• Journal of agricultural medicine and community health
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• v.33 no.2
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• pp.232-242
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• 2008

- Abstract - Objectives: We examined the effects of diabetes mellitus (DM) case management program developed by National Health Insurance Corporation in Korea. Methods: One trained nurse performed the case management for 30 DM patients recruited through the reimbursement information of National Health Insurance in a rural community. The case manager had four home visits and two telephone calls for 12 weeks. We evaluated the effectiveness of the program in terms of self-efficacy, self-care behaviors and glyco-metabolic control. Results: The self-efficacy score was significantly increased from 70.0 of pre-intervention to 80.5 of post-intervention (p<0.001). The self-care score was also significantly increased from 2.86 to 3.60 (p<0.001). The scores of its components such as nutritional care, self-test of sugar level, foot care, oral care, and aerobic exercise were significantly improved (p<0.001). However, the improvement of score in medication management was statistically marginal (p=0.071). The fasting blood sugar level and HbA1c level was significantly decreased from 128.6 mg/dl to 114.5 mg/dl (p<0.001) and from 6.78 % to 6.54 % (p<0.001) respectively. Conclusions: The case management program was effective to improve the self-efficacy and self-care behaviors, and to control blood sugar level in DM patients.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.4
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• pp.195-202
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• 2005

Purpose　：　The purpose of this study is to report clinical management of acute　dermatitis patient during the period of pregnancy by oriental medicine.　Methods : Generally acute dermatitis is treated by corticosteroids, antibiotics,　antihistamines ec. But the use of these drugs may affect pregnancy women　adversely. So we think that oriental medical therapy is useful to treat a pregnancy　women who has acute dermatitis. We experienced a case of acute dermatitis patient　during the period of pregnancy. In the beginning of treatment, she has severe　itching, burning sensation, bulla, papule. We treated her with herbal medicine and normal saline wet dressing. Results : After treatment during 10days(admission treatment-herb medication, normal saline wet dressing), her symptoms was improved fairly After that she took herb medicine for a month, and all of her symptoms was disappeared. So she was satisfied with the result. Conclusion : Dermatosis gravidarum is a pregnancy-associated disease, which include itching, papule, eczema ec. It is generally due to blood deficiency(血虛)　under pregnancy condition. So samooltang is effective on dermatitis under blood deficiency.

• Journal of Trauma and Injury
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• v.34 no.4
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• pp.288-293
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• 2021

In South Korea, most patients who visit trauma centers with abdominal injuries have blunt trauma, and penetrating injuries are relatively rare. In extremely rare cases, some patients are admitted with a long object penetrating their abdomen, and these injuries are referred to as abdominal impalement injuries. Most cases of impalement injuries lead to fatal bleeding, and patients often die at the scene of the accident. However, patients who survive until reaching the hospital can have a good prognosis with optimal treatment. A 68-year-old female patient was admitted to the trauma center with a 4-cm-thick tree branch impaling her abdomen. The patient was transported by a medical helicopter and had stable vital signs at admission. The branch sticking out of the abdomen was quite long; thus, we carefully cut the branch with an electric saw to perform computed tomography (CT). CT revealed no signs of major blood vessel injury, but intestinal perforation was observed. During laparotomy, the tree branch was removed after confirming that there were no vascular injuries, and enterostomy was performed because of extensive intestinal injury. After treating other injuries, the patient was discharged without any complications except colostomy. Abdominal impalement injuries are treated using various approaches depending on the injury mechanism and injured region. However, the most important consideration is that the impaled object should not be removed during transportation and resuscitation. Instead, it should only be removed after checking for injuries to blood vessels during laparotomy in an environment where injury control is possible.

