• Title/Summary/Keyword: out patient

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

  • Bae, Woon-Ho;Roh, Seon-Ju;Goh, Joon-Seock;Min, Byung-Woo
    • The Korean Journal of Pain
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    • v.3 no.2
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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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A Clinical Case Report on the Improvement of Respiratory Function of a Fascioscapulohumeral Muscular Dystrophy Patient after Korean Medical Treatment (안면견갑상완형 근이영양증 환자에 대한 한의학적 치료 이후 호흡기능 호전에 대한 임상 증례)

  • Lee, Sang Hyun;Jeong, Ju Yong;Cho, Myoung Rae
    • Journal of Acupuncture Research
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    • v.32 no.4
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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.

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

  • Kim, Seok Hyun;Jung, Jae Hwan;Sung, Eui Suk;Lee, Jin Choon
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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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.

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

  • Kim, Jun-Hyun;Lee, Jae-Ho;Kim, Seang-Oh;Shon, Heung-Ky
    • Journal of the korean academy of Pediatric Dentistry
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    • v.24 no.4
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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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Patient satisfaction of medical care in a public health center (보건소 진료서비스 이용자의 만족도에 관한 연구)

  • Moon, Young-Shin;Cho, Woo-Hyun;Kang, Im-Ok
    • Quality Improvement in Health Care
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    • v.5 no.1
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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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A Case of Subcorneal Pustular Dermatitis treated with Oriental Medicine (각질하 농포성 피부병 한방 치험 1례)

  • Kim, Min-Hee;Yun, Young-Hee;Yu, Seung-Min;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.2
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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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    • v.54 no.6
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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.

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

  • Yoo, Jin-Yeong
    • Journal of Digital Convergence
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    • v.18 no.7
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    • pp.299-306
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    • 2020
  • The purpose of this study is to find out specific measures that can help the management strategy of patient-centered medical institutions by conducting research on patient experience surveys of convergence outpatient medical services using data mining techniques according to changes in patient-centered medical culture. Using the raw data of the 2018 Medical Service Experience Survey, 8,843 people over the age of 15 who had patient experience in outpatient medical services were analyzed. Decision tree analysis was performed. The determinants of satisfaction with outpatient medical services patient experience were the doctor's area and patient's rights protection area, and the determinants of intention to recommend outpatient medical services were the doctor's area and facilities comfort. Women evaluated the experience positively in overall satisfaction as compared to men, and those over the age of 60 positively evaluated the overall satisfaction and intention to recommend. It is significant that the outpatient experience decision-making model is presented, and that the doctor's area, patient's rights protection area, and facility comfort are important factors. Long-term research on the 'Medical Service Experience Survey' is needed, and research on the inpatient medical service experience is needed.

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

  • Park, So-Jeong;Choi, Eun-Hee;Lee, Kyeong-Soo;Chung, Kwi-Ae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.11
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    • pp.332-339
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    • 2016
  • This study aimed to investigate the awareness and performance of safety in operating room nurses. There were 161 operating room nurses from eight general hospitals included for analysis in this study. The data were analyzed with t-test, one-way ANOVA, correlation analysis, and Scheffe's test. The results show that their perception of patient safety was 3.33 out of a total of 5 points. Moreover, the score of safety management activity for patients in the operating room was 4.28 out of 5 points. As the perception of patient safety in operating room nurses was significantly correlated with their safety management activities, nurses with higher awareness of patient safety were found to have higher degree of performance of safety management activities. In conclusion, to improve safety management activities, open discussion about patient safety should be encouraged and periodic education regarding patient safety should be implemented for operating room nurses to increase the perception of patient safety.

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

  • Lee, Sang-Wan;Lee, Geun-Bu
    • Journal of Korean Society for Quality Management
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    • v.13 no.2
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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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