• Title/Summary/Keyword: hospital patients

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Acute cholecystitis in pregnant women: A therapeutic challenge in a developing country center

  • Mohamed Fares Mahjoubi;Anis Ben Dhaou;Mohamed Maatouk;Nada Essid;Bochra Rezgui;Yasser Karoui;Mounir Ben Moussa
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.388-393
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    • 2023
  • Backgrounds/Aims: Acute cholecystitis is a rare condition in pregnant women, potentially affecting the maternal and fetal prognosis. Our aim was to report the main clinical and paraclinical features of acute cholecystitis during pregnancy and therapeutic modalities. Methods: We conducted a case series analysis recording pregnant patients with acute cholecystitis admitted to our surgery department over a period of 11 years. We collected clinical data, paraclinical features, and management modalities related to cholecystitis. Results: There were 47 patients. Twenty-eight percent was in the first trimester of pregnancy, 40% in the second, and 32% in the third trimester. Abdominal pain was located in the right hypochondrium in 75% of cases. Fever was noted in 21% of cases. C-reactive protein was elevated in 39% of patients. Cholestasis markers were high in four patients. Abdominal ultrasound showed a distended gallbladder in 39 patients, with thickened wall in 34 patients, and gallbladder lithiasis in all cases. No patient had a dilated main bile duct. All patients received intravenous antibiotic therapy. Tocolysis was indicated in 32 patients. Laparoscopic cholecystectomy was performed in 32 cases (68%), and open cholecystectomy in 15 cases (32%). Postoperative course was uneventful in 42 patients, and complicated in 5 patients. Rate of complications was statistically higher after open cholecystectomy (p = 0.003). Morbidity rate was higher in the third trimester (p = 0.003). Conclusions: Delay in the diagnosis of acute cholecystitis during pregnancy can lead to serious complications. Management is based on antibiotic therapy and cholecystectomy. Laparoscopic cholecystectomy appears to be less morbid than open cholecystectomy.

Factors Affecting the Reuse of Non-face-to-face Treatment by Non-face-to-face Treatment Patients in Tertiary General Hospital (상급종합병원 비대면 진료 재이용에 영향을 미치는 요인)

  • Sun-Young Min;Tae Hyun Kim;Sang Gyu Lee;Suk-Yong Jang
    • Korea Journal of Hospital Management
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    • v.28 no.4
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    • pp.1-22
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    • 2023
  • Purposes: The purpose of this study is to identify and analyze the factors that affect patients reusing non-face-to-face treatments at tertiary general hospitals. Methodology: We retrospectively analyzed a patient's reuse of non-face-to-face treatment from February 1, 2020, to December 31, 2021, at a tertiary general hospital in Seoul within one year of the first non-face-to-face treatment. A frequency analysis was conducted to identify the study subjects' demographic characteristics, treatment type characteristics, disease characteristics, and hospital use type characteristics. Also, across-analysis was conducted to verify the difference in non-face-to-face treatment reuse according to the characteristics a multiple logistic regression analysis was conducted to identify the factors affecting the reuse of non-face-to-face treatment by non-face-to-face treatment patients. Findings: The results of this study can be interpreted as indicating that the following groups are more likely tore use the non-face-to-face treatment: women, children, the elderly, Patients living far from the hospital, psychiatric patients, pediatric patients, medical benefits recipients, chronic patients, patients with mobility difficulties, and patients with high loyalty to hospitals. Practical Implications: When developing a non-face-to-face treatment system in the future, based on the results of this study, it is possible to target patients who prefer non-face-to-face treatment. And this study will be research material for vitalizing non-face-to-face treatment. In addition, the activation of the non-face-to-face treatment system will be an effective means for improving the quality of medical services and generating profits in hospitals in the future.

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Phase II Study on Breast Conservative Surgery Plus Chemo- and Radiotherapy in Treating Chinese Patients with Early Staged Breast Cancer

  • Liu, Yang-Chen;Zhou, Shao-Bing;Gao, Fei;Yin, Xiao-Xiang;Zhao, Ying;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3747-3750
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    • 2013
  • Purpose: To evaluate the efficacy of conservative surgery plus chemo-, radio-therapy in treating patients with early stage breast cancer. Patients and Methods: Eligible patients were treated by postoperative chemotherapy as well as whole-breast irradiation with tumor bed boost. Postoperative radiotherapy consisted of 6 MV whole breast linear accelerator irradiation with two tangential half fields to a total dose of 45~50 Gy, followed by $10{\sim}15MeV{\beta}$ boost irradiation to tumor bed for 10~20Gy, total dose 56~66Gy. Results: Fifty-two patients were enrolled. Overall 1-, 2- and 3 year survival rates were 98.1%, 92.3%, and 90.4%, respectively, with a local recurrence rate of 5.77%. Cosmetic results were evaluated as good by doctors in 90.4% of patients. Conclusions: Breast conservative surgery combined with chemo- radio-therapy could be a treatment option for Chinese patients with early stage breast cancer.

