• Title/Summary/Keyword: First-visit patient

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Diagnosis and Management of Suspected Case of Early Rheumatoid Arthritis in the Temporomandibular Joint: A Case Report

  • Tae-Seok Kim;Yeon-Hee Lee
    • Journal of Oral Medicine and Pain
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    • v.48 no.1
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    • pp.31-36
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    • 2023
  • This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

Factors Affecting Spatial Distance to Outpatient Health Services (공간분석을 이용한 외래의료서비스 접근성 요인분석)

  • Shin, Ho-Sung;Lee, Sue-Hyung
    • Health Policy and Management
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    • v.21 no.1
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    • pp.23-43
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    • 2011
  • Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

A Clinical Case Report of Soyangin Patient Diagnosed as Sjögren's Syndrome with Irritable Bladder (과민성 방광을 동반한 쇼그렌 증후군 소양인 환자 치험 1례)

  • Lee, Min-jung;Park, Minyoung;Hwang, Min-woo
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.3
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    • pp.46-54
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    • 2020
  • Introduction This study aims to report a significant improvement of Sjögren's syndrome patient with irritable bladder, diagnosed as 'Soyangin chest-binding symptomatology' based on Sasang medicine. Methods The patient had treatment with 'Dojeokganggi-tang' and western medications. We evaluated the treatment outcome of Sjögren's syndrome symptoms by using a numerical score of 0 to 10, based on the patient's subjective discomfort of dry eye and dry mouth, and irritable bladder symptoms by recording the number of night urination every month. Results Sjögren's syndrome symptoms were significantly improved, and the number of night urination was decreased. After 41 weeks of treatment, the patient didn't have dry mouth any more and had only a little dry eye. The number of night urination was decreased from 3-4 times to once a night. Discussion The patient diagnosed with Sjögren's syndrome, treated with Dojeokganggi-tang and western medications for 41 weeks, showed a significant improvement in dry eye, dry mouth, and night urination compared to the first visit.

A Survey on Acute Traffic Injury Patient's Perception on Korean Herbal Medicine (급성기 교통사고 상해 환자의 한약 복용에 관한 인식 조사)

  • Kim, Soo-yeon;Oh, Seung-ju;Hwang, Kyu-hyun;Jin, Eun-seok;Yeom, Sun-Kyu;Kim, Dong-woo;Kim, Seok-woo;Jin, So-ri;Park, Mu-Jin;Kim, Eun-song;Lee, Hyun-seok
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.165-178
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    • 2020
  • Objectives This survey study is designed to check the awareness and satisfaction of Korean herbal medicine in patients suffering from acute traffic accidents. Methods From May 1 to 20, 2020, patients who visited the hospital within 7 days after the accident and received prescription of Korean herbal medicine for the first-time symptoms were selected. Survey was conducted 10 days after the first visit to confirm the perception of Korean herbal medicine and expected to be used as a prior study to improve the quality of Korean medicine led by Korean herbal medicine. Results Most patients answered that they were aware of the prescribed Korean herbal medicine's dosage and treatment effects. 65% of the patients said they would like to receive other forms of prescription if possible. Most patients answered that portability is convenient and tastes better than normal. 48% of the respondents said that it was the first to time to take Korean herbal medicine, and 68% said that they were willing to take the Korean herbal medicine later. At the time of the first visit, the health condition assessed using EuroQol visual analogue scale (EQ-VAS) was 46.84, but 10 days after the treatment began, it increased significantly to 61.93. Conclusions The improvement of symptoms and high satisfaction with Korean medicine medical services contributed to the patient's willingness to visit the Korean medicine hospital again and to respond that they were willing to take further medication. EQ-VAS elevation suggests that overall patients' subjective health conditions have improved since treatment.

Congenital Bronchoesophageal Fistula: Two cases (선천성 기관지 식도루;수술치헙 2례)

  • Hur, Jin;Jang, Bong-Hyun;Lee, Jong-Tae;Kim, Kyu-Tae
    • Journal of Chest Surgery
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    • v.25 no.2
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    • pp.194-199
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    • 1992
  • Two patients with congenital bronchoesophageal fistula were treated with surgical division. The first case was a 56-year-old female patient complaining of aggravated coughing, fever and chest pain since 10 days before the visit. The above symptoms were mild and occurred intermittently since 17 years ago. After the fistula was confirmed on the eso-phagogram, it was treated with coil embolization. The coil had dislodged and couldn`t be found two months later on follow up chest film. The patient underwent a surgical division of the fistula and has been in good condition The bronchoesophageal fistula belongs to type II in Braimbridge`s classification. The second case was a 5 year-old-female patient who suffered with cough intermittently since 2 years old and had history of recurrent pneumonia in infancy. An esophagogram revealed a fistula between the esophagus and the right lower lobe of the lung. An aortogram showed an abnormal systemic arterial supply to the right lower lobe of the lung. The sequestrated rigth lower lobe was resected and the fistula was divided. This case may be the first case of type IV bronchoesophageal fistula in Korea. This case also had good operative result.

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Endodontic treatment of a mandibular first molar with 8 canals: a case report

  • Arora, Ankit;Acharya, Shashi Rashmi;Sharma, Padmaja
    • Restorative Dentistry and Endodontics
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    • v.40 no.1
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    • pp.75-78
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    • 2015
  • Presented here is a case where 8 canals were located in a mandibular first molar. A patient with continuing pain in mandibular left first molar even after completion of biomechanical preparation was referred by a dentist. Following basic laws of the pulp chamber floor anatomy, 8 canals were located in three steps with 4 canals in each root. In both of the roots, 4 separate canals commenced which joined into two canals and exited as two separate foramina. At 6 mon follow-up visit, the tooth was found to be asymptomatic and revealed normal radiographic periapical area. The case stresses on the fact that understanding the laws of pulp chamber anatomy and complying with them while attempting to locate additional canals can prevent missing canals.

