• 제목/요약/키워드: out patient

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반사상 교감 신경 위축 증후군에 대한 교감신경 차단효과 -증례 보고- (Effects of Repeated Sympathetic Blocks for Reflex Sympathetic Dystrophy Syndrome -A Case Report-)

  • 배운호;노선주;고준석;민병우
    • The Korean Journal of Pain
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    • 제3권2호
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    • pp.165-171
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    • 1990
  • The reflex sympathetic dystrophy syndrome (RSDS) consists of sustained burning pain and tenderness, vasomotor instabilitiy, swelling, occasional functional instability, trophic skin change and edema of extremity following trauma, peripheral nerve injury, spinal cord injury, infection, burn and other etiologic factors. The most important thing in RSDS is to start the treatment as soon as the disease was diagnosed. Most patients with RSDS respond dramatically and permanently to sympathetic blocks if treatment is instituted before irreversible trophic changes. The characteristic radiological finding in RSDS is a patchy osteoporosis in the cancellous bone. Periarticular hyperactivity is seen in RSDS by Tc99m bone scan. We have managed 4 cases of RSDS. The methods of management and effects are as follows: 1) In case 1, 28 lumbar sympathetic blocks in both sides were performed. The patient did not complain of pain or tenderness and the limping improved. 2) In case 2, 7 lumbar sympathetic blocks were performed, but we could find only a slight improvement in the symptoms. 3) In case 3, 8 stellate ganglion blocks were carried out. The patient refused the treatment of RSDS because of the lack of rapid improvement. 4) In case 4, total 64 stellate ganglion blocks were carried out; the patient was permanently improved.

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안면견갑상완형 근이영양증 환자에 대한 한의학적 치료 이후 호흡기능 호전에 대한 임상 증례 (A Clinical Case Report on the Improvement of Respiratory Function of a Fascioscapulohumeral Muscular Dystrophy Patient after Korean Medical Treatment)

  • 이상현;정주용;조명래
    • Journal of Acupuncture Research
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    • 제32권4호
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    • pp.195-201
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    • 2015
  • Objectives : The purpose of this study is to report on the improvement of respiratory function of a fascioscapulohumeral muscular dystrophy patient after receiving Korean medical treatment. Methods : This study was carried out on a 60 year-old male patient who suffered from fascioscapulohumeral muscular dystrophy. While we carried out Korean medical treatment, we observed $EtCO_2$ (end-tidal carbon dioxide), Vte (exhaled tidal volume) and PIP (peak inspiratory pressure). Results : $EtCO_2$ count decreased from 34 mmHg to 24 mmHg during the treatment period, and PIP count became stable. Vte count also did not worsen in this study. Conclusions : Based on this study, we concluded that Korean medical treatment could be effective in treating fascioscapulohumeral muscular dystrophy patients with respiratory failure.

술 중 대량 출혈을 동반한 거대 갑상선유두상암종 절제술 1례 (A Case of Giant Papillary Thyroid Carcinoma Resection with Massive Intraoperative Bleeding)

  • 김석현;정재환;성의숙;이진춘
    • 대한두경부종양학회지
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    • 제33권1호
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    • pp.85-89
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    • 2017
  • A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

유구치의 편측치아절제술을 이용한 공간유지장치 (A CASE REPORT ON THE SPACE MAINTAINER USING PRIMARY MOLAR HEMISECTION)

  • 김준현;이제호;김성오;손흥규
    • 대한소아치과학회지
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    • 제24권4호
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    • pp.776-780
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    • 1997
  • Patient with alveolar abscess due to dental caries with severe alveolar bone loss, severe tooth mobility, root resorption need extraction of tooth because it is impossible to carry out pulp treatment and restoration by using conventional method. Early loss of primary molar might cause masticatory interference, extrusion of opposing tooth, problem in maintaining space and interference on eruption of permanent tooth. Especially, early loss of primary second molar before the eruption of permanent first molar might cause space closure by mesially erupted permanent first molar and impaction of second premolar. In such a case, distal shoe space maintainer and removable space regaining appliance was the first choice of treatment. But, distal shoe space maintainer need precise adaptation and might cause chronic inflammation if the oral hygiene is poor. In a case using removable space regaining appliance, patient's cooperation is most important. If the distal root of primary second molar is comparably sound and alveolar abscess with alveolar bone loss is localized at mesial root, hemisection should be carried out for precise guide to eruption of the permanent first molar, restoration of masticatory fuction and solution to the discomfort of the patient

