• 한방안이비인후피부과학회지
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• 제20권3호
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• pp.169-180
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• 2007

Objective : This study was to explore the change of new outpatients in ophthalmology, otolaryngology, dermatology. Methods : We did stastical analysis about 4638 new outpatients who had visited the department of ophthalmology, otolaryngology, dermatology in Kyunghee oriental medicine center from January 1, 2004 to December 31, 2006 and had ophthalmologic, otologic, rhinologic, laryngologic and dermatologic diseases. Results : The results were as follows. 1. Distribution of ophthalmology, otology, rhinology, laryngology and dermatology classification in new outpatients was 44.74% in dermatology the most, 26.50% in rhinology, 14.45% in otology, 8.78% in ophthalmology, 5.54% in laryngology. In all classifications except ophthalmology, outpatients increased, but the proportion of outpatients increased the most in dermatology. 2. The proportion of the new outpatients in ophthalmology was 20.15% in 51-60 years old the most. And 36.61% in dry eye the most, next 27.03% in visual disorder, 10.07% in strabismus. The proportion of the new outpatients in ophthalmology in strabismus decreased by 43.93 percent point but in dry eye increased by 32.17 percent point. 3. The proportion of the new outpatients in otology was 24.94% in 61+ years old the most. And 64.03% in tinnitus, hearing loss the most, next 17.46% in vertigo, dizziness. By 17.36 percent point, it in tinnitus, hearing loss decreased. But in vertigo, dizziness increased by 14.91 percent point. 4. The proportion of the new outpatients in rhinology was 40.93% in 0-10 years old the most. And it increased by 20.08 percent point. 69.30% in rhinitis the most but it decreased by 17.70 percent point. But 32.59% in sinusitis, that means it increased by 14.41 percent point. 5. The proportion of the new outpatients in laryngology was 68.09% in female, 23.35% in 51-60 years old the most. And it was 29.96% in laryngopharyngitis, 19.07% in stomatitis, 14.40% in the diseases of tongue. 6. The proportion of the new outpatients in dermatology was 37.21% in 21-30 years old the most.And it was 22.93% in atopic dermatitis the most, next 14.77% in urticaria. That means it increased by 8.19 percent point. But the proportion of the new outpatients in dermatology decreaed in acne, pruritus. Conclusions : We could know that there had been many changes of new outpatients in ophthalmology, otolaryngology, dermatology

• 한국의료질향상학회지
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• 제10권2호
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• pp.204-215
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• 2003

Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10757-10762
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• 2015

The purpose of this study was to demonstrate the feasibility of VIA screening with cryotherapy and to record normative values for indicators anticipated in similar low resource settings. Women aged 30-49 years were targeted, resulting in 1961 women screened and treated at two primary health care (PHC) centres near Suva, Fiji. Recruitment was through provision of information, education and communication (IEC). Referrals to a gynaecology outpatient department (OPD) at a referral hospital occurred throughout the screening pathway. Participation was 32% (95%CI 31-33%), higher in iTaukei (Melanesians) women (34%, 95%CI 33-36) compared to Fijians of Indian descent (26%, 95%CI 24-28). Regression analysis, adjusted for confounders, indicated significantly lower participation in those of Indian descent, and age groups 35-39 and 45-49 years. Of those examined by VIA, 190 were positive with aceto-white lesions (9.9%), within the expected range of 8-15%, with minor geographic and ethnic variation. Positive VIA results were more common in the peri-urban area, and in those aged 35-39 years. Of women aged 30-49 years, 59 received cryotherapy (none of whom had significant complications), 91 were referred to OPD, two cervical carcinomas were identified and eight cervical intra-epithelial neoplasms (CIN) II-III were diagnosed. These results provide normative findings from a community-based VIA screening program for other similar low resource settings.

• 대한기관식도과학회지
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• 제2권1호
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• pp.103-110
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• 1996

Globus pharyngeus is a common problem comprising between 3% and 4% of new otolaryngology outpatient referrals. We do not understand the etiology of globus exactly and it is remained a disease of exclusion. The treatment of globus pharyngeus is still not established. The aim of this study is to understand the etiologic factors and determine the reliable guide for selecting method of choice of evaluation and improving therapeutic response of globus pharyngeus. A total of 141 patients were investigated by authors. 25 of 141 patients were excluded from the study because they could not satisfy the definition criteria of this study. After detailed Interview and comprehensive physical examinations, all the 116 patients had underwent barium esophagogram, fiberoptic esophagogastroscopy, esophageal manometry and 24-hour pH monitoring. They could follow up for at least 3 months. There were 43 male and 73 female subjects and the mean age was 46.5 year. Esophagogram revealed normal in 94(81%) subjects. 78 patients(67.2%) were normal in esophageal manometry. Gastroesophageal reflux(GERD) was found in 24 cases and borderline GERD was found in 25 cases showing an overall incidence of 42.2% for 24-hour pH monitoring. Especially 44(89.8%) of the 49 patients with proven reflux on 24-hour pH monitoring showed therapeutic response whereas 48(71.6%) of the 67 subjects without reflux showed response.

