• Journal of Preventive Medicine and Public Health
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• 제53권6호
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• pp.447-454
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• 2020

Objectives: The aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses. Methods: In the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance. Results: A total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance. Conclusions: Close correlations were found among occupational safety climate, patient safety climate, and nurses' safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses' safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.106-112
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• 2016

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.

• 대한장애인치과학회지
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• 제5권1호
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• pp.18-22
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• 2009

A 26-year-old female patient with Down syndrome visited to recieve dental treatment under gnenral anesthesia 6 years ago. The patient had difficulties in oral examination, radiograph taking and laboratory test. The patient had congenital heart disease and medical consultation based on the echocardiography was provided by a cardiologist indicating that the patient could tolearte general anesthesia during dental treatment. And two times of general anesthesia were administered during a dental treament with the interval of 3 years and no postoperpative complicaton was reported. At the third dental operation, the patient had a relatively good condition and her prescreening test revealed no abnormalities. Without further consultation with a cardiologist, general anesthesia was administered to the patient. Anaesthesia was based on thiopental and ventilation of desflurane and $N_2O$ in oxygen via an endotracheal tube with an appropriate monitoring. During the maintenance of anesthesia, the blood pressure of the patient started to drop and the oxygen saturation also began to decrease. Consequently, the proceding operation was discontinued and also inhalation anesthesia was ceased. As the patient was recovered from anesthesia, her systemic conditions were alleviated. After the complete recovery of the patient, she visited the cardiologist, and the cardiologic test revealed her severe right ventricular dilatation. In the anesthesia of patients with congenital heart disease, information on their systemic conditions needs to be undated from the medical consultation, which assures the safety of treatment.

• 치과방사선
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• 제29권2호
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• pp.507-521
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• 1999

Osteopetrosis is an uncommon hereditary bone disorder whose prominent radiologic feature characterized by increased bone density. The authors reported a 7-year-old male patient who referred from local dental clinic for dental problems such as early exfoliation of deciduous teeth(#54,73,83) and delayed eruption of permanent teeth(#31.41.36.46). The patient appeared as a poorly developed. Dental X-ray films showed early exfoliation of deciduous teeth, delayed eruption of permanent teeth, and rampant caries. Lateral view of skull demonstrated increased opacity of calvarium, facial bones, and skull base. Generally the skeletal density is greatly increased throughout all bones. Facial CT showed poor development of paranasal sinuses and mastoid air cells. No hematopoietic and neurologic complications such as anemia, thrombocytopenia, blindness and deafness were found. Also mental retardation was not found. The final diagnosis of this case was a osteopetrosis tarda. Sometimes patient with osteopetrosis tarda may be developed dental problems prior to severe systemic symptoms. The dentist can be the first clinician to see the patient. It is very important for the dentist to have the knowledge of the osteopetrosis and to care the patient's dental problems to prevent complication such as osteomyelitis of jaws.

• 대한치과보철학회지
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• 제31권1호
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• pp.151-162
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• 1993

The author installed $3.75mm\times10mm$ $Br{\aa}nrmark$ osseointegrated implants and $3.5mm\times8mm$ I.T.I. hollow screw implants(Benefit) as a free standing abutment to replace lower left and right molars of 44-year-old female patient. Form the foregoing procedure, the author obtained the following results. 1. Free-standing $Br{\aa}nrmark$ and I.T.I. Hollow screw implants(Benefit) could be used to replace molars effectively without reduction of adjacent natural teeth, 2. Rotation of occlusal gold screw of $Br{\aa}nrmark$ implants was observed under occlusal force. 3. Adjustment of height of I.T.I. abutments was necessary in the mandibular second molar because of the limited occlusal clearance. 4. Form the oral examination, patient comments, panoramic and periapical radiographs, there were no pain, gingival imflammation and mobility, but slight reduction of alveolar bone level was shown around both implant systems. 5. Patient comments were comfortable on both systems. but the patient complained about economic problem of $Br{\aa}nrmark$ system and long treatment treatment time of both systems.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권4호
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• pp.317-320
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• 2016

A 47-year-old woman was referred for surgical treatment of osteomyelitis of the mandible. She had already undergone three previous surgeries. Pre-anesthetic airway evaluation predicted a difficult airway, due to the thin, retro-positioned mandible, tongue, and atrophic changes in the lips and soft tissue. We inserted packing gauzes in the buccal mucosa for easier mask fitting and ventilation. During direct laryngoscopic intubation with a nasotracheal tube (NTT), fracture of a thin mandible can easily occur. Therefore, we used a fiberoptic bronchoscope to insert the NTT. After surgery, we performed a tongue-tie to protect against airway obstruction caused by the backward movement of the tongue during recovery. The patient recovered without any complications. We determined the status of the patient precisely and consequently performed thorough preparations for the surgery, allowing the patient to be anesthetized safely and recover after surgery. Careful assessment of the patient and airway prior to surgery is necessary.

