• 제목/요약/키워드: Chief complaints

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『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 마황행인감초석고탕(麻黃杏仁甘草石膏湯) 투여 후 호전된 증례 2례 고찰 (Two Case Reports treated by Mahwang-Haeangin-Gamcho-Seokgo-tang based on Shanghanlun Provisions)

  • 하현이;윤효중;이성준
    • 대한상한금궤의학회지
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    • 제8권1호
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    • pp.67-85
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    • 2016
  • Objectives: In this paper, two cases which showed the meaningful results on the patients' chief complaints were analyzed. The patients were treated with the Mahwang-Haengin-Gamcho-seokgo-tang herbal medication based on Shanghanlun disease pattern identification diagnostic system. Methods: The patients were diagnosed based on Shanghanlun, disease pattern identification diagnostic system. In case 1, the change of menstruation cycle was noted and pre-menstrual discomforts were measured with Menstrual Distress Questionnaire(MDQ). In case 2, Quality of life questionnaire for adult Korean asthmatics (QLQAKA) was used to estimate the quality of the patient's life. Results: All the symptoms were improved after the Mahwang-Haengin-Gamcho-seokgotang treatment. In case 1, the menstruation cycle decreased to 30 days average. MDQ score decreased 143 to 103. In case 2, the change of the QLQAKA score as 1.647 average point is considered as a meaningful improvement. Conclusion: With great difference to a 'Symptom-Medicine' diagnostic system, the disease pattern identification diagnostic system seeks the pathologic pattern through the patient's whole life. More studies and multiple cases based on the diagnostic system are needed to prove this possibility later.

『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 치료한 음양이차후노복병(隂陽易差後勞復病) 증례 4례 (4 Case Reports of Eumyangyeokchahunobok-byung treated by Herbal medicine based on Shanghanlun provisions)

  • 조성환;이성준
    • 대한상한금궤의학회지
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    • 제8권1호
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    • pp.121-143
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    • 2016
  • Objective : This study is to report 4 Eumyangyeokchahunobok-byung cases diagnosed and treated according to newly hypothesized Eumyangyeokchahunobok-byung definition based on Shanghanlun disease pattern identification diagnostic system. Methods : We analyzed 4 clinical cases diagnosed with Eumyangyeokchahunobok-byung and treated by herbal medicine, which included in Eumyangyeokchahunobok-byung chapter of Shanghanlun according to newly hypothesized definition. Results : Dermatology Life Quality Index decreased from 25 to 10 on first patient, dizziness handicap inventory decreased from 64 to 2 on second patient, dizziness handicap inventory also decreased from 56 to 2 on third patient, and fatigue severity scale decreased from 7 to 2 on fourth patient. Conclusions : Not only all the patients' chief complaints relieved but their other clinical problems such as allergic rhinitis, body pain, constipation, reflux esophagitis also improved. These results highly insist that there is quite a possibility that Eumyangyeokchahunobokbyung means various diseases caused by reversed sleep cycle.

혈관성 치매 환자 치험 3례 (Three cases of Vascular Dementia Patients)

  • 장문희;최재송;배나영;안택원
    • 사상체질의학회지
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    • 제23권3호
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    • pp.402-411
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    • 2011
  • 1. Objectives: This study is about three vascular dementia patients with disorientation, memory impairment and cognitive disorder. In this study, we evaluated the effects of Sasang constitutional treatment and suggested using the Mini Mental Status Examination - Korea (MMSE-K), Global Deterioration Scale (GDS). 2. Methods: These three patients were treated by Sasang constitutional herbal medications based on "Donguisusebowon". Acupuncture and west medications were limited as much as possible. We evaluated the symptoms through the Mini Mental Status Examination - Korea (MMSE-K), GDS (Global Deterioration Scale). 3. Results and Conclusions: Disorientation, memory impairment and cognitive disorder that were these three patients chief complaints were improved. This case study shows that Sasang constitutional herbal medications are an effective treatment for vascular dementia patients.

우심방에 발생한 원발성 섬유성 육종: 1례 치험 보고 (Primary Fibrosarcoma of Right Atrium: A Case Report)

  • 이성행
    • Journal of Chest Surgery
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    • 제10권1호
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    • pp.173-178
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    • 1977
  • A 51 year old man was admitted to the Thoracic and Cardiovascular Department of Kyungpook University Hospital on April 7, 1976, with chief complaints of orthopnea and the chest pain for about 3 months. Physical examination showed narrow pulse pressure, puffy face, engorged neck veins at sitting position, distant heart sound, enlarged liver and edematous upper extremities. The chest roentgenogram demonstrated markedly enlarged cardiac silhouette. Low voltage and the low to diphagic T`s were noted on the electrocardiogram. Paroxysmal ventricular tachycardia was developed intermittently and was subsided spontaneously. Repeated pericardiocentesis were performed each of which yielded from 100 to 300ml. but intractable cardiac failure was progressed. The bacteriology and cytology of the pericardial fluid were not revealed any specific findings. The pericardiectomy was performed to release the intractable cardiac tamponade. Pericardium was found to be thickened and cardiac constriction was noted. The thickened pericardium was easily removed. A large hen`s egg sized dark blue tumor mass occupied the anterior wall of the right atrium and two thumb tip sized pearl gray tumors were placed at the just below portion of the main pulmonary artery. The biopsy report revealed primary fibrosarcoma of the heart. The patient was improved from the symptoms of the cardiac failure during the postoperative course.

