• Title/Summary/Keyword: Usual Symptom

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Remissions of Crohn's Disease at Onset and Relapse Using Herbal Medicine: A Case Report (발병과 재발에 한약으로 관해가 유도된 크론병 증례 보고)

  • Lee, Byung-Hee;Won, Jiyoon;Park, Jae Rang;Lee, Hyangsook
    • Korean Journal of Acupuncture
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    • v.37 no.3
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    • pp.183-190
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    • 2020
  • This case report details two remissions at onset and relapse after 4 years each with Korean herbal medicine treatment in a 33-year-old male patient diagnosed as Crohn's disease (CD) by clinical and colonoscopic examination. He presented bloody diarrhea and severe abdominal pain, and his symptoms were persistent even with usual Western medications, so he was offered surgery and biologics. He was then given Sayeok-Tang for 8 months and remission was induced. Four years later he had a relapse and this time he was given Banha-Sasim-Tang, and Baekduong-Ga-Gamcho-Agyo-Tang, based on pattern changes with intense symptom monitoring. Clinical and endoscopic remission was confirmed after 4 months of herbal medicine treatment and no adverse events were reported. This case report shows that individualized Korean herbal medicine treatment has the potential for induction of remission of CD and further research is warranted.

Development of a Respiratory Nursing Program Using Recorder Playing for the Patients with Asthma and Measurement of Effectiveness (리코더를 활용한 천식환자의 호흡간호프로그램 개발 및 효과)

  • Jang, Hee-Jung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.1
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    • pp.19-27
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    • 2011
  • Purpose: This study was conducted to develop a respiratory nursing program using recorder playing for patients with asthma and to determine the effects of the program. Method: Participants were 26 patients with asthma (experimental group: 13, control group: 13). The experimental group participated in the respiratory nursing program for six months from April, to October, 2007. Content included playing a recorder, group education about asthma, and educational messages including cellular phone messages. The control group received usual care during the six months. Results: In this research the respiratory nursing program using recorders was developed in 3 stages: initial stage, advanced stage, and wrap up stage. Compared to the control group, fatigue status in the experimental group improved significantly as well as level of forced expiratory volume in 1 second. However significant differences were found in sleep status, mood, or quality of life. Conclusions: These results suggest that this respiratory nursing program for symptom management of patients with asthma led to improvements in self care activity. Nursing interventions are needed to maintain and further enhance the quality of life of these patients and the interventions should be implemented over a transition period.

Diagnostic Significance of Discography on Multiple Lumbar Disc Herniation (다발성 요추간반 탈출증에서 추간반조영술의 진단적 의의)

  • Lee, Sang-Won;Kim, Keung-Nyun;Chin, Dong-Kyu;Kim, Young-Soo;Cho, Yong-Eun;Jin, Byung Ho
    • Journal of Korean Neurosurgical Society
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    • v.29 no.5
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    • pp.628-634
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    • 2000
  • Objective : The introduction of MRI makes it easy to detect multiple lumbar disc herniation. However, MRI is not a physiologic test for detecting the symptomatic level. For the surgical plan, it is very important to determine the symtomatic level among the multiple lumbar disc herniation. In this regard, we studied diagnostic significance of discography on multiple lumbar disc herniation in determining the symptomatic level. Method and Material : We retrospectvely analyzed the discographic and clinical findings of 121 patients with multiple lumbar disc herniation for investigating the diagnostic availability of discography. All were surgically treated from January 1995 through May 1998. Result : Discography provocated the same pain as usual symptom in 99 out of 121 patients(81.8%). Compared with surgical findings, the diagnostic accuracy of the discography in multiple lumbar disc herniation was 75.6%, sensitivity was 64.6%, and specificity 87.2%. There was no correlation between the pain provocation of discography and the extent of annular degeneration on CT/discogram. The pain provocation showed good correlation with the extent of annular disruption on CT/discogram. The rate of same result(correlation rate) between the discography and D.I.T.I was 81.4% in multiple lumbar disc herniation patients with unilateral leg pain. Conclusion : These results indicate that in multiple lumbar disc herniation, the discography is considered useful diagnostic tool to determine the symptomatic level and to decide the surgical plan.

