• Title/Summary/Keyword: Patient outcome

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수지 첨부 손상에서 피부이식을 동반하지 않은 무세포 진피조직의 사용 (Application of acellular dermal matrix without skin graft in fingertip injury)

  • 이동휘;강재경
    • Journal of Medicine and Life Science
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    • 제15권1호
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    • pp.23-26
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    • 2018
  • The most common surgical repair method for fingertip injuries are replantation, flap coverage, and skin graft. In fingertip injury cases, acellular dermal matrix (ADM) is generally used in a two-stage operation. In the present case, only ADM was used in a 67-year-old male patient with a right fifth fingertip injury. The patient was undergoing chemotherapy after surgery for colon cancer, preventing prolonged hospitalization. In addition, wound healing was likely to be problematic. As a typical surgical method might have been difficult to apply in such a patient, we performed a one-stage operation, using only ADM on the injured area. Postoperative followup for 3 months showed good wound healing. Accordingly, we report a successful treatment outcome using ADM alone for a fingertip injury.

대전자 동통 증후군에 대한 복합 한의진료 경과: 증례보고 (Greater Trochanteric Pain Syndrome Managed with Korean Medicine Therapy: A Case Report)

  • 서지혜;조희근
    • 한방재활의학과학회지
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    • 제29권4호
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    • pp.127-134
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    • 2019
  • The Objective of this study is to report the results of greater trochanteric pain syndrome (GTPS) patient with Korean medicine therapy. There were insufficient clinical trials and case reports of GTPS treated with Korean medicine, we report the GTPS case remarkably improved treatment results. We treated the patient with acupuncture, acupotomy, pharmacopuncture, Chuna manual therapy and herbal medication. To evaluate the treatment effects, we used the measures including Verbal numerical rating scale, Oswestry disability index and Victorian Institute of Sport Assessment-gluteal tendinopathy scale. After total of 26 days of treatment, the patient's hip pain and disability were greatly reduced, and the outcome measures showed this great improvement. Korean medicine therapy might be effective in GTPS, although further study is needed to determine the role for Korean medicine.

Therapeutic Effect of Nangan-geon for an Elderly Patient with Refractory Abdominal Pain: a Case Report

  • Son, Chang-Gue
    • 대한한의학회지
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    • 제43권2호
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    • pp.110-116
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    • 2022
  • Objectve: To inform a clinical usefulness of Nangan-geon (暖肝煎) decoction to treat a refractory abdominal pain especially in eldery. Methods: This case report presents an 85-year old male patient who had been suffered with a refractory abdominal pain without any abnormality in laboratory test and radiological examination for 5-years. The clinical outcome was observed by numerical rating scale (NRS) of self-reporting method. Results: Based on his previous multiple normal examination results from Western hospitals and clinical features including thin body (19.6 BMI), nocturnal pain around lower abdomen and cold-sensitivity, author diagnosed him as "deficiency and cold of liver-Qi (肝氣虛寒)" similar to intestinal spasm. After prescription with Nangan-geon (暖肝煎) for one month, all symptoms became improved notably (NRS 5), and almost completely recovered as a level of normal condition in 3 months (NRS 1). Conclusion: This study would show the potential of traditional Korean medicine (TKM) therapies for a refractory functional abdominal pain, and especially efficacy of Nangan-geon against cold-pattern of nonspecific abdominal pain in elderly patients.

Foot Function Index와 Foot and Ankle Outcome Score의 기입방법 연구: 종이와 연필을 이용한 기입 방법과 전자기기를 이용한 두 가지 측정방법에 대한 일치도 비교 (The Methods for Foot Function Index and Foot and Ankle Outcome Score Measurement: A Comparison between Paper-and-Pencil Method and Electronic Method)

