• 제목/요약/키워드: 동반진단치료

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Clinical and Bronchoscopic Features in Endobronchial Tuberculosis (기관지 결핵의 임상상과 기관지 내시경 소견)

  • An, Jin Young;Lee, Jang Eun;Park, Hyung wook;Lee, Jeong hwa;Yang, Seung Ah;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.5
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    • pp.532-539
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    • 2006
  • Background : The incidence of pulmonary tuberculosis has been reducing, but endobronchial tuberculosis continues to be a signigicant heath problem. We performed prospectively bronchoscopy in patients diagnosed with pulmonary tuberculosis in order to evaluate the frequency of endobronchial tuberculosis and its related findings. Follow-up bronchoscopy was also performed after treatment to evaluate the incidence of endobronchial complications such as stenosis and remaining lesions. Methods : From January, 1999 to December, 2003, bronchoscopy was performed on patients newly diagnosed with pulmonary tuberculosis. Results : 458 patients were enrolled in this study, out of 699 patients with pulmonary tuberculosis from 1999 to 2003. 234(51%) had endobronchial tuberculosis. The frequency was 40.3% in males and 66.3% in females, The most common symptom was nonspecific cough and sputum, and the main radiologiy finding was patchy infiltration. The most common subtype of endobronchial tuberculosis was the edema-hyperemic form. The right lung was involved more frequently than the left, and the left upper lobe was the most commonly involved site. 58 patients underwent follow-up bronchoscopy and most of been cured without major sequels. However, 8 patients had a stenosis of trachea and main bronchus, and 6 patients had still had endobronchial lesions. Therefore the treatment was prolonged for 3 months. Conclusion : Endobronchial tuberculosis of pulmonary tuberculosis has been remained of high incidence. bronchoscopic and follow-up bronchoscopy examination needs to evaluate the incidence of endobronchial tuberculosis and its related findings and major complication despite of treatment.

Severity of Comorbidities among Suicidal Attempters Classified by the Forms of Psychiatric Follow-up (자살시도자의 정신건강의학과 치료 연계 형태에 따른 동반질병 심각도의 차이)

  • Lee, Hyeok;Oh, Seung-Taek;Kim, Min-Kyeong;Lee, Seon-Koo;Seok, Jeong-Ho;Choi, Won-Jung;Lee, Byung Ook
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.74-82
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    • 2016
  • Objectives : Suicide attempters have impaired decision making and are at high risk of reattempt. Therefore it is important to refer them to psychiatric treatment. Especially, People with medical comorbidity are at higher risk of suicidal attempt and mortality. The aim of this study was to investigate the characteristics of suicidal attempters and to analyze the influence of the medical comorbidity on decision to receive psychiatric treatment after visit to an emergency department. Methods : One hundred and thirty two patients, who visited the emergency room of a general hospital in Gyeonggi-do between January, 2012 and December, 2012 were enrolled as the subjects of this study. After reviewing each subject's medical records retrospectively, demographic and clinical factors were analyzed. Results : Regardless of the engagement type, either via admission or outpatient clinic, the determinant factors of psychiatric treatment engagement were psychiatric diagnosis, employment status, previous psychiatric treatment history, and previous attempt history. Comparison of severity of medical comorbidity(Charlson Comorbidity Index) showed that suicide attempters who received psychiatric treatment via admission or refused the treatment tended to have higher level of medical comorbidity than who received psychiatric treatment via outpatient department. Conclusions : Our findings showed that medical comorbidity of suicide attempters affected the decision to accept psychiatric treatment. All psychiatrists should evaluate the presence and the severity of medical comorbidity of the suicide attempters and consider implementing more intervention for the medically ill attempters who are willing to discharge against advice.

Movement Disorders that Psychiatrists Should Know (정신과의사가 알아야할 운동장애)

  • Cheon, Jin Sook
    • Korean Journal of Psychosomatic Medicine
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    • v.21 no.2
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    • pp.99-105
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    • 2013
  • The movement disorders in psychiatry have been neglected, though it is an important psychiatric dimension to exert unfavorable influence on patients'quality of life. The etiologies of movement disorders in psychiatry can be classified as primary neurological disorders, psychiatric comorbidities of neurological disorders, manifestations of primary psychiatric disorders, drug-induced movement disorders and psychogenic movement disorders. For the rapid and proper treatment for movement symptoms and signs easily observed from psychiatric patients, psychiatrists' ability toward precise disgnosis and differential diagnosis of movement disorders should be preceded.

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Streptococcal Toxic Shock Syndrome Occurred during Postoperative Radiotherapy in a Cancer Patient with Preexisting Lymphedema and Chronic Illness -Case Report- (수술 후 림프부종과 만성질환을 동반한 종양 환자에서 방사선치료 기간 동안 발생한 연쇄구균독소충격증후군 예)

  • Jang, Ji-Young;Oh, Yoon-Kyeong;Kim, Dong-Min
    • Radiation Oncology Journal
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    • v.24 no.4
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    • pp.317-321
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    • 2006
  • A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

Pulmonary Candidiasis in a Dog Receiving Long-term Management for Atopic Dermatitis (아토피성 피부염의 장기 치료중인 개에서 발생한 폐 칸디다증)

  • Han, Jae-Ik;Lee, Chang-Min;Kim, Taewoo;Lee, In;Choi, Soo-Young;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.32 no.3
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    • pp.259-262
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    • 2015
  • A canine patient exhibited partial anorexia and sudden respiratory distress. Diagnostic imaging and cytology of tracheal-lavage fluids revealed fungal pneumonia. Molecular identification and phylogenetic analysis detected Candida catenulata. Treatment with oral itraconazole for 3 weeks was effective. This is the first report of C. catenulata infection in a dog.

