Tae Kyung Kim;Eun Ju Lee;Chang Min Shin;Jong Cheol Seo;Cheol Hong Kim;Yoo Min Choi;Hyun Min Yoon
Journal of Acupuncture Research
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v.41
no.1
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pp.53-62
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2024
Background: The aim of this study is to determine the correlation between clinical assessment scales, self-assessment scales, and surface electromyography (SEMG) for facial nerve palsy. Methods: This study assessed 32 cases of facial nerve palsy on the first visit, 11 cases on the second visit, and 9 cases on the third visit to the Korean medicine hospital, university. This study was conducted from October 22, 2022, to December 22, 2022. The patients were evaluated using SEMG, clinical assessment scales, and self-assessment scales 3 times. The House-Brackmann grading systems (HBGS), Yanagihara unweighted grading system (Y-score), facial disability index, numerous rating scale, and accompanying symptoms of facial nerve palsy were used for assessment. Moreover, statistical correlation was analyzed using Pearson correlation. Results: On Visit 1, Significant correlations were observed between the results of SEMG and other clinical assessment scales as well as between SEMG-F (frontalis) and different parts of the Y-score. On Visit 2, significant correlations were observed between the results of SEMG and HBGS as well as between SEMG-F and the detailed parts of the Y-score. On Visit 3, significant correlations were observed only between SEMG-F and the detailed parts of the Y-score. A significant correlation was also observed between the changes in the clinical assessment scales on Visits 1 and 3 and between the changes in SEMG-F and those in the patient self-assessment scales. Conclusion: These findings suggest that SEMG can be used to evaluate facial nerve palsy in conjunction with the use of other clinical assessment scales.
In general, the skeletal class III has the characteristics of mandibular overgrowth with a normal maxillary growth or maxillary undergrowth with a normal mandibular growth And clinical and radiographic evaluations of the patient are needed. However, the treatment plan is not dependent on these evaluations alone, because patient's general condition and hope for aesthetics varies. The aim of this report is to consider the treatment of a medically compromised patient with an anterior open bite and skeletal class III, which showed a severe mandibular overgrowth. In 2003, a 17-year-old boy with epilepsy, mental retardation presented at our clinic complaining of concave profile. A clinical examination showed severe mandibular prognathism with an anterior open bite. The radiographic examination revealed a short cranial base, a moderate maxillary overgrowth, severe mandibular overgrowth and skeletal open bite tendency. In 2004, he was verified to have no potential of growth by hand-and-wrist radiographs and an endocrine examination. He completed the preoperative orthodontic treatment and orthognathic surgery (sagittal split ramus osteotomy, genioplasty). He was evaluated on the first visit, the preoperative period and the postoperative period with a clinical and radiographic examination. At the first visit, the patient showed moderate overgrowth of the maxilla, severe overgrowth of the mandible, and a subsequential skeletal open bite. After the preoperative orthodontic treatment (preoperative period), the patient showed the same skeletal problem as before and a decompensated dentition for orthognathic surgery. After orthognathic surgery, his profile had improved, but he had still a skeletal openbite tendency because the maxillary orthognathic surgery was not performed. Severe mandibular prognathism with a maxillary overgrowth and anterior open bite should be treated by bimaxillary orthognathic surgery. However, one-jaw orthognathic surgery on the remaining the skeletal open bite tendency was performed for his medical problem and facial esthetics. This subsequential open bite should be resolved with a postoperative orthodontic treatment.
Journal of agricultural medicine and community health
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v.24
no.1
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pp.91-101
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1999
The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.
Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data. Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience. Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience. Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.
This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.
Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.
Kim, Min-Hee;Lee, Byung-Chul;Yoon, Young-Hee;Choi, In-Hwa
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.25
no.1
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pp.104-111
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2012
Objective : The aim of this study is to report the effect and safety of Traditional Korean Medicine on the treatment of erythrodermic psoriasis which appeared after stopping high potency topical steroids. Methods : A patient with psoriasis stopped topical steroids after the first outpatient care and was treated with herbal medicine, acupuncture, moxibustion for eight months. The severity of psoriasis was assessed with Psoriasis Area and Severity Index. Liver and renal functions were tested to observe the hepatic and renal toxicity of the treatment. Results : PASI score were 6.2 on the first visit and three months after it increased to 30 and the patient showed symptoms of erythrodermic psoriasis. And seven months after the first visit, it decreased to 0.6. There was no hepatic and renal toxicity of the treatment. Conclusion : These findings suggest that Traditional Korean Medicine might be effective and safe for the treatment of erythrodermic psoriasis.
Objective : To evaluate the pain improvement of the lumbago patients taken the electro-acupuncture therapy using Visual Analogue Scale. Methods : The 25 patients of 46 lumbago patients visited department of Acupuncture & Moxibustion in National Medical Center from 1st March to 20th August had taken the electro-acupucture therapy more than 5 times. We checked on their age, sex, onset, radiating pain, back pain past history and Straight Leg Raising test. And we evaluated their improvement of back pain using Visual Analog Scale(VAS) at each visit. Then we analyzed the pain improvement by their age, sex, onset, radiating pain, back pain past history, Straight Leg Raising test, visiting frequency and Visual Analog Scale on 1st visit(VAS1) Results : VAS of 24 patients has improved and VAS of one patient has not been changed. There's no patient getting worse. The women and the positive group at SLR Test had better result of pain improvement. Conclusion : The lumbago patients taken electro-acupuncture more than 5 times showed significantly different pattern of pain improvement according to the sex and the SLR test.
This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.
Objectives: The current study was performed to compare the bee venom pharmacopuncture skin test reactions among groups with different sexes and Sasang constitutions. Methods: Between July 2012 and June 2013, all 76 patients who underwent bee venom pharmacopuncture skin tests and Sasang constitution diagnoses at Oriental Medicine Hospital of Sangji University were included in this study. The skin test was performed on the patient's forearm intracutaneously with 0.05 ml of sweet bee venom (SBV) on their first visit. If the patients showed a positive response, the test was discontinued. On the other hand, if the patient showed a negative response, the test was performed on the opposite forearm intracutaneously with 0.05 ml of bee venom pharmacopuncture 25% on the next day or the next visit. Three groups were made to compare the differences in the bee venom pharmacopuncture skin tests according to sexual difference and Sasang constitution: group A showed a positive response to SBV, group B showed a positive response to bee venom pharmacopuncture 25%, and group C showed a negative response on all bee venom pharmacopuncture skin tests. Fisher's exact test was performed to evaluate the differences statistically. Results: The results of the bee venom pharmacopuncture skin tests showed no significant differences according to Sasang constitution (P = 0.300) or sexual difference (P = 0.163). Conclusion: No significant differences on the results of bee venom pharmacopuncture skin tests were observed according to two factors, Sasang constitution and the sexual difference.
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