• Title/Summary/Keyword: Old patient

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A Case Report of Post-stroke Depression Patient Using Bunsimgi-eum(Fenxingiyin) (분심기음으로 호전된 뇌경색 후 우울증환자 치험 1례)

  • Ryu, Ho-Sun;Ahn, Hyo-Jin;Park, Se-Jin
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.86-94
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    • 2012
  • Object : The purpose of this case report is to show an efficacy of Bunsimgi-eum(Fenxingiyin) for patient with Post-stroke Depression. Methods : This Patient was 64 year-old man who was diagnosed with Stroke by Brain MRI. And after the stroke, the patient showed some Post-stroke depression(PSD) behaviors, like mutism, waxy flexibility and have no willness of rehabilitation. He was treated by Herbal medicines, acupunctore and moxibustion therapy. 40 days after hospitalization, Bunsimgi-eum was prescribed to the patient. Results : After Bunsimgi-eum Herbal treatment, the symtoms of Post-stroke depression have improved remarkably. The grade of Rt. side hemiparesis and time of rehabilitation treat were also increased. Conclusions : This study suggests that Bunsimgi-eum could have a positive efficacy for Post-stroke depression. As a result, it makes the patient to take more rehabilitation treatment.

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Use of Single Bedrooms versus Multiple Bedrooms: Selection Factors and Comparison of Patient Satisfaction (1인실과 다인실 입원 병상 이용에 관한 병상 선택 요인과 환자 만족도 분석)

  • Lee, Geun-Chan
    • Korea Journal of Hospital Management
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    • v.26 no.3
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    • pp.68-83
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    • 2021
  • Background: It is widely acknowledged that single bedrooms have many potential advantages compared to multiple bedrooms. However, Korea has a reimbursement system that patients have to pay the additional fee if they will use single bedroom or pay-bed (1-3 bedroom). There is little research on patients' bed selection and relationship between patient satisfaction and bed type in the Korean setting. Methods: Using the 2017 Korea Health Panel (KHP) Survey data, we modified bed type by two dichotomous variables: single bedroom vs. multiple bedroom (2+ bedrooms) and pay-bed (1-3 bedroom) vs. reimbursed bed (4+ bedroom). Multivariate logistic regression is performed to determine the factors affecting the patient's choice of room types. Multivariate regression analysis was conducted to examine how hospital room types are affecting patient satisfaction. Results: Single room and pay-bed (1-3 bedroom) use was influenced by patient age (19- years old), male, a person at work, hospitalizing in a clinic, and birth. After controlling variables of the behavioral model of medical utilization, the association between patient satisfaction and use of single bedroom & pay-bed (1-3 bedroom). Cause of hospitalization, major treatment, and recognition of unnecessary care are statistically significant variables on patient satisfaction. Conclusion: Although the single room is about the standard for newly built hospitals in western countries, it remains unclear that single room or pay-bed (1-3 bedroom) has positive effects on patient's outcomes and satisfaction. In this empirical study, the difference in patient satisfaction by bedroom type was not noticeable. In terms of bed management by hospital staff, securing patient credibility in hospital care is an important task. Patients' perception of whether medical staffs have encouraged unnecessary treatment or tests has a significant impact on patient's satisfaction.

Heart-Lung Transplantation in a Patient with VSD, PDA and Eisenmenger′s Syndrome (심실 중격 결손과 동맥관 개존증을 동반한 아이젠멩거 증후군 환자에서의 심장-폐이식 수술 -1예 보고-)

  • 홍유선;김도형;함석진;이교준;이두연;권혁문;김형중;조상호;백효채
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.418-421
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    • 2003
  • Heart-lung transplantation is a widely accepted treatment for Eisenmenger'syndrome. The patient is a 41-years-old male diagnosed with Eisenmenger'syndrome due to patent ductus arteriosus. The pressures were checked as follows: aorta 130/80 mean 100 mmHg, pulmonary artery 130/80 mean 109 mmHg, and right ventricle 130/20 mmHg, right atrium mean 20 mmHg. The patient needed heart-lung transplantation due to enlarged right pulmonary artery (diameter 7.5 cm). The donor was a 24 years-old male diagnosed as brain death due to subdural hematoma. Ligation of patent ductus arteriosus was performed under the cardiopulmonary bypass followed by heart-lung transplantation. Patient was extubated on postoperative day one, transferred to the general ward on day 3, and was discharged on postoperative day 33. Cardiac and lung biopsy was performed on postoperative day 41 with no signs of rejection.