The Treatment Result of Antituberculous Chemotherapy Followed by Surgical Excisions in Tuberculous Cervical Lymphadenitis (경부 결핵성 림프절염에서 외과적 절제수술후 항결핵제 요법시의 치료 성적)

  • Park Dong-Enn;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.192-196
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    • 2002
  • Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.

Performance of foreign patients attract according to the type, geographical position and scale of hospital (병원의 유형, 지리적 위치, 규모에 따른 외국인환자 유치 성과 연구)

  • Park, Cho-Hee;Ahn, Sang-Yoon
    • Korea Journal of Hospital Management
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    • v.20 no.3
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    • pp.13-23
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    • 2015
  • This research is intended to inquire any discrepancy depending on the variables such as types, geography and size of hospitals of Korea in order to develop differentiated marketing strategy and to investigate how the aforementioned variables affect the management performance such as the increase in the number of foreign patients, their willingness to re-visit, the increase in profit and etc. The survey for this research was conducted for five weeks from July 10th 2014 to August 30th 2014 with 251 participants in charge of foreign patient attraction for 161 domestic hospitals. As the method of the research, a hypothesis was first established based on previous studies, followed by the incorporation of self-administered questionnaire to confirm the formulated hypothesis. Frequency analysis and ANOVA analysis were used to analyze the result of the survey. The outcome of the research and the implications are as follows. First, according to the demography of the persons-in-charge of foreign patient attraction, the proportion of female was superbly high by 76.5%. As for the age, those in their 30s were highest in proportion. Finally, for the education level, college graduates took up the largest portion by 46.5%. Second, in respect to the hypothesis assuming the difference in performance depending on the types of hospitals, national university-affiliated hospitals showed the highest level of the increase in foreign patients by the average of 3.25. Third, in respect to the hypothesis assuming the difference in performance based on geographical position, it was confirmed that hospitals in Ulsan City experienced the largest growth in the number in foreign patients. Fourth, in respect to the sizes of hospitals, those with 201 to 300 sickbeds showed the highest increase by the average of 3.45. The implication of the above research outcome indicates that while the number of foreign patients visiting Korea for medical purposes is on the rise, the number of professionals in place with necessary knowledge and capacity is insufficient and requires improvement.

Effects of Low Grade Axial Loading on Discogenic Low Back Pain: A Case Report

  • Chang, Duncan;Boby, Arantxa;Madonna, James
    • Journal of International Academy of Physical Therapy Research
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    • v.9 no.4
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    • pp.1683-1686
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    • 2018
  • Low back pain (LBP) is the most common reason for seeking physical therapy (PT) care. Recent studies suggest that axial loading can have a positive impact on the intervertebral disc by improving its tensile strength. Further, whole body vibration (WBV) appears to improve spinal muscle relaxation. Therefore, this case study describes the use of axial loading using a mini-trampoline in a female with chronic LBP. This case report is a single subject design. This patient is a 29-year-old female with a six-month history of low back pain following a motor vehicle accident. MRI found herniated discs at L4 and L5, clinical tests were positive for pain in the L4 and L5 dermatome and myotome the slump test was positive for neural tension, and LBP was constant at 4-6/10 over the past four months. She received axial loading exercises using a mini-trampoline and performed six sessions that were, scheduled twice a week for three weeks. Her Oswestry Disability Index (ODI) score improved from 40% at the time of her first visit to 22% at her final visit. Pain measure on the Numeric Pain Rating Scale (NPRS) after the first treatment was 7/10, and her pain after the final treatment was 0/10. These changes in the pain scores are clinically significant and exceed the minimal clinically important difference (MCID). This patient had a significant improvement in her pain using the NPRS and the ODI. This case study suggests that axial loading may be an effective treatment for some individuals with discogenic chronic low back pain.

The Relationship between the Media Exposure of Hospital Physicians and Patient Volume - a University Hospital Case - (병원의료진의 언론노출과 진료실적간의 관계 - 일개 대학병원 사례를 기준으로 -)

  • Kim, Sung Cheol;Kim, Tae Kyung;Kim, Tae Hyun;Park, So Hee;Lee, Sang Gyu
    • Korea Journal of Hospital Management
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    • v.21 no.1
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    • pp.51-61
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    • 2016
  • This study attempted to investigate how mass media marketing of a hospital influences patient volume. Additionally, the association of patient volume with exposure time and the type of mass media was examined. Data from a university hospital in Bundang (from January 2014 to November 2014) were used. Degree of physicians' mass media marketing was measured by the number of media exposure. Linear mixed model for repeated measures data was run to identify the associations between the number of media exposure and patient volume. First, the number of hospital physician's mass media exposure and new patients and the first visit patients were positively associated. Second, broadcasting media which has relatively significant in patient volume is TV programs such as cultural programs and news. Third, hospital physicians with higher ranks who were exposed to press media receive more patient appointment. Also, nonsurgical hospital physicians who were exposed to press media receive more patients. Fourth, medical treatment activities for hospital staff who hold the rank of Professor in case of making an appearance at press media have relatively increased. Hospital physician's media exposure, particularly TV programs, was significantly related to patient volume for outpatients.