• 제목/요약/키워드: Medical history taking

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Management of patients with allergy to local anesthetics: two case reports

  • Arya, Varun;Arora, Geetanjali;Kumar, Sanjeev;Kaur, Amrita;Mishra, Santosh
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권6호
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    • pp.583-587
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    • 2021
  • Lidocaine is the most commonly used local anesthetic (LA) agent in various dental as well as oral and maxillofacial procedures. Although rare, adverse effects and allergic reactions to lidocaine have been reported. In patients with suspected allergy to LA or a history of such reaction, careful history-taking and allergy testing should be performed to choose an alternative LA agent to avoid any adverse effects. Here, we present two cases of delayed hypersensitivity reaction to lidocaine, wherein the patients presented with erythema, edema, and itching. Intradermal testing confirmed allergic reaction to lidocaine, and the patients underwent successful dental treatment using an alternative LA agent. This report highlights the importance of allergy testing prior to LA use considering the serious consequences of allergy to these agents and describes the management of such patients using an alternative LA agent.

이천 의학사상(醫學思想)의 학술계통(學術系統) 및 특징(特徵)에 대한 연구(硏究) (A Study of Yi cheon's Medical Ideology and Research System)

  • 차웅석
    • 한국의사학회지
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    • 제14권2호
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    • pp.189-248
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    • 2001
  • In this essay, following final conclusions have been drawn by analyzing medical ideology and research system of Yi cheon in Yi hak yip mun("醫學入門"). Firstly, even though the existing medical history researchers are not noting the system of Yi-cheon's medical ideology, this essay has proved the man as a doctor who succeeded the (main system) based on the content of Yi-hak-yip-mun("醫學入門") by Ju-Dan-Gae(朱丹溪). The outline of this proof is as follows. 1. Those doctors who had actively researched in Myung era(明代), were basically taking over the medical studies and result of Gum-Won era(金元代). However, depending on whose theory is to be followed, the followers are largely divided into two groups of Ju-Dan-Gae Academics(丹溪學派) and On-Boe Academics(溫補學派). In addition, both Ju-Dan-Gae Academics(丹溪學派) and On-Boe Academics(溫補學派) hold contradictory ideologies to that of the main medical system. In Yi-hak-yip-mun("醫學入門"), Yi-cheon(李?) ties The Text of Whang-Jae-Nae-Kyung("黃帝內經"), Jang-Jung-Kyung(張仲景), Yu-Ha-Gun(劉河間), Yi-Dong-Won(李東垣), Ju-Dan-Gae(朱丹溪) into one pedigree. With regard to the main system, he especially marks Ju-Dan-Gae(朱丹溪) for his efforts in gathering various medical theories into a large compilement. 2. When Yi-Cheon(李?) was writing Yi-Hak-Yip-Mun("醫學入門"), he made references to various medical publishings, among those book which he had utilized, books by Ju-Dan-Gae Academics(丹溪學派) had affected him more than anything else in terms of both quality and quantity. 3. Yi-Cheon(李?)'s "Congested Phlegm Theory(痰鬱論)" had succeeded "Congested Phlegm Theory(痰鬱論) of Ju-Dan-Gae Academics(丹溪學派). His Yi-Hak-Yip-Mun("醫學入門"), carries a more complete form of "Congested Phlegm Theroy(痰鬱論) which was made into a more systemic and widely applicable method which was by Ju-Dan-Gae Academics(丹溪學派). Secondly, Yi-Hak-Yip-Mun("醫學入門"), is a medical book which was written in the process of systemic reorganization of medical theories of various academic parties in Myung 명 era. Since this process was hearing its completion in the period of Yi-Cheon(李?), he chose specific ways of reshuffling, whilst seeking ways to efficiently utilizing existing medical information . He provided a standard to specific ways. He rearranged the existing medical theories based upon these standards. He also contributed to clinical medicine by providing description of symptoms focused upon the symptoms differentiated In Conclusion, Yi-Hak-Yip-Mun("醫學入門") holds systematic medical information which was developed by Ju-Dan-Gae Academics(丹溪學派). Also, Yi-Cheon(李?) uniformly classified the clinical experiences of existing Ju-Dan-Gae Academics(丹溪學派). He had contributed in the clinical use of Ju-Dan-Gae Academic(丹溪學派)'s clinical experience by providing main points from differentiation of symptoms.

