• Title/Summary/Keyword: Chronic Patient

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Chronic Traumatic Femoral Arteriovenous Fistula after Gunshot Vascular Injury - A case report - (총상 후 발생한 만성 외상성 대퇴동정맥루의 치험 -1예 보고 -)

  • Kim, Sang-Ik;Kim, Byung-Hun
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.120-123
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    • 2008
  • A 60-year-old man with a history of gunshot vascular injury on the right inguinal area, and this happened in the military service 40 years ago, was admitted to our hospital with claudication and dyspnea on exertion. The patient was diagnosed with a chronic traumatic femoral arteriovenous fistula. The patient underwent a successful operation for arteriovenous fistula closure with bovine pericardium and for femoropopliteal bypass with using a right greater saphenous vein graft. The patient is well at 14 months after the operation.

Two Case Report on the Patient with Fibromyalgia Syndrome(FMS) with Chuna and Acupuncture (추나와 침술 치료로 호전된 섬유근통증후군 증례 2례)

  • Lee, Chang-Hun;Lee, Myeong-Jong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.91-103
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    • 2006
  • Objective : The Fibromyaigia Syndrome(FMS) is frequently used to call at clinic. There are not case reports on the treatment of FMS by oriental medicine. We got a effect on three patient with FMS by oriental medicine and this case is observed the clinical symptoms and scaled by VAS with chuna and acupuncture. Methods : We used to take chuna and acupunture, though classifcated by pathologic symptom and classification criteria of American College of Rheumatology. Result : Usually, most patients with FMS on the chronic stage have chronic prognosis. But symptoms of the patient on this report were improved after above treatments. Conclusion : This case showed oriental medicine enough could be applied on diseases like this syndrome as one of conservative therapies. Of course, more accurate diagnosis and research would be needed afterwards.

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Malignant melanoma on a thermal burn scar

  • Lee, Han Byul;Han, So Eun;Chang, Lan Sook;Lee, Soo Hyang
    • Archives of Craniofacial Surgery
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    • v.20 no.1
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    • pp.58-61
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    • 2019
  • Chronic burn scars often cause various skin malignancies at rates of up to 2%. These lesions are usually squamous cell carcinomas, but rarely, malignant melanoma is reported. We report a 67-year-old male with a malignant melanoma on a burn scar with regional metastasis. This patient presented an ulcerative lesion only in 2 weeks. After histopathological diagnosis, we performed only palliative surgery on patient's demand, and followed up the subsequent deterioration course. Our case reemphasizes the need for rapid diagnosis and treatment when suspect lesions are present on chronic burn scar. Also, physician should be in mind and inform the patient about malignant melanoma and its aggressive course.

Utilization of end to side inverted mattress pancreaticojejunostomy for Duval procedure: A case report

  • Hyun Jeong Jeon;Sang Geol Kim
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.4
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    • pp.412-416
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    • 2022
  • Although a pancreaticojejunostomy (PJ) is not required after a distal pancreatectomy in most cases, it needs to be performed to prevent atrophy of the remnant pancreas when the proximal duct is obstructed by a tumor, stone, or etc. In these conditions, the critical postoperative pancreatic fistula (POPF) gives surgeons cause to hesitate before performing a PJ. We previously presented the modified technique of Mattress PJ named "inverted mattress PJ" (IM-PJ) and published improved outcomes in the aspects of POPF after a pancreaticoduodenectomy and a central pancreatectomy. Recently, we had a case of a patient who has chronic pancreatitis with a proximal pancreatic duct obstruction, requiring a distal pancreatectomy and PJ. Based on the previous report, we decided to apply the "inverted mattress PJ" (IM-PJ) technique for a Roux-en Y PJ after a distal pancreatectomy. The patient was discharged after surgery without complications. We reviewed a case of a patient requiring PJ following a distal pancreatectomy and discussed the safety of our technique.

