• 제목/요약/키워드: Patient type

검색결과 2,995건 처리시간 0.03초

식도질환의 외과적 치료 75례 (Surgical experience of esophageal disease: report of 75 cases)

  • 박창권
    • Journal of Chest Surgery
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    • 제16권2호
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    • pp.231-242
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    • 1983
  • A clinical study was performed on 75 cases of the esophageal cancer and benign esophageal diseases experienced at Department of thoracic & cardiovascular surgery, School of Medicine, Keimyung University during 3 year period from 1978 to 1982. Of 75 cases of the surgical esophageal diseases, there were 35 patients of the esophageal cancer. 17 patients of benign esophageal stenosis, 10 patients of esophageal perforation, 4 patients of diverticulum. 3 patients of achalasia, 2 patients of congenital T-E fistula, one of upper esophageal web, one of esophageal foreign body, one of leiomyoma and patient of hemangioma. First, esophageal carcinoma was more frequent in men than in women by a ratio of five to one, and the peak incidence occurred in the 5th to 6th decade. Dysphagia was the most common symptom in 88.6 percent of our cases. The tumor was located mostly in the middle & the lower one third [91.4%]. The histological diagnosis was made in 35 cases. The squamous cell carcinoma was the most common [82.9%] and the rest was the adenocarcinoma in the lower one third [17.1%]. Thirty-five cases were operated and resection was feasible in the twenty-five patients [71.4%] with 2 cases of hospital mortality [5.7%]. All but two of the esophageal stenosis were caused by corrosive esophagitis and ages ranged from 7 to 70 years with average age of 32 years. Corrective operations were performed on 17 patients of esophageal stenosis of whom 12 patients had esophagocologastrostomy, 3 patients esophagogastrostomy and in non-corrosive esophageal stenosis one case and esophagoplasty and another case had release of external compression. There was one complication of stenosis of the esophageal perforation were traumatic in five cases, empyema in three cases, caustics in one case and postemetic in one case. 10 patients of the esophageal perforation underwent operation: primary closure in 5 cases, two staged colon interposition in 2, esophagogastrostomy in 1 and closed thoracotomy in 2 cases There were 2 complications of leakage of anastomosis sites in postoperative period. 4 patients of traction type of diverticulum underwent diverticulectomy & 3 patients of achalasia underwent modified Heller`s operation. 2 patients of congenital esophageal atresia had distal tracheoesophageal fistula & underwent one staged operation with the results of one death caused by pneumonia. Upper esophageal web had divulsion through the esophagoscope and foreign body in upper esophagus was removed through cervical esophagotomy. One case of leiomyoma in esophagus had esophagectomy and reconstruction with right colon. And one case of hemangioma in esophagus had esophagectomy & esophagogastrostomy.

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뇌경색 환자의 당뇨병성 고지혈증에 대한 오적산가감방(五積散加減方) 호전 1례 (A Case Report of Diabetic Hyperlipidemia in a Patient with Cerebral Infarction Treated with Ojeok-san)

  • 한승혜;정병주;우성호;김병철;김용호;서호석;황규동;조철준;남효익;김진원
    • 대한한방내과학회지
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    • 제26권1호
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    • pp.275-280
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    • 2005
  • Hyperlipidemia is one of the major factors causing the atherosclerosis of coronary arteries and well-documented modifiable risk factors of stroke, especially of the ischemic type. For Insulin-Dependent Diabetes Mellitus sufferers, if blood sugar is appropriately maintained, lipid and lipoprotein are normal, but if blood sugar is inappropriately maintained or clinical Diabetic nephropathy induces metabolic disorder of lipid, then Total cholesterol, low density lipoprotein cholesterol, triglyceride and very low density lipoprotein cholesterol levels go up and high density lipoprotein levels go down. The purpose of this study is to evaluate the effect of treatment with Ojeok-san and to observe the changes in Fasting Blood Sugar(FBS), 2 Hours Postprandial Blood Sugar(PP2h), Haemoglobin A1c(HbA1c), Total Cholesterol(T-Chol) and Triglyceride(TG). After the treatment, Fasting Blood Sugar decreased from 149mg/dl to 89mg/dl. 2 Hours Postprandial Blood Sugar decreased from l85mg/dl to 110mg/dl. Haemoglobin A1c decreased from 6.3% to 5.7%. Total Cholesterol decreased from 268mg/dl to 217mg/dl. And Triglyceride decreased from 438mg/dl to 265mg/dl. These results support a role for oriental medical therapy in treating Diabetic Hyperlipidemia. Further case studies of herbal treatment of this ailment are needed.

