• Title/Summary/Keyword: 노인병원

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The Patterns of Medical Utilization on Dermatoses among Rural Inhabitants (농촌지역 주민들의 피부 질환에 대한 치료 행태)

  • Kim, Chang-Yoon;Joo, Ree;SaKong, Joon;Chung, Jong-Hak;Kwak, Tae-Hun
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.103-113
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    • 1999
  • The authors surveyed the inhabitants of a rural area to assess the patterns of medical utilization on dermatoses. Seven hundred and sixty new outpatients of dermatoses were examined and surveyed with formed questionnaire from March 1997 to February 1999. The results are as follows; 1. Among 760 new outpatients, the number of male patients was 283(37.2%) and that of female patients was 477(67.3%). 2. The most common dermatoses was Tinea pedis(34.9%), and follows senile pruritus, contact dermatitis, housewife eczema, seborrheic dermatitis, numular dermatitis, atopic dermatitis, Tinea corporis, Tinea ungium, acne vulgaris, impetigo, keratolysis exfoliativa, chronic urticaria, Tinea cruris and Molluscum contagiosum in orders. 3. Drug store was the most frequent places where patients initially visited for their skin diseases(39.6%) and followed by non dermatologic clinic, dermatologic clinic and general hospital in orders. 4. One hundred and twenty one(15.9%) patients have been experienced folk treatment. It was founded that the topical vinegar application or soaking was the most common method. Many patients felt no symptom improvement after the folk treatment(48.8%). Seventeen point four percent of patient felt symptom worsened. The results of this study suggest that many of the rural inhabitants are lack of understanding on their dermatoses. So many physician who are in charge of the primary care in rural area have to pay attention to the common dermatoses and educate patients on their medical utilization.

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Evaluation of the Clinical Usefulness of the Xeniss Rapid TB kit for the Diagnosis of Tuberculosis (결핵진단에서 Xeniss Rapid TB kit의 임상적 유용성)

  • Park, Seung-Kyu;Lee, Woo-Chul;Hwang, Soo-Hee;Kwon, Eun-Si;Lee, Hung-Soon;Lee, Duk-Hyoung
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.4
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    • pp.389-400
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    • 2002
  • Background : The rapid diagnostic tests for tuberculosis are needed to facilitate early treatment of tuberculosis and prevention of Mycobacterium tuberculosis transmission. The Xeniss Rapid TB kit is a rapid, card-based immunochromatographic test for the detection of antibodies directed against M. tuberculosis antigens including antigen 5(38-kDa antigen). The objective of this study was to evaluate the performance of the Xeniss Rapid TB kit for the diagnosis of active tuberculosis with serums from patients, asymptomatic healthy and close contact controls. Methods : 188 patients with active tuberculosis were tested; 177 with pulmonary tuberculosis(18 with combined pleurisy), and 11 with extrapulmonary tuberculosis. The control groups were composed of 82 close contacts and 57 healthy adults. Study subject were drawn from one national tuberculosis hospital for patients and close contacts, and another private hospital for healthy adults in Masan city, Korea. The Xeniss Rapid TB kit(Xeniss Life Science Co., Ltd., Seoul, Korea) was evaluated by using serum samples according to the instructions of the manufacturer by an investigator masked to the clinical and microbiological status of the study subjects. Results : The diagnostic sensitivity of the Xeniss Rapid TB kit was 73.9% in patients and specificities were 73.2% and 93.0% in close contact and healthy adults respectively. The positive predictive value in patients was 84.2% and the negative predictive value in controls was 85.8%. Conclusion : This study shows that the Xeniss Rapid TB test is a simple and fast method to diagnose active TB. The results of the sensitivity and specificites suggest that serodiagnosis using this point of care testing(POCT) device would be valuable and advantageous for screening tuberculosis in the clinical field.

Development and Evaluation of a Community Staged Education Program for the Cardiocerebrovascular Disease High-risk Patients (심뇌혈관질환 고위험군을 위한 지역사회 단계별 교육프로그램 개발 및 효과 평가)

