• Title/Summary/Keyword: chief complaint

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Treatment of Canine Tracheal Collapse by Injection-Acupuncture and Herbal Medicine (기관지허탈 견에서 약침과 한약제를 이용한 치료)

  • Jun, Hyung-Kyou;Chung, Jae-Seung;Seo, Young-Min;Park, Se-Kun;Lee, Young-Won;Kim, Duck-Hwan
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.419-421
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    • 2007
  • A 15 years old castrated male Pug dog was referred with chief complaint of cough, described as a goose honk. He was diagnosed into of tracheal collapse by clinical signs and radiography. He was received by injection- AP with butorphanol (0.15 mg/kg, SID) at BL13, LU01, LU05, LU06, LU07, LU09 and CV22 for 10 days, and he was also received by injection-AP with butorphanol (0.40 mg/kg, SID) at BL13, LU01 and CV22 for 9 days. The patient was given with Sochungryong-Tang (0.5 g/head, TID) for 7 days, and he was additionally given with Sojagangki-Tang (1 ml/kg, TID) for 12 days. Cough was not detected at all, and tracheal diameter was more increased than that of session 1 on radiograph at session 19. Cough was not detected at all and tracheal diameter at follow-up study of three month later was more dilated than that of session 19. In conclusion, the present patient was a case with canine tracheal collapse which showed favorable therapeutic response by injection-AP with butorphanol combined by administration of herbal medicine.

A Case of Nasal Cryptococcosis in a Domestic Shorthair Cat (코리안 쇼트헤어 고양이에서 발생한 크립토코쿠스 감염증 의심 1증례)

  • Lee, Jin Soo;Kim, Hyun Wook;Choi, Ul Soo
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.115-118
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    • 2013
  • An 8-year-old spayed female domestic shorthair cat was presented with a chief complaint of chronic nasal discharge and dyspnea. Physical examination revealed pyohemorrhagic nasal discharge, inspiratory dyspnea and stertor, and an enlarged right mandibular lymph node. Abnormalities of blood works and serum chemistry included mildly increased hematocrit, and globulin concentration. Serologic tests for FeLV and FIV, and a panel of polymerase chain reaction tests for Chlamydophila felis, Feline Calicivirus, Herpesvirus, Bordetella, Mycoplasma felis, and H1N1 influenza was all negative. Only radiographic finding showed increasing soft tissue density in the right nasal cavity and computed tomography disclosed soft tissue/fluid opacification in the right nasal cavity, paranasal sinus, and pharyinx along with slight deviation to the right of the osseous nasal septum. Focal lysis of ventral nasal septum was also suspected in CT scan. Cytological evaluation of fine needle aspirate smears of the enlarged mandibular lymph nodes revealed numerous fungal yeasts having variably thick capsule both extracellularly and intracellularly with low numbers of macrophages. Some yeasts showed narrow based budding, which was a consistent finding with Cryptococcus organisms. Serum protein electrophoresis was a polyclonal consistent with chronic infection and serum was submitted for a fungal serology panel test. In serologic tests Cryptococcus antigen titer was 1 : 32,768. In vitro culture was unsuccessful. Treatment was initiated with administration of fluconazole, clindamycin, and tocopherol. Clinical signs resolved within 3 days after the initial treatment. The cat was discharged and scheduled for periodic evaluation and continued therapy, but was lost to follow-up thereafter.

Clinical Investigation of Fatigue Among Outpatients (피로를 호소하는 외래환자에 대한 임상적 관찰)

