• Title/Summary/Keyword: 외래치료

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A Study of Psychiatric Problems of North Korean Refugees Who Visited a Psychiatric Clinic (한 정신건강의학과에 내원한 북한이탈주민의 정신의학적 문제 고찰)

  • Kang, Hee-Young;Byeon, Seong-Hye;Shin, Sang-Ho;Kim, Hyun-Chung;Lee, So-Hee;Yoo, So-Young
    • Sleep Medicine and Psychophysiology
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    • v.19 no.1
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    • pp.35-41
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    • 2012
  • Purpose: According to the statistics announced by the Ministry of Unification, the number of North Korean refugees living in South Korea has increased by 200 on average monthly in 2010. The number of refugees increased only by 300 annually until 2000. The total number of refugees as of February 2012 was 20,956. This study aims to investigate the psychobiology of the North Korean refugees who consulted psychiatric clinics among those living daily life in South Korea. Methods: The subjects of this study were 85 North Korean refugees that consulted psychiatric clinics from January 1, 2005 to July 2011. This study obtained demographic and psychiatric information in a retrospective approach. Results: Among the 85 North Korean refugees, 75 (88.2%) were females and their average age was 48 years of age. A total of 16 (18.8%) were admitted to a clinic and among the inpatients, 4 were admitted twice and two were admitted three times. As for the claimed symptoms of outpatients, insomnia was shown in 47 (55.3%) patients, headaches in 37 (43.5%), anxiety in 20 (23.5%), depression in 19 (22.4%), etc. The major symptoms represented by inpatients were insomnia in 14 (87.5%) patients, depression in 12 (75%), and headaches in 8 (50%), etc. Conclusion: The most frequent psychiatric symptoms of North Korean refugees living in South Korea were insomnia and headaches. It suggests that when performing psychiatric diagnosis and treatment of North Korean refugees, we have to take into consideration the fact that they claimed the physical symptoms more than the emotional ones. Also, from the aspect that most symptoms of North Korean refugees were insomnia, more profound research on sleep is required in the future.

A Case of Nonspecific Interstitial Pneumonia Associated with Systemic Lupus Erythematosus (전신성 홍반성 낭창에 병발된 비특이성 간질성 폐렴 1예)

  • Lee, Ho-Moeng;Hwang, Jae-Kyung;Park, Gae-Young;Park, Jeong-Woong;Park, Jae-Kyung;Jeong, Seong-Hwan;Nam, Gui-Hyun;Lee, Jae-Woong;Ha, Seung-Yeon;Lee, Han-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.6
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    • pp.732-739
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    • 2001
  • Systemic lupus erythematosus frequently has thoracic involvement among connective tissue diseases. One of the pleuropulmonary manifestations is diffuse interstitial lung disease including nonspecific interstitial pneumonia(NSIP). NSIP is a newly classified disease among interstitial lung diseases. Systemic lupus erythematosus has a better prognosis than usual interstitial peumonia(UIP) and responds well to steroids. In this report, a 34 year-old woman who complained of a dry cough, and exertional dyspnea for 2 months is described. The chest X-ray showed fine reticular opacities and a mild honeycomb appearance in both basal lungs. High resolution computed tomography(HRCT) showed bilateral patchy areas of ground-glass attenuation and a mild honeycomb appearance in the subpleural of both the lower and the middle portion of the lung fields. An open lung biopsy showed prominent lymphocytic interstitial inflammation and fibrosis with small areas with a honeycomb appearance. This case was diagnosed as NSIP associated with systemic lupus erythematosus and was managed with oral steroids. Here we report a case of nonspecific interstitial pneumonia associated with systemic lupus erythematosus confirmed by HRCT and an open lung biopsy with a review of the relevant literature.

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The Burden of Main Caregivers in the Family with Schizophrenic Patient (정신분열병환자 가족 주보호자의 부담에 관한 연구)

  • Hur, Bok-Sim;Ryu, So-Yeon;Park, Jong;Kim, Ki-Soon;Kim, Yang-Ok;Kim, Hack-Ryul
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.351-368
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    • 1999
  • The objective and subjective burden was evaluated toward 115 main caregivers in the family with schizophrenic patient by interview with structured questionnaire and self-report using Family Burden Scale (FBS) of family with schizophrenic patient in Korea. The results were as follows : 1) The mean age of onset by schizophrenic patient were 23 years old in male and 26 in female. 2) The mean scales of objective and subjective burden were 1.5 and 1.6. 3) By Logistic regression objective burden was significantly affected by family support (P<0.001), religion (P<0.05), occupation (P<0.05). 4) Subjective burden was significantly affected by family support (P<0.01) and family total income (P<0.05). 5) Total objective and subjective burden was significantly affected by family support (P<0.001), religion (P<0.05). In conclusion, this study suggests that main caregivers need family support from other family members. For them religion and social support are also helpful to cope with the burden to take care of the schizophrenic patients.

