• 제목/요약/키워드: Follow up medication

검색결과 261건 처리시간 0.029초

The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors

  • Chang, Min Cheol;Chun, Min Ho
    • Journal of Korean Neurosurgical Society
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    • 제63권2호
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    • pp.261-267
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    • 2020
  • Objective : We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection. Methods : From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI). Results : At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores. Conclusion : Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.

난치성 간질에 대한 기능적 대뇌반구 절제술 및 Peri-insular 대뇌반구 절제술의 효과 (Surgical Results of Functional Hemispherectomy and Peri-insular Hemispherotomy)

  • 이동걸;이완수;이정교;김정호;고태성;이상암
    • Journal of Korean Neurosurgical Society
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    • 제29권9호
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    • pp.1195-1203
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    • 2000
  • Objective : To confirm the efficacy of functional hemispherectomy and peri-insular hemispherotomy on treatment of intractable epilepsy. Materials & Methods : From April 1997 to February 1999, we performed 1 functional hemispherectomy and 6 peri-insular hemispherotomy in 7 consecutive patients. These procedures result in completely disconnected hemisphere while maintaining the disconnected portion of the hemisphere intact within the surgical cavity. The indications were hemimegalencephaly in 2 cases, infarction with encephalomalacia in 2, Sturge-Weber syndrome in 1, hemiconvulsion hemiplegia epilepsy syndrome in 1, cortical dysplasia with leptomeningeal cyst in 1. Mean follow-up is 15.8 months(range 8-28 months). Results : Among 7 patients, 1 patient died immediately after peri-insular hemispherotomy. Five patients became seizure free with reduced doses of medications. One patient developed rare disabling seizure with medication. In 6 patients, there were improvements in the function of the hemiparetic limbs in the postoperative phase. A 3-year-old boy with infarction and encephalomalacia died few hours after surgery due to postoperative hypothermia. Two patients required shunt after surgery. Two patients developed postoperative brain swelling but were successfully managed with conservative care. Conclusion : In conclusion, functional hemispherectomy and peri-insular hemispherotomy may provide substantial seizure control in selected cases of young hemiplegic patients with intractable epilepsy.

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말기 심부전 환자에서 심장이식의 교량으로서 좌심실 축소술 - 중례보고 - (Partial Left Ventriculectomy as a Bridge to Cardiac Transplantation in a Patient of End-Stage Heart Failure -Case Report-)

  • 전양빈;이창하;이재웅;박철현;박국양
    • Journal of Chest Surgery
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    • 제35권9호
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    • pp.672-674
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    • 2002
  • 확장성 심근병증과 말기 심부전으로 진단된 40세 남자환자가 1997년 7월 좌심실 축소술(partial left ventriculectomy)을 시행하고 18개월 후 1999년 1월 심장 이식술을 시행하였다 좌심실 축소술 시행후 3개월에 시행한 심초음파 소견상 좌심실 구출율은 26%에서 42.6%로 증가하였고, 확장기 좌심실크기는 71 mm에서 45mm로 감소하여 심초음파로 측정한 심박출량 및 심박출지수는 각각 3.95 L/min, 2.28 L/min/m$^2$이었다. 술 후 11개월뒤 심초음파상 좌심실 크기가 56/51 mm(확장기/수축기 직경)로 증가하고 좌심실 구출율은 17%로 감소하여 약물을 더 증량하고 18개월째에 공여심장이 제공되어 심장이식을 시행하였다. 1, 3, 6개월만에 3회 시행한 심근 조직검사상 ISHLT(International Society of Heart and Lung Transplantation) 분류상 la로 판정됐고 현재까지 거부반응으로 인한 치료는 필요하지 않았다. 말기 심부전을 동반한 확장성 심근병증 환자에서 심장 이식을 기다리는 동안 좌심실 축소술이 성공적인 교량역할을 했기에 이를 보고하는 바이다.

Successful Rechallenge with Imatinib in a Patient with Chronic Myeloid Leukemia Who Previously Experienced Imatinib Mesylate Induced Pneumonitis

  • Go, Seong Woo;Kim, Boo Kyeong;Lee, Sung Hak;Kim, Tae-Jung;Huh, Joo Yeon;Lee, Jong Min;Hah, Jick Hwan;Kim, Dong Whi;Cho, Min Jung;Kim, Tae Wan;Kang, Ji Young
    • Tuberculosis and Respiratory Diseases
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    • 제75권6호
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    • pp.256-259
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    • 2013
  • Imatinib mesylate is a targeted therapy that acts by inhibiting tyrosine kinase of the bcr-abl fusion oncoprotein, which is specific to chronic myeloid leukemia (CML), and the c-transmembrane receptor, which is specific to gastrointestinal stromal tumors. Interstitial pneumonitis is a rare adverse event of imatinib therapy. It is clinically difficult to distinguish from infectious pneumonia, which can frequently occur due to the underlying disease. The standard treatment for imatinib-induced pneumonitis is to discontinue the medication and optionally administer corticosteroids. However, there are a few cases of successful retrial with imatinib. We describe a case of successful rechallenge of imatinib in a patient with imatinib-induced interstitial pneumonitis and CML without a recurrence of the underlying disease after 3 months of follow-up.