• 성인간호학회지
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• 제28권3호
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• pp.302-313
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• 2016

Purpose: The objective of this study was to identify factors related to self-care adherence in symptomatic patients with heart failure (HF). Methods: Using a cross-sectional design, a convenience sample 209 outpatient clinic patients were recruited at two medical centers. Between October 2011 and August 2012, data were collected using the structured questionnaire. Factors related to self-care adherence were examined using hierarchical multiple regression. Results: Mean age of participants was 67.71 years and a half of them (53.6%) were female. They showed relatively low self-care adherence with mean scores of $61.88{\pm}12.92$. Lower self-care adherence was reported in asking for low sodium items, weighing oneself, checking for ankle edema, and exercising for 30 minutes. The overall model significantly explained 23.9% of variance in self-care adherence. Among the predictors, education, New York Heart Association functional classification, and social support were statistically significant in influencing self-care adherence. The variable of negative emotional status such as anxiety and depression were not found to be significant. Conclusion: These findings demonstrate that social support could help self-care adherence among symptomatic patients with HF. Thus, programs targeting self-care adherence in this population should consider the strategies improving social support.

• 생물정신의학
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• 제7권2호
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• pp.198-205
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• 2000

Objectives : Risperidone and clozapine belong to a new generation of antipsychotics that are reportedly more effective and better tolerated than conventional neuroleptics. However, each of these agents costs far more per unit than conventional neuroleptics. The purpose of our retrospective study was to ascertain the total cost and effectiveness of treatment before and after administration of risperidone and clozapine in "revolving door" schizophrenia patients. Method : Data collected on revolving door schizophrenics for 2 years before clozapine and risperidone treatment and for at least 2 years after clozapine and risperidone treatment. Direct cost of inpatient and outpatient treatment was measured. Effectiveness was scaled as "years of mild disability gained". Result : Both risperidone and cloazpine result in higher costs and additional benefits to patients, for example, increased mild disability, reduced number of relapse, and reduced hospital length-of-stay. An ICER of risperidone was less than Rc and ICER of clozapine was greater than Rc. According to decision-analytic this model, risperidone had favorable cost-effectiveness ratios relative to clozapine. Conclusion : We have assumed that risperidone is more cost-effective than clozapine.

• Journal of Korean Neurosurgical Society
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• 제63권6호
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• pp.681-688
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• 2020

Glioblastoma (GBM) is one of the most common tumors of the central nervous system, which is the most lethal brain cancer. GBM treatment is based primarily on surgical resection, combined with radiotherapy and chemotherapy. Despite the positive treatment, progression free survival and overall survival were not significantly prolonged because GBM almost always recurs. We are always looking forward to some new and effective treatments. In recent years, a novel treatment method called tumor treating fields (TTFields) for cancer treatment has been proposed. TTFields devices were approved by the Food and Drug Administration (FDA) for adjuvant treatment of recurrent and newly diagnosed GBMs in 2011 and 2015, respectively. This became the first breakthrough treatment for GBM in the past 10 years after the FDA approved bevacizumab for patients with relapsed GBM in 2009. This paper summarized the research results of TTFields in recent years and elaborated the mechanism of action of TTFields on GBM, including cell and animal experimental research, clinical application and social benefits.

• 대한두개안면성형외과학회지
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• 제18권3호
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• pp.186-190
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• 2017

We report a case of free flap deterioration which may have been induced by pressure gradient resulting from cranial defect overlying a ventriculoperitoneal shunt (VP shunt). The patient, male and aged 78, had a VP shunt operation for progressive hydrocephalus. Afterwards, the scalp skin flap surrounding the VP shunt collapsed and showed signs of necrosis, exposing part of the shunt catheter. After covering the defect with a radial forearm free flap, the free flap site showed signs of gradual sinking while the vascularity of the flap remained unimpaired. An agreement was reached to remove the shunt device and observe the patient for any neurological symptoms, and after the shunt was removed and the previous cranial opening filled with fibrin glue by Neurosurgery, we debrided the deteriorated flap and provided coverage with 2 large opposing rotational flaps. During 2 months' outpatient follow-up no neurological symptoms appeared, and the new scalp flap displayed slight depression but remained intact. The patient has declined from any further follow-up since.

• Journal of Audiology & Otology
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• 제25권1호
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• pp.43-48
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• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.

• 대한청각학회지
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• 제25권1호
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• pp.43-48
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• 2021

Background and Objectives: Conflicting mechanisms have been reported about spontaneous reversal of positional nystagmus during head-roll maneuver in patients with benign paroxysmal positional vertigo (BPPV). The objective of this study is to review the reports about the characteristics and possible mechanisms of reversing positional nystagmus and to present seven new cases. Subjects and Methods: Seven cases (5 males, 2 females; 4 left-sided, 3 right-sided) were recruited among 732 patients with BPPV seen outpatient clinic between 2009 and 2019. Diagnosis of lateral canal canalolithiasis was confirmed when transient geotropic nystagmus was documented during head-roll test. Reversing positional nystagmus was analyzed in each case and clinical characteristics of the patients were documented. Results: The age of patients was ranging between 30 to 64 years (46.44±10.91). Duration of symptoms was short (21.34±19.74). Six of them had a story of head trauma. Initial latency was short. First, intense geotropic nystagmus was observed following provocative head-roll position on the affected side. There was short "silent phase". Then, a longer second-phase of reversed nystagmus was noted. Total duration of nystagmus was 78.40±6.82 seconds. Maximal slow phase velocity was 24.05±6.34 deg/sec. All patients were cured with barbeque maneuver. Conclusions: Ipsilateral reversing positional nystagmus during head-roll maneuver is due to lateral canal canalolithiasis. Mechanism is likely to be due to endolymphatic double flow. Bilateral cases may be due to simultaneous co-existence of canalolithiasis and cupulolithiasis. Longer recording of nystagmus is recommended not to miss the cases with spontaneous direction-changing positional nystagmus.