• Title/Summary/Keyword: 협진

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A Case Report of Acute Primary Pontine Hemorrhage with One-and-a-Half Syndrome, Vertigo, and Paresthesia Treated with Eastern-Western Integrative Medicine (급성 원발성 교뇌 출혈 환자의 하나반증후군, 현기증, 이상감각에 대한 한양방 협진치료 : 증례보고)

  • Se-eun Chun;Ji-eun Lee;Min-gyeol Jeon;Yong-jeen Shin;Sun-ho Shin
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1289-1300
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    • 2022
  • Background: The purpose of this study was to report the improvement of a patient with one-and-a-half syndrome, vertigo, and paresthesia caused by acute primary pontine hemorrhage (PPH) after a combination treatment of traditional Korean and Western medicine. Case report: A 51-year-old female with one-and-a-half syndrome, vertigo, and paresthesia after PPH was treated with Korean medicine, including herbal medication, acupuncture, and moxibustion, and Western medicine, including medication and rehabilitation therapy during hospitalization. Her progress was evaluated by checking for changes in symptoms with the extraocular muscle (EOM) function test, numeral rating scale (NRS), and follow-up brain computed tomography scans and magnetic resonance imaging (MRI). After 41 days of treatment, the EOM movement was improved, leaving limited abduction of the left eye. The NRS scores for vertigo and paresthesia decreased from 10 to 5 and from 10 to 3, respectively. Improvement was noted in hematoma in MRI, but a new ischemic lesion was also discovered. Conclusion: This case reports the clinical course of one-and-a-half syndrome and suggests that a combined therapy of traditional Korean and Western medicine can be useful for PPH patients with one-and-a-half syndrome, vertigo, and paresthesia. However, studies of larger populations are required.

Remote Medical Equipment Training for Public Health Doctors in Vulnerable Medical Areas Using Smart Glasses (스마트 글래스를 활용한 공중보건의 대상 의료장비 원격교육)

  • Jongmyung Choi;So-Eun Choi;Ji Hyun Moon
    • Journal of Internet of Things and Convergence
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    • v.9 no.3
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    • pp.75-80
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    • 2023
  • In medically vulnerable areas in Korea, public health doctors play a significant role in providing not only general medical care but also emergency medical services to the local residents. However, it has been observed that public health doctors generally lack field experience, resulting in insufficient ability to handle emergency patients and to effectively use medical equipment. This study confirmed the effectiveness of education after conducting remote education using smart glasses on how to use medical equipment necessary for public health doctors. Specifically, real wear was used for smart glasses for medical equipment utilization education, and 10 public health officials in 10 islands in Shinan-gun were targeted. After the training, both the effect of using the equipment and the level of satisfaction were 3 or higher. Therefore, it was confirmed that remote education using smart glasses can be usefully used for public health doctors in medically vulnerable areas.

A Strategy for the Improvement of Health Care Inequality in the Southwestern region of Korea - Around the island area (서남권 의료불평등 개선을 위한 방안 -도서 지역을 중심으로-)

  • Moon, Ji Hyun
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.3
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    • pp.385-392
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    • 2022
  • The purpose of this study was to identify the degree of medical inequality in medical vulnerable areas, especially in the southwestern islands, and to prepare improvements. As a research method, 14 pieces were analyzed by systematic literature review with keywords such as 'medical vulnerability', 'medical inequality', and 'island area', and a focus group or in-depth interview (FGI) was conducted on 9 medical personnel in the public medical delivery system to identify the current status and demand. As a result of the study, medical inequality in the southwest region, especially in island areas, was confirmed, and the lack of professional manpower and administrative support system were confirmed through FGI. As a result of the study, it was confirmed that realistic measures should be prepared to increase the efficiency of public health care as well as active administrative support to improve the vulnerability of island areas.

Usage of Korean Herbal Medicine Banhabaekchulcheonmatang-Analysis of Korean Clinical Studies (반하백출천마탕을 사용한 국내 임상연구 분석)

