• Title/Summary/Keyword: Clinical Character

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A Clinical Analysis of Abdominal Stab Wounds (복부 자상의 치료 방법에의 접근)

  • Park, Ji-Yeon;Chung, Min;Lee, Yeong-Don;Lee, Jung-Nam;Lee, Woon-Ki;Park, Yeon-Ho;Baek, Jung-Heum;Park, Heung-Gyu;Kim, Keon-Kuk;Kang, Jin-Mo;Choi, Sang-Tae;Lee, Won-Suk;Park, Seung-Youn
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.134-141
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    • 2010
  • Purpose: A classic approach to abdominal stab wounds has been a routine laparotomy for the purpose of diagnosis or treatment. However, management protocols for abdominal stab wounds are still contentious in most trauma centers. We examined the relationship between the character of the stab wound and the injured intraabdominal organs by retrospectively analyzing the medical records of patients with abdominal stab wounds admitted to Gil hospital, and the findings for our patients are then confronted with a review of the literature. We aimed to propose proper management protocols to approach abdominal stab wounds. Methods: The medical records of all 80 patients sustaining abdominal stab wounds, admitted at the Department of Surgery, Gil Hospital, Gachon Medical School, from January 2004 to December 2008 were retrospectively reviewed. All the abdominal stab wounds were collated based on the site and the character of the injury, investigations performed on admission, results of investigations, operations performed and findings at the time of the operation. Results: The most prevalent age group was patients in their forties and the average age of the patients was 41 years for both genders. The stab wounds were most commonly located at the periumbilical area (16.9%), followed by the epigastric area (15.6%), and 18.2% of the patients had multiple wounds. The most commonly eviscerated organ was the omentum (9 out of 16 cases); 61.7% of non-eviscerated patients underwent a therapeutic laparotomy while 81.3% of eviscerated patients underwent a therapeutic laparotomy. The small bowel was the most commonly injured organ (22.7%, 17 out of 75 injuries). The review revealed a relatively common diaphragmatic injury in abdominal stab wound patients (8 cases, 10.5%). The average hospital stay was 11 days. Conclusion: This review revealed commonly eviscerated and injured intraabdominal organs in abdominal stab wound patients and their relationship with a therapeutic laparotomy. Although the management is still controversial, the authors suggest indications for an immediate laparotomy and a protocol for managing abdominal stab wounds. Hemodynamic instability and peritoneal irritation signs are definite indicators for an immediate laparotomy, but the review revealed intraabdominal organ evisceration alone not to be a statistically significant factor. In addition, the authors suggest that abnormal CT findings can be valuable for making a decision on management of hemodynamically stable stab wound patients. Further study may clarify a role for a more selective approach to operative intervention and for a more extensive use of selective observation.

A Retrospective Cross-sectional Study on Leukorrhea in Relation with Lower Abdomen Temperature and Physical Symptoms (대하증(帶下症)과 하복부온도 및 기타 동반 증상과의 연관성에 대한 후향적 단면연구)

  • Ahn, Ji-Yoon;Choi, Seok-Young;Hwang, Deok-Sang;Lee, Jin-Moo;Jang, Jun-Bock;Lee, Kyung-Sub;Lee, Chang-Hoon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.26 no.3
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    • pp.93-102
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    • 2013
  • Objectives: This study aims to research character of the patients with leukorrhea including Digital Infrared Thermal Imaging (DITI) and symptoms associated with leukorrhea in view of Korean medicine theory. Methods: We studied 71 patients visiting ${\bigcirc}{\bigcirc}$ Korean Hospital from April, 2012 to March, 2013. The subjects were categorized in two groups, leukorrhea group (n=40) and control group (n=31). We investigated the difference of DITI and other physical symptoms between two groups. Results: The average temperature of CV4 in leukorrhea group ($29.56{\pm}0.80^{\circ}C$) were significantly lower than that of control group ($30.12{\pm}0.54^{\circ}C$)(p<0.01). And there is no statistical difference of temperature of CV17 located in chest area between two groups. But temperature difference between CV17 and CV4 (${\Delt}T$) in leukorrhea group ($1.18{\pm}0.55^{\circ}C$) is significantly higher than control group ($0.68{\pm}0.43^{\circ}C$)(p<0.01). There is no correlation between leukorrhea and some sypmtoms, like menorrhea, irregular menstruation, fatigue, constipation and loss of appetite. But leukorrhea group is more likely to suffer from dyspepsia and insomnia than control group. Conclusions: Leukorrhea group is related to lower temperature in lower abdomen than control group. And patients with leukorrhea are more likely to appear dyspepsia and insomnia than no leukorrhea group.