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척추 경막외 출혈에 대한 수술적 치료성적 분석 (Analysis of the Outcomes of Surgically-Treated Spinal Epidural Hematomas)

  • 조영현;박진훈;김지훈;노성우;김창진;전상룡
    • Journal of Trauma and Injury
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    • 제23권2호
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    • pp.163-169
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    • 2010
  • Purpose: Spinal epidural hematoma (EDH) is a rare condition requiring an urgent diagnosis and management. We describe here the clinical features, magnetic resonance image (MRI) findings, and outcomes of surgery in six patients with spinal EDH. Methods: We retrospectively analyzed six patients who underwent surgery for spinal EDH between April 2004 and May 2010. Preoperative MRI findings within 48 hours of symptom occurrence were analyzed for cord compression, extent of EDH, and presence of vascular abnormalities. Pre- and postoperative neurological status was also assessed comparatively. Results: Our six patients consisted of three men and three women, with a mean age of 70 years (range: 54-88 years), who presented with the back pain or motor weakness. The mean follow-up period was 34 months (range: 2-72 months). Two patients had cardiovascular disease and were taking warfarin, but the others had no history of medical comorbidity. Those two patients taking warfarin had a history of trauma, another one experienced symptoms during a strenuous effort, and the others developed spontaneously. Before surgery, motor power was grade III in three patients, grade 0 in two patients, and normal in one patient. Preoperative MRI showed no vascular abnormalities except for the EDH in any patient. At the last follow-up, all those five patients with motor weakness showed neurological improvement compared to their preoperative status. There were no complications related to surgery. All six patients were able to ambulate with or without an assistive device. Conclusion: Spinal EDH can occur in patients without trauma, bleeding diathesis, or combined vascular pathology. The surgical outcomes of spinal EDH seem to be satisfactory, even in quadriplegic patients.

초음파기기를 이용한 맥상(脈象) 연구 (A Study on Pulse Pattern Using Ultrasonic Device)

  • 김희영;박정빈;금유정;여인금;엄동명;송지청
    • 대한한의학원전학회지
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    • 제34권2호
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    • pp.85-94
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    • 2021
  • Objectives : Pulse diagnosis is one of the main diagnostic methods of Korean Medicine that understands the patient's condition and illness by reading changes in the patient's pulse, which is described in terms of pulse condition While they are described in detail in medical texts, it is difficult to grasp their true nature, as the written descriptions fail to do justice to the experience of pulse taking it tries to convey. As a way to approach pulse condition the effect of the body's tension on the radial vein was measured using an ultrasonic device, after which the measured changes and how they could be reflected in pulse condition were studied. In other words, changes in the radial vein following induced tension were analyzed. Methods : 1) The thickness of the subject's radial vein was measured using a linear probe of an ultrasonic device[LOGIQ 5 Basic, GE, USA]. 2) Fatigue level was increased through artificial stimulation using the Gripmeter[ks-301, Lavisen, Korea]. 3) Thickness of the radial vein post tension induction was measured. 4) The results were analyzed with the Tukey test or paired t-test as post hoc tests. Results : Thickness of the radial vein of the subject pre- and post- Gripmeter stimulation decreased with significance. Conclusions : Constriction of the radial vein that happened after tension induction could be linked to the Tight Pulse[緊脈] that is related to patterns of contraction and pulling.

녹화영상 활용 학습법이 학생들의 '환자-의사관계'에서의 자기성찰에 미치는 영향 (The Effect of Recorded Video Monitoring on Students' Self Reflection of Patient-Physician Interaction)

  • 주미선;황지영;김재명;강재구
    • 의학교육논단
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    • 제19권2호
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    • pp.83-89
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    • 2017
  • The aim of this study is to examine the effect of recorded video monitoring on students' self-reflection after completing their clinical performance examination. Taking into account the particular cases involved in the examination, the present study utilized history-taking, physical examination, and patient education as bases for evaluating information-establishment ability, and asking, listening, understanding, explaining, and connectedness as the bases for evaluating patient-physician interaction ability. Student self-monitoring through recorded video feedback was carried out three days after completion of their clinical performance examination. Students self-evaluated their performance with a 10-point scale before and after self-monitoring. The results of this study show that students have a general tendency to lower their own self-evaluation scores after self-monitoring. Although there was not a statistically significant change of interrelationship in the information-establishment ability evaluation, there was a meaningful change of interrelationship in the patient-physician interaction ability evaluation after self-monitoring; specifically, in the case of acute lower abdominal pain, a high correlation was found (r=0.31, p=0.02) between the evaluation scores of standardized patients and students related to patient-physician interaction ability. This implies that self-monitoring enables the students to acquire a reflective viewpoint from which to evaluate their own performance. Therefore, it can be said that self-monitoring through recorded video feedback is a valuable method for students to use in reviewing their performance in patient-physician interactions.

