• Title/Summary/Keyword: First-visit Patients

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A Retrospective Review about Korean Medicine Treatment for Obesity and Change of Body Composition on Climacteric Women in a Korean Medicine Hospital (일개 한방병원에 내원한 갱년기 여성의 한의 비만 치료와 체성분 변화에 대한 후향적 분석)

  • Hye-Won An;Ji-Yeon Kim;Ji-Yeon Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.37 no.1
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    • pp.75-88
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    • 2024
  • Objectives: This study aimed to identify the current use of Korean medicine for obesity and its effect for women in climacteric period. Methods: We studied women aged 45-55 who visited Daejeon Korean medicine Hospital of Daejeon University to lose body weight from January 1, 2021 to December 31, 2022 via an analysis of the medical records. The treatment duration was continuous for more than 2 weeks, and a body composition was measured by Inbody 770 at 2 to 4 weeks after the first visit. Results: 28 patients were finally selected and their average age was 49.32±3.38 years. Based on the body mass index (BMI) classification, 19 were in the 1st obesity group, 5 in the 2nd obesity group, 3 in the overweight group and 1 in the normal group. Patients usually complained comcomitant symptoms, and the symptoms of menopausal disorder was the most frequent. The average treatment duration was 3.68±0.67 weeks and the average treatment frequency was 3.93±0.98 times. All patients took herbal medicines Gambi-tang and 23 took modified fasting therapy including Gamro-su. 14 were treated by whole body far-infrared therapy and 6 were gotten partial obesity treatment. Among patients treated for accompanying symptoms, menopausal disorders were the most common (35.71%), and herbal medicine such as Gamisoyou-san, Hominis Placenta Pharmacopuncture, moxibustion, and cupping were used. After treatment, on average, body composition changed significantly; body weight 3.28±1.82 kg, BMI 1.36±1.04 kg/m2, body fat 1.70±1.67 kg, skeletal muscle mass 0.81±0.91 kg, abdominal circumference 2.04±2.6 cm, and visceral fat area 8.91±12.83 cm2. Conclusions: We analyzed general characteristics, BMI distribution, types of Korean medicine treatment and change of body composition. This study could be used as reference to provide practical data of treatment for obese women in climacteric period.

The Application of Customer Relationship Management for the Effective Prenatal Care (효과적인 산전관리를 위한 고객관계관리(CRM)의 도입)

  • Shin, Sook;Paik, Soo-Kyung;Kang, Sung-Hong;Kim, Yu-Mi
    • Korea Journal of Hospital Management
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    • v.10 no.1
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    • pp.93-114
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    • 2005
  • The prenatal care is the preventive medical service to help the pregnant mother deliver the healthy baby. It's regular examines give some chances to check-up the healthy conditions. This thesis concentrates on the CRM system to support an effective prenatal care system and prove the effectiveness of it. As CRM is the adapted management related to the customer's own information, it is important to develop the CRM model classified by the patients characteristics. A general hospital in Busan operated the CRM system to carry out the effective prenatal care and there is an analysis to ensure the effectiveness of CRM system for the pregnant women in our maternity ward. The results can be summarized as follows: 1) According to the comparisons with the CRM system, we can conclude the system is desirable. (1) Maternal Age : In the age distribution, the prenatal visit frequency, triple marker freqency, oral GTT and targeted ultrasonography in the experimental group in 30 to 34 years old is higher on the whole. For over 35 years old group, the higher frequency comes out in the oral GTT and targeted ultrasonography and for 25 to 29 years old group the different figure shows just in the targeted ultrasonography. (2) Area of residence: There is a clear difference in all the items in Busan and near area but no sign of difference in prenatal visits and oral GTT in other residencial area. Especially in the targeted ultrasonography the higher figure shows in the experimental group located in the both areas. The targeted ultrasonography is known as the specific examination which should be examined by the specialists, on the contrary the other examinations can be operated in the small clinic. So the public information and seminars related with ultrasonography increases the check-up frequency. The clinic requests some ultrasonographical examinations to the specialists in general hospital. (3) Parity: The clear difference shows that the CRM system causes the prenatal visit frequency to become higher in experimental group. The figure is 9.7 times and 8.6 times each. This is opposite that the past study said multiparity reduced the average prenatal visits. But the result of CRM is considered as the method to help the multiparity understand the importance of the prenatal care. (4) Obstetrical history: In the experimental group of the spontaneous delivery group, the figure is higher in the prenatal visit frequency, triple marker, oral GTT and targeted ultrasonography but the Caesarean section delivery group has higher figure in targeted ultrasonography. (5) In the first check-up, the rate of targeted ultrasonography in under 16 week pregnancy, in the 16 week pregnancy to 32 week pregnancy and the over 32 week pregnancy in the experimental group is upper than the compared one. For the oral GTT, there is a difference in under 16 week pregnancy but no difference in prenatal visits and triple marker. 2) The analysis of characteristics of prenatal care through the decision tree resulted in the fact that the most important variable is the residential area. After the delivery frequency is following, the obstetrical history and maternal age are in order. It is the same result in the triple marker and oral GTT. Consequently it is the same order of important variables in CRM system. The effectiveness of CRM system is proved in this study. The CRM system is a marketing method to control and lead the customers through the segmentation of customer data. It increases the new customer aquisition, maintenance of loyal customers, augmentation of customers value, activation of potential customers and creation of life time customers. So eventually it can enlarge the customers value. The medical institution should make efforts to establish the data base enforced by the customer's information on the underlying ordinary data system to carry out the CRM system effectively. In addition, it should develop the a variety of marketing strategy in order to set up one to one marketing satisfying the needs of individual patients.

