• Title/Summary/Keyword: First-visit patient

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Analysis of Patients with Cervical Epidural Steroid Injection and Nerve Block (경부 경막외 Steroid 주입 및 차단술을 받은 환자의 분석)

  • Chung, Sung-Won;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.98-101
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    • 1996
  • Background: Lumbar epidural steroid injection for relief of low back pain and sciatica has become a popular procedure. further, cervical epidural steroid injection with nerve block (CESNB) is known to be effective for the management of acute and chronic pain of neck, shoulder and arm. However, many anesthesiologists are not familiar with CESNB. Methods: Charts of 34 patients who had undergone 60 cervical epidural steroid injections over a three year period, 1993 to 1995, were reviewed. We studied the followings: initial visit and department, injected interspaces, personal characteristics, indications for injection and complications. Results: Patients' first visits were mainly to orthopaedics (11 patients) and neurosurgery (10 patients). Epidural injection sites were: C7-T1 interspace (29 patients) and C6-C7 interspace (6 patients). Mean age of patients were 50.1 years. range 21~73 years. There were twenty male and fourteen female patients. Complications varied from dizziness after CESNB (1 patient). loss of consciousness with transient apnea (2 patients), and local infection with suspicious meningitis (1 patient). Conclusion: We conclude from the above data that CESNB is a good, safe and conservative form of therapeutic procedure in the management of patients suffering from cervical radiculopathy, and neck and shoulder pain.

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A Comparison of Patterns of Emergency Care Between Resident and Staff (전공의와 전문의의 응급진료 형태에 대한 비교 연구 - 전공의 파업기간을 전후로 -)

  • Lee, Jeong-Heon;Shin, Im-Hee
    • Quality Improvement in Health Care
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    • v.10 no.1
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    • pp.20-27
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    • 2003
  • Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.

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Application of radiographic images in diagnosis and treatment of deep neck infections with necrotizing fasciitis: a case report

  • Kim, Young-Joo;Kim, Ju-Dong;Ryu, Hye-In;Cho, Yeon-Hee;Kong, Jun-Ha;Ohe, Joo-Young;Kwon, Yong-Dae;Choi, Byung-Joon;Kim, Gyu-Tae
    • Imaging Science in Dentistry
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    • v.41 no.4
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    • pp.189-193
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    • 2011
  • The advent and wide use of antibiotics have decreased the incidence of deep neck infection. When a deep neck infection does occur, however, it can be the cause of significant morbidity and death, resulting in airway obstruction, mediastinitis, pericarditis, epidural abscesses, and major vessel erosion. In our clinic, a patient with diffuse chronic osteomyelitis of mandible and fascial space abscess and necrotic fasciitis due to odontogenic infection at the time of first visit came. We successfully treated the patient by early diagnosis using contrast-enhanced CT and follow up dressing through the appropriate use of radiographic images.

ORBITAL SUBPERIOSTEAL ABSCESS SECONDARY TO ODONTOGENIC INFECTION OF LOWER MOLAR : A CASE REPORT (하악대구치의 치성감염으로 유발된 안와골막하농양의 치험례)

  • Kim, Dong-Ryul;Hong, Kwang-Jin;Choi, Dong-Ju;Lee, Jeong-Gu
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.22 no.1
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    • pp.110-116
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    • 2000
  • A 61-years old man with diabetes mellitus(DM) was admitted to our hospital, complaining of progressive right periorbital swelling, headache and toothache on the right lower second molar. On the first visit, moderate swelling was noticed from the right periorbital region with exophthalmos and subconjunctival effusion. Intraorally, right lower second molar had a severe periodontal disease and fistular formation on its distal area. From 3 days after hospitalization, the visual acuity of his right eye was gradually worsen and we performed CT scan. CT scan demonstrated an inflammatory change at the right orbit with subperiosteal abscess at the inferior orbital wall, which was extended from the right infratemporal, parapharyngeal and internal pterygoid space. Patient was treated by mean of intraoral(right upper vestibular and retromolar) and extraoral(infraorbital) incision and drainage, massive anti-therapy and DM control. The patient improved gradually and finally was discharged from the hospital, but his visual loss of right side was not recovered.

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Carbon-ion radiotherapy in osteosarcoma of the mandible: a case report

  • Ha, Tae-Wook;Park, Slmaro;Youn, Min Yeong;Kim, Dong Wook;Kim, Hyung Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.4
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    • pp.315-320
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    • 2021
  • Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.

