuitum, 1주는 Mycobacterium chelonei로 등정되었다. 5. 항결핵제에 대한 시험관내 약제감수성검사에서 INH, SM에서는 10주가 전부 내성을 나타내었으며, EB, TH, 및 CS의 저농도인 10mcg, 50mcg, 및 40mcg에서 완전내성을 나타내었다. 그리고 EB, TH, 및 RFP의 고농도인 20mcg, 및 100mcg,에서 감수성을 나타내었다. 6. 비정형항산균이 배균된 환자의 X-선소견 및 임상적 소견 조사에서는 인형결핵균 감성으로 인한 폐결핵 환자의 증상에 비해 경하지 않는 것으로 사료되었으며 장기간 항결핵제의 투여치로 되어 왔으나 대부분 호전되지 않았다.

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양극성장애에 대한 Valproic Acid와 Olanzapine 치료 중 발생한 호산구증가증과 전신증상을 동반한 약물발진(DRESS) 증후군 1예 (A Case of Drug Rash with Eosinophilia and Systemic Symptoms Associated with Valproic Acid and Olanzapine Treatment in Patient with Bipolar Disorder)

  • 이웅;임세원
    • 생물정신의학
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    • 제24권3호
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    • pp.162-166
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    • 2017
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening, medication-induced hypersensitivity reaction with long latency. It is characterized by fever, rash, leukocytosis with eosinophilia, atypical lymphocytosis, and internal organ involvement. The most common causes of DRESS syndrome are sulfonamides and anticonvulsants such as carbamazepine and lamotrigine. However, valproic acid and olanzapine could develop DRESS syndrome. We report a case of DRESS syndrome associated with valproic acid and olanzapine in a 41 years old male patient with bipolar disorder.

Glomus Tumor Causing Anterior Thigh Pain: A Case Report

  • So, Sang Young;Kim, Byng Mook;Lee, Sun Yeul;Ko, Young Kwon;Shin, Yong Sup;Lee, Won Hyung
    • The Korean Journal of Pain
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    • 제27권2호
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    • pp.174-177
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    • 2014
  • Glomus tumors are a rare, benign neoplasm and 75% exist in the subungual region. Extradigital glomus tumors are much more difficult to diagnose because of their atypical location and symptoms. Furthermore, if their symptoms are similar to neuropathic pain, the patient can suffer from misdirected treatment due to misdiagnosis. It is essential to perform careful evaluation of the lesion itself in order to reduce misdiagnosis. Ultrasonography is a useful, non-invasive method that can be easily performed in the pain clinic for local evaluation and diagnosis. We report a case of misdiagnosed glomus tumor in the thigh which was properly diagnosed after ultrasonography.

조현병 환자의 입원 치료시 약물처방 경향의 변화 : 일 대학병원에서 1996~2000년과 2006~2010년의 차이 비교 (Psychotropic Prescription Patterns for Inpatients with Schizophrenia : 10-Year Comparison in a University-Affiliated Hospital in South Korea)

  • 황인환;김대호;오대영
    • 생물정신의학
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    • 제21권2호
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    • pp.49-56
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    • 2014
  • Objectives Previous literature on the prescription change among patients with schizophrenia mainly focused on antipsychotics. This study investigated chronological change in the patterns of discharge medication among inpatients with schizophrenia at a psychiatric inpatient unit of a university-affiliated hospital. Methods All admission records at a psychiatric unit of Hanyang University Guri Hospital with discharge diagnosis of schizophrenia during two different five-year time frames (1996-2000 and 2006-2010) were reviewed including the demographic and clinical data and discharge medications. The data were gathered from a total of 207 patients (95 in 1990s and 112 in 2000s). Results The frequency in use of atypical antipsychotics (p < 0.01), antidepressants (p < 0.05), beta-blockers (p < 0.01), and benzodiazepine (p < 0.01) was significantly higher in 2000s. Anticholinergic drugs were less likely used in 2000s (p < 0.01). We did not find significant differences in the equivalent dose of antipsychotic drugs, the use of mood stabilizers and cholinergic drugs between two time frames. Conclusions Increased proportion of atypical antipsychotics and decreased use of anti-parkinsonian drugs are in line with literature. Our results show that more diverse classes of psychotic medications are used for schizophrenia in recent years. It is likely that psychiatrists are becoming more conscious of negative symptoms, anxiety, and depression in the pharmacotherapy of schizophrenia as well as positive symptoms of the illness.