Schwannoma in the maxillary sinus and buccal space: Case report (협간극과 상악동에서 발생한 신경초종 : 증례보고)

  • Choi, Byung-Hwan;Park, Soo-Won;Son, Jang-Ho;Cho, Yeong-Cheol;Sung, Iel-Yong;Byun, Ki-Jung;Kim, Young-Min
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.6
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    • pp.494-498
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    • 2009
  • Schwannomas are tumors which originate from the neuroectodermal Schwann cell of cranial, intraspinal, peripheral and autonomic nerve sheaths, and they are solitary, benign, slow growing and well encapsulated neoplasm. Schwannomas are usually asymptomatic. No strong gender or age predominance exists. The incidence of extracranial schwannomas in the head and the neck region varies from 25~45%. In addition, schwannomas are rare in the maxillary sinus or buccal space. In this paper, it diagnosed and treated a 54-years old female patient, who had schwannoma in the maxillary sinus derived from infraorbital nerves, the branch of the left trigeminal nerve, and a 19-years old male patient, who had schwannoma arose in the buccal space derived from the buccal branch of the right facial nerve. There was no particular complication except sensory extinction of the nerve in the female patient and paralysis by the nerve in the male patient. It is determined those two cases of schwannoma in the rare portion is valuable and herein, it reports those with literature discussions.

Two Attenuated Cases of Methicillin-Resistant Staphylococcus aureus Infection Treated by Oriental Internal Medicine (한방처치를 통한 Methicillin내성 포도구균 감염의 음성화 및 약독화 2례)

  • Ko, Chang-Nam;Yun, Sung-Woo;Park, Sung-Wook;Lee, Hyung-Chel;Lee, Sang-Wook
    • The Journal of Internal Korean Medicine
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    • v.23 no.2
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    • pp.298-305
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    • 2002
  • These cases were performed on the bases of clinical consideration about patients who had Methicillin-Resistant Staphylococcus aureus(MRSA) infection. One patient was a 67-years-old women who had sequela of inter cranial hemorrhage & inter ventricular hemorrhage, hypertention, urinary tract infection and pneumonia. Clinical symptoms were intermittent fever, sputum, Lt. side hemiparesis and dysphagia. She was chronic, repeated infection state. It could be regarded as "unpreparedness of the spirit which animates and controls the universe; 正氣虛", the oriental term which indicates a condition of chronic disease or general weakness. According to the oriental medicine principle, oriental medicine was taken such as Wunggunza-tang(六君子湯) and the patient had taken a turn for the better. After 3 months, MRSA infection diappeared. The other patient was a 43-years-old women who had Both brain stem infarction, Lt. cerebellar infarction, hypercholesterolemia, urinary tract infection and pneumonia, Clinical symptoms were quadriplegia, dysphagia(levin tube insert state), aphasia, respiration disorder(tracheostomy cannular keep state) and sputum. She was chronic, repeated infection state. It could be regarded as "unpreparedness of spleen energy, unpreparedness of both energy and blood; 脾氣虛, 氣血兩虛", the oriental term which indicates a condition of chronic disease or immunodeficiency. According to the oriental medicine principle, oriental medicine was taken such as Bojungyggi-tang(補中益氣湯), Palmul-tang(八物湯) and the patient had taken a turn for the better. After I month, MRSA was turned into Escherichia coli.

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The Utilization of Western and Oriental Medical Services by Outpatients with Musculoskeletal System Disorders and Its Related Factors (근골격계질환자의 양.한방 외래 의료이용과 관련요인)

  • Kim, Sung-Young;Park, Jae-Young
    • The Korean Journal of Health Service Management
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    • v.6 no.1
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    • pp.27-38
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    • 2012
  • This study is to find out the correlation among the predisposing, enabling, and need factors in Anderson Behavioral Model using the data from Korea Medical Panel Survey conducted in the early part (April 1 - October 31) of 2008. The findings are as follows. It was found that the utilization rate of western medical service was far higher. the influential factor to choose western or oriental medical service taking western medical institutions as the reference group, the influential factor to choose oriental medical institution has significantly increased when the patient who have covered by medical insurance has one accompanied disease and their age was between 45 - 74, compared to the people less than 45 years old. It also increased when the age of the patient was between 45-54 years old, and in the event those who are not covered by medical insurance have accompanied disease and that the disease mobility period is 2-4 years. reviewing the several characteristics of the utilization of western and oriental medical services by the patient with musculoskeletal system disorders, the number of accompanied disease is an influential factor for the utilization of oriental medical services. And, disease mobility period is a significant factor for the utilization of both western and oriental medical services together, though it is not identified in this study. Therefore, it is expected that mutual cooperation between western and oriental medical services is more required for the patient with musculoskeletal system disorders as the aging society rapidly develops. In order to foster oriental medicine, it is required to specialize in competitive disease such as musculoskeletal system disorders.