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대전 일부 지역 치과종사자의 화학소독제에 관한 지식도 연구 (Knowledge on the chemical disinfectants among dental workers in some Daejeon region)

  • 민희홍;안권숙
    • 한국치위생학회지
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    • 제7권4호
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    • pp.455-470
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    • 2007
  • The usage of appropriate disinfectants is essential for infection control in dental hospitals, dental clinics. Inadequate use of disinfectants is the cause of human or environmental toxicity and is a waste of cost. This study was aimed to assess the level of knowledge on the disinfection and chemical disinfectants among dental workers in dental hospitals, dental clinics. It's ultimately intended to serve as a basis for the preparation of more effective, appropriate educational programs on the disinfection and manuals on the use of disinfectants for dental workers. This study enforced a questionnaire with 184 dental workers employed in dental hospitals, dental clinics from 15 Aug. to 15 Sep. 2007, in the area of Daejeon. The obtained result were as follows; 1. The population sociological feature of dental hospital and dental clinic showed that significant differences of dental service career(pM0.039). Dental service career of dental workers shows; below 3 years 42.9%, 4~6 years 34.7%, more than 7 years 22.4% in dental hospitals, below 3 years 30.4%, 4~6 years 26.7%, more than 7 years 43.0% in dental clinics(pM0.039). 2. The average score of dental workers knowledge in 'Critical item soaks in high-level disinfectants for 20minutes was 2.73V0.49 point, got from knowledge of dental instrument is appropriate to immerse before sterilization in the dental device disinfection(pM0.002). 3. In the general disinfection which it follows in education experience of chemical disinfectants direction for use, 'Direction for use by Spaulding process classification' responded that the correct answer was the education experience dental workers 60.0%, the education non-experience dental workers 39.5%(p=0.026). 4. In the dental device disinfection which it follows in education experience of chemical disinfectants direction for use. 'High level disinfection is not applied for the non-critical items and equipment' responded that the education experience dental workers 49.2%, the education non-experience dental workers 31.9%(pM0.045), 'Semi-critical items is applied same method in presence of the infection disease which it acts responded that the education experience dental workers 44.6% answer back, the education non-experience dental workers 24.4%(pM0.017). 5. 'A hand disinfectants of anticeptics have effect' the education experience dental workers 78.5% answer back, the education non-experience dental workers 52.9%(pM0.003). 1t uses with hand disinfectants when the instruments which be imbrued and patient contact', the education experience dental workers 78.5% answer back, the education non-experience dental workers 62.2%(pM0.026), 'Boric acid solution uses for the skin disinfectants the education experience dental workers 52.3% answer back, the education non-experience dental workers is 37.0%(pM0.016), 'Gluconate have effective difference which it follows in chemical disinfectant consistency and the solution type' education experience dental workers 72.3% answer back, education non-experience dental workers 47.9%(pM0.004). 6. The education experience dental workers were appeared higher than the education non-experience dental workers in knowledge of the disinfection and chemical disinfectants. Consequently system and the specialty education which is standardized continuously must be provided to all dental workers.

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Distribution of HCV Genotypes in Chronic Korean HCV Patients

