• Title/Summary/Keyword: multiple medications

Search Result 85, Processing Time 0.025 seconds

Caplan's Syndrome Presenting as Multiple Pulmonary Nodules (다발성 폐결절로 발견된 카플란증후군 1예)

  • Lee, Sang-Kook;Lee, Sang-Hoon;Kim, Song-Yee;Lee, Woo-Kyung;Shin, Dong-Ho;Bang, Woo-Dae;Noh, Song-Mi;Shim, Hyo-Sup;Park, Byung-Hoon;Lee, Kyung-Jong;Park, Moo-Suk;Kim, Young-Sam;Chang, Joon;Kim, Se-Kyu;Kang, Young-Ae
    • Tuberculosis and Respiratory Diseases
    • /
    • v.70 no.2
    • /
    • pp.150-154
    • /
    • 2011
  • We report a case of Caplan's Syndrome, which presented as multiple pulmonary nodules. A 58-year-old male was admitted to hospital due to multiple pulmonary nodules. In addition, the patient presented with multiple arthritis, and dyspnea on exertion. Rheumatoid arthritis had been diagnosed 35 years ago. The patient had worked as a stonemason for 20 years. Computed Tomography (CT) revealed numerous well-defined tiny nodules scattered in both lungs, which was suspicious of miliary tuberculosis or malignancy. The patient was started on antituberculous medications and referred to our hospital. First, a transbronchial lung biopsy was performed, which showed no evidence of granuloma. It was our opinion that the biopsy was insufficient, and a follow-up video-associated thoracoscopy was performed. The pathological report determined necrotizing granulomatous inflammation and silicosis on background. According to imaging studies, pathologic reports, and clinical symptoms, we concluded that the patient had Caplan's syndrome. We controlled his rheumatic medications, and instructed him to avoid exposure to hazardous dust.

Massive hemothorax after central venous catheter insertion in a patient with multiple trauma

  • Park, Jeong Heon;Song, Jaegyok;Oh, Pyeong-wha
    • Journal of Dental Anesthesia and Pain Medicine
    • /
    • v.21 no.1
    • /
    • pp.81-85
    • /
    • 2021
  • Central venous catheter (CVC) insertion is commonly used in the operating room and intensive care unit to monitor central venous pressure and secure an intravenous route to deliver medications and nutritional support that cannot be safely infused into peripheral veins. However, CVC insertion may be associated with serious complications such as arterial puncture, hematoma, pneumothorax, hemothorax, catheter infections, and thrombosis. Several methods have been recommended to prevent these complications. Here we report a case of massive hemothorax caused by attempts of CVC insertion into the internal jugular vein and subclavian vein in a patient with multiple trauma. CVC placement should be performed or supervised by an experienced physician to decrease the incidence of CVC-related complications. CVC insertion under ultrasound guidance is recommended.

Pleiotropic Effects of Caffeine Leading to Chromosome Instability and Cytotoxicity in Eukaryotic Microorganisms

  • Chung, Woo-Hyun
    • Journal of Microbiology and Biotechnology
    • /
    • v.31 no.2
    • /
    • pp.171-180
    • /
    • 2021
  • Caffeine, a methylxanthine analog of purine bases, is a compound that is largely consumed in beverages and medications for psychoactive and diuretic effects and plays many beneficial roles in neuronal stimulation and enhancement of anti-tumor immune responses by blocking adenosine receptors in higher organisms. In single-cell eukaryotes, however, caffeine somehow impairs cellular fitness by compromising cell wall integrity, inhibiting target of rapamycin (TOR) signaling and growth, and overriding cell cycle arrest caused by DNA damage. Among its multiple inhibitory targets, caffeine specifically interacts with phosphatidylinositol 3-kinase (PI3K)-related kinases causing radiosensitization and cytotoxicity via specialized intermediate molecules. Caffeine potentiates the lethality of cells in conjunction with several other stressors such as oxidants, irradiation, and various toxic compounds through largely unknown mechanisms. In this review, recent findings on caffeine effects and cellular detoxification schemes are highlighted and discussed with an emphasis on the inhibitory interactions between caffeine and its multiple targets in eukaryotic microorganisms such as budding and fission yeasts.

