• 제목/요약/키워드: Clinic day

검색결과 549건 처리시간 0.025초

Urokinase와 동의학적요법(東醫學的療法)으로 동시치료(同時治療)한 허혈성뇌졸중환자(虛血性腦卒中患者) 56례(例)에 대(對)한 임상적(臨床的) 연구(硏究) (Clinical Studies on 56 Cases of Having Treated patients suffering from Ischemic Stroke through both Urokinase and Therapeutics of Oriental Medicine)

  • 김인섭
    • 대한한의학회지
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    • 제15권2호
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    • pp.46-91
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    • 1994
  • l. Backgrounds of Studies Cerebrovascular accident. one of the three major causes of death among audults with cardiopathy and malignancy, has been on the increase in korea while it is on the decrease in European countries and Japan. Types of stroke undergo changes caused by prolongment of life expectancy. and social and economic variety. More patients of ischemic stroke show a tendency to increase now than those of hemorrhagic stroke in the past. Many clinical studies on medical cerebrovascular and oriental stroke of paralysis have been published. but few clinical studies on therapeutics of integrated oriental and western medicine are to be found. So I have made an attempt to study clinical observations and therapeutic responses of ischemic stroke under integrated oriental and western medicine. 2.Methods. Among the patients admitted into the clinic of Joong-Poong, Woo-Suk University Hospital from May 1. 1993 until April 30. 1994 those 56 patients who were diagnosed as ischemic stroke on Computed Tomography(CT) and showed no dubious symptom after examination of coagulation and bleeding time were classified into the following six steps and treated: l)diagnosis 2)emergency treatment 3)basic treatment 4)treatment of risk and provoking factors. and preceeding disease 5)complications and conservative therapy 6)rehabilitation. For a period of basic treatment both herb medication and urokinase therapy were applied at the same time. Intravenous injection has been given at a unit of 300.000 dosage a day as urokinase therapy during basic treatment. If they showed any dubious symptom in glucose tolerance test. fructose 500ml and urokinase 300.000 dosage were mixed and injected. In case of no symptom 5% DW 500ml was mixed with urokinase 300.000 unit. and injected at a speed of 15gtt per minute. 3. Results and Conclusions 1) The level of ambulation has been improved from 42.9% when admitted to 73.2% when discharged in the degree of recovery. The level of severe function disorder has been remarkably decreased from 55.4% when admitted to 19.6% when discharged. 2) The treatment effect on the basis of therapeutic response of clinical and subjective symptom shows as follows: 7.1% Excellent. 35.7% Good. 37.5% Effective. 10.7% Stationary. and 8.9% Aggravated. The total recovery above effective shows 80.3%. Judging from the above results I think it proper to develop the model of better preventing and treating ischemic stroke through effective therapeutic and clinical studies of integrated oriental and western medicine.

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Clinical outcome of conservative treatment of injured inferior alveolar nerve during dental implant placement

  • Kim, Yoon-Tae;Pang, Kang-Mi;Jung, Hun-Jong;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제39권3호
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    • pp.127-133
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    • 2013
  • Objectives: Infererior alveolar nerve (IAN) damage may be one of the distressing complications occurring during implant placement. Because of nature of closed injury, a large proportion is approached non-invasively. The purpose of this study was to analyze the outcomes of conservative management of the injured nerve during dental implant procedure. Materials and Methods: Sixty-four patients of implant related IAN injury, who were managed by medication or observation from January 1997 to March 2007 at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, were retrospectively investigated. The objective tests and subjective evaluations were performed to evaluate the degree of damage and duration of sensory disturbance recovery. Tests were performed on the day of the first visit and every two months afterward. Patient's initial symptoms, proximity of the implant to the IAN, time interval between implant surgery and the first visit to our clinic, and treatment after implant surgery were analyzed to determine whether these factors affected the final outcomes. Results: Among the 64 patients, 23 had a chief complaint of sensory disturbance and others with dysesthesia. The mean time until first visit to our hospital after the injury was 10.9 months.One year after nerve injury, the sensation was improved in 9 patients, whereas not improved in 38 patients, even 4 patients experienced deterioration. Better prognosis was observed in the group of patients with early visits and with implants placed or managed not too close to the IAN. Conclusion: Nearly 70% of patients with IAN injury during implant placement showed no improvement in sensation or dysesthesia with the conservative management. Earlier decision for active treatment needs to be considered because of possibility of deterioration of symptoms and unsatisfactory recovery.

