• Title/Summary/Keyword: 외래치료

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CLINICAL STUDY OF SUDDEN DEAFNESS (돌발성 난청에 관한 임상적 고찰)

  • 이철희;전종범;홍석찬;장선오
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1987.05a
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    • pp.5.2-6
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    • 1987
  • 저자들은 1978년부터 1986년까지 서울대학병원 이비인후과에 내원했던 원인불명의 돌발성 난청환자 중 추적조사가 가능하였던 60예에 대한 임상적 분석을 시행하여 다음과 같은 결과를 얻었다. 1) 60명의 환자중 45예가 입원 치료를 받았고 15예는 외래환자로 성별은 남자 36명. 여자 24명이었고 연령분포는 10대에서 50대에 걸쳐 널리 분포되었다. 2) 발생시기는 아침 기상시가 많았고 양측성인 경우는 4 예 있었다. 3) 동반증상은 이명, 이충만감, 현기증의 순으로 많았고 상기도염은 14예에서 있었다. 4) 입원치료는 prednisolone 경구투여와 저분자 dextran을 정맥주사하였고, 이중 25예는 histamine정맥주사나 heparin 피하주사를 추가로 겸용 치료하였다. 5) 청력회복의 결과는 Siegel의 분류방법을 따랐고, 입원 치료한 경우 완전회복이 6예, 부분회복이 8예, 경도호전이 9예로 23예(51.1%)에서 청력 호전이 있었다. Histamine과 heparin의 사용은 청력회복 결과를 높이지 못하였다. 외래환자의 경우는 입원치료군과 비교하는데 어려운 점이 있었으나 전체적으로 15예중 6예(40%) 에서 청력 호전이 있어서 입원 치료군이 좋은 성적을 보였다. 6) 치료의 예후에 관련된 요인으로 발병후 1주내에 치료를 시작한 경우 결과가 좋았다. 완전회복이 된 6예중 5예가 1주 내에 치료를 시작한 것이었다. 현훈이 동반된 경우는 현훈이 없는 경우보다 예후가 나빴다. 청력상이 하강형인 경우는 상승형이나 편평형보다 결과가 좋지 않았으며 내원시 고도의 심한 난청을 보인 경우는 청력회복이 거의 없었다.

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TELEPHONE PSYCHOTHERAPY WITH ADOLESCENTS (청소년 정신 장애자에 대한 전화 정신 치료의 효용)

  • Lee, Kil-Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.129-137
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    • 1992
  • This article describes several clinical usefullness of the telephone in psychotherapy with adolescents through case analysis by Tolchin, and discussed various management problems and some practical guidelines for therapists planning to utilize telephone psychotherapy with adolescents through literature analysis. In general, most adolescent patients in regular treatment benefit from knowing that the therapist can be reached by phone and that their call will be returned that same day. The therapist's telephone availability helps the young patient to develope a positive working alliance. Telephone psychotherapy had it's first widespread application in crisis intervention and suicide prevention. It's current uses also include enhancement of self-control in cases of self-destructive adolescents, and management of anxious, depressive, or anorexic adolescents. In addition, such widely divergent modalities of treatment as follow up of patients discharged from a psychiatric hospital, alcoholic rehabilitation programs, drug hotlines, sex counselling group therapy for visually impaired elderly, control of separation anxiety in girls, resolution of fear on the mental disorders, and helpful modality to continue psychotherapy without geographic barrier during longer periods of separation with therapist are currently available via telephone. But telephone psychotherapy is generally not suitable for more self-defensive and introverted cases, more dependent chronic callers, silent cases, test callers. the cases of telephone scatologias, the cases of intellectualized discussion, of more dependent cases calling phone in order to get attention from therapist. Telephone psychotherapy for adolescents serves as an important and useful method in the therapeutic armamentarium for this most challenging and rewarding population.

