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The Clinical Study of 29 Cases on Effects of Cervical Hyeopcheok(Jiaji) Point Treatment for Neck Pain (경항통 환자에 대한 경추 협척혈 치료 29례)

  • Ryu, Young-Jin;Sun, Seung-Ho;Lee, Yeon-Hee;Choi, Ga-Young;Lee, Sun-Ju;Lee, Kwang-Ho
    • Journal of Acupuncture Research
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    • v.27 no.4
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    • pp.239-245
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    • 2010
  • Objectives : The aim of this study is to evaluate the effect of cervical Hyeopcheok(Jiaji) point for neck pain. Methods : The twenty-nine patients who feel neck pain, are chosen from chart review, received acupuncture treatment on cervical Hyeopcheok(Jiaji) point. The evaulation of progress was checked by NDI(neck disability index), and VAS(visual analog scale). Data were analyzed by Friedman two way analysis of variance and Wilcoxon matched pairs signed rank test. Results : NDI value(mean${\pm}$SD) was $17.76{\pm}8.26$(n=29) at the first visit, $13.41{\pm}8.04$(n=29) at 3days after treatment, $10.85{\pm}8.46$(n=26) at 5days, $11.00{\pm}7.80$(n=13) at 9days, $7.22{\pm}4.76$(n=9) at 15days, $3.86{\pm}4.06$(n=7) at 20days, and $3.33{\pm}3.78$(n=6) at 30days. VAS value(mean${\pm}$SD) was $4.07{\pm}1.33$(n=29) at the first visit, $12.97{\pm}1.05$(n=29) at 3days after treatment, $2.15{\pm}1.12$(n=26) at 5days, $2.15{\pm}0.99$(n=13) at 9days, $1.56{\pm}0.73$(n=9) at 15days, $1.29{\pm}0.49$(n=7) at 20days, and $0.83{\pm}0.41$(n=6) at 30days. The value of NDI and VAS gradually decreased. Repeated measurement results(the difference between the first visit and each measurement day) and the difference between before and after the interval(except between 5 and 9days, between 20 and 25days) were statistically significant. Conclusions : This result was shown that treatment of cervical Hyeopcheok(Jiaji) acupuncture point for neck pain can be effective. Further systematic research will be needed.

Evaluating the Primary Care Quality of a Public Health Center in a Rural Area (농촌 지역 보건소 일차의료의 질 평가)

  • Byeon, Young-Kwan;Choi, Yong-Jun
    • Journal of agricultural medicine and community health
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    • v.42 no.1
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    • pp.24-35
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    • 2017
  • Objectives: This study aimed to evaluate the primary care quality of a public health center in a rural area using the Korean Primary Care Assessment Tool (KPCAT). It also examined some methodological issues in applying the KPCAT and interpreting its results. Methods: Seventy-nine patients who had visited their doctor more than four times responded to the KPCAT questionnaire. Descriptive statistics and a radar chart were used in analyzing data. Sign test was used to test the KPCAT score difference by don't know option scoring methods. Results: Median and interquartile range of the public health center's KPCAT scores were forty-five and sixteen points, respectively. Only the median of the first contact domain reached the expected value of seventy-five points. The proportions of those who scored under the expected value were under fifty percent in two of four comprehensiveness items, all of three coordinating function items, two of five personalized items and all of four family/community orientation items. There were some methodological issues including, how to score don't know option and make sure response scale consistency. Conclusions: There was much room to improve the primary care quality of the rural public health center. Especially, improvement is needed in the domain of coordinating function and family/community orientation. We also hope that methodological improvement of the KPCAT contributes to more valid and reliable primary care assessment.

CLINICAL STUDY OF COMPLICATIONS OF ORTHOGNATHIC SURGERY FOR THE DENTOFACIAL DEFORMITIES (악변형환자의 악교정수술시 합병증에 관한 연구)

