• 제목/요약/키워드: Patient Assessment Report

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산탄총에 의한 좌측 안면부 손상 환자의 치험례 (증례보고) (REPORT OF THE MANAGEMENT OF GUNSHOT WOUNDS TO THE LEFT FACE)

  • 김일규;이상선;오성섭;최진호;김형돈;오남식
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권2호
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    • pp.224-227
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    • 2000
  • Gunshot wounds to the face are often dramatic at the time of presentation. Although care must be individualized, protocol approach helps the clinician rapidly evaluate patient and plan treatment. Early X-ray films help to determine the precise trajectory. Rapid neurologic assessment and early CT scanning based on physical examination ot trajectory will allow for identification of even occult injuries early. Lead poisoning arising from bullet lead in the synovial cavity of the hip, synovial cavity of the chest and pleural space have been reported. A combination of surgical debridement and chelation therapy with oral succimer produce a satisfactory outcome. We have managed a patient with Lt facial gunshot wound and Lt mandible angle fracture by open reduction of angle fracture and surgical removal of remnant bullet and medially advanced cheek skin flap. We have obtained good result and report this case with review of literatures.

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Verrucous carcinoma arising from a previous cystic lesion: a case report

  • Kang, Sunghyun;Leem, Dae Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.31.1-31.8
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    • 2018
  • Background: Verrucous carcinoma (VC) accounts for 1-10% of cases of squamous cell carcinoma (SCC) in the oral cavity, and 75% of VC occur in the oral cavity. Only 3% of primary intraosseous squamous cell carcinomas (PIOSCC), which means SCC occurring primarily in the bone, are VC. Verrucous carcinoma arising from odontogenic cysts (OC) is very rare, with only seven cases reported to date. Case presentation: This study reported a case of a patient who underwent partial maxillectomy and neck dissection for VC that occurred in the right anterior maxilla. The patient was admitted to the emergency department at our institution 8 years ago and showed cystic lesions in the anterior maxilla on facial computed tomography (CT) images. Treatment through other departments including assessment of laceration in the mental region and only suture was performed. This report highlights a very rare case of VC in the right anterior maxilla arising from a previous cystic lesion. Conclusions: Since PIOSCC can arise from OC, appropriate treatment of intraosseous cysts and regular radiologic evaluation are necesssary. Surgical exicision of the primary lesion without neck dissection can lead to good prognosis for patients with primary intraosseous verrucous carcinoma.

과체(瓜蔕) 토법(吐法)을 이용한 심인성 진전 환자 치험 2례 (A Case Report of 2 Patients with Psychologic Tremor Using Korean Medical Treatments with MCVT (Melonis Calyx Vomiting Therapy))

  • 임교민;송건의;박세진;조승완;이주현
    • 동의신경정신과학회지
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    • 제30권2호
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    • pp.107-118
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    • 2019
  • Objectives: The objective of this study is to report the effectiveness of Korean medicine therapy on Psychologic tremor patients with MCVT. Methods: Korean medicine therapy including MCVT, herb, acupuncture, and psychotherapy are applied to psychologic tremor patients. Vas and AIMS are used as assessment tools to evaluate the effects of therapy. MCVT is a traditional Korean medicine technique usually for chronic diseases. Similarly, autogenic training by J.H.Schultz and Giungoroen-therapy was conducted as psychotherapy. Results: In case 1, the patient lost all symptoms from vas10 to vas0, while in case 2, symptoms of the patient decreased from vas10 to vas3. Additionally, there was a significant decrease in the AIMS measurement score for both patients. Psychotherapy helped to reduce depression and anxiety. Conclusions: Psychologic tremor can be treated using Korean traditional medicine such as MCVT, Sosiho-tang and psychotherapy.