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만성 비특이성 동맥염에 의한 비전형적 하행 흉대동맥 협착증: Bypass graft 를 시행한 1예 (Atypical Coarctation in the Descending Thoracic Aorta: Treated by Bypass Graft)

  • 장운하;유회성
    • Journal of Chest Surgery
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    • 제11권1호
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    • pp.81-84
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    • 1978
  • A 15 years Old girl was admitted with chief complaints of intermittent claudication of lower extremity, dizziness, and headache for 5 years. On admission, malignant hypertension was noted in the upper part of body [190-150/120-110] but femoral & dorsalis pedis pulse could not palpate. Once she had experienced C. V. A. due to hypertension of upper part, about years ago. On auscultation, systolic murmur was audible along the left sternal border. E.C.G. Showed left ventricular hypertrophy pattern, and others within normal limit. Retrograde aortography demonstrated diffuse narrowing of entire thoracic aorta with underdeveloped lower abdominal aorta [below the renal artery] & both common lilac artery, and rich collaterals, but normally visualized greater arteries in the aortic arch. On left posterolasteral thoracotomy, entire descending thoracic aorta revealed marked narrowing with mild perivascular adhesion, but no mediastinal pleura adhesion. These findings suggest as congenital type of atypical coarctation in the entire thoracic aorta with mild secondary change. But histopathology was showed the findings of chronic non-specific aortitis, later. Dacron by pass graft was performed with end to side anastomosis between graft and aortic wall. After operation, all her preoperative symptoms & signs were disappeared, and discharged with good general condition.

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다발성 원발성 식도종양 1례 보 (Multicentric Primary Tumor of the Esophagus)

  • 이재원;강정호;지행옥
    • Journal of Chest Surgery
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    • 제20권2호
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    • pp.348-352
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    • 1987
  • A 51 year-old male was admitted with the chief complaints of swallowing difficulty and pain on neck and upper chest for 2 months prior to admission: He was taken biopsy under esophagoscopy, and the result was squamous cell carcinoma. Preoperatively we studied the esophagogram and chest CT. On these, we found the main appreciable mass at midesophagus easily. But, we missed the upper cervical unexpected mass. So we performed the esophagectomy and lymph node dissection from upper clavicle level to the esophagogastric junction by thoracic approach as wide as possible, and cervical esophagostomy and feeding gastrostomy also. At that evening we reviewed the studied films in detail, and we found another mass lesion at C4-C6 level of cervical esophagus. We performed the 2nd operation e.g. cervical esophagectomy on next morning without hesitation. Between these two masses, there was almostly normally looking skip area grossly. The squamous cell carcinoma of the esophagus could be multicentric in character and may have skip area. But, we heard little reports until now. The two masses could be different in origin or be same probably by submucosal spreading. Anyway, it was an alarming case to the surgeon not to neglect the another possible lesions in squamous cell type. Postoperative course was uneventful, he took G-tube feeding with no problems on 7th postoperative day. Now he took the postoperative irradiation at out patient department.

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자연기흉에 대한 임상적 고찰 (Spontaneous Pneumothorax: Clinical Investigation of 142 Cases)

  • 정상조
    • Journal of Chest Surgery
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    • 제23권5호
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    • pp.887-893
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    • 1990
  • We have experienced 142 cases of spontaneous pneumothorax from January 1987 to June 1990 at the department of Thoracic and Cardiovascular Surgery, Inha General Hospital, Inha University College of Medicine. The age of patients ranged from 16 to 79 years \ulcornerold. The incidence was highest between late 2nd and 3rd decades in non tuberculous group. Males occupied 110 cases [77.6%] and females 32 cases [22. 5%], and its ratio was 3.4: l. The incidence of right side pneumothorax was 76 cases [53.5%] and left side was 65 cases [45.8%]. There was one case of bilateral pneumothorax. The most common chief complaints were chest pain and dyspnea. The associated pulmonary lesions were pulmonary tuberculosis, active or healed in 51 cases [35.9%], Subpleural bleb in 19 cases [13.4%], emphysematous bulla in 12 cases [13.4%], asthma in 3, bronchiectasis in 3, pneumonia in 1, cyst in 1. The unknown origin pneumothorax, so called "idiopathic spontaneous pneumothorax”, which seemed to be caused by the rupture of bleb or bulla most likely, were 52 cases [36. 6%] in our series. Generally, closed [tube] thoracotomy with underwater sealed drainage is the treatment of choice in spontaneous pneumothorax. We experienced 94 cases[66.2%] which were cured by closed thoracotomy. However, open thoracotomy and adequate surgical procedures were undertaken in patient with continuous air leakage or recurrent attacks of spontaneous pneumothorax in 48 cases [33.8%]. The minithoracotomy is a good procedure for the bullectomy of upper lobe.lobe.