A Case of the Localized Tension Pneumothorax Mimicking Giant Bullae (거대 폐기포 (giant bulla)로 오진된 국소형 긴장성 자발 기흉)

  • Ko, Hyuk;Park, Sung-Ho;Kim, Su-Hee;Park, Wan;Park, Chong-Bin;Kim, Jong-Wook;Ryu, Dae-Sik;Jung, Bock-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.740-746
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    • 2001
  • Background : A 35-year-old woman was admitted to the emergency room with sudden dyspnea that developed one day prior. The initial Chest X-ray showed multiple bullous changes at the right middle and lower lung field and long standing fibrotic tuberculous changes at the right upper lung field. The left lung field was totally collapsed by an fibrotic old tuberculous lesion. In spite of supportive medical care with oxygen therapy after admission, the radiographic lesions were no significant change but the respiratory distress had worsened. The patient suffered respiratory failure and received mechanical ventilatory support. The HRCT showed a localized tension pneumothorax mimicking multiple giant bullae at the right lower lung field. Immediately after a closed thoracostomy with a 32 French chest tube and air drainage, her vital signs and dyspnea were gradually improved. The patient was successfully weaned from mechanical ventilation after 5 days of mechanical ventilatory support. The patient had received talc pleurodesis through a chest tube to prevent the recurrence of the life-threatening localized pneumothorax. The patient was discharged without recurrence of the pneumothorax.

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Forehead reconstruction with a custom-made three-dimensional titanium implant in a Parry-Romberg syndrome patient

  • Kim, Jae Yoon;Jung, Bok Ki;Kim, Young Suk;Roh, Tai Suk;Yun, In Sik
    • Archives of Craniofacial Surgery
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    • v.19 no.2
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    • pp.135-138
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    • 2018
  • Parry-Romberg syndrome is a rare neurocutaneous syndrome characterized by progressive shrinkage and degeneration of the tissues usually on only one side of the face. It is usually difficult to restore the facial contour due to skin tightness. In this case report, we report a forehead reconstruction with custom-made three-dimensional (3D) titanium implant of a Parry-Romberg syndrome patient who was treated with multiple fat grafts but had limited effect. A 36-year-old man presented with hemifacial atrophy. The disease progressed from 5 to 16 years old. The patient had alopecia on frontal scalp and received a surgery using tissue expander. The alopecia lesion was covered by expanded scalp flap done 22 years ago. Also, he was treated with fat grafts on depressed forehead 17 years ago. However, it did not work sufficiently, and there was noted depressed forehead. We planned to make 3D titanium implant to cover the depressed area (from the superior orbital rim to the vertex). During the operation, we confirmed that the custom-made 3D implant accurately fit for the depressed area without any dead spaces. Previously depressed forehead and glabella were elevated, and the forehead contour was improved cosmetically. A custom-made 3D titanium implant is widely used for skull reconstruction and bring good results. In our case, the depressed forehead of a Parry-Romberg syndrome patient was improved by a 3D titanium implant.

Reconstruction of Disharmonious Upper Anterior Dentition by Implant Supported Fixed Prosthesis (임플란트 지지 고정성 보철물로 상악 전치부를 수복한 증례)

  • Oh, Sang-Chun;Chee, Young-Deok
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.183-192
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    • 2008
  • Modern dental reconstructions do not only aim at restoring the patient's mastication, but rather at improving general well-being and quality of life, especially in terms of esthetics. The media, the internet, advertising, and many other facts of society contribute to an increased cosmetic awareness. A 35-year-old male patient presented with as follows: 1) the porcelain fracture of ceramo-metal restoration on #11 and #23, 2) the inclination of incisal plane to horizontal reference plane, 3) the dental midline deviation to facial midline, and 4) the lack of symmetry on upper anterior dentition. The patient requested an aesthetic improvement using fixed prosthodontics including implant-supported restorations. In the upper anterior region, one of the goals of the conventional as well as implant prosthesis is to achieve restorations with the dental attractiveness and beauty in the respect of dental, dentofacial, and facial compositions. This case report presents geometrically improvement of dental esthetics using conventional and implant prosthesis with soft and hard tissue augmentation.

Complete denture rehabilitation of fully edentulous patient with severe bone resorption and class II jaw relation using piezography (심한 골 흡수와 2급 악간관계를 보이는 완전 무치악 환자의 Piezography를 이용한 총의치 수복)

  • Kwon, Wooil;Song, Young-Gyun;Lee, Joon-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.445-450
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    • 2016
  • Piezography, prosthetic space recorded by pronunciation, can be used as a reference for arrangement of artificial teeth and polishing surface of a denture. In this case, a 67 year old female patient was presented for new dentures. Old dentures had class II relationship and poor retention. For fabrication of stable dentures, using piezography and lingualized occlusion was planned. After taking impressions with conventional method, conventional denture bases with wax rim were fabricated. Then, additional mandibular denture base was fabricated for piezography. With fast setting silicon impression material, piezography was recorded by using six pronunciations, 'si', 'so', 'me', 'te', 'de', and 'mu'. According to the piezographic space, mandibular artificial teeth were arranged and modified for lingualized occlusion. As a result, the patient was satisfied with new dentures functionally and esthetically.