• Title/Summary/Keyword: Patient complaints

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Surgical Treatment of Left Subclavian Aneurysm -A case report- (Subclavian artery 의 동맥류 -1예 수술 경험-)

  • Lee, Sung Haing;Lee, Sung Koo;Han, Sung Sae;Lee, Khil Rho;Kim, Song Myung
    • Journal of Chest Surgery
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    • v.9 no.2
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    • pp.245-250
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    • 1976
  • A 33 year-old man was admitted with chief complaints of severe sharp pain on left upper interscapular region and motor weakness of left arm for 9 days. He had a history of blunt trauma over left shoulder about 3 years ago. Physical examination showed a ping pong ball sized mass which was located at the left supraclavicular area and was firm, fixed, and nonpulsatile. No bruit or murmur was obtained over the mass. Ipsilaterally, radial, ulnar, and brachial pulse were very weak and ptosis and anhidrosis were noticed. Neurologic examination revealed moderate or severe weakness of flexion and extension of left elbow, wrist and fingers, and anesthesia of the skin in left C8-T1 dermatome and hypalgesia in left C6-C7 dermatome. Retrograde aortography demonstrated complete obstruction of left subclavian artery. An exploratory operation was performed through the left 4th intercostal space. It was found that the mass was a left subclavian aneurysm of traumatic false type. Proximal and distal ligation of the aneurysm were applied and the sac was partially removed. The continuity of the subclavain artery was established by the use of a 6mm. Dacron graft from the root of the subclavian to the axillary artery. Postoperatively the patient was improved from the circulatory and neurologic disturbances.

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The Surveillance of Adverse Drug Reaction(ADR) Reported (3차 병원에서 보고된 의약품 부작용 현황 조사와 약물 부작용 관리를 위한 약사의 인식도 조사)

  • Choi, Yun Hee;Sohn, Uy Dong
    • Korean Journal of Clinical Pharmacy
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    • v.13 no.2
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    • pp.72-81
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    • 2003
  • Adverse drug reaction (ADR) may increase hospital admission, morbidity and mortality and adding extra cost to healthcare expenditures. AIMS: This study was performed to identify the types of ADR being reported in a tertiary hospital, and to find out the ways to improve current ADR monitoring system. To investigate the attitudes of hospital pharmacists towards, and their understanding of ADR reporting. METHODS: Of 117 reports submitted to the pharmacy department during 3 months survey period, A questionnaire survey of 75 randomly selected hospital pharmacists was conducted. RESULT: Of the report was from patients aged between 60 and 70. The medical department with the high frequency in ADR reporting was Internal Medicines $(60\%)$. The most common ADR manifestations were gastrointestinal complaints $(47.8\%)\;and\;80\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $38.4\%.\;55.5\%$ of respondent were aware of the need to education and information about ADR monitoring. The important reasons for unreporting ADR were unknown of how to report ADRs $(94.6\%)$. CONCLUSIONS: An ADR reporting system based on reporting by staff pharmacists has been effective increasing the number of reported reactions and pharmacist involvement in monitoring patients for ADRs. Pharmacists have the knowledge and responsibility to contribute to ADR reporting program. A great opportunity exists for pharmacists to contribute in this area of patient care.

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Survey for Standardization of Medical Examination Items in Oriental Medicine (한의 진찰항목 표준화를 위한 실태 및 수요조사)

  • Moon, Jin-Seok;Park, Sae-Wook;Kang, Byoung-Gap;Kim, Bo-Young;Kang, Kyung-Won;Choi, Sun-Mi
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.23-36
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    • 2007
  • Objective : To poll oriental medical doctors on their opinions about the necessity of standard medical charts and of detailed items in their development. Currently, oriental medical institutions use their own medical charts, but a standard medical chart is necessary for medical information sharing. Methods : Report by 912 of the 10,490 oriental medical doctors surveyed on their general aspects, actual conditions, and requirements. Results : The oriental medical doctors surveyed who worked in oriental medicine clinics, oriental medicine hospitals, and public health centers said medical examination programs should consist of chief complaints (said by 814 respondents or 89.25%), history (792 or 86.84%), ordinal symptoms (753 or 82.57%), diet (727 or 79.71%), emotions and overstrain (654 or 71.71%), side effects and allergies (622 or 68.20%), improvement of symptoms (605 or 66.34%), a questionnaire on particular diseases (558 or 61.18%), social aspects (523 or 57.35%), a physical examination (520 or 57.02%), a questionnaire on syndrome differentiation (514 or 56.36%), diagnosis using medical devices and laboratory tests (471 or 51.64%), and Sasang constitution (357 or 39.14%). Ninety-one percent of the respondents said they intended to use a standard chart, and 82.19% agreed to share patient information with medical institutions. Conclusions : Over 90 percent of the oriental medical doctors surveyed said they need a standard medical examination program. Oriental medical examination items that correspond with the opinions of the oriental medical doctors surveyed and of experts will thus be developed, and the draft chart will be distributed to oriental medical institutions with the developed medical forms and electronic medical chart.

