• Title/Summary/Keyword: 임상 경과

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Clinical Study of Cataract Surgery in Diabetic Retinopathy (당뇨망막증 환자의 백내장 수술에 대한 임상적 고찰)

  • Park, Young-Hoon
    • Journal of Yeungnam Medical Science
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    • v.11 no.1
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    • pp.153-159
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    • 1994
  • Extracapsular cataract extraction with posterior chamber intraocular lens in 24 eyes of 24 diabetics, with and without diabetic retinopathy, were followed up postoperatively for an average of 14 months to determine the incidence of progression of diabetic retinopathy, the final visual acuity and factors predictive of progression of retinopathy and final visual acuity. Overall, retinopathy progressed in 52% of operated-on eyes. Cataract extraction was highly associated with progression of diabetic retinopathy. Women had a significantly increased risk of progression of retinopathy in the operated-on eye compared to men. Visual acuity improved in 22 of 24 orerated-on eyes : however, only 11 eyes achieved a visual acuity of 0.5 or better and only 7 eyes achieved a visual acuity of 0.7 or better. Patients treated with oral hypoglycemic agents had a worse visual prognosis than those treated with insulin. The prognosis of patients with diabetic retinopathy about to undergo cataract surgery, even extracapsular cataract extraction with placement of a posterior chamber lens, is guarded.

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Pseudo Continuous Arterial Spin Labeling MR Imaging of Status Epilepticus (간질중첩증의 동맥 스핀 라벨링 자기공명영상)

  • Yi, Min-Kyung;Choi, Seung-Hong;Jung, Keun-Hwa;Yoon, Tae-Jin;Kim, Ji-Hoon;Sohn, Chul-Ho;Chang, Kee-Hyun
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.142-151
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    • 2012
  • Purpose : The purpose of this study was to describe arterial spin labeling MR image findings of status epilepticus. Materials and Methods: A retrospective chart review within our institute revealed six patients who had been clinically diagnosed as status epilepticus and had also undergone MR imaging that included ASL in addition to routine sequences. Results: Six patients with status epilepticus were studied by conventional MR and arterial spin labeling imaging. All patients showed increased regional CBF correlating with EEG pathology. Notably, in two patients, conventional MRI and DWI showed no abnormal findings whereas pCASL demonstrated regional increased CBF in both patients. Conclusion: Arterial spin labeling might offer additional diagnostic capabilities in the evaluation of patients with status epilepticus.

Mesenchymal Chondrosarcoma - 3 Cases Report - (간엽성 연골육종 - 3례 보고 -)

  • Gu, Mi-Jin;Bae, Young-Kyong;Choi, Joon-Hyuk;Kim, Mi-Jin;Choi, Won-Hee;Shin, Duk-Seop;Suh, Jang-Soo
    • Journal of Yeungnam Medical Science
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    • v.17 no.1
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    • pp.87-92
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    • 2000
  • Mesenchymal chondrosarcoma is a rare malignant tumor of skeletal and extraskeletal origin, and which shows aggressive local behavior as well as a high metastatic potential. We report 3 cases of mesenchymal chondrosarcoma. Two cases were male and one was female. Their ages ranged from 25 to 32 years(mean: 28 years). Tissue was obtained by wide excision in two patients. and by incisional biopsy in one. The mass was located in the rib(case 1), orbital floor(case 2), and abdominal wall(case 3). Roentgenographically, the tumor resembles ordinary chondrosarcoma, showing osteolytic and obstructive appearance with stippled calcification. Grossly, the tumor was lobulating, solid fish-fleshy like mass with calcification and ossification. Histologically, the tumor shows characteristic bimorphic pattern composed of islands of well differentiated hyaline cartilage admixed with a cellular area of undifferentiated small cells. The small cells usually displayed a hemangiopericytoid or an alveolar pattern.

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Conservative Treatment for Injured Anterior Cruciate Ligament - Two Cases Report - (손상된 전방십자인대의 보존적 치료 - 증례 보고 -)

  • Jung Young Bok;Tae Suk Ki;Yum Jae Kwang;Kim Jin Soo
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.112-115
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    • 1997
  • While the cruciate ligament has a profuse vascular response following injury, spontaneous repair does not occur. This may result from the fact that synovial fluid dilution of the hematoma following injury prevents the formation of a fibrin clot and thus the initiation of the healing mechanism. Another theory suggests that the dynamic nature of the fascicles of the anterior cruciate ligament(ACL) through even small ranges of motion prohibits spontaneous union to these fibers. But we experienced two cases of spontaneous healing of partially injured ACL. Initially they showed more than grade II anterior instability. 6 mm difference by stress roentgenographs(pull view) and difference of 8 mm by KT 1000TM arthrometer between the ACL injured knee and normal side knee. Lax, nearly complete tear of ACL and synovial bleeding were noted during arthroscopic examination but the continuity of synovial membrane was seemed to be intact. These cases were treated by conservative management rather than reconstructive procedure. Postoperatively they showed excellent clinical results, no anterior instability and unlimited athletic activity. Based on our clinical experience. we think that cruciate ligament has the spontaneous healing potential in acute stage and middle aged patient. We consider the microfracture technique and initial immobilization for accelleration of healing response of the ACL.