Specific DNA fragment analysis of Salmonella pullorum and S gallinarum by subtraction PCR (RDA method(Subtraction PCR) 기법을 이용한 닭의 Salmonella pullorum과 S gallinarum의 specific DNA fragment 분리 연구)

  • Park Jae-Myoung;Lee Jong-Jin;Choi Hae-Yeon;Jo Woo-Yeong;Lee Kyung-Hyeon;Song Jae-Chan
    • Korean Journal of Veterinary Service
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    • v.28 no.1
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    • pp.1-21
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    • 2005
  • Pullorum disease and Fowl typhoid are kind of poultry specific disease for poultry. The peculiar character of these poultry specific diseases is that it can be infected by transmitting vertically and horizontally, also it is hard to be discovered by clinical sign, and pathology or immunology. So, to develop the PCR method which distinguishes these two genetically similar diseases of separated the specific DNA fragment from each strain and use it for differential diagnosis by subtraction PCR method. Standard strain of S gallinarum and S pullorum, and field isolation strain were verified by biochemistry, It confirmed existence of plasmid by using the PFGE. Then, Isolated DNA from it and used it as materials for the experiment. After cutting genomic DNA of two strains by using Sau 3Al, It ligated primer to tester DNA for PCR amplification and separated specific DNA fragment bacteria with method of subtraction PCR. And, It confirmed that it is a piece of unique DNA in every bacteria using base sequence of separated DNA fragment. 1. The six specific DNA fragment were separated from the DNA of S gallinarum and S pullorum by the subtraction PCR method. 2. In the result of comparison after setting base sequence of each fragment, each separated base sequence of DNA fragment they did not correspond to each other 3. As the result of each DNA fragment is derived from the each strain of DNA, and there was no homology of genomic DNA level in mutual. 4. The fragment originated in plasmid and includes S pullorum did not separate. 5. In the result of searching base sequence in Genebank, it partially shows homology in Salmonella enterica, S typhimurium, S dublin, Escherichia coli, Shigella flexneri, Yersinia pestis, Klebsiella pneumoniae. 6. Primer design by S gallinarum DNA 2, 3 fragment used PCR, They are positive reaction in only S gallinarum at 276, 367 bp position.

An A Study on Concepts of ${\ulcorner}$Oi, Blood and Body Fluids${\lrcorner}$ (일본동양의학(日本東洋醫學)의 기혈수설(氣血水說)에 관(關)한 고찰(考察))

  • Joh, K.H.;Kang, B.J.;Terasawa, Katsutoshi;Goto, Hirozoh;Kim, Y.S.;Bae, H.S.;Lee, K.S.
    • The Journal of Internal Korean Medicine
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    • v.18 no.1
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    • pp.207-217
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    • 1997
  • The oriental medicine based on the traditional Chinese medicine has developed characteristically according to the history and racial character respectively; China, Korea and Japan. Japan, among these nations, has accepted western medicine earlier than other nations and has tried to compare western and oriental medicine and combine them. In Japanese traditional medicine, it is characteristic that the old medical classics focusing on Sanghannon (傷寒論) and Geumgyeyoryak(金?要略) has developed The recent tendencies of clinical medicine and researches in Korean oriental medicine are mostly about the study of oriental medicine in view of western medicine and the combination of western and oriental medical treatment like Japan. But the study on the Japanese oriental medicine hasn't so far been tried before in Korea. From now on, we should not overlook that a more interest on Japanese oriental medicine will be very useful. Therefore we have surveyed the background of its origin and the process of development of the theory of ${\ulcorner}$Qi, Blood and Body Fluids${\lrcorner}$. What we wish to show in this paper is to provide a source for the basic understanding by explaining a fundamental theory of physiology and pathology of Japanese oriental medicine. Concepts of ${\ulcorner}$Qi, Blood and Body Fluids${\lrcorner}$ suggested by Nangai Yoshimashi in 1792 is the way of thinking that the circulation of 3 factors- ${\ulcorner}$Qi, Blood and Body Fluids${\lrcorner}$ nourish human body. Among these 3 factors, if Qi does not function smoothly, it causes the condition of a disease like Qi-deficiency, imbalance of Qi-distribution or Qi-depression and stasis; in Blood's case, deficiency of Blood and Blood stasis; and as for Body Fluids, stasis of Body Fluids. In the recent trend of study, there's a try to combining the western and oriental medicine, Qi is considered as psychoneurotic system, Blood as circulatory and endocrinologic system and Body Fluids as immunologic system.

