• Title/Summary/Keyword: 병원재이용

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Hyperhidrosis Treated by Thoracoscopic Sympathicotomy (다한증 환자에서의 T2 Sympathicotomy의 효과)

  • 윤용한;이두연;김해균;이교준;신화균;강정신
    • Journal of Chest Surgery
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    • v.32 no.2
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    • pp.171-174
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    • 1999
  • Background: Hyperhidrosis of the palms, axillae and face has a strong negative impact on social and professional life. The present existing non-operative therapeutic options seldom give sufficient relief and have a transient effect. A definitive cure can be obtained by upper thoracic sympathectomy. However, this is offset by the occurrence of a high rate of side effects, such as embarrassing compensatory sweating. Material and Method: From Sep. 1997 to Feb. 1998, 89 cases of the needle(2 mm) thoracoscopic thoracic sympathicotomy were performed. The second thoracic ganglion was resected by cutting with a endoscissors. Result: A bilateral procedure takes less than 25 min and requires just one night in hospital. There have been no mortality or life-threatening complications. One patient(<2%) required intercostal drainage because of pneumothorax. Primary failure occurred in one cases(<2%) and recurrent hyperhidrosis occurred in no cases. The patients with failure was successfully re-sympathicotomy. At the end of postoperative follow-up(median 3 months), 96.6% of the patients were satisfied. Compensatory sweating occurred in 57 cases(64.0%) with fourteen of those cases classified as either embarrassing in 10 cases(11.2%) or disabling in 4 cases(4.5%). Conclusion: Endoscopic transthoracic sympathicotomy is an efficient, safe and minimally invasive surgical method for the treatment of palmar and craniofacial hyperhidrosis.

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Treatment of giant iatrogenic pseudoaneurysm of the femoral artery (대퇴동맥에 발생한 의인성 거대 가성동맥류에 대한 치료)

  • Kang, Wu-Seong;Park, Chan-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.3
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    • pp.423-428
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    • 2019
  • The role of angioembolization has increased because of increases in nonoperative treatment for traumatic splenic injury. We report here a case of successful treatment of iatrogenic pseudoaneurysm of the femoral artery by thrombin injection with coil embolization. A 55-year-old female was admitted to our hospital because of blunt trauma. Computed tomography (CT) revealed a grade V splenic injury with contrast extravasation; therefore, angioembolization was performed. Three days after admission, follow-up CT scan revealed rebleeding from the spleen, and repeat angioembolization was performed. Seven days after admission, an approximately $7.0cm{\times}4.0cm-sized$ pseudoaneurysm was found on follow-up CT scan and there was no bleeding from the spleen. Although thrombin was injected into the aneurysmal sac, there was still inflow of blood, as observed on color-doppler ultrasound. Therefore, coil embolization to the neck of the aneurysm was performed. On angiography, there was no contrast filling into the sac. The size of the pseudoaneurysmal sac had decreased on follow-up CT scan, and the patient was discharged to home without complications. We successfully treated a giant pseudoaneurysm of the femoral artery using thrombin and coil embolization.

Factors Associated with the Use of Medical Care at Hospitals among Outpatients with Hypertension: A Study of the Korea Health Panel Study Dataset (2010-2016) (우리나라 고혈압 환자의 병원급 의료기관 외래이용 관련 요인: 한국의료패널자료(2010-2016)를 이용하여)

  • Lee, Sumi;Park, Sohee;Kimm, Heejin;Lee, Yongjae;Chung, Woojin
    • Health Policy and Management
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    • v.30 no.4
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    • pp.479-492
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    • 2020
  • Background: As the prevalence of hypertension is increasing in Korea, the government is seeking policy actions to manage patients with hypertension more efficiently. In this paper, we aimed to identify factors associated with the use of medical care at hospitals among outpatients with hypertension. Methods: We analyzed a total of 15,040 cases of 3,877 outpatients with hypertension obtained from the Korea Medical Panel database from 2010 to 2016. The dependent variable was whether a patient with hypertension visited a hospital or not; and independent variables were the patient's various socio-demographic, health-related, and heath-status characteristics. We conducted a generalized linear mixed model analysis with logit link for all the cases and then conducted it stratified by gender. Results: As a result of a multivariable analysis, women were less likely than to visit at a hospital (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.32-0.61) and people aged 65 years and older than those aged less than 65 years (OR, 0.71; 95% CI, 0.57-0.89). Residents in Busan, Ulsan, and Gyeongnam were more likely than those in than Seoul, Gyeonggi, Incheon, and Jeju to visit a hospital (OR, 1.40; 95% CI, 1.05-1.86). The likelihood of visiting a hospital was high in people belonging to a group of: the highest level of annual household income (OR, 1.73; 95% CI, 1.30-2.29); Medical care aid recipients (OR, 1.94; 95% CI, 1.34-2.83); people having three or more complex chronic diseases (OR, 1.59; 95% CI, 1.19-2.11); people having diabetes (OR, 1.81; 95% CI, 1.41-2.32); or people having ischemic heart disease or cerebrovascular disease (OR, 6.80; 95% CI, 5.28-8.76). Also, we found that factors associated with the use of medical care at hospitals among outpatients with hypertension differed between genders. Conclusion: A variety of factors seem to be associated with the use of medical care at hospitals among outpatients with hypertension. Future research needs to find a way to help patients with hypertension visit an appropriate medical institution between clinics and hospitals.

