• 대한한방내과학회지
• /
• 제42권6호
• /
• pp.1319-1330
• /
• 2021

A 56-year-old male patient with a sudden onset of tremor and involuntary movement of right upper and lower extremities, head, and voice was diagnosed as having a drug-induced tremor, with valproic acid being the culprit drug. The patient had undergone admission treatment at an internal Korean medicine department with herbal medicine according to constitutional diagnosis, acupuncture, moxibustion, cupping, and rehabilitation. The change in the severity of tremor was assessed with the Fahn Tolosa Marine scale. After discharge, the patient took herbal medicine for two more months. After 20 days of admission and 2 months of treatment with herbal medicine, the patient's tremor improved. In this case, the patient with valproic acid-induced tremor showed improvement in symptoms after 20 days of hospitalization and further reduction of tremor and improvement of quality of life were confirmed through follow-up for 2 months.

• 지역사회간호학회지
• /
• 제10권1호
• /
• pp.80-92
• /
• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Journal of Chest Surgery
• /
• 제27권12호
• /
• pp.989-994
• /
• 1994

Between January 1986 and August 1993, 11 patients underwent surgical repair of ventricular septal defect [VSD] complicated with myocardial infarction. The ages of patients were ranged from 22 years to 83 years with a mean of 64 years. There were 8 male and 3 female patients. The preoperative cineangiograms of all patients were reviewed to measure both ventricular function and to evaluate coronary artery disease. The mean time interval between occurance of VSD and operation was 13 days. The operations were performed as soon as possible if there were hemodynamic derangement. Postmyocardial infarction VSD were repaired simultaneuously with coronary artery bypass graft in 3 patients, repaired with left ventricular aneurysmectomy in 6 patients, with left ventricular thrombectomy in 1 patient and with mitral valve chordae repair in 1 patient. There was no early death [within 30 days]. There were 6 postoperative complications; one with perioperative myocardial infarction, two with recurred VSD on postoperative 1 and 6 days respectively, two with lower leg embolism associated with intraaortic balloon pump insertion, one with wound infection. Of the complicated patients, 1 patient with lower leg embolism performed left above ankle amputation. Among two patients with recurred ventricular septal defect, one patient is doing well without problem. On follow up echocardiogram, the residual VSD was occluded completely. However another patient was with recurred VSD died 3 months after the operation because of congestive heart failure. Of the long term survivors, all patients are in NEW YORK Heart Association functional Class I or II. Although number of patients were small, our results of surgical closure of postmyocardial infarction VSD were favored to the others. Moreover, seven patients with preoperative cardiogenic shock among 11 were performed early operation after diagnosis of ventricular septal rupture. All of the patients were survived and doing well during the follow up period. Therefore early diagnosis with aggressive preoperative care with intraaortic balloon pumping and early operation seems to be very important for prevention of deterioration of vital organ.

• 한방안이비인후피부과학회지
• /
• 제21권1호
• /
• pp.121-132
• /
• 2008

Objective : This study was performed to examine the patterns of inpatients that had visited Dept. of Dermatology Hospital of Oriental Medicine, Dongguk University. Methods : We analysed statistic study in 106 patients, who had admitted to the Dept. of Dermatology, Ophthalmology & Otorhinolaryngology Hospital of Oriental Medicine, Dongguk University from July, 2005 to January, 2008. Results : The results were as follows; 1. Males were 50.94% and females were 49.06%. 2. Distribution of aging was 18.87% in twenties and 17.92% in fifties. 3. Common disease group were Facial palsy(33.96%); Atopic dermatitis(21.7%); Tinnitus(7.55%); Sudden Sensorineural Hearing loss(4.72%); Sore throat(5.66%). 4. Average age of Facial palsy patients was 50.9 years old, average hospitalized period were 10.47days and subjective satisfaction rate was 2.56 points on the basis of 4 points. 5. Average age of Atopic dermatitis patient's average age was 22.22 years old, average hospitalized period were 8.35days and subjective satisfaction rate was 3.44 points on the basis of 4 points. 6. 47.2% of all patient were admitted into the hospital on 1st or 2nd outpatient service and 44% of Facial palsy patient were admitted into the hospital via emergency room. 7. All patient's average hospitalized period were 7.5 days. 8. All patient's subjective satisfaction rate were 2.97 points on the basis of 4 points. Conclusion : This study suggests that oriental medical treatments is especially popular in facial palsy and atopic dermatitis. We have to take steps for effective management and treatment for special diseases and ages.

• 한국병원경영학회지
• /
• 제13권3호
• /
• pp.44-68
• /
• 2008

The purpose of this study is to identify which factors of medical service quality were considered important by patients based on survey on eight hospitals located in Seoul. We analyzed the difference in impact of health service quality factors between the two groups with short and long inpatient days. In addition, we analyzed which service factors affected the customer satisfaction more differently across the inpatient groups. We found that patient satisfaction was not different between the two groups with short and long inpatient days. But the two groups showed different priority orders of medical service factors that affect patient satisfaction. In the group with long inpatient days, the order of medical service factors are cleanness, speciality, process. In the group with short stay, important factors are speciality, cleanness and convenience of facilities. These findings imply that hospitals should set up different marketing strategies across the different inpatients groups.