Pain Disorder Associated with Psychological Factors - Case Report and Review - (심리적 요인과 관련된 통증장애 - 증례 및 고찰 -)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.10 no.2
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    • pp.166-175
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    • 2002
  • Recently many researches support the use of traditional psychiatric treatments in the management of chronic pain. Chronic pain is a significant public health problem and frustrating to everyone affected by it. Psychiatrists offer skills with treatments now recognized as effective in the management of chronic pain. In addition to the diagnosis and treatment of psychiatric co-morbidity, the application of psychological treatments to chronic pain, and the development of interdisciplinary efforts to provide comprehensive health care to the patient disabled with chronic pain, psychiatrists have particular skill in pharmacological treatment that have proven efficacy for a variety of chronic pain conditions. With their expertise in the use of psychoactive medication plus their interest in the personal and family dynamics of patients, psychiatrists have the capacity to be involved in the treatment of patients with chronic pain. So, the author reported three cases of patient with pain disorder associated with psychological factors, and reviewed to propose that psychiatrists in Korea should take an active role in the care of these patients.

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Increased Prevalence of Chronic Disease in Back Pain Patients Living in Car-dependent Neighbourhoods in Canada: A Cross-sectional Analysis

  • Zeglinski-Spinney, Amy;Wai, Denise C.;Phan, Philippe;Tsai, Eve C.;Stratton, Alexandra;Kingwell, Stephen P.;Roffey, Darren M.;Wai, Eugene K.
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.227-233
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    • 2018
  • Objectives: Chronic diseases, including back pain, result in significant patient morbidity and societal burden. Overall improvement in physical fitness is recommended for prevention and treatment. Walking is a convenient modality for achieving initial gains. Our objective was to determine whether neighbourhood walkability, acting as a surrogate measure of physical fitness, was associated with the presence of chronic disease. Methods: We conducted a cross-sectional study of prospectively collected data from a prior randomized cohort study of 227 patients referred for tertiary assessment of chronic back pain in Ottawa, ON, Canada. The Charlson Comorbidity Index (CCI) was calculated from patient-completed questionnaires and medical record review. Using patients' postal codes, neighbourhood walkability was determined using the Walk Score, which awards points based on the distance to the closest amenities, yielding a score from 0 to 100 (0-50: car-dependent; 50-100: walkable). Results: Based on the Walk Score, 134 patients lived in car-dependent neighborhoods and 93 lived in walkable neighborhoods. A multivariate logistic regression model, adjusted for age, gender, rural postal code, body mass index, smoking, median household income, percent employment, pain, and disability, demonstrated an adjusted odds ratio of 2.75 (95% confidence interval, 1.16 to 6.53) times higher prevalence for having a chronic disease for patients living in a car-dependent neighborhood. There was also a significant dose-related association (p=0.01; Mantel-Haenszel chi-square=6.4) between living in car-dependent neighbourhoods and more severe CCI scores. Conclusions: Our findings suggest that advocating for improved neighbourhood planning to permit greater walkability may help offset the burden of chronic disease.

The Effects of Traditional Physical Therapy on Pain Reduction and Depression Level of Patients with Chronic Low Back Pain (만성요통 환자의 우울수준과 통증감소에 미치는 전통적 물리치료의 효과)

  • You, Jae-Eung;Jung, Eun-Ha
    • The Journal of Korean Physical Therapy
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    • v.13 no.3
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    • pp.677-683
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    • 2001
  • The object of this study is in the comparison of level of depression between patients with chronic low back pain & normal adult, of the relation between reduction of pain & level of depression and in the examination of the influence of traditional physical therapy against the reduction of pain & level of depression of the patients with chronic low back pain for the new recognition of psychological factors to the physical therapists as well as patients. This study was targeted for 40 patients with chronic low back pain who were diagnosed as lumbar sprain & herniated intervertebral disk and compared & analyzed how traditional physical therapy has an influence to their reduction of pain and level of depression by questioning with visual an analog scale of Beck's depression inventory & pain inventory to them. The results are as follows. 1. Traditional physical therapy has an effect in the reduction of pain of the patients with chronic low back pain. 2. Although traditional physical therapy relieved a little the level of depression of patients with chronic low back pain. there was no evident effect statistically. 3. In the relation between the reduction of pain and level of depression, level of depression also showed somewhat relief according to the reduction of pain and appeared that they have some relationship. However, it's degree was not big. 4. In the comparison of the level of depression between the normal adult and the patient with chronic low back pain, the level of depression of the patient with low back pain are high rather than that of normal adult.