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Outpatient Radioablation Therapy for Thyroid Cancer Patients with Minimal Radiation Exposure to the Family Members (갑상선암 환자의 방사선옥소 외래치료시 가족 구성원의 방사선량 측정)

  • Park, Hee-Myung;Jang, Jung-Woong;Yang, Hee-Chul;Kim, Young-Gook
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.3
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    • pp.218-225
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    • 2007
  • Purpose: Postoperative thyroid remnant radioablation therapy is necessary to reduce the recurrence and mortality rates as well as to prepare the patients for a proper long term surveillance of well-differentiated thyroid cancers. The radiation safety rules of the government require the patient to be isolated in a hospital if the expected radiation exposure to the family members would be greater than 5 mSv (500 mRem). The purpose was to measure the radiation received by the family members of patients who received large doses of NaI-131. Material and Methods: We have administered 12 therapy doses ranging from 3.70-5.55 GBq (100 to 150 mCi) to 11 patients, and released them immediately if they met the radiation safety criteria. Informed consent was obtained from the subjects prior to the therapy, and each of them agreed to follow written radiation safety instructions. TLD badges were used to measure the radiation dose received by the family members and the room adjacent to the patient's bed room during the first 72 hours. Results: The average dose received by the family members who spent the most time in the closest distance with the patients was 0.04 mSv with a range of 0.01-0.17 mSv. Even the highest dose was only about 3% of the limit set by the government. The average radiation dose to the outer wall of the patient's room was 0.15 mSv. Conclusion: It is concluded that I-131 ablation therapy can be administered to outpatients safely to thyroid cancer patients who meet the established radiation safety criteria and follow the instructions.

ANALYSIS ON THE OUTPATIENT ANESTHESIA AT DENTAL CLINIC FOR DISABLED IN SEOUL NATIONAL UNIVERSITY DENTAL HOSPITAL (서울대학교 치과병원 장애인진료실의 외래환자마취 실태 분석)

  • Park, Chang-Joo;Jung, Jun-Min;Kim, Hyun-Jeong;Jang, Ki-Taeg;Lee, Sang-Hun;Yum, Kwang-Won
    • Journal of the korean academy of Pediatric Dentistry
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    • v.31 no.1
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    • pp.19-25
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    • 2004
  • Dentally disabled person means one who have difficulty in cooperating voluntarily with a dentist for routine dental care. Seoul National University Dental Hospital (SNUDH) Dental Clinic for Disabled has worked for them under outpatient anesthesia concept. The aim of this study was to determine the anesthetic characteristics of the patients attending for dental treatment at SNUDH Dental Clinic for Disabled in order to establish better future treatment plans. The data were drawn from the patients who visited SNUDH Dental Clinic for Disabled from January 1999 to October 2002. Total 93 dental treatments for 83 patients were enrolled in this study. Most patients had mental retardation and the conservative treatments were carried out under general anesthesia. Thiopental and vecuronium were mostly used for induction agent and neuromuscular blocker, respectively. Enflurane, with oxygen and nitrous oxide, was mostly used to maintain the anesthesia. Mean total anesthetic time was $164.4{\pm}57.2$ minutes and mean duration at the post-anesthetic care unit was $106.2{\pm}50.5$ min. Serious postoperative complications were not observed. These results showed our successful anesthetic outcomes without any severe side effect or complication and the needs of more outpatient centers for dental care for disabled.

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성대구증 환자의 음성기능 분석

  • 한경열;남순열
    • Proceedings of the KSLP Conference
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    • 1997.11a
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    • pp.255-255
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    • 1997
  • 서론 : 성대구증은 음성장애를 주소로 외래로 찾아오는 환자에서 드물지 않게 볼 수 있으나, 그 병인이 불명확하고 그간의 치료가 만족스럽지 못한 것으로 알려져 간과하기 쉬운 질환이다. 저자들은 이러한 성대구중 환자들의 음성기능 분석을 통하여 향후의 치료효과를 알아보는데 도움이 되고자 하였다. (중략)

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A Case of Vancomycin-Resistant Enterococci Peritonitis in a Pediatric Patient on CAPD Successfully Treated with Linezolid (지속성 외래 복막투석 소아에서 리네졸리드로 치료한 반코마이신 내성 장구균 복막염 1례)

  • Baek, Seung-Ah;Park, Sung-Sin;Kim, Sung-Do;Cho, Byoung-Soo
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.245-249
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    • 2008
  • Peritonitis is one of the major complications of CAPD(continuous ambulatory peritoneal dialysis). Recently, multidrug-resistant organisms, such as vancomycin-resistant enterococcus(VRE) have been rarely reported by the pathogen as of CAPD-associated peritonitis. But, there is limited information on choices of effective therapy for VRE peritonitis in patients undergoing CAPD. We present a pediatric case of successful treatment of CAPD-associated peritonitis due to VRE with linezolid, and review of the literature.

