• 제목/요약/키워드: First-visit Patients

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측두하악장애환자에서 한국어 통증척도를 이용한 통증에 관한 연구 (A Study on the Pain in Patients with Temporomandibular Disorders using Korean Pain Rating Scale)

  • Yoing-Gyu Bae;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • 제19권2호
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    • pp.169-180
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    • 1994
  • The aim of this study was to compare pain descriptions in common dental patients with those in patients with Temporomandibular disorders(TMDs). The study sample consisted of 104 common dental patients and 74 patients with TMDs, and their chief complaint was pain, Subjects were classified common dental pain group and TMDs pain group, respectively. All the subjects completed Korean Pain Rating Scale(KPRS) on first visit. KPRS contains 90 pain terms, which divided into 20 subclasses in 3 dimensions. Each subclass contains 3-6 pain terms. each patient had chosen only one term from each subclass. If there was no proper term, subject could pass the subclass without completion. Words chosen were categorized into sensory, affective, miscellaneous and total dimension. Thereafter they were processed and analyzed by SPSS/PC+ statistical package program with respect to rank values, scale values, number of words chosen and frequency of each subclass. The obtained results of this study were as follows : 1. Total mean number of words chosen was 7.6. 2. Chronic patients groups with Temporomandibular disorders had chosen more freuently from the subclasses in affective dimension than the patients in acute common dental pain group. 3. Frequency of affective dimension was higher in chronic patients groups with Temporomandibular disorders than that of acute patients group with Temporomandibular disorders. 4. Chronic patients group with Temporomandibular disorders had higher frequency in constrictive pressure pain, traction pressure pain, dull pain and fatigue-related pain terms than acute common dental patients group. 5. Acute patients group with Temporomandibular disorders had higher frequency in traction pressure pain and dull pain terms but had lower frequency in chemical pain, peripheral nerve pain and cold pain terms than acute common dental patients groups. 6. There were high positive correlation between the scale- and rank-value in the pain rating index.

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단독성 고메티오닌혈증 환아들의 임상적 특성과 유전자 분석 (Clinical Findings and Genetic Analysis of Isolated Hypermethioninemia Patients in Korea)

  • 유상수;이민희;이정호;이동환
    • 대한유전성대사질환학회지
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    • 제13권2호
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    • pp.98-103
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    • 2013
  • Purpose: MAT-I/III deficiency by MAT1A gene mutation causes isolated hypermethioninemia, which is considered to be a clinically benign disease. But in some patients, mental retardation, developmental delay, myelination disorder may be shown. This study was performed to find out the clinical manifestations and genetic characteristics of patients with isolated hypermethioninemia. Methods: Clinical, biochemical and genetic analysis were done to 10 patients with isolated hypermethioninemia who were referred to department of pediatrics, Soonchunhyang University Hospital from March 1999 to March 2012. Results: At first visit, all patients' mean plasma methionine level was 5.5 mg/dL (2.1-14.6) and there were no increase of amino acid levels including homocystine in all patients. Serum homocysteine level was evaluated in seven patients who visited after year 2003, and ranged from 4.96 to $11.15{\mu}mol/L$ (normal < $25{\mu}mol/L$). Methionine restricted diet was started to all patients. Nine patients who managed regularly showed normal development, but one patient whose initial plasma methionine level was 14.6 mg/dL showed language delay at 1 year of age and was diagnosed as mild mental retardation (IQ=66) at 6 years of age. Genetic analysis was done to eight patients, R264H mutation was identified in seven patients. Also, both R299C and R356Q mutation were identified in one patient. Conclusion: Clinical findings in patients with isolated hypermethioninemia were generally good, but one patient showed mental retardation and language difficulty. R264H mutation which usually inherits as an autosomal dominant trait was most frequently found in our patients, and R299C/R356Q mutation were also identified.

