• Title/Summary/Keyword: 외래치료

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The Comparison Study of Quality of Life between Hemodialysis Patients and Depressive or Anxious Psychiatric Patients (혈액투석 환자와 우울 또는 불안장애 환자의 삶의 질 비교연구)

  • Kim, Ji-Woong;Shin, Sang-Eun;Kim, Hyung-Ki;Jang, Eun-Young;Jung, Gun;Lee, Kye-Seong
    • Korean Journal of Psychosomatic Medicine
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    • v.11 no.2
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    • pp.170-181
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    • 2003
  • Objectives: The purpose of this study was to evaluate the quality of life in hemodialysis patients and compare it with those of depression or anxiety patients. Methods: Quality of life in hemodialysis patients(n=33) and depression or anxiety patients(n=34) was evaluated. we performed Korean Version of WHO Quality of Life Scale Abbreviated Version(WHOQOL-BREF), Beck Depression Inventory(BDI), State-Trait Anxiety inventory(STAI) to both hemodialysis patients and depression or anxiety patients. Results: The WHOQOL mean scores showed no differences between hemodialysis patients and depression or anxiety patients. Among WHOQOL domains, psychological domain score of WHOQOL was significantly higher in hemodialysis patients than in depression or anxiety patients. Anxiety score of hemodialysis patients was significantly lower than that of depression or anxiety patients, while depression score showed no difference. Conclusion: These results show that psychological domain score of WHOQOL was higher and anxiety score was lower in hemodialysis patients than in depression or anxiety patients. However, there were no significant differences in total QOL and depression between hemodialysis patients and depression or anxiety patients, and the prevalences of depression and anxiety were higher in hemodialysis patients than those of general population. This suggest that hemodialysis patients need more specialized help for psychiatric problems.

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Intracardiac Migration of a Renal Stent from the Left Renal Vein to the Right Ventricle during the Treatment of Nutcracker Syndrome - A case report - (Nutcracker Syndrome를 위해 왼콩팥정맥에 삽입한 스텐트의 우심실 이동 - 1예 보고 -)

  • Kim, JaeBum;Choi, Sae-Young;Park, Nam-Hee;Kum, Dong-Yoon;Park, Hoon;Hwang, Eun Ah
    • Journal of Chest Surgery
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    • v.43 no.1
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    • pp.100-103
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    • 2010
  • We report her on a rare case of a renal stent that migrated into the right ventricle in a patient with nutcracker syndrome. A 29-year-old woman was admitted to the hospital and she was suffering from flank pain. The computed tomography of the abdomen demonstrated that the left renal vein was compressed between the abdominal aorta and the superior mesenteric artery (nutcracker syndrome). A self expandable stent was placed across the left renal vein for treating her nutcracker syndrome. The next day after the procedure, the follow up chest radiograph showed that the displaced stent had migrated into the right ventricle. After percutanous endovascular stent removal had failed, the stent was ultimately removed by performing cardiac surgery. At the $6^{th}$ postoperative month, there have been no abdominal or cardiac symptoms.

Management of Urinary Tract Infections in Children: A Survey of Pediatricians in Daegu City (대구지역 소아청소년과 의사들의 요로감염 관리 실태분석)

  • Lee, Sang Su;Kang, Seok Jeong;Lee, Jae Min;Cho, Min Hyun;Park, Yong Hoon
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.95-101
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    • 2012
  • Purpose: Recently, many evidence-based guidelines for the management of urinary tract infection (UTI) have been developed because of the importance of proper management. However, there is a lack of data regarding how pediatricians manage UTIs in Korea. Therefore, we surveyed pediatricians to determine whether they manage UTIs in an appropriate manner. Methods: A postal questionnaire survey of 78 pediatricians practicing in Daegu city was performed. Subjects were asked about diagnosis, imaging studies, treatment, and prevention of UTIs. Results: Most of the respondents (94.8%) performed urinalysis to diagnose UTI in febrile children with an unknown fever focus. However, many preferred inaccurate collection methods, such as bagged urine collection, and did not obtain urine cultures. The most frequently performed imaging modality was renal-bladder ultrasonogram. Orally administered antibiotics were preferred unless admission was needed. After diagnosis of UTI, the pediatricians usually provided information to caregivers about the disease itself and supplementary treatment. Of the respondents, only 28.6% had their own guidelines for management of vesicoureteral reflux. Conclusion: Most pediatricians suspected UTI in febrile children with an unknown focus appropriately. Nevertheless, the fact that many pediatricians preferred inaccurate urine collection methods and did not perform sufficient imaging studies to detect associated abnormalities likely resulted in overtreatment due to false-positive diagnosis of UTI and a low probability of ruling out genitourinary anatomical problems. To improve the quality of management of UTI, pediatricians should follow scientific and evidence-based guidelines.

