• Title/Summary/Keyword: OPD

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A Clinical Analysis on 250 cases of Inpatients with Facial Paralysis (말초성 안면마비 입원환자 250례에 대한 임상적 고찰)

  • Kang, Na-Ru;Tark, Myoung-Rim;Byun, Soek-Mi;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.3
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    • pp.109-121
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    • 2010
  • Objectives : This study was performed to analysis the effect of oriental medical care for inpatients with facial paralysis that had visited Dept. of Otolaryngology Oriental medical hospital Dong-eui university. Methods : From January 2008 to September 2010, a clinical study was done on 250 inpatients who were treated as facial nerve paralysis at the Dept. of Otolaryngology Oriental medical hospital Dong-eui university. This study was assessed using the chart analysis. Results : 1. The distribution of sex : female 54.8%, male 45.2%. The distribution of age was pregented that fifty to sixty was the most in 67 cases(26.8%). 2. The distribution of the period of admission : female 12.5 days, male 9.9 days. 3. The distribution of past history : hypertention(18.8%), diabetes-mellitus(10.85%), facial paralysis(9.25%), cerebrovascular disease(4.4%), liver disease(5.6%), hyperlipidemia(1.2%), otitis media(1.2%), herpes zoster(1.2%), cardiac disease(2.45%), thyroid disease(1.2%). 4. The distribution of the region of facial paralysis : Rt(55.36%), Lt(56.52%). 5. Check the mastoid pain : 66.8%(female 73.91%, male 58.04%). 6. Out of prescription(Ko-Bang, 古方), Galgeun-Tang(葛根湯) and Gaejigeogaegayoungchul-Tang was used most in each 34 cases, Daesiho-Tang(大柴胡湯) 30 cases, Galgeungabanha-Tang(葛根加半夏湯) 27 cases, Sihogaeji-Tang(柴胡桂枝湯) 14 cases, Hwanggigaejiomul-Tang 12 cases, Odu-Tang(烏頭湯) 10 cases, Chijadaehwangsi-Tang 10 cases, Gaejigagalgeun-Tang(桂枝加葛根湯) 7 cases, Banhasasim-Tang(半夏瀉心湯) 5 cases, Injinho-Tang(茵蔯蒿湯) 5 cases in order. 7. The distribution of herb group : Mahwang-Jae(麻黃劑) 31.72%, Gaeji-Jae(桂枝劑) 26.00%, Siho-Gae(柴胡劑) 20.70%, Chija-Gae(梔子劑) 7.49%, Buja-Jae(附子劑) 4.41%, Banhahwanggeum-Gae(半夏黃芩劑) 3.08%, Daehwang-Gae(大黃劑) 2.64%, Bockryeong-Gae(茯笭劑) 1.76%, Jisil-Gae(枳實劑) 1.32%, Insam-Gae(人蔘劑) 0.88% in order. 8. The distribution of House-Brackmann grade of admission : Gr Ⅳ 74.85%, Gr.III 13.6%, Gr.V 11.6% in order. 9. The distribution of House-Brackmann grade of discharge : Gr.III 56%, Gr.IV 38.4%, Gr.II 5.6% in order. 10. The average number of OPD follow up is 6.46. Conclusion : This results indicated that oriental medical treatment with Ko-bang(古方) can be an effective way to treat facial paralysis. The more patients we treat with Ko-bang(古方), the more clinical report is accumulated. Then it would be helpful to map out a systematic treatment on facial paralysis.

Video-assisted Thoracoscopy in the Treatment of Multi Loculated Pleural Effusion and Empyema (다방성 흉막수 및 노흉 환자에서 비디오 흉강경의 치료)

  • 김영진
    • Journal of Chest Surgery
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    • v.37 no.2
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    • pp.160-165
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    • 2004
  • Successful treatment of multi-loculated pleural effusion or thoracic empyema requires effective drainage and definitive diagnosis of causative organism. The purpose of this study was to assess the efficacy of the video-assisted thoracoscopic surgery in the management of thoracic empyema or multi-loculated pleural effusion after chest tube drainage treatment had failed. Material and Method: Between April 2000 and July 2002, 20 patients with thoracic empyema or multi-loculated pleural effusion that failed to chest tube drainage or other procedures who underwent an operation. All patients were assessed by chest-computed tomogram and underwent video assisted thoracoscopic drainage, debridement, biopsy and irrigation of pleural cavity. Result: In 18 cases (90%), underwent successful video-assisted thoracoscopic surgery. In 2 cases, decortications by mini-thoracotomy were necessary. The ratio of sex was 4 : 1 (16 male: 4 female), mean age was 48.9 years old (range, 17∼72 years), mean duration of postoperative chest tube placement was 8.2 days (range, 4∼22 days), mean postoperative hospital stay was 15.2 days (range, 7∼33 days). Causative disease was tuberculosis, pneumonia, trauma and metastatic breast cancer, There were no major postoperative complications. Symptoms improved in all patients and were discharged with OPD follow up. Conclusion: In an early organizing phase of empyema or multi loculated pleural effusion, video-assisted thoracoscopic drainage and debridement are safe and suitable treatment.