Successful Management of Hepatic Lipidosis Accompanied by a Feline Skin Fragility Syndrome-like Lesion in a Cat (고양이 피부유약증 유사병변을 동반한 지방간에 이환된 한 마리 고양이의 성공적인 치료증례)

  • Park, Hyoung-Jin;Hong, Eun-Ji;Kwon, Hyo-Jung;Park, Seong-Jun;Park, Joo Min;Song, Kun-Ho;Seo, Kyoung-Won
    • Journal of Veterinary Clinics
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    • v.32 no.5
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    • pp.449-453
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    • 2015
  • A 7-year-old spayed female Somali-cross cat was admitted with a 4-week history of anorexia, vomiting, weight loss, and lethargy. The cat was diagnosed with hepatic lipidosis. With intensive care and nutritional support via a nasogastric feeding tube for 3 weeks, the clinical signs of hepatic lipidosis were improved. However, skin lesions were found in the left and right scapular regions during the treatment that were suspected to be due to feline skin fragility syndrome (FSFS). Intensive wound healing therapy with granulated sugar, laser therapy, and a surgical flap was conducted. Skin lesions improved uneventfully without other clinical signs or recurrence of any skin lesion for a year. To our knowledge, this is the first report of a good prognosis in a hepatic disorder and concurrent FSFS.

Instability of Biceps Tendon

  • 최창혁
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2004.03a
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    • pp.55-58
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    • 2004
  • 이두박건 활차의 역할은 견관절 운동 시 이두박건 장두에 가해지는 전상방 전단응력을 막아주며, 관절내에서 이두박건의 운동을 인도해줌으로써, 이두박건 장두의 관절내 유효거리를 유지해 주게 된다. 견관절의 외전 및 외회전 운동시 이두박건 장두의 내측으로 가해지는 응력은 이두박건 활차 및 견갑하건의 손상과 함께 이두박건 장두의 내측 탈구를 유발할 수 있으며, 회전건개 파열과 동반될 경우 증상을 더욱 악화시킬 수 있으므로 진단 및 치료에 주의를 요한다.

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Instability of Long Head of Biceps Tendon

  • 최창혁
    • Clinics in Shoulder and Elbow
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    • v.7 no.2
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    • pp.90-93
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    • 2004
  • 이두 근 활차의 역할은 견관절 운동 시 이두 근 장두에 가해지는 전상방 전단응력을 막아주며, 관절 내에서 이두 근의 운동을 인도해줌으로써, 이두 근 장두의 관절 내 유효거리를 유지해 주게 된다. 견관절의 외전 및 외회전 운동시 이두 근 장두의 내측으로 가해지는 응력은 이두 근 활차 및 견갑하건의 손상과 함께 이두 근 장두의 내측 탈구를 유발할 수 있으며. 회전근 개 파열과 동반될 경우 증상을 더욱 악화시킬 수 있으므로 진단 및 치료에 주의를 요한다.

Intentional Passive Eruption Combined with Scaling and Root Planing of Teeth with Moderate Periodontitis (중등도 만성 치주염에 이환된 치아의 의도적 수동 정출을 동반한 비외과적 치료)

  • Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.29 no.2
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    • pp.195-202
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    • 2013
  • The relationship between occlusion and periodontal health has been studied extensively. Despite this, there are few reports on the effects of intentional passive eruption (IPE) using an occlusal reduction. The aim of this clinical report was to present the favorable long-term results of IPE using an occlusal reduction combined with scaling and root planing. After periodontal examination, teeth were diagnosed as moderate chronic periodontitis with intrabony defects and mobility. IPE was performed using periodic occlusal reduction combined with initial periodontal therapy. All teeth examined healed uneventfully and the patients did not complain of discomfort. It has been clinically well maintained during 8 years after completion of IPE. Overall, these results suggest that the IPE would be helpful in improving periodontal health.

Active Infective Endocarditis with Vegetation of Right Atrium in Patient with End-stage Renal Disease (말기신부전환자에서 우심방 우종을 동반한 심내막염 환자의 수술 1례)

  • Kim, Chang-Young;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.680-683
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    • 2002
  • Infective endocarditis that involves the right side of the heart has been estimately 5% of all cases of infective endocarditis. It has been shown that about 70% of right-sided heart infective endocarditis cases have preexisting congenital heart disease or acquired valvular lesion. It would occur in intravenous drug users or end-stage renal disease patients with indwelling venous dialysis catheter. Antibiotic therapy is more effective in the right and, when it fails, the consequence of valve disruption and emboli are less. Patients receiving long-term hemodialysis are a unique population with regard in the risk of bacteremia and subsequent infective endocarditis. We experienced one case of the active infective endocarditis with right atrial vegetation without tricuspid or pulmonary valve involvement in patient with end-stage renal disease receiving long-term hemodialysis, who needed surgical correction after medical treatment failure. Then we reported it with references that right-sided heart infective endocarditis is rare, but difficult to diagnose, life-threatening because of delayed medical treatment.