• Title/Summary/Keyword: 외래 환자경험

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Related Factors of Quality of Life in Middle-male with Chronic Liver Disease (중년기 남성 만성 간 질환자의 삶의 질 관련요인)

  • Do, Eun-Su;Lee, Sun-Mi;Seo, Young-Sook
    • Journal of Digital Convergence
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    • v.13 no.2
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    • pp.267-277
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    • 2015
  • Purpose: The purpose of the study was to examine the related factors of quality of life (QOL) among middle-male with chronic liver disease. Method: The participants in this study were 110 patients with chronic liver disease who were recruited from the outpatient clinic of hospital. Between March and May 2014, data were collected through questionnaires and medical record review. Data analysis was performed using PASW (SPSS) 19.0 program, and one-way ANOVA, Pearson correlation coefficients, and enter multiple regression analysis. Results: The mean QOL of this study was 48.16/100. The significant correlates of QOL were anxiety-depression (${\beta}$=.33, p<.001), symptom experience (${\beta}$=.15, p=.001), health perception(${\beta}$=.31, p<.001), disease status(${\beta}$=.17, p=.022), spouse (${\beta}$=.23, p=.001), and these variables explained 68.6% of variance in QOL. Conclusion: The study suggests that psychological aspects are an important factor in explaining QOL of the middle-male with chronic liver disease. Screening and minimizing anxiety-depression could be effective strategies in enhancing QOL of middle-male with chronic liver disease.

Leiomyosarcoma of Small Intestine -Two cases report with literatural review- (소장의 원발성 평활근육종 2예)

  • Chung, Yong-Sik;Suh, Bo-Yang;Kwun, Koing-Bo;Lee, Tae-Sook
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.281-286
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    • 1985
  • Small bowel malignancy consists 1~2 % of overall gastrointestinal tract cancer and leiomyosarcomas of small intestine are 10~20% of small bowel malignancy. Small bowel leiomyosarcomas are rare in incidence and have no specific symptoms, signs or definite radiologic findings, so it is not easy to diagnose at early stage of disease. They are found occasionally by unknown origined gastrointestinal bleeding, abdominal pain, intestinal obstruction, perforation and palpable mass, and diagnosed mostly by operation. Recently annual case reports are increasing trend in Korea. We experienced two cases of small bowel leiomyosarcoma which was diagnosed finally by pathologic findings, so we report them With literatural review.

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A case of Primary Malignant Fibrous Histiocytoma of the Diaphragm (횡경막에 발생한 악성 섬유종 조직구종 1예)

  • Shim, Jaejun;Cho, Yongseon;Kim, Hyun-Sook;Choi, Hye-Sook;Choi, Cheon Woong;Yoo, Jee Hong;Kang, Hong Mo;Yang, Moon Ho
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.6
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    • pp.645-650
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    • 2003
  • A malignant fibrous histiocytoma (MFH) is a major subset of soft tissue sarcomas, which occurs principally on the extremities or in the retroperitoneum, as well as on the head and neck of elderly patient. However, it is an extremely rare event when a MFH occurs primarily in the diaphragm of a young people. A 25-year-old woman visited our hospital complaining of right chest pain. The chest X-ray showed a diaphragmatic mass. An exploratory thoracotomic biopsy revealed a primary MFH of the diaphragm. The patient was treated with combined chemotherapy consisting of ifosfamide and doxorubicin. A partial response was seen after 6 cycles of chemotherapy. However, she died of brain metastasis 12 months after the diagnosis.

Occlusion of the Right Coronary Artery Ostium due to Rheumatic Aortic Valve Stenosis (류마티스성 대동맥 판막협착증에 의한 우관상동맥 개구부 폐쇄)

  • Seo, Hong-Joo;Oh, Sam-Se;Kim, Jae-Hyun;Kim, Soo-Cheol;Na, Chan-Young
    • Journal of Chest Surgery
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    • v.40 no.6 s.275
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    • pp.445-447
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    • 2007
  • Occlusion of a coronary artery ostium and especially occlusion of the right by an aortic cusp is a rare condition. We experienced an adult patient with occlusion of the right coronary ostium that was due to fusion of the right coronary cusp to the aortic wall along with underlying rheumatic aortic valve stenosis. During the operation, the adherent right coronary cusp was excised. After confirming that the right coronary ostium was patent, the other cusps were removed, and this followed by replacement of the aortic valve with a mechanical valve. The postoperative course was uneventful.

