• 제목/요약/키워드: First-visit patient

검색결과 212건 처리시간 0.029초

A Case of Unexpected Clinostomum complanatum Infection Initially Presenting as Foreign Body in Pharynx

  • Kim, Hyunjung;Cho, Sung-Weon;Oh, Harim;Byeon, Hyung Kwon
    • Parasites, Hosts and Diseases
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    • 제57권2호
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    • pp.175-177
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    • 2019
  • A 46-year old man visited our outpatient clinic with complaint of foreign body sensation in throat after consuming raw freshwater fish 5 days ago. Laryngoscopic examination revealed a motile worm attached on posterior pharyngeal wall. The worm was removed using biopsy forceps under transnasal endoscopy and evidently identified as Clinostomum complanatum after microscopic examination. Patient's subjective foreign body sensation of throat and hyperemia of laryngeal mucosa remained for approximately 2 weeks post-removal, which were eventually resolved after administration of non-steroidal anti-inflammatory drug and anti-refluxant drug for 2 weeks. Treatment was ended at three weeks since the first visit. C. complanatum infections in humans are rare, and only four cases have been reported in Korea. Symptoms resembling pharyngitis or laryngitis occurs by consumption of raw, infected freshwater fish and treatment is done by mechanically removing the parasite.

Delayed Post-Traumatic Spinal Cord Infarction with Quadriplegia: A Case Report

  • Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • 제34권4호
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    • pp.279-283
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    • 2021
  • Traumatic spinal cord infarction is a rare condition that causes serious paralysis. The regulation of spinal cord blood flow in injured spinal cords remains unknown. Spinal cord infarction or ischemia has been reported after cardiovascular interventions, scoliosis correction, or profound hypotension. In this case, a 52-year-old man revisited the emergency center with motor and sensory abnormalities in all four extremities 56 hours after a motor vehicle collision. Despite the clinical presentation and imaging examination, there were no specific findings on the patient's first visit to the trauma center. Cervical spine computed tomography angiography showed a narrow vertebral artery, and diffusion-weighted imaging revealed spinal cord infarction from C3 to C5 with high signal intensity. It should be kept in mind that delayed-onset spinal cord infarction may occur in minor or major trauma patients as a result of head and neck injuries.

최근 8년간 전남대학교 치과병원 소아치과에 내원한 초진환자의 분포 및 진료현황에 관한 실태조사(2003-2010) (A STUDY ON THE CHANGES IN PATIENT DISTRIBUTION AND PRACTICE PATTERN FOR LAST 8 YEARS IN THE DEPARTMENT OF PEDIATRIC DENTISTRY OF CHONNAM NATIONAL UNIVERSITY DENTAL HOSPITAL)

  • 손정민;김선미;최남기
    • 대한소아치과학회지
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    • 제39권4호
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    • pp.373-382
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    • 2012
  • 본 연구는 소아 환자들의 변화하는 특성과 진료양상의 변화를 파악하여 소아치과 진료의 방향성을 고려하고자 시행되었다. 2003년부터 2010년까지 전남대학교 치과병원 소아치과에 내원한 모든 환자를 대상으로 하였으며 다음과 같은 결론을 얻었다. 전체 내원환자의 수는 2009년, 2010년에 들어 증가하였고 여자보다 남자의 비율이 높았다. 초진환자의 13~15세군의 내원율이 2003년 2.9%에서 2005년 23.5%로 가장 크게 증가하였고, 3~4세군의 내원율은 2003년 27.6%에서 2005년 3.2%로 가장 크게 감소하였다. 초진환자는 12월이 가장 많았고 이 중 광주시내 거주자가 가장 많았으며 전신질환을 가진 환자는 약 10.7%, 진정치료의 분포는 19.1%였다. 초진환자는 충치 치료를 주소로 내원한 경우가 36.0%로 가장 많았고 진료현황분포는 2003년에는 수복 치료가 38.4%, 2010년에는 30.4%를 차지함을 보여주었다.

종합병원 외래환자 진료시 의사의 보건교육활동 평가 (An Evaluative Study on Physician's Health Education Activities in Outpatient Medical Care)

