• Nutrition Research and Practice
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• 제17권2호
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• pp.218-227
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• 2023

BACKGROUND/OBJECTIVES: Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors. SUBJECTS/METHODS: This was a prospective study involving hospitalized adult patients aged 18-59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m²), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio; NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay. RESULTS: Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019). CONCLUSIONS: We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.

• 사상체질의학회지
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• 제25권4호
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• pp.406-413
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• 2013

Objectives The purpose of this case study was to report improvement of palpitation, epistaxis, nausea, and anorexia after treatment with Dojeokgangki-tang gamibang in a middle-aged woman who has been taking Panax Ginseng continually. Methods Upon beginning her Dojeokgangki-tang gamibang regimen the patient was asked to self-evaluate the degree of discomfort in her symptoms using a using a number scale from 0 (no symptoms) to 10 (most severe). Evaluation of palpitation and chest discomfort was made a high priority. Results The palpitation the patient experienced, and self-evaluated as an "8" on the number scale at the time of her admission to the hospital, had disappeared (become "0") by the fourth day of hospitalization. The numerous symptoms which accompanied her palpitations (chest discomfort, nausea, anorexia, general weakness, weight loss, and depression) also improved accordingly. Conclusions Health functional food can pose serious health risks such as sudden bleeding and palpitations in individuals with pre-existing health problems. One must exercise extreme caution in deciding to take such supplements. As seen in the case of the middle-aged woman, the quality of life of patients who had experienced adverse reactions to such supplements can be treated through the administration of Dojeokgangki-tang gamibang.

• Journal of Chest Surgery
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• 제50권5호
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• pp.399-402
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• 2017

We report the case of a patient with penetrating chest trauma (right chest) who had undergone a left pneumonectomy due to pulmonary tuberculosis 24 years ago. We performed an emergent thoracotomy, finding an opening of the penetrating wound in a lower-lobe basal segment of the right lung. A stapled tractotomy was performed along the tract. Bleeding control and air-leakage control was done easily and rapidly. The patient was discharged without any complications on the seventh day of admission. Tractotomy can be a good option for treating penetrating lung injuries in patients with limited lung function who need emergent surgery.

• Journal of Chest Surgery
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• 제25권4호
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• pp.429-434
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• 1992

We experienced a rare case of traumatic ventricular septal defect by penetrating stab injury The patient was 26-year-old women who got stab wound at the left anterior third intercostal space and left sternal border with a knife. seven hours after admission, the patient was undertaken an emergency thoracotomy due to hypovolemic shock caused by massive bleeding from transected left internal mammary artery, vein, and right ventricular outflow tract. On postoperative second day, the patient was suffered from moderate dyspnea, and arterial blood gas analysis and chest X-ray revealed hypoxemia and pulmonary edema. Right heart cardiac catheterization with Swan-Ganz Cathater showed oxygen step-up between right atrium and main pulmonary artery and a 1.6:1 ratio of pulmonary to systemic blood flow. At operation, harsh systolic thrill was palpable along right ventricular outflow tract. Through small vertical right ventriculotomy, the linear ventricular septal laceration on infundibular septum was noticed, and its size was 1.5cm with sharp margin This defeat was repaired by three interrupted matress sutures using Prolene 4-O with pledget. Her postoperative course was uneventful, and she discharged with good physical condition.

• 한국의료질향상학회지
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• 제2권1호
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• pp.58-67
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• 1995