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안면 마비의 재건에서 광배근 유리피판과 박근 유리피판의 비교 연구 (Comparative Study of the Latissimus Dorsi and Gracilis Muscle Reconstruction for Reanimation of a Paralyzed Face)

  • 강동희;임찬수;구상환;박승하
    • Archives of Plastic Surgery
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    • 제34권3호
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    • pp.336-341
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    • 2007
  • Purpose: The most accepted method for the reanimation of a paralyzed face is the two-stage method that combines cross-face nerve grafting with free-muscle transfer. Although the results of reconstruction with this method are satisfactory, there is an excessive delay between the stages, which prolongs the period of rehabilitation. In order to overcome this drawback, a one- stage, neurovascular free-flap reconstruction method using free neurovascular muscle flaps is introduced. Methods: From 1994 to 2004, 35 patients with longstanding facial palsy were treated. Fifteen patients underwent the single-stage reconstruction with the latissimus dorsi muscle, and 20 patients underwent the two-stage reconstruction method with the gracilis muscle. We compared the long-term results of the two methods of reconstruction. The mean follow-up period was 28.7 months for one-stage reconstruction, and 35.2 months for the two-stage, respectively. Results: In the patient group of the single stage reconstruction, both mouth corner excursion and animation grade were markedly improved at the final postoperative visit. Moreover, the first muscle contraction occurred earlier in this group, than in the two-stage reconstruction group. However, four patients in the single stage group never achieved a first muscle contraction or mouth corner excursion. Conclusion: Facial palsy is a very challenging condition for cosmetic surgeons to deal with. Traditional methods for treatment of chronic facial palsy use a two-stage muscle flap which is time-consuming and burdensome to patients, many of whom are averse to waiting 8 to 12 months to complete the two stages. The one-stage reconstruction method described herein uses a latissimus dorsi free-flap and has demonstrated consistent positive outcomes in clinical assessments.

턱관절 자세 음양 교정술을 병행한 한방치료가 벨마비에 미치는 영향 (The Effect of Korean Medical Treatments with Postural Yinyang Correction of Temporomandibular Joint on Bell's Palsy)

  • 서종철;김신영;서연주;박종현;이윤주;류혜민;이승정;윤현민;송춘호;이영준;김철홍
    • Korean Journal of Acupuncture
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    • 제33권4호
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    • pp.183-193
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    • 2016
  • Objectives : The purpose of this study is to find out the effect of Postural Yinyang Correction of TMJ(Functional Cerebrospinal Therapy; FCST) on Bell's palsy. Methods : We reviewed the medical records of 41 patients who were treated for Bell's palsy at the Dept. of Acupuncture and Moxibustion, Dong-Eui University from January $1^{st}$, 2016 to August $31^{st}$, 2016. The patients were divided into 2 groups: Group A(n=21), and Group B(n=20). Patients in Group A were treated by Korean Medical Treatments with FCST using ABA(Accurate Balancing Appliance), a standard intra-oral appliance. Patients in Group B were treated by Korean Medical Treatments without FCST. To estimate the efficacy in recovering palsy, we analyzed the House-Brackmann Grading Scale and Yanagihara's Unweighted Grading System. Results : In both groups, H-B grades were improved significantly during each period except the period from the first visit to one week later(P01). The improvement of H-B grade during each period in Group A is higher than Group B except the period from one week later to two weeks later, but statistically insignificant. In Group A, Y-score was significantly improved during each period except during P01. In group B, Y-score was significantly improved during each period except during P01 and the period from the first visit to two weeks later. The improvement of Y-score during each period in Group A is higher than Group B, but statistically insignificant. Conclusions : FCST using Standard Intraoral Appliance may be helpful in treating Bell's Palsy, but the further researches are needed.

視力低下에 對한 臨床的 考察 (A Clinical Study on the Decreased Visual Acuity)