Distribution of medical status and medications in elderly patients treated with dental implant surgery covered by national healthcare insurance in Korea

  • Lee, Kyungjin;Dam, Chugeum;Huh, Jisun;Park, Kyeong-Mee;Kim, Seo-Yul;Park, Wonse
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권2호
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    • pp.113-119
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    • 2017
  • Background: The purpose of this study was to investigate the distribution of systemic diseases and medications in patients older than 65 years of age who visited the hospital for implant treatment, as well as to investigate basic information about surgical complications that may occur after insured implant treatment. Method: A total of 126 patients over 65 years of age were treated for implant surgery from October 1, 2013 to October 30, 2016. Electronic chart review was conducted to obtain medical records, which included sex, age, systemic diseases, medication(s) being taken, and control of the medications. Five patients were excluded due to lack of medical records giving information about systemic disease. Results: Of the 126 patients, 112 (88.9%) were taking medication due to systemic disease and 9 patients (7.1%) were not. The sex distribution was 71 women and 55 men and the highest proportion of patients were between 65 and 69 years old. The most common diseases were, from most to least frequent, hypertension, cardiovascular disease, diabetes, and osteoporosis. The drug groups that can cause major complications after dental treatment were classified as hemorrhagic, osteoporotic, and immunosuppressive agents, and were taken by 45 (35.7%), 22 (17.5%) and 4 (3.2%) patients, respectively. Conclusion: Given that 88.9% of the elderly patients who were eligible for insurance implant treatment had systemic disease, it is necessary to carefully evaluate patients' medical histories and their general conditions in order to prevent emergencies during implant surgery.

동아시아에서 황칠수(黃漆樹)의 활용에 대한 연구(硏究) (A study of the application of Hwangchil Tree (黃漆樹 Dendropanax morbiferus H.Lév.) in East Asia)

  • 안영수;류정아
    • 한국의사학회지
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    • 제33권1호
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    • pp.43-57
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    • 2020
  • Essence of the Hwangchil tree (黃漆樹 Dendropanax morbiferus H.Lév.) has been used for various purposes, like waxing emperor's armors, covering an astrology board, or, during the Silla Dynasty, burying it to block something bad in the soil symbolically. Essence of the Hwangchil tree was known to have remarkable preservation effects such as waterproofing, damp-proofing, rust-proofing, and moth-proofing as well as not being easily peeled off from even soft surfaces like paper. There is a record in Prescriptions for Epidemic diseases of Cows, Horses, Sheep, and Pigs (牛馬羊猪染疫病治療方), published in 1541, of Hwangchil that is local to Jeju Island being used instead of benzoin (安息香), of burning Hwangchil, and of making cows inhale its smoke to prevent plague among them. Along the same lines, there are records in the Local Chronicle of Tamra (耽羅志) and the Book of Earth Geography (輿地圖書) that identify Hwangchil with benzoin. In Seonghosaseol (星湖僿說), a book written by Lee Yik in around 1760, it is acknowledged that Hwangchil could be medicinal herb. In 2000, Ahn Duk-Kyun registered the roots and branches of Hwangchil tree as 'Boncho' (本草 herbal medicine) in the Pictorial Book of Korean Medicinals (韓國本草圖鑑) and presented the method of taking it for medical purpose. Researchers have suggested that Hwangchil essence as well as diverse parts of the plant such as its roots, branches, leaves, flowers, fruits, and gum have various meaningful medicinal properties. Regarding the history and recent researches of using Hwangchil tree, it has various medicinal probabilities such as, 'dispersing miasma' (辟邪), 'opening holes' (開竅), 'waking the heart' (醒心), 'smoothing spirits' (安神), 'piercing the block' (疎泄), 'removing the old and welcoming the new' (去故生新). This paper contributes ideas about how to expand the uses of Hwangchil Tree.

