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6 Cases of Atopic Dermatitis patientsfor Short Term Hospitalization Program (단기 입원 프로그램을 시행한 아토피피부염 환자 6례)

  • Yu, Seung-Min;Yun, Young-Hee;Son, Byeong-Kook;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.22 no.1
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    • pp.219-236
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    • 2009
  • Background : Recently the number of atopic dermatitis patients has increased, but the treatment of atopic dermatitis is not effective, and the recurrence rate of atopic dermatitis is high. Many patients are suffering from pruritus. A new standard treatment system is needed. Objective : This study investigated the effect of Oriental medicine program for atopic dermatitis patients during short term hospitalization. Method : 6 patients were admitted for short term hospitalization program. The program includes Acupuncture, herbal medicine, examination, education, cupping therapy, herbal dressing, exercise and etc. Everyday we evaluated the patients by Severity Scoring Atopic Dermatitis(SCORAD) index and took the photos of lesions, and the patients evaluated themselves by atopic dermatitis diary which consists of emotion, pruritus, sleep loss. Results : Admission duration was 7 to 14 days. The SCORAD scores of them were decreased. Most symptoms of 6 patients were improved. Especially herbal dressing was effective for severe oozing. Subjective scores of atopic dermatitis diary were reduced. Conclusion : We expect that the short term hospitalization program could be helpful for uncontrollable atopic dermatitis patients.

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Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice

  • Douglas Lobb;Masoud MiriMoghaddam;Don Macalister;David Chrisp;Graham Shaw;Hollis Lai
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.1
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    • pp.19-28
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    • 2023
  • Background: Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings. Methods: A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness. Results: Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased. Conclusion: According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.

Reduction of inappropriate revisits to the emergency department 72 hours after being discharged by 'Discharge explanation report' ('퇴원설명문'에 의한 72시간내 부적절한 응급센터 재방문의 감소)

  • Park, Ha Young;Sim, Min Seob;Song, Hyoung Gon;Song, Keun Jeong
    • Quality Improvement in Health Care
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    • v.12 no.1
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    • pp.114-123
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    • 2006
  • Background : Patients who were discharged from the emergency department(ED) may revisit. These patients are divided into two groups; one is expected scheduled condition, the other is unexpected condition. These patients of inappropriate revisits to the ED would be unsatisfied, difficult to make rapport and take legal action as a result of additional medical charges. The purpose of this study was to reduce inappropriate revisits to the ED with a new method which was developed by analyzing inappropriate revisits in 2002. Methods : This study was conducted in a tertiary hospital consisting of 1,278 beds. The most common cause of inappropriate revisits was the medical team's lack of explanation about a disease. Thus we decided that the effective method was to offer full explanations to patients to understand the clinical pathway of a disease. We made four types of stickers to explain most common 4 diseases in 2003. An emergency physician completed 'discharge explanation report' and explained it to patients in 2004. Results : In 2002 inappropriate revisited patients were 164, patients with four diseases were 79. During the same period of 2003, inappropriate revisited patients were 56 (-65.9%), four disease patients were 6 (-92.4%) and in 2004 inappropriate revisited patients were 52, four disease patients were 19. Causes of revisits were lack of explanation about a disease in 35 patients (44.3%) in 2003, and 5 patients (83.3%) in 2003, and 16 patients (84.2%). Conclusions : Application of 'explanation stickers' at discharge reduced inappropriate revisits from 34.5% in 2002 to 15.9% in 2003. Application of 'Discharge explanation report' by emergency physician reduced inappropriate revisits from 15.9% in 2003 to 13.5% in 2004. Reduction of inappropriate revisits elevated the quality of medical treatment, and decreased patients' dissatisfaction in ED.

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Safety and efficacy of fimasartan with essential hypertension patients in real world clinical practice: data from a post marketing surveillance in Korea

  • Han, Su-Eun;Jeong, Seung Hee;Kang, Hye Jeong;Hong, Myung Sook;Paek, Eunah;Cho, Hijung;Choe, Seong Choon
    • Translational and Clinical Pharmacology
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    • v.26 no.3
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    • pp.118-127
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    • 2018
  • The safety and efficacy of fimasartan have been evaluated through post-marketing surveillance in real world clinical practice. The multi-center, prospective, open-label and non-interventional study. A total of 3,945 patients (3,729 patients for safety assessment and 3,473 patients for efficacy assessment) were screened in patients with essential hypertension in 89 study centers from 9 September 2010 through 8 September 2016. Among the total patients, 2,893 patients (77.6%) were administered fimasartan for 24 weeks or longer and were classified as 'patients with long-term follow-up', and the additional safety and efficacy analysis were performed. The improvement was defined as systolic blood pressure (SBP) controlled to ${\leq}140mmHg$ or decreased SBP differences ${\geq}20mmHg$ after treatment or diastolic blood pressure (DBP) controlled to ${\leq}90mmHg$ or decreased DBP differences ${\geq}10mmHg$ after treatment. Adverse drug reactions (ADRs) were reported in 3.8% patients; dizziness, and hypotension were the most frequently reported ADRs in total patients. The results of patients with long-term follow-up were comparable with total patients. The overall improvement rate in all efficacy assessment at the last visit was 87.1% (3,025/3,473 patients). The overall improvement rate of the patients with long-term follow-up was 88.9%. Fimasartan was well tolerated, with no new safety concerns identified and an effective treatment in the real world clinical practice for Korean patients with hypertension.