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Analysis of Telephone Follow-up Data of Out-patient Anesthesia for Dental Treatment of Disability Patients (치과장애인 환자의 외래마취 하 치과치료 귀가 후 전화추후 관리 분석)

  • Kim, Mi-Seon;Seo, Kwang-Suk;Lee, Jung-Man;Kim, Hye-Jung;Han, Jin-Hee;Han, Hee-Jeong;Lee, Eun-Hee;Shin, Soonyoung;Shin, Teo-Jeon;Kim, Hyun-Jeong;Chang, Juhea
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.12 no.2
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    • pp.93-97
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    • 2012
  • Background: Some disabled patients show insufficient cooperation during dental treatment, and general anesthesia in an outpatient setting can be successfully administered. To minimize post-anesthetic complications is an essential issue, and strict discharge protocols are required for the safety of the patients. Post-anesthetic follow-ups using telephone calls can be applied to improve the quality of the outpatient care system. The authors evaluated the post-operative condition of patients after dental treatment under general anesthesia. Methods: Total 143 patients and their caregivers included in this study. The patients received general anesthesia for dental treatment in Seoul National University Dental Hospital, Clinic for Persons with Disabilities from July, 2011 to April, 2012. Telephone calls were given to the patients or their caregivers to collect information about the patients' systemic condition and anesthesia-related complications. Results: Among 131 patients with responses of telephone calls, 87 patients (66.4%) reported no discomfort, while 44 patients (33.6%) presented post-anesthetic complications. A total of 20 patients reported mild fever, 10 patients had vomiting, and 7 patients had sore throat. Other complications included nausea, fatigue, nasal bleeding, skin sore, and body rash. Among the patients with the history of epilepsy, 63.6% showed post-anesthetic discomfort or complication (P = 0.027, ${\chi}^2$ test). Conclusions: One third of dental patients who received general anesthesia due to insufficientcooperation complained discomfort after discharged from outpatient anesthetic care.

Use of the Stomach as an Esophageal Substitute after Total Pharyngolaryngoesophagectomy for Treating Cervical Esophageal Cancer or Hypopharyngeal Cancer (경부식도암 및 하부인두암에서 근치적 전후두인두식도절제술 후 위를 이용한 재건술의 의의)

  • Lee, Sang-Hyuk;Lee, Sang-Hoon;Yoon, Ho-Young;Kim, Choong-Bai
    • Journal of Gastric Cancer
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    • v.7 no.4
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    • pp.200-205
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    • 2007
  • Purpose: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer. Materials and Methods: We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy. Results: There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%). Conclusion: The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.

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The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients (만성 폐쇄성 폐질환 환자의 중증도 분류시 FEV1과 PEFR의 연관성)

  • Shin, Sang Youl;Ho, Yoon Jae;Kim, Sun Jong;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.507-514
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    • 2005
  • Background : Measurement of the $FEV_1$ and PEFR in COPD patients is a significant indicator of the disease severity, the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and $FEV_1$ in COPD patients is not well known. Methods : From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The $FEV_1$ and PEFR of each patient were measured and all the data was analyzed using SPSS. Results : The average predicted $FEV_1$ % and PEFR % was $56.98{\pm}18.21%$ and $70{\pm}27.60%$, respectively. There was linear correlation between the predicted $FEV_1$ % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. Conclusion : In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the $FEV_1$. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the $FEV_1$.

The Reactivity to 2TU PPD Tuberculin Skin Test after Percutaneous Multiple Puncture BCG Vaccination (건강한 영아에서 경피다자법 BCG 접종후 2TU 투베르쿨린 검사의 반응성)

  • Roh, Hye Ok;Lee, Woo Gill
    • Pediatric Infection and Vaccine
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    • v.6 no.1
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    • pp.101-106
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    • 1999
  • Purpose : Tuberculosis, a major public health problem, is an important cause of childhood infectious diseases. To decrease the tuberculosis morbidity rate, BCG vaccination and chemoprophylaxis are performed. Recently 2TU PPD skin test was introduced as a diagnostic method for tuberculous infection. We studied the positive conversion rate of 2TU PPD test after percutaneous multiple puncture BCG vaccination. Methods : Four hundred seventy six infants from well baby clinic of Samsung Cheil Hospital were enrolled. They were immunized with percutaneous multiple puncture technique BCG(Japan BCG laboratory, Japan) at 1 month of age. Approximately 6 months later, tuberculin skin test using RT23 2TU PPD was performed. Induration size, family history of tuberculosis and number of BCG scars were evaluated. Induration greater than or equal to 5mm was defined as positive conversion. Results : Among 476 infants, 248(52.1%) were male and 228(47.9%) were female. PPD skin tests were performed $6.2{\pm}0.5$($mean{\pm}S.D.$) months after BCG vaccination. Mean induration size was $7.3{\pm}3.2mm$ and positive conversion rate was 85.5%. Total number of BCG scars was $15.5{\pm}3.2$. Conclusion : The seroconversion rate by 2TU PPD test after percutaneous multiple puncture BCG vaccination was high. But, more comparative studies with various age groups may be needed for 2TU PPD test used as diagnostic method of tuberculosis in the hospitals.