  • 김숙자
    • 보건교육건강증진학회지
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    • 제2권1호
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    • pp.56-80
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    • 1984
  • The main objectives of the present study is to evaluate Physician's Health Education Activities by means of physician's direct response to the prepared questionnaire and patient's perception to the physician in the course of medical care. For the data collection, the present study was conducted from Aug. 16 to Oct. 7, 1983 for 739 patients and 91 physicians who were attended outpatient clinics of 5 general hospitals in Seoul. The major findings are summarized as follows: 1. Self-evaluation on Physician's Health Education Activities (1) In consideration of health education services for the patient, the data revealed that 9.9% of the sampled physician wanted to strength public health and preventive medicine lecture in the curricula at medical education. On the other hand, only 1.1% expressed that they wanted to make it short. (2) In consideration of the necessity of health education service, it was shown that 95.6% of physicians agreed to take it into consideration. Self expression for the practice of health education was placed on the 3.15 score when 5 point scale used. (3) To evaluate the degree of an explanation about medical care for the patient, Index score with 4 point scale was employed. The Index score for the first time was shown that scale was placed on 3.23 for 'diagnosis', 3.12 for 'progress of the disease', 3.11 for 'discription of procedure' and 3.02 for 'cause of the disease' respectively. In comparison of the physician's explanation about the status of disease for the first and the second visitors to clinic, they evaluated themselves as giving more detailed explanation for the second visitors rather than the first visitors. 2. Physician's Health Education Services evaluated by patients (1) To evaluate physician-patient communication at beginning time for taking history about disease, the Index score with 5 point scale was employed. The data on taking history have shown that the score placed on 3.07 for those patients who visited the first time and 2.53 for second visitors. And the score about listening from the patients was placed on 3.52 and 3.42 respectively. (2) The Index score with 5 point scale, as used before, was also employed to evaluate medical care services for the patient. The data evaluated by the patients was shown that the score placed on 4.21 for patient treatment in general, 4.58 for physician's credibility, and 3.6 for physician's kindness. However, approximately 80% of those who failed to understand physician's explanation was caused by highly sophisticated medical terminology. (3) According to the Index score with 4 point scale, to evaluate physician's explanation, the data was shown that the patient who visited the first time gave 2.51 for 'diagnosis', 2.35 for 'progress', 2.11 for 'cause of the disease' and so on. It is acknowledged on the whole that the patients who visited the second time have more satisfaction in physician's explanation about their disease, than those who visited the first time. 3. Comparison of self-evaluation of Physician's Health Education Activities and patient's perception. (1) There was communication barriers between physicians and patients in expressing some medical terminology. For example physician understood that they explained more than 50% of medical terminology into common words for the patient, but 30% of patient complained medical terminology used by physician. (2) Comparing the index score of health education practice recognized by patients and physicians for both first visit and revisit groups, it was shown that the Index score of health education activities evaluated by physicians themselves were slightly higher than the score evaluated by patients.

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Long-term Survival after Repeated Local Therapy and Salvage Chemotherapy for Recurrent Metastases from Gastric Cancer: a Case Report and Literature Review

  • Kwon, Jihyun;Han, Hye Sook;Kim, Hee Kyung;Baek, Seung-Woo;Yang, Yaewon;Lee, Ki Hyeong;Son, Seung-Myoung;Kim, Won-Dong;Kim, Dae Hoon;Yun, Hyo Yung
    • Journal of Gastric Cancer
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    • 제18권3호
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    • pp.305-312
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    • 2018
  • We report a rare case of long-term survival in a patient who received local therapy and salvage chemotherapy for recurrent metastases, along with a literature review. A 65-year-old male patient underwent subtotal gastrectomy for advanced gastric adenocarcinoma. Six months after gastrectomy, 2 metastatic intra-abdominal lymph node enlargements were detected, which were treated with radiotherapy. At 55 months after gastrectomy, an abdominal wall mass was detected, which was treated by surgical resection. The patient received 5-fluorouracil/leucovorin/irinotecan chemotherapy for 27 months before and after radiotherapy and docetaxel chemotherapy for 6 months after surgical resection of the abdominal wall metastasis. At the last visit, 7.8 years since the initial resection of the primary gastric cancer and 6.2 years since detection of the first metastases, the patient was disease-free and required no further chemotherapy. This case suggests that repeated local therapy offers potential for long-term survival in a carefully selected subset of patients with recurrent metastases.

증례를 통해 본 치매의 한양방 협진 모델 연구 (A Study on the System of Collaborative Practice between Korean Traditional Medicine and Western Medicine for Dementia based on a Case Study)

  • 이고은;양현덕;전원경;강형원
    • 동의신경정신과학회지
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    • 제24권3호
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    • pp.211-228
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    • 2013
  • Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.

상급종합병원 진료의뢰 요인별 의료이용 양상 - 일개 S대학 병원을 중심으로 - (Aspects of Medical Utilization by Factors for Referrals at Tertiary Hospital - Focused on S University Hospital -)

