• Title/Summary/Keyword: Supportive therapy

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A Case of Acute Hydrogen Sulfide Intoxication Caused Rapid Loss of Consciousness (급속한 의식 변화를 초래한 급성 황화수소 중독 1례)

  • Ahn, Jung-Hwan;Jung, Yoon-Seok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.147-150
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    • 2004
  • Hydrogen sulfide is a colorless, and malodorous 'rotten eggs' gas that results from the decay of organic material. It is a byproduct of industry and agriculture. The mechanism of its toxicity is primarily related to inhibition of oxidative phosphorylation, which causes a decrease in available cellular energy. Because there is no rapid method of detection that is of clinical diagnostic use, management decisions must be made based on history, clinical presentation, and diagnostic tests that imply hydrogen sulfide's presence. Although there is some anecdotal evidence to suggest that the early use of hyperbaric oxygen is beneficial, supportive care remains the mainstay of therapy. We describe an occupational exposure to hydrogen sulfide gas in 51-year-old man. While cleaning the sewage of pigs. he became unconscious. When he arrived in the emergency department, he had irritability and confused mentality. The typical smell of rotten eggs on clothing and exhaled air were enough to be considered to be exposed to hydrogen sulfide. Hyperbaric oxygen therapy was performed. He had a recovery to normal function.

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Severe dapsone hypersensitivity syndrome in a child

  • Choi, So Yoon;Hwang, Ho Yeon;Lee, Jung Hyun;Park, Jae Sun;Jang, Min Soo
    • Clinical and Experimental Pediatrics
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    • v.56 no.6
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    • pp.260-264
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    • 2013
  • Dapsone (4,4'-diaminodiphenylsulfone, DDS), a potent anti-inflammatory agent, is widely used in the treatment of leprosy and several chronic inflammatory skin diseases. Dapsone therapy rarely results in development of dapsone hypersensitivity syndrome, which is characterized by fever, hepatitis, generalized exfoliative dermatitis, and lymphadenopathy. Here, we describe the case of an 11-year-old Korean boy who initially presented with high fever, a morbilliform skin rash, generalized lymphadenopathy, hepatosplenomegaly, and leukopenia after 6 weeks of dapsone intake. Subsequently, he exhibited cholecystitis, gingivitis, colitis, sepsis, aseptic meningitis, disseminated intravascular coagulation, syndrome of inappropriate antidiuretic hormone secretion, pneumonia, pleural effusions, peritonitis, bronchiectatic changes, exfoliative dermatitis, and acute renal failure. After 2 months of supportive therapy, and prednisolone and antibiotic administration, most of the systemic symptoms resolved, with the exception of exfoliative dermatitis and erythema, which ameliorated over the following 4 months. Agranulocytosis, atypical lymphocytosis, aseptic meningitis, and bronchiectatic changes along with prolonged systemic symptoms with exfoliative dermatitis were the most peculiar features of the present case.

The Effectiveness of Occlusal Splint for the Treatment of Temporomandibular Joint Dislocation

  • Lim, Hyun-Dae;Lee, You-Mee;Kang, Jin-Kyu
    • Journal of Oral Medicine and Pain
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    • v.39 no.4
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    • pp.152-155
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    • 2014
  • Temporomandibular joint (TMJ) dislocation is defined that the disc-condyle complex is positioned anterior to the articular eminence in the open mouth position, and is unable to return to a normal closed mouth position without a manipulative maneuver. TMJ dislocation can recur habitually and result several problems to patients such as discomfort, pain, fear, and anxiety. The only definitive treatment for TMJ dislocation is surgical alteration of the joint itself. In most cases, however, a surgical procedure is far too aggressive for the symptoms experienced by the patient. In addition, the effect of surgical treatment may be insufficient, and the recurrence have been reported. It is also possible to develop several complications after surgical treatment. Therefore much effort should be directed at supportive therapy in an attempt to eliminate the disorder or at least reduce the symptom to tolerable levels. Through this cases the authors present favorable treatment outcome using occlusal splint with the patient of TMJ dislocation. Occlusal splint therapy can be considered as easy, safe, and useful non-invasive modality to treatment of TMJ dislocation.