  • Lee, Hye-Jin;Lee, Jung-Jeung;Hwang, Tae-Yoon;Kam, Sin
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.167-180
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    • 2012
  • Objective: This study was conducted to evaluate an education program for cardiocerebrovascular high-risk patients. Methods: This program was developed according to Tyler's model for curriculum development. To evaluate the effects of this program, we measured clinical outcome change (weight, waist circumference, systolic blood pressure, diastolic blood pressure) and behavior change stages (checking blood pressure, blood sugar levels, doing physical activity, consistent maintenance of food intake, eating low amounts of salt, abstention from tobacco and alcohol) before and 4 weeks after participation in the education program. The group of subjects consisted of High-risk group patients who attended basic program(32 patients), and staged program(37 patients) during KHyDDI meetings from Oct. 2009 to May 2010. Results: The staged educational program was developed three aspects(disease, nutrition and exercise)and three stages(basic, in-depth and individual education). In the staged education program, the evaluations were made by measuring clinical outcome and stage of behavior before and after education. Significant differences were found in waist circumference, systolic blood pressure, diastolic blood pressure, consistent maintenance of food intake(p<0.05), and eating low salt(p<0.001)and their self efficacy. Conclusion: In the practice-oriented staged education program, significant differences were found in the clinical outcomes and stage of behavior before and after education. Possible limitations of the study include the small number of participating subjects and the short follow-up management period, but the results indicate that continued application of this program could contribute to the prevention of cardiocerebrovascular diseases for the elderly patients with long periods of chronic diseases.

Clinical Investigation of Tuberculous Pneumonia (결핵성 폐렴환자의 임상적 고찰)

  • Lee, Seung Heon;Hur, Gyu Young;Jung, Ki Hwan;Lee, Sung Yong;Lee, Sang Yeub;Kim, Jae Hyung;Park, Sang Myun;Shin, Chul;Shim, Jae Jeong;In, Kwang Ho;Kang, Kyung Ho;Ryu, Sae Hwa
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.1
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    • pp.19-24
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    • 2004
  • Background : It is difficult to differentiate between tuberculous pneumonia and Community Acquired Pneumonia, so the diagnosis and treatment of tuberculous pneumonia can be delayed frequently. In this study, we attempted to retrospectively evaluate the clinical and radiologic characteristics of tuberculous pneumonia. Methods : We conducted a retrospective analysis of clinical characteristics of 58 patients diagnosed with tuberculous pneumonia from Nov. 1997 to May 2001 at Korea university kuro hospital. Result : The male to female ratio was 1:1 and the mean age at diagnosis was $54.5{\pm}18.6$ years. Fifty five patients were confirmed microbiologically and three patients pathologically. There were 20 patients(34.5%) who had diabetes mellitus(8cases), chronic obstructive pulmonary disease(3cases), malignancy(3cases), bronchiectasis(2cases), chronic renal failure(1cases) or long term history of corticosteroid treatment(3cases). Many patients had multilobar infiltration in chest X-ray, dominantly in the lower lobe. thirty two patients(55.2%) had infiltration in more than 2 lobes and 5 patients in more than 4 lobes. The significant correlation between the diabetes mellitus and the infiltrated Rt lower lobe(RLL) was found on the borders of confidence limit.(P=0.07<0.1). There was significant correlation between woman and infiltrated lobe(RML, RLL, LLL) excluding the both upper lobe(P=0.029). Conclusion : We must consider tuberculous pneumonia when lobar pneumonia with consolidation resistant to antibiotics, especially in the patients who have diabetes mellitus, chronic obstructive pulmonary disease, malignancy, bronchiectsis, chronic renal failure or long term history of corticosteroid treatment.

Diagnostic Significance of the Serologic Test Using Antigen of Mycobacterium Tuberculosis for Antibody Detection by ELISA (결핵항원에 대한 혈청학적 검사와 진단적 유용성)

  • Park, Jae-Min;Park, Yeon-Soo;Chang, Yeon-Soo;Kim, Young-Sam;Ahn, Kang-Hyun;Kim, Se-Kyu;Chang, Joon;Kim, Sung-Kyu;Lee, Won-Young;Cho, Shang-Rae
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.2
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    • pp.271-279
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    • 1998
  • Background: Diagnosis by direct microscopy and/or by culture of the Mycobacterium tuberculosis from body fluids or biopsy specimens is "Gold standard". However, the sensitivity of direct microscopy after Ziehl-Neelsen staining is relatively low and culture of mycobacteria is time consuming. Detection of mycobacterial DNA in clinical samples by the polymerase chain reaction is highly sensitive but laborious and expensive. Therefore, rapid, sensitive and readily applicable new tests need to be developed. So we had evaluated the clinical significance of serologic detection of antibody to 38 kDa antigen, which is known as the most specific to the M. tuberculosis complex, and culture filtrate antigen by ELISA in sputum AFB smear negative patients. Method: In this study, culture tests for acid fast bacilli with sputa or bronchial washing fluids of 183 consecutive patients who were negative of sputum AFB smear were performed. Simultaneously serum antibodies to 38 kDa antigen and unheated culture filtrate of M. tuberculosis were detected by an ELISA method. Results: The optical densities of ELISA test with 38 kDa and culture filtrate antigen were significantly higher in active pulmonary tuberculosis cases than in non tuberculous pulmonary diseases (p<0.05), but in patients with active pulmonary tuberculosis, those of the sputum culture positive patients for M. tuberculosis were not significantly different from those of the sputum culture negative cases(p>0.05). In the smear-negative active pulmonary tuberculosis patients, the sensitivity of the ELISA using 38 kDa antigen and culture filtrate was 20.0% and 31.4%. respectively. The specificity was 95.3% and 93.9%. respectively. Conclusion : In active pulmonary tuberculosis but smear negative, the serologic detection of antibody to 38 kDa antigen and culture filtrate by ELISA cannot substitute traditional diagnostic tests and does not have clinically significant role to differenciate the patient with active pulmonary tuberculosis from other with non-tuberculous pulmonary diseases.

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An Analysis of 94 Percutaneous Renal Biopsies (경피적 신생검 94례에 대한 분석)

  • Kang, Ho-Jung;Lim, Sang-Woo;Do, Joo-Yeung;Yoon, Kyung-Woo
    • Journal of Yeungnam Medical Science
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    • v.12 no.1
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    • pp.84-95
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    • 1995
  • A clinical and histopathological study was performed on ninety-four patients with nephrotic syndrome (91 idiopathic and 3 secondary) who were admitted to Department of Internal Medicine, Yeungnam University Hospital during the period of nine years, from January 1985 to May 1994. The results were as following. 1. the ratio of male to female was 1.76:1. In young age group, minimal change was the most predominant type. In old age group, membranous glomerulonephritis and focal glomerulosclerosis were predominant types. 2. The primary nephrotic syndromes were 96.8% and secondary nephrotic syndromes were 3.2%. Histopathologic findings of 94 renal biopsy tissue were classified into minimal change (43.6%), mesangial proliferative glomerulonephritis (29.8%), membranous glomerulonephritis (12.8%), TypeI membranous proliferative glomerulonephritis (4.3%), focal glomerulosclerosis (3.2%) and others (6.4%). 3. The response of eighty-six patients treated with steroid showed complete remission in 51.2%, partial remission in 20.9%, steroid dependent in 2.3%, and no effect in 25.6% of cases respectively. The response to steroid therapy was most effective in the patients with minimal change lesion. 4. In the patient with membranous proliferative glomerulonephlitis, long-term angiotensin converting enzyme inhibitor treatment showed less deterioration of renal function.

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Ethanol Extract of Glycyrrhiza uralensis Protects Against Oxidative Stress-induced DNA Damage and Apoptosis in Retinal Pigment Epithelial Cells (망막색소상피세포에서 감초 추출물의 산화적 스트레스에 의한 DNA 손상 및 apoptosis 유발의 차단 효과)

  • Kim, So Young;Kim, Jeong-Hwan;Kim, Sung Ok;Park, Seh-Kwang;Jeong, Ji-Won;Kim, Mi-Young;Lee, Hyesook;Cheong, JaeHun;Choi, Yung Hyun
    • Journal of Life Science
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    • v.29 no.11
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    • pp.1273-1280
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    • 2019
  • Age-related macular degeneration (AMD) is one of the leading causes of blindness in the elderly population, and damage to retinal pigment epithelial (RPE) cells due to oxidative stress contributes to the development of AMD. Glycyrrhiza uralensis Fischer is one of the most widely used herbal medicines for the treatment of various diseases in Asian countries. Although recent studies indicated that treatment with G. uralensis can protect cells from oxidative stress, its mechanisms in RPE cells remain unknown. We evaluated the effect of a G. uralensis ethanol extract (GU) on $H_2O_2$-induced oxidative injury in ARPE-19 RPE cells. The GU pretreatment attenuated reactive oxygen species (ROS) generation induced by $H_2O_2$, which was associated with induced expression of nuclear factor erythroid-derived-2-like 2 (Nrf2) and heme oxygenase-1 (HO-1). GU also suppressed $H_2O_2$-induced DNA damage and mitochondrial dysfunction. The inhibitory effect of GU on $H_2O_2$-induced apoptosis was associated with the protection of caspase-3 activation. Overall, GU appeared to protect RPE cells from oxidative injury by inhibiting DNA damage and reducing apoptosis. Further studies are needed to determine the regulation of Nrf2-mediated HO-1 expression, but our results suggest the possibility of using GU to reduce the risk of AMD.

Job Characteristics and Status of Community Occupational Therapist : Focus on OTs in Public Health Centers (지역사회 작업치료사의 업무 특성 및 실태 조사 : 보건소 근무 작업치료사를 중심으로)

  • Min, Kyoung-chul;Kim, Eun-hee;Woo, Hee-soon
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.37-52
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    • 2020
  • Objective : This study was conducted to identify occupational therapists working in public health centers, the characteristics and actual conditions of occupational therapists in the community, and use them as basic data on occupational therapists in the community as of 2020. Methods : 77 questionnaires were replied by e-mail from OTs work at nationwide health public centers. Job characteristics and status were analysed by descriptive statistics and check correlation between job satisfaction and other factors. Results : Most survey respondents were female(77.9%) and 20-30(96.1%).. Some occupational therapists worked for dementia related team(72.7%) and others worked for like visiting care, health care, and rehabilitation center etc. Rate of experiences of public health center was 1-2 years(67.5%), the most common type of contract was flexible part-time worker(61%) and work intensity(94.8%) and satisfaction of work was very high(85.7%). The highest difficulty of their job was budget administrative work(26.7%) and of non-work difficulty was inequality under contracts(27.2%). They usually participated at dementia shelter, visiting OT, group OT. Difficulty of their job was high in budget administration, dementia shelters, and visiting work treatments. Goals of treatment were high in improvement of cognitive ability and, family support. Frequency of treatment was high in improvement of cognitive therapy, family support, and evaluation. Occupational therapy targets for health centers were dementia, the general elderly, and adult brain lesions, including those for ordinary people, psychiatric disorders and children. It was found that the primary occupations for evaluation were nurses (35.7%) and occupational therapists (33.7%), and that MMSE-DS, SGDS, and SMCQ were used a lot. Conclusion : This study could identify the job characteristics and status of community OTs. We hope that this result could be basic data for building expertise and role for community OTs in changing situations like community cares.

Nutrition and Psychosocial Factors were associated with Possible Sarcopenia in the Rural Elderly (농촌지역 주민의 영양결핍 및 사회심리적 요인과 근감소증 가능군과의 관련성)

  • Kim, Bokyoung;Lee, Gyeong-Ye;Seo, Ae-Rim;Kim, Mi-Ji;Seo, Sung-Hyo;Park, Ki-Soo
    • Journal of agricultural medicine and community health
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    • v.47 no.2
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    • pp.90-98
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    • 2022
  • Objective: This study aimed to provide basic data for preventing and managing sarcopenia by identifying the relationship between sarcopenia, malnutrition, and psychosocial factors among the elderly in the community. Methods: The study included 1,019 subjects aged 60 and over. "Possible sarcopenia" was defined by low handgrip strength with or without reduced physical performance. Nutrition was evaluated according to the mini nutrition assessment (MNA), and the psychosocial factors examined were self-efficacy, social isolation, fear of falling, and social capital (trust and participation). A logistic regression analysis was also performed on the relationship between risk of malnutrition, psychosocial factors, and sarcopenia. Results: MNA was significantly associated with social participation (OR = 1.747, p <0.001), fear of falling (OR = 2.905, p <0.001), and self-efficacy (high/low, OR = 0.654, p = 0.011). In model 3, which included both MNA and psychosocial factors, sarcopenia was significantly associated with MNA (OR = 2.529, p <0.001) and fear of falling (OR = 1.544, p = 0.045). Compared with the low self-efficacy group, the high group (OR = 0.589, p = 0.009) was significant. The factors related to possible sarcopenia include risk of malnutrition, fear of falls, and low self-efficacy. Conclusion: It will be necessary to improve self-efficacy so that individuals feel they can do activities of daily living themselves and to reduce their fear of falling through muscle strength and balance exercises. Finally, it is also necessary to increase regular participation in community social activities.

The Factors Influencing of Professional Consciousness of Long-term Care Workers (요양보호사의 직업의식과 영향요인)

  • Kim, Hyang Soo;Kim, Hee Kyung;Park, Yeon Suk
    • 한국노년학
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    • v.31 no.3
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    • pp.591-606
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    • 2011
  • The purpose of this study was to propose basis data to nursing intervention development in order to raise the professional consciousness of long-term care workers grasping influence factor and professional consciousness. The subjects were about 185 long-term care workers at D megalopolis and 4 cities of 3 provinces from November to December, 2009. The data were analyzed using the SPSS program for descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression. The correlated factors of professional consciousness included self-efficacy(r=.420, p=.000), sense of the calling(r=.636, p=.000), education training effectiveness(r=.441, p=.000), internal locus control(r=.378, p=.000), and external locus control(r=-.356, p=.000). Factors influencing of professional consciousness of them were to show in order of sense of the calling(B=.329, p=.000), education training effectiveness(B=.250, p=.000), internal locus control(B=.216, p=.000), external locus control (B=-.165, p=.002), consideration and opplicable job choose characteristic(B=.207, p=.004), these variables accounted for 57.5% of the variance of professional consciousness. Further research needs to develop well organized educational program, training of enhancing internal locus control, and clear examination about roles and tasks of long-term care workers. Also, it suggests education and research that can enhance professional consciousness by utilizing these factors.