A Preliminary Study on Quality of Life of Staffs in a Hospital - Comparisons between Direct and Indirect Patient Contact Group - (일 병원 직원의 삶의 질에 관한 예비적 연구 - 경험에 대한 비교 -)

  • Ryu, Seuk-Hwan;Seo, Seung-Woo;Jung, Soo-Gie
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.38-46
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    • 2004
  • Objectives: The aim of this study was to investigate the quality of life of staffs in a hospital. The results of the investigation were taken as a basic data of evaluating the quality of life of patients in psychiatric hospital and family members. Methods: The subjects of this study were Ankang Chungang Hospital staffs. The tool of this study was the Korean version of the SmithKline Beecham Quality of Life Scale. A total of 39 survey was returned. All answers were analyzed statistically by ANOVA or t-test. Results: Internal consistency was high, measuring 0.887 for the 23 items. Staffs have, statistically insignificant, relatively high quality of life. Indirect patient contact group and married group scored more higher than the other group. In so far as age, 30s and 40s scored more higher than the others averagely, the higher educated group, the higher quality of life, except factor competence and physical well-being. Conclusion: This study results support that the indirect patient contact group have higher quality of life in competence factor in quality of life. We recommend that the program that lift self-esteem and quality of life should be supplied for direct patient contact group who may have burnout syndrome. It will be necessary to evaluate the quality of life of patients in psychiatric hospital and patients' family members later.

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Factors Affecting the Satisfaction and Revisit Intension of Health Promotion Center In A University Hospital (한 대학병원 부속 건강검진센터 이용자의 만족도와 재이용 의사에 미치는 요인)

  • Kim, Hee-Kyoung;Ryu, Hwang-Gun
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.5-24
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    • 2001
  • The purpose of this study was to serve as a basis for providing quality medical service and mapping out consumer-centered marketing strategies to successfully cope with the rapidly changing medical environment and meet consumer needs, by examining what affected the satisfaction and revisit of health Promotion center Client. The subjects in this study were 186 of visitor to health Promotion center in a university hospital in the city of Busan. A survey was conducted with structured questionnaire from March 2 to 30, 2001. The collected data were analyzed with SPSS for Windows (ver10.0). For more statistical analysis, frequency analysis, component analysis, t-test, ANOVA and correlation analysis procedures were utilized. Results of the study can be summarized as follows: 1. Regarding demographic characteristics, 51.6% of the Client investigated were male, and 48.4% were female. The greatest number of them were in their 40s(38.9%). 86.5% were married, and 34.2% were self-employed. 44% were a high-school graduate, and the monthly mean income of 59.4% was one to three million Won. And, the residential area of 46.8%, the largest percentage, was a half-an-hour distance from health Promotion center. 2. The most common motivation of their selection of the health Promotion center was a recommendation by Staff and neighborhood(59.7%), followed by excellent facilities and services(17.2%), the tradition and reputation of the hospital(7.5%), and its publicity pamphlets(7.5%). 3. 45.9%, the largest percentage, acquired health-related information from their friends or acquaintances. 43.8%, the greatest percentage, visited there because they felt there's something wrong with their body. 53.4% worried about the possibility of being attacked by cancer, and 57.5% wanted to take a precise cancer examination. For health maintenance, 50.1% got regular exercise. Regular exercise was considered most crucial for health maintenance or promotion. 4. The largest reason they used that examination center again was the kindness of employees(52.7%), followed by the tradition and reputation of the hospital(21%) and excellent examination setting and equipment(10.8%). 5. By demographic factor, there was no significant difference between the man and women in satisfaction level with examination and expenses. The women expressed more satisfaction at facilities, and the high-school graduate group were more contented with expenses. 6. As a result of investigating their satisfaction level according to the motivation of selecting that examination center, the group that chose the center due to excellent facilities and services were more satisfied with examination and expenses. 7. As for the relationship of total examination satisfaction to revisit. intention, there was a higher correlational relationship between total health examination satisfaction and expense satisfaction. Especially, the more they were satisfied with examination, the more they were willing to revisit there for another examination.