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The limitation of Medical Underwriting on the definition of Critical cancer in Critical Insurance (CI보험중 '중대한 암'(Critical cancer)의 정의에 관한 Medical Underwriting의 제한적요소에 관한 고찰)

  • Chung, Hun-Jong
    • The Journal of the Korean life insurance medical association
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    • v.25
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    • pp.63-77
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    • 2006
  • The definition of 'critical cancer' in critical insurance(CI) is more insurance meanings than medical meanings. The difference between critical cancer of insurance and critical cancer of medical cancer is made difficult problem to the underwriting of insurer, contractor and medical doctor. The limited factors of underwriting in critical cancer of critical insurance as follows: (1) the limitation factors in the definition of 1st item critical cancer in CI 1) the definition differences of meanings in insurer, contractor, and medical doctor 2) the meanings of "the table of malignance" 3) the definition difference between 'critical cancer' and 'a large of medical expense cancer' (2) the limitation factors in the definition of second item critical cancer in CI 1) The limitation in the change of cancer character 2) The missing malignancy in pathological result due to localized cancer 3) The differences in the test result of hospital (3) the limitation factors in the definition of third item critical cancer in CI. 1) the lower items disobey the higher items 2) clinical malignancy of benign cancer pathologically 3) others: (1) low grade of malignant melanoma (2) early prostate cancer. (3) malignancy related HIV (4) all skin cancer excepted malignant melanoma (5) accepted clinically and a medical certificate by medical doctor as critical cancer of premalignant lesion, carcinoma-in-situ, and borderline cancer.

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Nutrition Survey in a Korean Mountainous Farming Area (산간지(山間地) 농촌주민(農村住民)의 영양실태조사(營養實態調査))

  • Ham, Jung-Rea;Kim, Hyong-Soo;Lee, Ki-Yull;Kim, Young-Hoo
    • Journal of Nutrition and Health
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    • v.6 no.3
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    • pp.37-45
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    • 1973
  • The main character of the Korean diet has been found to be low in protein both quantity and quality and high in carbohydrate. The purpose of this survey was to study the amount of salt intake related to the dietary pattern in Korea. The nutrition survey was conducted in a mountainous farming area located in Auhchun-ri, Gaebuk-myon, Changsoo-gun, Chunbuk Province, February 14-19 in 1973 (7 days). The precise weighing method was used in evaluating the kinds of foods and nutrients intake for 24 households during a three day period. The physical examinations were performed by a doctor on 120 persons and a detailed biochemical test on both blood and urine was made on 42 persons over 40 years old. The results obtained are summarized as follows: (1) Average nutrients intake of an adult per day: calorie intake was 2,446 Cal and its components-protein(61.1g) was 10 percent, fat(12.9g) was 5 percent and carbohydrate(521g) contributed 85 percent of the total calories. Other nutrients-calcium (443mg), thiamine(1.09mg), riboflavin (0.90mg), niacin (14.4mg) and vitamin C (63.2mg) were lower than the recommended daily allowance but vitamin A(2,083 I.U.), iron(11mg) and phosphorous(998mg) were slightly higher than that. (2) To evaluate the nutritional deficiences, clinical examinations were conducted. Angular stomatitis was present in 16.7 percent of those examiners. No edema was found. The rate of osteoarthritis, hepatomegaly diseases appeared in 20 percent of the total subjects and the symptoms appeared highest among those Iron 50 to 59 years old. (3) The following chemical components of blood serum were analyzed and found to be within the normal range: glucose, blood urea nitrogen, uric acid, total protein, albumin, globulin, bilirubin, total cholesterol, inorganic phosphate, alkaline phosphatase, sodium, potassium, chloride, calcium and lecithine dehydrase. One case of each of the following were found: hyperglycemia, hypocholesterolemia, renal problem, hypoproteinaemia and diabetes mellitus, and two persons were classified as showing hypoglycemia and hyponaturemia. (4) The sodium content in urine was 199.6 mEq/L, potassium content was 24.6 mEq/L. The sugar, pH and specific gravity in the urine was shown to be normal.

