• Title/Summary/Keyword: 내원환자

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Pulmonary Arteriovenous Fistula with Hemothorax - A case report- (혈흉을 동반한 폐동정맥루에 대한 치험 - 1예 보고 -)

  • 김인섭;정성철;김우식;신용철;유환국;김병열;안재범
    • Journal of Chest Surgery
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    • v.37 no.8
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    • pp.702-706
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    • 2004
  • Pulmonary arteriovenous fistula is usually considered as a subset of congenital anomalies or acquired causes which can produce a variety of conditions such as dyspnea, cyanosis, and pulmonary vascular bruit. The diagnostic methods can be diverse such as arterial blood gas analysis (ABGA), chest X-ray, chest CT and pulmonary angiogram but the most accurate diagnostic modality is thought to be the pulmonary angiogram. The complications of this disease are a rupture that can cause hemothorax, brain abscess, and cardiovascular accident, and the treatment options are either segmental resection or therapeutic embolization. A twenty-six year old female developed sudden dyspnea and visited our emergency room. The patient was diagnosed as having pulmonary arteriovenous fistula (size; 4${\times}$4${\times}$3 cm) in the superior segment of the right lower lobe, evidenced by chest CT and pulmonary angiogram. Consequently, she underwent an emergency right lower lobectomy. We report this rare case of combined hemothorax that we have experienced, from diagnosis to treatment.

Effects of Spatial Accessibility on the Number of Outpatient Visits for an Internal Medicine of a Hospital (공간적 접근성이 내과환자의 내원일수에 미치는 영향 분석: 대도시 일개 병원을 대상으로)

  • Lee, Eun-Joo;Moon, Kyeong-Jun;Lee, Kwang-Soo
    • Health Policy and Management
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    • v.26 no.3
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    • pp.233-241
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    • 2016
  • Background: This study purposed to analyze and understand how spatial accessibility of patients influenced the number of outpatient visits for the internal medicine of a hospital. Methods: A hospital with 100 beds in Seoul, South Korea provided data from 2013 January 1 to 2013 June 30. Euclidean distance and road ares were used to represent the spatial accessibility. Patient level data and dong level data were collected and used in spatial analysis. Dong level data was converted into grid level ($500{\times}500m$) for the multivariate analysis. Hot-spot analysis and generalized linear model were applied to the data collected. Results: Hot-spots of outpatient visits were found around the study hospital, and cold-spots were not found. Number of outpatient visits was varied by the distance between patient resident and hospitals, and about 80% of total outpatient visits was occurred in within the 5 km from study hospital, and 50% was occurred in within 1.6 km. Spatial accessibility had significant influences on the outpatient visits. Conclusion: Findings provide evidences that spatial accessibility had influences on the patients' behaviors in utilizing the outpatient care of internal medicine in a hospital. Results can provide useful information to health policy makers as well as hospital managers for their decision making.

Congenital Partial Pericardial Defect Presenting as Chest Pain (가슴 통증을 동반한 선천성 부분 심낭 결손증)

  • Kim, Yong-Ho;Kang, Min-Woong;Lim, Seung-Pyung;Lee, Young;Gil, Hong-Ryang;Yu, Jae-Hyeon
    • Journal of Chest Surgery
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    • v.40 no.10
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    • pp.719-721
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    • 2007
  • Patients with congenital pericardial defect display few symptoms and this is an unusual disease, so it is generally found incidentally in most of the cases. In some cases, symptoms such as chest pain are found due to partial cardiac herniation. We report here on a 14-year-old girl with dyspnea and chest pain that started during physical activity 3 months before the hospital visit. She was diagnosed with herniation of the left atrial appendage with a partial pericardium defect and she was treated with an operation.