  • Lee, Kyung-Ok;Jeong, Su-Jin;Byun, Ji-Young;Shim, Ae-Sug;Seong, Hye-Soon;Kim, Kyung-Tae
    • 대한임상검사과학회지
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    • 제39권1호
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    • pp.49-55
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    • 2007
  • HCV는 single stranded RNA 바이러스로서 감염 시에는 만성간염 및 간경화 간암으로 진행될 수 있는 가능성이 높다. HCV는 6종의 주된 genotype과 그에 따른 많은 종류의 subtype이 보고되고 있으며, 세계 각 지역별로 그 분포는 매우 다양하다. 여러 가지 HCV genotype 중에서 1b 형에 감염되었을 경우 간경화나 간암으로 진행할 가능성이 높으며 치료효과도 떨어진다는 보고가 있어, 최근 HCV 환자의 치료에 있어서 HCV 바이러스 정량검사와 함께 HCV genotyping 검사의 임상적 활용이 높아지고 있다. 본 연구에서는 PCR-direct sequencing을 이용한 HCV genotyping 검사방법을 이용하여, 한국인 만성 HCV 간염환자에서 HCV genotype의 분포를 조사하였다. 검체로는 232명의 한국인 만성간염환자의 혈청을 사용하였으며, HCV 5'UTR 영역에서 선택한 2쌍의 primer로 nested PCR을 실시하였다. 증폭된 PCR산물 (215 bps)은 2% agrose gel로 전기영동을 하고 sequencing을 실시한 후 GeneBank의 BLAST 프로그램을 사용하여 HCV genotype을 분석하였다. HCV genotyping을 실시한 232명에서 5종류의 genotype, HCV 1b, 2a, 2b, 2c, 3a, 이 발견되었으며, HCV genotype 4, 5, 6 은 검출되지 않았다. 발견된 HCV genotype 중에서 HCV 1b의 검출률이 53.9%로 가장 높았고, 다음은 HCV 2a가 35.8%로 높게 나타나, 위 두 가지 HCV genotype을 합하면 거의 90%였다. 다음으로 HCV genotype 2b가 3.9%, 3a가 3.4% 그리고 2c가 3.0%의 순서로 검출되었다. 본 결과는 한국인 만성 HCV간염 환자의 치료 및 예후관리에 참고가 될 것으로 사료된다. 또한 PCR-direct sequencing을 이용한 HCV genotyping 검사는 간편하고 분명하게 결과를 판독할 수 있어 임상실험실에서 유용하게 사용될 수 있을 것으로 판단된다.

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새성기형에 관한 임상적 고찰 (Clinical Analysis of Branchial Anomalies : A Review of 72 Cases)

  • 김무필;최환;박세진;정은재;백승국;우정수;권순영;이남준;정광윤
    • 대한두경부종양학회지
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    • 제25권1호
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    • pp.12-17
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    • 2009
  • Background and Objectives : Branchial anomaly is a common neck pathology seen by otolaryngologist. Although there is still controversy regarding the origin, almost all surgeon agree that branchial anomalies result from incomplete involution of the branchial apparatus. Depending on its anatomic location, branchial anomalies can be classified into first, second, third and fourth anomaly. The purpose of this study is to evaluate the incidence of different categories of branchial anomalies and to determine proper method of diagnosis and treatment. Subjects and Method : A retrospective chart review was conducted for 72 patients with branchial anomalies operated on at the Korea University Anam Hospital from 1996 to 2007. The patient's sex, age, presenting symptoms, classification, site of lesion, diagnostic studies, surgical therapy and post-operative surgical complication were reviewed. Results : Patients were commonly seen in the 3rd decades. Eleven patients(15.3%) were first branchial anomalies, 52(72.2%) were second, 1(1.4%) was third, and 8(11.1%) were fourth. Of the types of anomalies, cyst were most commonly seen. In cases of 3rd and 4th branchial anomalies, barium contrast study can delineate the course of sinus or fistula. All cases was operated on for branchial anomalies, there were no major post-operative complication. Conclusion : Cervical mass and recurrent cervical infection or abscess are suspect for branchial anomalies. Especially, clinical history of dysphagia, and recurrent painful swelling in the thyroid region in young patients should raise the suspicion of 3rd and 4th branchial anomalies. Careful history, clinical examination and radiographic study were essential parts in diagnosis of branchial anomalies. Although surgical management of branchial anomalies depend on its type, nature and extent, complete excision is the major surgical procedure.