The Research about Expected Hospital Management in Gynecology area based on the Medical Information Record of a University Hospital (일개 대학병원 의무기록정보 통계를 활용한 산부인과 병원경영 예측에 관한연구)

  • Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.10
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    • pp.2959-2965
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    • 2009
  • This research is based on the medical information record of a university hospital on analysis of outpatients, inpatients and delivery related information in gynecology area. The result of application having analysis of patients as basic material for hospital management is as follows. The number of new patients in average was 140.9, and as the year passes by, it seemed to decrease noticeably(p=0.000). In the first year (2001) the number was only 212.6, but increased to 140 by the year of 2007, showing increase of 80.9. The actual number of patients in the hospital was 124.6 in average and it showed noticeable decrease after each year (p=0.000), from 144.6 patients on the first year 2001, to 104.8 patients in 2007, showing approximately 40 patients decreased. Multiple regression analysis was performed having independent variables as characteristics of patients and cause of delivery related factors, and dependent variables as the number of patients in the hospital. According to analysis, the cause of affecting the number of patients in the hospital was selected as the number of new patients, the number of delivery per year. The reliability rate was recorded as 62.8%. Therefore, apart from the services on marketing and patient management which must come first, the effect of inviting them cannot be avoided, which directly links to trust resulting from the consideration to patients.

Transarterial Therapies for Hepatocellular Carcinoma: a Comprehensive Review with Current Updates and Future Directions

  • Kumar, Yogesh;Sharma, Pranav;Bhatt, Neeraj;Hooda, Kusum
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.473-478
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    • 2016
  • Hepatocellular cancer is a very common cause of cancer related deaths worldwide. Only 30-40% of patients present with early-stage disease open to curative treatments, such as resection or transplantation, while others can only undergo local therapies or palliative care. Various trans-arterial approaches have been used for treatment of hepatocellular carcinoma in patients who need a down-staging to liver transplantation, and who are not candidates for transplantation or radiofrequency ablation. Transarterial chemoembolization (TACE), transarterial embolization (TAE), drug-eluting beads, and radioembolization have been used for locoregional control, and have been shown to prolong the overall survival when compared with supportive care. In this review, we discuss patient selection, pre- and post-procedure imaging, techniques, safety, and clinical outcomes related to these therapies. Newer advances with future directions in various fields related to trans-arterial therapies are also discussed.

Socio-economic Factors Affect the Outcome of Soft Tissue Sarcoma: an Analysis of SEER Data

  • Cheung, Min Rex;Kang, Josephine;Ouyang, Daniel;Yeung, Vincent
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.25-28
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    • 2014
  • Background: This study analyzed whether socio-economic factors affect the cause specific survival of soft tissue sarcoma (STS). Methods: Surveillance, Epidemiology and End Results (SEER) soft tissue sarcoma (STS) data were used to identify potential socio-economic disparities in outcome. Time to cause specific death was computed with Kaplan-Meier analysis. Kolmogorov-Smirnov tests and Cox proportional hazard analysis were used for univariate and multivariate tests, respectively. The areas under the receiver operating curve were computed for predictors for comparison. Results: There were 42,016 patients diagnosed STS from 1973 to 2009. The mean follow up time (S.D.) was 66.6 (81.3) months. Stage, site, grade were significant predictors by univariate tests. Race and rural-urban residence were also important predictors of outcome. These five factors were all statistically significant with Cox analysis. Rural and African-American patients had a 3-4% disadvantage in cause specific survival. Conclusions: Socio-economic factors influence cause specific survival of soft tissue sarcoma. Ensuring access to cancer care may eliminate the outcome disparities.

The Need for a New Curriculum in Clinical Genetic Education (임상유전학 교육에서 새로운 교과과정 개발의 필요성)

  • Lee, Chang-Woo
    • Korean Medical Education Review
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    • v.16 no.1
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    • pp.50-54
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    • 2014
  • It is becoming increasingly important for medical doctors to have a thorough understanding of human genetics and the ethical, legal, and social implications of genetic testing, counseling, and treatment. As genetic engineering and technology evolves, medical doctors will find themselves called in to counsel patients about a rapidly increasing number of diseases for which genetic testing and treatments are available. Medical doctors will need to master a new set of principles and clinical skills. A lack of knowledge about these issues and problems may lead to serious, lifelong or even fatal negative effects on patients. Medical genetics has moved from the study of rare conditions to the illumination of disorders that impact the entire spectrum of medical practice. This study demonstrates several areas in which medical genetics is clearly an important tool in medical practice and the necessity of establishing new curriculum for clinical genetic education in Korea. Medical students nearing graduation may lack genetic knowledge that is essential for daily practice because genetics has little or no place in clinical teaching. Medical schools should make extensive curriculum changes to increase students' awareness of clinical genetics and its ethical implications. The medical school curriculum will need creative new approaches to keeping up with the rapid pace of evolution of clinical genetics.