• Title/Summary/Keyword: Patient classification criteria

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Two Cases of Non-Small Cell Lung Cancer Treated with Intravenous Cultivated Wild Ginseng Pharmacopuncture (산삼약침 혈맥주입을 시행한 비소세포성폐암 환자 2례)

  • Bang, Sun-Hwi;Kwon, Ki-Rok;Yoo, Hwa-Seung
    • Journal of Pharmacopuncture
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    • v.11 no.2
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    • pp.13-19
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    • 2008
  • Objectives To investigate the therapeutic effects of intravenous cultivated wild ginseng(Panax ginseng C.A. Meyer) pharmacopuncture(CWGP) in treating patients with non-small cell lung cancer(NSCLC). Design Prospective case series. Setting This study was conducted at the East-West Cancer Center of Dunsan Oriental Hospital, Daejeon University. Patients Two non-small cell lung cancer patients. Intervention Two non-small cell lung cancer patients were injected CWGP(20mL/day) mixed with 0.9% normal saline(100mL) intravenously. Each patient received a total of 16 and 9 cycles, respectively. One cycle is composed of 14 days. Outcome Measures The effect of intravenous CWGP was measured by scanning with computed tomography(CT) after every 2 cycle and Positron emission tomography- computed tomography(PET/CT) after every 6 cycles. Response and progression was evaluated using the Response Evaluation Criteria in Solid Tumors(RECIST) Committee classification of complete response(CR), partial response(PR), progressive disease(PD) and stable disease(SD). Results They were treated with intravenous CWGP for 8 and 5 months respectively. time later, each tumor remains stable disease(SD). Conclusion These cases may give us a possibility that intravenous CWGP offers potential benefits for non-small cell lung cancer patients.

One Case Treated Cerebral Infarction with Rheumatic Mitral Stenosis (류마티스성 승모판 협착증을 동반한 뇌경색 환자의 치험 1예)

  • Jeon, Jong-Chul;Gam, Chul-Woo;Park, Dong-Il;Jeong, Gwang-Sik
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.463-469
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    • 2001
  • Valvular heart disease is one of the main current of cardiac problems and has many problems must be solved by sequelae and complications, etc. Rheumatic Mitral Stenosis is mainly attacked by rheumatic fever and developed by process of treatment of mitral valve or formation of trace. The purpose of this study is to examine the efficacy of oriental treatment for Cerebral Infarction with Rheumatic Mitral Stenosis. At the time of visiting ER, he was shown the symptoms of dull mentality, Rt. hemiplegia, global aphasia, dysphagia, chest discomfort, insomnia, dyspnea, etc, It showed that Atrial fibrillation in EKG monitoring, Atrial fibrillation, Rheumatic Mitral Stenosis, Ejection-Fraction slope 60% in Cardiac echography, Lt. atrial hypertrophy, Rt. atrial hypertrophy, Rt. ventricular hypertrophy with pulmonary congestion in chest X-ray. From the view of oriental diagnostic criteria. We classified the patient's clinical conditions and treated accordingly. As a result of treatment, symptoms were markedly improved and he was discharged. Further elaboration of oriental diagnostic classification could possibly lead to the fundamental treatment.

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LITERATURE REVIEW OF INTERNATIONAL CARIES DETECTION AND ASSESSMENT SYSTEM II TO ORAL EXAMINATION FOR CHILDREN (어린이의 구강 검사를 위한 International Caries Detection and Assessment System II의 적용)

  • Kim, Hyun-Jung;Noh, Hong-Seok;Kim, Shin;Jeong, Tae-Sung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.38 no.2
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    • pp.202-209
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    • 2011
  • Current treatment concept of dental caries has been changed, because it has been proved that it is a preventable disease. The philosophy has been changed from purely restorative treatment to preventive caries control. Therefore the methods or criteria of oral examination has been changed. The clinician have to detect not only cavitation, but also the lesion of non-cavitation stage. International Caries Detection and Assessment System II (ICDAS II) was developed recently, which is a new criteria of classification of dental caries. This system was based on the current concept of prevention, early detection and patient-centered management of caries. Therefore this philosophy is in accord with the perspective of pediatric dentistry. The purpose of this article is to introduce this system for oral examination of children.