Pholiota adiposa and its Related Species Collected from the Wild Forestry (야생에서 채집된 검은비늘버섯(Pholiota adiposa)균에 관한 연구)

  • Lee, Sang-Sun;Kim, Mi-Hye;Chang, Hu-Bong;Shin, Chun-Sik;Lee, Min-Woong
    • The Korean Journal of Mycology
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    • v.26 no.4 s.87
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    • pp.574-582
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    • 1998
  • Five basidiocarps of Pholiota species have been collected from the areas of BubJu Temple for last two years, and identified to those of P. adiposa or Pholiota species. The taxonomy of these basidiocarps with the morphological aspects was compared with the analysis obtained from the polymorphisms of PCR-RAPD bands made after reacted with the random primers. The polymorphic variations were observed within the species of the basidiocarps, but not between genomic DNA's of the mycelia obtained and the basidiocarps. Several different bands made from the primers (28 and 36) in PCR-RAPD reactions were identified within the genus of Pholiota and speculated to be specific for the individual basidiocarp of P. adiposa collected. The primers employed here were considered to be very useful for distinguishing the individual isolates or basidiocarps collected from the fields. Also, the basidiospores were obtained from the sporeprints of the above basidiocarps as a simple agar and confirmed with observations of clamp connection under microscopes. The matings of them indicated the 'tetrapolar' type, being different from the 'bipolar' type reported by Japanese basidiocarps of P. adiposa or P. nameko. Based on our work, the edible fungi collected were speculated to be a new breeding resource for those of Pholiota commercialized in Japan.

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Surgical Treatment for Type 11 Distal Clavicle Fracture using Mersilene tape and K-wire (Mersilene tape와 K-강선을 이용한 제 II형 원위부 쇄골 골절의 수술적 치료)

  • Byun, Jae-Yong;Kim, Bo-Hyun;Kang, Shin-Taek;Whang, Chan-Ha;Hong, Chang-Wha;Lee, Bum-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.5 no.2
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    • pp.123-128
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    • 2006
  • Purpose: Surgical reconstruction is usually indicated for type II distal clavicle fracture due to high rate of nonunion and delayed union. We report the clinical outcome of a surgical technique for type II distal clavicle fracture using Mersilen tape and K-wire. Materials and Methods: From 1999 through 2003, this technique has been used on 11 patients with type II distal clavicle fracture. The procedure consist of fracture reduction with a Mersilene tape, repair of torn coracoclavicular ligament, and K-wire fixation of the fracture fragment. All patients with at least 12 months of complete postoperative follow-up were included for functional and radiographic evaluation. We used simple X-ray and UCLA scoring system and constant scoring system for evaluation at last follow up in OPD. Results: Solid union of the fracture could be achieved at 11 weeks after operation in all patients. All patients could return to the same level of preinjury activity. Good and excellent results were obtained in all patients according to UCLA system. Conclusion: This technique was simple procedure and allowed for stable fixation with early mobilization and early return to work and sports.

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Introducing the Insurance Health Care Delivery System and Its Impact on Patients Distribution of Medical Service Organizations (보험진료체계 개편이 의료기관 종별 환자분포에 미친 영향 분석 -3차 의료기관, 종합병원, 병원, 의원을 중심으로-)

  • 공방환;한동운;장원기;강선희;문옥륜
    • Health Policy and Management
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    • v.5 no.1
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    • pp.31-58
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    • 1995
  • The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.

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Clinical Comparison of Surgical Treatment and Close Observation Without Surgery in the Management of Schwannomas in the Neck (경부에 발생하는 신경초종에서 수술적 치료와 정기적 경과관찰의 임상적 비교)