  • 최은성;류혜정;채병윤
    • 한방안이비인후피부과학회지
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    • 제9권1호
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    • pp.146-158
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    • 1996
  • We observed 79 patients, who visited the Department of Oph. & Otorhinolaryngology in Oriental medicine of Kyung Hee University Medical Center from July 1995 to June. 1996, with the complaint of decreased visual acuity. The results were as follows. 1. In the incidence of decreased visual acuity, men's was $46.84\%$(37 cases) and women's was $53.16\%$(42 cases), which showed that more women were suffering decreased visual acuity than men. In the incidence of myopic ametropia and astigmatic ametropia among the total patients, men's was $44.62\%$(29 cases) and $37.50\%$(9 cases) each, and women's was $55.38\%$(36 cases) and $62.50\%$( 15 cases) each, which also showed that more women were suffering myopia and astigmatism than men. 2. The average age of patients was 11.08 years at the first visit. The most were the patients from 6 to 15 years old, with 63 cases($79.74\%$). 3. The age of onset in the decreased visual acuity was mainly 6∼10 years with 45 cases($56.96\%$). In the case of myopic ametropia and astigmatic ametropia, the age of onset was also mainly 6∼10 years with 65 cases($60.00\%$), and with 12 cases($50.00\%$) each. 4. In ABO blood type, the frequency was, A type, O type, B type and AB type in order. In men, O type was the most, while in women, A type. 5. In the liking for cool or warm food or tepidity, the liking for cool food was the most in both men and women. 6. The type of decreased visual acuity was mainly myopic ametropia with 65 cases($82.28\%$). Astigmatic ametropia was $30.38\%$ with 24 cases, hyperopic ametropia $2.53\%$ with 4 cases, and the decreased visual acuity accompanied by amblyopia $7.59\%$ with 4 cases. 7. At the first visit, the average visual acuity of O.D. was 0.29 and that of O.S.. 0.24, which showed that O.S.. is worse than O.D.. The visual acuity below 0.2 was the most, $63.29\%\;in\;O.D..\;72.15\%$ in O.S.. 8. In the treatment period, 4∼7 weeks occupied $35.44\%$ with 28 cases, 8∼11 weeks $30.38\%$ with 24 cases, so the treatment period was mainly these two periods with 52 cases($65.82\%$). 9. The average frequency of acupuncture treatment per week was mainly 2.1∼3.0 times with 45 cases($56.96\%$). In this case, men was 24 cases($53.33\%$) and women 21 cases($46.67\%$), so men was more than women. 10. The frequency of herbal prescription was mainly Gamijungjitang and Gamijingjibogansan with 76 cases($85.39\%$).

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한방병원에 내원한 소아청소년기 말초성 안면마비 환자 284례를 통한 임상적 고찰 (A Clinical Study on Children and Adolescents Who Visited the Hospital of Korean Medicine for 284-Peripheral Facial Palsy)

  • 강기연;이혜림;한재경;김윤희
    • 대한한방소아과학회지
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    • 제28권4호
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    • pp.45-63
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    • 2014
  • Objectives The purpose of this study is to investigate the clinical characteristics in children and adolescents with peripheral facial palsy that was treated with Korean medicine. Methods The study was conducted based on 284 cases that consisted of 261 children (less than 19 years old) who visited the hospital of Korean medicine from August 2010 to August 2014. Then, this study was analyzed by reviewing the patients' charts. Results The incidence of facial palsy in pediatric patients was more common in boys than in girls and the mean age was 11.2 years. The prevalence of facial palsy was more common in winter and most were diagnosed with Bell's palsy. Recurrence was identified in 12.6% of the patients. The average age of the first attack was 9.5 years. It took about 3.2 years for recurrence to occur from the first onset. It took about 5 days to visit the hospital of Korean medicine from the onset. 81% of the patients came within 1 week from the onset. 50.7% of the cases did not receive any treatment before and 49.3% were previously treated at other hospitals. More than half of the patients (65.1%) received Korean medicine first. 54.6% of the patients were hospitalized and 45.4% received outpatient treatments in the hospital of Korean medicine. Outpatient treatments were administered about 11.5 times while hospitalized patients were treated for an average of 16.6 days. In general, hospitalized patients were treated more often than the outpatient group. An overall average duration of treatment was 70.6 days from the onset of facial palsy until the last day of treatment, and 53.0 days from the first day of treatment until the last day of treatment. 41.5% of the cases were treated only with Korean medicine and 49.0% were treated with a combination of Korean and Western medicine. The types of Korean medicine treatment used for facial palsy in descending order of frequency were acupuncture, Infra red, herbal medicine, SSP therapy, electro-acupuncture, carbone, hot pack, cupping, and moxibustion. The treatments that were most frequently used from Western medicines were steroid as monotherapy (61.7%) and a combination of steroids and antiviral therapy (37.6%). Conclusions This result showed that the risk of facial palsy recurrence among children is relatively high and that facial palsy requires a long-term treatment. It's helpful to explain about prognosis, treatment duration, and recurrence potential in children. Facial palsy in children is treated in various ways but more studies about the therapeutic effects of Korean medicine, Western medicine, and combination of Korean-Western medicine in children are needed.

