• Title/Summary/Keyword: Patient experience

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Study on Utilization of Oriental Medicine by Residents in Rural Areas (농촌지역(農村地域)의 한방의료이용실태(韓方醫療利用實態) 일부(一部) 농촌지역(農村地域)의 군보건소이용자(群保建所利用者)를 중심(中心)으로-)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.118-129
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    • 1990
  • Socioeconomic status in this county progressed rapidly, this has brought about many changes in health care fields, namely, pattern of disease prevalence and morbidity, increase of the aged people, and also availability of health care in rural areas. According to the utilization study of medical care, it showed that the oriental medicine is used for the treatment of lasted chronic disease not the minor and common diseases which is quick in its effect. Particularly, in rural areas. prevalence of chronic disease is higher than that in urban areas. Although the health cafe need of the oriental medicine is high in rural areas, the distribution of manpower and facilities is lower than that in urban areas. Therefore the government has planned to implement the demonstration project for the oriental medicine at the designated 3 health centers in rural areas. The purpose of this study was to collect the utilization level of oriental medical care of the people in rural areas. To meet the purpose of this study, patient interview were applied. 790 patients visited to health center in project areas were selected and analyzed by experienced interviewers from 2 April to 21 April 1990. The major findings of this study were as follows ; 1) Of the 790 patients, 32.6 percent of the respondents had experience of using the oriental medicine. As for the utilization by age and sex. 54.8% of those was female and 70.7% was 40 years of age and more. 2) Reaction to the question of educational achievement showed that on schooling and primary school graduates accounted for 63.1%. 3) The most user of oriental medicine resides in country level, where the health center is located, and 80 percent of those users resides within 10Km. 4) More than 50% of the total was the chronic diseases which lingered for more than 3months. 5) 32.6 percent of the total cases used the oriental medicine. 61.2% among those was treated by oriental medical care hospital and 38.8% by oriental drug dispensaries etc. 6) The contont of oriental medical care varied ; 50.1% for prescription of herb drugs for treatment, 25.1% for health maintenance and 23.9% for acupuncture, moxibustion etc. 7) As for the motivation for using the oriental medicine. 56.6% of the respondents was for treatment of diseases and 27.9% wes for strengthening the physical weakness. 8) As for the effectiveness of the oriental medicine. 70.3% of the total cases satisfied with that treatment and 84.2% of the total cases will use the oriental medicine when is provided by health center.

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The Characteristic of Radiation Exposure for Radiologist with Applying Condition in Interventional Radiology in Cardiology (심장내과의 중재적 시술시 시술조건에 따른 방사선사의 방사선 노출 특성)

  • Park, Jeong-Kyu;Cho, Euy-Hyun
    • Journal of Digital Contents Society
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    • v.13 no.3
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    • pp.421-429
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    • 2012
  • Lately, the number of interventional radiology is increased by the extension of procedure in medical radiation, and radiation exposure may be appeared differently by interventional radiologists, it is caused increase of radiation dose for radiation worker, patient, and radiologists. This study has done a comparative analysis characteristic of radiation exposure for five radiologists who executed interventional cardiology for 303 patients in S university hospital of Gyeong-Buk from Nov. 1, 2011 to Jan. 31, 2011. The average exposure time of five radiologists was 697.95sec. The average of cumulative DAP(exp) for patients was $52,730mGycm^2$ and the average of total DAP for patients was $104,875.14mGycm^2$. The average of frames for image was 855.52 frames in acquired images, and the average of frames for images was 802.2 frames in exposure images. They were statistically significant differences (p<0.05). Exposure time, cumulative DAP(fluro), cumulative DAP(exp), total DAP, acquired image, and exposure image were high correlation except cumulative DAP(exp), and acquired runs in x-ray exposure characteristics of machine. Exposure time was a great influence on radiologist. It signified that the more exposure time lead to the more radiation dose for radiologist. Radiation dose is related to ability, experience, difficulty, and precision of procedures in interventional procedure. The number of angiography and exposure time is difficult to control by radiologists. Therefore, it is in need of reasonable system which was evaluated the real dose of medical teams in interventional proceedings. We think that self education and training are required to reduce radiation dose for radiologists and radiation workers.