  • 김지범;권민수;김정곤;이영;이우천;하정구;장석환
    • 대한족부족관절학회지
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    • 제21권1호
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    • pp.33-38
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    • 2017
  • Purpose: The patient-reported outcome measure (PROM) is used to quantify the subjective state of patients before and after the treatment. The electronic method was recently developed and used for the completion of PROM, in addition to the conventional paper and pencil method. This study identified whether the results of Foot Function Index (FFI) and Foot and Ankle Outcome Score (FAOS) using the paper and pencil method was different from those using the electronic method. Materials and Methods: Between May 2016 and August 2016, 42 patients who were admitted to the Seoul Foot and Ankle Center two days before surgery were included for evaluation. The mean age was 46 years (range, 21~72 years). There were 29 males and 13 females. To use the electronic method, the PADAS software (PADAS, Seoul, Korea) was implemented using a touch pad. The primary trial of FFI and FAOS was performed using either the paper-and-pencil method or the electronic method. At 24 hours after the primary test, a secondary trial of FFI and FAOS was performed using the other method. Then, we identified the reliability of FFI and FAOS between the two methods by calculating the intraclass coefficient. Results: Twenty-two patients underwent the first trial using the paper-and-pencil method, and 20 patients underwent the first trial using the electronic method. Of the 42 patients, 8 patients were excluded from this study and only 34 patients were included in this study. The reliability of FFI was excellent with an intraclass coefficient of 0.957, and the reliability of FAOS was also excellent with an intraclass coefficient of 0.840. Conclusion: The paper-and-pencil method and the electronic method have the same result for the completion of FFI and FAOS in this study. Therefore, it is commonly considered that the completion of FFI and FAOS using the electronic method can be applied in practice.

Endosaccular Treatment of Very Large and Giant Intracranial Aneurysms with Parent Artery Preservation : Single Center Experience with Long Term Follow-up

  • Huh, Chae Wook;Lee, Jae Il;Choi, Chang Hwa;Lee, Tae Hong;Choi, Jae Young;Ko, Jun Kyeung
    • Journal of Korean Neurosurgical Society
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    • 제61권4호
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    • pp.450-457
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    • 2018
  • Objective : Very large (20-25 mm) and giant (${\geq}25mm$) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation. Methods : From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26-82). Mean aneurysm size was 26.0 mm (range, 20-39) and 13 of the 24 aneurysms were giant. Results : Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2-77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1). Conclusion : The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.

완전무치악 환자에서 임플란트 하이브리드보철물을 이용한 전악 수복 증례 (Full mouth rehabilitation of fully edentulous patient using implant hybrid prosthesis)

  • 박상용;김윤영;박원희;이영수
    • 대한치과보철학회지
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    • 제53권3호
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    • pp.228-233
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    • 2015
  • 치아의 상실은 저작 및 발음 등의 구강 기능의 저하와 치조골 소실을 가져오며 또한 자신감 결여로 심리적 문제까지 초래하는데, 이는 완전 무치악 환자에서 더 큰 문제를 야기한다. 본 증례의 환자는 다수치아의 상실 및 잔존치 동요도 때문에 임플란트를 이용한 고정성 보철을 원하다는 주소로 내원하였다. 치주적으로 예후가 불량한 모든 잔존치를 발치 하였으며 상하악 완전 무치악에서 임플란트를 이용한 하이브리드보철물을 이용하여 전악 수복 시행하였다. 최종치료 후 심미적, 기능적으로 만족스러운 결과를 얻었기에 이를 보고하고자 한다.

당뇨로 인한 우측(右側 ) 족저부(足底部) 및 좌수지(左手指) 궤양(潰瘍)을 동반한 환자 치험 1 예 (A Case Study of One Patient Who Has Diabetic Gangrene in Foot and Finger Due to Diabetes)

  • 이상기;이경로;송정모
    • 사상체질의학회지
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    • 제16권3호
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    • pp.129-132
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    • 2004
  • 1. Objectives Besides Diabetes Mellitus, its complications are matter of concerns as well. Its following complications are cardiovascular disease, glomerulopathy, retinopathy, neuropathy and diabetic gangrene. These complications can cause overall damage in major organs. In traditional oriental medicine it has been perceived that gangrene is mainly caused by "hwa(火)" but under sasang constitutional medicine its has been diagnosed as Taeumin superficial-disease(太陰人 表病) and Taeumin Jowiseungchung-tang(調胃升淸湯) was prescribed. As a result, significal improvments was noted and thefore we report the outcome. 2. Methods We have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to a patient for treating diabetes complications. 3. Results This patient was treated with Sasang Constitional Medicine and acupuncture for about three weeks. After treatment, ulcer and whole body edema were improved considerbly. 4. Conclusions We have dianosed the patient as Taeumin superficial-disease(太陰人 表病) by undergoing several diagnostic method used in sasang constutional medicine. Therefore we have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to the patient and has obtained satisfactory results in curing several diabetic complications especially ulcer due to diabetes.

