• Title/Summary/Keyword: Clinical cases

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Clinical Analysis of Chest Trauma; Analysis of 247 patients (흉부 손상의 임상적 고찰)

  • 김승규
    • Journal of Chest Surgery
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    • v.26 no.12
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    • pp.944-949
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    • 1993
  • Clinical analysis were performed on 247 cases of thoracic trauma, those were admitted & treated at the department of thoracic & cardiovascular surgery,Hanyang University Hospital during the period from Jan,1989 to June,1992. Age distribution of those was from 2 to 80 years old & mean age was 38 years old. The ratio of male to female patient was 186:61 [3:1].This ratio revealed high incidence in male patient. The most common cause of trauma was traffic accident in this series.The modes of injury were as follows: traffic accident 124 cases[50.2%],fall down 52 cases[21.05%], stab wound 47 cases[19.03%] and gun-shut wound 1 case.Ellapse time from accident to admission were 141 cases [57.09%] under 6 hr.Rib fracture were observed in 159 cases[64.37%], hemo or pneumothorax were observed 134 cases[54.25%] of total cases and location distributed Right:Left:Both[74:112:37], in left predominant. Conservative,non-operative treatment were performed in 128 cases and operation[open thoracotomy] 32 cases.Mortality was 1.6%[4 cases] & most common cause of death were due to irreversible shock with brain edema. Conclusively, more evaluation & co-operation of other department were expected treatment & better prognosis.

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Treatment of Displaced Intra-articular Calcaneal Fracture using Ollier Approach (전위된 관절 내 종골 골절의 Ollier 접근법을 이용한 치료)

  • Kim, Keun-Woo;Cho, Sang-Gi;Lee, Dong-Yeon
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.174-179
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    • 2008
  • Purpose: We evaluated the clinical results of the intraarticular calcaneal fractures treated using Ollier approach by inexperienced orthopaedic surgeon. Materials and Methods: Between August 2003 and May 2007, Of the total 46 cases, 12 cases (9 patients) of displaced intraarticular calcaneal fracture who underwent open reduction and internal fixation using Ollier approach were evaluated. The means of age was 50.5 years. According to the Sanders classification, there was no type I case and 8 cases of type II, 1 case of type III, and 3 cases of type IV. We evaluated the treatment result by assessing radiologic parameters ($B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal height/width) and clinical outcomes (VAS and AOFAS score). Results: The means of follow-up period was 25.3 months. The means of B.hler angle was improved from $2.4^{\circ}$ to $26.1^{\circ}$. Radiologic and clinical union was achieved in all cases without additional procedures. Excellent result were noted in 2 cases, good in 5 cases, fair in 4 cases, and poor in 1 case. We experienced 2 cases of minor complications; 1 case of mild wound infection and 1 case of hypoesthesia on foot dorsum. Radiologic findings of subtalar arthritis were present in 2 cases. Conclusion: Ollier approach seems to be helpful to inexperienced orthopaedic surgeons for the treatment of intraarticular calcaneal fractures in that it enables them to achieve considerable clinical outcomes without serious complications.

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Analysis of L-asparaginase Related Adverse Reaction (L-asparaginase 약물 유해 반응 보고 분석)

