• Title/Summary/Keyword: Discharge patient treatments

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Traditional Korean Medicine for Non-Small Cell Lung Cancer Patient Undergoing Pembrolizumab Immunotherapy: A Case Report (Pembrolizumab 면역치료를 시행 중인 비소세포성 폐암환자의 한방치료 증례보고)

  • Shim, So-hyun;Seo, Hee-jeong;Seo, Hyung-bum;Cho, Im-hak;Lee, Chan;Kim, So-yeon;Han, Chang-woo;Park, Seong-ha;Yun, Young-ju;Lee, In;Kwon, Jung-nam;Hong, Jin-woo;Choi, Jun-yong
    • The Journal of Internal Korean Medicine
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    • v.40 no.4
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    • pp.709-722
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    • 2019
  • Objective: The purpose of this study was to report the effect of traditional Korean medicine (TKM) in alleviating the side effects of lung cancer patient undergoing immunotherapy. Method: A 43-year-old man, who was diagnosed with non-small cell lung cancer, received pembrolizumab treatments. The patient was treated with acupuncture and herbal medicine (Geoeoyangpye-tang) to control various uncomfortable symptoms. The degree of pain was measured by the numeric rating scale (NRS). The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and the EORTC 13-item lung cancer-specific module (EORTC LC-13 questionnaire) were used to assess the change in the quality of life. Results: After the TKM treatment, the flank pain and arthralgia based on the NRS were significantly improved. Various uncomfortable symptoms such as fatigue, dyspnea, insomnia, and loss of appetite were also significantly improved, based on the EORTC QLQ-C30 and EORTC QLQ-LC13. The size of the primary tumor was decreased during treatment. The disease status was stable radiologically after two months from discharge.

Three Cases of Cervical Branchial Remnants (경부 새성기형 3례)

  • Choi, Hwan-Jun;Kim, Hyun-Sung;Choi, Chang-Yong;Yang, Hyung-Eun;Tark, Min-Seong
    • Archives of Plastic Surgery
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    • v.37 no.3
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    • pp.297-300
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    • 2010
  • Purpose: Failure of proper migration, fusion, or maturation of the branchial apparatus components results in a variety of congenital defects. Of these, cartilaginous rests are infrequent, while branchial cysts and sinuses are more common, relatively. The purpose of this study is to examine the clinical and pathological features of rare cervical branchial remnants in order to provide basis for its correct diagnosis and treatment. Methods: We report three cases of cervical branchial remnants which were treated in our hospital from December 2004 to December 2009. These cases were examined their clinical features, histologic findings and treatments. The patients had been operated with simple excision, excision of the combined components and preoperative antiboitics. Results: A retrospective review produced 2 cases of the cervical branchial remnants and 1 case of the cervical chondrocutaneous branchial remnant. All cases were on the left side of the neck, and anterior to the sternocleidomastoid muscle. Histopathological examination showed that fistula & sinus were lined with stratified squamous epithelium, additionally, they were consisted of a cutaneous envelope containing sebaceous glands, hair follicles, various amounts of adipose tissue, and elastic fibers. And, One case revealed containing hyaline cartilage. No patient developed complications or reccurences. Conclusion: The authors recommend simple surgical excision of the remnants when discharge, infection, or cosmetic problem occur. Finally, these lesions do not have fistulous tracts or connections with important, deeper organs, and so can be safely transected at the level of the superficial musculature.

The clinical study of the 47 traffic accident victims (교통사고 환자 47례에 대한 임상적 고찰)

