• 제목/요약/키워드: Co-existing symptoms

검색결과 16건 처리시간 0.027초

'2019 한국형 조현병 약물치료 지침서'에 따른 조현병에서 동반증상 및 부작용의 치료 (Korean Treatment Guideline on Pharmacotherapy of Co-existing Symptoms and Antipsychotics-related Side Effects in Patients with Schizophrenia)

  • 윤제연;이정석;강시현;남범우;이승재;이승환;최준호;김찬형;정영철
    • 대한조현병학회지
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    • 제22권2호
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    • pp.21-33
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    • 2019
  • Objectives: The current study covers a secondary revision of the guidelines for the pharmacotherapy of schizophrenia issued by the Korean Medication Algorithm for Schizophrenia (KMAP-SCZ) 2001, specifically for co-existing symptoms and antipsychotics-related side-effects in schizophrenia patients. Methods: An expert consensus regarding the strategies of pharmacotherapy for positive symptoms of schizophrenia, co-existing symptoms of schizophrenia, and side-effect of antipsychotics in patients with schizophrenia was retrieved by responses obtained using a 30-item questionnaire. Results: For the co-existing symptoms, agitation could be treated with oral or intramuscular injection of benzodiazepine or antipsychotics; depressive symptoms with atypical antipsychotics and adjunctive use of antidepressant; obsessive-compulsive symptoms with selective serotonin reuptake inhibitors and antipsychotics other than clozapine and olanzapine; negative symptoms with atypical antipsychotics or antidepressants; higher risk of suicide with clozapine; comorbid substance abuse with use of naltrexone or bupropion/varenicline, respectively. For the antipsychotics-related side effects, anticholinergics (extrapyramidal symptom), propranolol and benzodiazepine (akathisia), topiramate or metformin (weight gain), change of antipsychotics to aripiprazole (hyperprolactinemia and prolonged QTc) or clozapine (tardive dyskinesia) could be used. Conclusion: Updated pharmacotherapy strategies for co-existing symptoms and antipsychotics-related side effects in schizophrenia patients as presented in KMAP-SCZ 2019 could help effective clinical decision making of psychiatrists as a preferable option.

Co-occurrence of both maternally inherited neurofibromatosis type 1 and Lesch-Nyhan disease in a child with severe neurodevelopmental impairment

  • Jae Hun Yun;Yong Hee Hong;Go Hun Seo;Young-Lim Shin
    • Journal of Genetic Medicine
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    • 제19권2호
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    • pp.94-99
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    • 2022
  • Lesch-Nyhan disease (LND) is a rare X-linked recessive inherited purine metabolic disorder that accompanies neurodevelopmental problems. Neurofibromatosis type 1 (NF1) is a relatively common autosomal dominant inherited genetic disorder characterized by tumors in various systems. Some children with NF1 also accompanies neurodevelopmental problems. Here, we describe a 5-year-old boy with a maternally inherited pathogenic variant in NF1 and hypoxanthine-guanine phosphoribosyltransferase (HPRT). He was referred for severe neurodevelopmental impairment and hyperuricemia. His mother was diagnosed with NF1 and the patient was also suspected of having NF1 because of cafe au lait macules. He had dystonia, rigidity, cognitive deficit, and speech/language impairment. Serum and urine uric acid concentrations were elevated. He had more severe neurodevelopmental delay than patients with only NF1, so his clinical symptoms could not be fully understood by the disease alone. To find the cause of his neurologic symptoms and hyperuricemia, the patient and his mother underwent a whole-exome sequencing test. As a result, the pathogenic variant c.151C>T (p.Arg51Ter) in HPRT1 was identified as hemizygote in the patient and heterozygote in his mother. The pathogenic variant c.7682C>G (p.Ser2561Ter) in NF-1 was identified as heterozygotes in both of them. Although the clinical symptoms of both diseases were overlapping and complicated, genetic testing was helpful for accurate diagnosis and treatment. Therefore, we suggest to consider preemptive genetic evaluation if there are symptoms not sufficiently explained by known existing diseases. And it is considered valuable to review this rare case to understand the clinical course and possible synergic effects of these diseases.