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Analysis of the Risk Factors Influencing the Severity of Injury in Pediatric Multiple Trauma Patients (소아 다발성 외상 환자의 중증도에 영향을 미치는 위험인자에 관한 분석)

  • Lee, Gang-Wook;Kim, Sun-Pyo;Kim, Seong-Jung;Cho, Soo-Hyung;Cho, Nam-Soo
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.68-74
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    • 2010
  • Purpose: The purpose of this study is, first, to analyze the risk factors that influence the severity of injury in pediatric multiple trauma patients and, second, to present solutions for the problems related to the treatment of such patients. Our living situations are so complicated that the danger of accidents is truly open to children who are not prepared. We need to draw attention to the increased numbers of various accidents involving children. Methods: We studied patients who visited the Emergency Medical Center at Chosun University Hospital from January 1, 2006, to December 31, 2008. Using medical records, we evaluated the general characteristics: the mechanism of injury, the vital signs, the revised trauma score (RTS), the injury severity score (ISS), and the hemoglibin value, which was checked at the time of visit, and the presence or the absence of emergent on regular surgery. We divided the level of injury as follows: light level (1-8 points), mid level (9-15 points), and serious level (above 16 points). We analyzed the medical data by using SPSS 17.0 for windows. Results: The average age of the patients examined was 8.6 years. The number of 6- to 11-year-old patients was 96, which was the largest, but the degree of injury severity was the highest among infant (0-2 years), according to ISS 7.95(${\pm}6.85$). The frequency of accidents was highest on sunny days, and most accidents occurred from 16:00 to 20:00. The cause of multiple trauma for children was the greatest in the traffic accident, (95 patients, 49.0%). In addition, the trauma caused by traffic accidents showed the highest ISS value ($9.02{\pm}6.42$) and the most serious degree (P=0.004). The ISS level of injury ($8.40{\pm}6.64$) for patients moved from a secondary hospital was higher than that ($6.49{\pm}5.57$) for patients who visited the medical center directly. The severity of injury was highest for patients who used a 119 ambulance ($8.84{\pm}5.80$). According to the injured parts of body, Injuries to the arms and the feet most frequent (79 patients, 40.7%), but the level of injury was the highest for internal organs and chest, $16.42{\pm}8.56$ and $11.23{\pm}6.97$, respectively. Conclusion: We used Abbreviated Injury Scale (AIS) in order to examine the characteristics by injured body part for pediatric multiple trauma patients. Because the degree of injury was the highest for internal organs or the chest, we need to more seriously examine and provide for patients who are suspected of having injuries to the internal organs or the chest. We need to quickly determine the need for surgery in patients with serious injuries to the arms and the feet, which is the greatest in frequency. In particular, we need to consider the surgical care of patients who are not very high in the severity of injury to their brains.