• 한국임상약학회지
• /
• 제23권1호
• /
• pp.26-32
• /
• 2013

Objective: This study was to define the clinical effect on the clinical decision support system (CDSS) for prescribing antibiotics integrated with the order communication system in a National Hospital. Method: We extracted data collected before integrating the CDSS of 4,406 adult patients in 2007 and data collected after integrating the CDSS of 4,278 adult patients in 2009. These patients were 50.4% and 45.2% of all patients admitted in 2007 and 2009, respectively. The clinical effect was defined as the proportion of prescribed antibiotics, the length of antibiotics use, and the DDDs (defined daily doses) of antibiotics per 1,000 patient-days using these retrospective data. Results: There were a significant change in the proportion of patient prescribed penicillins with extended spectrum (OR=0.55, p=001), penicillins included beta-lactamase inhibitors (OR=0.75, p<.001), 3rd cephalosporin (OR=1.47, p<.001). The mean of the length of antibiotics use was decreased statistically from $6.09{\pm}5.48$ to $5.85{\pm}5.51$ days (p=.003). The DDD of glycopeptides was decreased from 24.43 DDD to 19.55 DDD per 1000 patient-days. The DDD of 3rd cephalosporins was also decreased from 15.88 to 11.65. Conclusion: Therefore, the clinical decision support system for prescribing antibiotics was effective for the clinical outcomes.

• 대한상한금궤의학회지
• /
• 제7권1호
• /
• pp.65-73
• /
• 2015

Objective : The purpose of this paper is to report the effect of Sosiho-tang gagambang on Obesity based on Shanghanlun provisions Methods : According to a disease pattern identification diagnostic system based on Shanghanlun provisions, the patient was diagnosed as Yangmyung-byung, and treated for 90 days with Soshiho-tang gagambang that Scutellariae Radix was substituted with Salviae Miltiorrhizae Radix. The result of treatment was evaluated by Body Mass Index(BMI). Results : After taking Soshiho-tang gagambang for 90 days, the patient's BMI was decreased, and the patient is cured of Obesity. Conclusions : This study suggests that the treatment based on Shanghanlun provision has efficacy on Obesity. In addition, further studies are necessary in order to discover the roles of flavor of Shanghanlun herbal decoctions, and ensure the safety of it.

• 대한상한금궤의학회지
• /
• 제5권1호
• /
• pp.45-52
• /
• 2013

Objective : This case report aims to show the effect of Gamchogungang-tang, Hoiyeok-tang on an overactive bladder. The patient was diagnosed with Taeyang-byung based on Shanghanlun provisions. Methods : According to Diagnostic system based on Shanghanlun provisions, the patient was diagnosed with Taeyang-byung. So He was treated with Gamchogungang-tang, Hoiyeok-tang decoction for 70 days. We evaluated the results of treatment by Overactive Bladder Symptom Score(OBASS). Results : After taking Gamchogungang-tang, Hoiyeok-tang decoctions for 70 days, the patient's OBASS and symptoms was decreased from 12(severe) to 5(mile). Conclusions : This case report showed an effectiveness of using Gamchogungang-tang, Hoiyeok-tang according to Diagnostic system based on Shanghanlun provisions on overactive bladder.

• 대한상한금궤의학회지
• /
• 제6권1호
• /
• pp.97-111
• /
• 2014

Objective : This case report aims to show the effect of Bekhogainsam-tang on Overactive Bladder and Rheumatoid arthritis. The patient was diagnosed with Yangmyung-byung based on Shanghanlun provisions. Methods : According to Diagnostic system based on Shanghanlun provisions, the patient was diagnosed with Yangmyung-byng and has been unusual dietary habits. So she treated with Bekhogainsam-tang decoction for 75 days. We evaluated the results of treatment by Overactive Bladder Symptom Score(OABSS), Modified Overactive Bladder Validated 8-question Screener(OAB-V8), and Rheumatoid Arthritis Pain Score(RAPS). Results : After taking Bekhogainsam-tang decoction for 75 days, the patient's symptoms and OABSS was decreased from 20 to 11, OAB-V8 was from 42 to 20, and RAPS was from 130 to 63. Conclusions : This case report showed an effectiveness of using Bekhogainsam-tang according to Diagnositic system based on Shanghanlun provisions on Overactive Bladder and Rheumatoid Arthritis.

• 대한상한금궤의학회지
• /
• 제11권1호
• /
• pp.83-94
• /
• 2019

Objective : There was an improvement in a patient with psoriasis following the intake of Hoeyeok-tang for 317 days. By analyzing these cases, we reviewed the use of Hoeyeok-tang in skin diseases and attempted to interpret the related Shanghanlun articles. Methods : The diagnostic process was analyzed according to the disease pattern identification diagnostic system based on the Shanghanlun provisions. The progression of psoriasis, which was addressed, was assessed using the PASI score. Results : The patient was diagnosed with Soeum-byung 324, and the PASI score decreased from 13.6 to 0.4 after the intake of Hoeyeok-tang for 317 days. The patient's compliance and expectation from treatment were good, and no specific adverse effect was identified. Conclusions : This study suggests the clinical use of Hoeyeok-tang in psoriasis based on Shanghanlun.