Characteristics of non-emergent patients at emergency departments (응급실을 이용하는 비응급환자의 실태와 특성)

  • Chung, Seol-Hee;Yoon, Han-Deok;Na, Baeg-Ju
    • Health Policy and Management
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    • v.16 no.4
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    • pp.128-146
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    • 2006
  • The objective of this paper is to examine the proportion and characteristics of non-emergent patients at emergency departments. The observational survey was conducted using a structured form used by emergency medicine specialists or senior residents on June 7-20, 2005. 1,526 patients at ten emergency centers took part in this study. The structural form contained type of insurance, route and means of emergency department (ED) visit, triage based on the Manchester Triage Scale(MTS)-modified criteria, emergency level based on the government defined rule, type of emergency centers (Regional Emergency Medical Center; REMC, Local Emergency Medical Center; LEMC, Local Emergency Agency; LEA), as well as patient's general information. Data were analyzed using SAS statistical program(V.8.2). Descriptive analysis was performed to describe the magnitude of non-emergent patients. ${\chi}^2-analysis$ and logistic regression analysis was performed to identify the nonurgent patients' characteristics. In the MTS-modified criteria, we found a 15.3% rate of non-emergent patients. This rate differed from that of non-emergent patients obtained using government's rule. In particular, there were inaccuracies in the definition of government rule on non-emergent patients, so it is necessary to apply the new government rule regarding classification of non-emergent patients. There were significant differences in the rate of non-emergent patients according to type of ED, means of ED visit, time to visit, and insurance. Non-emergent patients are more likely to visit a D-type ED(LEA having less than 20,000 patients annually), not to use ambulance, to have 'Automobile Insurance, Industrial Accident Compensation Insurance, or pay out-of-pocket'. Non-emergent patients tend to visit ED due to illness rather than injury. Further studies on the development' of triage scale and reexamination of the government's rule on emergency visits are required for future policy in this area.

Analysis of Risk Factors for Infection in Orthopedic Trauma Patients

  • Moon, Gi Ho;Cho, Jae-Woo;Kim, Beom Soo;Yeo, Do Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • v.32 no.1
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    • pp.40-46
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    • 2019
  • Purpose: We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery. Methods: We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS. Results: Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor. Conclusions: The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

Rotator cuff repair: what questions are patients asking online and where are they getting their answers?

  • Alexander J. Hodakowski;Johnathon R. McCormick;Dhanur Damodar;Matthew R. Cohn;Kyle D. Carey;Nikhil N. Verma;Gregory Nicholson;Grant E Garrigues
    • Clinics in Shoulder and Elbow
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    • v.26 no.1
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    • pp.25-31
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    • 2023
  • Background: This study analyzed questions searched by rotator cuff patients and determined types and quality of websites providing information. Methods: Three strings related to rotator cuff repair were explored by Google Search. Result pages were collected under the "People also ask" function for frequent questions and associated webpages. Questions were categorized using Rothwell classification and topical subcategorization. Webpages were evaluated by Journal of the American Medical Association (JAMA) benchmark criteria for source quality. Results: One hundred twenty "People also ask" questions were collected with associated webpages. Using the Rothwell classification of questions, queries were organized into fact (41.7%), value (31.7%), and policy (26.7%). The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/management (21.7%), and pain (18.3%). Average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most commonly suggested question for rotator cuff repair/surgery was, "Is rotator cuff surgery worth having?," while the most commonly suggested question for rotator cuff repair pain was, "What happens if a rotator cuff is not repaired?" Conclusions: The most commonly asked questions pertaining to rotator cuff repair evaluate management options and relate to timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding questions their patients search online, surgeons can tailor preoperative education to patient concerns and improve postoperative outcomes.

