• Title/Summary/Keyword: 질병장애

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지역사회 건강관리담당자의 만성질환 관리실태:전라남도를 중심으로

  • Kim, Hye-Sook;Park, Jong;Jeong, Eun
    • Journal of agricultural medicine and community health
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    • v.34 no.3
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    • pp.334-345
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    • 2009
  • Objectives: This study was performed to investigate the management status of chronic disease at community health centers. Methods: The study subjects were 450 employed persons at community health centers in Jeonlanamdo. General characteristics, status of chronic disease management and health education were collected for statistical analysis. The differences on management status among working areas were assessed with chi-square test and ANOVA. Results: The mean values of work duration were 18.7 years in rural, 14.4 years in fishing village, and 17.4 years in urban-rural, respectively. The number of management registration was highest in hypertension. The ways of disease management were medication check-up, diet stopping smoking. The contents of group health education were exercise, diet and prohibition of smoking. The place of health education was town assembling hall. The fields which officials wanted to be educated were symptom, diagnosis, treatment and complication. The most important field was early detection of chronic disease patients and health education. Finally, the field requiring support was work standardization. Conclusions: Community health workers have worked positively in chronic disease management. The barriers to work were the lack of professional and preliminary data. The support system with other health organ and health education were needed for the improvement of working ability.

A Case of Rapidly Developed Obesity Hypoventilation Syndrome in a Patient with Kyphoscoliosis (척추후측만증 환자에서 급속히 진행된 비만성 저환기 증후군 1례)

  • Kim, Min Young;Jeong, Jee Sun;Jang, Yu Na;Go, Se-eun;Lee, Sang Haak;Moon, Hwa Sik;Kang, Hyeon Hui
    • Sleep Medicine and Psychophysiology
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    • v.22 no.1
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    • pp.30-34
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    • 2015
  • Obesity hypoventilation syndrome (OHS) is characterized by severe obesity, excessive daytime sleepiness, hypoxemia and hypercapnea. Because OHS mimics pulmonary hypertension or cor pulmonale, clinicians should recognize and treat this syndrome appropriately. A 58-year-old female visited the emergency room because of dyspnea. She was obese and had kyphoscoliosis. The patient also experienced snoring, recurrent choking during sleep and daytime hypersomnolence which worsened after gaining weight in the recent year. The arterial blood gas analysis showed she experienced hypoxemia and hypercapnea not only during nighttime but also daytime. We suspected OHS and the patient underwent polysomnography to confirm whether obstructive sleep apnea was present. During the polysomnography test, sleep obstructive apnea was observed and apnea-hypopnea index was 9.2/hr. The patient was treated with bilevel positive airway pressure therapy (BiPAP). After BiPAP for 4 days, hypoxemia and hypercapnia were resolved and she is currently well without BiPAP. We report a case successfully treated with clinical improvement by presuming OHS early in a patient who had typical OHS symptoms, even while having other conditions which could cause hypoventilation.

Clinical Characteristics of Diffuse Panbronchiolitis (미만성 범세기관지염의 임상상에 관한 연구)

  • Kim, Young-Whan;Yoo, Chul-Gyu;Han, Sung-Koo;Shim, Young-Soo;Kim, Keun-Youl;Han, Yong-Chol
    • Tuberculosis and Respiratory Diseases
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    • v.39 no.1
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    • pp.28-34
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    • 1992
  • Background: Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, Noirth American and Korean have been reported. During recent two years we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics. Method: We reviewed the patients' age, sex, duration of illness, smoking history, occupational history and past medical history. And we analyzed patients' symptoms, physical signs, laboratory findings and responses to treatment. Results: 1) Male: female ratio was 2.2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years. 2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB. 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis. 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients. 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients. 6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%). 7) The titers of cold hemaglutinin, RA factor and CRP were elevated in most of the patients. 8) Most of the patients improved after treatment with erythromycin. Conclusion: DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB.