A Clinical Analysis of Major Salivary Gland Tumors-104 Cases (주타액선종양 104례에 대한 분석)

  • Kim Myung-Sang;Kim Young-Ho;Hong Jung-Pyoe;Choi Eun-Chang;Kim Kwang-Moon;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.1
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    • pp.40-45
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    • 1998
  • Backgroud and Objectives: Major salivary gland tumor is a rare disease with a largely unknown origin. And also corresponding to the diversity of histopathologic characteristics is an equally wide distribution of clinical behavior that makes treatment decisions difficult. The aim of this study is to analysis the clinical experience of our major salivary gland tumor and to suggest a guidline of management. Materials and Methods : We studied clinical manifestations and treatment results of 104 patients who were diagnosed as major salivary gland tumors. Tumor site, patient age and sex of the patients were analysed. Histopathologic diagnosis, treatment modality, lymph nodes metastasis, recurrence rate and 5-year survival rate were studied on malignant tumors. Results: 1) 48 patients were male and 56 patients were female. 2) Benign tumors were 79 cases. They consisted of 57 cases(72%) of parotid tumor, 22 cases(27%) of submandibular tumor. And pleomorphic adenoma was the most common benign tumor. 3) Malignant tumors were 25 cases and were consisted of 19 cases(76%) of parotid tumor, 4 cases(l6%) of submandibular tumor and 2 cases(8%) of sublingual gland tumor with high-grade mucoepidermoid carcinoma as the most common cause. 4) In the malignant tumors, the number of stage I, II tumors was 14 and that of stage III, IV tumors was 11. Neck node metastasis was noted in 8 cases. 5) 8 cases of malignant tumor were died and all of them had high-grade malignancy. And they were dead before 17 months from the time of diagnosis. 6) Mean survival duration in the malignant salivary gland tumor was 56 months. 7) High-grade malignancy had a 5-year survival rate of 57.9%. A 5-year survival rate of TI, T2 patients was 92.9% and that of T3, T4 patients was 36.4%. That of patients who had neck node metastasis was 37.5% and that of those who had tree neck was 82.4%. Conclusion: The results of this study suggest that the survival rate is dependent on the tumor size, lymph node matastasis and histologic grade. And also the early diagnosis and radical surgery result in the increased survival rate and are effective for prevention of the tumor recurrance.

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Applying Inhaled Furosemide for Refractory Breathlessness in Terminally-ill Cancer Patients - Based on Seminar of Palliative Medicine Research Group, The Korean Academy of Family Medicine - (말기암환자에서 불응성 호흡곤란 완화를 위한 Furosemide 흡입치료 -대한가정의학회 완화의학연구회 세미나에 기초한-)

  • Hwang, In-Cheol;Lee, Min-Kyu;Kim, Kyoung-Kon;Lee, Kyoung-Sik;Suh, Heuy-Sun
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.252-256
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    • 2010
  • Breathlessness is a frequent and distressing symptom in terminal cancer patients. Refractory breathlessness is defined as a state that does not respond to conventional disease-specific therapy with an exclusion of reversible underlying causes, and the main classes of symptomatic drug treatments include opioids and benzodiazepines. Korean Family Medicine Palliative Medicine Research Group discussed two terminal cancer patients in whom severe breathlessness with different causes were treated with inhalation of nebulized furosemide, which is an emerging option of palliative treatment. It still remains unclear how it becomes effective or how much it is effective, therefore, its routine use seems to be somewhat early. Nevertherless, if a patient with intractable breathlessness does not have a marked obstructive airway lesion, its use should be considered. Based on the discussion in the seminar, we want to share our experience of the application of inhaled furosemide with other palliative care practitioners and strongly recommend further research on this topic in the future.

A Clinical Review on 143 Cases of Basal Cell Carcinoma (143례의 기저세포암에 대한 임상적 고찰)

  • Lee, Tae Sung;Pyon, Jai Kyong;Mun, Goo Hyun;Bang, Sa lk;Oh, Kap Sung;Lim, So Young
    • Archives of Plastic Surgery
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    • v.35 no.6
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    • pp.698-702
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    • 2008
  • Purpose: Basal cell carcinoma is one of the most common cancers in the western population and the annual incidence rate is still on an increasing course. In Asian countries such as Korea, the incidence of basal cell carcinoma is reported to be remarkably low but is estimated to be in a steep increase nowadays. This study was to analyze the recent clinical trends of basal cell carcinoma in Korea by reviewing a single institution's experience. Methods: Throughout an 11-year period, the surgical excision of 143 cases of basal cell carcinoma was performed in our department. General data of these cases such as the primary site of cancer, age and sex of the patient, operative methods, recurrence rate were reviewed retrospectively. Results: Among the 143 patients included in this study, 82 patients were men and 61 patients were women. The ages ranged from 27 to 89 years with a mean age of 64.0 years. The head and neck region was the most frequently involved primary site for the cancer as 95.1% of the total cases occurred in this area. Especially the nose and perinasal area were the most frequent region, which was followed by the periorbital area, cheek, and perioral area. During this study period, 9 cases showed recurrence of the cancer as the overall recurrence rate was 6.3%. Conclusion: Gradual increase in the incidence of basal cell carcinoma was demonstrated in this study. Basal cell carcinoma showed high incidence in the old-age population as 68.5% of the total patients were more than 60 years of age. High recurrence rate was noted in the nasal region especially after local flap reconstruction. A more cautious approach is to be required when handing such high risk lesions. Multiple factors such as extended life span, increased outdoor leisure activity and exposure to sunlight, higher accessibility to medical services and increased understanding of the public about skin cancer are assumed to be the main reasons for this increase of basal cell carcinoma.