A Studyof Psychiatric Treatment Compliance in Referred Patients at a General Hospital (자문의뢰된 입원환자의 특성과 정신과 치료 순응도에 대한 연구)

  • Shim, In-Bo;Ko, Young-Hoon;Lee, Moon-Soo;Kim, Yong-Ku;Han, Chang-Su
    • Korean Journal of Psychosomatic Medicine
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    • v.19 no.2
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    • pp.66-73
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    • 2011
  • Objectives:The present study investigates the status of inpatient psychiatric consultations at a general hospital in order to find factors that contribute to treatment compliance related to psychiatric consultations. Methods:The subjects were 333 patients who were hospitalized at Korea University Medical Center Ansan Hospital from 1 September 2009 to 31 July 2010.The patients were referred for psychiatric consultation during hospitalization. This study investigates demographic data, request department, referral causes, requestor, psychiatric history and diagnosis, andpsychiatric treatment compliance. Treatment compliance was defined as whether or not the patient had accepted psychiatric treatment during hospitalization or outpatient department(OPD) follow-up. This study ascertains the factors that have impact on compliance, by taking binary logistic regression with compliance and other variables. Results:Among the patients that were offered psychiatric treatment during hospitalization(N=310), treatment compliance was 82.9%. Among the patients that were offered OPD treatment(N=111), compliance was 55.8%. Elderly group(>65 years) showed better compliance to treatment during hospitalization than the younger patient group(OR=4.838, p=0.004). Patients with secondary psychiatric disorders showed better OPD follow-up compliance than patients with secondary psychiatric disorders(OR=8.520, p=.008). Conclusion:Elderly patients showed better compliance for psychiatric treatment during hospitalization. However they commonly have disorders such as delirium and mood disorders that have impact on the patient's physical state, hence further active measures should be carried out. Patients referred due to primary psychiatric disorders showed poor OPD compliance. Therefore clinicians have to suggest multidisciplinary interventions that will improve treatment compliance of such patients.

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IPAA의 효과를 고찰하기 위한 분류분석방법들의 비교연구

  • Lee, Seung-Yeon;Lee, Eun-Ju;Choe, Ho-Sik
    • Proceedings of the Korean Statistical Society Conference
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    • 2005.05a
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    • pp.291-298
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    • 2005
  • 지속성 외래 복막투석은 말기 신부전 환자들에게 널리 시행하는 신 대체 요법으로, 복막투석 환자에게서 주된 합병증으로 일어나는 단백질-열량 영양실조를 치료하기 위하여 아미노산을 복강 내로 주입하는 치료방법이다. 이현석 등(2004)의 연구에서는 아미노산 복막 투석액(IPAA)이 영양실조 환자들에게 실제로 영양상태에 미치는 영향을 평가하기 위하여 지속성 외래 복막투석 환자 43명을 12개월 동안 3개월 주기로 관측하여 얻어낸 반복측정자료를 바탕으로 IPAA의 효과 여부에 따라 반응군과 비반응군을 분류하였다. 본 논문에서는 이러한 두 그룹을 효과적으로 분류할 수 있는 분류기준변수들을 찾아내고 이 분류기준변수의 값을 바탕으로 새로운 환자에게 IPAA의 투여 여부를 진단할 수 있는 여러 분류방법들을 고찰하여 비교 연구하였다. 모수적인 방법으로 선형판별분석, 이차판별분석 및 로지스틱 판별분석을 소개하고 비모수적인 방법으로 support vector machine(SVM)을 소개하여 분류분석의 결과를 비교하여 두 그룹을 최소한의 오류로 분류하는 방법을 제안하였다.

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