By process of treatment for a case which diagnosed as spinal cord infarction and admitted from the 18th, April, 2000 to the 29th, July, 2000, the result are as foilows. Method and Results : In the earlier days of admission, this patient was diagnosed as damp-heat(濕熱) and was dosed with Cheongjo-tang. In medication, weakness in upper and lower limbs of the patient was improving. After diagnosed as Taeyangin, the patient was dosed with Ogapijangchuk-tang and punctured with Taeyangin Taegeuk-chim and Sagae-chim. As the result, Weakness in upper and lower limbs are improved remarkably. Conclusion : The prognosis of patients diagnosed spinal cord infarction is not so good. But, in the case of this patient, power and sense of four limbs improved remarkably through oriental medical treatment with rehabilitative therapy.
Purpose: A retrospective study was performed to assess the efficacy and tolerance of ${\beta}-blocker$ administration in patients with heart failure and diabetes. Method: Records of 164 patients who were treated for the heart failure condition more than a year were studied retrospectively. Patients were divided into 4 groups based on their diabetes(DM) status and the administration of ${\beta}-blockers$ ($DM+{\beta}-blocker$ group: 14, DM w/o ${\beta}-blocker$: 19, No DM + ${\beta}-blocker$: 62, No DM + no ${\beta}-blocker$: 69). All patients had been receiving conventional therapy such as digoxin, ACE-I, ARB, diuretics, nitrates, aspirin, anticoagulants or lipid-lowering agents. The primary endpoints (death and hospital admission) were recorded during 1 year period and hemodynamic factors (HR, LVEF, SBP, DBP) were obtained from all patient groups before and after 12 months of ${\beta}-blocker$ treatment. To evaluate toxicity of ${\beta}-blocker$, SCr, BUN, AST, ALT and Alkaline phosphatase were obtained. Result: There were less death and hospital admission in DM + ${\beta}-blocker$ group than in DM without ${\beta}-blocker$ group (p=0.014). Relative risk of hospital admission for $DM+{\beta}-blocker$ group over no DM group was 1.17. Long term ${\beta}-blocker$ administration was associated with an improvement of heart rate in patients with DM (P< 0.02) with no significant improvement of LVEF, SBP, DBP. in DM patient. In patient without DM, ${\beta}-blocker$ was associated with improvement in LVEF, HR and DBP (P<0.01, P<0.03), but not in SBP. The incidence of toxicity was similar between the four group with no significant difference. Conculsion: Treatment of heart failure patients with ${\beta}-blocker$ appears to be beneficial in terms of hospital admission event and several hemodynamic factors. The toxicities of ${\beta}-blocker$ treatment were not significant and the treatment is generally well-tolerated in most of the heart failure patients.
Keun, Seung On;Lee, Soo Young;Kim, Sun Mi;Jeong, Dae Chul;Chung, Seung Yun;Kang, Jin-Han
Pediatric Infection and Vaccine
/
v.9
no.2
/
pp.230-235
/
2002
We experienced a case of herpes zoster in a 9-months aged infant as followings; The patient had no history of chickenpox or varicella vaccination. Also, her mother had no history of varicella infection and no contact history with varicella during pregnancy. The patient had only a history of exposure to chickenpox patient at 7th days after birth, but fortunately chickenpox was not developed. Sequentially, symptoms of cough with fever and tachypnea were developed on admission date(7 days had passed already after development of the initial skin lesion). On physical examination, multiple grouped painless erythematous papulovesicles with small crusts were observed on the right lower back, flank and abdomen along the T11 dermatome. Coarse breathing sound was osculated, and increased linear infiltrations on both parahilar areas were seen on chest radiography. Liver enzymes were slightly elevated. Tzanck test was negative. The initial titers of anti-VZV IgM and IgG on admission were negative, but the following titers of anti-VZV IgM and IgG were positive. The patient received treatment of acyclovir for 7 days, and healed completely without sequelae. We report this case with brief review of related literatures.