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Incidence and Clinical Characteristic of Venous Thromboembolism in Gynecologic Oncology Patients attending King Chulalongkorn Memorial Hospital over a 10 Year Period

  • Oranratanaphan, S;Termrungruanglert, W;Khemapech, N
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6705-6709
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    • 2015
  • Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

A Study on the Correlation Lee Jae Ma's Four Types of Essential Physical Constitution and From index - Concerning Male and Female 3rd Year High School Student in Some Urban and Rural Areas - (사상체질류형(四象體質類型)과 체격(體格) 및 신체형태지수(身體形態指數)와의 비교연구(比較硏究) - 도시(都市)와 농촌(農村)의 일부지역(一部地域) 남녀고등학교(男女高等學校) 3학년(學年) 학생(學生)을 대상(對象)으로 -)

  • Lee, Moon-Ho;Hong, Sun-Yong
    • Journal of Sasang Constitutional Medicine
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    • v.2 no.1
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    • pp.71-85
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    • 1990
  • 673 third-year students of boy's and girl's high schools in Taegu city and Kuni-gun and Youngyang-gun and Euisung-gun in Kyongbuk province were selected and investigated as the subject, of this study on the correlation between Lee Jae Ma's Four Types of Essential Physical Constitution and Physical Form index. The result of the study was found as follows. First, as for Height, the findings were not identical with the expression that "person of shaoyin(minor Yin) Type are short and small -- while person of Taiyin (major Yin) Type are tall and big," cited in classification of four different constitutions in a document named "Dong-Eu-Su-Se-Bo-Won". Comparison of persons of Shaoyang (minor Yang) - Type proved infitness due to the lack of data on Height in documents concerning Lee Jae Ma's four types of essential physical constitution. Second, as for Sitting Height, the correlation was prored between the findings of this study and the expression in the above document describing external physical characteristics of shaoyin-Type persons that "The upper part and' the lower part of the body are well balanced", but in point of Relative Sitting Height, none between the two. Third, as for Chest-Girth and Relative Chest-Girth plus Weight and Relative Weight, the expression that "Persons of Taiyin(major Yin) Type have the largest physique of the lour types of persons in the characteristics of external physical features, and that they also tend to have continental(widechest or large-scaled) character and strong nerve, that they are stoutly-built and fal." proved to have the correlation with the findings of this study. Fourth, in point of Chest-Girth and Relative Chest-Girth, this study found that its findings have the correlation with the phrase that "Chests are well developed upwar -- and sturdy and solid." in describing the characteristics of Shaoyang (minor Yang)-Type person' external physical features, and that with the phrase that "Chests are narrow" in the case of Shaoyin(minor Yin)-Type persons. Fifth, as for Weight and Relative Weight, the correlation was found between the findings and the expression that "shaoyin-Type persons have comparatively less flesh" as a sign of external physical characteristics of Shaoyin-Type persons. The above-cited findings proved that there exist some correlations between external physique of the Lee Jae Ma's four types of essential constitution and physical Form Indexes. Actually, however, in clinical classification, it is desirable that this approach should be consulted only after carefull consideration based on Lee Jae Ma's theory, and it seems imperative to continue the study of objectivization of Lee's theory.