Pull-in Suture Technique for the Disinsertion of the Phalangeal Tendon Distal Insertion (Pull-in 봉합술을 이용한 수지건 원위 부착부 파열의 치료)

  • Kim, Jae Won;Chung, Sung Mo
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.723-728
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    • 2008
  • Purpose: The disinsertion of the phalangeal tendon distal insertion has difficulties in ordinary tenorrhaphy operation for the anatomical features, and still has controversy between non-surgical and surgical management. The purpose of this study is to select treatment for the injury of the phalangeal tendon distal insertion, as we've had a good results from operation treatment with Pull-in suture technique. Methods: We reviewed the hospital records of 12 patients treated with Pull-in suture technique with disinsertion of the phalangeal extensor or flexor tendon distal insertion from June 2006 to June 2007. Eight patients were involved with the tendon disinsertion without bone fracture, and 4 patients were involved with the fracture of the phalangeal tendon distal insertion site. After removal of the K-wire in week 6, active physical exercises were commenced immediately. The mean follow-up period was 12.4 months. Results: All the patients who had tendon disinsertion with bone fracture had IIB, by Wehbe and Schneider's classification 2, and we evaluated the results comparing the same finger of the other hand according to Crawford's evaluation criteria 5. The nine excellent and three good results were obtained and there were no limitation of motor for the patient who had operation for the rupture of flexor tendon as well. There were no particular complications during the follow-up period. Conclusion: The most important thing for the disinsertion of the phalangeal tendon distal insertion is to maintain an accurate and durable reduction state keeping the tension of tendon. At this point, after removal of the K-wire, the Pull-in suture technique allows accurate realignment of the tendon-bone unit without any specific instrumentation under the more stable state. The Pull-in suture technique seems to be a strong alternative for the treatment of disinsertion of the phalangeal tendon distal insertion, with successful treatment outcome(rapid functional recovery and high patient satisfaction).

Aortocoronary bypass surgery in the management of coronary artery disease (관상동맥협측증의 외과적 요법)

  • 이재원
    • Journal of Chest Surgery
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    • v.19 no.4
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    • pp.606-617
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    • 1986
  • During the period from November 1981 through June 1986, 18 cases of coronary arterial bypass graft were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital. They consisted of 13 males and 5 females with the mean age of 49 [range: 28-69 years]. History of myocardial infarction was noted in 50% of the patients and cardiomegaly on chest PA in 2 patients with preserved LV function. On resting EKG, except the evidences of old myocardial infarction, the findings of LVH were noted in 7 cases, acute myocardial infarction in 2, diffuse myocardial ischemia in 1, and significant ventricular arrhythmia in 2 cases. The angina by type of presentation is stable in 3 patients, unstable in 15 patients with resting, postinfarction and progressive angina as the criteria of unstability. The patterns of involvement of significant disease were single vessel involvement [5 cases] double vessel involvement [8 cases], and triple vessel involvement [5 cases] including 5 cases of left main coronary arterial diseases. The pattern of coronary arterial disease in individual patient was one or more stenosis of the proximal left coronary arterial system with or without right coronary involvement, in every case. We performed 9 cases of double bypass and 9 cases of triple bypass with great saphenous vein using single anastomosis technique except in 4 cases, One of the 4 cases is our first case, sequential anastomosis between LAD and diagonal was performed due to shortage of the prepared vein graft. In the other 3 cases, our latest experience, we adopted the left internal mammary artery for the left anterior descending coronary revascularization. The distribution of sites of distal anastomosis revealed more striking predilection to LAD, showing our attention on the significance of the revascularization of LAD system. The ischemic time was 35 minutes per graft and mean number of grafts per patient was 2.5. Of the 18 patients, 13 [77.2%] had complete revascularization, and incomplete in 5 cases with the causes of incompleteness as presented. The early results of operation were as followed: surgical death in 2 [11%], perioperative infarction 2 [11%], need of inotropic support 5 [28%], arrhythmia 2 [11%], wound problem, bleeding, and emotional dysfunction. The actuarial anginal free survival during the period of 6 months through 2 years was 85.2% with excellent symptomatic control according to the angina classification of Canadian Cardiovascular Society.