  • Kim, Min-jeong;Lee, Su-hong;Kim, Kyung-ho
    • Journal of Acupuncture Research
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    • v.17 no.3
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    • pp.250-264
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    • 2000
  • A retrospective study has been carried out for 47 cases of traffic accident victims which was entered to the Dongguk Bundang O. M. Hosp. from Jan 1, 1999 to May 4, 2000. This study was focused on finding out the distribution, pattern of the traffic accidents, clinical characteristics of the patients, motives of their choosing oriental medical treatments, the kinds of oriental medical treatment. This results were as follows : 1. The highest incidence was shown in the age of twenties to thirties as much as 59.6% and the ratio of male to female was 17:30. 2. 80.9% of all patients was injured by car accidents. 68.2% of all patients was injured as drivers and passengers and 19.2% was injured as pedestrians. The highest type in the collision between cars, was rear impact. 3. The number of patient(61.7%) via other hosp. was more than that of the first visitor(38.3%) to our hosp. 4. In admission motives, The patients who had been treated by western medical treatment, expressed the dissatisfaction of that treatment, so hoped to be treated by oriental medical styles. Also The others wanted to be treated by oriental medical methods in the reason of no deep surgical, orthopaedical lesions 5. C-spine sprain(80.9%) was the most frequent out of all patients's diagnosis and then L-spine sprain(51.1%), contusion(46.8%), etc. 6. Head Cervix(80.9%) was the commonest pain region of all patients. and then shoulder back(70.2%), lumbar region(61.7%), etc. 7. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 8. After discharge, Duration of OPD treatment was long as much as that of admission treatment. 9. At first stage of admission period, Herb medication was frequently prescribed for hwalhyultonglakgige(活血通絡之劑). but As going to end stage, was frequently used for bogi(補氣) bohyul(補血), gudam(祛痰), ansin(安神).

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Immediate implant placement and provisionalization of single implant in the esthetic region : Cases report (심미적 영역에서 즉시 임플란트 식립 및 임시 수복을 통한 단일치의 수복에 대한 증례 보고)

  • Lee, Song-Bea;Park, Yu-Seon;Kim, Byoung-Heon;Lee, Bo-Ah;Choi, Seong-Ho;Kim, Young-Taek
    • The Journal of the Korean dental association
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    • v.58 no.2
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    • pp.83-92
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    • 2020
  • In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.

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A Task Assignment Rule for the Registered Nurses of the Emergency Department of Hospital Using Multiple System Attributes (병원 응급실에서 여러 속성을 고려한 간호사 치료태스크 할당 규칙에 관한 연구)

  • Kim, Dae-Beom
    • Journal of the Korea Society for Simulation
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    • v.18 no.4
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    • pp.107-116
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    • 2009
  • Overcrowding in an Emergency Department (ED) of hospital is a common phenomenon. To improve the service quality and system performance of the ED, a task assignment rule for the Registered Nurses (RNs) is proposed in this paper. At each task assignment point, the rule prioritizes all treatment requests based on the urgency which is determined by the multiple attributes such as accomplishment time of treatment task, elapsed time of treatment request, total remain time to patient discharge, and number of remain treatments. The values of partial urgency with a single criterion are determined and then overall urgency is computed to find the most urgent one among current requests with the importance weights assigned to the criteria. Through computer simulation, the performance of the proposed rule is compared with current rule in terms of the length of stay and system throughput in a simplified ED system of the hospital M.

Post-Traumatic Cerebral Infarction : Outcome after Decompressive Hemicraniectomy for the Treatment of Traumatic Brain Injury

  • Ham, Hyung-Yong;Lee, Jung-Kil;Jang, Jae-Won;Seo, Bo-Ra;Kim, Jae-Hyoo;Choi, Jeong-Wook
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.370-376
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    • 2011
  • Objective : Posttraumatic cerebral infarction (PTCI), an infarction in well-defined arterial distributions after head trauma, is a known complication in patients with severe head trauma. The primary aims of this study were to evaluate the clinical and radiographic characteristics of PTCI, and to assess the effect on outcome of decompressive hemicraniectomy (DHC) in patients with PTCI. Methods : We present a retrospective analysis of 20 patients with PTCI who were treated between January 2003 and August 2005. Twelve patients among them showed malignant PTCI, which is defined as PTCI including the territory of Middle Cerebral Artery (MCA). Medical records and radiologic imaging studies of patients were reviewed. Results : Infarction of posterior cerebral artery distribution was the most common site of PTCI. Fourteen patients underwent DHC an average of 16 hours after trauma. The overall mortality rate was 75%. Glasgow outcome scale (GOS) of survivors showed that one patient was remained in a persistent vegetative state, two patients were severely disabled and only two patients were moderately disabled at the time of discharge. Despite aggressive treatments, all patients with malignant PTCI had died. Malignant PTCI was the indicator of poor clinical outcome. Furthermore, Glasgow coma scale (GCS) at the admission was the most valuable prognostic factor. Significant correlation was observed between a GCS less than 5 on admission and high mortality (p<0.05). Conclusion : In patients who developed non-malignant PTCI and GCS higher than 5 after head injury, early DHC and duroplasty should be considered, before occurrence of irreversible ischemic brain damage. High mortality rate was observed in patients with malignant PTCI or PTCI with a GCS of 3-5 at the admission. A large prospective randomized controlled study will be required to justify for aggressive treatments including DHC and medical treatment in these patients.

