• 제목/요약/키워드: First-visit Patients

검색결과 367건 처리시간 0.026초

통규탕가미방(通竅湯加味方)의 비질환(鼻疾患) 치료에 대한 임상고찰 (A Clinical study on the Treatment of Nasal disease using TonggyutangGamibang)

  • 김기훈;조형준;이진용;조백건
    • 대한한방소아과학회지
    • /
    • 제18권1호
    • /
    • pp.153-163
    • /
    • 2004
  • Objective: For last 20 years our living environment has been changed rapidly. Accordingly. there have been many changes in prevalence of diseases; In nasal disease of the pediatrics, the number of children suffering from chronic rhinorrhea and nasal obstruction has been increased. And respiratory symptoms suggesting rhinitis and sinusitis also were increased. Allergic disease is considered as an important cause of this phenomenon while importance of infection as pathogen is fading today. The aim of this study is to investigate the effect of TonggyutangGarnibang on the nasal disease of children. Methods: Children with nasal disease answer the questionnaires on their chief complaints and medical past history on their first visit to our clinic. They were treated 'With TonggyutangGarnibang for 4weeks. After treatment they answered the questionnaire on improvement of their symptoms. Results: Among treated patients, 70 were male(69%) and 32 were female(31%); sex ratio was 2.2.3:l(male:female). And children from 3-8 years old took majority of patients(64%). Major symptoms of children with nasal disease were as follows; nasal obstruction 9lchildren(62%), rhinorrhea 86children(84%), sneezing 63children(62%), cough 63children(62%), snoring 48children (47%), poor appetite 44children(43%), itching 39children(38%), headache 32children(31%), stomache 25children(25%), epistaxis 23children(23%), constipation 17children(17%), diarrhea 12children(12%). Past history and impression of the disease of the patients were as follows; allergic rhinitis(66%), atopic dermatitis(42%), sinusitis(40%), asthma(25%), urticaria(12%). Severity of symptom improved after TonggyutangGamibang treatment, it showed high treatment efficacy as follows; sneezing 70%, cough 70%, rhinorrhea 63%, nasal obstruction 59% Conclusion: This study shows TonggyutangGamibang has distinctive treatment effect on children with nasal disease.

  • PDF

만성 족부 질환이 환측 하지의 골밀도에 미치는 영향 (Effect of Chronic Foot Disease to Bone Mineral Density of the Affected Lower Limb)

  • 주인탁;유종민;강민구;정진화
    • 대한족부족관절학회지
    • /
    • 제14권2호
    • /
    • pp.165-168
    • /
    • 2010
  • Purpose: Pain or discomfort caused by foot diseases may lead to abnormal gait, resulting in decreased bone mineral density (BMD) of the affected lower limb. We analyzed the effect of foot affection to BMD and its clinical significance. Materials and Methods: Bilateral hip BMD was evaluated in 93 patients with unilateral chronic foot disease. To minimize statistical errors, we excluded patients with medical histories that had influence on BMD. Analysis was based on the results of BMD tests at the first visit. All patients denied past medical intervention for osteoporosis. The difference in density between bilateral limbs was determined by comparing BMDs of the neck, upper neck, trochanter and total area of hip. Results: Test results revealed the decrease of BMD in the lower limb with the affected foot, compared to the unaffected side. This decrease was significant in the area of the trochanter (p <0.05). There was no marked difference of BMD in relation with duration of affection, underlying disease or age. Pertaining the location of foot affection, the hindfoot group showed significant decrease in BMD compared to the forefoot group. The group with affection in bone and joint also showed a marked decrease in BMD compared to the soft tissue group (p <0.05). Conclusion: Pain and discomfort caused by chronic foot diseases can lead to a decrease in the BMD of the affected lower limb. This may increase the risk of complications such as osteoporotic fracture and muscular atrophy.

만성질환자 대상 맞춤형 투약상담 중재 프로그램 시범사업에 대한 평가 (Participants' Evaluation on the Payer-driven Medication Counseling Intervention for Individuals with Chronic Disease)

  • 손현순;장선미;이주연;한은아
    • 한국임상약학회지
    • /
    • 제26권3호
    • /
    • pp.245-253
    • /
    • 2016
  • Objective: This study was conducted to evaluate payer-driven medication adherence intervention program from the patient's and counselor's perspectives. Methods: Target patients for intervention were selected by retrospective adherence measures based on national health insurance claims data for hypertension, diabetes and hyperlipidemia. As a serial intervention for higher risk groups of medication non-adherence, initial direct mailing, the first direct telephone call and the second direct call or a home visit were followed. Interview approach to qualitative inquiry was used to evaluate intervention results. Results: Participants including 4 patients received telephone calls, and 4 National Health Insurance Service staff and 4 pharmacists participated as counselors were interviewed regarding their impression of the intervention program. Three major themes arose: overall perception; necessities; and suggestions for success, of the intervention. Despite short period of intervention, educational intervention by telephone counseling involving pharmacists shows potential to improve self-management of chronic disease, and pharmacist-involvement. But more sophisticated selection of target patients requiring the intervention and complementation of electronic database system would be necessary. In addition, personal disposition of counselor was revealed to be an important factor for achieving successful outcome of intervention. Conclusion: The findings suggest that the individualized counseling intervention would be an efficient option for improved medication adherence. Further researches should include longer periods of interventions, a quantitative analysis using adherence measures based on claims data and consideration of clinical benefits associated with the intervention.