SURGICAL REPOSITIONING OF AN IMPACTED INCISOR IN MIXED DENTITION (매복된 중절치의 재식)

  • Choi, Su-Mi;Lee, Keung-Ho;Choi, Yeong-Chul;Park, Jae-Hong
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.4
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    • pp.687-692
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    • 2005
  • Delayed eruption of a maxillary incisor results in midline shift, the space occupied by adjacent teeth and different levels of alveolar height. Extraction or surgical/orthodontic therapy is the most common treatment for a impacted maxillary incisor. Surgical repositioning provides another option for treatment of this problem. The advantages of this approach include immediate esthetic improvement, use of a single and simplified surgical procedure, simple and short orthodontic therapy, a normal gingival margin and the possibility of the developing root adapting to the new position. Autotransplantation of an immature tooth provides for possible adaptation of the developing root apex to the new position. A root with an open apex has good chance of pulp revascularization after transplantation.

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A Case of Severe Acute Respiratory Distress Syndrome Treated with Extracorporeal Life Support (체외생명보조를 이용한 중증 급성호흡곤란증후군 치료 1예)

  • Kim, Young Mook;Lee, Jue Yong;Lee, Myung-Goo;Lee, Chang Youl;Kim, Go Woon;Sohn, Kyoung Min;Yang, Ha Na;Kim, Dae Yong;Choi, Hyun Hee;Kim, Hyoung Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.6
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    • pp.526-530
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    • 2007
  • The incidence of acute respiratory distress syndrome (ARDS) has been estimated worldwide to range from 1.7 to 75 cases per 100,000. There are many treatments for ARDS, but only the low tidal volume strategy is based on strong clinical evidence from randomized clinical trials. The efficacy of extracorporeal life support (ECLS) in adults remains controversial. Ongoing clinical trials and research have shown a benefit for its use to salvage severe ARDS patients that are in failure with conventional treatment. We encountered a 41-year-old woman who developed ARDS induced by pneumococcal pneumonia. Despite conventional mechanical ventilation in the emergency room, severe hypoxia remained. We treated the patient immediately with ECLS. The patient has almost fully recovered, and was discharged from a 177-day stay at our hospital.

A Study on the Fear in Private Dental Clinics (치과내원환자의 치과 치료시 공포감에 관한 연구)

  • Lee, Hye-Jin;Jeon, Eun-Sook;Lee, Byung-Ho
    • Journal of dental hygiene science
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    • v.7 no.3
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    • pp.193-196
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    • 2007
  • From April 9th to May 4th 2007, making a random selection of three private dental clinics in Busan, this study investigated the fear for dental treatment for 178 adults over twenty. Using four items of General Characteristics and DFS of twenty items, the degree of fear for dental treatment was evaluated by self administrated questionnaire. The obtained results were as follows. 1. Reliability analysis of each factor in details was 0.662~0.921 in Cronbach' alpha Coefficients. For Cronbach' alpha Coefficients was over 0.6. Dental Fear Survey Scale was reliable. 2. Dental stimulus response scale of three factors appeared more fear than two factors of the rest. The fear for dental treatment was higher in wemen, older ages, high education level and high income. 3. Factor of dental stimulus response scale, avoidance of dentistry and physiologic response scale accounted for 66.1%($R^2=66.1$)of the variation in dental fear factor as a result from stepwise regression analysis.

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Chronic Lymphocytic Leukemia in a Dog

  • Jung, Seung-Woo;Choi, Eul-Soo;Lee, Jong-Bok;Hwang, Cheol-Young;Youn, Hwa-Young;Lee, Chang-Woo;Han, Hong-Ryul
    • Journal of Veterinary Clinics
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    • v.19 no.4
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    • pp.429-432
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    • 2002
  • Chronic Iymphocytic leukemia is a general disease that evolves over a longer duration and is characterized by more mature and well-differentiated Iymphocytes in blood and bone marrow than those seen in acute leukemia. This report presents a 2-year-old mix neutered male dog with seizure, ascites, and transmissible venereal tumor. Diagnostic works-up concluded chronic Iymphocytic leukemia. Chemotherapy composed of chlorambucil and prednisolone has been applied to the patient until now. Remission of almost manifestations was achieved, and the quality of life improved.