How Should the Pyloric Submucosal Mass Coexisting with Hypertrophic Pyloric Stenosis Be Treated?: A Case of Pyloric Ectopic Pancreas with Hypertrophic Pyloric Stenosis

  • Kim, Soo-Hong;Yoo, Tae-Kyung;Kim, Hyun-Young;Jung, Sung-Eun;Park, Kwi-Won
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제17권3호
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    • pp.196-200
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    • 2014
  • Co-existing pyloric submucosal masses with hypertrophic pyloric stenosis (HPS) are very rare and treating these lesions is always a problem. A 20-day-old boy presented with recurrent episodes of projectile non-bilious vomiting lasting for 5 days. HPS was suspected due to the presenting age and the symptoms. The sonography demonstrated not only circumferential wall thickening of the pylorus, but also a pyloric submucosal mass. At laparotomy, a 0.8 cm sized pyloric submucosal mass was identified along with a hypertrophied pylorus. Pyloric excision was performed due to the possibility of sustaining the symptoms and malignancy. The pathological report of the submucosal mass was ectopic pancreas. Coexisting pyloric lesions can be diagnosed along with HPS, and surgical excision, not just pyloromyotomy, should be considered in these circumstances. To the best of our knowledge, this is the first case report of pyloric ectopic pancreas and HPS to be diagnosed concurrently.

Evaluation of virulence reversion of an attenuated porcine epidemic diarrhea vaccine strain by serial passages in suckling piglets

  • Da-Jeong Kim;Seung-Chai Kim;Hwan-Ju Kim;Gyeong-Seo Park;Sang Chul Kang;Won-Il Kim
    • 한국동물위생학회지
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    • 제46권3호
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    • pp.193-202
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    • 2023
  • Porcine epidemic diarrhea is an infectious intestinal disease caused by the porcine epidemic diarrhea virus (PEDV). Especially, when suckling piglets are infected, the mortality rate is close to 100%. PEDV is classified into G1 and G2 types based on genetic differences. The G2 type PEDV outbreak in the United States in 2013 was highly pathogenic and contagious, and it has spread worldwide and caused continuous economic losses. Most commercial vaccines used are G1 type vaccines, and existing vaccines do not fully protect piglets due to genetic differences. In this study, we evaluated the safety of the newly developed G2 type attenuated HSGP vaccine strain by inoculating it into piglets and testing whether the vaccine virus spreads to the non-vaccinated, negative pigs and whether the vaccine reverts to its virulence during serial passage experiments. Each experiment lasted for 7 days for each passage, and fecal viral titers, clinical symptoms, and weight gain were measured daily. After the experiment, necropsy was performed to measure intestinal virus titer and pathological evaluation. As a result of the first passage, no transmission of the vaccine virus to negative pigs co-housed with vaccinated pigs was observed. In addition, after four consecutive passage experiments, the clinical symptoms and small intestine lesions were gradually alleviated, and no virus was detected in the feces in the fourth passage experiment. Therefore, it was concluded that the vaccine was safe without virulence reversion in accordance with the guidelines of the current licensing authority. However, further studies are needed on the genetic changes and biological characteristics of the mutant virus that occur during successive passages of the attenuated vaccine since the replication and clinical symptoms of the virus increased until the third passage during successive passages of the vaccine virus. Based on this study, it was concluded that virulence reversion and safety evaluation of attenuated vaccines through serial passage in target animals can be useful to evaluate the safety of attenuated viruses.

뚜렛 및 만성 틱 아동의 출생순위에 따른 특성 비교 (A COMPARISON OF THE CHARACTERISTICS OF CHILDREN WITH TOURETTE AND CHRONIC TIC DISORDER ACCORDING TO THEIR BIRTH ORDERS)