Multicentre Hospital-based Case-control Study of Diffuse Large B-cell Lymphoma in Shanghai, China

  • Fan, Rong;Zhang, Lu-Yao;Wang, Hong;Yang, Bo;Han, Tao;Zhao, Xiao-Li;Wang, Wei;Wang, Xiao-Qin;Lin, Guo-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3329-3334
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    • 2012
  • Background: Several potential risk factors have been identified for diffuse large B-cell lymphoma (DLBCL); however, epidemiological studies investigating the association between these risk factors and DLBCL have yielded inconsistent results. Objectives: To investigate potential medical, lifestyle, and environmental risk factors of DLBCL in Shanghai, China through a hospital-based case-control study. Method: One-hundred-and-forty-seven newly diagnosed DLBCL patients and 294 sex- and age-matched controls were recruited from 11 hospitals in Shanghai between 2003 and 2007. A standardized structured questionnaire was used to obtain patient data on demographics, medical history, family history, lifestyle, and environmental exposures. Conditional logistic regression models were used to estimate odds ratios (ORs), with 95% confidence intervals (CIs), for risk associated with each data category. Results: History of tuberculosis (TB) infection and "living on a farm" were positively associated with DLBCL (TB: OR=3.05, 95% CI: 1.19-7.80; farm: OR=1.82, 95% CI: 1.21-2.73). In contrast, taking traditional Chinese medicine was negatively associated with DLBCL (OR=0.36, 95% CI: 0.14-0.89). No significant correlation with DLBCL risk was found for any of the other potential risk factors (p>0.05), including but not limited to hair dyes, alcohol drinking, smoking, and home/workplace renovation within one year. Conclusions: Consistent with results from previous studies in other DLBCL case populations, traditional Chinese medicine appeared to have a direct or indirect protective effect against DLBCL. However, this study also identified a possible predisposition for DLBCL in TB sufferers and farmers.

A Case of Pentastomiasis at the Left Maxilla Bone in a Patient with Thyroid Cancer

  • Cho, Eunae Sandra;Jung, Seung Wook;Jung, Hwi-Dong;Lee, In Yong;Yong, Tai-Soon;Jeong, Su Jin;Kim, Hyun Sil
    • Parasites, Hosts and Diseases
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    • 제55권4호
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    • pp.433-437
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    • 2017
  • Pentastomiasis, a zoonotic parasite infection, is typically found in the respiratory tract and viscera of the host, including humans. Here, we report for the first time an extremely rare case of intraosseous pentastomiasis in the human maxilla suffering from medication related osteonecrosis of the jaw (MRONJ). A 55-year-old male had continuously visited the hospital for MRONJ which had primarily developed after bisphosphonate and anti-neoplastic administration for previous bone metastasis of medullary thyroid cancer. Pain, bone exposure, and pus discharge in the right mandible and left maxilla were seen. Osteolysis with maxillary cortical bone perforation at the left buccal vestibule, palate, nasal cavity, and maxillary sinus was observed by radiologic images. A biopsy was done at the left maxilla and through pathological evaluation, a parasite with features of pentastome was revealed within the necrotic bone tissue. Further history taking and laboratory evaluation was done. The parasite was suspected to be infected through maxillary open wounds caused by MRONJ. Awareness of intraosseous pentastomiasis should be emphasized not to be missed behind the MRONJ. Proper evaluation and interpretation for past medical history may lead to correct differential diagnosis and therapeutic intervention for parasite infections.

How to approach feeding difficulties in young children

  • Yang, Hye Ran
    • Clinical and Experimental Pediatrics
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    • 제60권12호
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    • pp.379-384
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    • 2017
  • Feeding is an interaction between a child and caregiver, and feeding difficulty is an umbrella term encompassing all feeding problems, regardless of etiology, severity, or consequences, while feeding disorder refers to an inability or refusal to eat sufficient quantities or variety of food to maintain adequate nutritional status, leading to substantial consequences, including malnutrition, impaired growth, and possible neurocognitive dysfunction. There are 6 representative feeding disorder subtypes in young children: infantile anorexia, sensory food aversion, reciprocity, posttraumatic type, state regulation, and feeding disorders associated with concurrent medical conditions. Most feeding difficulties are nonorganic and without any underlying medical condition, but organic causes should also be excluded from the beginning, through thorough history taking and physical examination, based on red-flag symptoms and signs. Age-appropriate feeding principles may support effective treatment of feeding difficulties in practice, and systematic approaches for feeding difficulties in young children, based on each subtype, may be beneficial.