  • Nokwon Kim;Minjung Bae;Youngju Yun
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.89-107
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    • 2024
  • Objectives : To investigate the clinical usage of Banhabaekchulcheonmatang (BBCT), this study reviewed clinical studies conducted in Korea. Method : Literature search was performed on four Korean database; OASIS, RISS, KTKP and NDSL. Studies published before July 2023 were categorized and analyzed according to the target disease. Results : Fifty-four studies including 36 single case reports and 18 case series were included in this review and the total number of case patients was 79. There were 24 patients with peripheral vertigo such as benign paraoxysmal positional vertigo and Meniere's disease, 17 with central vertigo such as cerebellar infarction, 15 with vertigo accompanied by digestive symptoms, 13 with headache, and 10 with other diseases. Vertigo treatment accounted for more than 70% of the total case and there was no cases of hypertension and dementia. The BBCT formulation used was decoction in 69 patients (87.3%), powder in 7 patients (8.9%), and combination of decoction and powder in 3 patients (3.8%). Conclusion : Clinical research should be accumulated to expand the use of BBCT in the treatment of hypertension and dementia. In order to increase the use of insurance-covered extract preparation, it is necessary to make an effort to include the various diseases actually treated with BBCT in the indications.

Analysis of Medical Decisions related to Epidural Hematoma after Spinal Surgery -Focusing on the Lumbar MRI- (척추 수술 후 발생한 경막외 혈종 관련 의료 판결 분석 -요추 MRI 시행 여부를 중심으로-)

  • Lee Dongjin
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.61-86
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    • 2024
  • The purpose of this study was to investigate the importance of continuous and detailed follow-up of patients after spinal surgery by reviewing the literature on epidural hematoma and the lower court ruling on lumbar MRI during the judgment on the negligence of postoperative follow-up. In the case of neglecting MRI examination or cooperation after surgery, delaying MRI examination after pain and symptom appeal after surgery, and returning home immediately after neurological symptom development after surgery, negligence in progress observation was recognized. In the case of the case where the negligence was not recognized even after the occurrence of the aftereffects by taking measures against the symptoms, and the case where the scope of the doctor's discretion for the execution of the test was recognized, It is hoped that this study will help prevent medical accidents and disputes related to follow-up after spinal surgery by increasing awareness of the importance of prompt MRI examination, diagnosis, surgical treatment, and power, especially in the case of new neurological symptoms.

Comparative Clinical Study between Oriental Medical and Oriental-Western Medical Treatment on Bell's Palsy (특발성 안면신경 마비(Bell's Palsy)의 한방치료와 한양방 협진치료의 효과에 대한 임상적 비교 연구)

  • Kwon, Na-Hyoun;Shin, Ye-Ji;Kim, Chan-Young;Kho, Pil-Seong;Yi, Won-Il;Joh, Byung-Jin;Woo, Hyun-Su;Baek, Yong-Hyeon;Park, Dong-Suk
    • Journal of Acupuncture Research
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    • v.25 no.3
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    • pp.19-28
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    • 2008
  • Objectives : The purpose of this study is to investigate the therapeutic effects of oriental medical treatment and oriental-western medical treatment on Bell's palsy. Methods : From 1st June, 2006 to 31th August, 2007, 30 Bell's palsy patients who visited the Facial palsy center at East-West Neo Medical Center within 7days of onset and treated for more than 4weeks were randomly divided into two groups. Group A was treated with oriental medical therapy(Acupuncture, Herb, Physical therapy) and Group B with both oriental and western medical therapy(Acupuncture, Herb, Physical therapy, Administration of prednisone). We evaluated the treatment effect of each group with the House-Brackmann Gross Grading System before treatment, after 1week, 2weeks, 3weeks and 4weeks of treatment. Results : After 1week of treatment, Group A showed better performance compared with Group B. After 3weeks and 4 weeks of treatment, Group B showed better performance than Group A. Conclusions : These results proved that combination treatment of oriental and western medicine was more effective than just oriental medical treatment in long term treatment of Bell's palsy. But we discovered that there were no significant differences between the two groups.

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SELF-INJURIOUS BEHAVIOR IN A PATIENT WITH AUTISM : A CASE REPORT (자폐 환자의 자해로 인한 구강 내 손상 : 증례 보고)

