• Title/Summary/Keyword: therapeutic case report

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Cardiopulmonary bypass preparation is mandatory in cardiac exploration for blunt cardiac injury patients: two case reports

  • Son, Shin-Ah;Cho, Joon Yong;Kim, Gun-Jik;Lee, Young Ok;Jung, Hanna;Oh, Tak-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.356-360
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    • 2021
  • Treating cardiac injuries following blunt trauma to the chest requires thorough examination, accurate diagnosis, and therapeutic plan. We present two cases; pulmonary vein rupture and left atrial appendage laceration, both as a result of blunt chest trauma. Through these cases, our team learned the importance of maintaining hemodynamic stability during the examination of injured cardiac structures. And based on the comprehensive cardiac examination, a decision to surgically intervene with median sternotomy via cardiopulmonary bypass was made, saving lives of the patient. This report introduces how such decision was made based on what supporting evidence and the diagnostic process leading to the initiation of surgical intervention. This report may help with decision-making process when confronted by blunt cardiac injury patients who need cardiac exploration.

Tourette Syndrome Treated with Hoeyeoksan Based on Shanghanlun Provisin 318: A Case Report (『상한론(傷寒論)』 소음병(少陰病) 318조(條)로 진단하여 회역산(回逆散) 투여 후 호전된 뚜렛장애 환자 1례 보고)

  • Kim, Chang-sig;Jeong, Yeon-Il;Lee, Soong-In
    • 대한상한금궤의학회지
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    • v.12 no.1
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    • pp.171-182
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    • 2020
  • Objective : The purpose of this study is to report the improvement in a patient who had Tourette syndrome treated with Hoeyeoksan based on Shanghanlun provisions. Methods: The symptoms of the patient were checked on days 14, 34, 62, 82, 103, and 119 after administration of Hoeyeoksan. Tourette syndrome was evaluated using Yale Global Tic Severity Scale (YGTSS), and oversleep and constipation were evaluated using visual analog scale (VAS). In addition, new clinical implications for the interpretation of Shanghanlun provision 318 were reviewed. Results: Daily tics occurred ten times a day for 14 days after the initial diagnosis but decreased to eight times a day after 34 days, six times a day after 62 days, five times a day after 82 days, twice a day after 103 days, and once a day after 119 days after administration of Hoeyeoksan. Oversleep and constipation improved together with Tourette syndrome. Conclusions: In this study, we observed that Hoeyeoksan had a therapeutic effect by improving the chief complaint of the patient. Hence, the interpretation of Shanghanlun provision 318 must include a patient's behavioral and sleep patterns as predisposing factors of Tourette syndrome.

A Case Report of Elderly Delirium Treated with Shihogayonggolmoryo-tang (시호가용골모려탕(柴胡加龍骨牡蠣湯)으로 호전된 노인 섬망 환자 증례보고)

  • Lee, Su-jung;Yang, Ji-soo;Cho, Eun-chai;Lew, Jae-hwan
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.144-151
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    • 2022
  • Objective: The purpose of this study is to report the effects of Shihogayonggolmoryo-tang on elderly delirium. Methods: A patient suffering from delirium was treated with Shihogayonggolmoryo-tang herbal therapy for 35 days. To evaluate the therapeutic effects, the Korean version of the Mini Mental State Examination (MMSE-K) and the Korean Nursing Delirium Screening Scale (nu-DESC) were used twice a week. Results: After treatment, the patient's MMSE-K score increased from 0 to 12, and the nu-DESC results decreased 4 to 0. Conclusion: These scores suggest that therapy with Shihogayonggolmoryo-tang has a positive effect on elderly delirium.

A Case Report on the Therapeutic Effect of Integrated Cancer Therapy for Glioblastoma Multiforme (교모세포종에 대한 통합암치료의 치료 효과 증례보고)

  • Yang, Jin-sung;Jang, Hyuk-jun;Song, Si-yeon;Park, Ji-hye;Park, So-jung;Yoo, Hwa-seung
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.320-325
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    • 2022
  • Objective: The purpose of this report is to present the effects of integrative cancer treatment (ICT) on a patient diagnosed with glioblastoma multiforme (GBM). Methods: A 71-year-old male GBM patient received ICT from May 14 to October 12, 2021 and concurrently received temozolomide and radiotherapy. The effect on symptoms was evaluated using a visual analog scale (VAS), and changes in tumor size were assessed using magnetic resonance imaging. Results: After treatment, the VAS score for nausea decreased from 5 to 1, and the tumor size also reduced. Conclusion: ICT could be effective in treating GBM patients by reducing the size of the tumor as well as alleviating the side effects.