Use of Complementary and Alternative Medicine among Cancer Patients in Korea (우리나라 소화기암 환자들의 대체의료이용에 관한 연구)

  • Jung, Eun-Young;Han, Dong-Woon;Choi, Byung-Hee;Kim, You-Kyum;Park, Yeon-Hee
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.21 no.6
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    • pp.1590-1596
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    • 2007
  • Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The use of CAM in cancer patients is common with about one third of patients using some form of CAM in Western countries. The purpose of this study was to analyze the use of CAM and determine what factors affect to use CAM among cancer patients to provide CAM therapy information and assist therapy selection among various CAM therapies to cancer patients. The design of the study was descriptive cross-sectional, and data were collected using a 16-item questionnaire. This study was conducted in subjects with confirmed diagnosis of stomach, colon, liver, or pancreas cancer, in both out-patients clinics and inpatients setting in a tertiary hospital in Seoul Korea. As a result, among the participants, past or current CAM use was reported by 75%, which shows a statistically significant difference in income groups(P<0.05), but no difference in age and religion groups. The most common therapies use by cancer patients included traditional Korean medicine (32.1%), folk remedies (26.6%), exercise (14%), dietary supplements (11.6%), physical therapy (9.9%), diet therapy (5%), and meditation (4%). 77.8% of patients show satisfaction and 64.4% shows perceived effectiveness of CAM. Male patients with higher income, and previous treatment were more likely to use CAM. The main benefits from CAM reported by cancer patients were psychological improvement and symptom improvement. Of the cancer patients used CAM, 30.9% were dissatisfied, 25.8% did not have benefits from the use, and 7.6% experience side effects. Cancer patients who prefer CAM (more than 3 kinds) used it to cure cancer, on the contrary, the one who do not prefer CAM used to improve symptoms and psychological stability. The main sources of information about CAM were family and friends(54.4%), and media(24.5%), doctor and nurse(18.3%), and religion group(2.6%). Findings suggest that due to the relatively high use of CAM among cancer patients in Korea, this topic should be taken into account in the development of a holistic approach to cancer patients and efficient cancer patients management system and proactive and consistent management of CAM is necessary in the health care system in Korea.

Combined Heart and Kidney Transplantation in Patient with Postpartum Cardiomyopathy and Renal Failure (분만 후 발생한 심근병증 및 만신신부전 환자의 심장-신장 동시이식 수술 체험 1예)

  • Lee Seung-Cheol;Hahm Shee-Young;Kim Jae-Joong;Han Duck-Jong;Song Meong-Gun
    • Journal of Chest Surgery
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    • v.39 no.9 s.266
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    • pp.714-717
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    • 2006
  • Heart and kidney transplantation has made great progress in the modern era. Coupled with the growing successes in individual solid organ transplantation, there has also been an increase in the number of multiple organ transplants, such as heart-kidney transplantation. This trend has been in part due to a better understanding of immunobiology, advances in surgical technique and postoperative care, and an often-common pathologic association between dual-organ failure. This pathologic course is representative for end-stage heart failure leading to secondary renal dysfunction or failure, or for end-stage renal failure as a cause for (uremic) cardiomyopathy. However, refractory cardiac failure has long been considered a contraindication to kidney transplantation. Additionally, cardiac transplantation has been denied for patients with end-stage renal disease. Over recent years, combined heart-kidney transplantation has been offered to select patients who were once denied transplantation. We report the first experience of combined heart-kidney transplantation with one year follow-up results.

Long Term Results of Carbomedics Mechanical Valve (Carbomedics 기계판막 치환환자의 장기성적)