Polypharmacy in Patients Discharged from Oncology Department (종양내과 퇴원 환자의 다제병용 분석)

  • Bae, Hyunjin;Hahn, Jimin;Lee, Yong Hwa;Kim, Hyangsook;Lee, Hye Suk;Lee, Se-Hoon;Heo, Dae Seog;Lee, Juyeun
    • Korean Journal of Clinical Pharmacy
    • /
    • v.23 no.1
    • /
    • pp.42-48
    • /
    • 2013
  • Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.

The Factors Affecting Health Promoting Lifestyle in Patients with Pulmonary Tuberculosis (폐결핵 환자의 건강증진 생활양식과 그 영향 요인)

  • Chon, Mi-Young;Ryu, Eunjung
    • Korean Journal of Adult Nursing
    • /
    • v.16 no.4
    • /
    • pp.575-584
    • /
    • 2004
  • Purpose: To describe the performance in the health-promoting lifestyle and to identify the major factors affecting the health-promoting relationships between self care behaviors and health promoting lifestyle profile in patients with pulmonary tuberculosis. Method: A convenience sample for this study was 172 pulmonary tuberculosis patients who have taken TB medications in urban city. The HPLP-II was selected to measure the concept of health-promoting lifestyle because of the number of research studies conducted using both the original HPLP and the revised HPLP-II. The statistical methods used in this study were t-test, ANOVA, Pearson correlations, and multiple regression. Result: The differences of the HPLP-II were found to have a significance of age, marital status, education level, and health service center. The level of self care behaviors was related positively to the level of health promoting lifestyle and their subcategories. Based on stepwise multiple regression analysis, the model that predicted factors included self care behaviors, age, health service center and education. Conclusion: After decades of decreasing rates, TB has reemerged as a serious national problem in Korea. The careful clinical management and more national concern of TB may help to improve the outcomes of many patients. The findings of this study suggest that TB patients who are more fulfilled in health-promoting lifestyles and self-care behaviors may be able to make better decisions regarding positive health-promoting behaviors.

  • PDF

Combination & Augmentation Strategies in the Treatment of Depressive Disorder (우울증 치료에 있어서 약물의 Combination과 Augmentation 전략)

  • Kim, Hyeong-Seob
    • Korean Journal of Biological Psychiatry
    • /
    • v.7 no.2
    • /
    • pp.131-139
    • /
    • 2000
  • Even the pharmacotherapy is more effective than placebo for the treatment of depression, the outcome of pharmacoltherapy remains unsatisfactory for many patients. Apart from side effects, there are two major limitations of antidepressant therapy. One is the delayed onset of improvement and another is partial response. In order to address these clinical dilemmas, many psychiatrists more commonly employ add-on therapy. In past, the practice of using multiple drugs to enhance treatment response was called polypharamcy, and was disparaged as poor clinical practice. However, with improved understanding of how drugs affects the central nervous system and increased communication in journals and on computer networks about the relative merits of specific combinations, the scientific basis for the combining drugs is being defined. Indeed, the use of multiple medications as a stratege to enhance response has become both acceptable and widespread now a days. It is now referred to more positively as add-on therapy, co-medication, combination therapy, or drug augmentation. Thus, as the methods of practical strategies for treatment of depression, switching classes antidepressant drugs, combination therapy, augmentation strategies and brief treatment algorithm will be presented with items of considerations. However, when combination of drugs being tried, knowledges about the action of mechanism, pharamcokinetics, and pharmacodynamics are essential to cope with the possible adversive reactions and to get the appropriate responses for the treatment of depressive symptoms.