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Cervical Spondylotic Myelopathy due to the Ochronotic Arthropathy of the Cervical Spine

  • Li, Nan;Tian, Wei;Yuan, Qiang;He, Da
    • Journal of Korean Neurosurgical Society
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    • 제59권1호
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    • pp.65-68
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    • 2016
  • Ochronosis is a musculoskeletal manifestation of alkaptonuria, a rare hereditary metabolic disorder occurs due to the absence of homogentisic acid oxidase and leading to various systemic abnormalities related to deposition of homogentisic acid pigmentation (ochronotic pigmentation). The present case reports the clinical features, radiographic findings, treatments and results of a cervical spondylotic myelopathy woman patient due to the ochronotic arthropathy of the cervical spine. The patient aged 62 years was presented with gait disturbance and hand clumsiness. Physical examination, X-rays, computed tomography and lab results of the urine sample confirmed the presence of ochronosis with the involvement of the cervical spine. The patient underwent a modified cervical laminoplasty due to multi-segment spinal cord compression. The postoperative follow-up showed a good functional outcome with patient satisfaction. The present study concludes the conditions and important diagnostic and surgical aspects of a patient. It is necessary to identify the condition clinically and if cord compression is observed, appropriate surgical interventions needs to be instituted.

Accessory penis: A rare method of peno-urethral separation of sexual function and voiding following successful complex hypospadias reconstruction with a free ileum flap

  • Elia, Rossella;Pafitanis, Georgios;Ciudad, Pedro;Chen, Hung-Chi
    • Archives of Plastic Surgery
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    • 제46권4호
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    • pp.381-385
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    • 2019
  • Hypospadias is a congenital malformation of the male genitalia. The reconstructive objectives are to obtain voiding with laminar flow and satisfactory sexual function. Several urethroplasty techniques have been described, but for perineal or revisional cases no single technique has shown robust success. In this study, we describe the expanded use of intestinal flaps for urethral reconstruction and report a peculiar request from a patient to undergo peno-urethral separation after successful hypospadias repair with a free ileum flap. A 51-year-old male patient with perineal hypospadias underwent several urethral reconstructive procedures with poor outcomes. A free ileum flap was attempted as a substitute for the urethra. Following successful reconstruction, separation of the neo-urethra (ileum) from the penile body was performed to address the patient's sexual expectations. A free ileum flap proved to be a reliable urethral substitute in perineal hypospadias reconstruction, with a successful outcome. The peno-urethral separation with the creation of an "accessory penis," however peculiar, optimized the results in terms of both sexual and urinary function. Anatomical restoration of the urethra and patient-reported expectations are the key to successful hypospadias reconstructive procedures. Sexual function outcomes and the patient's perception of success should not be underestimated, even when urinary function has been restored.

PNF를 이용한 닫힌사슬운동이 불완전 경수 손상 환자의 손 기능과 일상생활동작에 미치는 영향 : 단일사례연구 (The Effect of Closed Kinetic Chain Exercise Using PNF on Hand Function and Activities of Daily Living of Patient with Incomplete Spinal Cord Injure : Single Subject Design)

  • 정두교;이재한
    • PNF and Movement
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    • 제12권1호
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    • pp.45-50
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    • 2014
  • Purpose: Deficits in upper-extremity function in individuals with tetraplegia are primarily due to the loss of motor pathways. The purpose of this case report is to describe the effect of closed kinetic chain exercise using PNF on hand function and ADL of patient with incomplete spinal cord injure. Methods: Patient was a 53-year-old man with C4 tetraplegia and hand and upper extremity impairment who participated in this training intervention for 10 weeks. Results: Patient demonstrated improvements in upper extremity strength, hand function and performance of ADL. Outcome measures(ASIA motor scale, Hand power, Jebsen-Taylor Hand Function test, SCIM) were measured before and after the training program. Conclusion: The results of this case suggests that an closed kinetic chain exercise program in incomplete spinal cord injury patient may induce Hand function and ADL.