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Quantitative evaluation and affecting factors of post-treatment relapse tendency (교정치료 후 나타나는 재발 경향에 대한 정량적 평가와 영향을 미치는 요소에 대한 연구)

  • Son, Woo-Sung;Cha, Kyung-Suk;Chung, Dong-Hwa;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.41 no.3
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    • pp.154-163
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    • 2011
  • Objective: The purpose of this study was to quantitatively evaluate relapse tendency after orthodontic treatment and determine the contributing factors by using the American Board of Orthodontics objective grading system (ABO-OGS). Methods: The subjects were 80 patients with more than 2 years of retention period after completing orthodontic treatment at the dental hospitals of Busan University, Kyunghee University, and Dankook University. The posttreatment (T2) and post-retention (T3) ABO-OGS measurements were analyzed in relation to age, gender, Angle's classification, extraction, retention period, and pretreatment condition (initial peer assessment rating (PAR) index, T1) by multiple regression analysis. Results: Among the 7 ABO-OGS criteria, alignment worsened but occlusal contact and interproximal contact improved in T3, but not in T2 ($p$ < 0.01). The 4 other criteria showed no significant differences. Multiple regression analysis showed that alignment, occlusal relationship, overjet, and interproximal contact were significant linear models, but with a low explanation power. Age, gender, Angle's classification, extraction, retention period, and pretreatment condition (initial PAR index, T1) had little influence on the ABO-OGS changes between T3 and T2. Conclusions: An orthodontist's understanding of posttreatment relapse tendency can be useful in diagnosis and during patient consultation.

A Study on Characteristics of Core Projects Described in 3rd Community Health Plans (제3기 지역보건의료계획서에 기술된 핵심사업의 특성에 관한 연구)

  • Kim, Dong-Moon;Lee, Weon-Young;Moon, Ok-Ryun;Kim, Chang-Yup
    • Journal of Preventive Medicine and Public Health
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    • v.37 no.1
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    • pp.88-98
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    • 2004
  • Objectives : The 3rd community health plan let health centers select and promote core projects considering budget and manpower. This study analyzed the content and selection processes of core projects, using the nationwide 3rd community health plans, to give relevant information on health center policies. Methods : Classification criteria for content analysis of core projects were established and verified through a literature review and by specialist discussions. Fifty plans were selected by stratified proportional random sampling for regional characteristics. And coding criteria standardized through coding repetition and discussion, by 2 persons (k>0.7). Using stratified proportional random sampling for 16 cities and provinces, regional characteristics, 117 plans were selected, and the contents of the core project selection processes and program contents analyzed. Results : The survey was used by 59.8 % of samples as a core project decision-making method. The partici- pants included 98.6, 81.4, 40 and 38.6% of the health staffs, residents, medical institutions, and administrators, respectively. Discussion was used by 15.4% of samples. The participants were health staffs by 100% as a great. The ranking of the frequencies of the selected core projects were, in order; chronic disease control, health promotion, elderly health, maternal-child health, and oral health at 16.4, 14.8, 14.3, 12.7 and 11.9%, respectively. Analyses on the chronic disease control and elderly health contents showed the diversity of object disease, high rates of visitors on patient detection programs, high rates of unclear target populations, and the provision of medical exams and treatments as the main services, with high variations in business per-formance. The national health budgets for health centers in 2003 were about 910 and 240 million won for chronic disease control and elderly health, respectively, which were less than for the other five priority core projects. Conclusions : The chronic disease control and elderly health at the health centers were not standardized for object disease, patient detection program, target population, service provision, and national support budget was insufficient. Thus it is necessary to develop standard guidelines, and increase financial support, for chronic disease control and elderly health