  • 김병열;임용택;정승혁;강경훈;이정호
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.552-559
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    • 2000
  • Background; The aim of this study is to evaluate our clinical experience with the Carbomedics heart valve prosthesis. Material and Method; Between Aug. 1988 and Dec. 1998, 294 Carbomidics valves were implanted in 235 patients(mitral; 143, mitral and aortic; 59, aortic; 33) The mean age at operation is 40.0$\pm$12.3 years(range 7 to 68 years); 63.8% (150patients) were woman. Follow up was 97.4% complete and mean follow up time was 5.7years with a total of 1209.2 patient-years. Result; The hospital mortality was 8.9%(mitral; was 95.2$\pm$1.6%(mitral ; 94.9$\pm$2.1%, mitral and aortic 95.0$\pm$3.7%, aortic 96.2$\pm$3.8%). Actual freedom rates from complications(linearized rates in parentheses) were fllowings; thromboembolism 96.2$\pm$1.5%(0.59%pt-yr), valve thrombosis 96.7$\pm$1.4%(0.5%/pt/yr), anticoagulant related hemorrhage 98.3$\pm$1.0%(0.25%/pt-yr), perivalvular leak 99.0$\pm$1.4%(0.5%/pt-yr), endocarditis 98.7$\pm$1.0%(0.25%/pt-yr), perivalvular leak 99.0$\pm$0.7%(0.17%pt-yr), endocarditis 98.7$\pm$1.0%(0.17%$\pm$pt-yr) and overall valve-related complications 88.9$\pm$2.5%(1.68%/pt-yr). Conclusion; The clinical performance of the Carbomedics valve was quite satisfactory with a low incidence of valve related mortality and morbidity.

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Surgical Options for Malignant Mesothelioma: A Single-Center Experience

  • Kang, Seung Ri;Bok, Jin San;Lee, Geun Dong;Choi, Se Hoon;Kim, Hyeong Ryul;Kim, Dong Kwan;Park, Seung-Il;Kim, Yong-Hee
    • Journal of Chest Surgery
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    • v.51 no.3
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    • pp.195-201
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    • 2018
  • Background: We investigated the surgical outcomes of patients who underwent therapeutic surgery for malignant pleural mesothelioma (MPM) at a single center. Methods: A retrospective review of 21 patients who underwent therapeutic surgery for MPM from January 2001 to June 2015 was conducted to assess their outcomes. The patients' characteristics and postoperative course, including complications, mortality, overall survival, and recurrence-free survival, were analyzed. Results: Of the 21 patients who underwent therapeutic surgery, 1 5 (71.4%) underwent extrapleural pneumonectomy, 2 pleurectomy (9.5%), and 4 excision (1 9.1 %). The median age was 57 years (range, 32-79 years) and 15 were men (71.4%). The mean hospital stay was 1 6 days (range, 1-63 days). Median survival was 14.3 months. The survival rate was 54.2%, 35.6%, and 21.3% at 1, 3, and 5 years, respectively. In patients' postoperative course, heart failure was a major complication, occurring in 3 patients (14.3%). The in-hospital mortality rate was 2 of 21 (9.5%) due to a case of severe pneumonia and a case of acute heart failure. Conclusion: A fair 5-year survival rate of 21.3% was observed after surgical treatment. Heart failure was a major complication in our cohort. Various surgical methods can be utilized with MPM, each with its own benefits, taking into consideration the severity of the disease and the comorbidities of the patient. Patients with local recurrence may be candidates for surgical intervention, with possible satisfying results.

Extracorporeal Membrane Oxygenation in Pediatric Patients with Respiratory Failure: Early Experience with the Double-Lumen Cannula Over 2 Years

  • Kim, Woojung;Kwon, Hye Won;Min, Jooncheol;Cho, Sungkyu;Kwak, Jae Gun;Kim, Woong Han
    • Journal of Chest Surgery
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    • v.53 no.3
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    • pp.132-139
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    • 2020
  • Background: The double-lumen cannula (DLC) has begun to be used worldwide for venovenous (VV) extracorporeal membrane oxygenation (ECMO). We aimed to examine whether the DLC could be an effective tool in the treatment of pediatric respiratory failure in Korea. Methods: We reviewed the records of patients weighing under 15 kg who underwent ECMO due to respiratory failure between January 2017 and December 2018. Outcomes of ECMO using a DLC and conventional ECMO using central method or 2 peripheral cannulas were compared. Results: Twelve patients were treated with ECMO for respiratory failure. Among them, a DLC was used in 5 patients, the median age of whom was 3.8 months (interquartile range, 0.1-49.7 months). In these patients, the median values of pH, partial pressure of carbon dioxide, and partial pressure of oxygen were 7.09, 74 mm Hg, and 37 mm Hg before ECMO and corrected to 7.31, 44 mm Hg, and 85 mm Hg, respectively, after ECMO cannulation. Median blood flow rate in the patients treated with ECMO using a DLC was slightly higher than that in the conventional ECMO group, but this difference was not statistically significant (86.1 mL/kg/min and 74.3 mL/kg/min, respectively; p=1.00). One patient from the DLC group and 3 patients from the conventional group were weaned off ECMO. Conclusion: VV ECMO using a DLC provided adequate oxygenation, ventilation, and blood flow rate in Korean pediatric patients with respiratory failure. Further prospective and randomized studies are warranted.