Remote Afterloading Hish Dose Rate (HDR) Endobronchia1 Brachytherapy (원격조정 고선량 기관지내 근접 치료)

  • Chang Hyesook;Choi Eun Kyung;Yi Byong Yong;Kim Won Dong;Kim Woo Sung;Koh Youn Suck
    • Radiation Oncology Journal
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    • v.9 no.2
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    • pp.227-232
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    • 1991
  • Authors described the remote afterloading endobronchial brachytherapy (EBBT technique using the microSelectron HDR Ir-192 and the Asan Medical Center experience. Total 28 EBBT in 9 patients were performed since November 1989 and 24 EBBT in 8 patients were emploiyed for palliation and 3 EBBT in 1 patient was treated curatively. Authors observed a significant relief of obstructive symptom with tumor regression in 7 patients out of 8 who were treated palliatively but one of them died of pulmonary congestion in 3 weeks after EBBT One patient with prior therapy of extensive electrocautery expired within 1 day after 2nd EBBT procedure with massive hemorrhage from the lesion. EBBT procedure has been tolerable and can be performed as an outpatient.

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A Comparison Study of Cost Components to Estimate the Economic Loss from Foodborne Disease in Foreign Countries (국외 식중독으로 인한 손실비용 추정을 위한 항목 비교 연구)

  • Hyun, Jeong-Eun;Jin, Hyun Joung;Kim, Yesol;Ju, Hyo Jung;Kang, Woo In;Lee, Sun-Young
    • Journal of Food Hygiene and Safety
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    • v.36 no.1
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    • pp.68-76
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    • 2021
  • Foodborne outbreaks frequently occur worldwide and result in huge economic losses. It is the therefore important to estimate the costs associated with foodborne diseases to minimize the economic damage. At the same time, it is difficult to accurately estimate the economic loss from foodborne disease due to a wide variety of cost components. In Korea, there are a limited number of analytical studies attempting to estimate such costs. In this study we investigated the components of economic cost used in foreign countries to better estimate the cost of foodborne disease in Korea. Seven recent studies investigated the cost components used to estimate the cost of foodborne disease in humans. This study categorized the economic loss into four types of cost: direct costs, indirect costs, food business costs, and government administration costs. The healthcare costs most often included were medical (outpatient) and hospital costs (inpatient). However, these cost components should be selected according to the systems and budgets of medical services by country. For non-healthcare costs, several other studies considered transportation costs to the hospital as an exception to the cost of inpatient care. So, further discussion is needed on whether to consider inpatient care costs. Among the indirect costs, premature mortality, lost productivity, lost leisure time, and lost quality of life/pain, grief and suffering costs were considered, but the opportunity costs for hospital visits were not considered in any of the above studies. As with healthcare costs, government administration costs should also be considered appropriate cost components due to the difference in government budget systems, for example. Our findings will provide fundamental information for economic analysis associated with foodborne diseases to improve food safety policy in Korea.

The Factors Influence upon Employment Volition in Alcohol Use Disorder (알코올사용장애 환자의 취업의지에 미치는 영향요인)

  • Rho, In-Suk;Cho, Kyong-Ah
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.7
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    • pp.272-280
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    • 2019
  • This descriptive research study investigated the relationships between different degrees of family support, ego-resilience and employment volition of patients suffering from alcohol use disorder, and we identified the factors that had an influence on employment volition. This study used the survey research technique and structured questionnaires. The data was collected from 128 males (aged 20 years or older) and who had been diagnosed with alcohol use disorder. They had also undergone either inpatient hospital care or outpatient treatment. The data was analyzed using descriptive statistics, one-way ANOVA, Pearson's correlation coefficient and multiple regression analysis. The results of the study showed that family support had a value of 4.30, an ego resilience had a value of 2.37 and the employment volition had a value of 4.06. The results of the multiple regression analysis showed that there was statistically significant positive correlation between employment volition and ego resilience (${\beta}=-.314$, p<.01) and age (${\beta}=-.253$, p<.01), and the total explanatory power of these 2 factors was 16.3%. According to the results of this study, age-based approaches are needed to improve the employment volition of patients with alcohol use disorder. Additionally, the results of this study suggest that an ego resilience enhancement program be developed and implemented to help these patients.

Early Clinical Experience in Aortic Valve Replacement Using On-X$^{circledR}$Prosthetic Heart Valve (On-X$^{circledR}$ 기계판막을 이용한 대동맥판 치환술의 조기 임상 경험)