A Case of Psychogenic Tremor Improved by Complex Korean Medicine Treatment Including Cheongshimondam-tang-gamibang and Acupuncture Treatment - A Case Report (청심온담탕가미방과 침구치료를 포함한 복합한의치료로 호전된 심인성 떨림 환자 1례 - 증례보고)

  • Jihyun Lee;Seokyeong Yoon;Hyoenjun Cheon;Sungjun Joo;Jisu Lee;Jungtae Leem;Yanghee Han
    • The Journal of Internal Korean Medicine
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    • v.43 no.6
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    • pp.1186-1197
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    • 2022
  • Objectives: A case study about the effectiveness of integrative Korean medicine treatment in a psychogenic tremor patient. Case presentation: A 36-year-old male diagnosed with psychogenic tremor with low back pain underwent 29 days of inpatient treatment and 4 weeks of outpatient treatment. His pattern identification was a psychogenic tremor of the weakness of the heart and gall bladder (SimDamHeoGup) type. The treatments were herbal medicine and acupuncture. He took Cheongshimondam-tang for 29 days and Chunwangbosim-dan for 6 weeks when he had symptoms. He also received acupuncture for 20 minutes twice a day at GB20 (Pungji), L14 (Hapgok), HT4 (Yeongdo), PC6 (Naegwan), HT7 (Sinmun), GB34 (Yangleungcheon), ST36 (Joksamni), SP6 (Sameumgyo), and LR3 (Taechung). After 8 weeks of treatment, the Fahn Tolosa Marin rating (FTM) scale of his tremor, at rest, dropped from Grade 4 on both upper extremities, trunk, and both lower extremities at the time of admission to Grade 2 in both upper extremities and trunk, and Grade 0 in both lower extremities at the time of discharge. His Beck Anxiety Inventory (BAI) score decreased from 38 to 7, and his numerical rating scale (NRS) decreased from 8 to 1 for low back pain and from 9 to 2 for tremor. A follow-up visit to the hospital 2 months after the end of treatment confirmed continued symptom improvements and no significant side effects. Conclusions: This study suggests the possibility of treating psychogenic tremor using only Korean medicine treatments. Further studies with control groups and long-term follow-up are needed.

Consultations to Department of Dentistry for Child and Adolescent Inpatients with Dental Trauma (치과적 외상이 있는 소아청소년 입원환자의 치과 협진 의뢰)

  • Jo, Chanwoo;Kim, Jihun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.4
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    • pp.403-411
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    • 2017
  • The purpose of this research is analyzing present condition, and pursuing developmental direction of consultation to department of dentistry for medical inpatient with dental trauma. This research conducted a retrospective analysis of consultation to department of dentistry for medical inpatient at Wonju Severance Christian Hospital from March 2011 to February 2017. This research analyzed chief complaint and dental diagnosis, referring department, time of consultation after dental trauma, relation between hospitalization period and time of consultation after dental trauma, relation between dental trauma and admission in the medical department due to trauma, cause and age of dental trauma occurrence, treatment of dental trauma, and revisiting rate of inpatient with dental trauma after discharge. Among all the chief complaint and dental diagnosis, dental trauma was the highest. Among all the referring departments, departments of surgery were the highest. In relation to being delayed of consultation term after dental trauma, it turned out that there's pretty high mutual relation between the hospitalization period and the consultation term after dental trauma, and the hospitalization period had the quantitative influence on the consultation term. Statistically, dental trauma and admission in the medical department due to trauma had significant relations. In case of those patients due to car accidents, they had dental trauma without exception. Statistically, patient's group with dental trauma in hospital room was younger than patient's group with dental trauma in non-hospital room. Statistically, dental trauma and treatment in hospitalization had no significant relations, and dental trauma and revisiting department of dentistry after discharge had no significant relations. For the child and adolescent inpatients hospitalized for car accidents, there is high possibility of accompanying dental trauma, and dental consultations can be delayed. For the young child inpatients, the possibility of dental trauma occurrence in hospital room is high. Moreover, treatments during hospitalization and revisiting department of pediatric dentistry after discharge are not performed well for inpatients with dental trauma. Regarding these results, it can be an alternative that improving of consultation system, dedicated workforce placement and having dental facilities and equipment in the hospital ward, education to medical doctor and dentist, communication between medical doctor and dentist. This research can be used as a study material of medical and dental departments, and it's expected to be committed to developing of consultations to department of dentistry for child and adolescent inpatients with dental trauma.

