Calcaneal apophysitis is a relatively common disease in young athletes. On the other hand, if not treated properly, it can lead to apophyseal avulsion fracture in rare cases. In the case of apophyseal avulsion fractures, it is often necessary to remove or preserve the bone fragment, which often requires a suture of the Achilles tendon. A 10-year-old badminton athlete visited the outpatients' clinic with pain in both heels from 10 months ago without any trauma history. After conservative therapy, the pain in the left heel was relived but the right heel pain persisted. After 10 months of conservative therapy, the patient visited the outpatients' clinic showing a calcaneal apophyseal avulsion fracture with a total rupture of the Achilles tendon. In the operation room, a bone fragment needed to be removed because of its poor viability and the fragment was too thin for fixation. After removing the bone fragment, the ruptured Achilles tendon was fixed with an anchor system.
Recently the hospitals or clinics tend to get out of the functional and technological aspect so as to gradually emphasize service for patients. While qualitative rather than quantitative alteration is noticeable, the scale of clinics is getting larger. Especially, the opulence resulted from economic, social and cultural development has enabled more people to visit dermatology or plastic surgery besides treatment for disease. Responding to this tendency, dermatology is focusing on skin beauty, plastic operation, controlling obesity, etc. for women rather than ordinary treatment. Thus, dermatology is in need of space for skin control as well as ordinary treatment, which raises the immediate necessity of new plan for space and interior environment. In order to meet such necessity of dermatology, it is required to fully study and consider the plan for interior space. First, the purpose, scope and method of research will be defined in the introduction. Second, the concept of clinic as well at the characteristic of dermatology will be studied by theoretical investigation. Third, the general concept of dermatology will be analyzed by examining the characteristic of each room in dermatology, the moving line of nurses and patients, the color of dermatology and the design factor of finishing materials through general investigation on dermatology. Fourth, in order to look into the general case of dermatology, the object of examination will be selected for examination through literature and visiting. After examining data, the result will be analyzed and evaluated to prepare the ground for interior plan of dermatology.
Woo, Won Gi;Joo, Seok;Lee, Geun Dong;Haam, Seok Jin;Lee, Sungsoo
Journal of Chest Surgery
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v.49
no.3
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pp.185-189
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2016
Background: For treatment of pneumothorax in Korea, many institutions hospitalize the patient after chest tube insertion. In this study, a portable small-bore chest tube (Thoracic Egg; Sumitomo Bakelite Co. Ltd., Tokyo, Japan) was used for pneumothorax management in an outpatient clinic. Methods: Between August 2014 and March 2015, 56 pneumothorax patients were treated using the Thoracic Egg. Results: After Thoracic Egg insertion, 44 patients (78.6%) were discharged from the emergency room for follow-up in the outpatient clinic, and 12 patients (21.4%) were hospitalized. The mean duration of Thoracic Egg chest tube placement was 4.8 days, and the success rate was 73%; 20% of patients showed incomplete expansion and underwent video-assisted thoracoscopic surgery. For primary spontaneous pneumothorax patients, the success rate of the Thoracic Egg was 76.6% and for iatrogenic pneumothorax, it was 100%. There were 2 complications using the Thoracic Egg. Conclusion: Outpatient treatment of pneumothorax using the Thoracic Egg could be a good treatment option for primary spontaneous and iatrogenic pneumothorax.
High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at $T_{8-9}$ interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine 10 ml containing fentanyl $100{\mu}g$) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia ouccurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged 1 week later in good health.
Background: We started postoperative pain management service using an intravenous patient-controlled analgesia (IV-PCA, PCA), which is known as convenient and effective analgesic method. In this report, we describe the efficacy and safety of PCA and the experience of developing an acute pain service to treat postoperative pain using a PCA. Methods: Practices of an acute pain service were started at a ward for general surgery after preparation of the standardized protocols for PCA. In each patient, PCA was connected following administration of initial loading doses of analgesics at recovery room after operation. All patients were checked by acute pain service team once or twice daily. The scope of acute pain service was gradually spread to other departments such as orthopedic, thoracic, obstetric and gynecologic departments by requests of patients or surgeons. We managed 1,590 patients during first 22 months. among them, nine hundred seventy two cases were prospectively evaluated for their analgesis efficacy and side effects of PCA. Results: The number of patients was increased day by day. the most common type of operation was gastrectomy (21.6%). Commonly used analgesics were nalbuphine (59%) and morphine (37%). The mean duration of PCA attachment was 3.3 days. The degree of analgesia on operation day was good in 44.8% and tolerable in 52.6% of patients. Only 3.9% of patients complained severe pain during their postoperative periods. One elderly patient experienced respiratory depression (0.06%) owing to accidental misuse of PCA by his relatives. Overall patient's satisfaction was over 93%. Conclusion: According to our experiences, we conclude that PCA is an effective, relatively safe and highly satisfactory method for postoperative pain management. Because of these advantages of PCA, the creation of our acute pain service using a PCA was successful and expanded rapidly.
