• Title/Summary/Keyword: Old Patients

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A SURVEY OF DENTAL TREATMENT UNDER OUTPATIENT GENERAL ANESTHESIA AT CHONBUK NATIONAL UNIVERSITY DENTAL HOSPITAL BETWEEN 2014~2017 (2014년부터 2017년까지 전북대학교 치과병원에서 외래 전신마취 하에 치과치료를 받은 증례에 관한 연구)

  • Ahn, Na Hyun;Lee, Daewoo;Kim, Jaegon;Yang, Yeon Mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.1-6
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    • 2019
  • There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

Epidemiological Characteristics of Bicycle-Injured Patients (자전거손상 환자의 역학적 특성)

  • Nam, Young-Hee;Lee, Myung-Sun
    • The Journal of Korean Society for School & Community Health Education
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    • v.14 no.2
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    • pp.47-57
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    • 2013
  • Backgrounds: According to a high interest in health these days, a bicycle is being highlighted as a means of leisure activity and auxiliary transportation means. Along with an increase in this interest, there is tendency that even the width of bicycle utilization gets diverse and that bicycle accident is also rapidly growing. Purpose: The purpose of this study was to suggest a prevention measure available for reducing occurrence of bicycle accidents by analyzing the Epidemiological characteristics according to age and injury severity in bicycle-injured patients. Methods: This study analyzed 115 materials suitable for this study by examining a medical record of patients, who received the hospitalized treatment owing to bicycle accident from January 1, 2011 to December 31 at one general hospital in S city. Results: The male-and-female ratio of bicycle-injured patients stood at about 7:3. The average age was 38.14(${\pm}21.59$) years old. The largest injury happened in 40-59 years old(31.3%). The averagely hospitalized period was 17.33(${\pm}18.12$) days. Injury severity was the ratio of 2:8 in a mild case versus a serious case. As for drinking and smoking characteristics according to age, the injury occurred the most in between 40 and 59 years old for people with drinking and smoking and in under 19 years for people without drinking and smoking. According to injury severity, the ratio of serious case got higher in the higher age. This was indicated(${\chi}^2$=15.675, p=0.001) to be statistically significant. Conclusion: In this study, a bicycle accident was indicated to have high injury risk in young children, adolescents, and old-age group. Prevention measure and publicity are demanded for reducing injury occurrence such as the prevention education for bicycle accident and wearing protective gear focusing on the ages of corresponding to groups with risk of injury occurrence. In addition, the security of safe movement route is necessarily demanded in order to increase application level as an auxiliary transportation means.

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Operative Treatment for Hallux Valgus with Proximal Metatarsal Osteotomy in Patients over 55 Years Old (55세 이상 무지외반증 환자의 근위부 절골술을 이용한 치료)

  • Park, Han-Sung;Park, Hyung-Taek;Lee, Ghun-Shik;Kim, Sang-Hyo;Lee, Kyung-Tai
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.69-73
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    • 2005
  • Purpose: The purpose of our report was to evaluate the result of operative treatment of hallux valgus in old age patients. Materials and Methods: We studied about the clinical & radiologic results of the 31 patients over 55 years old, who had operative treatment of hallux valgus. Clinical evaluation, such as pain, activity limitation, footwear requirement, 1st metatarsophalangeal joint motion, and callosity, was done using AOFAS scale and preoperative and postoperative radiologic parameters, such as hallux valgus angle, intermetatarsal angle, tibial sesamoid position, 1st metatarsal shortening, were evaluated by conventional methods. Results: Objectively, according to AOFAS, the score improved from average of 57.8 to 71.5 postoperatively. The range of motion of first metatarsophalangeal joint was decreased from average of 60.7 to 56.8 degrees. Radiologically, the hallux valgus angle improved from average of 35 to 6.5 degrees and the first intermetatarsal angle improved from average of 14.2 to 4.4 degrees. The position of sesamoid was collected from an average of grade 3.6 to grade 2.2. Conclusion: The combination of proximal metatarsal osteotomy, distal soft tissue procedure and Akin osteotomy may yield rather satisfactory clinacal result in severe elderly hallux valgus patients with massive degenerative change and poor soft tissue condition.