  • Kim, Yeo-Gab;Lee, Sang-Chull;Lee, Baek-Soo;Kim, Byung-Ju
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.247-258
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    • 1994
  • We got this conclusion from an investigation about complications from 144 cases of 130 patients who were to be searched their personal records, admission chart, clinical laboratory sheet, anesthetic record, consult sheet and radiographic opinion. They had orthognathic surgery for maxillofacial deformity treatment at the department of oral and maxillofacial surgery in dental school of Kyung Hee university for 4 years and 10 months, from March 1989 to December 1993. 1. In the intraoperative phase, by the frequency of complication, blood vessel injury was found the most-22%, and then soft tissue injury, unfavorable osteotomy split, and there were some cases of tooth injury and inappropriate osteotomy. In the mandibular segmental osteotomy, blood vessel injury was found the most frequently-20 cases (27%), soft tissue injury, unfavorable osteotomy split were the second frequent cases, and then unfavorable fragment position was found. In the extraoral vertical ramus osteotomy and Le Fort I osteotomy also, blood vessel injury and nerve injury were found the most. 2. In the postoperative hospitalization phase, by the frequency of complication, hematoma (23%) was happened the most, except for that, lkie the complication that can be happened by adverse reaction of medicine or long hospital life. In the case of SSRO, there were 21 cases (20%) of hematoma, and this wal the most frequently case. In the case of EVRO, hematoma wasn't happened that much-2 case (4%). 3. In the follow up phase, relaps, numbness and TMJ dysfunction were happened. In mandibular surgery, the forward relapse percentage of point B, was 27% when used wire fixation on SSRO, was 15% by miniplate fixation on SSRO and was 7% on EVRO. In the case of SSRO, numbness was kind of high, comparing to ordinary surgery-12 cases(16 There were many difficulties in analyzing this data accurately, Although orthognathic surgery is done many times, only available date is from the "success" stories and data is not consistently recorded for the cases with complications. In this manner, much essential informantion is lost and overlooked. When data is charted including those cases that are seemingly insignificalt, we can have a much clearer understanding and more accurate guide on treatment protocols.

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Comparisons of HRV Parameters Among Anxiety Disorder, Depressive Disorder and Trauma·Stressor Related Disorder (불안장애, 우울장애, 외상 및 스트레스 관련 장애의 심박변이지표 비교 연구)

  • Kim, Ji-eun;Park, Do-won;Han, Ji-yeon;Lee, Jung Hyun
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.81-88
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    • 2020
  • Objectives : This study aimed to compare autonomic nervous system (ANS) dysregulation and differential relationships with clinical severities between anxiety disorder, depressive disorder, and trauma·stressor related disorder using heart rate variability (HRV) parameters. Methods : We conducted a retrospective chart review of outpatients from 2017 to 2018 in Stress Clinic of National Center for Mental Health. Total 473 patients were included; 166 anxiety disorder; 184 depressive disorder ; 123 trauma·stressor related disorder. Parameters of 5-min analysis of HRV were compared in three groups. Additionally, we investigated the differential association of each parameters with Clinical Global Impression-Severity Scale (CGI-S) across each group. Results : No significant differences were found in all HRV parameters between the three groups. However, significant group interactions by CGI-S were found in standard deviation of all RR intervals (SDNN) and the square root of the mean squared differences of successive normal-to-normal intervals (RMSSD) (SDNN, p=0.017 ; RMSSD, p=0.034). A negative relationship between CGI-S and SDNN, RMSSD has been found in anxiety disorder and depressive disorder. However, a positive relationship between CGI-S and SDNN, RMSSD has been found in trauma·stressor related disorder. Conclusions : Despite of no significant differences of each HRV parameter, our findings suggested the differential associations of HRV parameters with clinical severity among anxiety disorder, depressive disorder and trauma·stressor related disorder. In trauma·stressor related disorder, the clinical severity and degree of ANS dysregulation may differ, so more aggressive treatment is suggested.

STUDY OF INVERTLY IMPACTED SUPERNUMERARY TEETH IN THE MIDPALATAL REGION USING COMPUTERIZED TOMOGRAPHY (전산화 단층 방사선사진을 이용한 상악 정중부 역위 매복 과잉치에 관한 연구)

  • Choi, Byung-Jai;Lee, Yong-Seok;Kim, Seong-Oh;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.3
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    • pp.363-372
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    • 2003
  • Supernumerary teeth are found frequently in the dental office causing many dental complications. They are one of the many dental abnormalities that may occur during tooth development. Inversely impacted supernumerary teeth in the midpalatal area are especially important clinically because they occur with high frequency and many complications. Though many previous clinical and radiographical studies exist, the sample numbers were small and the evaluation of shape, location, and effects to its surrounding tissue may not be accurate due to the solitary use of intraoral radiographs or panoramic radiographs. Among the patients who visited department of pediatric dentistry, yonsei dental hospital, from July, 1998 to June, 2002, those with inversely impacted supernumerary teeth took computerized tomography for a more accurate diagnosis. Their dental chart, panoramic radiograph and computerized tomography were evaluated for this study. The number, form, convexity, location, distance, and complications of inversely impacted supernumerary teeth in the midpalatal area were recorded. This study show that when the supernumerary teeth is tuberculated with a curved root and is in close proximity to the adjacent teeth, it causes complications such as eruption disturbance, rotation, displacement of adjacent teeth, and diastema. Such factors must be considered in making decisions for diagnosis and treatment.

