• 제목/요약/키워드: progressive patient

검색결과 552건 처리시간 0.025초

Forehead reconstruction with a custom-made three-dimensional titanium implant in a Parry-Romberg syndrome patient

  • Kim, Jae Yoon;Jung, Bok Ki;Kim, Young Suk;Roh, Tai Suk;Yun, In Sik
    • 대한두개안면성형외과학회지
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    • 제19권2호
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    • pp.135-138
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    • 2018
  • Parry-Romberg syndrome is a rare neurocutaneous syndrome characterized by progressive shrinkage and degeneration of the tissues usually on only one side of the face. It is usually difficult to restore the facial contour due to skin tightness. In this case report, we report a forehead reconstruction with custom-made three-dimensional (3D) titanium implant of a Parry-Romberg syndrome patient who was treated with multiple fat grafts but had limited effect. A 36-year-old man presented with hemifacial atrophy. The disease progressed from 5 to 16 years old. The patient had alopecia on frontal scalp and received a surgery using tissue expander. The alopecia lesion was covered by expanded scalp flap done 22 years ago. Also, he was treated with fat grafts on depressed forehead 17 years ago. However, it did not work sufficiently, and there was noted depressed forehead. We planned to make 3D titanium implant to cover the depressed area (from the superior orbital rim to the vertex). During the operation, we confirmed that the custom-made 3D implant accurately fit for the depressed area without any dead spaces. Previously depressed forehead and glabella were elevated, and the forehead contour was improved cosmetically. A custom-made 3D titanium implant is widely used for skull reconstruction and bring good results. In our case, the depressed forehead of a Parry-Romberg syndrome patient was improved by a 3D titanium implant.

감두탕가미방(甘豆湯加味方)을 이용한 급성 파라콰트 중독후 급성 간염의 한방 치료 1예 (One Case of Gamdutanggamibang-treated Acute Hepatitis Caused by Acute Paraquat Poisoning)

  • 신선호;김동웅;최진영;서관수;조권일;신학수;한명아
    • 대한한방내과학회지
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    • 제22권2호
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    • pp.245-250
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    • 2001
  • Paraquat is one of the widely used herbicides. But it is fatal, if it is consumed by people. Paraquat poisoning causes acute renal failure, hepatic dysfunction, and progressive respiratory failure. There are no effective antidotes to paraquat. This report is about one case's treatment for acute hepatitis caused by paraquat. The patient was hospitalized in the Department of Internal Medicine, Wonkwang University Oriental Medical Hospital in Chonju. The patient received the following treatments while in an acute stage : Gamdutanggamibang(甘豆湯加味方), which consists of Radix glycyrrhizae(甘草), Semen mungo(綠豆), burned powder of Rhizoma rhei(大黃炒炭末), Succus phyllostachyos(竹瀝), chinese ink(墨汁) and fluid therapy. The patient received Sagunjatanggamibang(四君子湯加味方) while in a chronic stage. The patient improved faster with the above treatments than with the conventional treatment. We hope that this report will help widening the clinical range of oriental medicine, and improve systemic efforts in treating paraquat poisoning cases.

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구기지황탕 투여 후 호전된 경도인지장애 환자 1례에 대한 증례보고 (A Case Report of a Patient with Mild Cognitive Impairment Treated with Gugijihwang-tang)

  • 박미소;강석만;유대원;채인철;김경순;성현주;정광렬;유호룡
    • 대한한방내과학회지
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    • 제42권5호
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    • pp.1082-1093
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    • 2021
  • Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

임상가를 위한 특집 1 - 장노년의 생리적 교합변화의 이해와 치료전략 (Understanding and treatment strategy of the physiologic occlusal change in elderly patients)

  • 김지환;심준성
    • 대한치과의사협회지
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    • 제50권1호
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    • pp.6-12
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    • 2012
  • As in all other parts in the body, oral tissue also undergoes dramatic changes with increasing age. Since these changes occasionally go beyond physiological scope, which may result in pathological changes, it is essential for dentist to understand changes caused by normal aging process. With increasing age, tooth morphology and occlusion also varies, especially loss of hard tissue, which is taking place in lifelong time, occurs as a result of tooth wear. When this loss of hard tissue is presented rapidly or excessively, functional and esthetical problems are raised, resulting in lowering quality of life of patient as well as making dental treatment for oral rehabilitation even more complex. Therefore, based on understanding of change in occlusion with increasing age, strategic approaches for maintenance of oral health in both functional and esthetic aspect are required as appropriate restoration and maintenance for progressive tooth wear enables desirable occlusal relationship. Carefully planned-restorative treatment in accordance with changed occlusal relationship is also required in the same context. Instead of taking changes in oral tissue as only a consequence of ageing, it is vital to educate patient and his or her guardian, assuring maintenance of oral hygiene and regular dental check-up are of utmost importance for improved oral health.

외상성(外傷性) 측두골(側頭骨) 골절(骨折)로 발생(發生)한 구안와사(口眼喎斜)에 대(對)한 고찰(考察) (Clinical Study of Patient with Facial Nerve Paralysis Caused by Traumatic Temporal Bone Fracture)

  • 최석우;노정두;신민섭;설현;송범룡;육태한
    • Journal of Acupuncture Research
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    • 제19권3호
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    • pp.207-215
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    • 2002
  • Objective : Oriental medical treatment may be possibility or effect in patients with facial nerve paralysis caused by traumatic temporal bone fracture. Methods : The authors compared objectively improvement state of patient that operated acupuncture, herbal medicine and herbal acupuncture. Results : 1. A Facial nerve travel long and pass by narrow bone canal in temporal bone. so slow progressive paralysis is caused by nerve swelling and impedimental blood circulation in bone canal, if bruise happens. 2. At patients with traumatic facial nerve paralysis, acupuncture(LI TE centered operation), herbal medicine(理氣祛風散, 加味補益湯加滅 etc..) and herbal acupucture(SY-消炎, Hominis Placenta-紫河車, JGH-中氣下陷) are effective to improving symptoms. 3. In general, everyone consider surgical operation first of all, in the case of having traumatic facial nerve paralysis. Through this case, the authors are thought that can attempt access of Oriental medical treatment without doing surgical operation.