• 대한한방내과학회지
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• 제39권4호
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• pp.846-852
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• 2018

Objective: The aim of this report is to report the effects of Danggwisaeyeok-tang (當歸四逆湯) on Raynaud phenomenon in a patient. Methods: A 57-year-old male diagnosed in 2016 with Raynaud's phenomenon complained of pain, digital ulceration, and discoloration of his fingers. He underwent acupuncture and electroacupuncture treatment, but the symptoms gradually worsened, so we administered herbal medicine, Danggwisaeyeok-tang (當歸四逆湯). Visual observation of the affected part, changes in subjective symptoms, and a verbal numerical rating scale (VNAS) were used to assess the clinical response. Results: After treatment with Danggwisaeyeok-tang, the patient reported improvement in his symptoms of cold sensation, ulceration, and sclerosis of his digits. Furthermore, the patient exhibited no general adverse effects. Conclusions: Danggwisaeyeok-tang (當歸四逆湯) significantly improved the patient's clinical symptoms. This case suggests that Danggwisaeyeok-tang (當歸四逆湯) may represent a good option for the treatment of Raynaud's phenomenon.

• The Korean Journal of Pain
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• 제5권2호
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• pp.269-272
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• 1992

대상포진후 신경통은 통증 치료실에서 흔히 만나는 질환이지만 가장 치료하기 힘든 질환 중의 하나이다. 따라서 통증 치료를 담당하는 의사는 자기가 알고 모든 지식을 동원하여 환자를 치료하지만, 그 결과는 대개 만족스럽지 못하고, 또 뜻하지 않은 합병증을 당하여 당황하는 수도 있었다. 저자들은 폐 결핵등의 과거력을 가진 대상포진후 신경통 환자의 치료 도중에 반복적인 늑간신경 차단이 기여했으라라고 생각되는 흉막삼출액 발생을 경험하였기에 보고하는 바이다.

• The Korean Journal of Pain
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• 제10권1호
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• pp.117-120
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• 1997

Cancer is a devastating disease, and the treatment of related pain is an extremely challenging task. Providing adequate analgesia while avoiding unnecessary drug effects often requires a polypharmacologic approach in cancer pain management. A 36-year old woman with breast cancer metastatic to the axial skeleton and bilateral hip joints was admitted to hemato-oncology service with complaints of intractable abdominal and hip pain. Despite rapidly increasing doses of intravenous morphine up to 350 mg per day; transdermal fentanyl; midazolam; ketorolac; lorazepam; dexamethasone, the patient continued to describe her pain as 10 of 10, refusing all surgical/diagnostic interventions not directly related to pain control. She did, however, consent to lumbar epidural catheter placement. The patient was sedated with titrating doses of propofol to assist with positioning. Even though the procedure was not successful due to significant thoracolumbar scoliosis, the patient admitted feeling better than she has in months during attempted placement. After continuous infusion of propofol was initiated at subhypnotic dose, the patient's analgesic demand was drastically reduced and described her pain as "1 to 3" of "10". Approximately 96 hours after the propofol infusion was started, the patient expired comfortably. There had been no change in her medical regimen during fecal 48 hours. In the case described, propofol was extremely advantageous as an adjuvant in the management of cancer related pain.

• 대한한의학회지
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• 제40권4호
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• pp.91-100
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• 2019

Objectives: The present study reports case of an advanced gastric cancer patient who did not receive resection and was treated with Korean Medicine (KM) monotherapy. Methods: A 59-year-old female patient diagnosed with advanced gastric cancer visited the Dunsan Korean medicine Hospital of Daejeon University on April 15, 2018 for the Korean medicine treatment. The patient was treated with KM for approximately 1 year, from May, 2018 to May, 2019. Computed tomography (CT) was used to follow-up of the tumor site. Laboratory analysis and National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), version 5.0 were used to evaluate the safety of our treatment. Results: The patient's quality of life (QOL) and related symptoms improved during the treatment. Conclusion: This study suggests that KM may help to improve QOL of advanced gastric cancer patients. This is a valuable report that shows the natural history of Korean gastric cancer invasion to deeper layers over time.