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Ultrasonographic Evaluation of an Atypical De Quervain's Disease - A Case Report - (초음파를 이용하여 진단한 비전형적 De Quervain씨 병 - 1례 보고 -)

  • Koh, In-Jun;Kim, Jung-Man;Song, Chol
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.91-93
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    • 2008
  • De Quervain's disease is a stenosing tenosynovitis that affects the synovial sheath of the tendons of the abductor pollicis longus and extensor pollicis brevis; it can be considered a work-related disease, since it frequently is associated with highly repetitive movements in jobs using the hands. The usual sign and symptom of de Quervain's diseases are positive Finkelstein's sign and pain and tenderness around the radial styloid process. The majority of de Quervain's disease has a good results to conservative treatment, but surgery can be performed in case of recurrence or pain last more than 6 months without improvement in spite of conservative treatment. We diagnosed a patient with atypical de Quervain's disease by ultrasonography, treated by local steroid injection and pain was relieved. We report a case of atypical de Quervain's disease evaluated by ultrasonography with brief of literatures.

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A Case Report of Korean Medicine Treatment for A Patient with Variant Angina and Asthma Symptoms (천식 증상을 가진 변형 협심증 환자에 대한 한방치료 증례보고)

  • Kim, Min-joo;Kwo, Tae-ha
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.864-873
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    • 2022
  • Objective: The purpose of this case study was to report the symptom improvement effect of integrative Korean medicine treatment based on Pyongsim Solution: Cheonwangbosim-dan in a patient with variant angina and asthma symptoms. Methods: This 68-year-old male patient was treated with Pyongsim Solution, Gamihyangsayukgunja-tang, Gwakhyangjunggi-san, acupuncture, pharmacopuncture, and cupping therapy for 24 days. The European Quality of Life-5 Dimensions-5 Levels profile, Numerical Rating Scale score, and pulse rate per minute were measured on admission, at two weeks of hospitalization, and upon discharge to assess the clinical outcomes. Results: After treatment, the "mobility" dimension profile of the European Quality of Life-5 Dimensions-5 Levels changed from 1 to 1, "self-care" changed from 1 to 1, "usual activity" changed from 3 to 2, "pain/discomfort" changed from 4 to 3, and "anxiety/depression" changed from 3 to 2. The Numerical Rating Scale score for chest pain decreased from 7 to 5, chest tightness decreased from 6 to 4, sleep disturbance decreased from 6 to 3, polydipsia decreased from 5 to 3, and stomach discomfort decreased from 5 to 3. All the profiles of these five dimensions were unchanged for 11 days in the period between the two weeks of hospitalization and discharge. There were also no changes in the profiles of either "mobility" or "self-care" throughout the entire 24-day hospitalization period. Conclusion: This case report shows that integrative Korean medicine treatment based on Pyongsim Solution can improve the symptoms of patients with variant angina and mild intermittent asthma, suggesting that Pyongsim Solution could be an important herbal medication for treatment.

A Study on the Zhongfeng Treatment of Zhang Shanlei Based on the Zhongfeng Jiaoquan (장산뢰(張山雷)의 중풍(中風) 치료법(治療法)에 관한 연구(硏究) - 『중풍각전(中風斠詮)』을 중심으로 -)

  • Lee Sang-Hyup
    • Journal of Korean Medical classics
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    • v.36 no.4
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    • pp.93-108
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    • 2023
  • Objectives : This paper aims to study the characteristics of zhongfeng treatment by examining the eight principles of zhongfeng treatment in the Zhongfeng Jiaoquan of Zhang Shanlei along with Zhang Bolong's treatment of 'Yangxu Leizhongfeng[Yang deficiency pseudo Wind damage]' which is missing from the eight principles. Methods : The treatment methods in the Zhongfeng Jiaoquan was organized in the order of cause, characteristic, symptom, treatment, and precautions, in order to analyze features that were emphasized by Zhang in zhongfeng treatment. Results : First, treatment for bizheng is to 'open and close', then apply methods of 'qianyang jiangqi(潛陽降氣)' and 'zhenni huatan(鎭逆化痰)' while that for tuozheng is to 'lianyin yiye(戀陰益液)' accompanied by medicinals that 'qianzhen xutang(潛鎭虛陽)'. Second, treatment for ganyang shangnizheng is to 'qianzhen rougan', while for tanzian yongsezheng, one must 'dangdi(蕩滌)' for those who are strong in qi, 'xiehua(泄化)' for those who are weak in qi, while for those who have qinizheng[qi reverse syndrome] to 'shunqi(順氣).' Third, for deficiency in xinye and ganyin, one must 'yuyin yangxue[育陰養血]', while for deficiency in shenyin, one must first 'qianjiang shena[潛降攝納]' then slowly apply the method of 'ziyang shenyin[滋養腎陰]' if there is no phlegm turbidity. Fourth, in order to communicate the meridians and unfold collaterals, if the pathogen is external, apply the method of 'yangxue tongluo[養血通絡]', while if the pathogen is internal, calm by doing 'qianyang zhenni[潛陽鎭逆].' Fifth, in order to treat pseudo zhongfeng caused by yang deficiency, one must 'lianyin gutuo[戀陰固脫]' while using medicinals that 'jiangxiang[潛降]'. Conclusions : Treatment of zhongfeng in the Zhongfeng Jiaoquan diverged from 'wenjing sanhan', the usual approach to zhongfeng which sees it as external, and established the 'qianjiang zhenshe [潛降鎭攝]' treatment method based on the internal wind theory. It suggests a new Korean Medical pathology based on theories of Western medicine, and introduces eight principles in treating zhongfeng, which would influence the treatment of zhongfeng in the future.