Efficacy of Self-manipulation Technique in the Treatment of Patients with Anterior Disc Displacement without Reduction (비정복성 관절원판 전방변위 환자의 치료에 있어서 자가 수조작술의 효과에 대한 연구)

  • Kim, Ju-Sik;Lee, Chae-Hoon;Kim, Young-Ku
    • Journal of Oral Medicine and Pain
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    • v.32 no.4
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    • pp.441-447
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    • 2007
  • Internal derangement of the temporomandibular joint(TMJ) is defined as an abnormal relationship of the articular disc to the condyle. Mandibular manipulation is one of the conservative treatments to be considered first to manage the patients with anterior disc displacement without reduction. Mandibular manipulation is used to increase articular mobility and to restore the displaced disc into an anatomically normal position. While Farrar's technique has been popularly used, Minagi et al., Mongini and Suarez introduced the manipulation technique conducted by the patients themselves. But there is no study on the efficacy of self-manipulation technique, comparing with conventional one. The aim of this study was to investigate the efficacy of the conventional and self-manipulation technique, which was modified to complement the previously described technique by Minagi et al., in the treatment of patients with anterior disc displacement without reduction. TMD patients, who visited Department of Oral Medicine of Seoul National University Dental Hospital from December, 2002 to November, 2004 and were diagnosed as anterior disc displacement without reduction by TMJ magnetic resonance imaging (MRI) were enrolled. Conservative treatments including physical therapy, exercise, behavioral therapy, stabilization splint therapy, and manipulation therapy were done to every single patient until the symptomsimproved enough to discharge the patient. The charts were reviewed retrospectively according to the type of manipulation. In the results, patients whose maximum mouth opening was more than 40 mm was higher in the self-manipulation group(69.9%) than in the conventional manipulation group(42.9%). But difference between two groups was not significant. According to the fact that we decided to discharge the patients whentheir mouth opening increased to more than 40 mm and subjective symptoms such as pain and discomfort were improved as well, treatment period of discharged patients was significantly shorter in the self-manipulation group($29.2{\pm}12.3$ weeks) than in the conventional manipulation group ($61.0{\pm}38.0$ weeks) (p<0.01). In conclusion, in the treatment of TMD patients with anterior disc displacement without reduction, the self-manipulation technique which is performed by patients themselves is an effective treatment modality for increasing the range of mouth opening and shortening the total treatment period.

A Case Report of Isolated Inguinal Tuberculous Lymphadenitis (서혜부 단독 결핵성 림프염의 증례보고)

  • Koo, Hyun-Kook;Kim, Young-Seok;Kim, Min-Joo;Roh, Tai-Suk;Rah, Dong-Kwun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.705-707
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    • 2010
  • Purpose: Tuberculous lymphadenitis constitutes about 30% of all types of extrapulmonary tuberculosis. Cervical lymphadenitis is the commonest form (70%), followed by axillary and inguinal. But inguinal tuberculous lymphadenitis is rare form. Especially isolated inguinal tuberculous lymphadenitis was seldom reported. In Korea, that case was not reported. This case emphasizes the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis. Methods: We experienced one case of isolated inguinal tuberculous lymphadenitis. We analyzed clinical features, preoperative assessments and method of treatments. Results: A 37-year-old female patient presented with a painless swelling in the left inguinal region of 12 month's duration. There was no history of urethral discharge, dysuria, genital sores, unprotected sexual contacts or trauma. Examination revealed enlarged left inguinal lymph nodes, $2{\times}1\;cm$, non-tender and firm mass. The external iliac, popliteal, right inguinal and other groups of lymph nodes were normal. Serologic tests, urinary tests and chest radiologic test were normal. The excision of mass was performed under the general anesthesia. A excisional biopsy showed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. After excision, the primary repair was done and completely healed on postoperative 25 days. Conclusion: The isolated inguinal tuberculous lymphadenitis was rare form of inguinal suppurative mass. Although medical management is the principal mode of therapy of tuberculous adenitis and surgery is rarely necessary, we didn't consider the possibility of tuberculous lymphadenitis in our case. A high index of suspicion is essential for a diagnosis of isolated inguinal tuberculous lymphadenitis. Our case emphasizes this importance and illustrates the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis.