• Journal of Korean Orthopaedic Sports Medicine
• /
• v.5 no.2
• /
• pp.161-164
• /
• 2006

Purpose: Meniscal injuries are very common sports problems and indications for knee surgery. We analyzed the effectiveness of joint line tenderness retrospectively. Materials and Methods: From May 2005 to June 2006, 76 knees which were diagnosed meniscal injury and performed arthroscopic surgery by same surgeon at military hospital were included. We analyzed sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of joint line tenderness in meniscal diagnosis. Results: The joint line tenderness gave such results (78.8%, 32.6%, 52.6%, 47.3%, 66.7% for sensitivity, specificity, accuracy, positive predictive value, negative predictive value respectively). We got similar results in analyses with medial meniscal lesion, lateral meniscal lesion, and combined instability patients. Conclusion: The joint line tenderness is a easy and comfortable maneuver but, it's effectiveness is low when it is used lonely The composite examinations including MRI and diagnostic arthroscopy for meniscal injuries of the knee perform much better than joint line tenderness alone.

• Journal of Chest Surgery
• /
• v.36 no.12
• /
• pp.991-994
• /
• 2003

Primary leiomyosarcomas are rare tumors of the lungs. No typical roentgenographic findings of unusual complex of symptoms distinguish this tumor. The most common therapy is surgical resection. Prognosis and significant survivorship are related to the size, grade, metastasis of the lesion. A 25-year-old female patient with chest pain and cough was admitted. In chest X-ray and CT scan, there was a pulmonary nodule in left upper lung field, She was taken a percutaneous needle aspiration biopsy. The result was a spindle cell tumor. Left upper lobe lobectomy was done, and pathologic diagnosis was a low grade leiomyosarcoma arising from left bronchus. During 5 years of follow-up period, she has not shown any metastasis or local recurrence.

• Health Policy and Management
• /
• v.34 no.2
• /
• pp.196-210
• /
• 2024

Background: In January 2018, revised elderly fixed outpatient copayment for the elderly were implemented. When people ages 65 years and older receive outpatient treatment at clinic-level medical institutions (clinic, dental clinic, Korean medicine clinic), with medical expenses exceeding 15,000 won but not exceeding 25,000 won, their copayment rates have decreased differentially from 30%. This study aimed to examine the changes of health utilization of elderly after revised elderly fixed outpatient copayment. Methods: We used Korea health panel data from 2016 to 2018. The time period is divided into before and after the revised elderly fixed outpatient copayment. We conducted Poisson segmented regression to estimate the changes in outpatient utilization and inpatient utilization and conducted segmented regression to estimate the changes in medical expenses. Results: Immediately after the revised policy, the number of clinic and Korean medicine outpatient visits of medical expenses under 15,000 won decreased. But the number of clinic outpatient visits in the range of 15,000 to 20,000 won and Korean medicine clinic in the range of 20,000 to 25,000 won increased. Copayment in outpatient temporarily decreased. The inpatient admission rates and total medical expenses temporarily decreased but increased again. Conclusion: We confirmed the temporary increase in outpatient utilization in the medical expense segment with reduced copayment rates. And a temporary decrease in medical expenses followed by an increase again. To reduce the burden of medical expense among elderly in the long run, efforts to establish chronic disease management policies aimed at preventing disease occurrence and deterioration in advance need to continue.

• The Journal of the Korea Contents Association
• /
• v.18 no.4
• /
• pp.516-529
• /
• 2018

The purpose of this study is to investigate the effect of perceived medical service quality by outpatient on hospital image, satisfaction, and re-use intention in a general hospital. A total of 176 questionnaires were administered to outpatients who presented to a S general hospital in Daejeon. The results of this study are as follows. First, medical service quality had significant effects on re-use intention, satisfaction, and hospital image. Second, the mediating effect of satisfaction on the relationship between medical service quality and re-use intention was not significant but the mediating effect of hospital image on the relationship was significant. Third, satisfaction and hospital image had significant effects on re-use intention. Consequently, this study verified the influence of perceived medical service quality by outpatient on hospital image, satisfaction, and re-use intention in a general hospital. Further, considering that hospital image, rather than satisfaction, mediates the relationship between perceived medical service quality and re-use intention, it suggests that much more general satisfaction is required in the marketing activities of hospitals.

• Journal of Korean Biological Nursing Science
• /
• v.9 no.1
• /
• pp.59-69
• /
• 2007

목적: 본 연구의 목적은 뇌사자로부터 공여받은 신장을 이식한 대상자들이 프레드니손을 생체이식 대상자들보다 더 많이 투여받는 임상상황에서 프레드리손이 근력과 일상생활활동에 영향을 주는지 규명하기 위함이다. 방법: 연구 대상은 뇌사자로터 신장을 응급으로 수여받은 32명이었으며 모두 혈액투석을 하고 있었다. 이식 수술 전날, 환자의 일반적인 정보, 근력, 일상생활활동에 대해 조사하였으며 이식수술 후 12주째 되는 날 외래에서 근력과 일상생활활동을 다시 조사하였다. 프레드니손 용량은 임상기록지를 통해 수집하였다. 연구결과: 신장이식술 후 12주의 근력은 고관절 신전근력을 제외하고는 유의하게 감소되지 않았다. 그러나 신장이식 후 12주의 일상생활활동은 수술 직전보다 유의하게 감소된 것으로 나타났다. 근력은 혈액투석을 시행한 기간에 의한 영향을 더 받았으며 일상생황활동의 저하는 3개월간 활동을 제한하는 퇴원교육의 영향이 큰 것으로 볼 수 있다. 결론: 본 연구에서 대상자의 근력과 일상생활활동은 프레드니손 투약의 영향을 받지 않았으며 오히려 혈액투석을 시행했던 기간에 따라 영향을 받은 것으로 나타났다. 따라서 혈액투석 환자들의 근력 증진을 위한 간호중재 개발이 필요하다.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.7 no.2
• /
• pp.105-112
• /
• 2014

Purpose: Ultrasound-guided epidural caudal block for low back pain and radiating pain is often performed in the treatment of outpatients. However, this procedure has a failure rate of up to 25% even when it performed by an experienced physician. The authors investigate the effectiveness of Ultrasound-guided epidural caudal block in patients related to disc herniation or spinal stenosis. Materials and Methods: Ultrasound-guided caudal epidural block was performed in 55 outpatients with LBP and radiating pain. Patient was placed in the prone position and sonographic image of sacral hiatus was obtained using linear probe. A 22-gauge needle was advanced into the sacrococcygeal membrane under ultrasound guidance and then medication was injected into the caudal epidural space. There were 31 cases of disc herniation, and 24 cases of spinal stenosis. Patients were evaluated by Visual Analog Scale (VAS) pain score at pre-treatment, post-treatment, 2 weeks and 4 weeks by telephone interviews. Results: 53 of the 55 cases (96.4%) of needle insertion into the sacral canal under ultrasound guidance were successful. Gender was not significantly different between disc herniation group and spinal stenosis group. But there was a significant age difference between disc herniation group ($42.3{\pm}10.8$), and spinal stenosis group ($62.8{\pm}15.1$) [p<0.001]. The VAS score at pre-treatment, post-treatment, 2 weeks, 4 weeks in disc group were 6.84, 3.1, 1.8 & 1.77. The VAS score at pre-treatment, post-treatment, 2 weeks, 4 weeks in spinal stenosis group were 6.88, 3.58, 4.33 & 4.88. The VAS score in both groups was significantly improved after the procedure (p<0.001). Over time, the two groups were statistically significant differences in VAS score after adjusting for age (p<0.001). Conclusion: Ultrasound-guided caudal epidural block seems to provide a high success rate and a significantly better response in disc group than spinal stenosis group.

• Journal of Chest Surgery
• /
• v.32 no.8
• /
• pp.753-756
• /
• 1999

Iatrogenic suclavian artery aneurysm is a rare disease which requires surgery because of the dangers of a rupture. We report a case of an aneurysm of the right subclavian artery developed by an iatrogenic trauma in a 43-year-old male. The preoperative diagnosis was made by an angiography and Doppler ultrasonogram. After the resection of a 6${\times}$7 cm sized aneurysm, an end to end anastomosis was done with a 6 mm Gore-Tex vascular graft. The post-operative course was uneventful and has been followed up from 3 months after discharge.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• v.2 no.1
• /
• pp.13-17
• /
• 2009

Purpose: The purpose of this study was to know the cause of the tenderness at pes anserinus. Materials and Methods: Out of 24 patients with tenderness at pes anserinus, 23 patients were female and 1 patient was male, and their average age was 65.9 years old. We checked the tenderness at pes anserinus by history taking & physical examniation and then, checked the pes anserinus for the presence of bursitis by US in outpatient clinic. With no evidence of bursitis by US, we injected steroid-lidocaine mixture intraarticularly and checked whether the tenderness disappeared after 2~3 minutes. Results: There was no case with bursitis at pes anserinus by US. The tenderness at pes anserinus diminished in 2-3 minutes after the intraarticular injection of the steroid-lidocaine mixture. After 6 weeks follow up, 16 patients(66.7%) had little or no tenderness at pes anserinus. 8 cases had the recurrence of tenderness recurred, 4 cases underwent arthroscopic operation on the meniscal tear, and 1 case underwent total knee arthroplasty. All cases underwent any operations had the tenderness at pes anserinus disappeared. The others 3 cases did not undergo total knee arthroplasty despite of radiologic obliteration of knee joint adequate for Kellgren-Lawrence grade IV. Conclusion: Without the bursitis at Pes Anserinus, patients the osteoarthritis may have the tenderness due to the referred pain.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.9 no.1
• /
• pp.1-13
• /
• 2006