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Correlation of Posterior Echo Patterns and Histopathologic Features in Invasive Ductal Carcinoma of Breast (유방 침윤성 관상피암의 초음파 소견 중 후방 에코 양상과 조직소견의 상호 비교)

  • Choi, Jong-O;Cho, Hyun-Cheol;Hwang, Mi-Soo;Park, Bok-Hwan;Kim, Dong-Sug
    • Journal of Yeungnam Medical Science
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    • v.15 no.1
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    • pp.151-158
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    • 1998
  • Traditionally posterior shadowing is regarded as a malignant criterion in the evaluation of breast mass by sonogram. But on the basis of our clinical experiences of breast sonogram, we often met a breast mass without posterior shadowing later confirmed breast carcinoma through pathologic examination. For the focus of what character of pathologic breast tissue influence the posterior shadowing in breast sonogram, we analyzed retrospectively the sonographic findings of 26 histologically proven invasive ductal carcinomas. Even though invasive ductal carcinoma is the only one of the many breast cancers, it represents the greater part of breast malignancy. The posterior echo pattern was compared with various histologic characteristics, such as the amount of connective tissue, degree of elastosis, necrosis, gross circumscription, accompanying inflammation, histologic differentiation, and mitotic index. Nine breast masses (35%) demonstrated posterior echo shadowing, while 17 masses (65%) showed enhancement. The tumors with posterior echo shadowing had more abundant connective tissue, increased elastosis, and poorly demarcated margin (p<0.05). Other histologic characteristics are not influence in posterior shadowing with significant in stastically. On the basis of our study, the phenomenon of posterior shadowing by sonogram is difficult to accept as a specific criterion for malignancy. It is only a phenomenon influenced by the amount of connective tissue volume and elastosis.

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The Analysis of Research Trend about Management of Low Back Pain (요통관리에 관한 연구동향 분석)

  • Hyun, Kyung-Sun
    • The Korean Journal of Rehabilitation Nursing
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    • v.1 no.1
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    • pp.51-60
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    • 1998
  • The result of studying papers about management of lower back pain published in domestic and foreign nursing and medical magazines in these 10 years is as follows ; 1. General characteristic of lower back pain ; 1) In sex distribution, there were more men than women in 5 papers and more women than men in 4 papers among 9 papers surveryed. 2) In age distribution, thirties to forties of patients had more lower back pain as surveyed by general hospitals and fifties to sixties of patients had more lower back pain as surveyed by oriental medical hospitals. 3) In cause factor, there were 50 to 65% of sprain, 32 to 44% of herniated intervertebral disc and 13 to 29% of degenerative changes. 4) In symtom distribution, there were 26 to 57% of lower back pain, 42 to 65% of lower back pain with radiating pain and 34 to 99% of paravertevral muscle spasm. 5) In period of pain management distribution, 18 to 40% of patients experienced pain for less than 6 months and 59 to 82% of them experienced pain for more than 6 months in 3 papers among 4 papers. 6) In surveying the treatment, 66 to 88% of patients had conservative treatment and there were treatments of general hospital, oriental medicine, self remedy and traditional practice in conservative treatment. 7) In job distribution, 12 to 50% of them were housekeepers, 23 to 31% office workers, 4.6 to 36% blue color workers and 11 to 15% students. 2. As psychological character lower back pain paients had anxiety, depression, anger-hostility, phobic anxiety, neurasthenia, hypochondriasis, and interpersonal sensitivity. 3. To distinguish the cause of lower back pain, plain lumbar roentgenogram, straight leg rasing test, eletromyelogic findings, somatosensory evoked potentials CT and MRI were performed. 4. To relieve lower back pain. epidural adhesiolysis, epidulal injection of local anesthetic in mixture with steroid, lumbar spinal root block, low level laser therapy, acupuncture like transcutaneous nerve stimulation(AL TENS), topical capsaicin and lumbar orthotics were used in medical field, and relaxation technique was used in nursing field. 5. Mckenzie's extension exercise and William's flexsion exercise for lower back pain were used in medical field and Yoga exercise was applied in nursing field. 6. The more school education and self efficacy were high, the better they had active coping lower back pain positively and the less self efficacy was the more they had serious pain. As a result of studying the paper there have been very little research for lower back pain in nursing fields of Korea and foreign countries. Because 60 to 80% of population expeience lower back pain at least more than once, it is necessary to develop the study and clinical practice for management of lower back pain.

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