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Changes of Clinical Practice in Gastrointestinal Perforation with the Increasing Use of Computed Tomography

  • Park, Ji-Min;Yoon, Young-Hoon;Horeczko, Timothy;Kaji, Amy Hideko;Lewis, Roger J
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.25-32
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    • 2017
  • Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

Superficial Esophageal Carcinoma Coexisting with Esophageal Leiomyoma (식도의 평활근종과 공존하는 표재성 식도암)

  • Park Ji Kwon;Chon Soon-Ho;Kim Young Hak;Chung Won Sang;Kim Hynck;Lee Cheol Burm
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.76-79
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    • 2005
  • The coexistence of mesenchymal tumor and carcinoma in the esophagus is extremely rare. We report a case of squamous cell carcinoma located at the mucosal surface over leiomyoma of the esophagus. A 76-year-old man with complaints of 3 months onset of odynophagia was diagnosed preoperatively as squamous cell carcinoma over submucosal tumor with calcification. Esophagectomy and esophagogastrostomy were performed through the right thoracotomy and upper median laparotomy. The patient is doing well without evidence of recurrence in the 25 months after resection. We discuss the pathogenesis and possible relations between the two tumors.

Mesothelial Cyst of the Posterior Mediastinum - A case report - (후 종격동에 발생한 중피낭종 - 1예 보고 -)

  • Lee Jang-Hoon;Kwon Jin-Tae;Jung Tae-Eun;Kim Mi-Jin;Lee Jung-Cheul
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.655-658
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    • 2006
  • Mesothelial cyst is a rare mediastinal tumor and usually presents in the right cardiophrenic angle. However, it sometimes occurs in atypical locations and it’s locating in the posterior mediastinum, especially, is very rare. A large cystic mass of the posterior mediastinum between pericardium and vertebral body was incidentally recognized in a patient of a 30-year-old woman admitted due to traffic accident. Even though it was very large in size measuring 18 em at longest diameter and is extending mainly to the left pleural cavity, she had no symptomatic complaints. Complete excision was performed through video-assisted thoracoscopic surgery with a additional small working window, which was necessary for dissecting the deepest point to the right pleural cavity. She is in good condition without recurrence on long-term follow-up.

A Case of Type 1 Neurofibromatosis Associated with Multiple Metastatic Gastrointestinal Stromal Tumors (다발전이성 위장관 간질종양을 동반한 제 1형 신경섬유종증 1예)

  • Jang, Hyo Jin;Koh, Sung Ae;Jeong, Da Eun;Jung, Ji Yoon;Goo, Eun Ju;Lee, Kyoung Hee;Choi, Joon Hyuk;Hyun, Myung Soo
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.105-108
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    • 2013
  • Type 1 neurofibromatosis (von Recklinghausen's disease, NF-1) is an autosomal-dominant neurocutaneous-disorder characterized by systemic cafe'-au-lait spots, multiple cutaneous neurofibromas, axillary or inguinal freckling, and Lisch nodules (pigmented iris hamartomas). Approximately 10-25% of NF1 patients have gastrointestinal neoplasms. Gastrointestinal stromal tumor (GIST) in patients with neurofibromatosis is most commonly found in the small bowel and the stomach, and approximately 60% of such patients have multiple tumors or multiple tumor sites. Although, the increased incidence of GIST in patients with neurofibromatosis is well documented in pathology literature in English, but has rarely been documented in Korea. Here, we report a case of multiple GISTs in a 48-year-old woman accompanied by NF1. She was admitted to Yeung-nam University Hospital with complaints of melena and dyspnea. A contrast-enhanced computed tomography (CT) scan revealed that multiple soft tissue masses were occupying the entire peritoneal cavity. An ultrasonogram- guided biopsy was performed and the tumors were found to have been composed of tumor cells that were positive for c-kit protein. The patient was put on Imatinib mesylate treatment, and further follow-up will be carried out.