SQUAMOUS CELL CARCINOMA WITH APLASTIC ANEMIA PATIENT (재생불량성 빈혈 환자의 편평상피세포암)

  • Lee, Kye-Young;Lee, Ju-Hyun;Min, Kyong-In;Kim, Chul-Whan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.1
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    • pp.65-68
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    • 2001
  • The major manifestations of aplastic anemia are characterized by persistent bone marrow aplasia and peripheral pancytopenia due to defective stem cells in which differentiation is not curtailed or preferential elimination of stem cells with self-renewal capacity, which results in serious complications such as bleeding and infection. Recent advances in the therapeutic modalities, such as bone marrow transplantation and immunosuppressive therapy, and in supportive measures as component transfusion and infection control with better quality of antibiotics resulted in an improved survival and subsequently increased possibility of complications which need surgical intervention. Considering the fact that surgery may not only control complications, but offers the opportunity to give effective therapy for aplastic anemia and therefore improves chances for survival, it is strongly suggested that active surgical intervention should be performed. We report a case of patient with aplastic anemia who had been performed surgical intervention of partial maxillectomy for the squamous cell carcinoma on maxilla without serious complications during perioperative and postoperative period.

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Development and Evaluation of the Psychosocial Distress Nursing Intervention for Patients with Gynecological Cancer (디스트레스 간호중재가 부인암 환자의 디스트레스, 면역 및 삶의 질에 미치는 효과)

  • Park, Jeong-Sook;Oh, Yun-Jung
    • Korean Journal of Adult Nursing
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    • v.24 no.3
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    • pp.219-231
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    • 2012
  • Purpose: The purpose of this research was to develop and evaluate a distress nursing intervention for relieving psychosocial distress. Methods: We developed a twelve-week non-pharmacological distress nursing intervention to decrease distress. This intervention includes cognitive behavioral therapy, mindfulness based stress reduction, psychoeducation and supportive therapy. The participants were 27 gynecologic cancer patients who agreed to participate in this study, selected by convenience sampling (experimental group-17 and control group-10). The data collection period was performed from November, 8, 2010 to February, 1, 2011. Data were analyzed by using the SPSS/WIN 18.0 program. Results: There were no difference between the two groups distress score, distress problem and quality of life. The experimental group had significant higher IL-12 and IFN-${\gamma}$ and lower TGF-${\beta}$ between before and after the distress nursing intervention. Conclusion: The findings indicate that the distress nursing intervention was an effective intervention in improving immunologic function of gynecological cancer patients.

A Case of Multiple Sclerosis with Depression (우울증상을 동반한 다발성 경화증 재발 환자의 치험 1례)

  • Heo, Eun-Jung;Kim, Ji-Hyon;Yoon, Chang-Jun;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.217-227
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    • 2009
  • Objectives : Multiple sclerosis (MS) is a demyelination disease of central nervous system, presenting a various neurological disorders depending on the lesion. In the view of oriental medicine, MS is similar to Flaccidity-syndrome(痿證). Also, since MS is a chronic disease which repeats the recurrences with periods of remission of the symptoms in between, it may usually be accompanied by depression. However, the etiology, treatment, and cause of recurrence of MS remain unknown, and also, as the recurrences of MS have been repeated, disease burden has been accumulated, which aggravates disorder. This case of MS experienced depression after the patient had been diagnosed as bad consequence based on the past 5 times recurrences of multiple sclerosis. Methods : We saw the causes as vicera and bowels functional disorder which might have come from a poor diet. Thus, we diagnosed this case as dual deficiency of spleen and kidney(脾腎兩虛), stagnant qi transforming into fire(氣鬱化火) and liver-kidney deficiency(肝腎不足) and treated it with Herb medication, acupuncture therapy, and supportive therapy, making the patient better. Results : We have improved the patient's condition to the time before 5th recurrence. Conclusions : This result suggests that our oriental medical treatments was effective on multiple sclerosis with depression.

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A case of fatal malabsorption syndrome caused by strongyloidiasis complicated with isosporiasis and human cytomegalovirus infection (분선충, Isospora 및 인형세포거대바이러스에 감염된 흡수불량 증후군 1례)

  • 윤동헌;양승지
    • Parasites, Hosts and Diseases
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    • v.30 no.1
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    • pp.53-58
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    • 1992
  • This 54-year-old Korean coal miner soBered from continuous watery diarrhea and weight loss after corticosteroid treatment(${\beta}-methasone$, 4 mg daily for 1 week) due to hip-bone fracture in January 1991. Except for the short therapy f steroid, no other histories were contributory. The malabsorption syndrome was aggravated while the case was treated under the impression of amebiasis or intestinal tuberculosis. AIDS antibody test by EIA was negative and quantitative analysis of serum immunoglobulins was in normal ranges. Nine months after the onset of symptoms, the case was diagnosed as malabsorption syndrome caused by complected and aggravated infection by Strengyleides stercoralis, Isospora and cytomegalovirus in the small intestine, which were proved by stool examination and duodenal biopsy. His clinical course became worse even after high-dosaged and prolonged albendazole treatment for strongyloidiasis with supportive quid therapy. The patient was discharged in hopeless status in November, 1991 and died after one week at home.

