• 제목/요약/키워드: Out-patient Department

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환자호소에 대한 해결시간 단축을 위한 기초조사연구 (An analysis of in-patient complaints and subsequent intervention)

  • 김용순;박지원;박연옥
    • 한국의료질향상학회지
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    • 제4권1호
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    • pp.64-80
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    • 1997
  • Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "Kindness Movement" developing now, where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology, to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Results : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were voiced primarily by either of the patient's family, or by the patients themselves(78.4). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4, The method by which the complaints were resolved included the utilization of prescriptions(55.7%), further explanation and education(25. 5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift(42.6%, 7:00-15:00), followed by the evening shift(36.0% 15:00~22:00), and then the nightshift(21.3 %, 22:00-07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9min, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticipate problems and shorten reaction time, in order to provide for a more satisfied patient.

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자궁 경부암의 수술후 방사선 치료에서 선량 분포에 관한 연구 (A Study of Dose Distribution in Postoperative Radiotherapy in Uterine Cervical Cancer)

  • 신세원;김성규;김명세
    • Journal of Yeungnam Medical Science
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    • 제8권1호
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    • pp.166-177
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    • 1991
  • 1986년 4월부터 1991년 3월까지 영남대학교 의과대학 부속병원에서 자궁 경부암으로 확진되어 수술후 방사선치료를 시행한 22명의 환자에서 방사선 선량 분포에 따른 치료성적은 다음과 같다. 1. 22명중 3명(13.6%)에서 골반이나 복부에 재발이 생겼으며 임상적 병기가 진행될수록, 외부조사선량이 적을수록 재발이 많았다. 2. 골반내 임파선 전이와 임파혈관 침범인 경우에 재발이 되었다. 3. 강내조사 선량이나 수술방법은 재발과 무관하였다. 4. 중대한 합병중은 임상적 병기가 앞설수록 외부조사 선량이나, 총조사 선량이 증가할수록 많이 발생하였다. 이상의 결과를 보면 본원 치료방사선과의 자궁 경부암의 수술후 방사선 치료원칙은 적절하며 재발방지와 합병증의 예방을 위한 세심한 주의와 항암제를 위시한 전신요법의 추가를 고려하여야 하겠다.

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한국 침구 치료 현황 파악을 위한 설문조사 (A Survey of Actual State of Treatment with Acupuncture and Moxibustion in Korea)

  • 한창현;신선화;안상우;최선미
    • Journal of Acupuncture Research
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    • 제22권6호
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    • pp.141-153
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    • 2005
  • Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture treatment in real clinics. Methods : The survey questions were developed by the consensus from the professors who major in acupuncture and moxibustion. The questionnaire was given the 2731 Korean medical doctors at the mending education site; In addition, it was given to 793 doctors working at the 105 Korean medical hospitals listed on the National Korean Medical Hospital Associations Address book by postal mail; and also it was given to the 142 public health care Korean medical doctors who attended the conference for the municipal and provincial representatives of the public health service Korean medical doctors. Total of 1277 questionnaires were retrieved out of the 3666 subjects. Results : 1. Nine hundred out of 1277 Korean medical doctors used method of differentiation syndromes(70.4%) and 1184 out of 1277 Korean medical doctors convalescence decide with subjective symptom improvement of patient(92.6%). 2. Nine hundred eight out of 1277 Korean medical doctors used both local and remote points(71.0%) and 916 out of 1277 Korean medical doctors treat with method of reinforcement-reduction(71.7%). 3. Eleven hundred fifth five out of 1277 Korean medical doctors used cupping a boil(90.3%) and 1023 out of 1277 Korean medical doctors used moxibustion(80.1%). Conclusion : When Korean medical doctors treat with acupuncture, most of them diagnose with differentiation methods and meridian theory, decide convalescence with subjective symptom improvement of patient, select out of both local and remote acupuncture points, treat with method of basic reinforcement-reduction, apply moxa and cupping a boil when they are necessary. The cupping a boil comes to be used when being muscle and joint disease. The moxa comes to be used when being chronic disease.