  • 정영권;서원식
    • 한국병원경영학회지
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    • 제25권4호
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    • pp.13-28
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    • 2020
  • Purposes: The purpose of this study is to analyze the institutional and personal factors that affect the medical utilization of patients transferred to tertiary medical institutions. Methodology: We retrospectively analyzed the 2 weeks electronic medical records of 1,556 patients, who were referred to the tertiary hospital, from June 15 to 26, 2015. The patient's personal characteristics, referral hospital, referral path, medical experiences and expenses were analyzed for 6 months after the patient's first visit. Findings: The largest proportion (848; 54.5%) of referrals was referred from primary clinic but the referrals of the same tertiary hospital level were one in seven (228; 14.7%) of the patients. Most patients (1,401; 90%) were referred from the clinics and hospitals directly and only one in ten (155; 10%) of the patients utilized the medical referral center. Patients who had been referred from tertiary care institutions had significantly higher medical costs than those referred to primary care (7,560,000 vs 2,333,000 won). The institutional factors including the numbers of visits to outpatient clinic, previous history of hospitalization and operation, consultation to other medical departments and hospitalization fee significantly influenced on medical utility pattern. Personal factors including patient's medical diagnosis and department of disease have a highly correlation with patient's referrals. Practical implications: The medical utilization of medical expenses and experiences is influenced by institutional and individual factors, and it is important to establish a referral system considering the institutional factors of the type of referral hospital.

Satisfaction survey on music listening in patient waiting areas and hallways

  • Han-Kyung Seo
    • 핵의학기술
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    • 제28권1호
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    • pp.31-33
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    • 2024
  • Purpose: Music therapy helps alleviate anxiety, depression, and pain for cancer patients, contributing to stress relief. With such advantages, music therapy is applied across a broad spectrum of treatment areas, including mental disorders, developmental disabilities, and conditions affecting the elderly. It has been shown to enhance the quality of life for terminally ill cancer patients. Recent research has revealed its positive effects in boosting immune function and resilience. In light of these findings, the author conducted a study to investigate patient satisfaction with music listening. Materials and Methods: First, a survey was conducted with 30 individuals to inquire about the perceived necessity of listening to music in a waiting area. Next, participants were asked whether listening to music could contribute to psychological stability. Finally, preferences for music genres and satisfaction with music listening were assessed with a sample of 20 individuals. Results: In terms of the perceived necessity of listening to music in the waiting area, 28 out of 30 individuals, or 93%, expressed agreement. Regarding the belief that music listening could contribute to psychological stability, 28 out of 30 individuals, or 93%, believed that it would indeed help with stability. When it comes to preferred music genres, 4 individuals (13%) favored classical music, 2 individuals (6%) preferred traditional Korean music, 2 individuals (6%) enjoyed trot music, and 20 individuals (66%) had no specific genre preference. As for music listening satisfaction, 17 out of 20 individuals, or 85%, reported being satisfied. Conclusion: When patients visit the hospital, stress can increase due to concerns about their medical conditions. To address this, providing a variety of music genres at the hospital has been effective in reducing patient stress and promoting psychological stability.

환자를 위한 선수술 교정 접근 방법 (Surgery-First Orthodontic Approach for the patients)

  • 국민석
    • 대한치과의사협회지
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    • 제55권4호
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    • pp.296-302
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    • 2017
  • The traditional orthognathic surgery treatment consists of three steps: preoperative orthodontic treatment, orthognathic surgery, and postoperative orthodontic treatment, and the average treatment period is usually two years. Also, patients with Class III malocclusion should spend more time getting their facial features worse during the decompensation process. However, most of the patients who want orthognathic surgery visit the chief complaints of appearance improvement, and resolve this address as soon as possible. The concept of $^{\circ}{\AE}$Surgery - First 'does not cause a facial imbalance caused by decompensation for the pre - operative correction period, and the patient can obtain an improved facial profile immediately after the operation. In addition, the correction period is shortened by Regional Acceleratory Phenomenon (RAP) after surgery. However, it is not applicable to all patients. Patients with severe crowding, severe curve of spee or reverse curve of spee, severe transverse discrepancy of the maxilla and mandibular arch, and severe incisal angles are less likely to apply the technique. Although it is not yet possible to apply this technique to all patients, it has many advantages over the conventional method. Especially, the patients' preference is increasing due to the rapid appearance improvement and the shortening of the total treatment period.

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L-spine MRI로 관찰한 Disc extrution환자의 디스크 흡수 3례 보고 (The Clinical Reports on 3 Case of the Patient of Extruded Disc Treated by Conservative Oriental Medical Treatment)

  • 이진혁;민관식;김수영
    • 척추신경추나의학회지
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    • 제5권1호
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    • pp.101-110
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    • 2010
  • Objectives: The propose of this study is to find out the clinical application of conservative treatment to 3 patients who has Disc Extrusion on L-spine MRI Methods: We examined 3 patients with Lumbar Intervertebral Disc Herniation (HIVD of L-spine) with Disc Extrusion who showed changes on MRI images before/after the treatment among HIVD of L-spine patients who visited Jaseng Hospital of Oriental Medicine. Results: In this study, the first MRI examination of HIVD of L-spine patients was performed at the first visit and re-examination of MRI was done after the treatment. In each case, the size of the extruded disc was considerably reduced in MRI image. Low back and leg pain was also reduced significantly after conervative oriental medical treatment. Conclusions: Conservative oriental medical treatment can be effective for improving symptoms of HIVD, decreasing pain, also decreasing the volume of herniated disc.

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