Fragmentectomy versus Conventional Microdiscectomy in Single-Level Lumbar Disc Herniations : Comparison of Clinical Results and Recurrence Rates

  • Baek, Geum-Seong;Kim, Yeon-Seong;Lee, Min-Cheol;Song, Jae-Wook;Kim, Sang-Kyu;Kim, In-Hwan
    • Journal of Korean Neurosurgical Society
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    • v.52 no.3
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    • pp.210-214
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    • 2012
  • Objective : This retrospective study aimed to compare clinical outcomes in terms of pain relief and recurrence rate between fragmentectomies and conventional microdiscectomies in patients with lumbar disc herniation (LDH). Methods : Between January 2008 and May 2011, a total of 175 patients met the inclusion criteria of this study. The visual analogue scale (VAS) scores of back and radicular pains were recorded before surgery, 2 and 6 weeks after surgery. Recurrence was defined when a patient had the same pattern of preoperative symptoms and was confirmed with magnetic resonance imaging. Results : Seventy-four patients (42.3%) were suitable for fragmentectomy, and 101 patients underwent conventional microdiscectomy. There were no significant differences in VAS scores between the fragmentectomy and conventional microdiscectomy groups 2 and 6 weeks after surgery. During the follow-up period, 3 patients (4.05%) in the fragmentectomy group and 7 patients (6.93%) in the conventional microdiscectomy group relapsed. Conclusion : If patients are selected according to well-defined criteria, fragmentectomy can be a good surgical option for LDH, in the physiological aspect of preserving healthy intervertebral disc materials.

Retrospective Analysis of Re-operated Patients after Chronic Subdural Hematoma Surgery

  • Jeong, Chul-An;Kim, Tae-Wan;Park, Kwan-Ho;Chi, Moon-Pyo;Kim, Jae-O;Kim, Jung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.38 no.2
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    • pp.116-120
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    • 2005
  • Objective : The aim of this study is to analyze the clinical symptoms, radiological changes, interval from first operation to symptom recurrence and to propose the proper treatment method for re-operated patients following chronic subdural hematoma surgery. Methods : Between January 1992 and April 2003, 18 of 138patients of chronic subdural hematoma repeatedly underwent surgical treatment. The symptoms, mental status by Bender grade, radiological hematoma size and midline shifting, interval from symptom onset to diagnosis, surgical method and prognosis by Glasgow outcome scale[GOS] between the first attack and the recurrence were compared. Results : The symptoms at the time of recurrence were nearly the same as with the first attack, but two patients[2/18, 11.1%] showed a more declined mentality. In addition, the recurred hematoma sizes were the same or large than those previously found. Many patients were recurred within two weeks[13/18, 72.2%]. Most patients were operated on using the previous burr hole, with the exception of one patient who recurred at a different site. All patients had a good prognosis more than GOS 4 [GOS 4:4, GOS 5:12], but two died due to extracranial complication and infection. Conclusion : These results suggest that the early diagnosis and treatment are important, mostly recurred same symptoms within two weeks. Re-operation using the previous burr hole site is a good method.

Elevated Serum Ferritin Levels in Patients with Hematologic Malignancies

  • Zhang, Xue-Zhong;Su, Ai-Ling;Hu, Ming-Qiu;Zhang, Xiu-Qun;Xu, Yan-Li
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6099-6101
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    • 2014
  • Purpose: To retrospectively analyze variability and clinical significance of serum ferritin levels in Chinese patients with hematologic malignancies. Materials and Methods: Serum ferritin were measured by radioimmunoassay, using a kit produced by the Beijing Institute of Atomic Energy. Patients with hematologic malignancies, and treated in the Department of Hematology in Nanjing First Hospital and fulfilled study criteria were recruited. Results: Of 473 patients with hematologic malignancies, 262 patients were diagnosed with acute leukemia, 131 with lymphoma and 80 with multiple myeloma. Serum ferritin levels of newly diagnosed and recurrent patients were significantly higher than those entering complete remission stage or in the control group (p<0.001). Conclusions: Serum ferritin lever in patients with hematologic malignancies at early stage and recurrent stage are significantly increased, so that detection and surveillance of changes of serum ferritin could be helpful in assessing conditions and prognosis of this patient cohort.

Clinical Analysis of 312 Patients with Hepatobiliary Cancer in Oriental Hospital (한방병원에 내원한 간담도계 암 환자 312례의 임상 분석)

  • Jeong, Tae-Young;Park, Bong-Ky;Cho, Jung-Hyo;Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.30 no.5
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    • pp.163-173
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    • 2009
  • Objective: This study sought a clinical analysis of hepatobiliary cancer patients treated by oriental medical therapy. Methods: 312 hepatobiliary cancer patients treated in East-west Cancer Center of Dunsan Oriental Hospital from October 2004 to September 2008 were reviewed. These patients' general characteristics and clinical change after treatment were investigated. Results: 83.3% of patients' tumors were stage IV. The median survival period of stage IV patients was 107.0$\pm$82.2 (IVa), 207.0$\pm$26.8 (IVb) days (hepatocellular carcinoma), 132.0$\pm$15.8 days (cholangiocarcinoma), and 203.0$\pm$24.6 days (gallbladder carcinoma). Conclusions: This study presents the general characteristics of hepatobiliary cancer patients treated by Oriental medical therapies, and thus would be valuable for further studies of Oriental medicine-based cancer treatments.