A Study on the Improvement for Medical Service Using Video Promotion Materials for PET/CT Scans (PET/CT 검사에서 동영상 홍보물을 통한 의료서비스 향상에 관한 연구)

  • Kim, Woo Hyun;Kim, Jung Seon;Ko, Hyun Soo;Sung, Ji Hye;Lee, Jeoung Eun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.30-35
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    • 2013
  • Purpose: One of the current services, providing information to the patients and their guardians by using promotion materials induces positive responses and contributes to the improvement of the hospital reliability. Therefore, the objective of this study is to evaluate the effectiveness of audio visual materials, one of the means of promotion, as a way to give accurate medical information to resolve patient's curiosity about purpose and procedure of their examination and deplete complains about waiting which attributes negative effect to service quality assessment. Materials and Methods: 60 patients(mean age $53.97{\pm}12.24$, male : female = 26 : 34) who had $^{18}F-FDG PET/CT$ scan from July 2012 to August 2012 in Seoul Asan Medical Center were referred to the study. All of the patients having PET/CT scan were asked to watch an informative video material before the injection of radiopharmaceutical ($^{18}F-FDG$) and to fill in a questionnaire. Results: As a result of analyzing the contents of questionnaire, 52% of 60 patients had PET/CT scan for the first time and 72.4% of the patients read the PET/CT guidebook offered from their outpatient department or inpatient wards before their scan. After we searched the level of previous knowledge of the purpose and method of PET/CT scan, the patients answered 25.1% "know well", 34% "not sure", 40.9% "don't know" respectively. And 84.7% of the patients answered that watching the PET/CT guide video before the injection helps understanding what exam they were having and 15.3% of the patients did not. For the question asking ever the patients have experienced using our homepage or smart phone QR code to see the guide video before they visit out PET center, only 3.3% of them answered "yes". Lastly, the patients answered 60.1% "yes", 31.4% "so so" and 8.5% "no" respectively for the question asking whether watching the video makes the patients to fill the waiting time short. Conclusion: It is found that understanding of objective and method of the PET/CT scan and level of satisfaction was improved after the patients watched the guide video whether they had PET/CT scan before and read the PET/CT guidebook or not. Also, watching the video was effective for the reduction of perceptible waiting time. But while displaying the PET/CT guide video is useful for providing information about the scan and shortening the waiting time as one of the medical service, utilization of service was actually very poor because of the passive promotion and indifference of the patients about their examination. Therefore, from now on, it is necessary to construct the healthcare system which can be offered to more patients through the active promotion.

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Clinical Effect of the Subantimicrobial Dose of Doxycycline ( SDD ) on the Chronic Periodontitis (만성치주염 환자에 대한 저용량 독시싸이클린의 임상적 효과)

  • Kim, Yoon-Sik;Paik, Jeong-Won;Kim, Chang-Sung;Choi, Seong-Ho;Kim, Chong-Kwan
    • Journal of Periodontal and Implant Science
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    • v.32 no.2
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    • pp.415-428
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    • 2002
  • Periodontal disease is a complex infectious disease caused by bacteria in the oral mucosa, which results in gingival inflammation, breakdown of periodontal tissues, bone resorption, and finally tooth loss. Mechanical plaque control methods-scaling and root planing are effective methods to stop the progression of such periodontal disease. It was reported that subantimicrobial dose of doxycycline(SDD) regimen could improve clinical conditions of periodontal tissues without causing the overgrowth of opportunistic organisms that was a typical antibiotic side effect. Therefore pharmacological therapy, used in conjunction with mechanical therapy could be considered a useful treatment modality in the treatment of chronic periodontal disease. In this study, 30 patients diagnosed as moderate to advanced chronic periodontitis were divided into 2 groups. In this double-blind, placebo-controlled study, the patients were administered 20mg doxycycline capsule or placebo capsule b.i.d. for 4months, after scaling and root planing. Clinical parameters-bleeding on probing, pocket depth and clinical attachment level were compared and evaluated between these groups at periods of first visit, 1 month, 2 months, 3 months, 4 months. The results were as follows ; 1. In case of moderate periodontitis, pocket depth showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in pocket depth was observed in the experiment group compared to the control group(p<0.05). 2. In case of moderate periodontitis, clinical attachment level showed significant reduction after treatment in both the control & experiment groups, when compared with the baseline values(p<0.01), but in case of advanced periodontitis, only the experiment group showed significant reduction after treatment when compared with the baseline values(p<0.05). Statistically significant reduction in clinical attachment level was observed in the experiment group compared to the control group(p<0.05). 3. Bleeding on probing improved after treatment in both the groups. In case of moderate periodontitis, the experiment group showed statistically significant reduction of bleeding on probing when compared with the control group at 1 and 4 months after treatment(p<0.05). In case of advanced periodontitis, treatment resulted in statistically significant reduction of bleeding on probing in both the groups(p<0.05). These results indicate that the use of subantimicrobial dose of doxycycline is a useful supplement to mechanical treatment for periodontal patients in ameliorating the clinical parameters such as periodontal pocket, attachment level, and bleeding on probing.