Primary Renal Hemangiosarcoma Complicated with Hematuria and Hemoperitoneum in a Dog (개에서 발생한 혈뇨와 복강 내 출혈을 동반한 신장원성 혈관육종)

  • Yeo, Jung-Jin;Sur, Jung-Hyang;Eom, Ki-Dong;Park, Hee-Myung
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.165-168
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    • 2012
  • A 14-year-old intact male Siberian Husky was presented with hematuria, lethargy, and anorexia of 1-month duration. The physical examination revealed mild abdominal distension and pain. The hematology and serum chemistry revealed anemia and severe azotemia. The radiographic examination revealed renomegaly and the ultrasonographic examination, indistinct cortico-medullary junction, increased renal cortex echogenicity, and irregular margination. The urinalysis showed proteinuria and hematuria. The differential diagnosis included renal failure, cystitis, pyelonephritis, and neoplasia. The patient's condition continued to deteriorate, and the dog eventually died. The gross findings from the necropsy revealed hemoperitoneum and a bilateral renal mass. HSA was diagnosed by histopathological examination. This case report describes primary bilateral renal hemangiosarcoma (HSA), which is uncommon in dogs.

Traumatic Brain Injury in a Pomeranian Dog: Clinical, Computed Tomography, and Necropsy Findings (포메라니언 종에서 발생한 외상성 뇌손상 증례보고; 임상적, 전산화 단층촬영, 부검 소견)

  • Lee, Hee-Chun;Choi, Eul-Soo;Cho, Kyu-Woan;Kang, Byeong-Teck;Kim, Ju-Won;Yu, Chi-Ho;Sur, Jung-Hyang;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.579-583
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    • 2010
  • An 18-month-old intact male Pomeranian dog was presented because of traumatic head injury from a fall. Based on physical and neurological examination, brain injury was suspected. On plain skull radiographs, bony fragment following fracture was identified in the region of the right occipital bone. On computed tomography (CT) images, there were specific findings associated with an intracranial hemorrhage. The patient expired few hours after diagnosis, and performed necropsy. On gross findings, intracerebral hemorrhage and edema was detected and those were consistent with CT images. This report describes the clinical findings, CT imaging characteristics, necropsy findings, and histopathologic features of severe traumatic brain injury in a dog.

The Clusters of Fever-Related Symptoms among Patients at the Emergency Room (발열 증상 클러스터 - 응급실 내원 성인 환자를 대상으로)

  • Na, Sun Gyoung;Shin, Hyun A;Oh, Eui Geum
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.1
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    • pp.20-29
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    • 2017
  • Purpose: The purpose of this study was to investigate symptoms experienced by patients who reported fever at the emergency room (ER) and to identify any existing cluster of symptom related to fever. Methods: The study used a retrospective and descriptive design with secondary data analysis. Data were abstracted from 665 medical records of patients with fever who visited ER from September 1, 2015 to August 31, 2016 at a tertiary hospital. Results: The most frequently reported symptoms included cold (43.9%), myalgia (24.1%), headache (16.2%), general weakness (15.3%), respiratory symptoms (12.3%), gastrointestinal (GI) symptoms (12.0%), mental change (4.5%), sweating(1.8%), and warmth (0.9%). Analysis of the symptoms related to fever revealed seven symptom clusters; Cluster 1 (n=190) included cold (100%) and myalgia (28.9%); Cluster 2 (n=37), headache (100%) and myalgia (32.4%); Cluster 3 (n=33), GI symptoms (100%), general weakness, headache, and cold; Cluster 4 (n=34), cold (100%), myalgia, headache, and respiratory symptoms; Cluster 5 (n=241), respiratory symptoms (10.8%); Cluster 6 (n=76): myalgia (75.0%) and general weakness, and Cluster 7 (n=54), cold (87.0%), general weakness, and respiratory symptoms. Conclusion: The results of this comprehensive symptom assessment are hoped to be helpful in developing better symptom management for ER patients with fever than before. Further research is warranted to verify the symptom clusters of this study in different clinical settings.