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A Case of Bilateral Gynecomastia Associated with Isoniazid (Isoniazid를 포함한 항결핵약제 투여 후 발생한 여성형 유방 증례 1예)

  • Heo, Eun Young;Jeong, Ina;Lee, Jae Seok;Lee, Chang Hoon;Chung, Hee Soon;Kim, Deog Kyeom
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.4
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    • pp.308-312
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    • 2008
  • Gynecomastia is a benign enlargement of the male breast attributable to proliferation of the ductal elements. Gynecomastia has been rarely reported as an adverse effect of isoniazid therapy. We report the case of a 35-year-old man who was prescribed with isoniazid, rifampicin, ethambutol and pyrazinamide to treat pulmonary and lymphatic tuberculosis. After five months of treatment, the patient complained of painful engorgement in the bilateral breasts and the presence of male gynecomastia was confirmed with a physical examination and radiographical methods. The serum level of estradiol was also increased. Common causes of male gynecomastia were excluded through history taking and the laboratory findings. The anti-TB drugs were changed to a second line regimen due to radiographical progression and the intolerance of the patient to gynecomastia. Gynecomastia was relieved very slowly and a tender subareolar palpable mass decreased in size and consistency over five-month period after stopping the probable causative drug, isoniazid. From a review of the literature, gynecomastia has been shown to be a side effect of treatment with first line anti-tuberculosis drugs, and especially with isoniazid. We report the rare case.

Heartworm Extraction in a Pitbull Terrier Dog with Heavy Worm Burden Using A Loop Snare (심한 심장사상충 감염증에 걸린 핏불테리어 개에서 Loop Snare를 이용한 심장사상충 제거술)

  • Kim, Ji-Yoon;Yoon, Won-Kyoung;Yang, Hye-Mi;Choi, Won-Jin;Kim, Hyun-Wook;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.412-416
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    • 2014
  • A 7-year-old intact male Pitbull terrier dog was presented with complaints of marked abdominal distension and severe exercise intolerance. Diagnostic studies found a right-sided cardiomegaly with marked dilation of pulmonary arteries, diffuse interstitial pulmonary infiltration and heavy worm burden in the right atrium and ventricle. Color and spectral Doppler echocardiography also revealed tricuspid and pulmonic regurgitation indicating severe pulmonary hypertension. The 104 heartworms were removed by interventional extraction using a loop snare (Snare, Boston Scientific, USA) through external jugular vein. After heartworm removals, the clinical condition of this dog was remarkably improved. To author's best knowledge, this is the first case of interventional heartworm extraction using a loop snare in Korea.

Anti-diabetic Effect of the Methanolic Extract of Ligularia stenocephala Leaves in the Streptozotocin-induced Rat (스트렙토조토신으로 유도된 흰쥐에서 곤달비 추출물의 항당뇨 효과)

  • Choi, Jong-Won;Kim, Won-Bae;Nam, Jung-Hwan;Park, Hee-Juhn
    • Korean Journal of Plant Resources
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    • v.20 no.4
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    • pp.362-366
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    • 2007
  • The leaves of Ligularia stenocephala (Compositae) are used as a vegetable food to treat anxiety, weakness and menstrual disorder and are said to be effective against diabetic disease in Korea. This research was aimed to develop this vegetable food as a functional food to treat diabetic disease. Oral administration of MeOH extract exhibited significant hypoglycemic and hypolipidemic effects in streptozotocin (STZ)-induced diabetic rats at 100 and 200 mg/kg dose. This extract inhibited the increase of body weight, water consumption, food intake, blood glucose, lowered atherogenic index, and overcome glucose intolerance in the STZ-treated rat. These results suggest that the leaves of Ligularia stenocephala could be developed as a functional food with anti-diabetic effect.

Radiographic Diagnosis of Degenerative Joint Disease in Canine Hip Joint (개의 고관절 변성관절질환의 방사선학적 진단)