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보건소 진료서비스 이용자의 만족도에 관한 연구 (Patient satisfaction of medical care in a public health center)

  • 문영신;조우현;강임옥
    • 한국의료질향상학회지
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    • 제5권1호
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    • pp.2-14
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    • 1998
  • The aim of this study was to examine differences in the level of satisfaction with medical care at a public health center between patients receiving free-care compared to those paying out-of-pocket. SERVQUAL(Comprehensive Service Quality Measurement Scale), a pyschometrically valid measure for evaluating hospital service quality, was used to assess patient satisfaction. The study sample consisted of 279 patients who received medical care at a public health center. The interview was conducted between April 23 and May 7, 1998. The results was as follow: 1. There were more elderly people among free-care patients than out-of-pocket patients. Education and income levels were lower amongs those receiving free-care. There were, however, no differences in the distribution of gender and religion between the two groups. Patients receiving free-care tended to visit the public health center more frequently compared to those self-paying patients. 2. Overall, free-care patients showed higher satisfaction level than that of self-paying patients. except for the dimension on sympathy and shape.

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각질하 농포성 피부병 한방 치험 1례 (A Case of Subcorneal Pustular Dermatitis treated with Oriental Medicine)

  • 김민희;윤영희;유승민;최인화
    • 한방안이비인후피부과학회지
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    • 제24권2호
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    • pp.87-95
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    • 2011
  • Objective : Subcorneal pustular dermatosis is a rare, chronic neutrophilic dermatoses that was first described in 1956. The eruption is characterized by flaccid pustules grouped in a circinate pattern on normal or erythematous skin. We treated a case of subcorneal pustular dermatosis in one patient; there have been no former reports of this disease treated by oriental medicine. We present this case because we considered it to be useful as a possible Oriental medicine treatment for subcorneal pustular dermatosis, and something that canbe used for further study of neutrophilic dermatoses. Method : We used herbal medication, acupuncture, herbal wet dressing, herbal ointment, cupping therapy and phototherapy during treatment. We assessed symptoms during treatment and also carried out blood tests through out. Result : We observed and treated a case of subcorneal pustular dermatosis patient and after treatment the patient's objective and subjective symptoms showed noticeable improvement. Conclusion : We suggest that subcorneal pustualr dermatosis can be treated by Oriental medicine therapy effectively. We expect these study results will help provide useful evidence of Oriental medicine as an effective treatment for subcorneal pustualr dermatosis.

Non-Surgical Resolution of Inflow Cannula Obstruction of a Left Ventricular Assist Device: A Case Report

  • Lee, Yoonseo;Sung, Kiick;Kim, Wook Sung;Jeong, Dong Seop;Shinn, Sung Ho;Cho, Yang Hyun
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.543-546
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    • 2021
  • A 55-year-old woman who had received an implantable left ventricular assist device 3 months earlier presented with dyspnea and a low-flow alarm of the device. Computed tomography and log-file analysis of the device system suggested inflow cannula obstruction. Since the patient had cardiogenic shock due to pump failure, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. With ECMO, surgical exchange of the pump was considered. However, the obstruction spontaneously resolved without surgical intervention. It turned out that an obstructive thrombus was washed out by rebooting the pump. Moreover, the thrombus was embolized in the patient's left subclavian artery. The patient underwent heart transplantation 4 months after the pump obstruction accident and continued to do well.