Infections in oral and maxillofacial region are relativley common and self-limiting, but in some cases, infections spread to adjacent hard and soft tissue and to cause any complication, even threaten life. So we made retrospective study of patients with interfascial infection who had been hospitalized and been treated by surgical treatment in Dankook university about 10 years. We reviewed the charts of patient with interfascial infection from 1995 to 2005. The result were as follows: 1. In gender & age distribution, male(54.2%) & fouth decade were most frequently. 2. The most common cause of infection was dental caries(55.2%) and the most of involving teeth was lower posterior teeth(44.1%). 3. Submandibular space is most frequently involving space and most infection involved mainly one space. 4. The patients with systemic disease were 38.2%. Diabetic mellitus was 87.2% of systemic diease. The admission period was 19.5 days in systemic disease. 5. The most microorganism in culture was Streptococcus Viridans(36.2%) in all patient. Klebsiella Pneumoniae was found most in Diabetic Mellitus. 6. The patient were mainly treated I&D on admission day. Of them 5(1.1%) patients were received tracheostomy. 7. Serum albumin, CRP and body weight are associated with Nutritional Risk Index(NRI). High risk patient group according to NRI classification showed higher rate of complications & mortality. 8. The patients with complication were 28(6.7%) persons. 4(0.9%) patients were expired. Nutritional Risk Index was helpful to predict the prognosis. When interfascial infection starts to spread, we must pay attention to airway management. Fluid therapy with nutritional may support to healing of wound.
Objectives: Few studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes. Methods: This retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence. Results: A total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis. Conclusions: In patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient's motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.
Lee, Yu Ri;Cho, Na Kyung;Kim, Kyung Soon;Choi, Hong Sik;Kim, Seung Mo
Journal of Physiology & Pathology in Korean Medicine
/
v.32
no.6
/
pp.418-421
/
2018
The purpose of this study was to evaluate the changes of liver function test before and after treatment in patients admitted to Korean medicine hospital. We checked liver function test level (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin) of 147 patient who admitted in Korean medicine hospital from July 1, 2015 to June 30, 2018. The subjects were selected those who took herbal medicine continuously during the admission period and who performed liver function test on admission and before discharge. And the subjects were excluded those who had a history of liver and biliary disease at the time of admission or who took hepatoprotectants. Aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase significantly decreased compared with the values of admission(p<0.05), but total bilirubin and direct bilirubin were not significantly changed(p>0.05). On admission 31 patients(21.1%) had abnormal liver function and 6 patients(4.1%) had liver injury while 19 patients(12.9%) had abnormal liver function and 6 patients(4.1%) showed liver injury before discharge. This study suggests that herbal medicine may not injure liver function.
Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
Health Policy and Management
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v.29
no.2
/
pp.237-244
/
2019
Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.
The incidence of pulmonary leiomyosarcoma is very rare as a primary lung tumor. Usually, pulmonary leiomyosarcoma arise from the smooth muscle present in the bronchi or blood vessles. We had experienced two cases of primary pulmonary leiomyosarcoma. The first case was 28-year old male patient who had been in good health until admission, when he experienced an episode of dyspnea and sudden hemoptysis. The chest X-ray film revealed a large round tumor mass in left lower lobe measuring 6.5x9.5x5.3cm in dimension. On physical examination,the patient was friction rub and rales on the left lower chest and postoperative course was smooth and non-eventful. Emergency left lower lobectomy was performed due to repeated hemoptysis. Chemotheraphy was done postoperatively as an adjuvant therapy.The second case was 52-year-old man who had been well prior to admission, when recently he noticed a abrupt growing tendency of old pulmonary coin lesion in right lower lobe on routine physical examination. Since 1968, small round mass was gradually enlarged very slowly, during recent one year interval, the tumor mass was enlarged abruptly as twice in size on chest X-ray. Bronchoscopic examination revealed no specipic findings. Right lower lobectomy was performed and pathologic examination was answered as primary leiomyosarcoma without lymph node metastasis. Postoperative course was smooth, except local wound infection.
Kim, Won-Ky;Kim, Nam-Hyun;Huh, Jae-Man;Chang, Byung-Chul;Kim, Ji-Hyue
Proceedings of the KOSOMBE Conference
/
v.1992
no.05
/
pp.152-154
/
1992
We computerized outpatient's prescription using personal computer and local area network(LAN). The information and history of patient which is stored in the HOST computer is transfered to the local file server via emulatort & LAN. Then, the computerized outpatient's prescription which is made in each examination room is transfered to the admission of discharge office and pharmacy via LAN. In the admission of discharge office, drug charge is automatically calculated, and the prescription and envelope is printed out automatically in the pharmacy. Using this system, the patient takes the drug faster than before, eventually we improve medical service. Also, this system manage hospital works and administration effectively.
Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.
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