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Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma: is it different between Over and Under 50 Years of Age?

  • Monabati, Ahmad;Vahedi, Amir;Safaei, Akbar;Noori, Sadat;Mokhtari, Maral;Vahedi, Leila;Zamani, Mehdi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2285-2289
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    • 2016
  • Background: Epstein-Barr virus (EBV) positive diffuse large B-cell lymphoma (DLBCL) of the elderly is an entity introduced in the latest WHO classification of lymphoid tumors and defined in patients older than 50 years without prior lymphoma or immunodeficiency. However, recently it has also been seen in patients under 50. There is thus debate as to whether these are separate entities. Materials and Methods: In this retrospective study, we analyzed de novo DLBCL admitted to our institute over a period of two years. Clinical data included age, sex, nodal and extranodal presentation. The results of an immunohistochemistry (IHC) panel were also reviewed. IHC findings were mainly used to sub-classify DLBCL as germinal center vs. non germinal center types. IHC for identification of LMP-1 (latent membrane protein) and in situ hybridization for detection of EBV-encoded RNA (EBER) was performed. EBV prevalence, clinical data and IHC findings were compared between patients under and over 50 years of age. Results: Out of 95 DLBCL, 11.6% were EBV positive (7.5% and 14.5% in the young and old groups). We did not find any significant differences in IHC subclasses and clinical data between EBV positive DLBCL (EBV+DLBCL) of young and old groups. Conclusions: EBV+DLBCL are not exclusive to patients older than 50 years. With regard to clinical data as well as IHC subclasses, no differences were evident between EBV+DLBCL of young and old groups. Our suggestion is to eliminate any cut off age for EBV+DLBCL.

Two Cases Report of Herpes Zoster Patients Improved by Korean Medicine Treatment alone (대상포진에 대한 한방 단독 치료 치험 2례)

  • Bae, Jae Ryong;Kim, Su Jin;Jang, Sang Chul;Pi, Chien Mei;Roh, Ju Hee
    • Journal of Korean Medical Ki-Gong Academy
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    • v.16 no.1
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    • pp.116-136
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    • 2016
  • Objectives : The purpose of this study is to report a 67-year-old male patient with Herpes zoster(caseI) and a 38-year-old female patient with Herpes zoster(caseII), whose symptoms were relieved after Korean medicine treatment alone. Methods : Both patients took Yeonryeonggobondan and Pyungwee-san daily. Everytime they came to the hospital, they received acupuncture treatment, Hwidam's Su-Gi therapy and External Gigong Therapy. Acupuncture was applied by gall bladder seunggyeok(膽勝格, GB-), spleen jeonggyeok(脾正格, SP+), large intestine seunggyeok(大腸勝格, LI-) of Saam's Acupuncture Method. Hwidam's Su-Gi therapy was applied on neck. External Gigong Therapy was applied on skin lesion area. the patients' symptoms were evaluated with photographs and VAS. Results : The results were as follows: 1. In the case of a 67-year-old male patient, it took 14 days to recover the skin lesions and to reduce the pain after treatment started. And he visited 13 times during that period. 2. In the case of a 38-year-old female patient, it took 23 days to recover the skin lesions to reduce and the pain after treatment started. And she visited 10 times during that period. 3. Intensive treatment early in treating herpes zoster helped to shorten the treatment period. 4. Taking Yeonryeonggobondan and Pyungwee-san and receiving acupuncture treatment(SP+) can help to improve immunity and recover skin lesions in herpes zoster diagnosed with spleen deficiency with dampness encumbrance(脾虛濕困) and blood stasis due to qi stagnation (氣滯血瘀). 5. The combination of acupuncture treatment(GB-) and External Gigong Therapy was effective in controlling pain. 6. External Gigong Therapy is considered to be effective for the recovery of the skin as well as the pain of the herpes zoster. Conclusions : Korean medicine treatment alone has a great effect on the above two patients with herpes zoster. I hope the active research about Korean medicine treatment will be done not only for herpes zoster but also for various intractable pain diseases.