• Journal of Chest Surgery
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• v.20 no.4
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• pp.683-687
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• 1987

Bleeding from bone marrow after sternotomy for open cardiac surgery can be sometimes difficult to control and even lead to reoperation for hemostasis. A clinical comparative study was carried out to demonstrate the hemostatic effect of fibrin glue [Beriplast] for sternal marrow bleeding after sternotomy for open heart surgery. Postoperative blood loss was measured in two patient groups, group A included 19 patients operated upon from June to October 1987 and the fibrin glue was applied to the sternal marrow together with collagen fleece and group B consisted of 22 patients from January to May 1987 and only collagen fleece was applied without fibrin glue. There was no difference between two groups in age and sex distributions, coagulation state, method of extracorporeal circulation and operative management. The blood loss one hour after operation was 2.04 ml/hr/kg in group A and 3.55 ml/hr/kg in group B [P<0.001]. The most significant difference was observed during the first 4 hours after surgery with 1.34 ml/hr/kg versus 2.05 ml/hr/kg. over the following 20 hours the amount of drainage from the chest tubes was identical in both groups. Fibrin glue reduces blood loss after open heart surgery by local hemostasis at sternum. Our study has shown that local application of fibrin glue to sternal marrow is an effective method of controlling the sternal bleedings. No side effect or complication of fibrin glue was noted.

• Korean Journal of Adult Nursing
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• v.16 no.2
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• pp.222-232
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• 2004

Purpose: The purpose of this study was to identify the change in foot care knowledge, self care behavior, and physiologic indexes after foot reflexomassage education program, and the related factors. Method: Data were collected from 20 patients who were visited out patients clinic. The change and difference were analyzed with non-parametric statistics. Result: There were significant differences in foot care knowledge(P=.001), self care behavior(P=.000), dosalis pedis blood flow volume (P=.011), skin temperature of foot(P=.001), dorsalis pedis pulse(P=.000), capillary filling time of foot (P=.000) between pre and post. The level of changes of foot care knowledge was significant differences according to admission experience (P=.049), and negative related to systolic blood pressure(P=.028). The level of changes of self care behavior was related to age(P=.049), that of dosalis pedis blood flow was significant difference according to smoking(P=.042), that of skin temperatureof foot(P=.002) and dosalis pedis pulse(P=.038) were significant difference according to weight. The level of changes of capillary filling time of foot was related to diagnosis period(P=.014). Conclusion: Foot-Reflexo-Massage education program is an effective nursing intervention to promote foot care in diabetic patients. And the related factors can be recommended for the management of diabetic patients.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.4
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• pp.255-259
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• 2018

Sudden headache onset may rarely be caused by spontaneous intracranial hypotension (SIH). Other associated symptoms in patients with SIH are nausea, vomiting, vertigo, hearing alteration, and visual disturbance. This case report describes a 43-year-old female diagnosed with SIH who developed diplopia after resolution of an abrupt-onset headache, which was managed with conservative treatments, including bed rest and hydration. She was also diagnosed with secondary right sixth cranial nerve palsy. Although conservative management relieved her headache, the diplopia was not fully relieved. Application of an autologous epidural blood patch successfully relieved her diplopia, even after 14 days from the onset of visual impairment.

• The Korean Journal of Pain
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• v.18 no.2
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• pp.210-213
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• 2005

Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.470-474
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• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Journal of Medicine and Life Science
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• v.20 no.1
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• pp.48-52
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• 2023

High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.141-147
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• 2021

Background: Arteriovenous malformation (AVM) which is a high-blood-flow lesion with connections between arteries and veins without an intervening capillary bed, is difficult to manage. The ear is the second most common site of extracranial AVM. However, studies regarding the management of this condition remain lacking. The purpose of this study was to share managing experiences in our center and to investigate the treatment effect through a retrospective analysis of cases. Methods: Among 265 patients with AVM treated in our vascular anomalies center between January 2008 and January 2021, 10 patients with auricular AVM were included in the study to investigate the lesion distribution, clinical stage, and treatment methods by performing a retrospective evaluation. Results: Among 10 patients, five patients had AVMs distributed in the upper half of the ear, one patient in the lower half of the ear, and four patients in whole ear, respectively. Seven patients had Schobinger stage II, and three had stage III. One patient received surgical treatment only, four patients received sclerotherapy only, and five patients received both surgical treatment and sclerotherapy. The posttreatment status was checked as controlled in two patients, improved in seven patients, persistent in one patient. There were no worsening patients. Conclusion: Auricular AVM is a disease that is difficult to manage by one specific department, thus requiring a collaborative management effort from multidisciplinary team.