독립형 가정간호시범사업소의 가정간호행위분류체계 개발과 수가 연구 (Development of home nursing care classification and home nursing care costs of the free-standing home nursing care agency)

  • 윤순녕;박정호;김매자;홍경자;한경자;박성애;홍진의
    • 가정∙방문간호학회지
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    • 제6권
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    • pp.19-32
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    • 1999
  • The purpose of this study was to develop of home nursing care classification and home health care costs of the free-standing home nursing care agency. This study was done through 3 steps The First stage, home nursing care classification was identified and classified by literature, review-committee and expert meeting. The second stage, cost elements for home nursing care visit were identified and accounted. That were divided into direct nursing care cost, indirect nursing care cost, management cost and transportation cost. Third stage, total cost of per visit was produced. Data were collected from 810 visits of 120 patients received home dare and from January. 1999 to November, 1999, and analysed with EXCEL program. The obtained results are as follows : 1. Home nursing care classification was consisted of 6 high level classification domain and 10 low level classification domain and 163 home nursing care behavior. 2. The cost of home nursing care per visit was 30,638 won which were direct and indirect nursing care cost(16.305won), management cost(5,255won) and transportation cost (9,098won). In conclusion. Home nursing behavior care classification developed in this study would be used as home health care standard. And the home nursing care costs can be used as a fundamental data for the further development of home health care costs in Korea.

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족관절 급성 염좌의 일차 치료: 석고고정과 기능적 보조기를 이용한 치료의 후향적 비교 (Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace)

  • 배서영;안수형;정형진;감민철
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.105-109
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    • 2019
  • Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

Evaluation of functional suitable digital complete denture system based on 3D printing technology

  • Deng, Kehui;Chen, Hu;Wang, Yong;Zhou, Yongsheng;Sun, Yuchun
    • The Journal of Advanced Prosthodontics
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    • 제13권6호
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    • pp.361-372
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    • 2021
  • PURPOSE. To improve the clinical effects of complete denture use and simplify its clinical application, a digital complete denture restoration workflow (Functional Suitable Digital Complete Denture System, FSD) was proposed and preliminary clinical evaluation was done. MATERIALS AND METHODS. Forty edentulous patients were enrolled, of which half were treated by a prosthodontic chief physician, and the others were treated by a postgraduate student. Based on the primary impression and jaw relation obtained at the first visit, diagnostic denture was designed and printed to create a definitive impression, jaw relation, and esthetic confirmation at the second visit. A redesigned complete denture was printed as a mold to fabricate final denture that was delivered at the third visit. To evaluate accuracy of impression made by diagnostic denture, the final denture was used as a tray to make impression, and 3D comparison was used to analyze their difference. To evaluate the clinical effect of FSD, visual analogue scores (VAS) were determined by both dentists and patients. RESULTS. Two visits were reduced before denture delivery. The RMS values of 3D comparison between the impression made via diagnostic dentures and the final dentures were 0.165 ± 0.033 mm in the upper jaw and 0.139 ± 0.031 mm in the lower jaw. VAS ratings were between 8.5 and 9.6 in the chief physician group, while 7.7 and 9.5 in the student group; there was no statistical difference between the two groups. CONCLUSION. FSD can simplify the complete denture restoration process and reduce the number of visits. The accuracy of impressions made by diagnostic dentures was acceptable in clinic. The VASs of both dentists and patients were satisfied.

Risk factors for hospital admission in revisiting patients to the emergency department with abdominal pain

  • ;김혜진
    • 대한응급의학회지
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    • 제29권6호
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    • pp.679-686
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    • 2018
  • Objective: The aim of this study was to identify the clinical characteristics and risk factors associated with the admission of patients in the emergency department (ED) within 30 days after discharge. Methods: A retrospective, observational study was conducted on adult patients presenting with abdominal pain to the ED of a single, urban, university hospital, between January 2014 and December 2015, who revisited the ED within 30 days after discharge. Data was collected on the emergency severity index level, time to contact doctors, physical examination, laboratory tests, use of computed tomography (CT), and patient disposition on revisitation. The primary outcome was hospital admission following an ED revisit in the 30-day period after the first visit. Results: During the study period, 19,480 patients visited the ED with the chief complaint of abdominal pain, and 13,577 were discharged. A total of 251 patients (1.29%) revisited the ED within 30 days, of which 89 were eligible for the study. The primary outcome was associated with not performing a CT scan on the initial visit and an increased C-reactive protein (CRP) value. Receiver operating characteristic curve analysis showed that a cut-off baseline CRP value of >0.35 mg/dL can predict the primary outcome with a sensitivity and specificity of 75% and 62.1%, respectively (area under the curve, 0.701; 95% confidence interval, 0.569-0.833; P=0.007). Conclusion: An increased CRP value and not performing abdominal CT were associated with a higher rate of admission following ED revisits of patients with abdominal pain. Future prospective studies on the role of abdominal CT imaging in patients presenting to the ED with abdominal pain will be needed.