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An Epidemiological Investigation on an Outbreak of Shigellosis in a Special School for Handicapped in Yeongcheon-si and in a Rehabilitation Facility in Gyeongsan-si, Korea, 2008 (2008년 영천시 지적장애인 학교와 경산시 재활원에서 발생한 세균성이질에 관한 역학조사)

  • Lee, Hyun-Dong;Lee, Soon-Ok;Lim, Hyun-Sul
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.24-33
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    • 2009
  • Objectives: In September 2008, an outbreak of diarrhea occurred among students attending Y school in Yeongcheon-si. Shigella sonnei was cultured from some of the rectal swabs. An epidemiological investigation was carried out to determine the source of the infection and the mode of transmission of the shigellosis outbreak. Methods: The index case lived in the D rehabilitation facility in Gyeongsan-si and an additional epidemiological investigation was carried out there. The cases could not be questioned due to their mental handicaps. The teachers were interviewed instead. A patient case was defined as a resident with diarrhea more than one time a day from September 18 to September 26, 2008 or a resident with confirmed Shigella sonnei at the Y school or the D rehabilitation facility. Results: The attack rate was 1.2% (8 persons) among 659 persons in the Y school and D rehabilitation facility. Five persons were microbiologically confirmed to have the infection and three persons were diagnosed on the basis of symptoms. Shigella sonnei was cultured from five of the 659 rectal swabs. However, 80 environmental specimens including drinking water, preserved foods, and cooking utensils were negative. All eight patients were Y school students and had been living in group boarding and lodging. Six of them lived in the D rehabilitation facility and two lived in the dormitory at the Y school. Five cases showed pulsed-field gel electrophoresis patterns that were identical for Shigella sonnei. Conclusions: The results of this study showed that the infection source of the shigellosis outbreak, in the two places, were identical. It is likely that the infections initially spread from a teacher or volunteer and then among the students.

Evaluation of Taste in the Patients with Recurrent Aphthous Ulceration by Electrogustometer (전기미각측정기를 이용한 재발성 아프타성 궤양 환자의 미각평가)

  • Jun, Jin-Yong;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.32 no.1
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    • pp.1-8
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    • 2007
  • The purpose of this study was to investigate whether there were any changes in taste sensitivity with recurrent aphthous ulceration. Nintyseven subjects(25 males and 72 females) were included for the study and they were categorized into 2 groups(recurrent aphthous ulceration 27 persons, control 70 persons), recurrent aphthous ulceration group was investigated in the department of Oral Medicine, College of Dentistry, Pusan National University from April, 2005 to August, 2006 and control group was investigated in the clinic at Incheon city from June, 2006 to August, 2006. The electrical taste thresholds were measured using an electrogustometer of the 4 different sites(tongue tip, tongue lateral, circumvallate papilla and soft palate) in oral cavity. The results were as follows ; 1. The electrical taste threshold showed significant lower in the RAU group. 2. The electrical taste threshold showed significant lower in female group, and showed significant lower except soft palate in male group of the RAU group. 3. The electrical taste threshold showed a tendency to increase in all site of the multiple RAU group, but there were no significant differences. 4. The electrical taste threshold showed a tendency to increase in tongue lateral of the acute RAU group, and showed a tendency to increase in tongue tip, circumvallate papilla, soft palate of the chronic RAU group. 5. After treatment, electrical taste threshold was significant increase than initial visit in the RAU group. 6. After treatment, NAS showed a tendency to decrease in the RAU group.

Genotype and clinical features of Korean patients with methylmalonic aciduria and propionic aciduria (한국인 메틸말로닌산뇨증 및 프로피온산뇨증의 유전자형과 임상 양상)

  • Lee, Eun Hye;Ko, Jung Min;Kim, Jae-Min;Yoo, Han-Wook
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.964-970
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    • 2008
  • Purpose : Methylmalonic aciduria (MMA) and propionic aciduria (PA) are inborn errors in the catabolism of branched-chain amino acids. The study was undertaken to investigate the genotypes and clinical features of Korean patients with MMA and PA. Methods : This study examined 12 patients with MMA and eight with PA. We analyzed various clinical features, laboratory findings, treatments, and neuro-developmental outcomes. Diagnoses were based on the presence of characteristic compounds detected by amino acid analysis in serum and organic acid analysis in urine. Mutation analysis was performed in the genes of MUT, MMAA, MMAB, and MMACHC for MMA and PCCA and PCCB for PA. Results : Among the 20 patients, six patients were diagnosed before one month of age and nine patients were diagnosed after the newborn period. Five patients were diagnosed via a neonatal screening test. Patients with early-onset forms had more severe illness at presentation and generally poor outcomes. A favorable outcome was obtained in 55% patients; most of them were of a late-onset type or diagnosed by neonatal mass screening test without symptoms. Genotypes were confirmed in all patients with MMA. We detected 11 different mutations by MUT gene analysis in 10 patients, and three different mutations in MMACHC genes in two patients. PCCA and PCCB gene mutations were identified in 14 of the 16 alleles, in eight patients with PA. Conclusion : Organic aciduria is a fatal disease; however, better outcomes are expected whenever early diagnosis and prompt management are made possible. Mutation analysis is useful for confirming diagnoses and planning management strategies.