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기능적 전기자극 치료가 편마비 환자의 균형에 미치는 영향 (Effects of Functional Electrical Stimulation on the Balance of Hemiplegic Patients)

  • 김용철;이석민;송창호
    • The Journal of Korean Physical Therapy
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    • 제16권3호
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    • pp.97-111
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    • 2004
  • This study, adopting the pretest-post test experimental study, is designed to find out how the functional electrical stimulation makes effect on the balance of a patient with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke. The 46 subjects for this study were randomly sampled out of the patients who were hospitalized from September 1, 2003 to November 30, 2003 in H sanitarium in Yangpyung. The patients were with spasticity of the ankle plantarflexor muscle caused by hemiplegic after stroke and able to walk without supporting implements. The purpose of the study is firstly to analyze the change of ROM, FRTof a patient with spasticity of the ankle plantarflexor muscle when the functional electrical stimulation is applied and secondly to find out how the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient make effect on the change. The experimental group for the study is divided into two to compare the differences of the effect. The exercising treatment only was performed for the conrtol group, and the functional electrical stimulation to the ankle dorsiflexor muscle as well as the exercising treatment was applied to the experimental group. The ROM test was performed to check the range of motion of the ankle with a double armed universal goniometer. The test was done 3 times to take an average. FRT were performed to check the balance. The statistical test was conducted using the SPSS 10.0/PC program by means of the following methods: χ2-test and t-test for testing homogeneity between the groups; paired t-test, independent sample t-test, F-test, and two-way ANOVA for analyzing the changes before and after the treatment. The levels of statistical significance of all the data were maintained at p<.05. According to the test, ROM has more decreased in experimental group than in control group when the functional electrical stimulation was applied only to the experimental group. However, the significant statistic difference was not shown (p=.059). FRT showed remarkable differences in the experimental group compared to the control group, showing the significant statistic difference (p=.000). On the one hand, the change of ROM, FRT related with the sex, age, height, weight, part of the diagnosis, and experience relapse was a meaningless minimum value. The change of ROM related to the duration of pain and the experience of falling down was also meaningless. However, FRT showed significant statistic difference (p<.05). According to the test above, the application of functional electrical stimulation to a patient with spasticity of the ankle dorsiflexor muscle caused by hemiplegic after stroke makes significant effect on the balance of a patient, but the result has nothing with the sex, age, height, weight, part of the diagnosis, duration of pain, experience of relapse and getting hurt from a fall of a patient. However, it is regarded to give contribution to the balance improvement of a patient. Therefore, this study expects to be a valuable clinical material for a patient with spasticity.

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휴대용 무선 응급 단말기 및 통합 시스템 개발 (Development of Portable Wireless Emergency Units and Integrated System)

  • 송미혜;명현석;이경중
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2006년도 제37회 하계학술대회 논문집 D
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    • pp.2161-2162
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    • 2006
  • In this study, we developed five mobile units and an integrated system which can manage vital signs from each unit using Bluetooth wireless communication. The five kinds of mobile unit were so designed that each has different function to be applied according to the condition of patient properly. The mobile units can measure ECG signal of single or 12 channel, blood pressure, pulse and SpO2 signal from a patient. Also, to reduce the uncomfortable measurement, several types of units such as belt type, wrist type and necklace type were designed. Our proposed system can integrate and monitor several biological signals from different patient by using Bluetooth wireless communication simultaneously. The developed system was evaluated in the simulated emergent situation and showed the system can monitor 5 patients in maximum according to the data quality. It showed the possibilities that the developed system can be used effectively for emergency situation or in- or out-hospital transport of patient. In future, with the combination of mobile communication technique, a patient who is in emergency situation can be provided with proper first-aid and a doctor can pile information of patient and give better diagnosis and treatments.

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요관결석 쇄석술 후 심한 혈뇨 소견을 보인 환자 임상증례 (A Clinical Case Report of Severe Hematuria Patient after Ureterolith Lithotripsy)

  • 이상현;정주용;조명래
    • Korean Journal of Acupuncture
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    • 제32권3호
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    • pp.144-150
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    • 2015
  • Objectives : The purpose of this study is to report the improvement after the Korean medical treatment about a severe hematuria patient after ureterolith lithotripsy. Methods : This study was carried out on 60 year-old female patient who suffered from severe hematuria. We diagnosed a severe hematuria patient after ureterolith lithotripsy as kidney deficiency and blood deficiency pattern in the symptom-differentiation system of Korean medicine and applied herbal medicine, acupuncture and moxibustion to the patient. Results : After Korean medical treatment, we observed improvement of the symptom process by Numeric Rating Scale (NRS), hematologic findings and urinalysis. Blood count of blood and urine had been in the normal range, and NRS of three symptoms had dropped below 0.5. Conclusions : We concluded that Korean medical treatment was an effective treatment for a hematuria patient after ureterolith lithotripsy.