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Prognosis after treatment with multiple dental implants under general anesthesia and sedation in a cerebral palsy patient with mental retardation: A case report

  • Hong, Young-Joon;Dan, Jung-Bae;Kim, Myung-Jin;Kim, Hyun Jeong;Seo, Kwang-Suk
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권2호
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    • pp.149-155
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    • 2017
  • Cerebral palsy is a non-progressive disorder resulting from central nervous system damage caused by multiple factors. Almost all cerebral palsy patients have a movement disorder that makes dental treatment difficult. Oral hygiene management is difficult and the risks for periodontitis, dental caries and loss of multiple teeth are high. Placement of dental implants for multiple missing teeth in cerebral palsy patients needs multiple rounds of general anesthesia, and the prognosis is poor despite the expense. Therefore, making the decision to perform multiple dental implant treatments on cerebral palsy patients is difficult. A 33-year-old female patient with cerebral palsy and mental retardation was scheduled for multiple implant treatments. She underwent computed tomography (CT) under sedation and the operation of nine dental implants under general anesthesia. Implant-supported fixed prosthesis treatment was completed. During follow-up, she had the anterior incisors extracted and underwent the surgery of 3 additional dental implants, completing the prosthetic treatment. Although oral parafunctions existed due to cerebral palsy, no implant failure was observed 9 years after the first implant surgery.

메니에르 병 환자의 허실별(虛實別) 치험례 (Clinical Reports of the Meniere's Disease in the Diagnosis of Deficiency-Excess)

  • 장수영;신현철
    • 대한한방내과학회지
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    • 제32권1호
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    • pp.121-128
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    • 2011
  • Meniere's disease is an idiopathic syndrome of endolymphatic hydrops characterized by episodic vertigo, tinnitus, fluctuating hearing loss and ear fullness. The etiology and pathophysiology of the disease is still disputed. As yet, no treatment has conclusively modified the clinical course of the condition and thereby prevented the associated progressive hearing loss. We observed two cases of Meniere's disease treated with oriental herbal medication by the diagnosis of Deficiency-Excess. One patient had taken BangHyunOnDam-tang, and the other had taken ChungGanESa-tang. After treatment, vertigo attacks were controlled in both. Tinnitus and hearing loss were improved in one patient and unchanged in the other. Therefore, we believe that oriental herbal treatment may be a therapeutic modality that is effective in controlling Meniere's disease.

자기공명촬영에서 침강 레벨을 나타낸 뇌하수체 선종 - 증 례 보 고 - (A Sedimentation Level in Pituitary Adenoma on Magnetic Resonance Imaging - Case Report -)

  • 김영래;송준혁;박향권;김성학;신규만
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.518-521
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    • 2001
  • We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.

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Paradoxical Exacerbation of Symptoms with Obstruction of the Venous Outflow after Gamma Knife Radiosurgery for Treatment of a Dural Arteriovenous Fistula of the Cavernous Sinus

  • Ko, Jun Kyeung;Cho, Won Ho;Lee, Tae Hong;Choi, Chang Hwa
    • Journal of Korean Neurosurgical Society
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    • 제57권2호
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    • pp.127-130
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    • 2015
  • A 59-year-old female presented with progressive right proptosis, chemosis and ocular pain. An imaging work-up including conventional catheter angiography showed a right-sided dural arteriovenous fistula of the cavernous sinus, which drained into the right superior petrosal sinus, right superior ophthalmic vein, and right inferior ophthalmic vein, and cortical venous reflux was seen via the right petrosal vein in the right posterior fossa. After failure of transvenous embolization, the patient underwent Gamma Knife radiosurgery (GKRS). At one month after GKRS, she developed increasing ocular pain and occipital headache. Repeat angiography showed partial obliteration of the fistula and loss of drainage via the superior and inferior ophthalmic veins with severe congestion, resulting in slow flow around the right cerebellar hemisphere. Prompt transarterial embolization relieved the patient's ocular symptoms and headache. We report on a case of paradoxical exacerbation of symptoms resulting from obstruction of the venous outflow after GKRS for treatment of a dural arteriovenous fistula of the cavernous sinus.

Cervical Fibrous Dysplasia Presenting as a Pathologic Fracture in an Older Patient

  • Lee, Su-Heon;Han, In-Ho;Kang, Dong-Wan;Choi, Byung-Kwan
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.139-142
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    • 2011
  • Vertebral involvement of fibrous dysplasia (FD) is rare, especially in the cervical spine. Moreover, cervical FD presenting as a pathologic fracture in older patients is extremely rare. We report a case of symptomatic cervical FD associated with pathologic fracture in a 63-year-old man. The patient presented with progressive weakness of the left arm and pain in the shoulder and arm. Radiologic studies revealed a collapsed and typical 'ground glass' radiolucency of C4. Multiple lytic lesions involved the odontoid process of C2 and the body, left pedicle, and posterior elements of C4. Combined anterior and posterior decompression and reconstruction were performed. Post-operatively, the histopathologic examination confirmed FD. On the post-operative follow-up examination, the neurologic deficits had completely resolved.