• Title/Summary/Keyword: Discontinuation

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The Study of Pullout-Behavior Characteristics of The Ground Anchor Using Expanded Hole (확공을 이용한 지압형 앵커의 인발거동 특성 연구)

  • Min, Kyong-Nam;Jung, Chan-Mook;Jung, Dae-Ho
    • Proceedings of the KSR Conference
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    • 2011.05a
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    • pp.1502-1508
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    • 2011
  • Ground anchor expands the hollow wall of settled part and has the structure which resists the designed tensile load by the bearing pressure generated by the wedge of the anchor body pressing in the expanded part. Such ground anchor has been recognized for stability and economicality since 1960s in technologically advanced nations such as Japan and Europe, and in 1970s, the Japan Society of Soil Engineering has established and announced the anchor concept map. The ground anchor introduced in Korea, however, has the structural problem where the tensile strength is comes only from the ground frictional force due to expansion of the wedge body. In an interval where the ground strength is locally reduced due to fault, discontinuation or such, this is pointed out as a critical weakness where the anchor body of around 1.0m must resist the tensile load. Also, in the installation of concrete block, the concentrated stress of concrete block constructed on the uneven rock surface causes damage, and many such issues in the anchor head have been reported. Thus, in this study, by using the expanded bit for precise expansion of settled part, the ground anchor system was completed so that the bearing pressure of ground anchor can be expressed as much as possible, and the bearing plate was inserted into the ground to resolve the existing issues of concrete block. Through numerical analysis and pullout test executed for verification of site applicability, the pullout-behavior characteristics of anchor was analyzed.

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A Case of Azathioprine Induced Severe Myelosuppression and Alopecia Totalis in IgA Nephropathy

  • Kim, Jae Choon;Kim, Ye Kyung;Hyun, Hye Sun;Park, Eu Jin;Kang, Hee Gyung;Ha, Il Soo;Cheong, Hae Il
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.35-39
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    • 2017
  • Azathioprine is commonly used as immunosuppressive therapy for various inflammatory diseases including chronic glomerulonephritis. Myelosuppression is a common side effect of azathioprine, resulting in the need for dose reduction. However, severe pancytopenia or alopecia is not often encountered. Here, we report a case of severe myelosuppression, and alopecia totalis that occurred after azathioprine treatment in a patient with IgA nephropathy. A 10-year-old boy with IgA nephropathy was treated with oral deflazacort and later with azathioprine. After 4 weeks, the patient complained of hair loss, and despite a dose reduction in azathioprine, he developed bone marrow suppression and alopecia totalis in two weeks. The blood indices and alopecia of the patient had returned to normal after azathioprine withdrawal and 3 consecutive doses of granulocyte colony-stimulating factor. We suggest that physicians remain vigilant to the side effects of azathioprine. Unusual hair loss after azathioprine treatment might suggest a defect in the metabolism of the drug, warranting the discontinuation of azathioprine to prevent more severe side effects.

The Development of Leveled Reading Education Support System Using Multimedia Technology for Elementary School (멀티미디어 기술을 활용한 초등학교 수준별 독서지원 시스템 개발)

  • Choi, Chang-Hun;Ma, Dai-Sung;Kim, Jeong-Rang
    • Journal of The Korean Association of Information Education
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    • v.9 no.2
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    • pp.211-219
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    • 2005
  • Several problems occur in reading education in a elementary school. They are the lack of considering the difference of student's capability and diagnosing their reading ability, the review activity focusing on only text and the discontinuation between school and home. Our system is designed and implemented to support leveled reading education using multimedia technology. We can diagnose the student's reading ability exactly and promptly and introduce suitable books considering their ability, and work the proper review activities with this system. It can help the students to interest their reading.

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Venlafaxine-Induced Acute Toxic Hepatitis (Venlafaxine에 의한 급성 독성 간염 1예)

  • Na, Kyeong-Sae;Hwang, Hee-Sung;Kim, Shin-Gyeom;Lee, So-Young-Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.18 no.3
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    • pp.159-162
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    • 2011
  • Venlafaxine is among the most widely prescribed antidepressants. It is extensively metabolized to O-desmethylvenlafaxine via cytochrome P450 (CYP) 2D6. We report a case of acute toxic hepatitis resulting from venlafaxine in a 54-year-old woman with pain disorder. During venlafaxine treatment, laboratory tests revealed elevated liver enzymes with a maximum of 169 IU/L for aspartate transaminase (AST) and 166 IU/L for alanine transaminase (ALT). AST and ALT levels returned to normal after 6 days of discontinuation of venlafaxine. The patient was finally diagnosed with acute toxic hepatitis through liver biopsy. This case indicates the importance that clinicians should be aware of the hepatotoxicity of venlafaxine in practice.

Psychotic Disorder Induced by Appetite Suppressants, Phentermine or Phendimetrazine : A Case Series Study (식욕억제제 Phentermine, Phendimetrazine으로 유발된 정신병적 장애 증례군 연구)

  • Kwak, Sookyoung;Youn, Tak;Lee, Nam Young;Chung, In Won;Kim, Se Hyun
    • Korean Journal of Biological Psychiatry
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    • v.24 no.3
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    • pp.134-141
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    • 2017
  • Objectives A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. Methods A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. Results Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. Conclusions These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.

