• Title/Summary/Keyword: Patient care report

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Treatment of Pseudoarthrosis due to Nonunion of the Acromial Fracture with LCP - Case Report - (견봉 골절의 불유합으로 기인한 가관절증의 잠김 금속판을 이용한 치료 - 증례보고 -)

  • Kim, Yong-Min;Park, Kyoung-Jin;Kim, Dong-Soo;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Keum, Sang-Wook;Jeong, Ho-Seung
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.130-134
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    • 2013
  • A painful pseudoarthrosis will develop due to a delay in diagnosis and treatment, and surgical care is required. Treatment of pseudoarthrosis is really difficult because the acromion is a thin flat bone that is difficult to be fixed firmly. A 52-year-old woman with multiple trauma had an acromial fracture that was not detected until it had caused pain after ambulation. Open reduction and internal fixation with a variable angle locking compression plate for distal radius and autogenous iliac bone graft were performed. At nine months after the operation, there was partial tear in the supraspinatus tendon, and arthroscopic repair of the supraspinatus tendon was performed. At nine months after the operation, radiographs showed a complete union. At three months after tendon repair, the patient had excellent function of the shoulder. We have reported a case of a successful treatment of nonunion and pseudoarthrosis of acromial fracture that is difficult to be fixed.

A CASE REPORT AND DENTAL TREATMENT CONSIDERATIONS OF FIBRODYSPLASIA OSSIFICANS PROGRESSIVA PATIENT (Fibrodysplasia ossificans progressiva 환자의 증례보고 및 치과 치료시 고려 사항)

  • Kweon, Young-Sun;Hyun, Hong-Keun;Kim, Young-Jae;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Hahn, Se-Hyun;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.1
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    • pp.95-100
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    • 2011
  • Fibrodysplasia ossificans progressiva(FOP) is characterized by episodes of permanent heterotopic ossifications of soft tissues throughout the body. FOP is inherited in an autosomal dominant pattern, but most cases result from new mutations in the ACVR1 gene. Even minimal trauma can cause permanent ossifications of soft tissues and give rise to complications following routine dental care. Dental block anesthesia, severe stretching of the jaw and biopsies are all contraindicated in children with FOP. There is no effective treatment. Since the prevalence of FOP is very low and most patients with FOP are misdiagnosed during childhood, they undergo dangerous and unnecessary treatment that can lead to permanent harm. For patients with FOP, early diagnosis and prevention of complications are most important. This study aims at contemplating the characteristic features and consideration factors for the dental treatment of FOP patients in relation to the case of an eight years-and-one month old boy who was referred to Pediatric Dentistry due to prolonged retention of mandibular right and left deciduous central incisors after being diagnosed with sporadic FOP at Pediatric Orthopaedics, Seoul National University Hospital, and received dental treatment without the exacerbation of the FOP symptoms.

Clinical diagnostic study on Physiological Signal data measured on 31 cases of lumbago with EAV(Electro-puncture According to Voll) (요통환자(腰痛患者) 31례(例)에 대(對)한 EAV측정치(測定値)의 진단적(診斷的) 고찰(考察))

  • Han, Sang-Gyun;Ha, Chi-Hong;Kim, Jae-Hong;Cho, Myung-Rae;Bae, Eun-Jeong;Shin, Young-Il;Yang, Ki-Yong;Hwang, Kyu-Jung;Lee, Byung-Ryul
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.101-110
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    • 2002
  • Background and Purpose : Most diagnostic method for lumbago were invasive and complex. So we need to simplify and objectify diagnostic method for lumbago. Some study with EAV which is one of Physiological Signal Measuring Instruments, report significantly result as objective diagnostic method for other clinical symptom. By using EAV, we have obtained some physiological signal data from meridian-acupoints of 31 lumbago cases. Objective and Methods : This study researched into the clinical statistics for 31 case who ware in lumbago, and they ware treated with oriental medical care at the Dong-shin university oriental hospital during 6 month from June 1 2001 to November 10 2001. The data were analyzed and interpreted to compare with traditional differentiation of symptom-complexes, then further evaluated as the Five Evolutive Phases to make them differentiated. The EAV valus of Five Evolutive Phases were identified with the sequence of wood(木), fire(火), earth(土)steel(金), water(水). Results and Conclusion : These values of physiological signal were identical with standard differentiation of symptom-complexes of lumbago which is the main cause of deficiency of Qi and blood of the kidney and bladder. Among Five Evolutive Phases, Earth and wood values were increased, steel, fire and water were decreased significantly. This data imply the possibility of somewhat generalization from measuring instruments.