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The Antibiotic Resistance Pattern of Gram-Negative Bacteria in Children Younger Than 24 Months with a Urinary Tract Infection: A Retrospective Single-Center Study over 15 Consecutive Years

  • Lee, Yoon Kyoung;Lee, Haejeong;Kim, Jong Min;Kang, Ji-Man;Lee, Sang Taek;Lee, Nam Yong;Kim, Yae-Jean;Cho, Heeyeon
    • Childhood Kidney Diseases
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    • v.19 no.2
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    • pp.148-153
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    • 2015
  • Purpose: We investigated trends in antibiotic resistance for gram-negative bacteria in infants with a urinary tract infection (UTI) over 15 years at a single institution. Methods: A retrospective chart review was conducted for children younger than 24 months who visited the emergency room and were diagnosed with a UTI between January 2000 and December 2014. We selected urine culture data that grew Escherichia coli and Klebsiella pneumoniae. Baseline clinical information and results of antimicrobial susceptibility tests were analyzed by dividing the 15-year study time frame into three periods (A: 2000-2004, B: 2005-2009, and C: 2010-2014). Results: During the study period, 478 applicable children were identified (E. coli, 89.7% and K. pneumoniae, 10.3%). Antibiotic resistance to third-generation cephalosporins was increased from period A to period C (A, 2.1%; B, 8.3%; C, 8.8%; P=0.025). Resistance to quinolones also showed a steady pattern during periods A to C, although it was not statistically significant (A, 7.9%; B, 9.7%; C, 12.4%; P=0.221). The incidence of Extended-spectrum ${\beta}$-lactamase (ESBL)-producing gram-negative bacteria increased from period A to period C (A, 1.4%; B, 7.6%; C, 8.2%; P=0.012). Conclusion: This study revealed that the common uropathogens E. coli and K. pneumoniae experienced increasing resistance rates against third-generation cephalosporins and a constant antibiotic resistance to quinolones in children younger than 24 months. We also showed a recent increased incidence of ESBL-producing gram-negative bacteria in patients with community-acquired UTIs. Therefore, it is necessary to actively surveil resistance in order to properly select empirical antibiotics.

Thoracic Surgeon's Role in Differential Diagnosis of the Interstitial Lung Disease (간질성 폐질환의 확진을 위한 흉부외과의 역할)

  • Kim Sung-Whan;Yahang Jun-Ho;Kim Jong-Woo;Choi Jun-Young;Rhie Sang-Ho;Jang In-Seok
    • Journal of Chest Surgery
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    • v.39 no.5 s.262
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    • pp.382-386
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    • 2006
  • Background: Pathologic confirmation is needed to diagnose various forms of interstitial lung diseases. We wanted to find out how much the thoracic surgical lung biopsies will be needed for definite diagnosis of interstitial lung diseases. Material and Method: 17 patients underwent surgical lung biopsy in the department of thoracic and cardiovascular surgery, Gyeongsang National University Hospital from June 1995 to November 2002. Chart review and telephone questionnaire were done for retrospective study. Result: Mean age was $49{\pm}22$ years. Age ranged from 1 to 70 years. Dyspnea was the most common complaint. They were referred for definite differential diagnosis from pediatrics and internal medicine. Biopsy methods were thoracotomy in 11 cases, and thoracoscopy in 6 cases. Pathologic confirmation was possible in 11 cases (65%). According to the pathologic reports, treatment plans were changed in 13 cases (76%). Conclusion: Surgical lung biopsy was effective method in differentiating diagnosis of the interstitial lung disease, There was no mortality during operation. It is important that undiagnosed fibrous lung disease should be recommanded the lung biopsy for planning patient's treatment.