Free Flaps for Old High Tension Electrical Burns Around the Wrist (고압 전기감전시 발생한 수근관절 주위의 진구성 연부조직 결손에 대한 유리 피판술)

  • Kim, Hyoung-Min;Jeong, Chang-Hoon;Lee, Gee-Heng;Koh, Young-Seok
    • Archives of Reconstructive Microsurgery
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    • v.7 no.1
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    • pp.68-72
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    • 1998
  • With the advent of microvascular free-tissue transfer, this single stage resurfacing method for large scar and soft tissue defects around the wrist in the patients of electrical burn has distinctive advantage over the conventional multistage pedicle-flap transfer. Between 1992 and 1996, we treated 9 cases of 8 patients who had large scar around the wrist due to old electrical burn with free flaps as a preparation of staged tendon graft. Mean age was 30.3 years and average scar area was $6{\times}11cm$. The length of time the injury and free flaps was 9 months on an average. Prior to the free flap, we performed the angiography to all patients in order to evaluate the circulation of the forearm and hand and to choose the recipient vessel. In all cases, proximal ulnar arteries in the forearm remained intact and all radial arteries remained intact in 8 of 9 cases on angiogram. The interosseous arteries were well visualized in all cases. We used the ulnar arteries as a recipient artery. The types of flaps used were f scapular cutaneous flaps, 2 dorsalis pedis flaps and a radial forearm flap. Flap survial was 100 percents with satisfactory functional and cosmetic results. Free flaps using ulnar artery as a recipient artery is one of the useful reconstruction methods for the resurfacing of large scar around the wrist in the patients of old electrical burn.

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The Study of Satisfaction of Voice Therapy in Patients with Voice Disorders (음성장애환자의 음성치료 후 만족도 연구)

  • Ahn, Cheol Min;Shin, Ik Seo;Shin, Jeong Eun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.35-39
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    • 2016
  • Background and Objectives : Voice therapy is proven to be effective, but patients are reluctant to receive the therapy when physicians recommend it. This phenomenon may due to patients'lack of trust in or low satisfaction level of the therapy. This study aimed to evaluate patients'satisfaction level after voice therapy and identify factors that could increase the satisfaction. Materials and Methods : First, the fraction of patients who were recommended voice therapy ahead and completed it was studied, and survey was conducted on those who finished ten voice therapy sessions. The patients'1) satisfaction level during the therapy, 2) satisfaction level about physician's explanation about the therapy, 3) willingness to recommend, 4) satisfaction level about the results were assessed, and was correlated with overall satisfaction level. In each category, patients' gender-, age-, and disease type-related differences were analyzed. Results : Patients under 19 years old were most satisfied during the voice therapy; patients above 40 years old showed statistically significantly higher satisfaction level regarding satisfaction with physician explanation about treatments and with treatment results compared to other ages groups. Patients above 40 also showed the highest willingness to recommend. 26.5% of patients either refused to or discontinued voice therapy. 84.3% were satisfied with treatment results. Considering variabilities among factors, patients'satisfaction with physician explanation about treatment and willingness to recommend had positive correlation. Conclusion : Though 26.3% of patients received voice therapy when physicians recommended, patients who completed the therapy were overall satisfied.

