• Title/Summary/Keyword: Diagnosis and treatment

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Does the Level of Hospital Caseloads Influences on the Length of Stay for the Delivery Inpatients (입원환자의 집중도 수준에 따른 재원일수의 변이 분석: 분만환자를 중심으로)

  • Moon, Kyeong-Jun;Lee, Kwang-Soo
    • The Journal of the Korea Contents Association
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    • v.13 no.8
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    • pp.314-323
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    • 2013
  • This study analyzed the relationship between the level of hospital caseloads and length of stay for the delivery patients. The differences of hospital caseloads were measured by the Internal Herfindahl Index, which measured the concentration of delivery patient in a hospital. And the structure variables of hospitals such as the number of bed, the number of treatment, and the number of doctors and nurses per 100 beds were included as control variables. And average length of stay of delivery patients was used as the dependent variable. Concentration status of delivery patients was measured in two models: (1) first model represents the concentration level of delivery patient in all hospital patients, (2) second model represents the concentration level of delivery patient in all obstetrics and gynecology patients. In regression analysis, patient concentration index was not statistically significant in explaining the variation of average length of stay in two models. But the number of delivery patients and number of beds were statistically significant. The number of delivery patient variable showed negative regression coefficient with average length of stay and the number of beds showed positive coefficient with average length of stay. This study result indicated that the volume of delivery patients in a hospital will play a significant role in reducing the length of stay of delivery patients. Patient volume could contribute in improving the efficiency of patient care in a hospital.

A Study of Psychiatric Problems of North Korean Refugees Who Visited a Psychiatric Clinic (한 정신건강의학과에 내원한 북한이탈주민의 정신의학적 문제 고찰)

  • Kang, Hee-Young;Byeon, Seong-Hye;Shin, Sang-Ho;Kim, Hyun-Chung;Lee, So-Hee;Yoo, So-Young
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.35-41
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    • 2012
  • Purpose: According to the statistics announced by the Ministry of Unification, the number of North Korean refugees living in South Korea has increased by 200 on average monthly in 2010. The number of refugees increased only by 300 annually until 2000. The total number of refugees as of February 2012 was 20,956. This study aims to investigate the psychobiology of the North Korean refugees who consulted psychiatric clinics among those living daily life in South Korea. Methods: The subjects of this study were 85 North Korean refugees that consulted psychiatric clinics from January 1, 2005 to July 2011. This study obtained demographic and psychiatric information in a retrospective approach. Results: Among the 85 North Korean refugees, 75 (88.2%) were females and their average age was 48 years of age. A total of 16 (18.8%) were admitted to a clinic and among the inpatients, 4 were admitted twice and two were admitted three times. As for the claimed symptoms of outpatients, insomnia was shown in 47 (55.3%) patients, headaches in 37 (43.5%), anxiety in 20 (23.5%), depression in 19 (22.4%), etc. The major symptoms represented by inpatients were insomnia in 14 (87.5%) patients, depression in 12 (75%), and headaches in 8 (50%), etc. Conclusion: The most frequent psychiatric symptoms of North Korean refugees living in South Korea were insomnia and headaches. It suggests that when performing psychiatric diagnosis and treatment of North Korean refugees, we have to take into consideration the fact that they claimed the physical symptoms more than the emotional ones. Also, from the aspect that most symptoms of North Korean refugees were insomnia, more profound research on sleep is required in the future.

A Case of Primary Leiomyosarcoma with Prominent Osteoclast-like Giant Cell of Lung with Cardiac Invasion (심장 침습을 동반한 현저한 파골세포 모양의 거대세포로 구성된 원발성 폐평활 근육종 1예)

  • Song, Ki Ryong;Cho, Yongseon;Sin, Sung Kyun;Jeon, Ho Seok;Hyun, Woo Jin;Lee, Yang Deok;Han, Min Soo;Rho, Ji Young;Kim, Kyung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.3
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    • pp.278-283
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    • 2004
  • The incidence of a pulmonary leiomyosarcoma as a primary lung tumor is quite rare. We report a case of primary leiomyosarcoma with a cardiac invasion in a 76 year old man. He was admitted due to left anterior chest wall pain for one month. Chest computed tomography showed a $9{\times}8{\times}10cm$ sized, large round mass in the left upper and lower lobes, and an amorphous low density lesion within the left atrium. Chest magnetic resonance imaging showed a large round mass in the left upper and lower lobes with growth into the left atrium. A diagnosis of leiomyosarcoma with prominent osteoclast-like giant cells was made based on the microscopic and immunohistochemical findings of a permanent specimen by explothoracotomy. The pathologic features of the tumor showed round mononuclear hyperchromatic cells and multinucleated giant cells that resembled osteoclasts. The immunohistochemical staining showed that the giant cells are positive for CD68 but negative for the muscle markers while the round cells were positive for the muscle marker. The patient refused further treatment and died after two months.