  • 엄기동;장동우;서민호;정주현;장진화;원성준;정우조;최호정;이기창
    • Journal of Veterinary Clinics
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    • v.18 no.3
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    • pp.243-248
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    • 2001
  • Radiographic findings of degenerative joint disease (DJD) in the coxofemoral joints were studied in 108 dogs referred to Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Seoul National University. Radiographic findings were identified with a extended ventrodorsal projection. Clinical signs such as pain in the affected joint, exercise intolerance, lameness, crepitation on flexion and extension of the joint and decreased range of motion, were shown in 40% and radiographic changes of bilateral coxofemoral joints were identified in 69% of a group of dogs. There are no sex predilections. Thirty-seven dogs were diagnosed as canine hip dysplasia (CHD; 10 cases), avascular necrosis of the femoral head (Legg-Calves-Perthes disease [LCPD]; 12 cases), fracture of the acetabulum (1 case), luxation(10 cases) and subluxation (15 cases), however, luxation and subluxation were identified in 11 dogs affected with CHD and LCPD. Causes of DJD in others (71case) were not identified. Radio-graphic findings identified included osteophyte formation at the attachment of the joint capsule (70%), sclerosis of the subchondral bone of the cranial acetabular edge (47%), remodeling of the femoral head (34%), thickening of the femoral neck(31%), perichondral osteophyte formation (31%), joint laxity (30%) and so on. All of the dogs diagnosed as CHD were large breed such as Retriever, Germain Shepherd, and Weimaraner and their age was under 1 year. This condition occurred bilaterally in 70% of affected animals. Dogs diagnosed as LCPD were young (under 1 year), small breed dogs. The incidence of LCPD is greater in Yorkshire Terrier, Miniature Pinscher and Poodle. This condition occurred unilaterally in 67% of affected animals. Clinical signs of dogs with unknown cause were shown in 15% and this condition occurred bilaterally in 75% of affected animals. Radiographic findings varied with patient's age and breed, however, the most common finding was osteophyte formation at the attachment of the joint capsule.

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Trilogy of Fallot in a Dog (개에서 발생한 팔로삼징)

  • Choi, Ran;Ahn, Hyo-Jin;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.29 no.5
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    • pp.404-407
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    • 2012
  • A 3 years-old female mixed dog (weighing 5.3 kg) was referred to veterinary teaching hospital of Kangwon National University with primary complaints of syncope, severe exercise intolerance, depression and lethargy. Diagnostic studies revealed polycythemia, right sided cardiac enlargement on thoracic radiography and right-to left atrial septal defect, severe pulmonary stenosis (~5 m/s of peak velocity) and right ventricular hypertrophy. Based on diagnostic findings, the dog was diagnosed as trilogy of Fallot. To improve clinical condition of this dog, diltiazem and enalapril were prescribed with weekly phlebotomy. To author's best knowledge, this is the first case of trilogy of Fallot in Korea.

Rate-Responsive Permanent Pacemaker Implantation in a Pekingese Dog with a Sick Sinus Syndrome (동방결절 기능 부전군을 가진 페키니즈 종의 개에 대한 심장 박동수 반응형 영구 심장 박동기의 장착)

  • Han, Dong-Hyun;Choi, Ran;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.569-572
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    • 2010
  • A 4-year-old neutered female Pekingese dog (weighing 3.6 kg) was referred with the primary complaint of exercise intolerance with occasional syncope. Physical examination revealed irregularly irregular heart rhythm with persistent pulse deficits. The 12-lead surface ECG showed a marked sinus arrest with occasional junctional escape beats, indicating a sick sinus syndrome. Permanent transvenous cardiac pacing with a rate-responsive bipolar implantable pacemaker (VVIR type) was performed in the right ventricle. After pacemaker implantation, the clinical signs were remarkably improved. No further syncopal episodes have yet been occurred after implantation.

Cardiac Lymphoma in a Shih Tzu Dog (씨츄 개에서 발생한 심장 림프종)

  • Kim, Tae-Young;Joo, Jeong-Hoon;Hyun, Changbaig
    • Journal of Veterinary Clinics
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    • v.30 no.3
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    • pp.196-200
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    • 2013
  • A 7 years-old intact female dog (4.8 kg) was referred with primary complaints of enlarged surface lymph nodes, cardiac murmur, coughing and exercise intolerance. Diagnostic imaging studies found cardiomegaly with distended caudal vena cava, marked left ventricular and interventrciular septal thickening and flattening, severe aortic and pulmonic stenosis (~5 m/s), and mitral and tricuspid regurgitation (~4 m/s). Cytology for the samples obtained from submandibular lymph node and left ventricle revealed high grade malignant lymphoma. The case was diagnosed as cardiac lymphoma. The dog was treated with prednisolone (2 mg/kg, PO, q24h), lomustine (80 $mg/m^2$ PO, q3wk), diltiazem (1 mg/kg, PO, q12h) and enalalpril (0.5 mg/kg, PO, q12h). The clinical signs were improved after therapy. The dog is still on the chemotherapy and regularly checked up.