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The Effect of Medication in the Patients with Bee-Sting (약물투여가 벌자상환자에게 미치는 효과)

  • Cho, Byung-Jun;Moon, Soo-Jae;Kim, Seon-Rye
    • The Journal of the Korea Contents Association
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    • v.15 no.1
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    • pp.350-356
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    • 2015
  • The purpose of this study is effect factors of Pre-Hospital Medication in the Patients with Bee-Sting. This study is to identify the necessity of using epinephrine in prehospital stage from the perspective of early management of anaphylaxis following a bee sting. Methods: Patients suffering from a bee sting who used the 119 rescue between 2013 from 119 center data were included. Age, sex, month of injury, time factors, vital signs, medication, signs, distance factors, presence of cardiac arrest, AVPU triage by EMT were extracted. The severity of bee sting injury was divided into mild, moderate, and severe according to the presenting symptoms and signs. Results: The severe patients treated by using oxygen, IV, ECG, Medication. Anaphylaxis is a serious allergic reaction of rapid onset that may lead to death. One of Anaphylaxis patients lived by using epinephrine. Most patients collapsed at the scene of mount. Bee sting injuries occurred primarily during summer to the farmer. Nine patients collapsed at the scene. Bee sting injuries occurred primarily from June to October. Conclusion: The primary treatment for anaphylaxis is epinephrine. Epinephrine in pre-hospital stage is factors of essential for patients. Also epinephrine will permit to be equipped in the EMT-P and use of epinephrine by law.

A Study on Information Sharing Methods for Casualties in Maritime Emergency Scenes (해양응급현장에서의 사상자 정보 공유 방안에 관한 연구)

  • Seungyong Kim;Incheol Hwang;Dongsik Kim;Jungjae Shin
    • Journal of the Society of Disaster Information
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    • v.20 no.1
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    • pp.206-212
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    • 2024
  • Purpose: This study conducted research on the sharing of information to enhance the survival rate of emergency patients by swiftly transferring them to appropriate hospitals through sharing the patients' conditions, treatment histories, and transportation information with the Maritime Police Agency and relevant agencies when emergencies occur in the marine environment. Methods: In this study, emergency patient information classified in a smartphone app was received, stored, and transmitted using the LoRa communication method by electronic triage tags, and the transmitted emergency patient information was implemented to be collected in real-time through a hybrid triage system along with LoRa receivers. Results: Through the hybrid triage system, it was possible to receive emergency patient information according to the distance or confirm delayed reception. It was observed that most data were received when the distance was short, while data reception was unsuccessful in relatively longer distances. Conclusion: It was confirmed that in mass disaster environments where internet communication is impossible, rapid and accurate understanding of casualty information at disaster sites and appropriate disaster responses can be achieved using self-networking methods such as LoRa communication. However, limitations inherent in communication methods were also recognized. Further research on various communication methods is required to collect emergency patient information and transfer them to appropriate hospitals in situations where internet communication is unavailable.

Evaluation of Reference Intervals of Some Selected Chemistry Parameters using Bootstrap Technique in Dogs (Bootstrap 기법을 이용한 개의 혈청검사 일부 항목의 참고범위 평가)

  • Kim, Eu-Tteum;Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.24 no.4
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    • pp.509-513
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    • 2007
  • Parametric and nonparametric coupled with bootstrap simulation technique were used to reevaluate previously defined reference intervals of serum chemistry parameters. A population-based study was performed in 100 clinically healthy dogs that were retrieved from the medical records of Kangwon National University Animal Hospital during 2005-2006. Data were from 52 males and 48 females(1 to 8 years old, 2.2-5.8 kg of body weight). Chemistry parameters examined were blood urea nitrogen(BUN)(mg/dl), cholesterol(mg/dl), calcium(mg/dl), aspartate aminotransferase(AST)(U/L), alanine aminotransferase(ALT)(U/L), alkaline phosphatase(ALP)(U/L), and total protein(g/dl), and were measured by Ektachem DT 60 analyzer(Johnson & Johnson). All but calcium were highly skewed distributions. Outliers were commonly identified particularly in enzyme parameters, ranging 5-9% of the samples and the remaining were only 1-2%. Regardless of distribution type of each analyte, nonparametric methods showed better estimates for use in clinical chemistry compare to parametric methods. The mean and reference intervals estimated by nonparametric bootstrap methods of BUN, cholesterol, calcium, AST, ALT, ALP, and total protein were 14.7(7.0-24.2), 227.3(120.7-480.8), 10.9(8.1-12.5), 25.4(11.8-66.6), 25.5(11.7-68.9), 87.7(31.1-240.8), and 6.8(5.6-8.2), respectively. This study indicates that bootstrap methods could be a useful statistical method to establish population-based reference intervals of serum chemistry parameters, as it is often the case that many laboratory values do not confirm to a normal distribution. In addition, the results emphasize on the confidence intervals of the analytical parameters showing distribution-related variations.