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THE CARE OF DELAYED MALUNION AFTER MAXILLARY FRACTURE BY DIFFERENT METHODS:REPORT OF THREE CASES (치료법을 달리한 상악골절후 부정유합 2예)

  • Yoo, Jae-Ha;Lee, Won-Yoo;Rew, Soo-Jang
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.13 no.1
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    • pp.117-127
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    • 1991
  • When open reduction of maxilla fractures is postponed due to concurrent life-threatening injuries, delayed union may result with malunion or nonunion. If delayed malunion is occurred, significant facial deformity may result, including a dished-out face, irregular retromaxillism with Angle's class III malocclusion, open anterior bite, nasal collapse, telecanthus and malar flattening. The treatment planning for this problem includes cephalometric evaluation anterior and lateral tomograms, dental casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue casts, orthodontic planning, dental planning and use of impression tray to rupture the fibrous tissue attachment at the fracture site. In this paper, one case presented a 58-year-old female patient with maxilla retrusion after comminuted fracture, who was treated with orthodontic methods of maxillary protraction headgear and Plaster headcap, whereas the other two cases were about male patients who were treated principally with surgically open reduction or Le Fort I-controlled transverse osteotomy with iliac bone graft.

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Pruritus in Burn Survivors (화상환자의 소양증 특성 조사)

  • Kim, Kyung Ja;Won, Mi Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.45-53
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    • 2016
  • This study examined pruritus to provide the data based on burn patient pruritus. A self-report questionnaire survey was conducted among ninety five burn survivors, who were over 18 years of age with admission periods longer than two weeks. The results indicated that the average burn range was $18.95{\pm}17.10%$, severity was $48.83{\pm}23.96$, and distress was $46.42{\pm}25.80$. A significant difference in pruritus consequences was observed according to frequency. The patients consistently experienced pruritus, even if it happened less often, difficulty in falling asleep (F=4.817, p=.004), poor mood (F= 5.955, p=.015)), and loss of concentration (F=6.483, p<.000). A significant difference in the pruritus consequences according to duration was observed, lasting for 30 minutes for all groups, more than the population and less than 30 minutes, difficulty in falling asleep (F=7.452, p<.000), poor mood (F=3.655, p<.015), and loss of concentration (F=12.564, p<.000). The frequency, duration (r=.29, p=.004), severity (r=.45, p<.000), distress (r=.44, p<.000), and consequences of pruritus in burn patients (r=.29, p=.004) showed a positive correlation. The results of this study could be used as a base material for the care of burn patients experiencing pruritus.

DENTAL TREATMENT OF A PATIENT WITH BARTTER SYNDROME: CASE REPORT (Bartter 증후군 환아의 치아우식 치료: 증례보고)

  • Kim, Minji;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Kim, Jung-Wook;Lee, Sang-Hoon;Jang, Ki-Taeg
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.45-49
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    • 2019
  • Bartter syndrome is an inherited renal tubular disorder characterized by hypokalemia, hypochloremic metabolic alkalosis, hyperreninemia, hyperprostaglandinism, and normal blood pressure. Bartter syndrome is classified by neonatal and classic type. Clinical manifestation of Bartter syndrome considered in dental treatment include tendency to dehydration, vomiting and erosion, attrition and abrasion of the teeth. A 2-year-4 month old boy with Bartter syndrome type III was referred to the Seoul National University Dental Hospital for dental evaluation and treatment. He showed hypokalemic hypochloremic metabolic alkalosis and had been treated with indomethacin and potassium chloride. He had hypocalcified teeth with or without multisurface caries lesions in all dentition and the erosion of maxillary teeth was detected. Dental procedure under general anesthesia was scheduled due to multiple caries and his medical condition. The dental procedure was successfully performed. This case suggests that electrolyte imbalances need to be treated prior to dental treatment and complete coverage restoration is necessary to protect the eroded teeth. An appropriate management plan for the patients with Bartter syndrome should include considerations of the need for close interaction with the pediatrician for pre- and post-operative care. General anesthesia may be recommendable to manage the patients having multiple caries with Bartter syndrome.

DENTAL MANAGEMENT OF A PATIENT WITH MUSCULAR DYSTROPHY UNDER GENERAL ANESTHESIA: CASE REPORT (근이영양증(muscular dystrophy) 환자의 전신마취 하 치과치료 : 증례보고)