Retrospective clinical study of mandible fractures

  • Jung, Hai-Won;Lee, Baek-Soo;Kwon, Yong-Dae;Choi, Byung-Jun;Lee, Jung-Woo;Lee, Hyun-Woo;Moon, Chang-Sig;Ohe, Joo-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제40권1호
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    • pp.21-26
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    • 2014
  • Objectives: The purpose of this article is to analyze the incidence, demographic distribution, type, and etiology of mandible fractures that were treated by the Department of Oral and Maxillofacial Surgery in Kyung Hee University Dental Hospital from January 2002 to December 2012. Materials and Methods: This was a descriptive and analytic retrospective study that evaluated 735 patients that were treated for mandible fracture. Results: This study included 1,172 fractures in 735 patients. The ratio of male to female patients was 5.45 : 1; the maximum value was in patients between 20 and 29 years (38.1%) and the minimum in patients over 70 years old. The monthly distribution of facial fractures peaked in the fall and was lower during winter. No specific correlation was identified based on the annual fracture distribution. Among the 735 fracture patients, 1.59 fracture lines were observed per patient. The most frequent site was the symphysis, which accounted for a total of 431 fractures, followed by the angle (348), condyle (279), and body (95). The symphysis with angle was the most common site identified in combination with fracture and accounted for 22.4%, followed by symphysis with condyle (19.8%). The angle was the most frequent site of single fractures (20.8%). The major cause of injury was accidental trauma (43.4%), which was followed by other causes such as violence (33.9%), sports-related accidents (10.5%), and traffic accidents (10.1%). Fracture incidents correlated with alcohol consumption were reported between 10.0%-26.9% annually. Conclusion: Although mandible fracture pattern is similar to the previous researches, there is some changes in the etiologic factors.

습관제거장치와 근기능요법을 이용한 혀내밀기 원인성 개방교합의 치료 (TREATMENT OF OPEN BITE BY TONGUE THRUSTING HABIT USING HABIT BREAKING APPLIANCE AND MYOFUNCTIONAL THERAPY)

  • 최지원;오유향;이창섭;이상호;이난영
    • 대한소아치과학회지
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    • 제32권2호
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    • pp.229-235
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    • 2005
  • 흡지벽, 수직적인 골격 발육부전 등 여러 원인을 갖는 개방교합은 치아와 치조돌기에 국한되어 있는 단순 개방교합, 수직골격 발육부전에 의한 골격성 개방교합인 복잡 개방교합으로 나눌 수 있다. 단순 개방교합은 흡지벽, 농설벽 등 국소적 원인에 의하며 치조돌기의 수직적 발육결여와 상하악 잔치의 맹출 장애 등의 특징을 보인다. 농설벽은 혀가 상하악 전치 사이에 위치하고 혀의 주변부위가 구치부 교합면 사이에 놓이지 못하게 됨으로써 구치부 과맹출에 의한 전치부의 개방교합과 상악전치의 전돌을 가속화하게 된다. 악습관에 의한 개방교합을 가진 어린이에서는 습관을 없애주는 것이 개방교합을 치료하는 가장 좋은 방법일 것이다. 그리고 Hawley type 장치에 crib을 첨가하거나 oral screen을 장착시켜 농설벽을 치료할 수 있다 그리고 근기능요법은 동기유발과 혀의 기능을 조절하고 입술운동을 통해 새로운 연하운동을 발전시키도록 훈련하여 부정교합을 교정하거나 개방교합의 재발을 방지한다. 본 증례는 농설벽에 의한 개방교합을 가진 8세 여자 환자에서 탄성고무, 빨대를 이용한 연하연습과 발음연습을 포함한 근 기능요법과 습관제거장치를 이용해 습관의 중지 및 개방교합의 개선을 얻었기에 보고하는 바이다.

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미성숙 영구 전치의 외상 후 MTA를 이용한 치근단 형성술 : 후향적 연구 (MTA APEXIFICATION OF TRAUMATIZED IMMATURE PERMANENT INCISORS: A RETROSPECTIVE STUDY)

