• Title/Summary/Keyword: Hospital medicine

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Prasugrel-based De-Escalation of Dual Antiplatelet Therapy After Percutaneous Coronary Intervention in Patients With STEMI

  • You-Jeong Ki;Bong Ki Lee;Kyung Woo Park;Jang-Whan Bae;Doyeon Hwang;Jeehoon Kang;Jung-Kyu Han;Han-Mo Yang;Hyun-Jae Kang;Bon-Kwon Koo;Dong-Bin Kim;In-Ho Chae;Keon-Woong Moon;Hyun Woong Park;Ki-Bum Won;Dong Woon Jeon;Kyoo-Rok Han;Si Wan Choi;Jae Kean Ryu;Myung Ho Jeong;Kwang Soo Cha;Hyo-Soo Kim;HOST-RP-ACS investigators
    • Korean Circulation Journal
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    • v.52 no.4
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    • pp.304-319
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    • 2022
  • Background and Objectives: De-escalation of dual-antiplatelet therapy through dose reduction of prasugrel improved net adverse clinical events (NACEs) after acute coronary syndrome (ACS), mainly through the reduction of bleeding without an increase in ischemic outcomes. Whether the benefits of de-escalation are sustained in highly thrombotic conditions such as ST-elevation myocardial infarction (STEMI) is unknown. We aimed to assess the efficacy and safety of de-escalation therapy in patients with STEMI or non-ST-segment elevation ACS (NSTE-ACS). Methods: This is a pre-specified subgroup analysis of the HOST-REDUCE-POLYTECH-ACS trial. ACS patients were randomized to prasugrel de-escalation (5 mg daily) or conventional dose (10 mg daily) at 1-month post-percutaneous coronary intervention. The primary endpoint was a NACE, defined as a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, clinically driven revascularization, stroke, and bleeding events of grade ≥2 Bleeding Academic Research Consortium (BARC) criteria at 1 year. Results: Among 2,338 patients included in the randomization, 326 patients were diagnosed with STEMI. In patients with NSTE-ACS, the risk of the primary endpoint was significantly reduced with de-escalation (hazard ratio [HR], 0.65; 95% confidence interval [CI], 0.48-0.89; p=0.006 for de-escalation vs. conventional), mainly driven by a reduced bleeding. However, in those with STEMI, there was no difference in the occurrence of the primary outcome (HR, 1.04; 95% CI, 0.48-2.26; p=0.915; p for interaction=0.271). Conclusions: Prasugrel dose de-escalation reduced the rate of NACE and bleeding, without increasing the rate of ischemic events in NSTE-ACS patients but not in STEMI patients.

A case of Chronic renal failure complicated by Diabetes mellitus (당뇨합병증으로 인한 만성 신부전 환자 1례에 대한 임상적 고찰)

  • Moon, Mi-Hyun;Cho, Young-Kee;Rhim, Eun-Kyung;Hwang, Sang-Il;Baek, Dong-Gi;Song, Chul-Min;Jang, Tong-Young;Jeong, Hyun-Ae;Yun, Jong-Min;Woo, In;Shin, Sun-Ho;Lee, Yun-Jae
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.442-449
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    • 2004
  • This study was designed to evaluate the effects of oriental medicine and acupuncture therapy on a chronic renal failure patient suffering complications from diabetes mellitus. Methods: The clinical data was analyzed on a patient with chronic renal failure complicated by diabetes mellitus whose main symptoms were edema and numbness of lower limbs, anorexia, indigestion, nausea, vomiting, and general weakness. The patient was admitted to the internal medicine department of Wonkwang University Oriental Jeonju Medicine Hospital on July 31, 2004, and remained until August 17, 2004. He was treated with herbal medicine(Palmijiwhangtanggamibang) and acupuncture therapy. Results: After treatment, improvement was seen in symptoms and laboratory examinations(creatinine clearance). Conclusions: This study suggests that oriental medicine therapy is significantly effective in the treatment of a chronic renal failure complicated by diabetes mellitus.

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A Case of Pulmonary Edema by Idiopathic Rupture of Mitral Chordae Tendinae (승모판 건삭 파열로 인한 급성 폐부종 1예)

  • Park, Hye Kyeong;Kang, Yeun Jeong;Choi, Sang Bong;Park, I Nae;Jeung, Hoon;Hur, Jin Won;Lee, Hyun Kyung;Yum, Ho Kee;Lee, Hyuk Pyo;Jang, Ji Min;Kim, Joung Sook;Choi, Soo Jeon
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.458-461
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    • 2007
  • The typical radiographic findings of pulmonary edema from the increased hydrostatic pressure shows centrally localized consolidation, which is known as a "butterfly or bat's wing" pattern. These terms describe the anatomic distribution of edema that uniformly involve the hilum and medulla of the lung but not the peripheral region of the lung parenchyma (cortex). We present a case of butterfly wing-like pulmonary edema on a chest radiograph by mitral regurgitation due to an idiopathic chordal rupture.