Bilateral foot drop caused by T12 infectious spondylitis after vertebroplasty: a case report

  • Kim, Dong Hwan;Shin, Yong Beom;Ha, Mahnjeong;Kim, Byung Chul;Han, In Ho;Nam, Kyoung Hyup
    • Journal of Trauma and Injury
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    • 제35권1호
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    • pp.56-60
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    • 2022
  • The most common cause of foot drop is lumbar degenerative disc herniation, particularly at L4/5. We present a rare case of spinal cord injury accompanied by a thoracolumbar lesion that presented with bilateral foot drop. A 69-year-old male patient presented with sudden-onset severe bilateral leg pain and bilateral foot drop. Radiologic findings revealed T12 spondylitis compressing the conus medullaris. He had undergone vertebroplasty for a T12 compression fracture after a fall 6 months before. A physical examination showed bilateral foot drop, paresthesia of both L5 dermatomes, increased deep tendon reflex, and a positive Babinski sign. An acute bilateral L5 root lesion and a conus medullaris lesion were suspected based on electromyography. A surgical procedure was done for decompression and reconstruction. After the operation, bilateral lower extremity muscle strength recovered to a good grade from the trace grade, and the patient could walk without a cane. The current case is a very rare report of bilateral foot drop associated with T12 infectious spondylitis after vertebroplasty. It is essential to keep in mind that lesions of the thoracolumbar junction can cause atypical neurological symptoms. Furthermore, understanding the conus medullaris and nerve root anatomy at the T12-L1 level will be helpful for treating patients with atypical neurological symptoms.

The Clinical Feature of Reflux Esophagitis Patients Visiting a Single Korean Medicine Hospital: A Retrospective Study

  • Lee, Ga-young;Choi, Tae-joon;Lee, Nam-hun;Choi, Seo-hyung
    • 대한한방내과학회지
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    • 제42권6호
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    • pp.1245-1254
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    • 2021
  • Objectives: This study investigated the clinical characteristics and symptoms of patients with reflux esophagitis (RE) visiting a Korean medicine hospital. Methods: We retrospectively reviewed the medical records of patients with an RE diagnosis who visited a Korean medicine hospital from June 15, 2020, to April 15, 2021. We analyzed the clinical characteristics and the results of a symptoms questionnaire. Results: Our sample included 1,151 patients (711 females). The median age was 58 years; the most common age bracket was 60-69 years. A total of 837 patients (72.7%) presented with symptoms lasting more than one year, and 1,035 (89.9%) had been prescribed medications for more than three months before visiting a Korean medicine hospital. Belching (77.6%) and acid regurgitation (70.9%) were the most frequent symptoms, followed by epigastric pain (61.6%) and throat globus (58.5%). Throat globus was the most bothersome symptom, and 72.4% of the patients experienced the symptom on more than five days in the preceding two weeks. Patients with a longer symptom duration were older (p<0.01) and more likely to be overweight (p=0.03). Patients experiencing symptoms for more than five years were more likely to report throat globus (p=0.02), hoarseness (p<0.01), and coughing (p<0.01). Conclusions: Most RE patients visiting a Korean medicine hospital were females in their sixties with chronic and refractory RE. Atypical symptoms (belching, epigastric pain, and throat globus) were common. Throat globus was highly prevalent in severe cases, suggesting that it warrants attention when treating RE patients.

Intradural Extramedullary and Subcutaneous Tumors in Neonate : Atypical Myxoid Spindle Cell Neoplasm

  • Yu, Dong-Woo;Choi, Joon-Hyuk;Lee, Eun-Sil;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제52권4호
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    • pp.417-419
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    • 2012
  • Tumors of the central nervous system are common in the pediatric population and constitute the second most prevalent tumor type in children. Within this group, spinal cord tumors are relatively rare and account for 1 to 10% of all pediatric central nervous system tumors. We describe a very rare case of an intradural extramedullary spinal cord tumor with a subcutaneous mass and discuss its clinical presentation, pathogenesis, and treatment. A male infant was delivered normally, with uneventful development. At 16 days post-delivery, his family took him to a pediatrician because of a mass on his upper back. Magnetic resonance imaging of the thoracic spine revealed a well-demarcated soft-tissue mass with central cystic change or necrosis at the subcutaneous layer of the posterior back (T2-7 level). Another mass was found with a fat component at the spinal canal of the T1-3 level, which was intradural extramedullary space. After six weeks, the spinal cord tumor and subcutaneous mass were grossly total resected; pathologic findings indicated an atypical myxoid spindle cell neoplasm, possibly nerve sheath in type. The final diagnosis of the mass was an atypical myxoid spindle cell neoplasm. The postoperative course was uneventful, and the patient was discharged after nine days without any neurological deficit. We report a rare case of an intradural extramedullary spinal tumor with subcutaneous mass in a neonate. It is necessary to monitor the patient's status by examining consecutive radiologic images, and the symptoms and neurological changes should be observed strictly during long-term follow-up.