이 연구는 3차 진료기관 응급실의 기능을 정상화하기 위한 기초 자료를 수집하기 위하여, 한 3차 진료기관 응급실을 방문한 환자를 대상으로, 입원 결정서 발부와 환자의 입원 결정 양상 및 이에 영향을 미치는 요인을 파악하였다. 또한 적절성 평가 지침을 이용하여 응급실을 통한 입원의 적절성을 평가하였고 입원의 적절성과 응급실 입원 대기시간의 적절성에 영향을 미치는 요인을 분석하였다. 입원 결정서 발부에 영향을 미치는 요인은 환자의 내 외과계 구분, 진료과수, 환자 상태, 방문 경로, 방문 시간과 방문 요일이었다. 입원 결정서 발부 후 환자의 입원 여부는 환자의 성, 환자 상태, 방문 경로, 방문 요일에 따라 달리 나타났다. 환자의 연령, 내 외과계 구분과 방문 요일에 따라 입원의 적절성에 차이를 보였다. 입원 대기시간은 환자의 연령이 증가할수록 적절성이 낮았다. 이 연구를 통하여 응급실을 통한 입원 중 반수 이상의 입원이 부적절한 입원으로 평가되었고, 이 중 일부는 입원을 빨리 하기 위한 방법의 하나로 응급실을 편법으로 이용하고 있기 때문인 것으로 판단되었다. 또한 입원 결정서가 발부된 환자 중 상당수의 환자가 병상을 구할 수 없어 입원하지 못하고 있는 것으로 보아, 3차 진료기관의 환자 집중 현상과 응급실 과밀화 요인 해소를 위한 의료정책의 수립이 필요함을 확인할 수 있었다.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.231-233
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• 2005

Here we report a case of ruptured dissecting aneurysm of the posterior inferior cerebellar artery[PICA] treated with proximal PICA coil occlusion using an endovascular technique. A 28-year-old man presented with acute severe headache and vomiting followed by seizure. At admission, he was drowsy, with diplopia and right ankle hypesthesia. Computed tomographic scans demonstrated a subarachnoid hemorrhage. Cerebral angiography demonstrated a dissecting aneurysm of the left proximal PICA. One day after the bleeding episode, he was undergone proximal PICA coil occlusion using an endovascular technique. The patient's postoperative course was uneventful. The decision that led to the choice of treatment is discussed.

• Tuberculosis and Respiratory Diseases
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• 제42권1호
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• pp.105-109
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• 1995

저자들은 53세 여자 환자에서 Salmonella Group B에 의한 농흉 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Journal of Trauma and Injury
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• 제34권4호
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• pp.299-304
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• 2021

Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

• 대한한방소아과학회지
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• 제21권3호
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• pp.1-10
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• 2007

Objectives The purpose of this study is to report a pediatric patient with bilateral facial nerve palsy. Methods The patient was treated by acupuncture, moxa, herb(Cheongungkyeoji-tang, Palmulgunja-tang) for 1 month. We described his progression and measured the degree by House-Brackmann scale and Yanagihara's scale. Results He started getting better from 7th day of the onset. During admission, the facial palsy had improved from Grade V/V(Rt/Lt) to Grade II/II(Rt/Lt) by House-Brackmann scale and from 0/0(Rt/Lt)score to 36/36(Rt/Lt)score by Yanagihara's scale. Conclusions Compared with unilateral facial nerve palsy cases, this case was not different from the time when it got better, and how much it improved. However, biased degree had increased and then decreased because of the time gap between the right facial improvements and left facial one.

• Journal of Chest Surgery
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• 제30권7호
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• pp.719-723
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• 1997

저자들은 대동맥 판막치환술 후 생긴 대동맥 판막 주위 누출과 관련된 대동맥동류의 심실 중격 박리를 경험하였다. 37세 남자 환자가 호흡 곤란의 증가를 주소로 응급실을 통하여 입원하였다. 그는 6년전 대동맥판 폐쇄 부전과 승모판 폐쇄 부전으로 인공 기계 판막(Carbomedic 23mm와 31mm)으로 치환 수술을 받고 정기적으로 추적 검진 중이었다. 진단은 경흉부및 경식도 심초음파로 이루어졌고, 대동맥 조영술로 확인되었다. 폐동맥판 동종이식편(Pulmonary homoyaft)를 사용하여 대동맥 판막 치환술을 다시 시행하였다. 심실중격내의 낭 입구에서 3-0 prolene을 사용하여 심근 내막, 외막과 homograft muscle shoulder를 한꺼번에 연속 봉합하였다. 술후 경과는 양호하여 환자는 수술 후 11일째 퇴원하였다.