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Development of Rule-based Expert System for Interpretative Report with Health Screening Tests (건강검진자를 대상으로 해석적 보고를 위한 전문가 시스템의 개발)

  • Lee, Chae-Hoon
    • Journal of Yeungnam Medical Science
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    • v.24 no.2
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    • pp.137-147
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    • 2007
  • Background : Interpretative reporting is an important aspect of laboratory medicine. The large menu of laboratory tests available today makes it increasingly difficult for the non-specialist to order and interpret all laboratory tests. The aim of this study was to determine the usefulness of an expert system to interpret laboratory tests and help physicians order the appropriate tests. Materials and Methods : In order to interpret laboratory tests, a rules-based expert system was developed. In this module, if-then rules were used to interpret the given test result patterns (e.g. urinalysis, anemia, hepatitis B virus, hypercholesterolemia, glucose, syphilis, and tumor markers) and select matching text elements. The system was used to evaluate 535 subjects who visited a health-check program. Results : The overall abnormal rate was 50.5% in the expert system; 34% for cholesterol, 9.9% for urinalysis, 8.0% for anemia, 7.7% for thyroid function tests, 4.5% for tumor marker study, 4.7% for hepatitis virus antigen, 4.3% for serum glucose, and 1.1% for syphilis. Conclusion : These results indicate that the application of the expert system for the interpretation of laboratory tests may provide a useful method for the interpretation of reports. However more rules are needed for the application to in-patients.

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Analysis on Effect of Health Promotion Program for the Patients with Rheumatoid Arthritis (환자를 위한 건강증진 프로그램의 효과 분석 연구)

  • Oh, Hyun-Soo;Kim, Young-Ran;Park, Won;Song, Jeong-Soo
    • Journal of Korean Academy of Nursing
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    • v.30 no.2
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    • pp.342-353
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    • 2000
  • This study was performed to examine the effect of a 7-week comprehensive health promotion program for improving pain, depression, and disability by employing a quasi-experimental design. The subjects were regular out-patients of a RA aclinic in an University Hospital in Inchon from November 11. 1998 to December 24. 1998. The Experimental group included 18 patients who participated in an arthritis health promotion program, and the control group included 18 patients who did not. The 7-week health promotion program, which had the objective to enhance health promoting skills, was provided to patients. The effects of this program on the patients' pain, depression, and functional disability were examined. According to the study results, a significant group difference was found on these dependent variables (Hotelling's T =.30, F=3.11, p=.04). To examine which dependent variables had significant effects, one-way ANOVAs were performed. There were significant group differences in pain (F=4.35, p=.05) and in depression (F=4.22, p=.05) However, no significant group differences on functional disability (F=.04, p=.84) were found. Conclusively, the arthritis health promotion program, which was designed to enhance 11 health promoting skills, can be evaluated as successfully achieving the ultimate goal of enhancing the patients' quality of life. It can also be contended that the improvement of the patients' quality of life was enabled by relieving pain and reducing depression.

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Development of Prediction Model for Depression among Parents with Disabled Children: Based on the Mediation Effect of Social Supports and Family Resilience (장애아동부모의 사회적지지, 가족건강성 및 우울의 구조모형)

  • Keum, Hyesook;Shin, Yeonghee;Kim, Hyeyoung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.171-178
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    • 2016
  • In this study, a prediction model for depression among parents with disabled children was developed by verifying the effects of social support and family resilience. One hundred forty one parents with disabled children were recruited from three out-patient clinics of rehabilitation hospitals in D city between August and September, 2014. The instruments used were the QRS, CES-D, MSPSS, and KFSS-II. The average score of depression was 20.18/60. The levels of depression were significantly different among variables, e.g., sex, age, and monthly income. The mean scores of the item for social support and family resilience were 3.11/5 and 3.32/5, respectively. Family resilience differed significantly according to monthly income. Parental depression was negatively correlated with the social supports and family resilience. Social support was correlated positively with family resilience. In conclusion, family resilience and social support are predictable factors for depressed parents with disabled children.