• Title/Summary/Keyword: days of hospitalization

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Clinical Studies on 5 Cases of Acute Viral Hepatitis A Treated by Oriental Medicine (급성 바이러스성 A형 간염의 한방치료 5례에 관한 임상보고)

  • Ie, Jae-Eun;Heo, Su-Jung;Kim, Hyun-Jin;Cho, Hyun-Ju;Kim, Hyuck
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1480-1485
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    • 2009
  • We conducted this study to report the clinical manifestations of 5 acute viral hepatitis type A treated by oriental medical treatment. Five hepatitis A patients who visited OO oriental hospital from May 2008 to July 2009 were treated by oriental medical treatment, including herbal acupuncture, acupuncture and herbal medicine and western medical treatment, including fluid therapy and peroral medicine. Prodromes were similar to influenza and duration from symptom onset to first visit were $5.0\;{\pm}\;1.6$ days. Chief symptoms included jaundice, itching, dark urine, anorexia, fatigue, nausea, vomiting, abdominal discomfort. The mean values of the initial laboratory test were serum total bilirubin(TB) of $3.62\;{\pm}\;2.77\;mg/dL$, aspartate aminotransferase(AST) of $729\;{\pm}\;422\;IU/L$, alanine aminotransferase(ALT) $774\;{\pm}\;754\;IU/L$. The peak mean values of those were $6.30\;{\pm}\;2.13\;mg/dL$, $2177\;{\pm}\;2573\;IU/L$, $2238\;{\pm}\;1682\;IU/L$ respectively. The mean duration of hospitalization were $15\;{\pm}\;3$ days. Follow-up at 3 weeks after discharge showed that all patients recovered without complications. Treatment of oriental medicine has effectiveness on acute viral hepatitis type A. Further study is needed.

A Case Report of a Patient with Ptosis and Ataxia Diagnosed as Claude's Syndrome Who Was Treated with Korean Medicine (Claude's syndrome으로 인한 안검하수 및 운동실조에 대한 한방 복합 치료 치험 1례)

  • Kim, Su-bin;Jeong, Yun-kyeong;Yang, Jung-yun;Mun, Sang-kwan;Jung, Woo-sang;Kwon, Seung-won;Cho, Ki-ho
    • The Journal of Internal Korean Medicine
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    • v.38 no.2
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    • pp.93-102
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    • 2017
  • Objective: We describe the case of an 84-year-old man with a midbrain infarction causing pupil sparing oculomotor nerve palsy, with ipsilateral cerebellar ataxia diagnosed as Claude's syndrome. Methods: The patient was treated with Korean medicine, including herbal medicine, acupuncture, and electro-acupuncture, during 45 days of hospitalization. Improvements in the patient's symptoms and changes in ptosis were evaluated using the Korean version of the Scale for the Assessment and Rating of Ataxia (SARA). Results: After 45 days of treatment with the Korean medicine, the patient's symptoms, including ataxia and ptosis, improved. Conclusions: This study suggests that the treatment with Korean medicine was effective in aiding the patient's recovery.

The effects of Constant Use of Herbal Medicine with Western Medicine On Liver and Kidney Functions (뇌졸중환자에서 한약과 양약의 병용투여가 간장 및 신장에 미치는 영향)

  • Park Sung-Wook;Lee Hyung-Chul;Ko Chang-Nam;Yun Sung-Woo;Han Ji-Young;Lee Sang-Wook
    • The Journal of Internal Korean Medicine
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    • v.24 no.1
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    • pp.68-74
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    • 2003
  • Objectives : The purpose of this study was to evaluate whether herbal medication may injure the liver function and kidney function. We clinically studied the changes of biochemistry and complete blood cell count in patients who were hospitalized in Korean hospital. Methods : The subjects were 160 patients admitted in Kangnam Korean hospital, Kyung Hee, whose mean duration of medication was 70 days(min 30, max 252). All patients had been checked biochemistry and complete blood cell count for 30 days since their hospitalization. Results : Aspartate aminotransferase(AST), alanine aminotransferase(ALT), alkaline phosphatase(ALP), blood urea nitrogen(BUN) and Creatinine(Cr) decreased significantly on discharge, compared with the values of admissoin(P<0.05). Total protein significantly elevated on dischrge compared with the values of admisson(P<0.05). Conclusions : This study suggests that even though there are few toxic herbal medicines, in general, herbal medications which are prescribed by oriental medicine doctors should be carefully administered not to hurt liver and kidney function.