  • Ko, Kyung Mi;La, Hyen O
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.3
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    • pp.143-149
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    • 2017
  • Background: L-asparaginase (L-ASP) is a critical agent for the treatment of acute lymphoblastic leukemia and lymphoma, which is associated with serious toxicities including hypersensitivity, pancreatitis and thrombosis. Methods: To evaluate the toxicity of L-ASP in real clinical settings, we included the patients with L-ASP adverse drug reactions (ADRs) reported in a regional pharmacovigilance center of Seoul St. Mary's hospital from January 2014 to December 2015. Results: A total of 83 cases of L-ASP related ADRs were reported in 54 patients. Of these 83 cases, 65 cases (78.3%, 65/83) were spontaneously reported and 18 cases (21.7%, 18/83) were detected by further medical records review. Of the patients with ADRs, pediatric patients accounted for 83.3% of the cases (45/54) and median age was 9 years. The most common clinical manifestations of ADRs were hematology manifestations (31.3%, 26/83), followed by hepatobiliary manifestations (18.1%, 15/83). Thirty-four serious ADRs were reported in 19 patients. The sserious ADR group showed significantly longer hospitalization and higher rate of discontinuation of L-ASP than the non-serious ADR group (p = 0.005, 0.03). The most common clinical manifestations of serious ADRs were hepatobiliary manifestations (41.2%, 14/34). In total, 8 cases (9.6%, 8/83) of unlabeled ADRs were identified. They were serious ADRs. Conclusion: We identified unlabeled serious ADRs of L-ASP. Also, correlations were observed between serious ADRs and length of hospitalization, discontinuation rate respectively. Further investigations and developed spontaneous ADR reporting systems are needed to evaluate these correlations.

Clinical and Electrophysiological Characteristics of Post-stroke Tremor (뇌졸중후 진전의 임상적, 전기생리학적 특성)

  • Seo, Man-Wook;Kim, Young Hyun
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.128-135
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    • 2001
  • Background : Tremor is uncommon manifestation of stroke. Therefore a few cases have been reported until now. There is still uncertainty about the characteristics of post-stroke tremor. Furthermore the pathogenesis and responsible structures of post-stroke tremor are not precisely known. We have recently experienced 34 cases of post-stroke tremor for the past 6 years. We analysed the clinical features and electrophysiologic findings of post-stroke tremor to evaluate the general characteristics and to analogize the possible pathogenetic mechanisms of post-stroke tremor. Methods : The clinical characteristics of post-stroke tremor were summarized in according to the onset time, involved body parts, types, tremor frequencies, neuroradiologic findings, and associated symptoms. The tremor frequencies were recorded by using a gyroscope. The spectral analysis of tremor frequencies were done automatically with Motus I soft ware. Results : Tremor onset were remarkably varied. Some patients showed a tremor appearing at the onset of a stroke and other patients showed delayed-onset tremor 10 years after a stroke. Tremor frequencies were also much varied. The range of hand tremor frequencies were from 1.5 to 12 Hz. Lesions were found in 31 cases(infarction 27, hemorrhage 4) on neuroimaging. In the cases of cerebral infarctions, 7 cases showed multiple small vessel diseases and 20 cases showed cerebral vessel lesions. The most commonly involved cerebral vessel lesion was the middle cerebral artery territory Several different clinical patterns of post-stroke tremor were identified. Conclusions : There are some evidences from the data summarized here to suggest that several pathogenetic mechanisms including central oscillators could be involved for the development of tremors and that tremor generating neural circuits could be more complex than previously suggested neural circuits.

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Complementary health education and clinical guidance for treating women experiencing infertility along with unexplained resistant hyperprolactinemia

  • Atef M.M. Darwish;Dina A.M. Darwish
    • Journal of Medicine and Life Science
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    • v.20 no.4
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    • pp.158-165
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    • 2023
  • This study prospective randomized controlled trial aims to test the impact of adding health education, awareness of some contributing factors and clinical guidance to therapeutic cabergoline given to infertile women with unexplained resistant hyperprolactinemia. It comprised 120 infertile women with unexplained persistent hyperprolactinemia not responding to therapeutic doses of cabergoline 1.5-2 mg/week who were subjected to proper history taking to exclude concomitant drug intake or possible brain problems in all cases. They were classified into group A (60 cases) who received health education and clinical guidance to search for possible contributing factors and were instructed to avoid them in addition to proper therapeutic doses of cabergoline, while group B (60 cases) received proper therapeutic doses of cabergoline only without clinical guidance. After 1 month, serum prolactin (PRL) was measured for all cases. All cases had high PRL level at the start of the study (79.9±28.4 [39-195] and 78.2±19.9 [42-189] in group A and B, respectively) without any significant difference. Pretreatment counselling revealed that lifestyle factors, sexual behaviors or feeding habits may contribute to resistant hyperprolactinemia in all cases without a significant difference between both groups. Serum PRL dropped significantly more in group A (20.14±10.31 [11-45] vs. 49.32±37.03 [12-100]) after combined health education, clinical guidance of the couple and proper treatment. It is concluded that lifestyle factors, sexual behaviors, and feeding habits would affect the response of hyperprolactinemia to treatment. Health education and clinical guidance with some advice to avoid them, would concomitantly improve the response of resistant hyperprolactinemia to therapeutic doses of dopamine agonists.