Insomnia Treated with Baekho-tang Based on the Shanghanlun Disease Pattern Identification Diagnostic System (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 백호탕(白虎湯) 투여 후 호전된 불면증 증례 1례)

  • Jeong, Yeon-il;Kim, Chang-sig;Lee, Soong-in
    • 대한상한금궤의학회지
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    • v.13 no.1
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    • pp.165-178
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    • 2021
  • Objective: This study aimed to report the improvement of a patient with chronic insomnia who was treated with Baekho-tang based on the Shanghanlun disease pattern identification diagnostic system (DPIDS). Methods: The patient's symptoms were checked on days 19, 37, and 52 after taking Baekho-tang. Chronic insomnia was evaluated by the degree of insomnia, hours spent asleep, and the number of times the patient woke up during the night, which were all assessed by a visual analog scale (VAS) with the Leeds Sleep Evaluation Questionnaire. In addition, new clinical implications for the interpretation of the 350th Shanghanlun provision were reviewed. Results: After administering Baekho-tang for 52 days, based on the 350th Shanghanlun provision according to the DPIDS, the VAS score decreased from 10 to 1. Conclusions: The patient recovered from chronic insomnia. This case report suggests that the words "滑," "厥," and "裏" in the 350th provision of Shanghanlun mean physical and psychological causes of insomnia. In addition, Baekho-tang had a therapeutic effect in improving the chief complaint of the patient. Therefore, the interpretation of the 350th Shanghanlun provision requires a new definition that includes the patient's lifestyle, family conflict, and past history of the patient as a cause of chronic insomnia.

Chronic Intractable Calcific Lateral Epicondylopathy Treated with Ultrasound-Guided Barbotage Combined with Extracorporeal Shock-Wave Therapy (석회성 외측 상과병증의 초음파 유도 하 세척흡인술과 체외충격파치료의 병행)

  • Kim, Kun-Woo;Yoon, Kyung Jae;Do, Jong Geol;Hwang, Jin-Tae;Lee, Yong-Taek
    • Clinical Pain
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    • v.18 no.2
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    • pp.138-141
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    • 2019
  • Lateral epicondylopathy represents pain in the lateral (radial aspect) of the elbow caused by degeneration in the common extensor tendon. Calcium deposit frequently developes in lateral epicondylopathy, with the prevalence up to 46%. There are considerable debates on its treatment protocols for lateral epicondylopathy so far, likewise, the effective treatment method for calcific lateral epicondylopathy has not been established. We report here a case of chronic intractable calcific lateral epicondylopathy treated with ultrasound-guided barbotage and focused type extracorporeal shock wave therapy (ESWT). To our knowledge, this is the first report of calcific lateral epicondylopathy treated by ultrasound-guided barbotage combined with ESWT.

Metastatic papillary thyroid cancers with malignant pleural effusion aggravated during thyroid hormone withdrawal for radioiodine therapy

  • Seo, Ji Hye;Je, Ji Hye;Lee, Hyun Jung;Na, Young Ju;Jeong, Il Woo;An, Jee Hyun;Kim, Sin Gon;Choi, Dong Seop;Kim, Nam Hoon
    • Journal of Yeungnam Medical Science
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    • v.32 no.2
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    • pp.138-142
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    • 2015
  • L-thyroxine (LT4) withdrawal prior to radioactive iodine (RAI) ablation therapy is a commonly used method for successful treatment of patients with papillary thyroid cancer (PTC). However, a prolonged period of hypothyroidism induced by LT4 withdrawal is sometimes associated with impaired quality of life and cardiopulmonary dysfunction in PTC patients. Furthermore, LT4 withdrawal may have a trophic effect on residual cancer by means of increased thyrotropin. We report on 2 cases of metastatic PTC patients with malignant pleural effusion (MPE) whose disease showed rapid worsening after LT4 withdrawal and RAI therapy. The first case is a 65-year-old woman who had PTC with multiple distant metastases and MPE. During LT4 withdrawal for RAI therapy, MPE showed rapid worsening, and the patient required repetitive therapeutic thoracentesis. The second case is a 49-year-old woman with PTC who underwent 3 additional operations for cancer recurrence in the neck lymph nodes and 6 times of RAI treatments. While preparing for the $7^{th}$ RAI treatment by withdrawing LT4, she developed MPE which became progressively aggravated after RAI therapy. Both patients experienced increased pleural effusion during the LT4 withdrawal period and a rise in the thyroglobulin level was observed after RAI therapy. MPE was not controlled with therapeutic thoracentesis and pleurodesis. Eventually, both patients died of rapid disease progression after RAI therapy. In summary, LT4 withdrawal may have an adverse effect on metastatic PTC patients, particularly those with MPE.