The Journal of Korean Academic Society of Nursing Education
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v.15
no.2
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pp.274-284
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2009
Purpose: This study surveyed how victims with acute traumatic hand injuries received pre-hospital care and how satisfied they were with that care. Method: A total of 100 adults were interviewed using a questionnaire at one microsurgical clinic in Korea. Results: Only 12 patients (12.0%) were transported by the ambulance and the others by private or company's vehicles. Only 9 patients (9.0 %) were able to get appropriate first response from the EMTs or industrial health providers at the scene of the accidents. The mean time required for transportation from the scene of the accident to the operation room of the microsurgical clinic was $372.65{\pm}719.17$ minutes. Most of the patients were satisfied with the pre-hospital care provided by the EMT or industrial health providers but dissatisfied with that provided by lay persons. Conclusion: This study demonstrates that there is a lack in the first response provided at the scene and the activation of EMS (Emergency Medical System) for acute hand injury. It is necessary to educate the public about the appropriate first response and rapid transportation to the appropriate microsurgical clinic.
Recently, the Korean medical system changed with diversification & specialization and the field of medical service is also specialized in these days. And healing environment is proposed as a general concept in the hospital architecture. There is a trend that a establishment of women's hospital is increasing as specialized type. In difference from general hospital, they are providing specialized and integrated services in response to the women's disease and demand. Particularly, Outpatient department space in women's hospital has been changed in terms of area, shape and program. However, there used to be not enough research efforts of responding these changes. This study includes the Outpatient department of s women's hospital in the form of small and medium sized building over a certain level in Korea. And the methods of the study adopted the theoric examination based concept and features of women's hospital, the abstraction of distinctions in the Outpatient department through the analysis of the drawing, and the analysis of distinctions in the Outpatient department of women's hospital with the structural space classified and the analysis of space relation. Therefore, the purpose of this is to study investigates and analyzes the spatial characteristics of the Outpatient department space in women's hospital through a analysis of case study. To conclude, the space composition can be classified into the entry space, the clinic space for patients, the support space of patients' check-up, the reception and waiting space, the rest and convenience space, and the link space in the Outpatient department of women's hospital. The level space can account for the waiting space type, the clinic office type, the type based on the relation between the waiting room and the clinic office with its features. As a result, the results will be applied for the planning & design for the future women's hospital.
Alif, Sheikh Mohammad;Haque, Sejuty;Nimmi, Naima;Ashraf, Ali;Khan, Saeed Hossain;Khan, Mahfujul Haq
Imaging Science in Dentistry
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v.41
no.4
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pp.155-159
/
2011
Purpose : This study was performed to determine the prevalence of maxillary canine impaction on a basis of a single panoramic radiograph in Bangladeshi population. Materials and Methods : A random sample of seven hundred panoramic radiographs was collected from the patient record of a dental clinic. All the selected panoramic radiographs were taken from January 2009 to August 2010 by a single panoramic radiograph machine with the same exposure time (19 seconds) for all radiographs. One hundred and twenty panoramic radiographs were excluded to minimize the selection bias. In a dim lit room, an observer assessed the radiographs on a standard radiographic light box. The position of the impacted maxillary canine was recorded in line with the longitudinal axis of a tooth using the edge of a metal ruler. Data were subsequently put on SPSS 11.5 software and chi-square (${\chi}^2$) tests were applied to find out the association. Results : Among 580 panoramic radiographs it was found that impacted maxillary canines were present in only 7 (1.2%) radiographs. A statistical significant difference was found between the age of the patients and the vertical position of the impacted canines (p=0.000) and between the age of the patients and the horizontal position of the impacted canines (p=0.003). Conclusion : The prevalence was found to be low compared with the present study from the limitation of panoramic image. Further study needs to include three-dimensional imaging modality.
Park, Eun-Ok;Lee, Kun-Sei;Jang, In-Soon;June, Kyung-Ja
Women's Health Nursing
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v.7
no.3
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pp.382-392
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2001
The purpose of this study is to investigate breast-feeding and breast-feeding health behavior among korean first-time mothers and to provide basic data for promoting breast- feeding. Data were collected by interview or self report from 444 first-time mothers who visited health clinic center in the area of metropolitan, medium or small city, countryside. and whose infants were under 12 months old from January 2001 to February 2001. The results show that breast-feeding was 31.5% in a week after childbirth, 25.8% in 4 weeks after childbirth, 22.7% in 2 months, 17.8% in 3 months, 14.3% in 6 months, 2.5% in 12 months after childbirth. Breast-feeding rate was very low in Korea and the duration of breast-feeding was very short. Breast-feeding health behavior did not show significant differences by general characteristics of the subjects except area. The subjects in the health clinic center with MCN project did better breast feeding health behavior than the subject in the health clinic center without MCN project. To raise breast-feeding rate, several strategy could be suggested. Systemic education about importance and advantages of breast-feeding and desirable breast-feeding method should be provided to pregnant women and postpartum women. Childbirth leave in the work should be prolonged, and supportive facility such as nursery room should be installed for working mothers. Hospitals should follow the guideline of 'Baby Friendly Hospital Initiative' which was provided by UNISEF and WHO, including rooming-in after delivery.
In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.
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