Predicting Life Span for Terminal Colon Cancer using Clinical Symptoms (말기 대장암환자에서 중상을 통한 예후 측정 및 증상조절)

  • Lee, Do-Haeng;Choi, Youn-Seon;Hong, Myung-Ho;Kim, Jun-Suk;Lee, Kyung-Jin;Kim, Young-Soo
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.138-143
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    • 1999
  • Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

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A Case of Severe Serotonin Syndrome Induced by Fluoxetine and Sertraline (Fluoxetine 및 Sertraline으로 유도된 심한 세로토닌 증후군 1예)

  • Cheon, Jin-Sook;Lee, Sang-Shin;Kim, Sung-Hi;Cho, Woong
    • Korean Journal of Biological Psychiatry
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    • v.8 no.1
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    • pp.167-174
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    • 2001
  • A 54-year old male patient who was suffering from bipolar I disorder for 19 years and was admitted to the National Bugok Mental Hospital due to a depressive episode, was referred to the Kosin University Gospel Hospital. On arrival at the emergency room, he had confused mentality with disorientation, memory impairment, hypomania, marked anxiety and hyperirritability. The change of neuromuscular activity such as ataxia, gait disturbance, tremor, shivering, myoclonus and epileptic seizures was also shown. In addition, the symptoms and signs of autonomic instability including diaphoresis, tachycardia, hypotension, fever and facial flushing were noticed. The above symptoms developed after the administration of sertraline successive to the discontinuation of fluoxetine without any washout period. The degree of severity seemed to be severe because he had epileptic seizures, fever and hypotension. He was recovered from the severe serotonin syndrome by the supportive symptomatic treatment with sodium valproate, clonazepam, lorazepam and cyproheptadine after cessation of the selective serotonin reuptake inhibitors during hospitalization. Therefore, this rare case of severe serotonin syndrome was reported and related literatures were also reviewed.

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Three Cases of Typical Clinical Characteristics and Overview of Neuroleptic Malignant Syndrome (항정신병약물성 악성증후군에 관한 3증례 및 개관)

  • Lee, Kyung-Kyu;Kim, Hyun-Woo
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.136-145
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    • 1997
  • We are report on three cases of typical clinical characterstics and treatment response in neuroleptic maligant syndrome(NMS), and reviewed the literatures of NMS. NMS was first recognized as a life-threatening complication of dopamine receptor antagonists, and defined as a catatonic-like states associated with fever, obtundation, muscle rigidity, and unstable vital sign in patients taking neuroleptic agents. Concepts of NMS have changed because medications other than classic neuroleptic drugs have been implicated as triggering agents and syndromes identical to NMS have been observed in other conditions. The important neurochemical features are probably functional dopamine deficiency and ensuing hyperactivity of excitatory amino acid neurotransmission in the basal ganglia and hypothalamus. Recognition of NMS and early discontinuation of neuroleptics are the most important step in its management. Supportive care includes management of hyperthermia and fluid replacement. Controversial therapeutic measures include the application of dopamine receptor agonists, excitatory amino acid antagonists, or dantrolene. Psychiatric patients with a history on NMS and psychotic relapse necessitating antipsycotics do not commonly redevelop NMS.

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Psychosis in Parkinson's Disease-Treatment with 5-HT Receptor Antagonist (5-HT 수용체 길항제를 이용한 파킨슨 환자의 정신 증상의 치료)

  • Koh, Seong-Beom;Park, Kun-Woo;Lee, Dae-Hie
    • Korean Journal of Biological Psychiatry
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    • v.4 no.1
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    • pp.132-135
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    • 1997
  • Current treatment strategies for levodopa-induced psychosis in advanced Parkinson's disease have had limited success. Reduction or discontinuation of levodopa and coadministration with dopamine-blocking neuroleptics may attenuate the psychotic symptoms, but these strategies are associated with worsening of parkinsonian symptoms. Administration of 5-HT3 receptor antagonist ; ondansetron, a newer strategy to attenuate psychosis of Parkinson'disease without motor deterioration was introduced. A 41-year-old young-onset male, who was diagnosed as Parkinson's disease 7 years ago, was treated with levodopa therapy, and had levodopa-induced psychosis(delusion, hallucination, paranoid, insomnia). After trial of ondansetron, he showed improvement in the Brief Psychiatric Rating Scale(from 21 points to 9 points) in spite of increasing the dosage of levodopa. With ondansetron, we could increase the dosage of levodopa without psychotic complications(esp, hallucination), and he showed improvement in the motor fluctuation.

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Two Cases of Toxic Epidermal Necrolysis Associated with Deflazacort Therapy in Nephrotic Syndrome: Successfully Treated with Cyclosporine A

  • Lim, Myung Hee;Bae, Hee Jung;Park, Sun Young;Kim, Sae Yoon;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.20 no.2
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    • pp.97-100
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    • 2016
  • Toxic epidermal necrolysis (TEN) is a rare, acute, serious, and potentially fatal skin disease, in which cell death causes the epidermis to separate from the dermis. It is thought to be a hypersensitivity complex that affects the skin and mucous membranes, and is caused by certain medications, infections, genetic factors, underlying immunologic disease, or more rarely, cancers. We report two cases of TEN associated with deflazacort (DFZ), a derivative of prednisolone, used in the first episode of nephrotic syndrome (NS). The skin eruption appeared on the $4^{th}$ and $5^{th}$ weeks after DFZ administration, while NS was in remission. The widespread lesions were managed by intensive supportive treatment, discontinuation of DFZ, and oral administration of cyclosporine. Both patients showed a rapid improvement in symptoms of TEN without any complications or relapse of NS.