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A Case of Hemoperfusion and L-Carnitine Management in Valproic Acid Overdose (혈액관류 요법과 함께 L-카르니틴을 투여한 valproic acid 중독 환자 1례)

  • Jung Jin Hee;Kim Gi Beom;Ahn Ki Ok;Eo Eun Kyung
    • Journal of The Korean Society of Clinical Toxicology
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    • v.3 no.2
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    • pp.126-129
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    • 2005
  • Valproic acid (VPA) is used in the management of a variety of conditions including simple and complex absence seizure disorder. bipolar disorder, and migraine prophylaxis. Clinical manifestation of VPA overdose vary in severity from mild confusion and lethargy to severe coma and death. The treatment of VPA toxicity is mainly supportive. There is no specific antidote, nor are there specific guidelines for the management of VPA intoxication. Anecdotal reports describe the efficacy of naloxone and L-carnitine, but the data are insufficient to make strong conclusions. Various techniques of extracoporeal therapy for the management of VPA toxicity have been described, but none has prevailed as standard therapy. We report a patient with VPA overdose who was successfully treated with hemoperfusion with activated charcoal and L-carnitine. VPA levels of the patient was more than 1,000 ${\mu}g$/ml and was normalized after 3 times hemoperfusion. The patient was injected with L-carnitine by maximum 600 mg/kg/day for 5days without complications.

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Acute Organophosphorus Pesticide Poisoning (급성 유기인계 농약 중독)

  • Lee, Mi-Jin;Park, Joon-Seok;Hong, Tai-Yong;Park, Sung-Soo;You, Yeon-Ho
    • Journal of The Korean Society of Clinical Toxicology
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    • v.6 no.2
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    • pp.83-90
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    • 2008
  • Organophosphate (OP) pesticides are the most common source of human toxicity globally, causing high mortality and morbidity despite the availability of atropine as a specific antidote and oximes to reactivate acetylcholinesterase. The primary toxicity mechanism is inhibition of acetylcholinesterase (AchE), resulting in accumulation of the neurotransmitter, acetylcholine, and abnormal stimulation of acetylcholine receptors. Thus, the symptoms (muscarinic, nicotinic, and central nervous system) result from cholinergic overactivity because of AchE inhibition. OP can also cause rhabdomyolysis, pancreatitis, parotitis, and hepatitis. OP therapy includes decontamination, supportive therapy, and the use of specific antidotes such as atropine and oximes. However, there has been a paucity of controlled trials in humans. Here we evaluated the literature for advances in therapeutic strategies for acute OP poisoning over the last 10 years.

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Evaluating the Efficacy of Pharmacological Therapy for Prader-Willi Syndrome: A Systematic Review and Meta-analysis

  • Alim Yoo;Sohyeon Park;Heeyoung Lee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.336-351
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    • 2022
  • Background: Prader-Willi Syndrome (PWS) is a rare genetic disorder. To improve the health deterioration of PWS, investigating optimal treatment options for PWS is required. Thus, we aimed to evaluate the efficacy of pharmacotherapies compared with supportive care or placebos in patients with PWS. Methods: PubMed and EMBASE databases were used to search for randomized controlled trials (RCTs) evaluating the efficacy of pharmacotherapy in PWS patients. Only RCTs that evaluating the efficacy of pharmacotherapy in PWS patients were retrieved. Results: A total of 26 studies were included to evaluate body composition, hormones, glucose levels and hyperphagia behavioral status. Pharmacological treatment group showed a significant decrease of body fat (mean difference (MD): -6.32, 95% confidence interval (CI): -10.58 to -2.06, p=0.004), a significant increase of lean body mass (LBM) (MD: 1.86, 95% CI: 1.43 to 2.30, p<0.00001) and insulin-like growth factor 1 (IGF-1) levels (MD: 241.62, 95% CI: 68.59 to 414.64, p=0.006) compared with the control group. Nevertheless, based on other outcomes evaluated by the current systematic review, pharmacological options showed different efficacy in treating PWS. Conclusion: Pharmacological therapies were effective to decrease significantly in body fat and increase significantly on LBM and IGF-1 levels in patients with PWS. However, still, individualized therapies should be considered in real-world practice in PWS treatment.