Purpose: Acute gastroenteritis in children is one of the frequently encountered diseases with relatively high admission rate. The aim of this study is to determine the isolation trends of common and emerging pathogens in acute gastroenteritis in children over a 12-month period in a community hospital. Methods: The study group included the children who were hospitalized to Seoul National University Boramae Hospital from April, 2003 to March, 2004 or visited outpatient clinic from April, 2003 to July, 2003 with presenting features of acute gastroenteritis. Stool specimens were obtained within 2 days after the visit and examined for the following pathogens: rotavirus, adenovirus, Salmonella, Shigella, Vibrio, pathogenic Escherichia coli (E.coli), Campylobacter and Yersinia species. Viral study was done with commercial kits for antigen detection. Identification of the bacterial pathogens was done by culture using selective media. For pathogenic E.coli, polymerase chain reaction (PCR) was done with the target genes related to the pathogenecity of enterotoxigenic E.coli (ETEC), enteropathogenic E.coli (EPEC) and enterohemorrhagic E.coli (EHEC). Results: The 130 hospitalized children and 28 outpatients were included in this study. The majority of children (>93%) were less than 6 years. Pathogens were isolated in 47% of inpatients and 43% of outpatients, respectively. Rotavirus was the most frequently identified pathogen, accounting for 42.3% of inpatients and 29.6% of outpatients. Nontyphoidal salmonella is the most commonly isolated bacterial pathogen (3.9%) in hospitalized children. Pathogenic E.coli (EPEC, ETEC) was detected in 2.1% (2/97) of inpatients and 25% (3/12) of outpatients. EHEC, adenovirus, Campylobacter, Yersinia and Shigella species were not detected in this study. Conclusion: Rotavirus is the most common enteropathogen in children with acute gastroenteritis. Nontyphoidal salmonella and pathogenic E.coli are important bacterial pathogens. Campylobacter species may not be commonly detected organism in hospitalized children with acute diarrhea.

• Journal of Chest Surgery
• /
• v.34 no.4
• /
• pp.345-350
• /
• 2001

배경: 항부정맥 술식으로서의 메이스 술식은 우수한 동율동 전환율을 보고 있으나, 술식의 복잡성과 상대적으로 긴 수술 시간 등으로 모든 환자들에게 적용할 수는 없기에, 일부 환자군에서 보다 간단한 항부정맥술인 폐정맥 분리술을 시행 받은 환자들을 대상으로 동율동 전환율 등의 수술 성적과 위험 인자 등에 대해 알아보고자한다. 대상 및 방법: 1995년 10월부터 1999년 2월까지, 폐정맥 분리술을 시행받은 96명의 환자들을 대상으로 후향적 연구를 시행하였다. 남자가 37명(38.5%), 여자가 59명(61.5%) 이었고, 평균 연령은 46.9$\pm$11.6세 이었다. 승모판 협착 환자가 50명(52.1%), 폐쇄 부전이 24명(25%), 협착과 폐쇄부전이 같이 있었던 경우가 22명(22.9%)이었다. 판막 술식과 폐정맥 분리술을 시행하고 좌심방이 제거술을 시행하였다. 모든 환자들은 술 후 6개월 내지 1년 이내에 외래에서 심전도와 심초음파를 시행받았다. 평균 추적 관찰 기간은 25.9$\pm$11.5개월 이었다. 술 후 최근 추적일까지 동율동으로 전환된 군과 안된 군으로 나누어 분석을 하였다. 결과: 조기 성적으로는 사망이 3명(3.1%), 술 후 6개월 이내의 추적관찰 유실이 2명(2.1%) 이었다. 조기 합병증으로 재수술이 필요 했던 출혈이 4례, 심폐바이패스 이탈 실패오 심실보조장치 등의 삽입이필요했던 경우가 1례, 뇌혈관질환 1례, 심근경색이 1례 등이 있었다. 만기 합병증으로는 동기능 부전 증후군으로 영구 심박동기를 삽입한 경우가 1례, 일시적인 뇌경색 1례 있었고 다른 판막과 연관된 합병증은 없었다. 동율동 전환 환자 수는 75명(82%)이었다. 동율동으로의 전환이 어려운 위험인자로 50세로 이상의 연령(p=0.03), 65mm 이상의 좌심방 크기(p=0.03), 동반 우심 술식 시행(p=0.02)등이 있었다 결론: 승모판 질환을 동반한 심방 세동 환자에서 폐정맥 분리술을 시행하여 만족할 만한 동율동 전환율을 얻을 수 있었다.