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Emerging Role of Robot-assisted Gastrectomy: Analysis of Consecutive 200 Cases

  • Park, Ji Yeon;Kim, Young-Woo;Ryu, Keun Won;Eom, Bang Wool;Yoon, Hong Man;Reim, Daniel
    • Journal of Gastric Cancer
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    • v.13 no.4
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    • pp.255-262
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    • 2013
  • Purpose: Robotic surgery for gastric cancer is a promising alternative to laparoscopic surgery, but the data are limited. We aimed to evaluate whether gaining experience in robotic gastrectomy could improve surgical outcomes in the treatment of gastric cancer. Materials and Methods: Two hundred and seven consecutive cases of patients with clinical stage I gastric cancer who underwent robotic surgery at the National Cancer Center of Korea between February 2009 and February 2012 were retrospectively reviewed. Surgical outcomes were analyzed and compared between the initial 100 and later 100 cases. Results: Seven patients required conversion to open surgery and were excluded from further analysis. The mean operating time for all patients was 248.8 minutes, and mean length of hospitalization was 8.0 days. Twenty patients developed postoperative complications. Thirteen were managed conservatively, while 6 had major complications requiring invasive procedures. One mortality occurred owing to myocardial infarction. Operating time was significantly shorter in the latter 100 cases than in the initial 100 cases (269.9 versus 233.5 minutes, P<0.001). The number of retrieved lymph nodes was significantly greater in the latter cases (35.9 versus 39.9, P=0.032). The hospital stay of patients with complications was significantly longer in the initial cases than in the latter cases (16 versus 7 days, P=0.005). Conclusions: Increased experience with the robotic procedure for gastric cancer was associated with improved outcomes, especially in operating time, lymph node retrieval, and shortened hospital stay of complicated patients. Further development of surgical techniques and technology might enhance the role of robotic surgery for gastric cancer.

A Comparative Study between Laparoscopic and Open Appendectomy in Childhood (소아에서 복강경 충수절제술과 개복 충수절제술의 비교)

  • Lee, Byung-Eun;Lee, Nam-Hyuk;Lee, Jung-Ahn;Kim, Sang-Youn
    • Advances in pediatric surgery
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    • v.2 no.1
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    • pp.8-16
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    • 1996
  • Laparoscopic appendectomy is relatively well-established as an alternative to conventional open appendectomy by many laparoscopic surgeons. However, experience in the pediatric population remains limited. Over a period of 2 years, a total of 155 pediatric patients with acute appendicitis or complicated appendicitis were studied to compare laparoscopic and open appendectomies in childhood. Laparoscopic appendectomy was attempted in 49 patients and completed in 48 patients(98.0%). Open appendectomy was performed in 107 patients. The severity of disease, age, and male to female ratio were similar in both groups. The operation time was shorter in the laparoscopic group than open group but the difference was not significant statistically($43.7{\pm}11.3$ minutes versus $49.0{\pm}21.4$ minutes, p=0.066). In the laparoscopic group, the mean duration of surgery for the former half patients was significantly longer than for the latter half($49.6{\pm}9.2$ minutes versus $38.1{\pm}10.3$ minutes, p=0.001). The mean number of doses of analgesia required postoperatively was significantly less in patients undergoing laparoscopic appendectomy($2.4{\pm}1.8$ versus $3.3{\pm}2.5$, p=0.021). There were only 2(4.2%) wound infections after laparoscopic appendectomy compared with 10(9.3%) complications including 7 wound infections, 1 intestinal obstruction, and 2 pulmonary complications after open appendectomy, but the difference was not significant(p=0.614). Patients undergoing laparoscopic appendectomy had a shorter period of hospitalization($3.2{\pm}2.2$ days versus $6.4{\pm}1.6$ days. p=0.001). The present study suggests that laparoscopic appendectomy shortens operating time and hospital stay with diminished postoperative pain. Laparoscopic appendectomy in children offers advantages over open appendectomy as noted in adults. The authors consider laparoscopic appendectomy to be the reasonable alternative to open appendectomy in children.

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Preoperative Serum Albumin Levels Predict Treatment Cost in Total Hip and Knee Arthroplasty

  • Rudasill, Sarah E.;Ng, Andrew;Kamath, Atul F.
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.398-406
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    • 2018
  • Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

Adverse Drug Reactions of Dextran 40 Treated to the Cerebral Infarction Patients (뇌경색 환자에게 사용된 덱스트란 40의 부작용 분석)

  • Kim, Jae-Hyeon
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.473-481
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    • 2016
  • Adverse drug reactions(ADRs) were caused by dexran 40 in patient with ischemic stroke and related 22 patients reported to formal ADRs at Jesus Hospital in Jeonju. This study was aimed to search ADRs related factors, type and the degree associated with dextran 40. Adverse Effects of Dextran 40 is including marked hypotension, nausea, dyspnea, generalized urticaria, fever and pulmonary edema. The average hospitalization period was 20 days and it was extended 26.8%. ADRs of Dextran 40 to incidence is 12.4%, and 9 persons(28.1%), itching, rash was 7 people (21.9%). Dextran induced ADRs reaction may be reported on early injection period and first time shot, but adverse drug reactions occurred after 4 days in 4 patients(18.2%). US FDA has recommanded that Dextran 1 significantly reduces the incidence of severe ADRs in USA. Because low molecular weighted dextran 1 prevented dextran molecules from combined Ig G completely. In Korea. Generally not yet introduced dextran 1, active use dextran 1 is able to be a good way in order to reduce ADRs of dextran 40.