이하선의 기저세포선암 (Basal Cell Adenocarcinoma of the Parotid Gland)

  • 이준호;정웅윤;박정수
    • 대한두경부종양학회지
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    • 제13권1호
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    • pp.81-85
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    • 1997
  • Basal cell adenocarcinoma is a rare, recently described neoplasm of the salivary gland. We have experienced three cases of basal cell adenocarcinoma of the parotid gland. The tumors from patient 1 and patient 2 showed intraparotid growth in superficial lobe without cervical lymphnode metastasis. So, patient 1 and patient 2 underwent only a superficial parotidectomy and subdigastric lymphnode dissection without any adjuvant therapy. They are alive without recurrence or distant metastasis. But that of patient 3 showed widely invasive growth with multiple cervical lymph node metastases. The CT scan showed a $8{\times}7cm$ sized huge mass replacing the parotid gland with irregular margin and multiple lymphnode enlargements along the internal jugular vein. Total parotidectomy with sacrifying the facial nerve and standard radical neck dissection were caried out. Microscopically, the tumor consisted of solid nest and sheet of uniform basaloid cells separated by a fibrous connective tissue stroma with the evidence of lymphovascular invasion. As a result of the lymphnode metastasis and invasiveness of the tumor, radiation therapy was given postoperatively. We thought that close follow-up would be mandatory in this patient because of high risk of possible local recurrence and distant metastasis.

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Disulfiram Implantation for the Treatment of Alcoholism: Clinical Experiences from the Plastic Surgeon's Point of View

  • Sezgin, Billur;Sibar, Serhat;Bulam, Hakan;Findikcioglu, Kemal;Tuncer, Serhan;Dogan, Bilge
    • Archives of Plastic Surgery
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    • 제41권5호
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    • pp.571-575
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    • 2014
  • Background Disulfiram implantation is a widely used treatment alternative for alcohol abuse, yet reports on the surgical aspect of disulfiram implantation with respect to patient and drug-related treatment efficacy and wound complications are very limited. We present our clinical experiences with disulfiram implantation and discuss the surgical outcomes obtained with different anatomical planes for implantation. Methods Medical records of all patients referred to our clinic from the psychiatry department between 2007 and 2013 for disulfiram implantation were retrospectively analyzed. Implantation was carried out using 10 sterile Disulfiram tablets (WZF Polfa S.A.), each tablet containing 100 mg of disulfiram. The procedure was carried out by implanting the tablets randomly in either a subcutaneous or an intramuscular plane. The location and the plane of implantation and the complications were recorded for each patient and compared to determine the differences in the outcomes. Results A total of 32 implantation procedures were evaluated for this study. Twenty-five implants were placed in the intramuscular plane (78.2%), while seven implants were placed subcutaneously (21.8%). Exposure was encountered in three of the seven subcutaneous implants (42.9%), while no exposure was seen with the intramuscular implants. Incomplete absorption of the tablets was encountered in one patient with a previous subcutaneous implant who presented 1 year later for re-implantation as part of the continuation of therapy. Conclusions To overcome the issue of treatment continuation in the case of disulfiram therapy, which may be ceased due to frequently encountered wound complications, we believe that implantation in the subscapular intramuscular plane allows both uneventful healing and an out-of-reach implant location.

Intracranial abscess from facial cellulitis

  • Park, Jonghyun;Kim, Woo Seob;Kim, Han Koo;Bae, Tae Hui
    • 대한두개안면성형외과학회지
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    • 제20권5호
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    • pp.332-335
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    • 2019
  • Cellulitis, one of most common diseases of everyday life, is often overlooked for its significance. Although cellulitis does not cause or lead to serious problems usually, its possibility to cause lifethreatening problem should be known. In present case, a patient who had received acupuncture treatment a week earlier presented to the clinic with symptoms of facial cellulitis. The disease resolved within few weeks under empirical antibiotic treatment but recurred after 3 months. Under close history review of the patient, we found out that the patient had received craniectomy 20 years ago. The patient had blunt headache with no other neurological symptoms that could suspect cranial infection, but considering the risk originating from the patient's surgical history, brain computed tomography (CT) was taken. CT images revealed abscess formation in the subgaleal and epidural spaces. Craniotomy with abscess evacuation was done promptly. With additional antibiotic treatment postoperatively, the disease resolved, and the 1-month postoperative followup brain CT showed no signs of abscess formation.