Clinical Study on 2 Cases of Cervical Spondylotic Myelopathy Treated by Korean Traditional Medicine (한의학적 치료를 통하여 호전을 보인 경추증성 척수증 환자 치험 2예)

  • Lee, Tae-Geol;Kim, Kwang-Hwi;Kim, Tae-Yeon;Lee, Sang-Woon;Chu, Hui-Yeong;Kim, Ho;Lee, Sang-Gun;Choi, Jae-Yong;Choi, Kang-Eah;Cho, Hyun-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.29 no.3
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    • pp.141-148
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    • 2019
  • Cervical spondylotic myelopathy (CSM) is a severe disease that usually needs surgical treatment. We have treated two CSM patients with Korean traditonal medicine, which includes acupuncture, pharmacopuncture, herbal medicine and manual treatment (Chuna). For objective evaluation, we used Nurick's classification, JOA (Japanses Orthopedic Association) score, grip and release test and hand grasping power measurement. Post-treatment analysis has shown that grip and release test score and grasping power of two patients were both remarkably improved, along with the improvements on both Nurick's classification and JOA score. This study showed that Korean traditional medicine could be effective conservative treatment for CSM.

One case of Ramsay Hunt Syndrome which were treated with Daewhangchijahwangbaeg-byung(大黃梔子黃栢餠) and Yongdamsagantang-gami(龍膽瀉肝湯加味) (Ramsay Hunt Syndrome 환자를 대황치자황백병(大黃梔子黃栢餠)과 용담사간탕가미(龍膽瀉肝湯加味)로 치료한 치험1례)

  • Rhim Eun-Kyung;Lee Yun-Jae;Hwang Sang-Il;Baek Dong-Gi;Hong Seok-Hoon;Kim Song-Baeg;Yun Jong-Min;Yang Kyung-Suk;Choi Deok-Hwa;Shin Sun-Ho
    • The Journal of Internal Korean Medicine
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    • v.24 no.4_2
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    • pp.1007-1013
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    • 2003
  • Ramsay Hunt Syndrome is caused by infection of herpes zoster and associated with otalgia, herpetic eruptions, facial palsy, trigerminal pain and cochleovestibular dysfunction such as deafness, tinnitus, vertigo and so on. A 60-year old female, who has tinnitus, peripheral facial palsy, deafness, vertigo, postauricular pain and herpetic eschar, had been admitted to Wonkwang University Oriental Jeonju Medicine Hospital. We treated this patient with Daehwangchijahwangbaeg-byung and Yongdamsagantang-gami, and the patients showed improvement in the symptoms. So we describe the process and contents about the way the patient was cured.

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Ticagrelor Monotherapy After 3-Month Dual Antiplatelet Therapy in Acute Coronary Syndrome by High Bleeding Risk: The Subanalysis From the TICO Trial

  • Yong-Joon Lee;Yongsung Suh;Jung-Sun Kim;Yun-Hyeong Cho;Kyeong Ho Yun;Yong Hoon Kim;Jae Young Cho;Ae-Young Her;Sungsoo Cho;Dong Woon Jeon;Sang-Yong Yoo;Deok-Kyu Cho;Bum-Kee Hong;Hyuckmoon Kwon;Sung-Jin Hong;Chul-Min Ahn;Dong-Ho Shin;Chung-Mo Nam;Byeong-Keuk Kim;Young-Guk Ko;Donghoon Choi;Myeong-Ki Hong;Yangsoo Jang;TICO investigators
    • Korean Circulation Journal
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    • v.52 no.4
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    • pp.324-337
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    • 2022
  • Background and Objectives: Identifying patients with high bleeding risk (HBR) is important when making decisions for antiplatelet therapy strategy. This study evaluated the impact of ticagrelor monotherapy after 3-month dual antiplatelet therapy (DAPT) according to HBR in acute coronary syndrome (ACS) patients treated with drug eluting stents (DESs). Methods: In this post-hoc analysis of the TICO trial, HBR was defined by 2 approaches: meeting Academic Research Consortium for HBR (ARC-HBR) criteria or Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent DAPT (PRECISE-DAPT) score ≥25. The primary outcome was a 3-12 months net adverse clinical event (composite of major bleeding and adverse cardiac and cerebrovascular events). Results: Of the 2,980 patients without adverse events during the first 3 months after DES implantation, 453 (15.2%) were HBR by ARC-HBR criteria and 504 (16.9%) were HBR by PRECISE-DAPT score. The primary outcome rate was higher in HBR versus non-HBR patients (by ARC-HBR criteria: hazard ratio [HR], 2.87; 95% confidence interval [CI], 1.76-4.69; p<0.001; by PRECISE-DAPT score: HR, 3.09; 95% CI, 1.92-4.98; p<0.001). Ticagrelor monotherapy after 3-month DAPT was associated with lower primary outcome rate than ticagrelor-based 12-month DAPT regardless of HBR by ARC-HBR criteria, with similar magnitudes of therapy effect for HBR and non-HBR patients (p-interaction=0.400). Results were consistent by PRECISE-DAPT score (p-interaction=0.178). Conclusions: In ACS patients treated with DESs, ticagrelor monotherapy after 3-month DAPT was associated with lower rate of adverse clinical outcomes regardless of HBR, with similar magnitudes of therapy effect between HBR and non-HBR.