Clinical and autonomic characteristics in patients with postural tachycardia syndrome (기립빈맥증후군 환자의 임상적 및 자율신경 특성)

  • Kim, Duk Ju;Kang, Sa-Yoon;Kim, Joong Goo
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.96-100
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    • 2019
  • Postural tachycardia syndrome (POTS) is common, although not so well-known variant of cardiovascular autonomic disorder characterized by an excessive heart rate increase on standing. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology. This study aimed to evaluate the clinical and autonomic features in patients with POTS. We reviewed the medical records of patients with POTS. Medical records include onset age, sex, presenting symptoms, body mass index (BMI) and prognosis. All patients had an autonomic function and laboratory tests. Ninety-nine patients met the inclusion criteria for POTS (51.5% male; mean±SD age, 20.0±9.7 years; mean±SD, BMI 21.9±3.9). Common presenting symptoms were a brief loss of consciousness, dizziness, blurred vision and headache. Autonomic function tests showed abnormal quantitative sudomotor axon reflex testing in 20 patients of 99 POTS patients. The abnormal post-ganglionic sympathetic sudomotor function is generally considered to reflect a neuropathic form of POTS. In treatments, 83 patients were treated by non-pharmacological management including lifestyle changes and 16 patients required the initiation of pharmacological therapies. Most patients with POTS showed a relatively favorable prognosis. POTS is a chronic disease with a substantial subset of patients recovering within a few years after the initial presentation. Future efforts should focus on better understanding of POTS pathophysiology and designing randomized controlled trials for the selection of more effective therapy.

A Case of Bromocriptine Resistant Hyperprolactinemia Which was Responsive to Pergolide (Pergolide에 반응한 Bromocriptine 저항성 고프로락틴혈증 1례)

  • Nam, Y.S.;Han, S.Y.;Choi, D.H.;Yoon, T.K.;Cha, K.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.287-291
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    • 1999
  • Dopamine agonists are commonly used in the medical treatment of prolactinomas. Bromocriptine has been the most widely used ergot derivative for two decades. Its oral administration, at a daily dose of $2.5{\sim}7.5mg$, restored normal gonadal function and normoprolactinemia in about 80% of patients. Nevertheless, a subset of patients could not achieve normal prolactin levels or resume normal gonadal function despite $15{\sim}30mg$/day bromocriptine for at least 6 months. Subsequently, these prolactinomas were consedered to be resistant to bromocriptine. The percentage of bromocriptine - resistant prolactinoma patients reported in the literature varies between 5 and 17% according to the series. Patients with bromocriptine resistance or bromocriptine intolerance have, however, been treated with other dopamine agonists, such as lysuride, pergolide, cabergoline, or quinagolide. Until cabergoline recently gained a product licence in the UK, there was no alternative dopamine agonist with a licence for this purpose. Quinagolide (CV $205{\sim}502$, Norprolac, Sandoz) is a nonergot dopamine agonist with improved selectivity for the D2 receptor, designed to retain the active pharmacophore of bromocriptine without the ergot moiety that might be responsible for side - effects. We have experienced a case of bromocriptine resistant hyperprolactinemia which was reponsive to pergolide. So we report this case with a brief review of literatures.

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A Study on Nursing Diagnoses and Nursing Intervention Classification -focused on Home Health Care Clients- (간호진단과 중재분류에 관한 조사연구 -가정 간호 대상자를 중심으로-)

  • 김조자;최애규;김기란;송희영
    • Journal of Korean Academy of Nursing
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    • v.29 no.1
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    • pp.72-83
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    • 1999
  • The purpose of this study was to classify, from collected home health care records data, nursing diagnoses according to the NANDA system and nursing interventions according to the NIC system, and to link nursing interventions to nursing diagnoses. For this study, 101 home health care records of clients seen between September, 1994 and November, 1996 at Yonsei Medical Center, Seoul, were analyzed. The results of this study are summarized as follows : 1. The most frequent nursing diagnoses were ‘Risk for infection’ and ‘Altered nutrition : Less than body requirements’, then ‘Impaired skin intergrity’ and ‘Ineffective airway clearance’ in the Exchange pattern of NANDA nine human response patterns. 2. The most frequent nursing interventions were the interventions in the Physiological : Complex domain, there were 690(50.7%) interventions among a total 1347 interventions. This results corresponds to Yom, Young Hee(1995)’s research, both Korean and U.S. nurses used the interventions in the Physiological : Complex do main most often on a daily basis. And respiratory nursing interventions were most frequent because 32.7% of the subjects were respiratory patients. 3. The next step was to link the nursing interventions to nursing diagnoses. The most frequent nursing diagnosis was ‘Risk for infection’ and 19 interventions for ‘Risk for infection’ were used 267 times. Then 14 interventions for ‘Impaired skin integrity’ were used 258 times, 12 interventions for ‘Ineffrective airway clearance’ were used 193 times, 12 interventions for ‘Altered nutrition : Less than body requirements’ were used 122 times, 10 interventions for ‘Activity intolerance’ were used 75 times, and 11 interventions for ‘Knowledge deficit’ were used 52 times. 4. The use of standardized classification in the areas of nursing diagnoses and nursing interventions facilitates clinical decision making and prompt nursing activity, and so enhances the effectiveness of nursing care.

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