뇌졸중 환자에게 유치도뇨관 삽입 이후 발생한 다제내성 녹농균 요로감염 한방치험 1례 (A Case Report of a Stroke Patient Treated with Korean Medicine Diagnosed with a Catheter-associated Urinary Tract Infection Caused by Multidrug-resistant Pseudomonas Aeruginosa)

  • 장철용;김효린;황규상;유근정;이수영;김준현;김민수;신용진;신선호
    • 대한한방내과학회지
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    • 제37권6호
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    • pp.1042-1050
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    • 2016
  • This case study reports on the effect of Korean medicine on a catheter-associated urinary tract infection (CAUTI) caused by multidrug-resistant Pseudomonas aeruginosa. An 83-year-old man diagnosed with stroke had dysuria, and it was found that an indwelling urinary catheter led to CAUTI. From laboratory tests, we identified multidrug-resistant Pseudomonas aeruginosa and applied Korean medicine to him. After herbal medication with acupuncture and moxibustion, we studied a urinalysis and urine culture again for follow-up. We found meaningful improvement in bacteriuria and bacterial identification. This case suggests that Korean medicine could have a beneficial effect on urinary tract infections caused by multidrug-resistant Pseudomonas aeruginosa.

신체화장애 환아 증례 1례 (A clinical case report of somatization disorder patient)

  • 하수연;김하얀;김선미;하광수;송인선;김경혜
    • 대한한방소아과학회지
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    • 제20권3호
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    • pp.75-85
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    • 2006
  • Objectives : The somatization is various physical symptoms that have no pathologic manifestation. It is very common to Korean children and adolescents as well as adults, because cultural background and immature verbal expression. DSM-Ⅳ(Diagnostic and Statistical Manual of Mental Disorders Fourth Edition) presented diagnostic criteria for Somatization disorder by grouping some symptoms out of somatization. This report is on a case of somatization disorder patient. The patient is 13-year-old female. She has been suffered from various physical symptoms those are coincided with diagnostic criteria for Somatization disorder by DSM-Ⅳ. Methods : The authors treated her by acupuncture and 3 kinds of herb medicine-Bunsimgium, Hyungbangdojuksan, Yangguksanwhatang. Results : Bunsimgium was showed a little improvement but could not solved chief complaint. Hyungbangdojuksan was not given a help. After her taking Yangguksanwhatang, most symptoms were subsided. Conclusions : A patient with the somatization disorder was improved by herbal medication and acupuncture. But the Somatization disorder repeats to take a good turn and a bad turn and continues for long time, so we need to follow up her condition.

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Oral bisphosphonates induced osteonecrosis of the mandible : A case report

  • Son, Hyo-Jeong;Jang, Ho-Yeol;Keum, Yun-Seon;Lee, Jang-Yeol;Kim, Hyoun-Chull;Lee, Sang-Chull
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제35권2호
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    • pp.106-111
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    • 2009
  • Bisphosphonates have been approved for Paget's disease, cancer-related hypercalcemia, bone involvement in multiple myeloma or solid tumors and osteoporosis. Although, underlying pathophysiological mechanisms remain unclear, it seems that bisphosphonates inhibit osteoclast precursor cells, modulate migratory and adhesive characteristics and induce apoptosis of osteoclasts. Furthermore impacts on angiogenesis, microenvironment and signal transduction between osteoclasts and osteoblasts. In this report, we present a case of oral bisphosphonates induced osteonecrosis of the mandible in a 84-year-old patient who received for two years. Two tapered screw vent implants(Zimmer, USA) were placed in the area of first and second molar. Two weeks later after crowns restored, some inflammatory signs and symptoms were observed on the second molar area. Sequestrum was formed and the sequestrum was removed with the implant. Frequent follow-up checks and oral hygiene maintenances were done and the first molar implant was restored. There is insufficient evidence suggests that duration of oral bisphosphonate therapy correlates with the development and severity of osteonecrosis. Therefore, dentists should not overlook the possibility of development of bisphosphonate induced osteonecrosis in patients who have taken oral forms of medication for less than three years.