  • Chae, Jong Kyun;Song, Ji-Soo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.50-54
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    • 2019
  • Muscular dystrophy (MD) is a heterogeneous group of inherited neuromuscular disorders, characterized by progressive muscle weakness. Severity of the disease ranges from mild to severe, and the disease is mostly caused by mutations in a number of genes. These genetic mutations cause lack of proteins which are essential for muscle cell stability. Muscle fibers are gradually replaced by fat and fibrous tissue. The muscles of the head and neck are affected in several types of MD that manifest as altered craniofacial morphology and dental malocclusion. A 3-year-10-month old, 15.0 kg boy with MD presented to Seoul National University Dental Hospital, Seoul, South Korea because of extensive carious teeth. A number of dental caries in primary dentition were identified during clinical oral examination. Due to dental anxiety and underlying systemic disease, general anesthesia was considered. General anesthesia was induced and maintained with intravenous anesthetics, propofol and remifentanil. Caries treatments - resin restoration, pulpectomy, zirconia crown restoration, stainless steel crown restoration - were performed. Under general anesthesia, successful dental procedure was done. Total intravenous anesthesia (TIVA) was performed instead of inhalation anesthesia in order to avoid risk of complications such as malignant hyperthermia and life-threatening rhabdomyolysis. With decreasing muscle function, plaque control becomes more difficult and leads to gingivitis. Especially, the open-mouth posture worsens gingivitis and can leads to malocclusions and problems in swallowing. Regular and periodic dental care is essential for maintaining oral health for patients with MD.

Spontaneous Resolution of Iatrogenic Calcinosis Cutis after Parenteral Calcium Gluconate Therapy in Neonates (신생아에서 비경구적 칼슘 글루코네이트 요법 이후의 의인성 피부 석회침착증 후 자연관해)

  • Song, Kwang Soon;Lee, Si Wook;Kim, Du-Han;Min, Kyung-Keun;Yon, Chang Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.192-196
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    • 2019
  • Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.

Preliminary Report of the $1998{\sim}1999$ Patterns of Care Study of Radiation Therapy for Esophageal Cancer in Korea (식도암 방사선 치료에 대한 Patterns of Care Study ($1998{\sim}1999$)의 예비적 결과 분석)

  • Hur, Won-Joo;Choi, Young-Min;Lee, Hyung-Sik;Kim, Jeung-Kee;Kim, Il-Han;Lee, Ho-Jun;Lee, Kyu-Chan;Kim, Jung-Soo;Chun, Mi-Son;Kim, Jin-Hee;Ahn, Yong-Chan;Kim, Sang-Gi;Kim, Bo-Kyung
    • Radiation Oncology Journal
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    • v.25 no.2
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    • pp.79-92
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    • 2007
  • [ $\underline{Purpose}$ ]: For the first time, a nationwide survey in the Republic of Korea was conducted to determine the basic parameters for the treatment of esophageal cancer and to offer a solid cooperative system for the Korean Pattern of Care Study database. $\underline{Materials\;and\;Methods}$: During $1998{\sim}1999$, biopsy-confirmed 246 esophageal cancer patients that received radiotherapy were enrolled from 23 different institutions in South Korea. Random sampling was based on power allocation method. Patient parameters and specific information regarding tumor characteristics and treatment methods were collected and registered through the web based PCS system. The data was analyzed by the use of the Chi-squared test. $\underline{Results}$: The median age of the collected patients was 62 years. The male to female ratio was about 91 to 9 with an absolute male predominance. The performance status ranged from ECOG 0 to 1 in 82.5% of the patients. Diagnostic procedures included an esophagogram (228 patients, 92.7%), endoscopy (226 patients, 91.9%), and a chest CT scan (238 patients, 96.7%). Squamous cell carcinoma was diagnosed in 96.3% of the patients; mid-thoracic esophageal cancer was most prevalent (110 patients, 44.7%) and 135 patients presented with clinical stage III disease. Fifty seven patients received radiotherapy alone and 37 patients received surgery with adjuvant postoperative radiotherapy. Half of the patients (123 patients) received chemotherapy together with RT and 70 patients (56.9%) received it as concurrent chemoradiotherapy. The most frequently used chemotherapeutic agent was a combination of cisplatin and 5-FU. Most patients received radiotherapy either with 6 MV (116 patients, 47.2%) or with 10 MV photons (87 patients, 35.4%). Radiotherapy was delivered through a conventional AP-PA field for 206 patients (83.7%) without using a CT plan and the median delivered dose was 3,600 cGy. The median total dose of postoperative radiotherapy was 5,040 cGy while for the non-operative patients the median total dose was 5,970 cGy. Thirty-four patients received intraluminal brachytherapy with high dose rate Iridium-192. Brachytherapy was delivered with a median dose of 300 cGy in each fraction and was typically delivered $3{\sim}4\;times$. The most frequently encountered complication during the radiotherapy treatment was esophagitis in 155 patients (63.0%). $\underline{Conclusion}$: For the evaluation and treatment of esophageal cancer patients at radiation facilities in Korea, this study will provide guidelines and benchmark data for the solid cooperative systems of the Korean PCS. Although some differences were noted between institutions, there was no major difference in the treatment modalities and RT techniques.

Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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