올란자핀의 체중증가 부작용 발생율 및 체중변화량 (Incidence and Severity of Weight Gain Associated with the Use of Olanzapine for the Treatment of Schizophrenia)

  • 이경희;스리니바산샨무감;렌가라잔바스카란;산토쉬쿠마르나가야스리라만;용철순;최한곤;우종수;유봉규
    • 약학회지
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    • 제52권4호
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    • pp.288-292
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    • 2008
  • Olanzapine, an atypical antipsychotic, has been widely used for the treatment of schizophrenia and bipolar disease. Although olanzapine is less associated with extrapyramidal symptoms and neuroleptic malignant syndrome compared to existing typical antipsychotics, the use of this drug has a problematic side effect of weight gain, which may cause metabolic syndrome such as type 2 diabetes. However, there are few hospitals practicing body weight monitoring of the patients on olanzapine or other atypical antipsychotics. The goal of this study was to identify the incidence and severity of weight gain associated with the use of the drug in Korea. We performed body weight monitoring of the patients who were on the drug in a hospital setting. Mean of the weight gain (as of one-month-transformation) was 4.33 and 3.39 kg for the male and female patients, respectively. The incidence in the young patients was higher than that observed in the old patients, and the severity was the highest in patients in their thirties followed by twenties or younger. This result suggests that the pattern of the weight gain associated with the use of olanzapine in Korea is similar to the reports performed and documented in US and European countries. Therefore, it appears that healthcare professionals in Korea should also watch on the weight gain issue in patients who are on olanzapine or other atypical antipsychotics.

Glyphosate 음독의 임상양상 (Atypical Clinical Course of after Glyphosate Herbicide Intoxication)

  • 김용원;김현;차경철;신형진;차용성;이강현;황성오
    • 대한임상독성학회지
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    • 제9권1호
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    • pp.8-13
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    • 2011
  • Purpose: Although glyphosate-surfactant herbicide intoxication is relatively mild toxic in humans, we encountered an atypical clinical presentation. We performed this study to understand the atypical clinical course and factors associated with severe intoxication after glyphosate ingestion. Methods: We conducted a retrospective study of 61 patients (male 43, mean age $54{\pm}18.8$ years) who were presented with glyphosate ingestion between March 1997 and March 2011. The severe intoxication group was defined as patients with systolic blood pressure less than 90 mmHg, respiratory distress needing intubation, or altered mental state. Results: Of the 61 patients, 22 patients (36.1%) had a severe clinical course, 1 patient (1.6%) had died and 1 patient (1.6%) had moribund discharge. The most common symptoms were nausea with or without vomiting which occurred in 30 patients (49.2%). Twenty-seven patients had metabolic acidosis that was the second most common medical complication. Advanced age, pH, base excess, $HCO_3$, Sat, creatinine, X-ray abnormalities and ECG abnormalities were significant factors. Hemoglobin, platelet, $pO_2$, $pCO_2$, BUN, sodium, potassium and AST levels were not different comparing the laboratory characteristics between the severe and mild intoxication groups. Conclusion: The results of this study showed that severe intoxication occurred in 22 patients (36.1%) after glyphosate intoxication. Advanced age, pH, base excess, $HCO_3$, Sat, creatinine, X-ray abnormality and ECG abnormalities were significant predictive factors for severe intoxication in patients with glyphosate surfactant herbicide poisoning.

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비전형적인 모양과 위치를 보이는 상의하세포종: 2개의 증례 보고 (Atypical Appearance and Location of Subependymomas: A Report of Two Cases)

  • 이지현;김은수;이열;이관섭;권미정;송준호
    • 대한영상의학회지
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    • 제79권5호
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    • pp.294-301
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    • 2018
  • 상의하세포종은 드문 중추신경계 종양으로 두개내 발생하는 종양의 0.7%를 차지한다. 두개내 상의하세포종은 위치에 따라 특징적인 MR 소견을 보여주는데 가끔 비전형적인 소견도 존재할 수 있다. 또한 매우 드물게는 척수내에 발생하기도 한다. 우리는 각각 뇌실내 위치에도 불구하고 비전형적인 소견을 보인 경우와 드물게 척수 내에 나타난 상의하세포종의 경우, 두 가지 조직학적으로 확진된 상의하세포종 증례를 소개하고 그 임상적 증상과 영상학적 소견에 대해 고찰하려고 한다.