A Clinical Study on the Taste Threshold of the Patients with Xerostomia (구강건조증환자의 미각역치에 관한 연구)

  • Ko, Myung-Yun;Kwon, Kyung-Min;Heo, Jun-Young;Tae, Il-Ho;Ahn, Yong-Woo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.67-73
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    • 2008
  • To investigate the change of taste sensitivity which follows after treatment for xerostomia, from September, 2006 to July, 2007, we categorized the patients, who were diagnosed as xerostomia in Oral Medicine, College of Dentistry, Busan National University, as subject group and from September, 2007 to December. The patients who were not diagnosed as systemic disease were categorized as control group. The results were as follows ; 1. Taste threshold comparison showed the differences at tongue lateral, tongue tip, circumvallate papilla between subject and control. 2. Taste threshold comparison showed no difference in male between subject and control. 3. Taste threshold comparison showed decrease in whole tongue except soft palate in female. 4. Taste threshold comparison showed no difference between first and second visit, but there was a tendency to change in circumvallate papilla.

The Effect of korean, Chinese and American Ginseng on Blood Pressure of Hypertensive Patients (한국삼, 중국삼, 서양삼이 고혈압 환자의 혈압에 미치는 영향)

  • Lee Cha-ro;Lee Sang-Ho;Rhee Jun-Woo;Na Byong-Jo;Kim Tae-Hun;Jung Woo-Sang;Moon Sang-Ho;Cho Ki-Ho;Bae Hyung-Sup;Kim Young-Suk
    • The Journal of Korean Medicine
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    • v.26 no.3 s.63
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    • pp.228-238
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    • 2005
  • Objectives : We conducted a randomized, double-blinded clinical trial to assess the anti-hypertensive effect of Ginseng and to know the difference of the effect according to it's growing districts md species by 24-hour ambulatory blood pressure measurement (ABPM). Methods : We allocated 96 hypertensive patients enrolled in this trial to Korean ginseng(KG), American ginseng (AG), Chinese ginseng (CG), and Korean red ginseng (KRG) groups by randomization. Each subject was administered 4.5mg/day of encapsulated ginseng for 4 weeks. We assessed anti-hypertensive effect, blood pressure variability using ABPM and toxicity by blood chemistry before and after treatment. We also evaluated changes of symptoms due to hypertension and adverse effect in all groups at the first visit, 2 weeks later and 4 weeks later. Results : Blood pressure after treatments showed significant decrease of systolic blood pressure (sBP) in the CG-group (p<0,05) and diastolic blood pressure (dBP) in the KRG-group (p<0.05). However, there were no significant changes of sBP (or dBP) after treatment in the other groups and no significant difference in changes of BP between before and after treatment among the 4 groups. Blood pressure variability in the CG-group showed significant decrease after treatment but not in the KRG-group. Symptoms such as headache or neck stiffness and heating sensation due to hypertension improved significantly in all groups, especially in the KRG-group. A3l patients had no adverse effect after treatment and there was no liver or kidney toxicity. Conclusions : CG and KRG seem to have anti-hypertensive effects, but there was no significantly different effect depending on growing district and species of Ginseng.

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Factors Influencing the Length of Stay Ischemic Heart Disease Utilizing Medical Information (의료정보를 활용한 허혈성 심장질환의 재원일수에 영향을 미치는 요인 분석)

  • Park, Ji-Kyeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.10
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    • pp.354-362
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    • 2017
  • Due to population aging and westernized lifestyle, ischemic heart diseases are increasing, and Korea has one of the highest lengths of stay for ischemic heart diseases. Since the increase in the length of stay is a major cause of the increase in medical expenses, it is necessary to prepare a plan to manage the length of stay. Accordingly, this study was conducted to identify the factors influencing the length of stay of ischemic heart disease, and provide the elementary resources necessary for the management of the length of stay. The study subjects were 566 ischemic heart disease patients of a tertiary hospital. As the result of the study, first, the number of inpatients with chest pain as the chief complaint was the largest. Second, the average length of stay was 4.89 days, and the length of stay varied depending on the type of ischemic heart disease. Third, the age of over 75 years, diabetes, and dyspnea were the factors increasing the length of stay. Therefore, for management of adequate length of stay for ischemic heart disease, it is important to prevent the progression of illness through blood sugar control for ischemic heart disease patients with diabetes. Also, it is necessary to prepare a system where patients can visit hospitals as fast as possible if they have any symptoms.