A Pilot Study for Development of the Serious Game Contents for Education in the Elderly Diabetes (노인 당뇨환자 교육용 기능성 게임 콘텐츠 개발을 위한 예비연구)

  • Kim, Yu Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.184-192
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    • 2017
  • This study was a pilot test of serious educational game content(named Roly Poly 160) designed to enhance self-care by elderly diabetics. Roly Poly 160 was developed in eight steps (literature review, demand survey and consultation, extraction of serious content using games, development of Roly Poly 160, pretest for users, workshop for health care workers, final completion of Roly Poly 160 and user satisfaction survey of Roly Poly 160). Roly Poly 160 is intuitively structured in three modules (self-management, card games, and quiz games) that can be self-managed by the elderly and is designed based on six principles. First, we constructed an intuitive interface considering the age of users. Second, the menu was selected as the main menu for Koreans and calorie learning was made at the same time. Third, the calories and nutrients (carbohydrate, fat, protein, calcium, sodium) of selected foods are analyzed, and all test data recorded in the questionnaire chart are graphically displayed by year, month and week so that the change trends can be grasped at a glance. Fourth, necessary data were saved and output and used as educational data. Fifth, user data are made compatible and aggregated and up to 100 million members can be registered. Sixth, it is designed to be developed as a mobile app if necessary. Using Roly Poly 160, 119 diabetic patients were diagnosed with diabetes, and the satisfaction score was 4.26 out of 5. These findings indicate that Roly Poly 160 is appropriate as a diabetes self-care tool and suggests that there is a possibility to use it as a program to educate people about diabetes in public health centers, hospitals and clinics.

Ten-year Refractive Error and Astigmatism Changes in Korean Subjects (한국인의 10년간 굴절이상과 난시 축 변화)

  • Ha, Na-Ri;You, Jung-Kone;Kim, Jai-Min
    • Journal of Korean Ophthalmic Optics Society
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    • v.15 no.4
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    • pp.389-397
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    • 2010
  • Purpose: This study was to investigate the changes of refractive error and astigmatism associated with age in Korean subjects between the ages of 6 and 80 years during 10-year period. Methods: 220 normal subjects (345 eyes) who visited ophthalmic clinic was recruited and followed for 10 years between 1999 and 2009, cycloplegic manifest refraction being performed annually. Visual acuity was tested on a Han's chart. Results: The mean 10-year change in the spherical equivalent refraction (SER) of age 6 to 10 years old and 10 to 20 years was -3.649D and -2.165D respectively. There was no change of refractive error in age 21 to 40 years. The myopic shift decreased with age from 41 up to 69 years but increased slightly in patients 70 years and older; the hyperopic shift showed the opposite trend. The distribution of refractive error over the 10 years in aged 6 to 10 and 11 to 20 years was shifted myopic. The incidence of medium (> -3.01D) to high myopia at age 6 to 10 years was 4.8% and after 10 years was 62.5%. The 10-year change of astigmatism axis was in "with the rule" direction for younger age group and in a "against the rule" direction for older subjects. Conclusions: This study has documented refractive error changes in Korean subjects and confirmed reported trends of myopic shift from age 6-20 years and hyperopic shift before age 70 years and a myopic shift thereafter. The axis of astigmatism turns to "against the rule" after 40's.

Full mouth rehabilitation on the patient with deep bite and posterior bite collapse using re-establishment of occlusal vertical dimension (구치부 교합 지지 상실과 전치부 과개 교합을 가진 환자의 교합 재설정을 통한 구강 회복 증례)

  • Jang, Woo-Hyung;Jo, Yu-Jin;Lim, Hyun-Pil;Yun, Kwi-Dug;Park, Sang-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.58 no.1
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    • pp.50-57
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    • 2020
  • The loss of posterior support and the abnormal jaw relation can cause pathologic findings. If deep bite patients with multiple missing teeth, can not have the stable posterior contact, the mandible moves posteriorly, and consequently the overjet and overbite get worse. And when the mandibular irregular occlusal plane is corrected, it is easier to have the bilateral balanced occlusion with the maxilla. So the treatment goal is to give proper posetrior support and establish appropriate anterior guidance, and ultimately provide improved mastication and esthetics recovery. In this case, a 68 year old man, having deep bite without posterior support was evaluated by the vertical dimesion decision flow-chart. An available prosthetic height, anterior occlusal relation such as overjet, overbite and the esthetic part such as facial height and the cephalometric analysis are the factors to be considered.