  • Park, Shin-Myong;Seung, Hyun-Suk;Kim, Young-Chul;Lee, Jang-Hoon;Woo, Hong-Jung;Lee, Ji-Hyeon
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.299-307
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    • 2001
  • Objectives: Fatigue is a common symptom experienced by many people who visit Oriental medical clinics or hospital. However, there has been little study about the fatigue in the Oriental medical academic world. For this reason, we attempted to investigate the present status of fatigue of outpatients, and its relation with Health Practice Index(HPI). Methods: The subjects were 63 outpatients who visited the Tonification Clinic in Kyunghee Oriental Medical Center between January 1, 2001 and July 31, 2001. Their chief complaint was fatigue and they did not have any physical or mental problem. They were given a questionnaire which included questions reflecting general characteristics, fatigue degree and health habits. We measured degree of fatigue by Chalder scale et al. Health habits were investigated about 5 articles out of 'Breslow 7 Health habits'. Results: Among the subjects, 48 people(76.2%) were considered as 'fatigue patients' by the Chalder scale. Of this 48 fatigue patients, 27 people(56.3%) had manifested fatigue for more than 6 months. The average of scale II for all the patients was 14.05, which indicates moderate degree of fatigue. They complained fatigue, drowsiness and general weakness, dryness and discomfort of the eyes, headache, shoulder pain and neck stiffness, dizziness, heat in the upper part of the body, and poor concentration. There were no differences in degree of fatigue according to Health habits including exercise or not, smoking or not, the frequency of drinking, hours of sleeping, and body mass index. Conclusions: Many people complain fatigue symptom. Therefore doctors should have more interest in fatigue and care. This study can provide standards of prognosis of fatigue patients. Also prospective studies are needed to find relationship between health habits and fatigue degree.

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Deep Sedation with Sevoflurane in Patients with Double Outlet of Right Ventricle (양대혈관 우심실 기시 환아의 Sevoflurane을 이용한 깊은 진정 하 치과치료)

  • Hyun, Hong-Keun;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Kim, Chong-Chul;Kim, Hyun-Jeong;Seo, Kwang-Suk;Lee, Jung-Man;Shin, Soonyoung
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.2
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    • pp.115-119
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    • 2012
  • Double outlet of right ventricle (DORV) refers to a congenital heart disease in which pulmonary and systemic circulation originates from the right ventricle. In the patient with DORV, it is important to maintain the balance between pulmonary and systemic circulation in anesthetic management. A 4-year-old boy with DORV, who underwent a Blalock-Taussig shunt operation, was transferred to the clinic with a chief complaint of multiple caries. Due to poor cooperability, it was impossible to treat the caries without sedation or general anesthesia. We planned to sedate him with consideration with detrimental effects associated with positive pressure ventilation for dental treatment. After a prophylactic administration of antibiotics, sevoflurane was administered through T-cannula site. Throughout the treatment, His blood remained stable around 80/40 mmHg, oxygen saturation remained around 91%. After 3 hour of sedation with sevoflurane (end-tidal sevoflurane con 1-1.8 vol%), he fully regained consciousness, and discharged from hospital without complications. In case of DORV patient, deep sedation with sevoflurane may be used as effective method of behavioral management during dental treatment.

Epidemiologic Study on the Elderly Patients Visited Oral Medicine (고령환자의 구강내과 진료실태)

  • Hong, Seong-Ju;Kang, Seung-Woo;Ryu, Ji-Won;Yoon, Chang-Lyuk;Cho, Young-Gon;Ahn, Jong-Mo
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.133-141
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    • 2009
  • We reviewed retrospectively the medical records of 600 elderly patients, over 65 years old who visited oral medicine. The ratio of the age group was composed of 65${\sim}$74 years old group was 63.7%, 75${\sim}$84 years old group was 32.2%, over 85years old group was 4.2%, and the patients were mostly females. The main chief complaint was composed of oral soft tissue problem(44.1%) and oromaxillofacial pain(39.0%). The majority of systemic diseases was composed of diseases of the circulatory system(30.1%), diseases of the musculoskeletal system and connective tissue(16.8%), endocrine, nutritional and metabolic diseases, and diseases of the digestive system(10.1%). The numerous pateints were diagnosed as soft tissue disease(32.0%), arthrogenous disease(24.1%), and myogenous disease(18.1%) of temporomandibular disease.Principally medication(43.9%), physical therapy(24.2%) were performed. 14.2% of all patients visited oral medicine with a letter of request written by other medical departments or local dental clinics, or referred from other departments in Chosun university dental hospital. These findings indicate epidemiologic characteristics on the elderly patients visited oral medicine. We hope that this study will play a basis in the future research about the elderly patients.