  • PDF

Beneficial and adverse effects of toad venom, a traditional Oriental medicine

  • Xie Jing-Tian;Maleckar Spring A.;Yuan Chun-Su
    • Advances in Traditional Medicine
    • /
    • v.2 no.1
    • /
    • pp.28-35
    • /
    • 2002
  • Toad venom, 'Chan su' in Chinese and 'somso' in Korean, is a well-known traditional oriental medicine obtained from the skin venom gland of the toad. Formulations of toad venom have been widely applied in China, Japan, Korea and other oriental countries for a long time. It is often found in traditional Chinese formulations, such as Jiuxin (or Kyushin in Japan), Yixin, Huoxin, Shexiang baoxin wan, Lu shen wan and Laryngitis pills. According to a pharmaceutical chemistry study, toad venom contains multiple biological active substances, such as bufalin, resibufogenin and cinobufagin. Modern pharmacological studies indicated that toad venom has multiple pharmacological actions, including acting as a cardiotonic, antitumor local anesthetic effects, stimulates the respiratory center, vasopressor action, anti-inflammatory and diuretic effects. Like other medications, toad venom also has certain toxicity and adverse effects, for example, inducing delayed afterdepolarization and triggered arrhythmia. The major chemical constituents, basic pharmacological actions and adverse reactions of toad venom are discussed in this article.

Multiple Cervical Spinous Process Fractures in a Novice Golf Player

  • Kim, Sei-Yoon;Chung, Sang Ki;Kim, Dong-Yun
    • Journal of Korean Neurosurgical Society
    • /
    • v.52 no.6
    • /
    • pp.570-573
    • /
    • 2012
  • Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.

Clinical implications of the Hippo-YAP pathway in multiple cancer contexts

  • Kim, Han-Byul;Myung, Seung-Jae
    • BMB Reports
    • /
    • v.51 no.3
    • /
    • pp.119-125
    • /
    • 2018
  • The Hippo pathway plays prominent and widespread roles in various forms of human carcinogenesis. Specifically, the Yes-associated protein (YAP), a downstream effector of the Hippo pathway, can lead to excessive cell proliferation and the inhibition of apoptosis, resulting in tumorigenesis. It was reported that the YAP is strongly elevated in multiple types of human malignancies such as breast, lung, small intestine, colon, and liver cancers. Recent work indicates that, surprisingly, Hippo signaling components' (SAV1, MST1/2, Lats1/2) mutations are virtually absent in human cancer, rendering this signaling an unlikely candidate to explain the vigorous activation of the YAP in most, if not all human tumors and an activated YAP promotes the resistance to RAF-, MAPK/ERK Kinase (MEK)-, and Epidermal growth factor receptor (EGFR)-targeted inhibitor therapy. The analysis of YAP expressions can facilitate the identification of patients who respond better to an anti-cancer drug treatment comprising RAF-, MEK-, and EGFR-targeted inhibitors. The prominence of YAP for those aspects of cancer biology denotes that these factors are ideal targets for the development of anti-cancer medications. Therefore, our report strongly indicates that the YAP is of potential prognostic utility and druggability in various human cancers.

A Case Study of Soeumin Greater Yin Symptomatology Patient Diagnosed as Cerebellar Ataxia (소음인 태음증으로 진단한 소뇌성 운동실조 환자 1례)

  • Park, Yu-Gyeong;Lee, Mi-Suk;Bae, Na-Young
    • Journal of Sasang Constitutional Medicine
    • /
    • v.26 no.2
    • /
    • pp.194-204
    • /
    • 2014
  • Objectives The aim of this study was to examine significant improvement of gait ataxia, vertigo and tremor after treatment with Sipyimigwanjung-tang, Hyangsayangwi-tang in a Soeumin Greater Yin Symptomatology patient Diagnosed as Cerebellar ataxia. Methods The patient was diagnosed with Soeumin Greater Yin Symptomatology and treated with Soeumin's constitutional medications and acupuncture. The primary outcome measures for this study were the Unified Multiple System Atrophy Rating Scale(UMSARS) and Cerebellar function test to assess the overall function of patient. Secondary outcome assessment included Global Assessment Scale(GAS), change of patient's sleep, stool and digestion. Results The symptoms of gait ataxia, vertigo and tremor decreased from GAS 100 to GAS 0~40 after treatment, and the UMSARS score decreased in Part I, II. Conclusions This case showed that Sasang Constitutional medicine treatment can be effective treatment method for cerebellar ataxia. We consider that consistent treatment can contribute to improve the patient's quality of life.