Diagnosis of Interstitial Lung Disease -Comparison of HRCT, Transbronchial Lung Biopsy and Open Lung Biopsy- (간질성 폐질환의 진단 -HRCT, 경기관지폐생검, 개흉폐생검의 비교-)

  • Park, Jae-Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.65-74
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    • 1999
  • Background : Open lung biopsy(OLB) has conventionally been regarded as the gold standard for the diagnosis in interstitial lung disease. With recent advances in diagnostic technique such as high resolution computed tomography(HRCT), and transbronchial lung biopsy(TBLB) which provide relatively accurate diagnosis of ILD, it is necessary to reevaluate the role of these methods in the diagnosis of ILD. Methods: We carried out a retrospective analysis of nineteen patients who underwent OLB at Dankook University Hospital for the diagnosis of acute and chronic ILD, between May 1995 and June 1998. By reviewing the medical records, the demographic findings, underlying conditions, HRCT and TBLB findings, OLB diagnosis, therapy after OLB, and complication of OLB were evaluated. Results: Thirteen patients(68.4%) had chronic ILD(symptom duration over 2 weeks prior to OLB), and six patients(31.6%) had acute ILD(symptom duration less than 2 weeks). Specific diagnosis were reached in 92%(12/13) of chronic ILD(5 bronchiolitis obliterans organizing pneumonia(BOOP), 2 constrictive bronchiolitis, 3 usual interstitial pneumonia, 1 hypersensitivity pneumonitis, 1 eosinophilic pneumonia), and in all patients of acute ILD(5 acute interstitial pneumonia, 1 pneumocystis carinii pneumonia). HRCT were performed in all patients and a correct first choice diagnosis rate of HRCT was 42%(5/12) in chronic ILD. In chronic ILD patients, 62%(8/13) received specific therapy(steroid therapy in 7 patients and moving in one patient), after OLB, but in acute ILD, all patients received specific therapy(steroid therapy in 5 patients and steroid and antibiotic therapy in one patient) after OLB. The in-hospital mortality after OLB was 5.3%(1/19). Conclusion: OLB is an excellent diagnostic technique with relatively low complications in patients with ILD. Therefore OLB should be considered in patients with ILD when the specific diagnosis is important for the treatment, especially in patients with acute ILD.

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Clinical Course of Usual Interstitial Pneumonia (통상성 간질성 폐섬유증의 임상경과)

