• Title/Summary/Keyword: initial medication

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A case of newly developed pulmonary lesion during the antitubercular agents in tuberculous pleurisy : A paradoxical response (결핵흉막염 치료중에 새로이 발생한 폐병변 1예 : 역설적 반응)

  • Park, Jee Min;Shin, Youn Ho;Chon, Gyu Rak;Shin, Hyun Joon;Choi, Young Chil
    • Clinical and Experimental Pediatrics
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    • v.52 no.6
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    • pp.717-720
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    • 2009
  • Paradoxical response refers to the enlargement of old lesions or unexpected appearance of new lesions after initial improvement following treatment with antitubercular agents. Various types of paradoxical responses have been reported in the world, but they are rarely reported in Korean children. We report the case of a 17-year-old boy who was diagnosed with tuberculous pleurisy and was treated appropriately. Although the tuberculous pleurisy initially responded to medication with resolution of the pleural fluid, a new pulmonary lesion subsequently developed 3 weeks after the initiation of treatment that eventually cleared with continuation of the original drug regimen.

Percutaneous Discectomy of Herniated Intervertebral Disc with a Dekompressor(R) (요추 추간판 탈출증에서 Dekompressor(R)를 이용한 경피적 수핵 감압술)

  • Cho, OiGyeong;Kim, Chan;Han, Kyung Ream;Lee, Hyun Ho;Cho, Hye Won
    • The Korean Journal of Pain
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    • v.18 no.2
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    • pp.192-197
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    • 2005
  • Background: Radicular pain, associated with herniated intervertebral disc, has been treated with either conservative treatments or a traditional surgical discectomy. Several modalities for minimally invasive percutaneous procedures have been developed as alternatives to a surgical discectomy. Percutaneous decompression using a $Dekompressor^{(R)}$ probe has been recently introduced. Herein, we report the outcome of percutaneous decompression with a $Dekompressor^{(R)}$ for the treatment of a herniated intervertebral disc. Methods: Between August 2004 and April 2005, percutaneous decompression was performed using a $Dekompressor^{(R)}$, 1.5-mm percutaneous lumbar discectomy probe in 17 patients with a herniated lumbar intervertebral disc resistant to conservative treatments, with the results reviewed retrospectively. The procedure was performed under fluoroscopic guidance after local anesthesia. Disc access was gained with a posterolateral approach on the symptomatic side and intradiscal placement of the discectomy probe in the herniated disc confirmed from the anteroposterior and lateral views on the fluoroscopy. Results: We obtained satisfactory clinical results in 14 patients with a decrease in the initial Visual analogue scale (VAS) of more than 55% and the elimination or reduction of analgesic medication, with a follow-up of 3 to 11 months. Conclusion: We concluded that a percutaneous discectomy with a $Dekompressor^{(R)}$ probe might be an effective alternative for the treatments of painful disc herniations resistant to conservative managements when performed under proper selection criteria.

A Preliminary Study for the Rating of Pharmacological Effect with Aberrant Behavior Checklist in Children with Autistic Disorder (자폐장애 아동의 약물효과 평정을 위한 이상행동 체크리스트 예비연구)

  • Moon, Duk-Soo;Chung, Un-Sun;Jung, Sung Hoon;Cho, Ah Rang;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.24 no.3
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    • pp.164-169
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    • 2013
  • Objectives : We assessed the availability of Aberrant Behavior Checklist (ABC) for the evaluation of the pharmacological effect in autistic disorder. Methods : A retrospective review of the medical records of 27 children with autistic disorder, who visited the department of child and adolescent psychiatry of Kyungpook National University Hospital, from October 2011 to February 2013, was conducted. After treatment with risperidone, changes in the severity and improvement of symptoms were measured using ABC at the baseline, 2nd visit and 3rd visit, respectively. Results : The mean daily dose of risperidone increased from $0.66{\pm}0.27mg$ (baseline, initial dose) to $1.02{\pm}0.50mg$, 2nd visit, and $1.19{\pm}0.50mg$, 3rd visit. According to ABC, irritability, lethargy, hyperactivity, and inappropriate speech subscale scores decreased significantly from the baseline to 2nd visit. Irritability and Hyperactivity subscale scores decreased significantly from the 2nd to 3rd visit. All subscales and total scores of ABC decreased significantly from the baseline to 3rd visit. Conclusion : The results of this study suggest that ABC can be used as an efficient tool to measure the symptoms of autistic disorder and to evaluate the medication effect on continuous treatment.

