• 제목/요약/키워드: chief complaint

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A simple statistical model for determining the admission or discharge of dyspnea patients (호흡곤란 환자의 입퇴원 결정을 위한 간편 통계모형)

  • Park, Cheol-Yong;Kim, Tae-Yoon;Kwon, O-Jin;Park, Hyoung-Seob
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.2
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    • pp.279-289
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    • 2010
  • In this study, we propose a simple statistical model for determining the admission or discharge of 668 patients with a chief complaint of dyspnea. For this, we use 11 explanatory variables which are chosen to be important by clinical experts among 55 variables. As a modification process, we determine the discharge interval of each variable by the kernel density functions of the admitted and discharged patients. We then choose the optimal model for determining the discharge of patients based on the number of explanatory variables belonging to the corresponding discharge intervals. Since the numbers of the admitted and discharged patients are not balanced, we use, as the criteria for selecting the optimal model, the arithmetic mean of sensitivity and specificity and the harmonic mean of sensitivity and precision. The selected optimal model predicts the discharge if 7 or more explanatory variables belong to the corresponding discharge intervals.

A Case report of Idiopathic Scoliosis Patient : Comparison of X-ray and Digital Infrared Thermographic Imaging (특발성 척추측만증 환자의 X-ray와 적외선 체열촬영의 비교 1례)

  • Jo, Jun-Young;Kim, Jin-Woo;Park, Kyoung-Sun;Lee, Jin-Moo
    • Journal of Oriental Medical Thermology
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    • v.9 no.1
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    • pp.51-56
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    • 2011
  • Purpose : The purpose of this study is to report the comparison of X-ray and Digital Infrared Thermographic Imaging (DITI) of a patient with idiopathic scoliosis. Method: The patient in this case was a 25-year-old female. Her chief complaint was a pain in lumbar, scapular and shoulder regions. We examined her with DITI and X-ray. And then We compared DITI and X-ray. Results: Cobb's angle of thoracic spine was $24.78^{\circ}$ as a primary curve. Cobb's angle of thoracolumbar spine was $17.63^{\circ}$. Temperature on convex side of the thoracic spine was $0.3^{\circ}C$ higher than the other side. Temperature on convex side of cervical spine was $1.4^{\circ}C$ higher than the other side. There was no correlation curvature degree with temperature difference. Conclusion : There was a tendency that the temperature on convex side of the spine is higher than the other side of the spine. DITI is a useful assessment tool when it is used with X-ray as a diagnostic tool of idiopathic scoliosis. Further studies are needed.

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A CASE REPORT OF BRANCHIAL CLEFT CYST IN THE NECK (경부에 발생한 새열낭 (branchial cleft cyst)의 증례보고)

  • Lee Young-Mi;Choi Soon-Chul;Park Tae-Won;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.23 no.2
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    • pp.365-372
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    • 1993
  • Branchial cleft cyst is the most common lateral neck cyst; the vast majority are of the second branchial cleft origin. This presumably reflects the greater depth and longer persistence of the second cleft, compared with the first, third, and fourth clefts. We experienced a 49-year-old male whose chief complaint was a abnormal mass of the left parotid gland area and neck. As a result of careful analysis of clinical, radiological, and histopathological findings, we diagnosed it as a second branchial cleft cyst in the neck and obtained results as follows: 1. In clinical examination, there was a 10×15㎝ sized, fluctuant painful mass in the left neck and parotid area. 2. In radiographic examination, a low echogenic mass with internal cystic change in the inferior parotid gland area was noted sonographically. Computed tomograph showed a 3×4㎝ sized, well-defined cystic mass with heterogenous solid component in the anterior border of sternocleidomastoid muscle. MRI revealed 5×6㎝ sized, well-marginated multi separated mass in the same area. 3. In histopathological examination, lining of cyst was stratified squamous epithelium with typical lymph node pattern and inflammatory cell infiltration.

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BENIGN TUMORS IN THE ALVEOLAR RIDGE OF NEWBORNS (신생아의 치조제에 발생한 양성 종물)

  • Lee, Jae-Ho;Kim, So-Hwa;Yun, Jung-Hun;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.2
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    • pp.310-315
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    • 2001
  • The soft tissue tumors that occur commonly in newborn infants include palatal and gingival cyst of the newborn, congenital epulis, hemangioma, teratoma, pyogenic granuloma, and irritation fibroma. Such soft tissue tumors in the alveolar ridge of newborns are usually treated by surgical excision. If untreated, they can cause airway obstruction and breathing difficulty due to aspiration. They also cause discomfort during oral feeding. If nasal feeding is tried, since vomitting is impossible, there is a risk of aspiration pneumonia. In this case, a newborn infant visited our hospital with soft tissue tumor as chief complaint, and the infant was treated by surgical excision. It appeared to be similar to pyogenic granuloma and irritation fibroma upon histologic exam. However, it was different from those diseases since multinucleated giant cells were observed and it was congenital. The pathologic process of this neoplasm is not clear. This case is reported, since it is difficult to classify it as a specific disease.