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이하두정 방사선 사진을 이용한 악교정수술 계획의 유용성에 대한 평가 (EVALUATION OF THE AVAILABILITY OF SURGICAL TREATMENT OBJECTIVE(STO) USING SUBMENTOVERTEX(SMV) VIEW)

  • 김범수;김종완;김영균;윤필영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권5호
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    • pp.324-328
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    • 2009
  • Submentovertex(SMV) projection shows the base of skull, positions of mandibular condyle and zygomatic arches. We would like to investigate how to use SMV and evaluate its availability for the construction of the plan for orthognathic surgery of mandible prognathism and asymmetry. Preoperative Surgical Treatment Objective(STO) using SMV was performed to 12 patients, who visited to Seoul National University Bundang Hospital with chief complaints like mandible prognathism or asymmetry from Dec 2007 to Feb 2009. Surgical splint was made of stone model repositioned according to STO using SMV. We estimate the change in skeletal midline and the stability of occlusion through superposition between preoperative and postoperative SMV. It was effective on the amount of mandible movement and the correction of mandibular asymmetry, while the facial asymmetry involved with maxilla was excluded. It was concluded that STO using SMV is available and predictable method for not only the setback of prognathic mandible but also the correction of mandible asymmetry accurately.

진통 분만, 질출혈과 성폭행 환자에 대한 119구급대원의 병원전 응급처치 분석 (Analysis on prehospital care of emergency labor pain, vaginal bleeding and sexual assault patients by 119 emergency medical technicians)

  • 백미례
    • 한국응급구조학회지
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    • 제17권2호
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    • pp.9-20
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    • 2013
  • Purpose: The purpose of this study is to provide basic data to improve prehospital emergency care for patients with labor pain, vaginal bleeding and rape experience by analyzing the reports of 119 emergency medical technicians. Methods: Data were prehospital reports of 190 patients having chief complaints of labor pain, vaginal bleeding and rape in Chungcheongnam-do from January 1, 2012 to December 31, 2012. Data were analyzed using SPSS 21.0 descriptive statistics and $x^2$-test. Results: From the 190 cases of labor pain, vaginal bleeding and rape, labor pain accounted for 57.9% including 75.5% of normal delivery; vaginal bleeding accounted for 35.8% including 26.5% of postpartum hemorrhage; and rape victims accounted for 6.3%. Cases with more than one vital sign accounted for 94.2%, but cases without primary assessment of the obstetrics and gynaecology accounted for 38.4% from gestation weeks, 78.0% from parity, and 87.4% from history taking relating to event. Patient care including emotional support was the first priority care accounted for 78.4% and 60% of care was keeping the patients warm. Conclusion : In order to handle various emergency situations properly, the records must be supplemented by obstetrical and gynaecological rape checklist and rape victims supporting system should be established.

악하부종괴에 대한 임상적 연구 (CLINICAL STUDY ON SUBMANDIBULAR MASSES)

  • 장현석;유준영
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제18권4호
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    • pp.701-705
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    • 1996
  • There are many kind of diagnostic entities in submandibular or neck masses, and we can set up treatment plan and estimate treatment result, prognosis by accurate diagnosis. By reasoning medical and dental history, physical examination, anatomical consideration of masses in submandibular or neck area, location of masses, laboratory and radiographic studies, we can formulate a clinical diagnosis or differential diagnosis. Although a clinical diagnosis might suffice in some instances, a definitive(microscopic) diagnosis is frequently required for proper treatment. In order to get some information about making accurate diagnosis and setting up appropriate treatment plan, we did clinical study and histopathologic classification of 82 patients who visited and were operated for submandibular masses at Department of Oral and Maxillofacial Surgery in Seoul National University Hospital from 1988 to 1992. The result were as follows : 1. Submandibular masses occured most frequently in forties and fifties, and there was no sex predilection. 2. Chief complaints were in order of mass, swelling, pain and consistency were soft mass, mobile hard mass, firm mass, diffuse swelling in descending order. 3. Most frequent pathologic finding was lymphadenitis. 4. Site of submandibular masses were submandible, neck, submental, retromandible in descending order, and there was no predilection between left and right side. 5. Accuracy rate between clinical impression and result was 51.2%.

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