Common Peroneal Neuropathy Treated with Acupuncture plus Electro-acupuncture: Case Report (총비골신경병증 환자에 대한 침 및 침전기 자극술 병용 치험 1례)

  • Lee, Sang Young;Shin, Hyun Kwon;Kim, Ki Yuk;Hwang, Choon Ho;Jung, Pil Sun;Kim, Hee Young;Go, Yong Jun;Jo, Hyun Jung;Park, Jae Suk;Sul, Jae Uk;Jo, Hee Guen
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.5
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    • pp.672-676
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    • 2013
  • The purpose of this study is to report that a patient suffered from Common Peroneal Neuropathy (CPN) caused by ankle sprain was improved by acupuncture plus electro-acupuncture. In this study, the patient was diagnosed with magnetic resonance image(MRI) and electomyography(EMG). We treated at acupoints ST36, ST41, SP9, GB34, GB39 and LR3 by acupuncture plus electro-acupuncture twice a day for 16 days; a total of 30 times. We used evaluation scale including muscle manual testing(MMT) and visual analogue scale (VAS). MMT changed from Grade 0 to Grade 5 and VAS changed from 10 to 2 after treatment for 16days with hospitalization. Though it is a case report, these results suggest that acupuncture and electrical acupuncture might have valid effect on CPN in controlled environment.

Effectiveness of Drain Insertion and Irrigation in the Treatment of Septic Arthritis of the Knee under Local Anesthesia (국소 마취하 배액관 삽입 및 세척을 통한 화농성 슬관절염의 치료의 효용성)

  • Yi, Jin Woong;Oh, Byung Hak;Heo, Youn Moo;Jang, Min Gu;Min, Young Ki;Seo, Kyung Deok
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.310-316
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    • 2021
  • Purpose: Septic arthritis of the knee is an orthopedic emergency that requires early diagnosis and surgical treatment. This study examined the effectiveness of drain insertion and irrigation in the treatment of septic arthritis of the knee under local anesthesia. Materials and Methods: A retrospective study was conducted on nine cases (eight patients) diagnosed with septic arthritis of the knee from September 2017 to February 2020 and treated with drain insertion and irrigation under local anesthesia. After penetrating through the superolateral portal to the superomedial portal and inserting the drain, daily irrigation of approximately 3 L of normal saline was done. The following were investigated: age, sex, underlying disease, cause, degree of osteoarthritis, time from diagnosis to surgery, duration of hospitalization, duration of normalization of C-reactive protein, and smear and culture. Results: The initial white blood cell count of joint fluid was 71,472±51,667/mm3 (32,400-203,904/mm3), and polymorphic leukocytes were 91.1%±2.6% (86%-95%). The average time from diagnosis to surgery was 8.3±1.3 hours (6-10 hours), and the irrigation period was 8.2±3.2 days (4-15 days). The average length of hospitalization was 20.8±8.7 days (9-37 days). There was no reoperation or recurrence. Smear and culture tests were not identified. Conclusion: In the treatment of septic arthritis of the knee, the insertion of a drain tube and irrigation under local anesthesia is a relatively fast and simple method to reduce pain by repetitive draining of purulent joint fluid and can be used as an alternative treatment for patients with a risk of general or spinal anesthesia.

The Comparison of Video Assisted Thoracic Surgery (VATS) with 10 mm Thoracoscopy to 2 mm Thoracoscopy for Primary Spontaneous Pneumothorax (원발성 자연 기흉에서 10 mm와 2 mm 비디오 흉강경 수술의 비교)

  • Hwang Jin-Wook;Jo Won-Min;Min Byoung-Ju;Son Ho-Sung;Lee In-Sung;Shin Jae-Seung
    • Journal of Chest Surgery
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    • v.38 no.9 s.254
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    • pp.627-632
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    • 2005
  • Background: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. Material and Method: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS blob resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mn VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. Result: The mean follow-up duration was 20,8$\pm$16.1 months in 10 mm VATS group, and 13.9 $\pm$8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax ($34\%$) in 10 mm VATS and patient's desire ($40\%$) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, $R^2$ values were lower than 0.1. The postoperative recurrence rate was $2.7\%$ in 10 mm VATS and $2.9\%$ in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. Conclusion: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.