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Clinical Study in 17cases of patients for sinusitis(treated with aroma-therapy) (향기요법(香氣療法)을 병행(幷行)한 소아비연(小兒鼻淵) 환자(患者) 17예(例)에 대한 임상적(臨床的) 연구(硏究))

  • Han Jae-Kyung;Kim Yun-Hee;Kim Yeon-Jin
    • The Journal of Pediatrics of Korean Medicine
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    • v.14 no.2
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    • pp.105-120
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    • 2000
  • Clinical studies were done treated with aroma-therapy in 17cases of patients for suffering sinusitis, who were treated at Dept. of Pediatrics in the Hospital of Daejon from March 2000 to November 2000. The results were as follows. 1. In distribution of sex & age, 70.6% was men and 29.4% women. 47.1% was between 5 and 7 years old, 35.3% within 5 years old. 2. In distribution of the period of the clinical history, 35.3% was over 6 momths, 29.4% of them between 6 and 12 months. 3. In the living environment the apartment was 58.5% and the residental zone is 29.4%. 4. The incurrence of season is winter, 47.0% next is change of season, 29.4%. 5. At night the symptom is the most common, 52.9%. In the morning is the next, 35.3%. 6. In the past history. tinnitus was the best at 38.4%. The otitis media. atopic dermatitis, convulsion disease is next at 15.4%. 7. In the family history. the allergic rhinitis or sinusitis is the most rich at 38.4% and tinnitus is next at 23.0%. 8. In distribution of the chief complain companied with sinusitis, 23.3% was nasal obstruction, each 18.4% of them nasal discharge, cough. 9. In distribution of the duration of therapy, 29.4% was over 6 months, 23.5% between 5-6 months. In distribution of the therapeutic method, 47.1% was treated with western and oriental medicine and 42.1% only oriental medical care. 10. In distribution of the period of improvement of symptom(by X-ray reading), 35.2% was between 2-3 momths, 29.4% between 1-2 months. 11. In emotional change, after aroma-therapy, 82.4% of them felt good. 12. After treatment, 70.6% was excellent, 17.6% was good.

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Review of Korean Clinical Studies on Treatment for Childhood Obesity (소아비만의 치료에 대한 국내 임상연구 동향)

  • Kim, Kyoung Ri;Han, Jae Kyoung;Kim, Yun Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.30 no.3
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    • pp.108-120
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    • 2016
  • Objectives The purpose of this study is to investigate Korean clinical studies on treatment of childhood obesity and to propose for better treatment options for childhood obesity. Methods Based on RISS, KISS, OASIS, KMbase with the keyword 'childhood obesity', 'child obesity', 'obese child', 'overweight child', total of 21 randomized controlled trials (RCTs), 11 single clinical studies, 3 chart reviews and 3 case reports have been found, and were analyzed. Results and Conclusion 1. Some study subjects were classified based on their sex - only men or women in a group or sometimes both. Another way of classify the study subjects were based on their age - preschooler, primary school students, middle school students, and high school students. The diagnostic criteria of the subjects were BMI (body mass index), Body fat percentage, Obesity index, Weight and unknown criteria. 2. The treatments used in 38 studies were exercise alone, education alone, both exercise and education or herbal therapy. The 7 studies that used herbal therapy as part of their study intervention had a study group with herbal intervention only and the other 2 study group with herbal treatment in addition to exercise and education. 3. 9 studies included herb medicines, electroacupuncture, auricular acupuncture, cupping, aroma massage, infrared light, and abdomen pad. Herb medications used in 5 studies included Chegameuiin-tang 2 kinds, Sobieum, Biman-tnag, and I-razin. 4. The methods of assessment used in 38 studies were classified by 7 categories and anthropometry parameters which is the basic methods are used in all studies 5. Almost studies (29 studies in all 38 studies) were using anthropometric parameters results on significantly effectiveness of childhood obesity. 6. More studies are needed to prove true effectives from various treatments, especially herbal therapy for childhood obesity.

Partial thickness tear: Debris vs. Repair (회전근 개 부전층 파열: 변연절제술가 봉합술)

  • Oh, Jeong-Hwan;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.34-39
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    • 2005
  • Partial thickness rotator cuff tears (PTRCTs) are now a well-established clinical entity, yrt there is no consensus in regards to surgical management. Recommended treatment varies widely from simple debridement of the torn tendon to subacromial decompression to excision of the degenerative tendon and repair. Surgery may be performed using an open, arthroscopically assisted (miniopen), or entirely arthroscopic procedure. The advantages and disadvantages of open and arthroscopic procedures may lie in the balance between precision and morbidity. Visualization of both the articular and bursal surfaces is mandatory to determine the level of rotator cuff disease and formulate a treatment strategy. Because these tear often are secondary finding, recognition of the primary pathology is critical. Treatment of the primary problem usually remedies the partial tear. However, when there is significant PTRCT, an arthroscopic or open repair of the diseased tendon will give the most consistent results.