  • 김자성;홍강의
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제4권1호
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    • pp.124-132
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    • 1993
  • 45명의 틱 증상을 보인 아동들의 임상적 양상을 검토하였고 형제순위별로 나눠 비교하였다. 성비는 14:1로 남자가 압도적으로 많았고 형제순위로는 맏이가 46.7%, 막내가 33.3%. 외동아 15.6%, 쌍생아 4.4%로 맏이가 많았다. 기질성 시사소견은 37.8%에서, 초기발달 이상은 71.1%, 가족관계의 이상이 89.9%에서 보였고 동반 증상들로는 주의력결핍 과잉운동장애 46.7%, 강박장애 17.7%, 격려불안은 24.4%, 범불안, 수면불안은 17.8%, 신체화 증상 및 아뇨가 각각 13.3%, 말더듬 8.9% 외에 분뇨, 우울증 등을 보여 총 84.4%에서 최소한 하나 이상의 동반된 문제를 가졌다. 형제별로 나눠 특징을 비교했을 때 발병 시기에서 현저한 차이를 보였는데 막내 유형은 입학과 연관된 시기에 발병율이 의미있게 높았다.(p<0.01) 쌍생아의 경우는 저 출생체중아가 환아였다. 이들 소견을 종합해볼 때 틱 및 뚜렛 장애의 발현에는 선천적 기질적 요인뿐 아니라 상당한 환경적인 요인이 작용한다고 보겠다.

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A Computerized Doughty Predictor Framework for Corona Virus Disease: Combined Deep Learning based Approach

  • P, Ramya;Babu S, Venkatesh
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제16권6호
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    • pp.2018-2043
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    • 2022
  • Nowadays, COVID-19 infections are influencing our daily lives which have spread globally. The major symptoms' of COVID-19 are dry cough, sore throat, and fever which in turn to critical complications like multi organs failure, acute respiratory distress syndrome, etc. Therefore, to hinder the spread of COVID-19, a Computerized Doughty Predictor Framework (CDPF) is developed to yield benefits in monitoring the progression of disease from Chest CT images which will reduce the mortality rates significantly. The proposed framework CDPF employs Convolutional Neural Network (CNN) as a feature extractor to extract the features from CT images. Subsequently, the extracted features are fed into the Adaptive Dragonfly Algorithm (ADA) to extract the most significant features which will smoothly drive the diagnosing of the COVID and Non-COVID cases with the support of Doughty Learners (DL). This paper uses the publicly available SARS-CoV-2 and Github COVID CT dataset which contains 2482 and 812 CT images with two class labels COVID+ and COVI-. The performance of CDPF is evaluated against existing state of art approaches, which shows the superiority of CDPF with the diagnosis accuracy of about 99.76%.

A Non-yeast Kefir-like Fermented Milk Development with Lactobacillus acidophilus KCNU and Lactobacillus brevis Bmb6

  • Lee, Bomee;Yong, Cheng-Chung;Yi, Hae-Chang;Kim, Saehun;Oh, Sejong
    • 한국축산식품학회지
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    • 제40권4호
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    • pp.541-550
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    • 2020
  • The use of yeast assist kefir fermentation, but also can cause food spoilage if uncontrolled. Hence, in this study, the microbial composition of an existing commercial kefir starter was modified to produce a functional starter, where Lactobacillus acidophilus KCNU and Lactobacillus brevis Bmb6 were used to replace yeast in the original starter to produce non-yeast kefir-like fermented milk. The functional starter containing L. acidophilus KCNU and L. brevis Bmb6 demonstrated excellent stability with 1010 CFU/g of total viable cells throughout the 12 weeks low-temperature storage. The newly developed functional starter also displayed a similar fermentation efficacy as the yeast-containing control starter, by completing the milk fermentation within 12 h, with a comparable total number of viable cells (108 CFU/mL) in the final products, as in control. Sensory evaluation revealed that the functional starter-fermented milk highly resembled the flavor of the control kefir, with enhanced sourness. Furthermore, oral administration of functional starter-fermented milk significantly improved the disease activity index score by preventing drastic weight-loss and further deterioration of disease symptoms in DSS-induced mice. Altogether, L. acidophilus KCNU and L. brevis Bmb6 have successfully replaced yeast in a commercial starter pack to produce a kefir-like fermented milk beverage with additional health benefits. The outcome of this study provides an insight that the specific role of yeast in the fermentation process could be replaced with suitable probiotic candidates.