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A Clinical Experience of Dermatitis suspected Chronic Arsenic Intoxication (만성 비소 중독으로 의심되는 피부염 치험 1례)

  • Kang, Byung-Soo;Choi, Jeong-Hwa;Park, Soo-Yeon;Jung, Min-Yeong;Kim, Jong-Han
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.201-210
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    • 2017
  • Objectives : To report the patient suspected chronic arsenic intoxication after Korean medicine treatment. Methods : One patient with highly suspected chronic arsenic intoxication was selected. He was suspected to be chronic arsenic intoxication because symptoms and hair heavy metals test. Acupuncture was applied for twice a day and herbal medicine(Pyeonghyeol-eum) was administered in 28 days. Evaluation method applied to xeroderma, pruritus, psoriasis were overall dry skin score(ODS), visual analogue scale(VAS), pruritus grading system(PGS). Results : Pyeonghyeol-eum, acupuncture and the other Korean medicine treatments improved xeroderma, pruritis, psoriasis after 28 days of treatment. ODS decreased from 3 to 2. VAS of Pruritus decreased from 8 to 1. PGS decreased from 15 to 4. Adverse effects were not reported. Conclusions : This study shows that the Korean medicine treatment was effective in impoving symptoms of chronic arsenic intoxication. But the additional study will be conducted for revealing dermatitis caused by chronic arsenic intoxication.

The Expression of RANK and RANKL in Gingival Tissue of Human Chronic Periodontitis (만성 치주염 환자의 치은 조직에서 RANK 및 RANKL의 발현)

  • Baek, Young-Ran;Lee, Jae-Mok
    • Journal of Periodontal and Implant Science
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    • v.37 no.4
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    • pp.849-857
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    • 2007
  • Purpose: The purposes of this study were to compare and quantify the expressions of RANK and RANKL in the gingival tissues of non-periodontitis patient and patients with chronic periodontitis, in order to understand the contribution of these proteins to periodontal destruction. Material and methods: Gingival tissue samples were obtained during periodontal surgery or tooth extraction. According to the patient's systemic condition & clinical criteria of gingiva, each gingival sample was divided into two groups. Group 1 (n=8) is clinically healthy gingiva without bleeding and no evidence of bone resorption or periodontal pockets, obtained from non-periodontitis patients. Group 2 (n=8) is inflammed gingiva from patients with chronic periodontitis. Tissue samples were prepared and analyzed by Western blotting. The quantification of RANK and RANKL were performed using a densitometer and statistically analyzed by Student's t-Test. Results: The expression of RANK were similar in group 1 and 2. The difference between group 1 and 2 was not statistically significant. And the mean amount of RANKL was more increased in group 2 than group 1. The difference between group 1 and group 2 was statistically significant. Conclusion: The expression level RANK didn't show any significant difference between healthy tissue from non-periodontitis patients and inflamed tissue from chronic periodontitis, but the expression level of RANKL in inflammed tissue from chronic periodontitis showed significantly increased tendency compared to healthy gingiva from non-periodontitis patients. Therefore, characteristics of RANK and RANKL in progress of chronic periodontitis would be basis of further studies in diagnostic method and treatment index of the disease.

Chronic Central Post-Stroke Pain Treated with Scalp Acupuncture and Traditional Korean Medicine: A Case Report

  • Park, Jang Mi;Lee, Jae Sung;Jeong, Jae Eun;Lee, You Jung;Lee, Cham Kyul;Roh, Jeong Du;Jo, Na Young;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • v.36 no.4
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    • pp.277-281
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    • 2019
  • A patient with central post-stroke pain was treated for 4 weeks with scalp acupuncture and traditional Korean medicine (following a cerebral infarction in 2013). The patient presented at Chungju hospital in January 2019 with left side weakness and tingling, numbness in the left hemisphere, chronic pain and dysarthria. Initially, herbal medicine, acupuncture, pharmacupunture, indirect moxibustion, and physiotherapy were administered together with Western medicine, with no improvement in the patient's condition. On Day 5, scalp electroacupuncture (MS1, MS5, MS10, MS11) was introduced. The numbness feeling in the patient's head resolved, and the pain in his upper body decreased. Grip force difference between the left and right hand improved from 3 kg to 0-0.5 kg. Sleep disturbance was resolved after 4 weeks treatment, and his average numeric rating scale score for pain improved from an admission score of 10, to a discharge score of 5. The patient could walk unaided after treatment.