항경련제 Vigabatrin이 시야에 미치는 영향 (Assessment of the Relationship between Vigabatrin and Visual Field Defect in Children)

  • 정사준;정용환;조의현
    • Clinical and Experimental Pediatrics
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    • 제45권12호
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    • pp.1546-1550
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    • 2002
  • 목 적: 본 저자들은 VGB과 시야결손과의 관련성을 알기 위해 본 연구를 시행하였다. 방 법: 간질로 진단 받고 VGB을 추가 복용으로 치료를 시행한 환아 중 발달 연령이나 인지 연령이 8세 이상인 환아 78명을 대상으로 하였다. 시야검사는 Humphrey 자동 시야측정계로 시행한 후 결과가 의심이 되면 Goldman 시야측정계로 검사를 즉시 다시 시행하였으며, 이들은 다시 6개월 후에 재검을 실시하였다. 결 과 : 본 연구에서는 78명 중 5명에게 의증이 있었으나 재검시 다시 정상으로 나와 시야결손이 있는 환아는 없었다. 결 론: 본 조사에서 VGB은 시야결손을 일으키는 약물로 나타나지는 않았다. VGB의 시야결손으로 사용에 제한을 두기보다 다른 약으로 조절이 되지 않는 부분발작과 영아연축의 치료에 초기 선택 약물로 조심스럽게 사용하면 무방할 것으로 생각되어진다. 이와 함께 시야결손의 선별검사가 추천되며, VGB을 복용하는 소아에게 있어 정기적인 검사가 필요하겠다.

동결견에 대한 주사요법; 통증유발부위 주사 및 신경 차단술 (Injection Treatment for Frozen Shoulder ; Trigger Point Injection and Neruologic Blockade)

  • 오창욱;인주철;홍정길;박찬식
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.193-197
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    • 1998
  • Frozen shoulder is known as a self-limited disease. But, its long duration and pain nature can make the patients debilitative. And most patients cannot tolerate a chronically painful extremity and are concerned about the possibility of developing permanent dysfunction. In painful phase of frozen shoulder, some aggressive mordalties as like trigger point injection or suprascapular nerve block can beneficial to: reduce discomfort and pain. In order to document clinical results, we evaluated the results of 134 frozen shoulders treated with trigger point injection and/or suprascapular nerve block at Kyungpook National University Hospital, from January 1995 to April 1997. The treatment group was divided into 3 modalities: 17 cases in trigger point injection(TPI), 39 cases in suprascapular nerve block(SSB), and 78 cases in both methods. The supportive treatment including oral medication, heat and stretching exercise was also applied. The average age at the time of diagnosis was 57 years old and average follow-up time was 18 months. The results were as follows: Average time of significant improvement in pain was 9 days. Eighty-eight percent (119 cases) was improved in pain and range of motion after injecllion treatments; 82%(14/17) with TPI, 85%(33/39) with SSB, and 92%(72/78) with both. Early improvement of paih within 1 week was 72% in the treatment-responsive group, in which TPI group has 100% response(14/14) and sse has 94% response(31/33)

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인천광역시 의원기반 건강포인트제도가 고혈압·당뇨병 환자의 지속치료에 미치는 영향 (The Effect of a Clinic Based Incentive Program on Medication Adherence among Patients with Hypertension or Diabetes Mellitus in Incheon)

  • 정원;임준;오대규;임정수;고광필;박이병
    • 보건행정학회지
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    • 제23권4호
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    • pp.427-433
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    • 2013
  • Background: This study was conducted to evaluate the factors affecting adherence in patients with hypertension and type 2 diabetes mellitus before and after a clinic based patient incentive program in Incheon. Methods: An observational follow-up study was done for 28,355 patients in one registered group and 245,598 patients in a non-registered group from March 16th 2009 to December 31th 2010 in Incheon. The registration, mandatory laboratory tests and number of clinic visits were collected by merging the Incheon Chronic Disease Management System data and the National Health Insurance Corporation (NHIC) data. As a measure of patient adherence, we used a variable of prescription days from the NHIC and defined above 80% of average prescription days as an appropriate patient adherence. Repeated measures analysis of variance and logistic regression were used to analyze the differences in patient adherence and factors affecting adherence. Results: The changes in prescription days for the registered group are larger than for the non-registered group. In the logistic regression model, including the variables with sex, age, income status and number of clinic visits, the registered group exhibited a higher Odds ratio in the patient adherence. Conclusion: This study revealed the association between registration and appropriate patient adherence in patients with hypertension or type 2 diabetes mellitus.