Clinical Study of the Primary Mediastinal Tumor (원발성 종격동 종양에 관한 임상적고찰)

  • Choe, Pil-Jo;Lee, Jong-Su;Lee, Seong-Gwang
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.141-145
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    • 1990
  • Author made a clinical study of 48 cases of primary mediastinal tumors experienced in the dept. of the thoracic and cardiovascular surgery of Pusan National University Hospital during the 12 years period from march 1978 to march 1989. There were 34 males and 14 females. Their age distribution was from 4 months to 70 years, with the mean age of 34.4 years. 8.3 % of the patients were younger than 15 years old. There were teratoma 14 cases[29%], thymoma 11 cases[23%], neurogenic tumor 10 cases[21 %], lymphoma 6 cases[13 %], benign cyst 6 cases[13 %], and one case of fibrous histiocytoma in the histological distribution. The malignant tumors were 12 cases[25 %]. The common symptoms were chest pain and discomfort[35.4], coughing[18.8], general weakness and dyspnea. 16.7% of the patients were asymptomatic at admission. The successful removal was done in all cases of benign mediastinal tumors. In malignant cases, the surgical removal could be done in 5 cases. There was not postop. mortality. The frequent complications were atelectasis, infection, bleeding.

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Travelers' malaria among foreigners at the Hospital for Tropical Diseases, Bangkok, Thailand - a 6-year review (2000-2005)

  • Piyaphanee Watcharapong;Krudsood Srivicha;Silachamroon Udomsak;Pornpininworakij Karnchana;Danwiwatdecha Phatcharee;Chamnachanan Supat;Wilairatana Polrat;Looareesuwan Sornchai
    • Parasites, Hosts and Diseases
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    • v.44 no.3
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    • pp.229-232
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    • 2006
  • We retrospectively examined the charts of travelers admitted to the Hospital for Tropical Diseases, Bangkok, Thailand, with malaria during the years 2000-2005. Twenty-one cases of malaria were identified, of which 12 (57%) were Plasmodium vivax infections and 9 (43%) were P. falciparum infections. There was one mixed case with vivax and falciparum infection. Only 1 P. falciparum case had complications. All cases were successfully treated with standard antimalarial drugs. Only 3 of the 21 cases were thought to be acquired in Thailand, the rest were regarded to be imported.

Malignant Melanoma of the Foot (족부의 악성 흑색종)

  • Moon, Sung-Hoon;Park, Hong-Gi
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.18-23
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    • 2006
  • Purpose: We reviewed the clinical finding of malignant melanoma of the foot in korean because it's advanced stage and extended lesion at diagnosis. Materials and Methods: Retrospective study was enforced about the 11 cases who has diagnosed to malignant melanoma of the foot from February 1995 to March 2004. The mean follow up period was 61 months. In this study we used age, sex, site, depth, histology, clinical stage, precursor lesion, misdiagnosis, interval to diagnosis, survival time, survival. Results: Average age was 58 years and number of female was six. Common site of involvement were heel of plantar surface (6 cases) and subungual area (2 cases). Depths of involvement were 0.3 to 10 mm, most common histological type was acral lentiginous melanoma (7 cases), stage 5 according to classification of Clark were 5 cases and stage 2 or more according to clinical staging were 8 cases. precursor lesion were benign melanocytic nevi (2 cases) and ill defined (9 cases). Chief complaint were increasing of size, color change, pain and ulceration. Conclusion: Malignant melanoma of the foot usually arise at nonvisible area and is easy to be misdiagnosed or delayed treatment. So it is hard to early diagnosis and have poor prognosis. So we need education and effort to early detection and diagnosis.