A Case of Nonspecific Interstitial Pneumonia in a Child (소아 비특이성 간질성 폐렴 1례)

  • Kim, Tae Wan;Lym, Dae-Hyun;Kim, Jung Hee;Son, Byong Kwan;Han, Hye-Seung;Shin, Young Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.529-534
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    • 2002
  • Interstitial pneumonia is a heterogenous group of inflammatory and fibrosing lesions that manifest themselves as infiltrative lung disease. Of these, nonspecific interstitial pneumonia is characterized as a variable degree of interstitial inflammation with or without fibrosis and is distinguished from usual interstitial pneumonia and desquamative interstitial pneumonia, histologically. The influx of inflammatory cells and the responses of immune effector cells injury to the alveolar wall and these initial injuries results in alveolitis and fibrosis. Consequently, the gas exchange throughout the alveolar wall is impaired and the patients suffer from lung diseases of a restrictive pattern. The chief complaints represented are dyspnea and dry cough. We experienced a case of nonspecific interstitial pneumonia in a 10-year old girl. The patient had been healthy and had not been exposed to organic dusts or other toxic materials. The pathology of lung biopsy tissue showed that the alveoli were thickened by a mixture of chronic inflammatory cells and collagen type fibrosis. High resolution computed tomography(HRCT) found the patchy areas of ground-glass opacity with patchy consolidation and irregular reticular opacity, and diffuse distribution without zonal predominance. The forced vital capicity(FVC) was 31%, forced expiratory volume in one second ($FEV_1$) 29% and $FEV_1/FVC$ 90%, so a restrictive pulmonary insufficiency was found.

Clinical Factors Related with Helicobacter Pylori Infection - Is there an Association with Gastric Cancer History in First-Degree Family Members?

  • Demirel, Busra B.;Akkas, Burcu Esen;Vural, Gulin Ucmak
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1797-1802
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    • 2013
  • Background: The aim of this study was to assess clinical factors associated with Helicobacter pylori positivity and to evaluate the incidence of gastric carcinoma in first-degree family members of infected patients. A total of 580 patients (mean age:$38{\pm}17$) with gastrointestinal complaints underwent C-14 urea breath test (UBT). Patients were grouped as: Group-1, untreated patients (n:384); and Group-2, patients who previously treated with eradication triple therapy (n:196). C-14 UBT was performed 1-2 months after the completion of eradication therapy. Associations of H pylori positivity with age, gender, ABO and Rhesus groups, smoking, dietary habits, and history of gastric cancer in first-degree family members were evaluated. The frequency of H pylori positivity was significantly higher in group-1 (58%) compared to group-2 (20%), p=0.001. There were no correlations between H pylori positivity and age, gender, ABO groups, Rhesus subgroups, smoking and dietary habits in both patient groups. The frequency of gastric cancer in family members was significantly higher in patients with H pylori infection among group-1, compared to infected patients among group-2 (56% vs. 28.6% respectively, p=0.03). We observed a significant association between H pylori positivity and the presence of gastric cancer in first-degree relatives of group-1 patients. Our results provide some confirmation of the presence of a link between gastric cancer development and H pylori. C-14 UBT is a sensitive, reliable and a widely recommended test for the detection of H pylori infection and recurrence. We suggest that detection and eradication of H pylori may contribute to a reduced risk of gastric cancer in the family members of infected patients.

Prostate Cancer Incidence in Turkey: An Epidemiological Study

  • Zorlu, Ferruh;Divrik, Rauf Taner;Eser, Sultan;Yorukoglu, Kutsal
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9125-9130
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    • 2014
  • Background: This study aimed to determine the incidence of prostate cancer in Turkey in a population-based sample, and to determine clinical and pathological characteristics of the cases. Materials and Methods: All newly diagnosed prostate cancer patients were included in this national, multi-centered, prospective and non-interventional epidemiological registry study conducted in 12 cities representing the 12 regions of Turkey from July 2008 to June 2009. The population-based sample comprised 4,150 patients with a recent prostate cancer diagnosis. Results: Age-adjusted prostate cancer incidence rate was 35 cases per 100,000 in Turkey. At the time of diagnosis, median age was 68, median PSA level was 10.0 ng/mL. Digital rectal examination was abnormal in 36.2% of 3,218 tested cases. Most patients had urologic complaints. The main diagnostic method was transrectal ultrasound guided biopsy (87.8%). Gleason score was ${\leq}6$ in 49.1%, 7 in 27.8% and >7 in 20.6% of the cases. There was a statistically significant positive correlation between serum PSA level and Gleason score (p=0.000). The majority of patients (54.4%) had clinical stage T1c. Conclusions: This is the first population-based national data of incidence with the histopathological characteristics of prostate cancer in Turkey. Prostate cancer remains an important public health concern in Turkey with continual increase in the incidence and significant burden on healthcare resources.