치과병·의원 내원환자의 구강건강관리 및 진료특성별 구강위생용품 사용실태 비교 (Comparison study of oral health care and dental treatments about the use of oral hygiene devices among the patients)

  • 이형숙;김영선
    • 한국치위생학회지
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    • 제8권3호
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    • pp.149-160
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    • 2008
  • This study has been performed for patients who visited dental clinic in Daegu and kyungpook area. The oral health care, dental treatments about the use of oral hygiene devices were obtained through self-administering questionnaires from 1 to 30, August, 2006. The obtained results were as follows: 1. The average percent of using dental floss was 34.2%, followed by interproximal brush was 33.9%, mouthrinse was 33.5%, electric toothbrush was 19.6%, orthodontic brush was 10.6%, and tongue cleaner was 10.2%. 2. Poor to perceive oral health was 36.4% in the patients who perceived oral hygiene device, and there was statistically significant difference (p<0.05). Moderate to perceive oral health was 40.8% in the patients who using oral hygiene device, and there was also statistically significant difference (p<0.05). 3. In the patients who 3 or 4 times toothbrushing a day, the average percent of perceived oral hygiene device was 67.7%, and the average percent of using oral hygiene device was 59.8% (p<0.05). In the patients who had experience of toothbrush education, the average percent of perceived oral hygiene device was 81.8%, and the average percent of using oral hygiene device was 58.1% (p<0.05). 4. The average percent of perceived oral hygiene device was 67.9% in dental implant treated patient, and was 69.0% in patients with cold teeth (p<0.05). The average percent of using oral hygiene device was 64.2% in prosthesis treated patient, and was 83.3% in patients with cold teeth (p<0.05). The average percent of non-using oral hygiene device was 67.6% in orthodontic treated patient (p<0.05). 5. In patient with periodontal disease, the average percent of using interproximal brush was 44.3%, followed by dental floss was 35.4%, mouthrinse was 27.8%, and electric toothbrush was 21.5%. In prosthesis treated patient, the average percent of using interproximal brush was 31.6%, followed by dental floss was 28.9%, and mouthrinse was 23.7%. In orthodontic treated patient, the average percent of using orthodontic brush was 82.4%, followed by interproximal brush was 64.7%, and mouthrinse was 47.1%. In dental implant treated patient, the average percent of using interproximal brush was 50.0%, followed by mouthrinse was 46.4%, and dental floss was 25.0%.

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서울올림픽대회 기간중 스포츠의료 이용에 관한 분석 (Analysis of Sports Medical Care Utilization during the 24th Seoul Olympic Games)