Hepatic/Renal Safety Evaluation of Cheongsimyeonja-tang (Qīngxīn Liánzǎo Tāng), Dodam-tang (Táodàn Tāng), Hyeolbuchukso-tang (Xuè Fǔ Zhú Yū Tāng), and Boshiniknai-tang (Bǔ Shèn Yì Nǎo Tāng) for Cerebrovascular Diseases : A Retrospective Study (뇌혈관질환 환자에 대한 청심연자탕(淸心連子湯), 도담탕(導痰湯), 혈부축어탕(血府逐瘀湯), 보신익뇌탕(補腎益腦湯)의 간기능과 신기능 안전성 평가 : 후향적 연구)

  • Min-hwa Kim;Im-hak Cho;I-rang Nam;Maria Kim;Ki-beom Ku;Se-yeon Lee;Jung-nam Kwon;In Lee;Jin-woo Hong;Young-ju Yun;So-yeon Kim;Chang-woo Han;So-jung Park;Jun-yong Choi;Hyeun-kyoo Shin
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.439-454
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    • 2023
  • Objectives: As Korea transitions into an aging society, the incidence of cerebrovascular disease is expected to increase. Herbal medicine is commonly used in Oriental medicine to treat cerebrovascular disease. However, there is insufficient clinical evidence to actively support the safety of herbal medicine in clinical practice. Therefore, the aim of this study was to determine the toxicity and safety of four herbal medicines (Cheongsimyeonja-tang, Dodam-tang, Hyeolbuchukso-tang, and Boshiniknai-tang) in patients with cerebrovascular disease. Methods: This study used electronic medical records to analyze patients admitted to an oriental medicine hospital from April 1, 2017, to December 31, 2020. Liver and renal function values at the time of admission and discharge were compared. Results: A total of 25 patients were included in this study. We found no significant differences in various variables, such as complete blood count, liver-renal function test, and urine, before and after the administration of the four herbal medicines. Additionally, no significant adverse events related to herbal medicine were observed. Conclusions: This study confirmed the safety of the four herbal medicines in patients with cerebrovascular disease who were hospitalized in a single Oriental medicine hospital.

A Case Report of a Patient with Facial Paralysis and Accompanying Trigeminal Neuralgia Improved by Integrative Korean Medicine Treatment (통합적인 한방치료로 호전된 삼차신경통을 동반한 말초성 안면마비 환자 1례 보고)

  • Kim, Soo-yeon;Kim, Seok-woo;Jin, So-ri;Kim, Dong-woo;Kang, Kyung-rae;Ha, Do-hyung;Kim, Eun-song;Kim, Soo-yeon;Oh, Seung-ju;Kim, Eun-jung
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.760-767
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    • 2019
  • Objective: This study reports the efficacy of using integrative Korean medicine treatments for a patient with facial paralysis and accompanying trigeminal neuralgia. Methods: A 45-year-old male patient with left side facial palsy and facial pain due to Bell's palsy with trigeminal neuralgia was treated with herbal medicine, acupuncture, pharmacopuncture, and cupping for 18 days. The treatment effect was evaluated by measuring the scores for the numerical rating scale (NRS) of facial pain, the House-Brackmann scale, and the Yanagihara scale. Results: After the hospital treatment, the patient's facial pain NRS score was decreased, and the House-Brackmann scale and Yanagihara scale scores improved after the administration of the Korean medicine treatments. Conclusions: The integrative Korean medicine treatments appeared to be effective in treating facial nerve palsy and associated trigeminal neuralgia.

A Case Report on a Patient with Aggravated Functional Dyspepsia due to COVID-19 Improved by Korean Medicine Treatment (COVID-19 후유증으로 기능성 소화불량이 악화된 환자에 대한 한의치험 1례)

  • Joo-hee Oh;Woo-sub Song;Eun-je Oh;Seung-hee Lee;Mu-jin Park;Yoon-jung Lee;Ju-yeun Shin;Dong-jin Jang;Jeong-hee Noh;Tae-ha Kwon;Dong-soo Seol
    • The Journal of Internal Korean Medicine
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    • v.44 no.5
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    • pp.875-884
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    • 2023
  • Objective: The purpose of this study is to report the clinical improvement of aggravated functional dyspepsia due to COVID-19 with Korean medicine treatment. Methods: To assess treatment outcomes, we used the GIS (Gastrointestinal Symptom Score), European Quality of Life-5 Dimensions (EQ-5D) scale, and Numeral Rating Scale (NRS). Results: After treatment, the patient's clinical symptoms improved, as indicated by GIS, EQ-5D, and NRS scores. Conclusions: Korean medicine treatment improved late complications in COVID-19 patients. This finding suggests the possibility of Korean medicine treatment for long-term COVID infections.