A Case Study of Taeumin Patient with Gastro-esophageal reflux disease(GERD) who Treated Successfully with Yeoldahanso-tang(Reduohanshao-tang) (열다한소탕(熱多寒少湯)으로 호전된 역류성 식도염 환자 1례)

  • Kim, Yun-Hee;Kim, So-Yeon;Hwang, Min-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.1
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    • pp.132-138
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    • 2011
  • 1. Objectives: This case study reports a Taeumin patient with Gastro-esophageal reflux disease who had suffered from chest pain, heartburn, acid regurgitation and dyspepsia who improved after Yeoldahanso-tang(Reduohanshao-tang) medication. 2. Methods: This patient had started treatment with Yeoldahanso-tang(Reduohanshao-tang), three times per day for three months and assessed the changes of the main symptoms such as chest pain, heartburn and acid regurgitation from baseline to post-treatment using a questionnaire with visual analogue scale(VAS). Electrogastrography(EGG) was also performed for assessment of gastric function from baseline to post-treatment. 3. Results: After the treatment, symptoms of GERD such as chest pain, heartburn, and acid regurgitation are almost disappeared. The patient don't need to take the proton pump inhibitor therapy. There was significant increase of % bradygastria parameters in fed EEG after treatment with Yeoldahansotang(Reduohanshao-tang). And significant increase of the power ratio after treatment was shown (20.5), compared with initial EGG(0.0). 4. Conclusions: This results show Yeoldahanso-tang(Reduohanshao-tang) can be used to treat GERD with Dry-heat symptom of Taeumin. This results suggest that Sasang Constitutional treatment for GERD patients who has a chronic condition with highly recurrence rate, might be a candidate for a therapeutic agent. Also effects of Yeoldahanso-tang(Reduohanshaotang) on GERD need further studies such as clinical trials.

Effects of Extruded and Extruded-Pelleted Corn Products Partially Substituted for Unprocessed Corn of the Starter Diet on Growth Performance and Incidence of Diarrhea in Weanling Pigs

  • Park, Byung-Chul;Han, Jeong-Cheol;Ko, Young-Hyun;Ha, Duck-Min;Kim, Doo-Hwan;Jang, Insurk;Lee, C. Young
    • Journal of Animal Science and Technology
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    • v.55 no.2
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    • pp.109-113
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    • 2013
  • The aim of the present study was to investigate the effects of partial substitution of an extruded or extruded-pelleted corn product for unprocessed corn of the starter diet on growth performance and incidence of diarrhea in weanling pigs. Seventy-two 21-day-old weanling pigs were allotted to 24 pens and provided ad libitum with one of the four experimental diets for 3 wk in two serial feeding trials during summer beginning from late June. The treatments were a milk product-soy-corn-based control diet containing 25% unprocessed corn and the other three diets only substituted with 12.5% extruded corn Suprex$^{(R)}$, Optigrain$^{(R)}$, an extruded mixture of wheat, rye and durum, or extruded-pelleted corn for an equal percentage of unprocessed corn of the control diet. All diets were supplemented with 100 ppm sulfathiazone, 50 ppm penicillin, and 100 ppm chlortetracycline for preventive medication. The initial and final weights as well as gain : feed were less in the second trial than in the first one (P<0.05). However, effects of the dietary treatments were not detected in any of the performance variables including final weight, ADG, ADFI, and gain : feed, nor were there any interactions between the trial and dietary treatment. In addition, almost all pigs exhibited normal firm feces in both trials and therefore there was no main effect in the fecal consistency score. Results suggest that partial substitution of the thermally processed corn for unprocessed corn of the milk product-corn-soy-based and medicated starter diet has no effect on growth performance or incidence of diarrhea in weanling pigs.

Effects of Hoehn-Yahr Scale on the Activation of Lower-Extremity Muscles during Walking with Parkinson's Patients (파킨슨 환자들의 질병등급척도가 보행 시 하지의 근육활동에 미치는 영향)

  • Kim, Chang-Hwan;Kim, Mi-Young;Moon, Je-Heon;Lim, Bee-Oh
    • Korean Journal of Applied Biomechanics
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    • v.24 no.3
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    • pp.287-293
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    • 2014
  • The purpose of this study was to investigate the effects of Hoehn-Yahr scale on the activation of lower-extremity muscles during walking. Electromyography (EMG) analysis was carried out on 36 patients with Parkinson's disease in the off phase of the medication cycle. We recorded EMG signals of the tibialis anterior (TA), medial gastrocnemius (MG), lateral gastrocnemius (LG), soleus (SOL), rectus femoris (RF), vastus lateralis (VL), semitendinosus (ST) and biceps femoris (BF) using Noraxon 16 channels EMG system during walking at preferred speed. Rectified EMG signals were normalized to reference voluntary contractions (RVC) over a gait cycle at the preferred speed, allowing for an assessment of how the activity was distributed over the gait cycle. Compared to the H & Y Scale 1, H & Y Scale 3 exhibited greater activation of the vastus lateralis during mid-stance and greater activation of the medial gastrocnemius during terminal swing. Compared to the H & Y Scale 1, H & Y Scale 2 and 3 exhibited less activation of the tibialis anterior during initial swing. We conclude that the more Hoen & Yahr Scale increase, the more abnormal lower-extremity muscles activation.

Postthyroidectomy Hypocalcemia (갑상선수술후의 저칼슘혈증)

  • Choi Daeh-Wa;Kim Kyu-Yul;Ko Byung-Kyun;Nam Chang-Woo;Yu Hwa-Kyung;Cho Hong-Rae
    • Korean Journal of Head & Neck Oncology
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    • v.15 no.1
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    • pp.52-60
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    • 1999
  • Objectives: For investigation of the differentiation between transient and permanent hypocalcemia, we focused on a postoperative calcium requirement and an interval of normalization in serum hypocalcemic level and studied for the causes of postoperative hypocalcemia. Material and Method: Postthyroidectomy hypocalcemia was studied in 193 patients who were admitted from January, 1991 to December, 1998 and underwent lobectomy, subtotal thyroidectomy or total thyroidectomy. We compared postoperative serum calcium, phosphate and ionized calcium levels among three groups which were lobectomy, subtotal thyroidectomy and total thyroidectomy, respectively. Result: All patients revealed postoperative decline in serum calcium and ionized calcium, especially, the lowest serum calcium level was seen in 48 hours after surgery. Serum calcium level was returned to normal in five to six postoperative days in most patients. But 24 patients required calcium supplementation due to symptomatic hypocalcemia. In this series, we discovered that the important period for monitoring of serum calcium level was 24 to 96 hours after surgery. If the calcium replacement therapy was not required in the first 72 hours after surgery, it would not be needed during the remainder of the patient's hospital course. Symptomatic transient hypocalcemia was 22 cases(11.4%) and permanent hypocalcemia was 2 cases(1%). Conclusion : We found that hypoalbuminemia, preoperative hyperthyroidism and impairment of blood supply to parathyroid were the main causes of postthyroidectomy hypocalcemia. We also thought that the interval from initial medication to normalization in serum calcium level, and the increase of requirement in calcium and vitamin D were the important factors for differentiation between transient and permanent hypocalcemia.

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The Literature Review of FibroMyalgia Syndrome (섬유근통 증후군에 대한 문헌고찰)