Clinical Research of the Effects of Sumsu (Bufonis venenum) Pharmacopuncture on Insomnia and Depression in Patients with Sleep Disorder (섬소약침이 수면장애 환자의 불면 및 우울 증상에 미치는 영향에 대한 임상적 고찰)

  • Seo, Dong Kyun;Shin, So Yeon;Kim, Shin Young;Seo, Jong Cheol;Seo, Yeon Ju;Park, Jong Hyeon;Yoon, Hyun Min;Jang, Kyung Jeon;Song, Chun Ho;Kim, Cheol Hong
    • Journal of Acupuncture Research
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    • v.32 no.3
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    • pp.175-183
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    • 2015
  • Objectives : The purpose of this study is to investigate the effects of Sumsu (Bufonis venenum) pharmacopuncture on insomnia and depression. Methods : We investigated 32 patients with a sleep disorder who had been recruited at a Korean medical hospital from March $1^{st}$, 2014 to April $16^{th}$, 2015. We divided subjects into two groups : The control group(N=15) was treated with Normal Saline and the experimental group(N=17) was treated with Sumsu(Bufonis venenum) pharmacopuncture. The subjects were injected with 0.05 ml~0.1 ml, for a total of 0.6 ml on each acupuncture point. These were Pungbu ($GV_{16}$), Pungi ($GB_{20}$), Gyeonjeong ($GB_{21}$), and Anmyun(EX-$HN_{20}$). Both groups were evaluated with the beck depression inventory(BDI) and given an insomnia score before treatment, after one week, two weeks and four weeks from the initial visit. Results : The Insomnia score and BDI decreased significantly in the experimental group. In comparing the control group with the experimental group, there was a more significant improvement of the insomnia score in the experimental group during all periods of this study. However, the difference of change in BDI between the control group and experimental group was only significant in the first week. Conclusions : Sumsu (Bufonis venenum) pharmacopuncture can be used as an effective treatment for patients with insomnia and depression.

Associations of Elderly Onset Headache With Occurrence of Poor Functional Outcome, Cardiovascular Disease, and Cognitive Dysfunction During Long-term Follow-up

  • Cho, Soo-Jin;Kim, Byung-Kun;Kim, Byung-Su;Kim, Jae-Moon;Kim, Soo-Kyoung;Moon, Heui-Soo;Cha, Myoung-Jin;Park, Kwang-Yeol;Sohn, Jong-Hee;Chu, Min Kyung;Song, Tae-Jin
    • Annals of Geriatric Medicine and Research
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    • v.22 no.4
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    • pp.176-183
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    • 2018
  • Background: Although the frequency and intensity of headaches decrease in older adults, headaches in this population are still an important neurological disorder. The purpose of this study was to investigate the associations of headache characteristics in older adults with the development of cardiovascular disease and cognitive dysfunction. Methods: We prospectively enrolled 125 older (${\geq}65$ years old) patients with headache who were making their first visit to outpatient clinics and who had no prior history of cognitive dysfunction from 11 hospitals in Korea between August 2014 and February 2015. We investigated the occurrence of newly developed/or recurrent headache, cardiovascular disease, cognitive dysfunction, and poor functional outcomes. Results: The mean age of all included patients was 72.6 years, 68.8% were women, and 43 (34.4%) had newly developed/or recurrent headache during follow-up. During a median follow-up of 31 months (interquartile range, 28-34 months), 21 participants (16.8%) experienced cardiovascular disease, and 26 (20.8%) developed cognitive dysfunction. Upon multivariate analysis and after adjusting for sex, age, and other factors, presence of newly developed/or recurrent headache was found to be associated with cardiovascular disease (hazard ratio [HR], 4.03; 95% confidence interval [CI], 1.28-12.61; p=0.017) and frequency of headache for the recent 3 months was related with cognitive dysfunction (HR, 1.05; 95% CI, 1.00-1.09; p=0.017) and poor functional outcomes (HR, 1.06; 95% CI, 1.01-1.11; p=0.011). Conclusion: Our study demonstrated that there is an increased risk of cardiovascular disease, cognitive dysfunction, and poor functional outcomes in older patients with frequent, newly developed, or recurrent headache.