  • Ji, Eun-Hye;Lee, Hyo-seol;Choi, Hyung-Jun;Kim, Seong-Oh;Choi, Byung-Jai;Son, Heung-Kyu;Lee, Jae-Ho
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.8 no.1
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    • pp.10-14
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    • 2012
  • Self-injurious behavior (SIB) has been defined as the deliberate destruction or alteration of body tissue without conscious suicidal intent. It occurs in conjunction with a variety of psychiatric disorders as well as various developmental disabilities and some syndromes. The behavior is destructive and causes concern and distress to all involved in the care and treatment of the affected individual. A 13-year-old girl with autism, mental retardation and delayed development was reffered from her pediatrician because of severe and painful lower lip biting. An intraoral examination revealed a diffuse swelling of lower lip. It was covered with necrotic slough and the ulcer and scarring of the lower lip was observed. We chose to use an oral removable prosthesis for Conservative treatment. It was decided to use a soft silicone mouthguard in the maxillary arch. Initially, she could not tolerate the appliance inside her mouth but soon adapted with the appliance. After one month, she lost the mouth guard and started lip biting. So we made mouth guard again. There are no standard methods for preventing self-injurious behavior in a patient who is developmentally disabled. Appropriate preventive methods must be developed for each individual patient based on close observation and clinical findings. Behavior modification techniques, pharmacological treatment, extraction of teeth, orthognathic surgery and intra/extra oral appliances can be performed for adjust self-injurious behavior. A suitable oral guard could be tried initially before employing more invasive approaches.

Clinical Study on East-West Combination Treatment in Joint Disorders (관절.류마티스 질환의 한.양방 협진에 관한 임상적 고찰)

  • Shin, Ye-Jji;Kim, Chan-Young;Kwon, Na-Hyoun;Kwon, Sin-Ae;Lee, Jung-Woo;Koh, Hyung-Kyun;Woo, Hyun-Su;Park, Dong-Suk;Baek, Yong-Hyeon
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.121-132
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    • 2009
  • Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.

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Clinical Analysis of the Suicidal Attempters to Change Who Visited Emergency Medical Center (응급의료센터에 내원한 자살기도자의 임상적 변화 분석)

  • Choi, Jeong Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.12
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    • pp.8728-8737
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    • 2015
  • The purpose of this study compared the clinical features of suicidal attempters who visit in the past and present of an emergency medical center, used as a basic data for clinical severity and suicide prevention research of future patients. The author conducted a retrospective analysis of the changed characteristics of suicidal attempters who visit an emergency medical center of Wonkwang University Hospital between from January $1^{st}$, 1998 to December $31^{th}$, 1998 and from August $1^{st}$, 2013 to July $31^{th}$, 2015. Factors related to increased occurrence was changed from male(1.1:1) in 1998 to female(1.3:1) in 2013-2015, from age of $2^{nd}$, $3^{rd}$, and above $6^{th}$ decade in 1998 to $3^{rd}-5^{th}$ decade in 2013-2015. Poisoning was the most common method of suicidal attempt(90.8%;1998, 72.7%;2013-2015), Mortality rate was changed from 16.9%(male 23.1%, female 10.0%) in 1998 to 13.8%(male 18.1%, female 10.5%) in 2013-2015. Among the suicidal attempters(total=516), 37 patients has recurred. But consultant of neuropsychiatric department was 48.3%, All suicidal attempters in future were necessarily neuropsychiatric consultant and continuously follow-up because all patients had recurrent suicide attempt, psychologic disorder, suicide rates are higher than in the general population.

DENTAL TREATMENT OF A PEDIATRIC PATIENT WITH HOMOZYGOUS PROTEIN C DEFICIENCY: A CASE REPORT (동형접합성 단백 C 결핍 환아의 치과적 치험례)

  • Yoon, Mi;Kim, Seung-Oh;Kim, Jong-Soo;Yoo, Seung-Hoon
    • Journal of the korean academy of Pediatric Dentistry
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    • v.37 no.2
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    • pp.207-212
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    • 2010
  • Protein C deficiency increases the risk of thrombosis due to the lack of anticoagulant factor protein C. Among the numerous congenital protein C deficiencies, homozygous protein C deficiency has an especially low protein C activity level, that it is almost undetectable. It is a rare disease with a probability of 1:250000~500000. The signs and symptoms of homozygous protein C deficiency include purpuric, necrotic dermatosis, ecchymosis, blindness, and thrombosis in central nervous system. A 4-year-old girl was brought to the clinic with a chief complaint of extensive caries. The child was under warfarin medication in order to prevent possible complications during dental treatment. We consulted the pediatric department. Without warfarin intake, serious complications may occur due to thrombosis during dental treatment. Therefore, certain warfarin dosage (INR 3~5) and fresh frozen plasma as a backup for excessive hemorrhage were recommended. This child was a severely disabled child with the loss of vision, and it was difficult to manage her behavior effectively. Thus, dental treatment was carried out under general anesthesia, where bleeding control would be also easier to achieve.This report presents the case of a 4-year-old girl with protein C deficiency, who has received dental treatment for extensive caries under general anesthesia.