  • 유승흠;손명세;이영두;박은철;김춘배
    • Journal of Preventive Medicine and Public Health
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    • 제22권1호
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    • pp.136-145
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    • 1989
  • This study made a descriptive analysis of the cumulative amount and rate of sports medical care utilization during the 24th Seoul Olympic Games by the participating athletes, officials, etc. The sports medical care utilization was a component of the total medical care use and was basically caused by the prevention and treatment of sports injuries. The analytic data were derived from the Olympic Health Management Information System(OHMIS) of the SLOOC and the Korea Athlete Trainer Association(KATA). These were analyzed according to the quantity of physician visits and the utilization rate, which was the amount of utilization divided by the total number of participating persons. The results were as follows: Firstly, the sports medical care utilization by the persons participating in the Seoul Olympics amounted to 17.9% of the total medical care utilization. The venue medical services utilization accounted for 54.7% of the total physician visits, which was larger than the village medical center's utilization. The number of physician visits per hundred persons during the 2 week period in the venue clinic was 3.03 and that of the village medical center was 2.51, therefore, the total was 5.54. Secondly, athletes accounted for 82.3% and officials 12.2% in the sports medical care utilization by participants. These results were because athletes, who were directly related to the games, called extremely often on the physicians. The utilization rate of sports medical care by athletes was 34.29. Thirdly, the sports medical demand according to type of therapy could be ranked from high to low in the following order: sports massage, thermal therapy, and electrical stimulation treatment, etc. The department of physical therapy in the village medical center was used a great deal. Fourthly, the trend of daily sports medical care utilization by the athletes showed a bell shape centering around the opening day of the Seoul Olympic Games. The utilization rate of athletes was 2.3; however, that of officials was 0.6. Lastly, the sports medical demand was calculated according to the continents, and Central America, Africa and Middle-East Asia proved to have a higher rate of sports medical care utilization than the more powerful and industrialized continent or regions.

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암성통증환자(癌性痛症患者)의 신경차단요법(神經遮斷療法)의 분석(分析) (An Analysis of Nerve Block for Cancer Pain Patients)

  • 이중석;김해규;김인세;정규변
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.53-58
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    • 1988
  • 암으로 인하여 상하복부 및 하지에 심한 통증을 호소하는 환자에게 지주막하강 및 경막외강에 각각 미량의 몰핀을 지속적으로 주입하여 진통효과를 얻은 바 진통효과 발현시간은 지주막 하강 투여군이 빨랐고 지속시간 별로는 큰 차이가 없었고 제통효과 면에서는 지주막하강 투여 군이 더욱 확실하였고, 지속적 몰핀 주입에 의한 내성발현 정도는 경악의장 투여군이 심하였고 합병증 발현정도로는 경막외강 투여군이 경미하였음을 봐서 내성발생문제를 앞으로 해결한 다면 장기간 몰핀 등 마약성 약물을 투여해야되는 암성통증환자에서는 경막외강 투여법이 지주막하강 투여법보다 안전한 제통방법으로 사료된다.

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전신질환자에서 과도한 감염치아 발치시 스트레스 감소법 : 문헌적 고찰 및 증례보고 (STRESS REDUCTION PROTOCOL FOR PROPER EXTRACTION OF ADVANCED INFECTED TEETH IN MEDICALLY COMPROMISED PATIENTS : REVIEW OF LITERATURE & REPORT OF CASES)

  • 유재하;최병호;홍순재;남웅;김종배;윤정훈
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제26권1호
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    • pp.85-92
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    • 2000
  • Common dental procedures(dental extraction & minor operation) are potentially stress-inducing in many patients, especially medically compromised patients. The body's response to dental stress involves the cardiovascular system(an increase in cardiovascular workload), the respiratory organ and the endocrine system(change in metabolism). To minimize the stress to the medical risk patient, the stress reduction protocol was established. The obtained contents were as follows: (1) Recognize the patient's degree of medical risk (2) Complete medical consultation before dental therapy (3) Schedule the patient's appointment in the morning (4) Monitor and record preoperative and postoperative vital signs (5) Use psychosedation during therapy (6) Use adequate pain control during therapy (7) Short length of appointment : do not exceed the patient's limits of tolerance (8) Follow up with postoperative pain/anxiety control (9) Telephone the higher medical risk patient later on the same day that treatment was given Though the stress reduction protocol above was applied to the dental extraction in medically compromised patients with the advanced infected teeth, the final responsibility for the complications(syncope, bleeding & infection, etc.) in a patient rests with the dentist who ultimately treats him. For the prevention of postextraction complications & poor prognosis, the authors treated the advanced infected teeth with the pulp extirpation, opening drainage through the canal and complete occlusal reduction. The final extraction and wound closure were then done after $1{\sim}2$ weeks. The final prognosis was comfortable without common complications.