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Korean Medical Treatment including Phototherapy after Hip Fracture Surgery: Three Case Reports (고관절 골절 수술 이후 광선치료를 포함한 한방치료 3예 보고)

  • Chang, Hokyung;Kim, Hyungsuk;Kim, Soojeon;Kim, Seyoon;Park, Jae-Hyun;Bae, Jun-hyeong;Shin, Woochul;Yoon, Ye-Ji;Lee, Hansol;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.113-124
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    • 2018
  • This study is designed to report three cases of postoperative care after hip surgery using conventional Korean Medicine treatments including phototherapy. Three patients undergone hip fracture surgery were treated with acupuncture, herbal medicine, and phototherapy. We used Visual analogue scale (VAS), EuroQol five dimension scale (EQ-5D), and hip disability and osteoarthritis outcome score (HOOS) to evaluate treatment effectiveness. After the treatment, VAS score was improved in all three cases, while EQ-5D and HOOS showed different results by items. EQ-5D (pain/discomfort) and HOOS (pain, symptoms, activities of daily living) were improved in all three cases. EQ-5D (self-care) and HOOS (quality of life) showed improvements in two cases. EQ-5D (mobility, usual activities, anxiety/depression) and HOOS (sports/recreation) were improved in one case. Conventional Korean Medicine treatments including phototherapy can be effectively used to alleviate pain and symptoms after hip fracture surgery.

Statistical evaluation of ameloblastoma on the relationship between radiological and clinical characteristics (법랑모세포종의 방사선학적 소견에 따른 임상 통계학적 평가)

  • Park, Ji-Hoon;Kim, Jin-Wook;Kwon, Tae-Geon;Kim, Chin-Soo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.176-183
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    • 2011
  • Introduction: Very high aggressiveness and recurrence are important clinical characteristics of ameloblastoma compared to the other benign tumors. Therefore, an accurate diagnosis and treatment plan is important. This study examined the association of the clinical findings and recurrence based on the radiological findings of ameloblastoma. In recurrent cases, these results are expected to help in the diagnosis and treatment of ameloblastoma to examine the relevance with the clinical characteristics and radiological features. Materials and Methods: For a clinical (gender, age) and radiological (location, internal pattern, size, perforation, border pattern, impacted tooth, root resorption) evaluation, this study examined 156 cases of 147 patients diagnosed with ameloblastoma, who had been treated and in most cases regularly checked at the department of oral and maxillofacial surgery, Kyungpook National University Hospital, between January 1993 and December 2009. For a recurrent rate evaluation, a more than 3 years follow-up period is needed. Accordingly, 116 patients diagnosed with ameloblastoma between January 1994 and December 2007 were investigated. Results: The recurrence rate in all cases was 6.1% but was 7.8% in cases with follow-up periods more than 3 years. The male-to-female ratio was 3:2, showing a slight male predilection. Ameloblastoma had a peak occurrence in the second decade of life followed by the fourth decade of life. The mandibular angle area is the most frequent site of ameloblastoma (50.8%) in the jaws. Six cases of unilocular (7.8%) and 3 cases of multilocular (7.7%) ameloblastomas recurred. Seven cases of smooth (10%) and 2 cases of irregular (4.3%) ameloblastomas recurred. No cases of ameloblastomas without perforation of the cortical bone (0%) and 9 cases with a perforation of cortical bone (11.1%) recurred. Four cases of the ameloblastomas with impacted teeth (11.4%) and 5 cases of ameloblastomas without impacted tooth (6.2%) recurred. Seven cases of ameloblastomas with root resorption (10.9%) and 2 cases of ameloblastomas without root resorption (3.8%) recurred. Conclusion: A multiple smooth margin, unilocular ameloblastoma with an impacted tooth, root resorption tends to recur more easily. Therefore, they need to be treated more carefully and require a a longer follow-up.