Late Vascular Complication after Mandibular Ramus Sagittal Split Osteotomy: A Case Report (하악지 시상 분리 절골술 후 발생한 후기 혈관성 합병증의 치험례)

  • Nam, Doo Huyn;Tark, Min Seong;Kim, Cheol Hann;Kang, Sang Gyu;Lee, Yung Man;Park, Sung Tae
    • Archives of Plastic Surgery
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    • v.34 no.1
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    • pp.137-139
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    • 2007
  • Purpose: The mandibular ramus sagittal split osteotomy is a common procedure in cosmetic surgery. A late complication of this procedure, pseudoaneurysm rarely happens. The purpose of this case is to present our experience that is rare late vascular complication after mandibular ramus sagittal split osteotomy. Methods: A 21-year-old male was operated by local plastic surgeon for treatment of mandibular prognathism. After 9 days, the man was transferred to our hospital with persistent bleeding and swelling on the mandibular area. We operated the man three times and failed to control hemorrhage. Therefore, we did angiography and found the pseudoaneurysm on the buccal and pterygoid branches of internal maxillary artery. Then we did selective embolization for removal of the pseudoaneurysm. Results: The man was operated using the therapeutic embolization, and the pseudoaneurysm was removed. The results were successful, and we couldn't find any bleeding and the pseudoaneurysm during the follow-up of 12 months. Conclusion: The selective embolization is the good therapeutic method of late vascular complication after mandibular ramus sagittal split osteotomy.

Individualized Therapy to Manage Quadriplegic Spastic Cerebral Palsy with Unani Treatment Modalities

  • Fahmida Kousar;Arshiya Sultana;Shahzadi Sultana;Taseen Banu;Arfa Begum
    • CELLMED
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    • v.13 no.14
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    • pp.16.1-16.14
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    • 2023
  • Objective: Cerebral palsy (CP) is a neurodevelopment disorder attributed to an insult or injury to the developing brain with abnormalities in muscular tone, movement and motor skill. Improvement in quality of life and ameliorating symptoms can be achieved. Therefore, this case report details a distinctive approach to treating a 5-year-old male child with quadriplegic spastic cerebral palsy utilizing Unani treatment modalities. Methods: The treatment regimen commenced with 'Habb Ayarij for constipation followed by Sharbat Ustukhuddus administered orally. Notably, Sharbat Ustukhuddus was combined with Melia Azedarach L. leaves vapour bath. Subsequently, Roghan Babunna douche was performed followed by Dalk Layyin andcontinued until symptomatic improvement was observed. Majun Falasfa, Khamira Marwareed and Khameera Gauzaban were administered for 30 days. The therapeutic outcome included anthropometrical measurements, developmental milestones, spasm/reflex scale, and muscle power grading. Results and conclusion: Over the course of a 2-year follow-up, several clinical findings emerged. These included notable improvements in anthropometric measurements, developmental milestones such as improved head control and sitting ability, and a reduction in spasticity of the upper limbs, along with decreased muscle spasms. The therapeutic outcome of this individualized and holistic approach is potentially due to the multifaceted properties of medicinal plants (Musakkin wa Muharrik wa Muqawwi-i- A'sab wa Dimāgh, Munawwim, Dafi-i-Tashannuj, Muqawwi-i-Qalb-i-Ruh). Furthermore, the use of Dalk and Naṭūl was instrumental in providing nourishment to musculoskeletal cells and initiating intracellular signaling cascades. While these findings are encouraging, further research in the form of case series andrandomized controlled trials is warranted to validate the efficacy of this unique holistic approach.

Negative myoclonus associated with tramadol use

  • Bae, Seong Yoon;Lee, Se-Jin
    • Journal of Yeungnam Medical Science
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    • v.37 no.4
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    • pp.329-331
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    • 2020
  • Negative myoclonus (NM) is a shock-like jerky involuntary movement caused by a sudden, brief interruption of tonic muscle contraction. NM is observed in patients diagnosed with epilepsy, metabolic encephalopathy, and drug toxicity and in patients with brain lesions. A 55-year-old man presented with NM in both his arms and neck. He has taken medications containing tramadol at a dose of 80-140 mg/day for 5 days due to common cold. He had no history of seizures. Acute lesions were not observed during magnetic resonance imaging, and abnormal findings in his laboratory tests were not noted. His NM resolved completely after the discontinuation of tramadol and the oral administration of clonazepam. Our case report suggests that tramadol can cause NM in patients without seizure history or metabolic disorders, even within its therapeutic dose.