대퇴부 괴사성 근막염의 외과적 수술 후 한방치료에 대한 증례 보고 (Korean Medical Treatment after Surgical Treatment of Necrotizing Fasciitis on Thigh : A Case Report)

  • 금지혜;하원배;이정한
    • 척추신경추나의학회지
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    • 제13권2호
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    • pp.85-95
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    • 2018
  • Objectives : The aim of the present study was to report the clinical progress of a patient who underwent surgical treatment of necrotizing fasciitis. Methods : During the admission period, The patient was treated with acupuncture, cupping, Korean Medicine, Chuna therapy every day and observed by Numeric Rating Scale(NRS), Pain Disability Index(PDI), Beck Depression Inventory(BDI), and assessment about range of motion(ROM) and manual muscle test(MMT) for hip & knee joint. Results : After treated by using above treatment, NRS, PDI, BDI and ROM, MMT were improved. Conclusions : Korean Medical treatment are estimated to be good for patients after surgical treatment of necrotizing fasciitis. But more cases are required to prove the effectiveness of the treatment.

Efficacy of Integrated Korean Medicines in the Treatment of Partial Triangular Fibrocartilage Complex Tears: A Case Report

  • Jae-Joon Ha;Myeong-Yeol Yang;Ji-Sun Kim;Hong-Wook Choi;Gyu-Bin Lee;Dong-Ju Yoon;Dong-Jin Kim;Do-Young Kim
    • Journal of Acupuncture Research
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    • 제40권4호
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    • pp.382-388
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    • 2023
  • The triangular fibrocartilage complex (TFCC) is crucial for stabilizing the ulnar side of the wrist but can be partially torn due to degenerative changes, falling, or sudden injuries. However, only a few studies have focused on the use of Korean medicine treatments for TFCC-related wrist pain. This case report presents the successful outcomes of integrated Korean medicine treatment in a patient with a partial TFCC tear. The diagnosis was confirmed via magnetic resonance imaging, which revealed the tear. Subsequently, the patient received integrated Korean medicine treatments. The assessment of the pain scale scores revealed a significant reduction in wrist pain and an improvement in daily life activities. Based on the findings of this study, integrated Korean medicine treatments have been proven to be an effective treatment option for patients with a partial TFCC tear. However, further research is needed to determine the potential benefits and mechanisms of these treatments in managing TFCC-related wrist pain.

출혈을 동반한 급성기 허혈성 뇌중풍 환자에 대한 한방치료 증례 보고 1례 (A Case Report of Korean Medicine Treatment for Acute Cerebral Infarction with Cerebral Hemorrhage)

  • 전상우;이기향;강세영
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.999-1006
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    • 2019
  • Objectives: The purpose of this study was to report the improvement of symptoms by Korean medicine in acute hemorrhagic infarction. Method: The patient was diagnosed with a cerebral infarction of the right temporal lobe accompanied by cerebral hemorrhage of the left basal ganglia. He did not receive intravenous thrombolytic treatment. Sunghyangjungi-san-gamibang was initially administered, and Gami-daebo-tang was administered during the recovery phase, together with Uhwangchungsim-won, Simjeok-hwan, and acupuncture. The prognostic observation was conducted using the manual muscle test (MMT), the Korean version of the modified Bathel index (K-MBI), and subjective assessment. Results: After Korean medicine treatment, the K-MBI score was improved from 52 to 93. The MMT score and subjective assessment also showed improvement. Conclusions: For patients who cannot be treated with intravenous thrombolytic treatment, Korean medicine treatment is effective during the early and recovery stages of stroke.

Treatment of velopharyngeal insufficiency in a patient with a submucous cleft palate using a speech aid: the more treatment options, the better the treatment results