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The Gait Analysis of Hemiplegic Patients After Stroke I. Spatio-Temporal Parameters, Pelvic Anterior Tilting and Ground Reaction-Vertical Force (뇌졸중으로 인한 편마비환자의 보행분석 I. 시간-거리변수, 골반경사각 및 지면반발력 -수직력 중심)

  • Kwon Young-Sil;Kim Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.10 no.1
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    • pp.127-138
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    • 1998
  • This study was carried out tn invstigate and compare biomechanical characteristics during free speed gait in hemiplegic patients after stroke who took therapeutic exercise by analyzing kinematic and kinetic data in the sagital plane and electromyographic data. Six patients($41\~69$ years old) and age-matched six volunteers in good health(51-61 years old) wire studied. The patients were sorted into two groups, depending on their self-speed of walking : fast speed group(3 patients) and slow speed group(3 patients). The results were as fellows. : 1. In spatio-temparal parameters, affected and unaffected side of fast group showed symetry but blew group showed asymetry of single limb support, opposite foot contact and stance phase (p<0.05). Compared with normal group, patient group showed slower velocity, shoter stride length and longer double limb support (p<0.05). 2. In the pelvic anterior tilt, patient group showed lower valued than normal group. It. In the ground reaction force-vertical force, fast group showed similar double peak gragh compared with normal group, butvslow group showed lower values without double peak (p<0.05).

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Surgical correction of congenital heart defects in adult (성인 선천성 심장기형의 외과적 치료)

  • 신현종
    • Journal of Chest Surgery
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    • v.22 no.1
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    • pp.95-105
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    • 1989
  • The records of 248 patients over 16 years of age who had undergone a surgical correction of a congenital cardiovascular malformation during the period of 10 years from August, 1978 to July, 1988 were reviewed. During this period, the incidence of congenital cardiovascular malformation in adult was 18.2% of 1376 total heart disease operated on and 25.5% of 986 congenital heart defects. Among them, there were 200 patients in acyanotic group and 48 patients in cyanotic group. Male versus female ratio was 1:1.28. The oldest patient was 59 years old female who had atrial septal defect. The mean age was 24.4 years old. The distribution of the lesions showed a large preponderance of atrial septal defects [37.19o] followed in frequency by ventricular septal defects [918.1%], patent ductus arteriosus [17.3%], tetralogy of Fallot [16.1%], and a variety of other complex malformations[3.2%]. In the pediatric age group, relative frequency was different from that of this adult group, showing ventricular septal defects, tetralogy of Fallot, patent ductus arteriosus and atrial septal defects in order of incidence. The hospital mortality and late mortality were 6.0% and 1.7% respectively. The causes of hospital death were low cardiac output in 10 patients, arrhythmia in 2, air embolism in 1, sepsis in 1 and respiratory failure in l. Clinical improvement upto NYHA functional class I or II postoperatively has been achieved and sustained in all patients following repair except the patients of late death and receiving reoperation. This result confirms that congenital heart defects in the adults can be corrected with a good outcome and an aggressive operative approach seems justified.

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Considerations in dental management and medication for the medically compromised patients (임상가를 위한 특집 2 - 전신질환을 가진 환자의 치과처치 및 약물처방시 주의할점)

  • Nam, Jeong-Hun
    • The Journal of the Korean dental association
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    • v.48 no.1
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    • pp.27-37
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    • 2010
  • Current trend of aging society suggests that many patients are at risk for various preoperative preparations and postoperative complications during and following invasive dental procedures, due to an acquired medically compromised conditions from systemic disease and/or from medications. The medical history is critical for the identification of patients potentially at risk for medically compromised and old aged patients' factors from dental treatment. The proper dental management requires an understanding of certain principles of pathophysiology for these medical conditions and some standard laboratory tests. Polypharmacy in old age, besides representing a risk in and of itself, points to the potential risk the underlying diseases that necessitated the drugs can present in the dental office. These diseases and medications can also present a risk to oral health. A sequence for categorizing drugs in a medication list is presented here to aid in the identification of potential risks in the dental treatment and management of patients with complex medical histories and drug regimens. Specific patient populations, such as pediatric, may have specific drugs or additional criteria that need to be considered. Practitioners must use the health history and the medication list in concert, using one to make sense of the other and utilizing all the information available from reviewing each one carefully in order to manage their increasingly complex patients safely and effectively.