의료기관 종별 만성 치주염 진료의 지역 간 차이 (Regional Difference of Chronic Periodontal Care Services in Korea)

  • 윤영주;이경수;김창숙;김창윤;황태윤
    • 한국치위생학회지
    • /
    • 제15권5호
    • /
    • pp.899-905
    • /
    • 2015
  • Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

후두(候頭) 유표피암(類表皮癌) - 20년간(年間) 263 치험례(治驗例)를 중심(中心)으로 - (Epidermoid Carcinoma of the Larynx - Twenty-year Experience with 263 Cases -)

  • 박윤규;유봉옥;설대위;이영식;천경두
    • 대한두경부종양학회지
    • /
    • 제3권1호
    • /
    • pp.15-24
    • /
    • 1987
  • This study is limited to epidermoid carcinoma arising in the larynx. The 623 patients in this series comprised 1.6% of all malignant neoplasms seen during the 20-year period .from 1965 to 1984 ; it comprised 13.2% of all cancers of the head and neck registered during this period. The male: female ratio was 11:1, and the highest incidence was in the fifth decade of life. Analysis by anatomical site revealed that 51.7% were supraglottic, 36.1% glottic, and 6.8% subglottic in oriain. One-hundred eighty-nine(79%) were clinically Stage III or Stage IV lesions at the time of the first visit. Of the total of 263 cases, 113 refused treatment, 4 definite radiation for $T_1$. lesion,21 underwent palliative therapy only, and 125 underwent surgical management with intent to cure. This surgical category included 53 patients who had surgical treatment only and 72 who underwent combined therapy(preoperative radiation, postoperative radiation, or inductive chemotherapy followed by surgery and postoperative radiation). The surgical management varied from partial laryngectomy to widefield laryngectomy and ipsilateral neck dissection. In 14.4% pathologically positive node or nodes were found in the clinically negative contralateral neck nedes. Such contralateral spread was most common in supraglottic site of origin(222%). Combined modality of management was compared to single therapy. Although results at three years showed no difference in determinate disease-free survival between patients treated by surgery only and those treated by surgery followed by postoperative radiation therapy at 5 years a statistically significant difference emerged, only 36% of those receiving surgery alone surviving as compared to 65.4% in the surgery with radiation group.

  • PDF

Bone-added osteotome sinus floor elevation with simultaneous placement of non-submerged sand blasted with large grit and acid etched implants: a 5-year radiographic evaluation

  • Jung, Jee-Hee;Choi, Seong-Ho;Cho, Kyoo-Sung;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
    • /
    • 제40권2호
    • /
    • pp.69-75
    • /
    • 2010
  • Purpose: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. Methods: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. Results : All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. Conclusions: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.

Autogenous fat grafting for mild-to-moderate postoperative temporal hollowing after decompressive craniectomy: One-year follow-up

  • Choi, Jaemin;Choi, Hyungon;Shin, Donghyeok;Kim, Jeenam;Lee, Myungchul;Kim, Soonheum;Jo, Dongin;Kim, Cheolkeun
    • Archives of Plastic Surgery
    • /
    • 제45권1호
    • /
    • pp.69-73
    • /
    • 2018
  • Background Temporal hollowing is inevitable after decompressive craniectomy. This complication affects self-perception and quality of life, and various techniques and materials have therefore been used to restore patients' confidence. Autologous fat grafting in postoperative scar tissue has been considered challenging because of the hostile tissue environment. However, in this study, we demonstrate that autologous fat grafting can be a simple and safe treatment of choice, even for postoperative depressed temporal scar tissue. Methods Autologous fat grafting was performed in 13 patients from 2011 to 2016. Fat was harvested according to Coleman's strategy, using a tumescent technique. Patient-reported outcomes were collected preoperatively and at 1-month and 1-year follow-ups. Photographs were taken at each visit. Results The thighs were the donor site in all cases for the first procedure. The median final volume of harvested fat was 29.4 mL (interquartile range [IQR], 24.0-32.8 mL). The median final volume of fat transferred into the temporal area was 4.9 mL on the right side (IQR, 2.5-7.1 mL) and 4.6 mL on the left side (IQR, 3.7-5.9 mL). There were no major complications. The patient-reported outcomes showed significantly improved self-perceptions at 1 month and at 1 year. Conclusions Despite concerns about the survival of grafted fat in scar tissue, we advise autologous fat grafting for patients with temporal hollowing resulting from a previous craniectomy.