  • Kim Myung-Chul;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.23-37
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    • 2004
  • Fibromyalgia syndrome(FMS) is a chronic pain disorder of unknown etiology characterized by widespread musculoskeletal aches and pains, stiffness, and general fatigue, disturbed sleep and sleepiness. Frequently misdiagnosed, FMS is often confused with myofascial pain syndrome, polymyalgia rheumatica, polymyositis, hypothyroidism, metastatic carcinoma, rheumatoid arthritis (RA), juvenile rheumatoid arthritis, chronic fatigue syndrome, or systemic lupus erythematosus, any of which may occur concomitantly with FMS. The management of FMS often begins with a thorough examination and a diagnosis from a physician who is formally trained in tender-point/trigger-point recognition. An initial diagnosis provides reassurance to the patient and often reduces the anxiety and depression patterns associated with FMS. The most common goals in the management of FMS are (1) to break the pain cycle, (2) to restore sleep patterns, and (3) to increase functional activity levels. Because FMS is a multifactorial syndrome, it is likely that the best treatment will encompass multiple strategies. Medication with analgesics and antidepressants and also physiotherapy, are often prescribed and give some relief. The other most effective intervention for long-term management of FS to date is physical exercise. Physical therapists can instruct patients in the use of heat at home (moist hot packs, heating pads, whirlpools, warm showers or baths, and hot pads) to increase local blood flow and to decrease muscle spasm and tension. Also instruct patients in the proper use of cold modalities (ice packs, ice massage, and cool baths) to anesthetize localized areas of pain (tender points) and break the pain cycle. Massage and tender-point massage also may promote muscle relaxation. To date, the two most important interventions for the long-term management of FS are patient education and physical exercise. Lately, is handling FMS and Chronic Fatigue syndrome(CFS) together, becuase FMS and CFS are poorly understood disorders that share similar demographic and clinical characteristics. Because of the clinical similarities between both disorders it was suggested that they share a common pathophysiological mechanism, namely, central nervous system dysfunction.

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Sinoatrial Reentrant Tachycardia in a Yorkshire Cross Dog (요크셔테리어 잡종견에서 나타난 동방회귀성 빈맥증)

  • Nam, So-Jeong;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.391-395
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    • 2008
  • An 8-year-old intact male Yorkshire cross dog (7.5 kg of body weight) was referred with the primary complaint of exercise intolerance and occasional syncope. Initial cardiological examination could not identify any abnormalities except mild mitral regurgitation. Exercise stress test revealed chronotrophic incompetence. Furthermore the 1 hr-digital event recording found the sudden onset of paroxysmal sinus tachycaridas (156-172 bpm) lasting few minutes and stopping abruptly. In addition, the tachycardia terminated by vagal maneuver and verapamil administration. Based on this finding, the case was diagnosed as sinoatrial reentrant tachycardia (SART). The dog was treated with diltiazem and enalapril. Although the dog still has exercise intolerance, no syncope has been observed after medication.

Obese Patients Who Lost Weight and Improved Glycemic Control Through Walking Exercise (걷기 운동으로 체중감량 및 혈당 호전을 보인 비만 환자)

  • Kim, Yang-Hyun
    • Archives of Obesity and Metabolism
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    • v.1 no.2
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    • pp.74-77
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    • 2022
  • Treatment of obesity includes diet therapy, exercise therapy, cognitive behavioral therapy, drug therapy, and bariatric surgery. Most obese patients lose weight by combining diet, exercise, cognitive behavioral therapy or medication. But, in some cases, only one of these treatments is preferred. A 56-year-old male patient had a body mass index (BMI) of 33.1 kg/m2 and a waist circumference of 108 cm. He had been treated for hypertension; diabetes and dyslipidemia were diagnosed but not treated. However, at the initial visit to treat obesity, he was diagnosed with type 2 diabetes mellitus and dyslipidemia again. So he decided to treat these two diseases with drugs first and modify his lifestyle. He started walking more than 20,000 steps every day and then he really walked about 15,000 steps every day during 5 months, although diet calorie or alcohol drinking amount was not significantly decreased. After about 6 months, the patient's weight decreased by 10.1 kg, the BMI decreased by 4.1 kg/m2, the waist circumference decreased by 10 cm, the glycated hemoglobin (HbA1c) decreased by 4.59%, the visceral fat area decreased by 115 cm2, and the subcutaneous fat decreased by 38 cm2. As a result of body composition analysis, muscle mass increased by 1.2 kg, and the percentage of body fat decreased by 10.4%. The walking exercise does not have any space restrictions and has high accessibility by using a mobile phone app. Therefore, considering the patient's situation, it would be better to treat obese patients by first recommending walking exercises and increasing the number of steps to lose weight and improve the comorbidities.