• Title/Summary/Keyword: 환자의 접근

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A Case of Epiglottic Epidermoid Cyst (후두개 유표피낭종 1례)

  • 이종원;김성남;김성곤;권영춘;양한모
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.7.3-8
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    • 1977
  • In the ENT fields, epidermoid cysts occur infrequently in the oral region and often situated on the floor of the mouth or the submental region. Moreover, epidermoid cyst on the laryngeal surface of the epiglottis occurs rarely. Authors experienced a case of epiglottic epidermoid cyst and treated successfully by transhyoid pharyngotomy approach and marsupialization. It was 46 years old male patient who has been suffered from intermittent sorethroat for 2 years prior to admission, hoarseness for 2 months and dyspnea for 1 month. Indirect laryngoscopy revealed a pigeon egg-sized, round, smooth tumor mass on the laryngeal surface of the epiglottis which had soft consistency on digital examination. Biopsy proved epidermoid cyst. Marsupialization of the cyst by transhyoid pharyngotomy approach was performed and the postoperative course was uneventful.

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Shifting of Centricity: Qualitative Meta Synthetic Approach on Caring Experience of Family Members of Patients with Dementia (중심성의 이동: 치매 환자 가족의 돌봄 경험에 대한 질적 합성 접근)

  • Ryu, Young Mi;Yu, Mi;Oh, Seieun;Lee, Haeyoung;Kim, Haejin
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.601-621
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    • 2018
  • Purpose: This study aimed to synthesize the caring experiences of Korean family members of patients with dementia through a qualitative meta-synthesis method. Methods: By searching through nine Korean and English databases, we compared 37 qualitative studies on caring experiences of family members of patients with dementia. The selected studies were synthesized through meta-synthesis, proposed by Sandelowski and Barroso (2007). Results: The meta-synthesis elicited four themes: tough life due to care for patients, changes in relationships, adaptation to caregiver's roles, and new perspectives of life through personal growth. Caregivers were shocked when a sudden diagnosis of dementia was made prior to any preparation on their part. They were tied to their patients all the time and their mind and body got exhausted. Their relationship with patients began to change and they looked at them differently. They experienced conflicts with the other non-caring family members and were alienated from them. They were also socially isolated. However, by building their own care strategies and utilizing social resources, they gradually adapted to their caregiver roles. Finally, they experienced personal growth and acquired a new perspective toward life by accepting their roles and finding meaning in their lives. Shifting the caregiver's centricity from themselves to the patient was the process of becoming human beings who actively constructed their realities while giving meaning to their painful lives and interacting with the environment. Conclusion: The results of the study can be useful for nurses in understanding the experiences of caregivers of the patients with dementia and in providing them with practical interventions.

Clinical Evaluation of Traumatic Diaphragmatic Ruptures (외상성 횡격막 파열에 대한 임상적 고찰)

  • 조재민;김은기;이종국;박승일
    • Journal of Chest Surgery
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    • v.29 no.11
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    • pp.1257-1262
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    • 1996
  • From January 1989 to February 1996, 50 patients with a traumatic diaphragmatic rupture were treated at the Yonsei University Wonju College of Medicine. There were 40 male and 10 female patients. The ages ranged from 2 to 80 years, with peak incidence in third decades. Thirty-nine cases had blunt trauma (traffic accident 29, falls down 7, others 3), and 11 cases had penetrating injuries (stab injury 9, gun shot 1, broken glass 1). The most common symptoms were dyspnea (76%), chest pain (58%), and abdominal pain (52%). In blunt trauma, the rupture was located in the left in 30 cases, right in 9 cases and in penetrating trauma, the rupture was located in the left in 8 cases and in the right in 3 cases. Eighteen cases underwent thoracotomy alone, 29 cases underwent laparotomy only and 3 cases had combined thoracotomy and laparotomy. The postoperative mortality occurred in 6% (3 cases), and the cause of death were septic shock (1), intracranial hemorrhage (1), and respiratory failure (1).