Factors Potentially Associated with Chemotherapy-induced Anemia in Patients with Solid Cancers

  • Cheng, Ke;Zhao, Feng;Gao, Feng;Dong, Hang;Men, Hai-Tao;Chen, Ye;Li, Long-Hao;Ge, Jun;Tang, Jie;Ding, Jing;Chen, Xin;Du, Yang;Luo, Wu-Xia;Liu, Ji-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5057-5061
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    • 2012
  • Purpose: Chemotherapy-induced anemia (CIA) is one of the most important causes of anemia in cancer patients. This study was conducted to describe the prevalence and characteristics of CIA in solid cancer patients in the Chinese population, and to explore the relationship of white blood cell (WBC) or platelet decrease with CIA. Methods: Data on age, gender, tumor diagnosis, anti-cancer treatment and blood cell analyses were available from 220 untreated non-anemic cancer patients who received at least 2 cycles of chemotherapy, and the data were analyzed to assess their relationship with CIA or its severity. Results: 139 patients (63.2%) presented anemia, most being Grade 1 or 2. Esophageal and lung cancers were associated with a high prevalence. G3/4 leucopenia and decrease of platelets were identified as independent risk factors for the occurrence of CIA. Moreover, G3/4 leucopenia, decrease of platelet and G3/4 thrombocytopenia were found to be also associated with the severity of CIA. Cisplatin-containing regimens were a main potential factor in causing CIA, although significant association was only found on univariate analysis. Conclusion: Anemia or decrease in hematoglobin are common in Chinese cancer patients receiving chemotherapy. Cisplatin-containing regimens might be an important factor influencing the occurrence of CIA. Our analysis firstly described some risk factors, such as decrease of platelets or WBCs, severity of leucopenia or thrombocytopenia, associated with the occurrence and severity of CIA.

Dedifferentiated Parosteal Osteosarcoma - A Case Report - (역분화성 방골성 골육종 - 증례 보고 -)

  • Sung, Ki-Sun;Chang, Moon-Jong;Lim, Kyung-Sub
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.195-200
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    • 2007
  • Dedifferentiated parosteal osteosarcoma is an uncommon variant of osteosarcoma. Dedifferentiation is known to be associated with a greater metastatic potential and a more rapid lethal clinical course. Thus recognition of dedifferentiation is important to establish the treatment strategy. But there may be few significant clinical clues to distinguish between dedifferentiated parosteal osteosarcoma and conventional one. A 29-year-old woman presented with 2-year history of discomfort and swelling in her proximal thigh. Examination showed a large, hard, non-mobile mass. Radiographs revealed a large ossified mass attached to the proximal femur. Diagnosis of parosteal osteosarcoma was established by MRI and needle biopsy. But she had a history of abrupt severe thigh pain and increased swelling before surgery. Follow up MRI showed enlargement of mass with invasion to muscle around tumor. The patient underwent an en-bloc resection of tumor and reconstruction. Histological examination showed parosteal sarcoma with dedifferentiation. The patient expired due to local recurrence of tumor and distant lung metastasis 2 months after the surgery. In case with rapid growth of a lesion or unusual severe pain, one must have a high index of suspicion with regard to dedifferentiation.

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Compensation of female adults with openbite tendency (개방교합 경향을 갖는 성인 여성 환자들의 보상양상에 관한 연구)

  • Kim, Dong-Un;Yoo, Eem-Hak
    • The korean journal of orthodontics
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    • v.32 no.1 s.90
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    • pp.1-7
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    • 2002
  • The purposes of this study were to observe the compensation pattern of human female adults with openbite tendency and to provide the decision criteria of the diagnosis and treatment planning for those patients. Fifty patients with anterior openbite and fifty-five Patients without anterior openbite patients were selected as a control and a test group. ODI of the all patients was below 66. Mean ages of the control and the test group were 23.88 ${\pm}$ 4.53 and 24.7 ${\pm}$ 6.20 years, respectively. Lateral cephalograms were taken and forty-one variables were measured. To identify the morphological differences between the groups, statistical analyses were performed. Statistically significant differences were found in the measured variables of lower face height, N-Me, ANS-Me, ANS-Me/N-Me ratio, Mx1-SN, Mx1-FH, Mx1-NA(mm), Mx1-APo, PP to Mx6, Mn1-NB(degree), Mn1-NB(mm). The test group showed decreased lower face height, N-Me, ANS-Me, ANS-Me/N-Me ratio, more uprighted and retruded maxillo-mandibular incisors. Overeruption of the maxillary first molar was found in the control group.

