Background and Purpose : This study was to assess characteristics in acute stroke patients according to obesity and abdominal obesity. Methods : From1 Oct. 2005 to 31 Jul. 2007, 629 patients with a stroke were included. Patients were hospitalized within 30 days after the onset of stroke at Kyungwon University Incheon Oriental Hospital, DongGuk University International Hospital and Department of Cardiovascular and Neurologic Disease (Stroke Center), or Kyung Hee University Oriental Hospital. We investigated general characteristics preferences according to general obesity and abdominal obesity. Results : 629 acute stroke patients were included in the final analysis. Male, young age, hypertension, heart disease in the family history, hypertension in the past history, care of invalids or grandchildren and Taeumin in the Sasang constitution were higher among obese patients. Male, transient ischemic attack in the past history, smoker and Soyangin in the Sasangconstitution were higher among patients with abdominal obesity. The incidence of abdominal obesity corresponded to lower education level. Conclusions : In our study, we observed the general disposition of various characteristic distributions according to obesity and abdominal obesity in acute stroke patients.
Purpose: To describe the effectiveness of traditional Korean medicine (TKM) on the patients with secondary dementia (case 1: Rt. MCA infarction; case 2: traumatic subacute subdural hemorrhage and traumatic intracranial hemorrhage; case 3: delayed encephalopathy after carbon monoxide poisoning). Methods: We used a complete TKM treatment. The acupoints used were as follows: acupoints frequently used in hemiparesis (GV20, GV24, ST4, LI11, LI14, ST36, GB34, SP9, and LR3), and we used herbal medicine (補腎益腦湯加味, Boshiniknoe-tang-gami). The efficacy was evaluated using the Mini-Mental State Examination for Dementia Screening (MMSE-DS) and the Modified Barthel Index (MBI). Results: After treatment, the total MMSE-DS score was increased from 14 to 24 (case 1), 14 to 19 (case 2), and 0 to 17 (case 3). The total K-MBI was increased from 30 to 44 (case 1), 82 to 86 (case 2), and 30 to 86 (case 3) Conclusions: We suggest that TKM could positively influence cognition and improve activity of daily living (ADL). This study has limitations, so further studies are needed.
Objectives: We examined the effects of Sinbi-tang on a patient with pontine hemorrhage and respiratory disturbance. Methods: A patient diagnosed with pontine hemorrhage and respiratory disturbance was treated with herbal medicine and acupuncture. We checked the peripheral oxygen saturation ($SpO^2$) by oximetry three times a day, and obtained an average value. We evaluated the improvement of symptoms by changes in the average applied $O^2$ and average $SpO^2$. Results: After taking Sinbi-tang and treatment with acupuncture therapy, the patient showed improvement in respiratory disturbance. Applied $O^2$ was gradually decreased from 4 L/min to 0 L/min and $SpO^2$ was stabilized. Conclusions: Korean medicine may provide effective treatment for respiratory disturbance in patients with pontine hemorrhage, but further study is needed.
Objective: Our aim was to report a case of hematoma in the lower extremity induced by anti-platelet agents (Astrix, Plavix). Methods: The patient was prescribed anti-platelet agents and a hematoma occurred three times in the lower extremity. Before admission, the hematoma had occurred in the lateral compartment area of left lower extremity ($2{\times}2cm$). We detected a spontaneous hematoma in the lateral compartment area of right lower extremity ($8{\times}4cm$) and we stopped the Astrix medication. We also used herbal medicine (大黃左經湯加味方 (Daehwangjwagyeong-tang-gami)), external therapy of 大黃梔子 (Dae-hwang-Chi-ja) powder, and wet cupping therapy. We then detected a spontaneous hematoma in the posterior compartment area of the left lower extremity ($5{\times}5cm$) and we stopped the Plavix medication. We also used herbal medicine and external therapy. Results: After cessation of the anti-platelet agents (Astrix, Plavix), no recurrence of hematoma was observed in lower extremity and there was no recurrence of cerebral infarction. Conclusions: When anti-platelet agents are administered, attention should be paid to the patient's age and adverse events of the drugs. Bleeding symptoms and adverse effects should be continuously monitored.