Prognostic Factors Affecting Postoperative Morbidity and Mortality in Destroyed Lung (파괴폐의 술후 합병증과 사망에 영향을 미치는 예후 인자)

  • 홍기표;정경영;이진구;강경훈;강면식
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.387-391
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    • 2002
  • Background: Postoperative morbidity and mortality in destroyed lung are relatively high. We tried to identify the prognostic factors affecting postoperative morbidity and mortality in destroyed lung through a retrospective study. Material and method: The retrospective study was undertaken in 112 patients who had undergone pneumonectomy or pleuropneumonectomy for destroyed lung at Severance Hospital from 1970 to 2000. We analyzed the correlation between postoperative morbidity and mortality and etiology, duration of disease, preoperative FEV1, presence or absence of peroperative empyema, operation timing, the side of operation, duration of operation, and operation type. Result: There were 55 men and 57 women, aged 20 to 81 years (mean 44 years). Etiologic diseases were tuberculosis in 86 patients(76.8%) including tuberculos empyema in 20 and tuberculous bronchiectasis in 4, pyogenic empyema in 12(10,7%), bronchiectasis in 12(10.7%), and lung abscess in 2(1.8%). Postoperative morbidity were 25%(n=28) and postoperative mortality was 6%(n=7). The presence of preoperative empyema(p=0.016), pleuropneumonectomy(p=0.037) and preoperative FEV1 of less than 1.75 L(P=0.048) significantly increased the postoperative morbidity, If operation time was less than 300min, postoperative morbidity(p=0.002) and mortality(p=0.03) were significantly low. Conclusion: Postoperative morbidity and mortality in destroyed lung were acceptable. Postoperative morbidity and mortality were significantly low when operation time was less than 300 min. Preoperative existence of empyema, pleuropneumonectomy and preoperative FEV1 of less than 1.75 L significantly increased postoperative morbidity.

The Study on the Independent Predictive Factor of Restenosis after Percutaneous Coronary Intervention used Drug-Eluting Stent : Case on MDCT Calcium-Scoring Implementation Patient (약물용출 스텐트를 이용한 관상동맥중재술 후 재협착의 독립적 예측인자에 관한 연구 : MDCT calcium-scoring 시행 환자 대상으로)

  • Kim, In-Soo;Han, Jae-Bok;Jang, Seong-Joo;Jang, Young-Ill
    • Journal of radiological science and technology
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    • v.33 no.1
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    • pp.37-44
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    • 2010
  • We sought to confirm an independent factor about in-stent restenosis (ISR) in the patients who underwent drug-eluting stent (DES) and know a possibility as a predictor of measured coronary artery calcium score by MDCT. A total of 178 patients (159 men, $61.7{\pm}10.0$ years of age) with 190 coronary artery lesions were included in this study out of 1,131 patients who underwent percutaneous coronary intervention (PCI) with DES implantation for significant stenosis on MDCT at Chonnam National University Hospital between May 2006 and May 2009. All lesions were divided into two groups with the presence of ISR : group I (re ISR, N = 57) and group II (no ISR, N = 133). Compared to group II, group I was more likely to be older ($65.8{\pm}9.0$ vs. $60.2{\pm}9.9$ years, p = 0.0001), diabetic (21.8% vs. 52.6%, p = 0.0001), have old myocardial infarction (8.8% vs. 2.3%, p = 0.040), left main stem disease (5.3% vs. 0.8%, p = 0.047), and smaller stent size ($3.1{\pm}0.3\;mm$ vs. $3.3{\pm}0.4\;mm$, p = 0.004). Group II was more likely to be smokers (19.3% vs. 42.1%, p = 0.003), have dyslipidemia (8.8% vs. 23.3%, p = 0.019). Left ventricular ejection fraction, lesion complexity, and stent length were not different between the two groups. Total CAC score was $389.3{\pm}458.3$ in group I and $371.2{\pm}500.8$ in group II (p = 0.185). No statistical difference was observed between the groups in CAC score in the culprit vessel, left main stem, left anterior descending artery, left circumflex artery, and right coronary artery. On multivariate logistic regression analysis, left main stem disease (OR = 168.0, 95% CI = 7.83-3,604.3, p = 0.001), male sex (OR = 36.5, 95% CI = 5.89-2,226.9, p = 0.0001), and the presence of diabetes (OR = 2.62, 95% CI = 1.071-6.450, p = 0.035) were independent predictors of ISR after DES implantation. In patients who underwent DES implantation for significant coronary stenosis on MDCT, ISR was associated with left main stem disease, male sex, and the presence of diabetes. However, CAC score by MDCT was not a predictor of ISR in this study population.