The Development of Classification System of Dental Services for Temporomandibular Joint Disorders (측두하악장애 의료행위분류에 관한 연구)

  • Song, Yun-Heon;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.257-268
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    • 2005
  • It is recently suggested in Korea that Resource-Based Relative Value Scale (RBRVS) is an alternative plan of Korean Dental Fee Schedule which has been operated on a fee-for-service basis since the introduction of the national health insurance program in 1977. RBRVS applicable to diagnosis and treatment for temporomandibular disorders (TMD), a common cause of orofacial pain, is needed to be estimated in Korea and the establishment of the standard terminology of dental procedures for TMD should be preceded. The purposes of this study were to develop a new classification system of health care service items for TMD and to investigate time needed for each item, which enables RBRVS to be estimated prior to establishment the payment system of health care services for TMD. The dental service items for TMD in this study were categorized through Delphi process which 10 TMD specialists were participated in and the time needed for each service item was investigated by work sampling and time study method with a stopwatch. The results of this study demonstrated the new classification system of dental services for TMD comprising 151 service items and exhibited the average time for each items ranging from 7.22 min for cold laser therapy to 171.71 min for direct fabrication of anterior repositioning splint. Conclusively, it is suggested that the classification system for TMD developed in this study, considering specific characteristics on basis of resources for health care service of dental procedures, should be helpful to estimate payment level for each service item.

The Result of Ventilating Bronchoscopy for the Air Way Foreign Bodies (Ventilating bronchoscopy로 치유시도된 기도이물의 치료성과)

  • 우훈영;고건성;이희배;윤태현;안회영;백만기
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.4.3-5
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    • 1978
  • The foreign bodies in air way require the emergent managements in the otolaryngolagic field, and if the diagnosis and treatment were delayed, unexperted catastrophic situations may occur. The authors had analysed the airway foreign bodies of 50 cases which had been ventilating bronchoscopy. 1. In sex distribution, male to female ratio was 2.8 : 1. 2. In the age incidence, 58% were 1∼5 yrs. 3. Frequent symptoms, were coughing (68%), dyspnea (52%) and cyanosis (18%) in the oder. 4. The significant foreign body histories were noticed in 33 cases (66%). The initial misdignosis were 28%, and af which 57.1% were URI 5. In auscultation, decreased breathing sounds were noticed in 46%, wheezing were 24% and 26% were with in normal limit. 6, In duration af lodgement, 68% were removed within 24 hours. 7. Tracheostomy were performed in 24%, and foreign bodies were removed by ventilating bronchoscope in 72%. 8. The foreign bodies were vegetable (46%), metal (28%), plastic (18%) and fish bone (8%). 9. The prevalent site of foreign body were right main bronchus, left main bronchus, and trachea in the order mentioned.

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A Case of Bronchial Artery Aneurysm Presenting with Massive Hemoptysis (대량 객혈이 발생된 기관지 동맥류 1예)

  • Choi, Hyo-Jin;Ok, Kyung-Sun;Jung, Sung-Mo;Lee, Young-Min;Kang, Yun-Kyung;Jin, Jae-Youg;Jin, Sung-Lim;Lee, Hyuk-Pyo;Choi, Soo-Jeon;Yum, Ho-Kee
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.86-91
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    • 2002
  • A bronchial artery aneurysm(BAA) is rare, and has an unclear etiology. However, it may be caused by congenital abnormalities and acquired diseases like as bronchiectasis, tuberculosis, and other infections. The pathogenesis of a bronchial artery dilatation and the formation of an aneurysm results in an increase in the systemic blood flow to the chronic inflammatory pathologic lungs such as bronchiectasis or tuberculosis. It can be divided into the mediastinal and intrapulmonary BAA according to their location. The most common symptom is hemoptysis. Chest computed tomography and bronchial artery angiography may be used for a diagnosis. Treatment is mainly by a surgical resection of the aneurysmal artery. However, when patient is unstable due to massive hemoptysis or recurrent hemoptysis, bronchial artery embolization is useful. Here, we experienced a case of a bronchial artery aneurysm presenting as a massive hemoptysis.

Coexistence of Hodgkin's Lymphoma and Tuberculosis in the Same Axillary Lymph Nodes (결핵과 호지킨 림프종이 액와부 림프절에 공존하였던 1예)

  • Ban, Woo-Ho;Kang, Hyeon-Hui;Baeg, Myong-Ki;Kim, Jae-Gyung;Kim, Hyun-Jin;Baek, In-Woon;Kim, Eun-Oh;Ko, Sun-Hye;Lee, Sang-Haak;Moon, Hwa-Sik;Min, Ki-Ouk
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.342-346
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    • 2011
  • Herein we report the case of a 71-year-old woman who complained of fatigue and enlarged right axillary lymph nodes for 18 months. At her first visit, her chest X-ray showed diffuse nodular opacities in both lung fields. Initial excisional biopsy of the axillary lymph nodes showed granulomatous lesions and acid fast bacilli were seen on Ziehl-Neelsen staining. However, even after 15 months of anti-tuberculosis (TB) medication, her right axillary lymph nodes were enlarged. We re-performed an excisional biopsy of the nodes, which showed Hodgkin's lymphoma (HL). A retrograde review of the biopsy before anti-tuberculous medication, revealed HL coexisting with TB. HL and TB cause difficulties in differential diagnosis due to similarities in clinical course, imaging procedures and histopathological analysis of the involved tissue. Therefore, it is important to consider the possibility of concurrent HL and TB when patients who undergo treatment for TB or chemotherapy for lymphoma complain of persistent systemic symptoms or enlarged lymph nodes.