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초오(草烏) 봉밀(蜂蜜) 혼합물(混合物)이 백서(白鼠)의 말초신경병증성 통증 억제에 미치는 영향 (Analgesic Effects of the Combination of Aconitum Ciliare Tuber with Honey in the Rat Models of Peripheral Neuropathic Pain)

  • 조희근;박애련;최진봉
    • 한방재활의학과학회지
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    • 제21권2호
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    • pp.159-170
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    • 2011
  • Objectives : We have studied to know analgesic effects of the combination of Aconitum Cilliare Tuber with honey in the models of peripheral neuropathic pain. Methods : Neuropathic pain model was made by ligating left 5th lumbar spinal nerve. After 3 days, combination of Aconitum Ciliare Tuber and honey extract was administrated each alternate day. Administration was divided three groups, that is NP-OA1(0.06 mg/ml), NP-OA2(0.24 mg/ml), and NO-OA3(0.96 mg/ml). After that, we examined the withdrawl response of neuropathic rats legs by von Frey filament and acetone stimulation. And also we examined c-Fos, glutamic oxaloacetic transaminase(GOT), glutamate-pyruvate transaminase(GPT) and change of weight. Results : Mechanical allodynia in NP-OA1 groups were significantly decreased compared with the control group. Cold allodynia in all experimental groups were no significant differences with the control group. c-Fos protein expression on the central grey, all experimental groups were lower than that of control groups. But, there were no statistically significant differences. Change of weight in all experimental groups were significantly increased compare with the control group. In blood serum GOT in NP-OA1, NP-OA2 groups were significantly decreased compare with the control group. In blood serum GPT in all experimental groups were no significant difference with the control group. Conclusions : We had noticed that the combination of Aconitum Ciliare Tuber and honey decreased mechanical allodynia in the model of neuropathic pain compared with the control group and it has not efficacy in elevation of GOT, GPT and weight loss etc., the element of which becomes damage to liver. This study can be proposed that Aconitum Ciliare with Honey may be applicable to neuropathic pain in clinic. But it is reliability not that cold allodynia and c-Fos expression have effectively to control pain. Therefore we have to follow up about that.

한국 외래형 국소용 피부 외용제의 사용 현황에 대한 기초 평가 (Evaluation of Using Pattern of the Topical Agents in Korean Community)

  • 천영주;김숙현;김옥주;홍세화;양진욱;김정태;임성실
    • 약학회지
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    • 제58권6호
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    • pp.378-386
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    • 2014
  • Topical agents including of steroids are easily exposed to Korean patients in community setting. Those topical agents must be use cautiously because can cause adverse drug reaction unlike other oral medication. We evaluate the using pattern topical agents of Korean in community setting. We performed a questionnaire survey in three different pharmacies (general community pharmacy, dermatology clinic oriented pharmacy, general hospital oriented pharmacy) and in three university town. The survey asked necessity of topical agents, the number of applications per day, application period, site, and exist of steroids ingredient, etc. Total 330 people was participated in the survey from May 1st to July 31st, 2014. We analysed the survey by the frequency of each question and cross-analysis of the compliance between general public and pharmacy groups. In results, Korean people used topical agents for sudden skin diseases (66.9%), was gotten by dermatologist's prescription (89.1%), and did not know their diagnosis (39.2%). The people applied topical agents on face (22.3%), less one half FTU (finger tip unit) per application (61.9%), less than one week (62.9%). Though they was received drug education from pharmacist (52.2%), did not heard about adverse effects (78.4%). And compliance of applied times in pharmacy group was higher than in-non-pharmacy group (56% vs 38%, p=0.002). The highest compliance between 3 pharmacy subgroup was general community pharmacy (76.3% vs 61.6%, 61.2%, p=0.039). Compliance of applied duration was no difference between groups. Majority of respondents did not know diversity of ingredients, potency, application area of topical steroids, and replied to feel some vague reluctance and to think so dangerous about topical steroids. In conclusion, Korean people in community use topical agents well but still some exposed to risk from topical agents.