High-dose Intravenous Immune Globulin Retreatment in Kawasaki Disease (가와사끼병에서의 고용량 정주용 면역글로불린 재치료)

  • Shim, So Yun;Heo, Mi Young;Kim, Hae Soon;Sonh, Sejung
    • Clinical and Experimental Pediatrics
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    • v.45 no.10
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    • pp.1273-1277
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    • 2002
  • Purpose : To determine clinical features, laboratory findings and cardiac abnormalities of highdose immune globulin(IVIG) retreatment in patients with Kawasaki disease, and to report effectiveness of retreatment. Methods : Retrospective study of 174 children diagnosed with Kawasaki disease at Ewha Mokdong hospital from March, 1999 to July, 2001. Results : Twenty(11.5%) of 174 patients were retreated with high-dose IVIG. After this, only two patients(1.1%) did not respond to IVIG retreatment. Patients with failure to respond to initial IVIG did not differ from the patients who responded to a single course of IVIG in sex, age, days of fever at initial IVIG and clinical characteristics. Compared with responders with single IVIG treatment, the patients who were retreated had significantly lower albumin(3.7 vs 3.4 g/dL, P < 0.05), higher ALT(118.2 vs 229.3 U/L, P < 0.05) and CRP(8.9 vs 13.3 mg/dL, P < 0.05). On echocardiography, patients who recieved IVIG retreatment were significantly more likely to have caronary abnormalities(45.0% vs 13.6%, P < 0.05). Conclusion : Retratment with IVIG for persistent or recurrent fever was safe and effective.

The clinical study for hearing handicaps by Goodman classification (Goodman 씨 분류에 따른 청력장애도에 대한 임상적 고찰)

  • 김기령;김영명;정진선;이정권
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.5.2-5
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    • 1977
  • Many persons, both children and adults, suffer from impaired hearing. The handicaps that arise from this are economic, educational and above all, social. These persons need help, both medical and educational. In order to plan facilities for the medical treat ment, the rehabilitation, and the special education required by those with impaired hearing, we must know how many persons with hearing problems there are and the severity of their handicaps. The first step in knowing these is to devide hearing impairent into categories of handicap. Historically, since Beasley (1940) proposed progressive stages of deafness in terms of social disability, there was no well organized classification. of hearing handicap except related material from Huzing (1959) and Silverman (1960). In 1965, Goodman advocated a guide hearing threshold levels and degres of relating hearing impairment. During recent one year, on the bases of Goodman classification of hearing impairment and the report from Illinois Comission on children (1968), we have studied about hearing handicaps and speech life for the 180 cases, who visited to our otolaryngology department with hearing impairment. Now, we report the results of study with the referred references.

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Medical Characteristics of the Elderly Pedestrian Inpatient in Traffic Accident (노인 보행자 운수사고 입원환자의 의료적 특성연구)

  • Park, Hye-Seon;Kim, Sang-Mi
    • Journal of Digital Convergence
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    • v.17 no.12
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    • pp.345-352
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    • 2019
  • This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

The Effects of Depression, Cognitive Function, and Activities of Daily Living on Quality of Life for Patients with Stroke (뇌졸중 환자의 우울, 인지, 일상생활활동이 삶의 질에 미치는 영향)

  • Lee, Jong-Min;Kim, Hyeong-Min;Kim, Ji-Hoon
    • The Journal of Korean society of community based occupational therapy
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    • v.5 no.1
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    • pp.1-9
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    • 2015
  • Objective : To purpose of the this study was to investigate the effect of depression, cognitive function, and activities of daily living on quality of life for patients with stroke. Methods : This study was conducted at K hospital located in Daegu, inpatients or outpatients in 50 stroke patients. Appropriate selection criteria for the study subjects who study subjects to evaluate the cognitive function, activities of daily living. General characteristic, depression and quality of life were examined through a questionnaire, which was in the final analysis. Results : Factors that affect the quality of life of the correlation as a result of negatively correlated with their depression(r=-.460, p<.01), age(r=-.481, p<.001), cognitive function(r=.458, p<.01), activities of daily living(r=.560, p<.001), education standard(r=.338, p<.05) was found in the positively correlated. Finally, the effect on quality of life for patients with stroke in variables affecting depression(${\beta}=-.253$, p<.05), age(${\beta}=-.272$, p<.05), and activities of daily living (${\beta}=.279$, p<.05) were the order of analysis. Conclusion : Through this study result, depression and activities of daily living that affect their quality of life has been identified as the main variable.