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Thoracoscopic Surgery for Esophageal Perforation and Achalasia - Two cases report - (흉강경을 이용한 식도천공과 이완불능증에 대한 수술 -2예 보고 -)

  • Oh, Se-Jin;Kim, Hyeong-Ryul;Lim, Cheong;Park, Kay-Hyun;Sung, Sook-Whan;Jheon, Sang-Hoon
    • Journal of Chest Surgery
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    • v.40 no.9
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    • pp.655-658
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    • 2007
  • Esophageal perforation is relatively uncommon but it often cause fatal if not properly treated, and it is associated with high morbidity and mortality. We report here on two cases of esophageal perforation caused by Boerhaave syndrome or pneumatic dilatation for treating achalasia. The patients were successfully treated with thoracoscopic primary repair and esophagomyotomy.

Current State and Limit of Mobile-Based Mental Health Intervention Using Information & Communication Technology (정보통신기술(Information & Communication Technology)을활용한 모바일 기반 정신건강개입의 현황과 한계)

  • Lee, Sang Min;Kim, Seung-Jun;Im, Woo-Young;Paik, Jong-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.61-65
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    • 2016
  • Currently, a variety of Information and Communication Technology(ICT) is being broadly utilized for mental health. Especially, mobile application is one of the effective ICT, and several applications have been developed after the spread of smartphones. The mobile-based mental health has several strengths, such as better treatment accessibility and easier check-ups of symptoms or daily activities by real-time monitoring. Better follow-ups of treatment course, more customized feedback and better transportability enable patients to be more adherent. However, there are some limitations of mobile technology about the mental health, such as technical troubles of electric errors, data safety problems and personal information extrusion. Therefore, full considerations should be given during the development and provision of the technology. Most of all, mental health specialists should actively participate in the development process by incorporation of evidence-based experiences and assurance of good clinical qualities.

TREATMENT BARRIERS OF SPECIAL NEEDS PATIENTS - PART 2. CONSIDERATION FROM THE PERSPECTIVES OF CAREGIVERS (장애인 구강진료 접근성 제약 - Part 2. 장애인 환자 보호자 측면에서의 고찰)

  • Chang, Juhea
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.14-22
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    • 2019
  • The aim of this study was to determine the factors contributing to the barrier of dental treatment for special needs patients perceived by the main caregivers of the patients. A questionnaire was developed with three parts: patient-related factors, caregiver-related factors, and factors for treatment barriers. Patient- and caregiver-related factors were analyzed for correlations with the barrier factors. Fisher's exact test and Chi-square test were used at the level of 0.05. A total of 52 caregivers (mean age [SD]=50.2 [11.5] years) for the patients with intellectual and cognitive disabilities (mean age [SD]=38.9 [21.3]) responded to the questionnaires. Oral hygiene status, need for assistance in tooth brushing, and cooperation for tooth brushing were correlated with the level of treatment cooperation of the patients (p<0.05). The above three factors were also correlated with the treatment barrier despite patients presenting oral symptoms (p<0.05). Two thirds of the caregivers felt the treatment cost as severe or a considerable financial burden. For patients, insurance types and need for assistance in tooth brushing, and for caregivers, education levels and financial status were significant factors contributing to financial burden (p<0.05). There were background factors of the patients and their caregivers associated with access to dental treatment for special needs patients. Deficient cooperative skills and financial burdens were the main obstacles to treatment access. Tooth brushing skills and oral hygiene status can be proxy measures to cooperative ability for dental treatment.

A literature review on burning mouth syndrome (구강작열감 증후군에 대한 논문 고찰)

  • Choi, Sung-Hyeon;Lee, Bin-Na;Lim, Hae-Soon;Oh, Won-Mann;Kim, Jae-Hyung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.35 no.3
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    • pp.123-131
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    • 2019
  • Burning mouth syndrome (BMS) is defined as the xerostomia, burning sensation and various discomfort of tongue and oral mucosa. BMS can occur in both men and women, but is more frequent in middle-aged menopausal women. Because exact cause can't be identified clearly and it is hard to make diagnosis in clinic, the purpose of the treatment have been to relieve symptoms. Etiology of BMS is divided into local, systemic, and psychological factors. ${\alpha}$-lipoic acid, clonazepam, supplemental therapy and cognitive behavior therapy can be prescribed for BMS. Nowdays, many experts focus attention on effect of combination therapy. It is necessary to solve the symptoms of the patients by combination of pharmacological approach and psychotherapy with cognitive behavior therapy considering the factors in various aspects.