A Case Report on the Immediate Effects of Cytoskeletal Manual Therapy on Pain, Muscle Thickness, and Pressure Pain Threshold in a Patient with Scoliosis

  • Hyunjoong Kim;Dajeong Kim
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.19-25
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    • 2023
  • Objective: Patients with scoliosis complain of various symptoms such as muscle imbalance, dysfunction, back pain, abnormal posture and gait abnormality. The most basic treatment for scoliosis is to observe the progress based on conservative treatment. Therefore, in this case report, the effect of cytoskeletal manual therapy (CMT), a soft tissue mobilization technique, on pain intensity, muscle thickness, and pressure pain threshold (PPT) in a patient with scoliosis was investigated. Design: A case report Methods: A 25-year-old male diagnosed with scoliosis visited the Neuromusculoskeletal Science Laboratory with chronic back pain. In the laboratory, scoliosis was confirmed through the X-ray image used for his diagnosis, and it was confirmed again through Adam's forward bending test. Pain, pressure pain threshold and muscle thickness were measured to compare the immediate effects of CMT applied in the laboratory for 40 minutes. Treatments were visited two weeks after the first visit and outcome measures were assessed after a total of two visits. Results: After receiving CMT up to the second session, the pain intensity decreased by 4 points and the screening angle decreased by 15 degrees. Muscle thickness decreased in all but 10 mm on the dominant side of the thoracic spine. All of the PPTs increased, and the greatest increase was 3.1 lb on the dominant side of the thoracic spine. Conclusions: CMT showed positive improvement in pain during trunk flexion, spinal curvature, muscle imbalance, and pressure pain, which is considered as an ancillary treatment option for scoliosis management.

A Case Report of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Treated with Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment (회음혈 봉약침 치료와 팔료혈 자침을 통한 만성전립선염/만성골반통증 증후군 치험 1례)

  • Do-yeon Park;Hyang-ran Moon;Hui-jeong Noh;Sang-yoon Jeon
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.536-543
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    • 2023
  • Objectives: The purpose of this study was to report the effectiveness of Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment in the management of chronic prostatitis/chronic pelvic pain syndrome. Methods: A patient with chronic prostatitis/chronic pelvic pain syndrome underwent Korean medical treatment, including Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment. The severity of symptoms was assessed with a daily visual analog scale (VAS) for orchialgia and lower abdominal pain. In addition, we measured the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) on the first and last days of visit. Results: The patient's symptoms were improved after treatment. The severity of orchialgia was reduced from VAS7 to VAS2, and lower abdominal pain was improved from VAS6 to VAS1. NIH-CPSI decreased from 21 to 5. Conclusion: Hoeeum Bee-venom Therapy and Balio Acupuncture Treatment are effective in treating chronic prostatitis/chronic pelvic pain syndrome.

Clinical Characteristics of Coronary Artery Disease Patients by Comorbidity of Diabetes Mellitus (당뇨병을 동반한 관상동맥질환자의 임상적 특성)

  • Choi, Eun-Ha;Song, Mi-Soon
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.1-10
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    • 2011
  • Purpose: The study was conducted to find out clinical characteristics for coronary artery disease patients with diabetes mellitus. Methods: We retrospectively reviewed the electronic medical records which included the data of 6,792 patients, who had been diagnosed coronary artery disease (CAD) such as angina or acute myocardial infarction and admitted to a university hospital in Seoul from January, 2005 to November, 2010. Results: Of the 6,792 patients, 43% had been diagnosed diabetes as comorbidity. The CAD patients with diabetes had lower left ventricular ejection fraction, stayed longer at hospital, and spent on more time from the first symptom to hospital visit than those without diabetes. In addition, they were more likely to have multi vessel coronary artery disease. Conclusion: The CAD patients with diabetes lay on the various factors which can make more worsen condition. Hence, we need to pay attention to specialized nursing care and patient education for the CAD patients with diabetes.

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Endodontic flare-ups incidence and related factors

  • Jung, Hye-Young;Choi, Kyoung-Kyu;Choi, Gi-Woon
    • Proceedings of the KACD Conference
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    • 2003.11a
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    • pp.555-555
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    • 2003
  • The purpose of this prospective study was to assess the incidence of flare-ups among patients who received endodontic treatment for the last 11 months and to examine the correlation with pre-operative and operative variables. Data were gathered on 840 teeth of 755 patients over 11 months. At first visit, information was obtained on each patient as to their demographics, presenting signs, symptoms and diagnosis, and treatment performed. Treatment procedures were routine. If additional appointments were necessary, the access cavity was closed with a dry cotton pellet and ZOE.(omitted)

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Surgical management of an accessory canal in a maxillary premolar: a case report

  • Kim, Hee-Jin;Yu, Mi-Kyung;Lee, Kwang-Won;Min, Kyung-San
    • Restorative Dentistry and Endodontics
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    • v.44 no.3
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    • pp.30.1-30.6
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    • 2019
  • We report the surgical endodontic treatment of a maxillary first premolar with a lateral lesion that originated from an accessory canal. Although lesions originating from accessory canals frequently heal with simple conventional endodontic therapy, some lesions may need additional and different treatment. In the present case, conventional root canal retreatment led to incomplete healing with the need for further treatment (i.e., surgery). Surgical endodontic management with a fast-setting calcium silicate cement was performed on the accessory canal using a dental operating microscope. At the patient's 9-month recall visit, the lesion was resolved upon radiography.