  • Hong, Sung-Lyong;Jung, Young-Ho;An, Soo-Youn;Hah, J.-Hun;Sung, Myung-Whun;Kim, Kwang-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.1
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    • pp.24-27
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    • 2009
  • Backgrounds and Objectives : Most patients with neck schwannomas are asymptomatic. Surgical management of neck schwannomas could cause various complications. The aim of this study is to evaluate the necessity of surgical management in all of the neck schwannoma patients. Material and Methods : Thirty-four patients diagnosed and undergone surgical management as neck schwannomas and 30 patients diagnosed and observed closely by OPD base from 1996 to 2005 were included. The medical records were reviewed retrospectively. Results : In surgical management group, mean age was 39.3 years and mean size of tumors was 4.4cm. Twenty-five patients had their tumors at parapharyngeal space, 2 at anterior neck and 7 at lateral neck. Nerves of origin were vagus nerve in 12 patients, cervical sympathetic chain in 11. Presenting symptoms were neck mass in 22 patients and no symptom in 9. On the other hand, in close observation group, mean age was 47.1 years and mean size of tumor was 3.7cm. Seventeen patients had their tumors at parapharyngeal space, 5 at anterior neck and 8 at lateral neck. Presenting symptoms were neck mass in 13 patients and no symptom in 13. There were no patients with neurologic complications. Mean follow-up duration was 38.2 months and there were only 2 patients whose size of tumors was increased and no patients who had newly emerged symptoms. Conclusion : Neck schwannomas grows slowly, has little chance of malignant transformation, but can complicate serious problems after surgical management. Therefore close observation could be considered in many asymptomatic patients.

A CASE OF PERVASIVE DEVELOPMENTAL DISORDER NOS WITH REPETATIVE SELF-INJURIOUS BEHAVIOR (반복적으로 머리를 때리는 전반성발달장애 환아 1례)

  • Kim, Jeong-Lim;Chung, Bo-In;Cho, Soo-Churl;Hong, Kang-E;Lim, Myung-Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.244-251
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    • 1999
  • Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

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Studies on Curved Diffractive Optical Elements in EUV (극자외선 영역에서 곡면 DOEs에 관한 연구)

  • Choi, Sung-Eul;Lee, Yong-Woo;Kwon, Myung-Hoi;Kim, Yong-Hoo
    • Korean Journal of Optics and Photonics
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    • v.16 no.4
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    • pp.304-312
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    • 2005
  • Field performance of several different types of diffractive optical elements(DOEs) has been carried out. Using Zemax model, we have designed five different types of DOEs, such as transmissive flat-DOE, transmissive curved-DOE, reflective flat-DOE, reflective curved-DOE and parabolic mirror, We have applied two different wavelengths, i.e., 13 m(EUV) and 632.8 nm(visible) to above DOEs. Off_axis dominate aberrations and the diffraction limiting (Rayleigh limit) field angles have been investigated and compared at both wavelengths for each DOE. At diffraction limit, field angle of curved-DOEs was much greater than that of flat-DOEs for both transmission and reflective types. We also showed that dominated off_axis aberration of flat-DOEs was coma, but that of curved-DOEs was mixture of astigmatism and curvature of field. The measured field angle and expected OPD aberrations were well coincided with theoretical ones. Increasing the ratio of field angle with wavelength was more effective in curved-DOEs than flat-DOEs.

Morphological, Cytological and Molecular Evidence for Intersubgeneric F1 Hybrid between Glycine max x G. tomentella (콩 Glycine max와 G. tomentella의 종간교잡으로부터 얻은 Fl식물체 검증을 위한 형태적 · 세포학적 · 분자유전학적 연구)

  • Choi, In-Soo;Kim, Yong-Chul
    • Journal of Life Science
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    • v.18 no.4
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    • pp.454-460
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    • 2008
  • This study was carried out to demonstrate morphological, cytological and molecular evidence for intersubgeneric $F_1$ hybrid between Glycine tomentella and G. max cv. ‘Baemkong’. Morphological features of $F_1$ plant for pistil and stamen, flower color and growth habit showed intermediate type between G. tomentella and G. max cv. ‘Baemkong’. Chromosome number of $F_1$ plant was 2n=39, which explained the evidence of $F_1$ hybrid between G. tomentella (2n=38) and G. max cv. ‘Baemkong’ (2n=40). Polyacrylamide isoelectric focusing pattern for esterase and peroxidase also showed that the $F_1$ plant was true $F_1$ hybrid between G. tomentella and G. max cv. ‘Baemkong’. From RAPD analysis, we identified that 62 primers showing bands in $F_1$ hybrid had both bands from G. tomentella and G. max cv. ‘Baemkong’, which suggested that this was true $F_1$ hybrid. Based on our results from morphological, cytological and molecular analyses, we suggest that the $F_1$ plant was true intersubgeneric hybrid between G. tomentella and G. max cv. ‘Baemkong’. Our results still remain us further study to recover fertility of $F_1$ hybrids. The occurrence of maternal and/or paternal inheritance in $F_1$ hybrid from intersubgeneric cross between G. tomentella and G. max cv. ‘Baemkong’ need to be explained.

THE STUDY ON RELATIONSHIP BETWEEN PSYCHOPATHOLOGY AND NEUROLOGICAL FACTORS IN CHRONIC EPILEPTIC CHILDREN (경련 질환 환아의 정신병리와 신경학적 요인과의 관계에 대한 연구)

  • Kim, Bung-Nyun;Cho, Soo-Churl;Hwang, Yong-Seung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.92-109
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    • 1996
  • The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.

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