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Clinical Nurses' Knowledge and Visual Differentiation Ability in Pressure Ulcer Classification System and Incontinence-associated Dermatitis (임상간호사의 욕창분류체계와 실금관련피부염에 대한 지식과 시각적 감별 능력)

  • Lee, Yun Jin;Park, Seungmi;Kim, Jung Yoon;Kim, Chul-Gyu;Cha, Sun Kyung
    • Journal of Korean Academy of Nursing
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    • v.43 no.4
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    • pp.526-535
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    • 2013
  • Purpose: This study was done to compare clinical nurses' knowledge and visual differentiation diagnostic ability for the pressure ulcer classification system (PUCS) and incontinence-associated dermatitis (IAD). Methods: A convenience sample of 602 nurses took the pressure ulcer classification system and incontinence-associated dermatitis knowledge test (PUCS & IAD KT) and completed the visual differentiation tool (VDT), consisting of 21 photographs with clinical information. Results: The overall mean score for correct answers was 14.5 (${\pm}3.2$) in PUCS & IAD KT and 11.15 (${\pm}4.9$) in PUCS & IAD VDT. Incorrect responses were most common for statements related to stage III, IAD for PUCS & IAD KT, and suspected deep tissue injury (SDTI), unstageable, and stage III for PUCS & IAD VDT. Significant correlations were found between PUCS & IAD KT and VDT (r=.48, p<.001). Factors affecting scores for PUCS & IAD VDT were PUCS & IAD KT, frequency of pressure ulcer, IAD management and participation in wound care education programs. Conclusion: Results indicate that nurses have an overall understanding of PUCS & IAD, but low visual differentiation ability regarding stage III, SDTI, and unstageable ulcers. Continuing education is needed to further improve knowledge and visual differentiation ability for PUCS & IAD.

A Clinical Study of the Children and Adolescents Inpatients Admitted to the Oriental Medical Hospital (한방병원에 입원한 소아.청소년 환자에 관한 임상적 연구)

  • Son, Mi-Ju;Han, Jae-Kyung;Kim, Yun-Hee
    • The Journal of Pediatrics of Korean Medicine
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    • v.25 no.2
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    • pp.55-72
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    • 2011
  • Objectives: The purpose of this study is to investigate clinical features of children and adolescents patients admitted to the oriental medical hospital. Methods: The study composed of 1284 inpatients aging from 0 to 19 who had been admitted in 4 oriental medical hospitals located in Daejeon and Chungcheong. Results: 1. In this study, 688 boys and 715 girls were examined, giving the ratio of 0.96:1. Average age of the children and adolescents was 11.5, and the number of inpatients has increased as getting older. 2. The percentage of children and adolescents inpatients has increased every year : 9.1% in 2005, 13.0% in 2006, 13.8% in 2007, 16.3% in 2008, 18.0% in 2009, with 22.2% in 2010, 7.8% until May 2011. The month scored the highest admittance was December and the lowest was March. 3. In systemic division, the musculoskeletal system was the most common, followed by neuromuscular system, respiratory system, digestive system, psychological system, and nervous system. 4. Most patients have admitted in acupuncture & moxibustion department, followed by oriental pediatrics, oriental rehabilitation medicine. 5. In Pediatrics, 196 boys and 166 girls were admitted. The age distribution showed that 6.4% were in infancy, 43.6% in preschool period, 30.1% in prepuberal period, 18.8% in early puberty and 1.1% in late puberty. The percentage of pediatrics inpatients has increased every year. Conclusions: More data of patients should be collated for further study. More detailed study with different kinds of diseases are expected based on this study.

Total Spinal Anesthesia following Epidural Block for Correction with IIizarov Apparatus in an Achondroplasia Patient -A case report- (연골무형성증(Achondroplasia) 환자에서 술 후 교정시술을 위한 경막외차단 중 발생한 전척추 마취 -증례보고-)

  • Choi, Won Hyung;Lee, Il Ok;Lee, Mi Kyung;Kim, Nan Suk;Lim, Sang Ho;Kong, Myoung Hoon
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.288-291
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    • 2006
  • Epidural analgesia using an epidural catheter is an effective method to relieve the pain during the rehabilitating procedure for postoperative orthopedic patients. Total spinal anesthesia is one of the possible complications of epidural catheterization which can lead to a life-threatening condition. Achondroplasia is the most common form of short-limbed dwarfism resulting from a failure of endochondral bone formation. In patients suffering with short stature syndrome like achondroplasia, the incidence and risk of total spinal anesthesia during epidural anesthesia may increase because of the technical difficulty and structural anomaly of the spine. We report here on a 35-year old female patient with a height of a 115 cm. She was diagnosed as achondroplasia and she had a previous Ilizarov operation; both tibial lengthening and correction of valgus were done. No specific event occurred during epidural catheterization. Immediately after the injection of a test dose via epidural catheter, the patient became hypotensive, drowsy and showed weakness of both her upper and lower extremities. The symptoms were disappeared after 40 minutes. The catheter was removed on the next day. We concluded that the total spinal anesthesia was caused by intrathecal injection of local anesthetics through the epidural catheter, and the anesthesia then migrated into the subarachonoid space.