Korean Medical Treatment Including Miniscalpel Acupuncture for Patients After Rotator Cuff Tear Surgery: A Report of Two Cases

  • Kim, Su Gyeong;Park, Eun Jin;Lim, Jae Eun;Do, Hyun Jeong;Kim, Jeong Yoon;Cho, Sung Woo;Yoon, Hyun Min;Kim, Cheol Hong
    • Journal of Acupuncture Research
    • /
    • 제36권3호
    • /
    • pp.166-171
    • /
    • 2019
  • This study aimed to report the effect of Korean medical treatment including miniscalpel acupuncture on 2 patients who underwen tsurgery for rotator cuff tear. They were treated for almost 4 weeks at the Department of Acupuncture and Moxibustion, Dong-Eui University Korean Medicine Hospital. Visual analog scale (VAS), and range of movement (ROM) were used to evaluate treatment effects. In both patients, shoulder pain and restriction of shoulder joint movement improved after miniscalpel acupuncture treatment. In Case 1, shoulder pain decreased from a VAS score 8 to a VAS score 3, and ROM of the shoulder improved from flexion $100^{\circ}$ to $160^{\circ}$, extension $10^{\circ}$ to $30^{\circ}$, abduction $90^{\circ}$ to 1$30^{\circ}$, adduction $10^{\circ}$ to $40^{\circ}$, internal rotation $10^{\circ}$ to $50^{\circ}$, and external rotation $10^{\circ}$ to $50^{\circ}$. In Case 2, shoulder pain, which was rated a VAS score 8 at first-visit, disappeared, and ROM of the shoulder recovered to normal range. These results suggest miniscalpel acupuncture may contribute to the recovery process after rotator cuff tear surgery.

보건의료 빅데이터를 활용한 소아 감기 치료의 동향 조사 (A Study on the Trend of Childhood Common Cold Treatment Using Health Big Data)

  • 김태정;성현경;민상연
    • 대한한방소아과학회지
    • /
    • 제36권2호
    • /
    • pp.1-12
    • /
    • 2022
  • Objectives We analyzed visiting patterns to medical institutions and cost per visit according to the common cold patients aged 0-19 years. We analyzed Korean medical treatment for common cold. Methods Using the Pediatric Patient Sample data of the Health Insurance Review and Assessment Service (HIRA-PPS), we analyzed the data on health insurance claims of approximately 1 million people from 2017 to 2019. The data included the number of patients who visited the hospital due to common cold for the first and second time, the ratio of second visits by type of medical institution, and the status of prescriptions in Korean medical institutions. Results The number of patients visiting healthcare providers for common cold was higher in Western medical institutions than in Korean medical institutions. However, the number of second visits was higher in Korean medical institutions. Acupuncture is the most commonly used medical treatment in Korean medical institutions for common cold. Herbal medicine for common cold was usually prescribed for 2-3 days for children and adolescents. Conclusions Although the average medical cost of Korean medical institutions was higher than that of Western medical institutions, the rate of second visits to Korean medical institutions was higher because of the demand for Korean medical treatment

대구치-절치 형태이상 환자의 임상적 치료 및 단기 예후: 증례 보고 (Clinical Management and Short-term Prognosis of Molar-Incisor Malformation Affected Patients: Case Reports)

  • 김효진;임수민;김진영
    • 대한소아치과학회지
    • /
    • 제49권1호
    • /
    • pp.121-130
    • /
    • 2022
  • 대구치-절치 형태이상(MIM)은 비교적 최근에 보고되고 있는 치아의 형태 이상으로, 주로 제1대구치의 치근, 제2유구치의 치근, 상악 중절치의 치관에 형태이상이 나타난다. MIM을 일으키는 원인에 대해서는 아직 정확하게 밝혀진 바가 없으나, 공통적으로, 조산을 포함한 생 후 1 - 2년 이내에 발생한 의학적 병력을 가진다. MIM에 영향을 받은 제1대구치는 임상적으로 정상적인 치관 형태를 가지므로, 정확한 진단을 위해서는 방사선학적 검사가 꼭 필요하다. 주로 대구치 부위의 극심한 통증과 붓기를 주소로 내원하여 발견되는 경우가 많으며, 염증이 심하지 않고, 치근의 형태 이상이 비교적 양호한 경우에는 근관치료를 시도해 볼 수 있다. 그러나 치근주위 염증이 상당히 진행되어 광범위한 치조골 소실이 관찰되는 경우 발치가 불가피하다. 발치를 해야 하는 경우에는 발치 시기와 제3대구치의 존재 여부를 고려해야 하며, 추후 안정적인 교합을 위해서 적절한 공간 관리와 장기적인 계획이 필요하다. MIM 환자들은 혼합치열기에 있으므로, 정확한 진단과 시기에 맞는 적절한 치료가 중요하다. 이번 증례에서는 두 명의 MIM 어린이의 치료과정과 치료 후 2년의 경과에 대하여 보고하는 바이다.