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Reconstruction of microstomia considering their functional status

  • Ki, Sae Hwi;Jo, Gang Yeon;Yoon, Jinmyung;Choi, Matthew Seung Suk
    • Archives of Craniofacial Surgery
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    • v.21 no.3
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    • pp.161-165
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    • 2020
  • Background: Microstomia is defined as a condition with a small sized-mouth that results in functional impairment such as difficulty with food intake, pronunciation, and poor oral hygiene and cosmetic problems. Several treatment methods for microstomia have been proposed. None of them are universally applicable. This study aims at analyzing the cases treated at our institution critically reviewing the pertinent literature. Methods: The medical records of all microstomia patients treated in our hospital from November 2015 to April 2018 were reviewed retrospectively. Of these, all patients who received surgical treatment for microstomia were included in the study and analyzed for etiology, chief complaint, surgical method, and outcomes. The functional outcomes of mouth opening and intercommissure distance before and after the surgery were evaluated. The cosmetic results were assessed according to the patients' satisfaction. Results: Five patients with microstomia were corrected. Two cases were due to scar contracture after chemical burn, two cases derived from repeated excision of skin cancer, and one patient suffered sequela of Stevens-Johnson syndrome. The following surgical methods were applied: one full-thickness skin graft on the buccal mucosa, three buccal mucosal advancement flaps after triangular excision of the mouth corner, and one local buccal mucosal flap. Mouth opening was increased by 6.0 mm, and the intercommissure distance improved by 7.2 mm on average. Follow-up was 9.6 months (range, 5-14 months). Cosmetic assessment was as follows: two patients found the results excellent, three judged it as good. Conclusion: Microstomia has several causes. In order to achieve optimal functional recovery and aesthetic improvement it is important to precisely evaluate the etiologic factors and the severity of the impairment and to carefully choose the appropriate surgical method.

MALIGNANT FIBROUS HISTIOCYTOMA OF THE MAXILLA ; REPORT OF A CASE (상악골에 발생한 악성섬유성조직구종)

  • Ryu, Sun-Youl;Park, Suk-In;Lee, Jin-Hwan;Chung, Mu-Gang;Chung, Jong-Chull;Choi, Hong-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.1_2
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    • pp.117-123
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    • 1992
  • Malignant fibrous histiocytoma rarely occurs in the jaws. A case of malignant fibrous histiocytoma originated from the maxillary sinus is reported with review of literature. A 59-year-old woman visited the Chonnam University Hospital in March, 1990, with chief complaint of swelling and tenderness in the right cheek. Radiographic findings revealed wide destruction of the maxilla. The biopsy taken from the maxilla showed histopatholgic findings of malignant fibrous histiocytoma. Accordingly the patient received preoperative and postoperative anticancer chemotherapy by the modified CY-VA-DIC protocol of the Southwest Oncology Group (SWOG). Preoperative and postoperative radiotherapy were also given to her in total 40Gy of $^{60}Co$ And she underwent radical resection of the maxilla. No evidence of recurrence or metastasis was shown for 2-year period of postoperative follow up.

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A REPORT OF CALCITYING ODONTOGENIC CYST (석회화 치원성 낭종의 치험례)

  • Lee, Sang-Chull;Kim, Yeo-Gab;Ryu, Dong-Mok;Lee, Wan-Kee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.14 no.3
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    • pp.185-193
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    • 1992
  • The calcifying odontogenic cyst was identified as a pathological entity by Gorlin & his associates in 1962. This lesion is one of the rarest and most disputable cysts in the oral region. The calcifying odontogenic cyst has variable clinical and radiological features. We review the previous literatures and report 2 cases of calcifying odontogenic cyst at Department of Oral and Maxillofacial Surgery, Kyung-Hee University. The 1st case was as follows. The patient vas 22 year old female. The past dental history revealed extraction of prolonged retained #73 tooth about 15days ago. She complained a painful swelling on the lower anterior teeth area. There were chin and vestibular swelling on the lower anterior teeth area, tenderness and missing of #33 tooth. The radiograph revealed well-demarcated unilocular radiolucency containing radiopaque calcific flecks around impacted #33 tooth. The clinical diagnosis was COC, so surgical enucleation was done. There was no recurrence and COC was confirmed by pathologist. The second case was as follows. The patient was 72 year old male. The past history revealed inactive tuberculosis, bronchial asthma and denture construction. The chief complaint was rapidly growing mass on the lower left anterior edentulous area. The clinical findings were chin swelling protruding mass with surface ulceration, fluctuation and a few bloody fluid in aspiration. The radiograph revealed well-demarcated radiolucency mimiking the residual cyst. The biopsy result was COC. The surgical excision was done, but the lesion was recurred 10 months later. The treatment was surgical excision with aggressive peripheral bone grinding and FTSG form groin area. There was no problem during the postoperative period.