Objectives: We report a case of traditional Korean medicine (TKM) treatment for skin side effects after taking afatinib (Giotrif$^{(R)}$). Methods: A 62-year-old female who was diagnosed with non-small cell lung cancer stage 4 (T4N2M1b) and was on treatment with afatinib (29.56 mg/day for 4 months) complained of skin toxicity as a side effect. For 16 admission days, the patient was treated with acupuncture, moxibustion, and herbal medicine (oral decoction and external ointment). Results: Improvement of skin toxicity was measured by a numeric rating scale. In addition, Quality of life (QOL) was measured using EORTC Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and EORTC Quality of Life Questionnaire, 13-item lung cancer-specific module (EORTC QLQ-LC13) Developed by the European Organization for Research and Treatment of Cancer (EORTC). Tumor size and carcinoembryonic antigen (CEA) were also examined during follow up. Conclusions: After a combined TKM treatment, skin toxicity symptoms and quality of life scales were significantly improved with no side effects. The tumor size was not changed on computed tomography during follow-up period. CEA levels were decreased.
Objectives: We treated a stroke patient with vancomycin-resistant enterococci (VRE) colonization using Gami-sipjeondaebo-tang. Methods: A patient diagnosed with intracranial hemorrhage with VRE colonization was treated with herbal medicine and acupuncture. We checked general conditions every day and performed stool VRE culture once a week. We evaluated the improvement of symptoms by change in VAS grade, general weakness, and stool VRE culture results. Results: After a treatment of Gami-sipjeondaebo-tang combined with acupuncture therapy, improvement of the general condition was observed. Also, VRE colonization was no longer detected in the stool culture. Conclusions: This case report proved the effect of Korean medicine for a stroke patient with VRE colonization, but further study is needed.
Objectives : The goals of the present study are to assess children with tic disorders, their clinical characteristic and to prove the effectiveness of herbal treatments of tic disorders. Methods : The present study was conducted from January 2006 to April 2011, with 200 out-patient children between the age of 6 to 12 diagnosed with tic disorder (after excluding 10 children who could not be clearly diagnosed) at the "H'herbal medicine clinic located in Seoul. Of these 200 children, we have evaluated the epidemiology and clinical manifestation, and analyzed the results of herbal medicine treatments. Results : 1. Among the children diagnosed with tic disorder, TTD was most prevalent (43.3%) and males were more likely than females to express tics (5.45:1). Children with TD sought help significantly later (average age of 9.03 years) than the other types. 2. The analysis results of herbal medicine treatments are as follows. Compared to the pre-treatment assessment, children who received herbal medicine treatment for more than three months (n=52) showed a marked decrease in symptoms of motor tics (the number of motor tics, frequency, severity, complexity) and vocal tics (the number of vocal tics, frequency, severity), in the impairment level of combined tics (motor and vocal tics together) and in the overall score. Conclusions : In conclusion, we apprehended demographic and clinical characteristics of tic disorder patients who visited a Korean traditional medicine clinic by analyzing the psychological assessment results. Furthermore, we identified the effectiveness of herb formula in tic disorder.
Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.
The objective of this study is to present basic data for producing tools to measure Yangseng of the elderly aged older than 65 by reassessing the validity and reliability of such tools already developed. In the present study, total 855 subjects were divided into 4 groups and given 31 question for the ultimate factor analysis of each item. The results cloud be summarized as follows: 1. In case of 'don't have sex in drunken state or right after dinner'(the 31st item of sex live yangseng). factor loading came out proportionally in 3 factors such as factor 4=0.358, factor 5=0.389 and factor 6=0.386. As they all failed to reach the general standard of 0.5 or more and even the minimum standard of 0.4 or more, the 31st item was deleted from the questionnaires. 2. From the factor analysis after exclusion of the 31st item, factor loading of the 25th item of sleep yangseng 'go to bed and get up regularly' appeared to be proportional in 2 factor(factor 4=0.393 and factor 7=0.373). Since it was shown that the 25th item could not be classified into a category but interacted with others in common and didn't satisfy the minimum standard of 0.4, it was deleted form the questionnaires, too. 3. From the factor analysis conducted after excluding the item numbers 31 and 25, factor loading of the 12th item of diet yangseng 'do not eat much' turned out to be relatively high with such values as factor 5=0.518 and factor 3=0.453. As it was, however, tied up with the factor of exercise yangseng, it was also deleted. In conclusion, 28 items after excluding the item numbers 12, 25 and 31 form 4 group showed the same results as divided into 8 factor with high grade of reliability and validity, evidencing the assumption that they can be employed practically to measure yangseng of the elderly aged 65 and oder.
The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.
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