  • Park, Joo-Hun;Kitaichi, M.;Yum, Ho-Kee;Shim, Tae-Sun;Lim, Chae-Man;Koh, Youn-Suck;Lee, Sang-Do;Kim, Woo-Sung;Kim, Won-Dong;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.601-613
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    • 2000
  • Background : Idiopathic pulmonary fibrosis (IPF) is a fatal progressive fibrous disease of the lung of unknown etiology. Recently it has been classified into several distinct entities on the basis of pathologic and clinical characteristics, ie : usual interstitial pneumonia (UIP), desquamative interstitial pneumonia (DIP), acute interstitial pneumonia (AIP), bronchiolitis obliterans with organizing pneumonia (BOOP), and nonspecific interstitial pneumonia (NSIP). IPF is now applied only for UIP, which has the worst prognosis. The previous reports of 3-5 year median survival appears to be overoptimistic because other types with better prognosis like NSIP or BOOP might have been included. Therefore, this study was performed to determine the clinical course and the prognostic factors of UIP as diagnosed by surgical lung biopsy. Methods : The subjects were 72 UIP patients (age $58.2{\pm}11.6$ years, M : F=45 : 27, median follow up period : 18.1 months (0.7-103.6) diagnosed by surgical lung biopsy at the Asan Medical Center (68 patients) and the Paik Hospital in Seoul (4 patients). Clinical scores (level of dyspnea : 1-20 points), radiologic score (honeycombing : HC score 0-5 points, ground glass : GG score 0-5 points), and physiologic scores (FVC : 1-12 points, $FEV_1$ : 0-3 points, TLC : 0-10 points, $D_{LCO)$ : 0-5 points, $AaDO_2$ : 0-10 points) were summed into a total CRP score. Results : 1) The one year survival rate was 78.3%, while the rate for three year survival was 58.1%, and the median survival period was 42.5months. 2) Short term (1 year) prognosis : The patients who died within one year of diagnosis (14 patients) had the higher initial total CRP score ($28.6{\pm}8.3$ vs. $16.6{\pm}9.7$) than those who lived longer than one year (46 patients). The difference in the total CRP score was attributed to the symptom score ($8.4{\pm}2.1$ vs. $5.7{\pm}3.9$) and the physiologic score ($15.7{\pm}7.1$ vs. $6.7{\pm}5.7$) including FVC, $D_{LCO)$ and $AaDO_2$. 3) Long-term (3year) prognosis : The total CRP score ($12.2{\pm}6.7$ vs. $28.7{\pm}7.9$ : including symptom score, FVC, $D_{LCO)$ and $AaDO_2$) at the time of diagnosis were also different for the long-term survivors and those who lived less than 3 years. 4) Cox regression analysis showed $D_{LCO)$ (${\geq}$60%) (Hazard ratio : 4.56, 95% CI : 2.30-16.04) was the independent prognostic factors of UIP (P<0.05). Conclusion : These results suggest that $D_{LCO)$ at the time of diagnosis seem to be a prognostic markers of biopsy-proven UIP.

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Difference of Pain Description According to Gender in the Elderly (노인의 성별 만성동통 호소의 차이에 대한 조사연구)

  • 김명애;박경민;김효정
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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    • pp.369-379
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    • 1998
  • Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence (69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001), the greatest impact was on movement (83.5%) , followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture.byssocausis(55%). The conclusion : Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, especially by gender and by age.

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A New Approach to the Whole Body Intervention Program(General Coordinative Manipulation Program) of Nonspecific Back Disorder

  • Moon Sang-Eun
    • The Journal of Korean Physical Therapy
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    • v.15 no.4
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    • pp.112-128
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    • 2003
  • Since areas of pain and dysfunction of musculoskeletal typically suffered by the patients with back disorders spread all over the body, WBIP(GCM Program) for the primary treatment and management is required. The purpose of this study is to analyze if WBIP(GCM Program) based on the hyper/hypomobility pattern of Four Body Types can identify the effective treatment of back disorders and the effect on the postural balanced restoration of the spine and extremities. Non-specific back disorder is still a major reason for sick leave. And moreover, its been reported that there was often recurrence to the patients whose symptom had been diminished. As a WBIP(GCM Program) based on kinematic chain patterns of Four Body Types, this study gave a new information on the effective diagnosis, treatment and management of non-specific back disorders. 337 patients above the twenty-five years old with the non-specific back disorders at the hospital and oriental medical clinics at Kyungnam and Busan areas in South Korea from August 24th, 2000 to Feb 23rd, 2001 have randomly been assigned to four experimental groups such as Whole Body Intervention Program Group, Physical Therapy Group like modality treatments, Acupuncture-Treatment Group, and Placebo Control Group. According to intervention program applied to the each four group for three times per week(twelve times per 4weeks), as the time-series methods, we compared and evaluated the body status of the pretest with that of post treatment completion of four week, three month, and six month, respectively. As the analytical method of measurement, our researchers used the Moire Interferometry Unit and Postural Kit that could measure the postural balance of spine and extremities. The collection of data was performed in the designated hospital and oriental medical clinics. For the analysis of the data, the SPSS 10.0 package program was used. X2-test has been taken in order to compare and analyze characteristics and GPES of the patients in four experimental groups. Repeated Measure ANOVA and Tukey post hoc test has been adopted in order to compare the effects of the balanced restoration of the spine and extremities among four Groups categorized for this study. Statistical significance was accepted at the 0.05 level of confidence The effect of the balanced restoration on the spine and extremities of the patients with non-specific back disorders has been proved in all of the Groups. As for the restoration degree, however, WBIP(GCM Program) Group produced the highest effectiveness in terms of the fact that it had a dense moire in comparison with the other three Groups and that the Moires of both sides had the same level by the time(p<0.01). WBIP(GCM Program) based on four tilting types of scapular and ilium and hyper/hypomobility pattern took a higher effect on the balanced restoration of the spine and extremities through a whole body as well as the treatment of back disorders than the other three Groups which the usual remedy without classification of body type had been applied to.

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