Trends in Malocclusion Patients of Yeungnam University Hospital (영남대학교병원 치과에 내원한 부정교합환자의 특성)

  • Chung, Sung-Ho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.71-81
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    • 2006
  • Background: This study was done to better understand patterns, trends and local distribution patterns of malocclusion so that we can provide adequate information to patients, to help make the appropriate diagnosis and therapeutic plans, and to assess the future directions of malocclusion treatment. Materials and Methods: Malocclusion patterns, distribution and trends of visiting patients were examined in 993 malocclusion patients who had been evaluated and diagnosed at the Department of Dentistry, Yeungnam University Hospital over a 10-year period from 1995 to 2004. Results: The number of visiting patients per year showed an increasing trend and the visit rate was 1.28 time-higher in females(56.1%) than in males(43.9%). 1) Age distribution showed that the 7-12 year-old group was the largest (36.7%). Geographic distribution showed the majority of patients were from the Dalseo district(28.2%). Angle's malocclusion classification revealed that class III was the largest(38.4%). Crowding was the chief complaint in the highest percentage of patients(33.9%). The therapeutic method used was the fixed appliance in 61% of cases and a combination with extraction in 30.8%. Conclusions: The availability of dental services can accommodate orthodontic needs adequately as well as obtain reliable quantitative information regarding the characteristics of orthodontic patients.

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Abdomino-perineal Organ Injuries Caused by Cultivators (경운기 사고에 의해 발생한 복부 및 회음부 장기 손상)

  • Yeo, Kwang Hee;Park, Chan Yong;Kim, Ho Hyun;Park, Soon Chang;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.28 no.2
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    • pp.60-66
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    • 2015
  • Purpose: Cultivator accidents are frequent and often lead to abdomino-perineal organ injury and, if severe, to death. This study presents the clinical characteristics, outcomes, and factors associated with mortality in patients who sustained an abdomino-perineal organ injury in cultivator accidents. Methods: We retrospectively analyzed the records of 53 patients who visited the emergency department of a tertiary hospital with abdomino-perineal organ injuries caused in cultivator accidents from April 2005 to March 2010. Results: All 53 patients had visited other medical institutions before visiting our hospital. Their mean age was $64.0{\pm}11.1$ (range, 20-80) years and 32 (60.4%) patients were 65 or older. The male-to-female ratio was 46:7. The chief complaint was abdominal pain (38 cases, 71.7%). The 53 patients included 41 cultivator operators (77.4%), 11 passengers (20.8%), and 1 passerby (1.9%). The causes of the injuries included a direct impact of the handlebar in 20 cases (37.7%), a rollover in 21 cases (39.6%), a fall in 10 cases (18.9%), and a wheel in two cases (3.8%). Several of the 53 patients had injuries to multiple abdomino-perineal organs, and the injured organs included the liver (23 cases, 26.4%), spleen (16 cases, 18.4%), pancreas (7 cases, 8.0%), small bowel (7 cases, 8.0%), mesentery (6 cases, 6.9%), adrenal gland (5 cases, 5.8%), and other organs. According to the abbreviated injury scale (AIS) dictionary, a thoracic injury was the most frequent co-injury (33 of 53 cases, 62.3%). Abdomino-perineal surgery was performed in 31 cases (58.8%) and angio-embolization was performed for six liver and two kidney injuries. Thirteen patients died (24.5%); all were males. The Injury Severity Scale (ISS) was lower in the survivors ($17.8{\pm}8.5$ vs. $27.0{\pm}16.0$; p=0.010). Conclusion: With the aging of agricultural workers, safety education programs should be implemented. Furthermore, the patient transfer system in agricultural areas must be improved.

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Non-hemolytic, Mucinous, Coagulase Negative MRSA Isolated from Urine (소변에서 분리된 비용혈성, 점액성, 응고효소 음성 MRSA)