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DENTAL MANAGEMENT OF A 46-MONTH-OLD CHILD WITH PRADER-WILLI SYNDROME : A CASE REPORT (프래더-윌리 증후군을 가진 46개월 소아의 치과치료 : 증례보고)

  • Choi, Kyung Hwa;Kim, Mi Sun;Nam, Ok Hyung;Lee, Hyo-Seol;Choi, Sung Chul;Kim, Kwangchul
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.29-34
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    • 2019
  • Prader-Willi Syndrome (PWS) is a rare neurologic disorder with a prevalence 1/10,000-30,000. The cause of PWS is an abnormalities of chromosome 15q11.2-q13 which is an imprinting gene. Obesity and hyperphagia are characteristic features on a PWS adult. On the other hand, the birth weight, height and body mass index (BMI) of PWS infants are 15-20% lower than those of normal babies and there is a failure to thrive until 24-month-old. Most of PWS patients are treated under general anesthesia and conscious sedation. This case is a treatment of severe caries in a PWS 46 month-old child without general anesthesia and conscious sedation. He came to the Department of Pediatric Dentistry, Kyung Hee University Dental Hospital at Gangdong, Seoul, Korea with a trauma history. He had a medical history with heart surgery and needed to take antibiotics prophylaxis. The luxated left upper primary tooth were removed and caries treatment were done as an outpatient without general anesthesia, conscious sedation.

Risk Factors in Stability after Immobilization of the Distal Radius in Unstable Fractures in Children (소아 요골 원위부 불안정 골절의 캐스트 후 안정성에 영향을 미치는 요소)

  • Shin, Yong-Woon;Sohn, Jong Min;Park, Sang-Yoon
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.3
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    • pp.215-223
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    • 2021
  • Purpose: Distal radius fractures in youth are treated conservatively in most cases, but there are some cases of redisplacement in the follow-up period after cast immobilization, even after complete reduction. This study examined the risk factors of redisplacement in reduced unstable distal radius fractures. Materials and Methods: From February 2011 to June 2018, 44 unstable distal radius fractures were managed with a closed reduction and cast immobilization. The patients were aged between 6 and 14 years. The cases of redisplacement were analyzed with the fracture characteristics (fracture obliquity, fracture level ratio, ulnar fracture combined), cast qualities (gap index, cast index, 3 point index, and radius-2nd metacarpal angle) and host factors (age, sex). Results: The mean angulation in the union was 9.2° (0°-32.8°). In the categorical grouping 29 cases were within 10° angulation, and 15 cases were more than 10°. No significant differences in the factors of the cast indices or host factors were noted. The meaningful factor was the fracture level calculated by the relative width of the fracture site divided by the sum of width of diaphysis and epiphysis (p=0.001) and combined ulnar fracture (p=0.019). Conclusion: Unstable distal radius fractures should be treated with more stubborn guidelines lest the fracture loses its anatomical alignment. In particular, in patients with less remodeling power, operative treatment would secure a better result if the fracture occurs in a more proximal location.

Changes in C-Reactive Protein and Complete Blood Cell Count According to Procalcitonin Levels (프로칼시토닌의 수준에 따른 C-반응성단백과 혈구산정검사의 변화)

  • Kim, Jin-San;Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.1
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    • pp.15-22
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    • 2022
  • Procalcitonin (PCT) can provide an experimental rationale and a diagnostic lead to distinguish between bacterial and viral infections. This study sought to investigate the clinical characteristics and prognosis of patients with high PCT levels, to improve clinical diagnosis, and to determine whether PCT levels were associated with the subsequent development of sepsis in the general population. This was a retrospective observational study conducted on outpatients (N=127) over a year. The general data and laboratory parameters studied were PCT, C-reactive protein (CRP), and complete blood count (CBC). The positive rates of CRP and white blood cells (WBCs) in the elevated PCT group were higher than those of the normal group (P<0.05); the specificity and sensitivity of the PCT levels were obviously higher than those of the CRP and WBC levels at diagnosis (P<0.05). The mean PCT levels in the low group were significantly higher than those in the high or moderate group (P<0.001). There was a significant positive correlation with CRP, total WBCs, and neutrophils (P<.001). The main finding of this study was the significant association between an elevated PCT level and CRP and WBC levels, signifying a high diagnostic value. This has important implications for the diagnosis of bacterial infections and therapeutic implications for the use of antibiotic treatment in specific patients.