  • 안병희;전준경;류상완;최용선;김병표;홍성범;박종춘;김상형
    • Journal of Chest Surgery
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    • v.36 no.9
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    • pp.651-658
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    • 2003
  • Since the first implanted in September 1997, the use of On-X prosthetic heart valve has been increasing around in the world. This study was designed to assess the feasibility, safety, and the postoperative hemodynamics with this new valve in clinical setting. Material and Method: The current study was carried out on 52 patients undergoing aortic valve replacement with this prosthesis between April 1999 to August 2002 at Chonnam National University Hospital to evaluate the surgical results. 52% of the patients were male and the average age at implant was 50$\pm$13 years. The study followed the guidelines of the AATS/STS. Preoperatively, 32(61.5%) patients were in NYHA functional class III or IV and 2 patients had previous aortic valve surgery. Concomitant cardiac surgery was performed in 71.1%. The implanted valve sizes were 19 mm in 13 patients, 21 mm in 26, 23 mm in 10 and 25 mm in 3, respectively. Mean follow-up was 16.6$\pm$10.5 months (1∼39 months). Echocardiographic assessment was performed pre- and immediate postoperatively, as well as 3, 6, 12 months after surgery, evaluating pressure loss and regression of left ventricular hypertrophy. Result: Mean cardiopulmonary bypass time was 191$\pm$94.7 minutes with an aortic cross-clamp time of 142$\pm$51.7 minutes. There was no early and late mortality, Freedom from adverse events at 1 year in the study were as follows: thromboembolism, 95.6$\pm$6%; bleeding events, 90.2$\pm$4%; paravalvular leakage 92.3$\pm$4%; and overall valve-related morbidity at 1 year was 76.6$\pm$3%. There were no cases of valve thrombosis, prosthetic valve endocarditis and structural or non-structural failure. Left ventricular function at 12 months after surgery (EF=62.7$\pm$9.8%) revealed a statistically significant improvement compared to preoperative investigation (EF=55.8$\pm$15.9%, p=0.006). Left ventricular mass index was 247.3$\pm$122.3 g/$m^2$ on preoperative echocardiographic study, but regressed to 155.5$\pm$58.2 g/$m^2$ at postoperative 1 year (p=0.002). Over the follow-up period a further decrease of peak transvalvular gradients was observed in all patients: 62.5$\pm$38.0 mmHg on preoperative assessment, 18.2$\pm$6.8 mmHg at immediate postoperative period (p < 0.0001), 7.6$\pm$5.09 mmHg (p<0.0001) at 6 month, 18.0$\pm$10.8 mmHg (p<0.0001) at 1 year. Conclusion: The On-X prosthetic heart valve performs satisfactorily in the first 1 year period. Clinical outcome by examining NYHA functional classification revealed especially good results. Effective regression of left ventricular hypertrophy and statistically significant decrease of transvalvular gradient were observed over the first year, but longer-term follow-up of this patient group is needed to establish the expected rates for late valve-related events as well as the long-term clinical efficacy of this valve.

Use of herbal medicine in epileptic children (소아 간질 환자에서 한약 복용 실태)

  • Lee, Jee Yeon;Choi, Wook Sun;Eun, So-Hee;Eun, Baik-Lin;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.415-419
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    • 2008
  • Purpose : Herbal medicine is thought to be widely used by children with epilepsy, but there have been few studies. This study aimed to investigate the perceptions and the actual conditions of usage of herbal medicine by children with epilepsy. Methods : From July to August 2007, three hundred seventy eight questionnaires were completed by parents of epileptic children who visited pediatric neurology clinic of Korea University hospital and Kwangmyung-Sungae hospital. Demographic data and patterns of usage of herbal medicine were investigated. Results : Among 378 patients, sixty five (17.2%) reported using herbal medicine. Major reasons for using herbal medicine were 'to enhance general health' and 'belief that it has fewer side effects'. Majority of respondents did not notify their physician about using herbal medicine because 'they did not need to share this with doctor' and 'they thought their doctor would disapprove'. After taking herbal medicine, 33.3% of patients reported that it did not benefit their seizure but they felt healthier. Usage of herbal medicine was significantly related to number of AEDs (antiepileptic drugs), duration of AED treatment, association with psychosomatic disorders and motivation by other people or by mass media. Conclusion : Considerable numbers of epileptic children were using herbal medicine during treatment with AED and did not inform their physician about usage of it. Physicians should be aware of benefits and harms of herbal medicine and actively intervene in the usage of herbal medicine by epileptic patients.

Cardiac Malignant Mesenchymoma - Two Cases Report - (심장의 악성 간엽세포종 - 2례 보고 -)

  • Ku, Gwan-Woo;Kang, Shin-Kwang;Won, Tae-Hee;Kim, Si-Wook;Yu, Jae-Hyun;Na, Myung-Hoon;Lim, Seung-Pyung;Lee, Young
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.750-754
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    • 2002
  • Primary cardiac tumors are rare and about 20~25% of primary cardiac tumors are malignant. Moreover, primary malignant mesenchymoma of the heart is extremely rare. Recently, we have experienced two cases of cardiac malignant mesenchymoma. In the first case, malignant mesenchymoma which was originated from the posterior wall of the left atrium obstructing the mitral orifice was revealed pathologically in a 61-year-old woman with mitral regurgitation. The mass, which was 2.7$\times$3.7cm in size on the posterior wall of left atrium, was extended to the posteromedial commissure and annulus of the mitral valve. The mass was resected partially without excision of the left atrial free wall. She was discharged after 30 days without any problems and she received chemotherapy and followed up for 19months. The second case was a 4$\times$5cm in size, friable, yellow-whitish multilobulated mass in the left atrium which was originated from the left lower pulmonary vein. Multiple minor tumor nodules were found in the wall of the left atrium and the posterior leaflet of mitral valve. Partial mass excision and mitral valve replacement were performed.