  • Park, Yun-Ha;Jo, Hyun-Jun;Hong, In-Seok;Leem, Dae-Ho;Baek, Jin-A;Ko, Seung-O
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제41권
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    • pp.19.1-19.6
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    • 2019
  • Background: The submucous cleft palate (SMCP) is a type of cleft palate that may result in velopharyngeal insufficiency (VPI). Palate muscles completely separate oral and nasal cavities by closing off the velopharynx during functional processes such as speech or swallow. Also, hypernasality may arise from anatomical or neurological abnormalities in these functions. Treatments of this issue involve a combination of surgical intervention, speech aid, and speech therapy. This case report demonstrates successfully treated VPI resulted from SMCP without any surgical intervention but solely with speech aid appliance and speech therapy. Case presentation: A 13-year-old female patient with a speech disorder from velopharyngeal insufficiency that was caused by a submucous cleft palate visited to our OMFS clinic. In the intraoral examination, the patient had a short soft palate and bifid uvula. And the muscles in the palate did not contract properly during oral speech. She had no surgical history such as primary palatoplasty or pharyngoplasty except for tonsillectomy. And there were no other medical histories. Objective speech assessment using nasometer was performed. We diagnosed that the patient had a SMCP. The patient has shown a decrease in speech intelligibility, which resulted from hypernasality. We decided to treat the patient with speech aid (palatal lift) along with speech therapy. During the 7-month treatment, hypernasality measured by a nasometer decreased and speech intelligibility became normal. Conclusions: Surgery remains the first treatment option for patients with velopharyngeal insufficiencies from submucous cleft palates. However, there were few reports about objective speech evaluation pre- or post-operation. Moreover, there has been no report of non-surgical treatment in the recent studies. From this perspective, this report of objective improvement of speech intelligibility of VPI patient with SMCP by non-surgical treatment has a significant meaning. Speech aid can be considered as one of treatment options for management of SMCP.

Rhinoplasty Education Using a Standardized Patient Encounter

  • Wright, Eric J.;Khosla, Rohit K.;Howell, Lori;Lee, Gordon K.
    • Archives of Plastic Surgery
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    • 제43권5호
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    • pp.451-456
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    • 2016
  • Background Comprehensive aesthetic surgery training continues to be a challenge for residency programs. Our residency program developed a rhinoplasty-based objective structured clinical examination (OSCE) based upon validated methods as part of the residency education curriculum. We report our experience with the rhinoplasty-based OSCE and offer guidance to its incorporation within residency programs. Methods The encounter involved resident evaluation and operative planning for a standardized patient desiring a rhinoplasty procedure. Validated OSCE methods currently used at our medical school were implemented. Residents were evaluated on appropriate history taking, physical examination, and explanation to the patient of treatment options. Examination results were evaluated using analysis of variance (statistical significance P<0.05). Results Twelve residents completed the rhinoplasty OSCE. Medical knowledge assessment showed increasing performance with clinical year, 50% versus 84% for postgraduate year 3 and 6, respectively (P<0.005). Systems-based practice scores showed that all residents incorrectly submitted forms for billing and operative scheduling. All residents confirmed that the OSCE realistically represents an actual patient encounter. All faculty confirmed the utility of evaluating resident performance during the OSCE as a useful assessment tool for determining the Next Accreditation System Milestone level. Conclusions Aesthetic surgery training for residents will require innovative methods for education. Our examination showed a program-educational weakness in billing/coding, an area that will be improved upon by topic-specific lectures. A thoroughly developed OSCE can provide a realistic educational opportunity to improve residents' performance on the nonoperative aspects of rhinoplasty and should be considered as an adjunct to resident education.

The effect of hip joint strengthening exercise using proprioceptive neuromuscular facilitation on balance, sit to stand and walking ability in a person with traumatic brain injury: a case report

  • Jung, Du Kyo;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • 제6권2호
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    • pp.96-104
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    • 2017
  • Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

A Patient with Symptoms Caused by Electric Shock Treated with Traditional Korean Medicine

  • Lee, Young Rok;Kim, Beom Seok;Lee, Ye Ji;Kim, Hyo Bin;Sung, Ki Jung;Cha, Hyun Ji;Jeon, Ju Hyun;Kim, Young Il
    • Journal of Acupuncture Research
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    • 제37권3호
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    • pp.193-201
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    • 2020
  • This case report describes a 60-year-old female patient diagnosed with intercostal neuropathy and vertebral compression fractures which occurred following an electric shock injury. The patient received acupuncture, pharmacopuncture, and herbal medicine administration between February 10th, 2020 and April 25th, 2020. The pain level in the thoracic and left intercostal areas was assessed using the Numerical Rating Scale. The Self-report of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale were used to diagnose neuropathic pain. The Neuropathic-Pain -Scale was used to evaluate the degree of neuropathic symptoms. The Oswestry Disability Index and the European Quality of Life-5 Dimensions were used to assess quality of life scales and functional disorder. Following combined Korean medicine treatment, the patient exhibited reduced levels of pain and significant improvement in functional disorder symptoms and quality of life.