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HYPOPHOSPHATASIA : CASE REPORT (Hypophosphatasia 환아의 치료 증례)

  • Park, Soo-Jung;Lee, Jae-Ho;Choi, Hyung-Jun;Kim, Kee-Deog;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.555-561
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    • 1998
  • Hypophosphatasia is a rare metabolic disorder which manifests characteristics such as abnormal mineralization of bone and dental tissues, diminished serum and tissue alkaline phosphatase, and increased urinary secretion of PEA. It inherited as an autosomal recessive or dominant trait and occurs in all races. In general, hypophosphatasia can be classified in 4 subtypes which are the perinatal, infantile, childhood, adult type depending upon the age at presentation and severity. In young children with Hypophosphatasia the long bones show irregular defects, and the skull showes poor calcification. In older children with premature closure of the skull sutures there may be multiple lucent area called gyral or convolutional markings, described as resembling beaten copper, presumably resulting from increased intracranial pressure. Examination of the jaws reveals a generalized lucency of the maxilla and mandible. the cortical bone and lamina dura are thin, and the alveolar bone may be deficient. Clinical features of Hypophosphatasia include premature loss of deciduous teeth, especially incisors, hypoplasia or aplasia of root cementum, enamel hypoplasia, irregular calcification of dentin, large pulp chamber, and resorption of marginal alveolar bone and roots. Our report involves a patient with a chief complaint of early loss of both Mx. and Mn. deciduous incisors. After conducting a through clinical and radiographic examination this patient was referred to pediatrics under the suspicion of hypophosphatasia, the diagnosis proved to be correct and successful results were accomplished through a denture made to improve esthetics and function.

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[ $GARR{\grave{e}}'s$ ] OSTEOMYELITIS IN CHILDREN (어린이의 악골에 발생한 $Garr{\grave{e}}'s$ osteomyelitis)

  • Kim, Shin;Jeong, Tae-Sung;Kim, Hong-Ryoul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.25 no.3
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    • pp.533-538
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    • 1998
  • [ $Garr{\grave{e}}'s$ ] osteomyelitis is a chronic form of osteomyelitis in which periosteum is thickened with peripheral reactive bone formation. Carl $Garr{\grave{e}}$ first reported localized periosteal thickening as a response to mild stimuli. In dental literatures, Pell et al. first reported $Garr{\grave{e}}'s$ osteomyelitis in jaws. This disease frequent occurs in youngsters and usually in mandible. It usually results in hard swelling over the jaws with little or no pain. Palpation reveals a localized bony swelling lesion. In radiographic findings, it usually reveals laminated periosteal thickening on lesion. The treatment of $Garr{\grave{e}}'s$ osteomyelitis usually consists of elimination of the sources of infection, i.e., either extraction of an infected teeth or root canal therapy. Two children were admitted with the chief complaint of intraoral swelling on lower deciduous molar areas which was diagnosed as $Garr{\grave{e}}'s$ osteomyelitis. The root canal therapy and antibiotic therapy were performed and prognosis was checked. From these case studies, some results were obtained as follows : With the aid of root canal therapy and antibiotic administration, the size of periapical lesions was reduced, the mandible with bony swelling recovered its normal shapes radiographically, and the permanent tooth germs resumed sound development.

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A CASE REPORT OF TREATMENT OF RECURRENT GRANULAR-TYPE AMELOBLASTOMA (하악골에 발생한 재발성 법랑아 세포종의 치험례)

  • Yoon, Kyu-Ho;Rho, Young-Seo;Park, Seong-Won;Shin, Myoung-Sang;Jeon, In-Seong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.2
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    • pp.179-185
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    • 1994
  • The Ameloblastoma is a true neoplasm of enamel organ-type tissue histopathologically. Ameloblastoma is recognized as a benign tumor, but its clinical behavior is locally invasive. Therefore treatment of choice is surgical resection rather than conservative enucleation. This is a case report about En-bloc excision of granular ameloblastoma arising from dentigerous cyst in the right mandibular angle area of 50-year male patient. He visited local clinic with chief complaint of facial swelling on the right mandibular angle area. Surgical removal was performed by cyst enucleation and En-bloc excision with preservation of inferior border of mandible. After 1 year, iliac bone graft was done and hyperbaric oxygen therapy was applied. We obtained a good result of bony regeneration without any sign of recurrence.

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