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10 Cases of Patients with Lumbar Disc Herniation Improved after Oriental Intensive Therapy (한방 집중 치료 후 호전된 요추 추간판 탈출증 환자 10례)

  • Lee, Sang-Young;Cheong, Pil-Sun;Han, Se-Hyuk;Hwang, Choon-Ho;Yoon, Young-Jeoi;Kim, Hyung-Seok;Kim, Hyung-Woo;Jeong, Hyun-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.4
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    • pp.702-707
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    • 2011
  • Patients with lumbar disc herniation are faced with lowered quality of life. For this reason, we investigated the effects of Oriental Intensive Therapy (OIT) including acupuncture, pharmacopuncture, manual therapy and herbal medicine on patients with lumbar disc herniation. Ten patients, diagnosed with lumbar disc herniation by MRI in hospital, were treated with OIT for 12 weeks. Symptoms of the patients were assessed using Verbal Numerical Rating Scale (VNRS) and Oswestry Disability Index (ODI). All patients were investigated every a week. In our results, intensity of pain was reduced after 4 weeks treatment significantly by VNRS, Quality of life has also improved after 4 weeks treatment by ODI. In conclusion, this study suggests that OIT may be effective to treat patients with lumbar disc herniation.

The Efficacy of Microvascular Decompression in Hemifacial Spasm over the Course of Time

  • Kang, Young-Soo;Lee, Hyuk-Gee;Ryu, Kee-Young;Cho, Jae-Hoon;Kang, Dong-Gee;Kim, Sang-Chul
    • Journal of Korean Neurosurgical Society
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    • v.39 no.4
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    • pp.265-270
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    • 2006
  • Objective : Microvascular decompression[MVD] at root exit zone[REZ] of the facial nerve has been largely popularized and it has become the standard treatment for patients with hemifacial spasm[HFS]. This sturdy is performed to evaluate the efficacy of MVD over the course of time. Methods : From 1994 to 2003, 50 patients with HFS who underwent MVD were followed up for more than 6 months. We retrospectively analyzed results with medical records and telephone researches. Results : The mean age of patients at the time operation was 57.6 years and 84% of the patients were female. The mean duration of follow-up after operation was 3.4 years [range $0.5{\sim}7.8\;years$]. One day after MVD, 54% of patients had complete relief of spasm immediately. Continuous improvements of HFS were observed during the follow-up period and these improvements were statistically significant with time (P< 0.05). Until 6 months after operation, complete relief of spasm was observed in 84% of patients. The delayed relief of spasm was observed in 35.7% of our patients who experienced complete relief. Conclusion : The efficacy of MVD in HFS is improves with time. Continuous follow-up evaluations for the duration of more than at least 6 months after MVD are important for the decision of its clinical results because delayed relief of spasms occurs.

Efficacy and patient satisfaction regarding lymphovenous bypass with sleeve-in anastomosis for extremity lymphedema

  • Chung, Jae-Ho;Baek, Si-Ook;Park, Ho-Jin;Lee, Byung-Il;Park, Seung-Ha;Yoon, Eul-Sik
    • Archives of Plastic Surgery
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    • v.46 no.1
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    • pp.46-56
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    • 2019
  • Background When performing lymphovenous anastomosis, it is sometimes difficult to find venules in the proximity of an ideal lymphatic vessel that have a similar diameter to that of the lymphatic vessel. In this situation, larger venules can be used. Methods The authors evaluated the efficacy of and patient satisfaction with lymphovenous bypass with sleeve-in anastomosis. Between January 2014 and December 2016, we performed this procedure in 18 patients (eight upper extremities and 10 lower extremities) with secondary lymphedema. Lymphovenous bypass with sleeve-in anastomosis was performed under microscopy after injecting indocyanine green dye. The circumferential diameter was measured before lymphovenous bypass and at 1, 2, and 6 months after the procedure. An outcomes survey that included patients' qualitative satisfaction with lymphovenous bypass was conducted at 6 months postoperatively. Results Almost all patients showed quantitative improvements after surgery. The circumferential reduction rate in patients with stage II lymphedema of both the upper and lower extremities was significantly greater than in their counterparts with stage III/IV lymphedema. The circumferential reduction rate was lower in lower-extremity patients than in upper-extremity patients. Conclusions Lymphovenous bypass surgery with sleeve-in anastomosis in lymphedema patients is beneficial, and appears to be effective, when adequately-sized venules cannot be found in the proximity of an ideal lymphatic vessel.