Esthetic restoration in mandibular anterior region with one-piece implant and immediate loading (하악 전치부에서의 일체형 임플란트 식립 후 즉시부하)

  • Yoon, Sena
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.27 no.2
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    • pp.97-104
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    • 2018
  • Mandibular anterior region has high implant survival rates and better accessibility compared with any other region. Even if there are possibilities for perforation on lingual cortical bone due to improper drilling and bleeding caused by lingual artery damage, mandibular anterior region is a safe region because less amount of major anatomical structures exist compared with other regions. However, because of narrow bucco-lingual width of alveolar ridge, it is challengeable to obtain esthetic implant prosthesis. Although patients are less sensitive subjectively, mandibular anterior region is as difficult as maxillary anterior region in that implant placement location plays a critical role on the prognosis of implant prosthesis. One-piece implant is a very useful option for mandibular anterior region. Considering the narrow roots and thin alveolar bone of mandible, it is clinically difficult for implant diameter to be greater than 3mm In this case, we could approach the esthetic restoration in mandibular anterior region with one-piece implant and immediate loading.

Family's Perception of Proxy Decision Making to Authorize Do Not Resuscitate Order of Elderly Patients in Long Term Care Facility: A Q-Methodological Study (심폐소생 금지 대리 결정에 대한 요양병원 노인 환자 가족의 인식 유형: Q 방법론적 접근)

  • Cho, Hyeon Jin;Kang, Jiyeon
    • Journal of Korean Academy of Nursing
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    • v.51 no.1
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    • pp.15-26
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    • 2021
  • Purpose: This study aimed to distinguish and describe the types of perceptions of do not resuscitate (DNR) proxy decisions among families of elderly patients in a long-term care facility. Methods: This exploratory study applied Q-methodology, which focuses on individual subjectivity. Thirty-four Q-statements were selected from 130 Q-populations formed based on the results of in-depth interviews and literature reviews. The P-samples were 34 families of elderly patients in a long-term care hospital in Busan, Korea. They categorized the Q-statements using a 9-point scale. Using the PC-QUANL program, factor analysis was performed with the P-samples along an axis. Results: The families' perceptions of the DNR proxy decision were categorized into three types. Type I, rational acceptance, valued consensus among family members based on comprehensive support from medical staff. Type II, psychological burden, involved hesitance in making a DNR proxy decision because of negative emotions and psychological conflict. Type III, discreet decisions, valued the patients' right to self-determination and desire for a legitimate proxy decision. Type I included 18 participants, which was the most common type, and types II and III each included eight participants. Conclusion: Families' perceptions of DNR proxy decisions vary, requiring tailored care and intervention. We suggest developing and providing interventions that may psychologically support families.

The Effects of Integrative Intervention Approach on a Patient with Lumbar HNP : A Case Report (요추 추간판탈출증 환자에 대한 통합적 중재접근의 효과: 단일사례연구)

  • Lee, Jae-Hong;Son, Jong-Chan;Koo, Seong-Rin;Lee, Seok-Hun;Lee, Dong-Hun;Shin, Yong-Wung;Choi, Ja-Eun;Han, Jae-Kyoung;Kim, Dong-Han;Kim, Jeong-Min;Kim, Min-Chul;Jan, Jin-A;Hwang, Sung-Hyun;Kwon, Won-An
    • PNF and Movement
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    • v.10 no.2
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    • pp.33-39
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    • 2012
  • Purpose : The purpose of this case report was to examine the effects of intergrative intervention approach on a patient with lumbar herniated nucleus pulposus (HNP). Methods : The subject was a 53 years old woman with lumbar HNP. The subject received conventional physical therapy combined with exercise therapy and manual therapy. Pain on visual analog scale (VAS), finger to floor (FTF), lumbar lateral flexion, L5 motor, and straight Leg-Raising (SLR) were evaluated at baseline and after 4 weeks. Results : The change of VAS, FTF, left lateral flexion, and right lateral flexion were decreased (9 vs. 5, 41 vs, 25, 56 vs. 42, 54 vs. 41, respectively) and the change of L5 motor and SLR were increased (Fair vs. Fair+, 60 vs. 75, respectively). Conclusion : Our findings suggest that Integrative intervention may be considered in patient with lumbar HNP.