  • 정서영;안병덕;홍소이;공은경;마연주;정영정
    • 대한소아치과학회지
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    • 제38권1호
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    • pp.17-24
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    • 2011
  • 미성숙 영구 전치에서 MTA를 이용한 치근단 형성술의 예후를 평가하기 위해, 영구 전치의 외상으로 MTA를 이용한 치근단 형성술을 받은 환자 중 최소 3개월 이상의 경과 관찰이 시행된 환자 49명, 치아 64개의 의무기록과 방사선 사진을 검토하였다. 환자 정보, 치아 및 치주조직 외상 위치와 유형, 치료 전 치근단 병소 유무, 임상 증상 유무, MTA 충전 상태, 치근단 형성술 이후 치근단 병소 치유 및 치근단 경조직 장벽 형성 여부를 조사하고, 임상적, 방사선학적 성공을 평가하여 다음과 같은 결과를 얻었다. 1. 64개의 미성숙 영구전치에 시행된 MTA를 이용한 1-visit 치근단 형성술은 89.1%의 임상적 성공률과 73.4%의 방사선학적 성공률을 보였다. 2. 상악 치아와 하악 치아에 행해진 MTA를 이용한 1-visit 치근단 형성술 비교시 상악에서 유의하게 더 높은 성공률을 보였다. 3. 치아 외상 및 치주조직 외상 유형에 따른 성공률은 유의한 차이를 보이지 않았다. 4. MTA의 적절한 충전 여부는 성공률에 영향을 미치지 않았다.

고분자 기반 코팅형 상아질 지각 과민 처치제의 효과에 대한 비교 연구 (Comparison of high molecular coating type dentine hypersensitivity desensitizers)

  • 노영훈;이주연;박현정;최차남;박윤정;구기태;김태일;설양조;이용무;구영;류인철;정종평
    • 대한치과의사협회지
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    • 제46권11호
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    • pp.683-688
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    • 2008
  • Purpose : The aim of this study was to evaluate the clinical efficacy of two commercially available desensitizing agents over 3 weeks on patients with dentin hypersensitivity. Materials and Methods : An oxalate-based solution, Sensblok (NIBEC Inc. Seoul, Korea) & Superseal (Pheonix Inc. Michigan, USA), and a distilled water placebo were compared in a clinical setting. Seven volunteers exhibiting three or more teeth that were sensitive to tactile & air were enrolled in the study (35 teeth total). A visual analog scale (VAS) was used for recording each patient s level of sensitivity to tactile & air stimuli. A Florida probe was rubbed across the exposed dentin three times with a constant pressure 20 grams to measure the tactile stimulus. The air stimulus was generated by dental unit air syringe for 1-second blast from 1/2 inch distance. The desensitizing agents were applied according manufacture s guideline. VAS scores were recorded at baseline, 1 minute after treatment, at 1 week, 2weeks, 3weeks. VAS score were analyzed using a repeated measures ANOVA ( =0.05). Results : The Sensblok, Superseal, and distilled water placebo all decreased dentin sensitivity. A statistically significant difference existed between Sensblok and placebo when tactile stimulus was applied (P<0.05), but no significant difference was found among other desensitizing agents and tactile and air stimuli.

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장애인 환자의 치과치료를 위한 진정법 (Sedation for Dental Treatment of Patients with Disabilities)

  • 빙정호;전재윤;정세화;황경균;박창주;서광석;김현정;염광원;심광섭
    • 대한치과마취과학회지
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    • 제7권2호
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    • pp.114-119
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    • 2007
  • Background: Dental disabilities mean the poor cooperation for dental treatment because of patient's inherent disability, severe fear and anxiety, and communication problem. Sedation and general anesthesia are usually used for behavioral control in dentally disabled patients. In particular, sedation (conscious and deep) can help them to tolerate the proper dental treatment effectively and safely. Methods: From March 2002 to September 2007, total 35 sedation were carried out in 33 patients (male : female = 20 : 13) with dental disabilities at Seoul National University Dental Hospital and Hanyang University Medical Center. Patients' dental charts and sedation records were retrospectively reviewed. Results: Tooth extraction (19 cases) was the most common dental treatment performed under intravenous sedation (30 cases). Occasionally, inhalation sedation using Sevoflurane 1-2% was adapted (5 cases). Deep sedation (28 cases) was carried out using midazolam 2-3 mg bolus injection and propofol infusion via TCI (4.2 ${\pm}$ 0.9 mg/kg/h), and conscious sedation (7 cases) was carried out using midazolam bolus onlywithout severe complications. The duration of dental treatment was 25.5 ${\pm}$ 12.3 min and that of sedation was 43.2 ${\pm}$ 9.7 min. Conclusion: Sedation for dentally disabledpatients should be selected for effective behavioral control in conjunction with general anesthesia, considering the duration and pain-evoking potentials of dental treatment, the type and severity of patients' disabilities, and the experience of dental anesthesiologists altogether.

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