데이터마이닝 기법을 이용한 융복합 외래 의료서비스 환자경험조사 연구 (Convergence outpatient medical service patient experience research using data mining)

  • 유진영
    • 디지털융복합연구
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    • 제18권7호
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    • pp.299-306
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    • 2020
  • 본 연구는 환자중심성 의료문화 변화에 따라, 데이터마이닝 기법을 이용한 융복합 외래 의료서비스 환자경험조사 연구를 시행하여 환자중심성 의료기관 경영전략에 도움이 될 수 구체적 방안을 모색하고자 하였다. '2018 의료서비스경험조사' 원시자료를 이용하여 외래 의료서비스 환자경험이 있는 만 15세 이상 8,843명을 분석하였다. 의사결정나무분석을 수행하였다. 외래 의료서비스 환자경험에 대한 전반적 만족도 결정요인은 의사와 환자 권리보호였으며 추천의사 결정요인은 의사와 시설의 안락함과 편안함이었다. 여성이 남성에 비해 전반적 만족도에서 경험을 긍정적으로 평가했으며 60세 이상이 전반적 만족도와 추천의사에 대한 경험을 긍정적으로 평가했다. 외래 의료서비스 환자경험 의사결정예측 모형을 제시하고 의사 영역과 환자권리보호 영역, 시설의 안락함과 편안함이 중요한 요인임을 확인한 점이 의의가 있다. '의료서비스경험조사'에 대한 종단적 연구가 필요하며 입원 의료서비스경험에 대한 연구가 필요하다.

수술실 간호사의 환자안전의식과 안전관리활동 (A Study on Perception and Nursing Activity for Patient Safety of Operating Room Nurses)

  • 박소정;최은희;이경수;정귀애
    • 한국산학기술학회논문지
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    • 제17권11호
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    • pp.332-339
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    • 2016
  • 본 연구는 수술실 간호사의 환자안전인식과 안전관리활동을 분석한 후 상관관계를 파악한 연구이다. 목적은 수술환자의 안전관리활동 수행정도를 향상시키기 위한 교육 프로그램 개발과 안전한 수술실 환경 조성을 위한 기초자료를 제공하고자 함이다. 연구대상은 대구광역시와 경상북도에 소재한 8개 종합병원 수술실 간호사 161명이었고, 자료 분석은 SPSS 21.0 program을 이용하여 t-test, ANOVA, Correlation coefficient를 실시하였으며 사후분석으로 Scheffe's test를 실시하였다. 그 결과 수술실 간호사의 환자안전인식 점수는 5점 만점에 3.33점이었으며, 환자안전관리활동 점수는 5점 만점에 4.28점이었다. 대상자의 일반적 특성과 근무특성에 따른 환자안전인식을 분석한 결과 수술실 간호사의 근무시간에 따라서 환자안전인식이 차이가 있었으며 안전관리활동은 병상 수와 인증평가 준비 유무에 따라 차이가 있었다. 수술실 간호사의 환자안전에 대한 인식과 안전관리활동 간의 관계를 파악한 결과 유의한 양의 상관관계가 있어 환자안전인식이 높을수록 안전관리활동 정도가 높은 것으로 나타났다. 결론적으로 안전관리활동을 향상시키기 위해서는 환자안전에 대한 인식을 증가시키는 것이 필요하며, 환자안전에 대한 인식을 증가시키기 위해서는 직원 간의 개방적인 논의와 환자안전에 대한 병원의 지원 및 주기적인 교육과 같은 중재가 필요하다.

통계적(統計的) 방법(方法)에 의한 병원관리(病院管理) System 설계(設計) (Design of Hospital Management System Using the Statistic Methodologyo)

  • 이상완;이근부
    • 품질경영학회지
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    • 제13권2호
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    • pp.21-28
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    • 1985
  • The purpose of this study is to analyze the direct relationship between doctors and number of patients to be treated by applying many kinds of IE techniques. Generally, doctors in this research work both at Out Patient Data & In Patient Data. Under the hospital management system that they are applying in, doctor's daily working schedules are instable because the number of OPD patients daily. Therefore, the amount of time they spend for inward patients are variable too. So the numbers of patients have great influence to the whole hospital system management.

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