이산화탄소 레이저를 이용한 모설의 치료 ($CO_2$ Laser Application for Treatment of the Hairy Tongue)

  • 정다운;조은애;안형준
    • Journal of Oral Medicine and Pain
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    • 제38권2호
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    • pp.97-101
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    • 2013
  • 모설(hairy tongue)은 혀의 사상유두(filiform papillae)가 과도하게 신장되어 발생하는 질환이다. 임상적으로 혀의 배면후방 1/3 부위에 주로 발생하며, 혀의 측면과 첨부에 생기는 경우는 드물다. 섭취하는 음식물과 색소유발 박테리아 등에 따라 백색에서 갈색, 검은색까지 다양한 색의 착색을 보인다. 대부분 증상이 없지만, 환자들은 주로 심미적인 문제로 병원을 찾으며, 드물게 오심, 구취, 미각이상, 불쾌한 느낌 등을 유발할 수 있다. 정확한 병인은 알려져 있지 않지만, 구강위생 관리 소홀, 구강 내 세균총의 변화, 감염, 방사선치료, 항생제, 면역 억제제 등의 사용, 과도한 음주, 흡연, 타액분비 감소 등이 소인으로 작용할 수 있다. 임상 소견이 매우 전형적이므로 육안으로도 진단이 충분히 가능하며, 생검은 필요하지 않다. 모설의 치료는 기본적인 유발요인들을 찾아서 제거해 주며, tongue cleaner 등을 이용해 혀를 부드럽게 닦아주도록 교육하고, 일부 경우에 있어서는 keratolytic agent를 사용하기도 한다. 모설 치료에 외과적 술식을 사용하는 경우는 드물지만, 유발 요인 제거 등의 다양한 치료법을 적용하였음에도 불구하고 장기간 호전이 없는 모설 환자에서, 이산화탄소 레이저(Carbondioxide laser, $CO_2$ laser)를 적용하여 효과적으로 치료한 증례를 보고하고자 한다.

스마트워터그리드 맞춤형 기계과부하시 오감기술을 이용한 무인 수처리 시스템에 관한 연구 (Unmanned Water Treatment System Based on Five Senses Technology to Cope with Overloading of Customized Smart Water Grid Machines)

  • 김재열;유관종;정윤수;안태형;이학재
    • 한국기계가공학회지
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    • 제16권2호
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    • pp.69-80
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    • 2017
  • In or To use, manage, and preserve sustainable water resources for the current and future generations amid the threat of abnormal climate, it is necessary to establish a smart water grid system, the next-generation intelligent water management system. In this study, sensors, which make use of the five senses to watch, listen, and detect machine vibration, bearing temperature, machine operation sounds, current, voltage, and other symptoms that cannot be verified when the irrigation facilities are running, are used to establish various decision-making criteria appropriate to on-site situations. Based on such criteria, the unmanned conditions in the facilities were verified and analyzed. Existing technologies require on-site workers to check any defects caused by overloading of machines, which is the biggest constraining factor in the application of an unmanned control system for irrigation facilities. The new technology proposed in this study, on the other hand, allows for the unmanned analysis of the existence of machine vibration. This controls the decision-making process of any defect based on the analysis results, and necessary measures are taken automatically, resulting in improved reliability of the unmanned automation.

소방공무원과 외상 후 스트레스 장애 (Firefighters and Posttraumatic Stress Disorder)

  • 류지아;하은희;정최경희;김지은;박신원;김현주
    • 생물정신의학
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    • 제24권1호
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    • pp.10-18
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    • 2017
  • Occupational hazards of firefighting and rescue works include frequent exposure to emergencies and life-threatening situations. These stressful work conditions of being constantly under pressure and exposed to potentially traumatic events put them at higher risk of developing posttraumatic stress disorder (PTSD), compared to the general population. PTSD is a potentially debilitating mental disorder, due to persistent intrusive thoughts, negative alterations of mood and cognition, hypervigilance, avoidance of similar situations and reminders, and re-experiences of the traumatic event. Previous studies have shown a relatively high prevalence of PTSD among firefighters, indicating the need for a systematic approach of early detection and prevention. Therefore, a critical review of the current literature on PTSD in firefighters would provide valuable insights into developing effective prevention and intervention programs. Literature indicated that there are risk factors of PTSD in firefighters, such as pre-existing depression, anxiety, sleep disorders, occupational stress, physical symptoms, and binge drinking, whereas social support and adequate rewards are protective factors. Although there are differences in the prevalence of PTSD across studies, partly due to various assessment tools utilized, different sample sizes, and sample characteristics, over one tenth of the firefighters were estimated to have PTSD. The current review warrants further investigations to precisely assess PTSD and co-morbid mental disorders, functional outcomes, and associated factors, and to develop evidence-based preventive and interventional programs to help firefighters with PTSD.