  • Kim, Jae Soo;Choi, Qute;Jung, Bo Kyeung;Kim, Jong Wan;Kim, Ga Yeon
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.2
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    • pp.260-264
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    • 2019
  • An 84-year-old woman presented to the emergency department with a chief complaint of pressure sores of the anus. She had a urine catheter when she showed pyuria three times but had no fever. A microscopic examination revealed many grapevine-like Gram positive strains and neutrophils. After 24 hours of urine culture on blood agar, non-hemolytic mucous colonies were found and further enlarged after 48 hours of culture. The capsules were identified after India ink stain. The catalase was positive, but the tube coagulase and latex coagulase were both negative. The S. aureus was identified by Vitek-2 and mass spectrometer Vitek MS V-3 IVD. The strain was confirmed by 16S rRNA gene sequencing and multilocus sequence typing (MLST). The phenotypically atypical MRSA found in the tube coagulase and latex coagulase were both negative. MRSA often show no beta hemolysis as in this case but are rarely latex coagulase-negative. We report a woman whose urine culture showed non-hemolytic, tube coagulase-negative, and latex coagulase-negative MRSA.

Risk factors for hospital admission in revisiting patients to the emergency department with abdominal pain

  • Bae, Jung Kwang;Kim, Hye Jin;Ryu, Seokyong;Choi, Seung Woon;Kang, Tae Kyung;Oh, Sung Chan;Cho, Suk Jin;Lee, Sun Hwa
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.679-686
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    • 2018
  • Objective: The aim of this study was to identify the clinical characteristics and risk factors associated with the admission of patients in the emergency department (ED) within 30 days after discharge. Methods: A retrospective, observational study was conducted on adult patients presenting with abdominal pain to the ED of a single, urban, university hospital, between January 2014 and December 2015, who revisited the ED within 30 days after discharge. Data was collected on the emergency severity index level, time to contact doctors, physical examination, laboratory tests, use of computed tomography (CT), and patient disposition on revisitation. The primary outcome was hospital admission following an ED revisit in the 30-day period after the first visit. Results: During the study period, 19,480 patients visited the ED with the chief complaint of abdominal pain, and 13,577 were discharged. A total of 251 patients (1.29%) revisited the ED within 30 days, of which 89 were eligible for the study. The primary outcome was associated with not performing a CT scan on the initial visit and an increased C-reactive protein (CRP) value. Receiver operating characteristic curve analysis showed that a cut-off baseline CRP value of >0.35 mg/dL can predict the primary outcome with a sensitivity and specificity of 75% and 62.1%, respectively (area under the curve, 0.701; 95% confidence interval, 0.569-0.833; P=0.007). Conclusion: An increased CRP value and not performing abdominal CT were associated with a higher rate of admission following ED revisits of patients with abdominal pain. Future prospective studies on the role of abdominal CT imaging in patients presenting to the ED with abdominal pain will be needed.

Analysis of the Numeric Rating Scale (NRS) Used in Clinical Studies Based on Randomized Controlled Studies (임상연구에서 사용되고 있는 NRS에 대한 분석 : 무작위대조군연구를 중심으로)

  • Lee, Chan;Cho, Im-hak;Heo, Gi-yoon;Kang, Hee-kyung;Kim, Min-hwa;Han, Chang-woo;Kim, So-yeon;Choi, Jun-yong;Park, Seong-ha;Yun, Young-ju;Hong, Jin-woo;Kwon, Jung-nam;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.510-531
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    • 2021
  • Objectives: The purpose of this study was to review the status of numeric rating scale (NRS) usage and suggest the potential for use in multicenter retrospective studies of various diseases. Methods: Articles published from 2011 to 2021 that used the keywords "NRS", "Multi-center", and "RCT" were identified in foreign databases, including EMBASE, PubMed, CENTRAL. The articles were analyzed according to their use of "NRS" by symptoms and by disease group using the major classifications of the Korean Standard Classification of Diseases (KCD-7). Results: Classification by symptom in a total of 288 articles illustrates that the NRS was not only commonly used in pain evaluation but also for non-pain symptoms. In usage with non-pain symptoms, chief complaint of patients was the most common at 79%, and other factors included treatment satisfaction, evaluation of daily life, and sleep quality. In disease classification according to the KCD-7, the NRS was commonly used in connection with musculoskeletal and connective tissue diseases but was also utilized in various other disease groups. Conclusions: This study confirms usage of the NRS in multi-center RCTs, as the NRS was widely used in all types of diseases and symptoms. Considering the result and the advantages of the NRS, it is recommended for use as a daily evaluation tool for the collection of common data in multicenter retrospective studies.