일부 대학생의 구강건강지식도 및 예방행태에 관한조사 (Survey on the Knowledge Level of Oral Health and Prevention Behaviors of some College and University Students)

  • 박홍련;문선정
    • 치위생과학회지
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    • 제9권5호
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    • pp.485-490
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    • 2009
  • 본 연구는 일부 대학생들이 구강건강지식도 및 예방행태를 파악하여, 대학생들의 위한 가장 효과적인 구강보건교육프로그램 개발에 있어, 구강보건교육의 방향 설정 및 내용과 방법을 개선하는 데 필요한 기초 자료로 사용하고자 실시하였다. 본 연구는 2009년 6월 한 달 동안 편의로 선정한 대구시에 소재하는 4개 대학에 재학 중인 학생을 대상으로 실시하였으며, 총 332부를 최종부석에 사용하여 다음과 같은 결론을 얻었다. 1. 충치 발생 원인은 남녀 모두 88.3%로 '양치질 부족'으로, 불소의 충치 예방효과는 85.5%가 '있다'로 나타났다. 잇몸병 발생원인은 남자는 '잇몸이 약한'이 39.2%로 높았고, 여자는 '양치질 부족'이 50.5%로 높았다. 2. 정기적 치과 검진기간에 대하 성별에 따라서는 '6개월에 1회 이상'이 남자는 52.5%, 여자는 66.5%로 더 높게 나타났으며, 통계적으로도 유의미한 차이를 보였다(p < .001). 3. 치과내원 이유는 전체적으로 '치료 목적'이 72.0%였다. 치아 건강이 삶의 질에 미치는 영향은 전체에서 '아주 중요하다'는 응답이 82.5%였다(p < .05). 4. 잇솔질 소요 시간은 '3분 이하'가 남자는 46.7%, 여자는 52.4%로 여자가 약간 높았고, 잇솔질을 하는 횟수는 '하루 2번'이 44.8%로 가장 높게 나타났고, 현재 사용 중인 구강위생 보조 용품은 '치실'이 남자가 각각 15.2%, 여자는 16.6%로 나타났다. 5. 구강건강지식이 높아질수록 구강보건태도와 구강건강인식이 높아지며, 보건태도가 높아질수록 구강 내 이상증상은 낮아지는 것으로 나타났다($^*p<.05$, $^{**}p<.01$).

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종양내과 퇴원 환자의 다제병용 분석 (Polypharmacy in Patients Discharged from Oncology Department)

  • 배현진;한지민;이용화;김향숙;이혜숙;이세훈;허대석;이주연
    • 한국임상약학회지
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    • 제23권1호
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    • pp.42-48
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    • 2013
  • Background: Patients diagnosed with cancer tend to have multiple risk factors for drug related problems such as old age, comorbid conditions, self-medication, additional medications for supportive therapy, and the cancer treatment itself. Objective: The aim of this study was to investigate notable polypharmacy and related problems in oncology patients during hospitalization or following clinic visit. Method: The electronic medical records of patients who were discharged from oncology division at Seoul National University Hospital (SNUH) from June $1^{st}$ to June $30^{th}$, 2011 were retrospectively reviewed. Results: A total of 334 discharged patients were included in this study. Among them, 221 patients had pre-admission medications. Forty percent of the patients, including 60.3% of elderly patients (over 65 years of age) were prescribed more than 5 kinds of medications. Twenty percent of the patients were prescribed to take medications more than 7 times a day. Medication duplications were observed in 2.4% of patients. In 10.5% of the reviewed patients, 47 cases of potential drug-drug interaction including 3 cases of contraindication and 17 cases of major clinical implication according to Micromedex were detected. Medication changes were made in 88% of patients during hospitalization and in 94.7% of patients at their first visit after discharge. Antidiarrheal agent (loperamide) was prescribed along with laxatives in 18.5% of the prescriptions and inadequate instructions on how to take it were observed in 63% of the prescriptions. Conclusion: This study identified the prevalence of polypharmacy and related problems in cancer patients, which presents the need for an active role of pharmacists in pharmaceutical care in oncology wards.