Study on Effect of Varience of Physiological Responses in Color Foot Reflexology Using Color Light (컬러광을 활용한 발반사요법이 인체 생리적 반응 변화에 미치는 영향에 관한 연구)

  • Jin, Hye-Ryeon;Yu, Mi;Park, Kyung-Jun;Kim, Nam-Gyun;Chung, Sung-Whan;Kim, Dong-Wook
    • Science of Emotion and Sensibility
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    • v.13 no.1
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    • pp.187-196
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    • 2010
  • Recently, people have been suffering from stress-related fatigue and psychological disorders. Most people depend on medicine for pain relief; many treat pain also through alternative medicine or replacement therapy. However, drug therapy has many side effects, including increased stress after the therapy. In comparison, alternative therapies such as massage and foot reflexology are less damaging to the body, and such therapies can be provided without physical or psychological discomfort. In this regard, the author had previously co-developed color foot reflexology, which combines the merits of color therapy and foot reflexology; color foot reflexology has been shown to have beneficial effects without undue pain. This study investigates the effects of color foot reflexology on the physiological response of the body by comparing the body’s response to the signal with that to the placebo. Healthy adult subjects were selected for the experiment, which was conducted under optimal experimental conditions and design. The results indicated that when stimulated, parasympathetic nerves increased in HRV and that blood pressure, pulse, body heat, peripheral blood flow were dramatically activated. However, the results for the placebo indicated minimal changes or irregular outcomes. The results provide strong evidence for the beneficial effects of the color foot reflexology instrument on the autonomic nervous system and on the physiological response of the body. Future research is warranted to verify the results of the current study by examining patients suffering from diseases and disorders arising from irregular physiological functions in the context of the foot.

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A Survey of Role Perception and Function Performance Related to Public Health Service among the Medical Staff in a National Hospital (일개 공공병원 종사자의 공공보건의료에 대한 인식과 기능수행에 대한 조사연구)

  • Cho, Young-Hye;Lee, Sang-Yeoup;Jeong, Dong-Wook;Choi, Eun-Jung;Kim, Yun-Jin;Lee, Jeong-Gyu;Go, Yu-Young;Lee, Yu-Hyone;Bae, Mi-Jin;Kim, Chang-Hoon
    • Journal of agricultural medicine and community health
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    • v.37 no.2
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    • pp.67-75
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    • 2012
  • Objectives: While there have recently been efforts to improve public health service at a governmental level, there is actually insufficient research on awareness of the roles related to public health service among hospital employees. This study examined role perception and function performance related to public health service among the medical staff in a national hospital. Methods: 15% were randomly sampled from each type of occupation among the medical staff in a national university hospital, a survey was conducted in 323 persons, and there were a total of 265 participants (80.2%): 103 doctors(38.9%), 98 nurses (37.0%), and 64 others (24.1%). Results: The hospital employees had insufficient awareness of their roles as public health service providers in terms of six required items for public health service: 1) services for supporting establishment, implementation, and assessment of public health service policies, 2) participation in the health service activities and support services by central or local governments, 3) technological support and educational services for private health service institutions, 4) health service for unprivileged brackets, 5) health service that requires association with other areas dealing with geriatric, disabled, and mentally-disordered people, and 6) health service for children and mothers. Conclusions: In general, since the hospital employees had insufficient awareness of their roles and responsibilities as public health service providers, it is necessary to secure manpower exclusively in charge of public health service and provide education about strategic public health service.

The Study for the State of Nutrition & the Development of Physical Standard of Nursery School Children (보육원아(保育園兒)의 영양상태(營養狀態)와 체위(體位)의 발달도(發達度)에 관(關)한 연구(硏究))

  • Lee, Geum-Yeong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.5 no.1
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    • pp.31-37
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    • 1976
  • 1. In order to increase our physical power through raising the amount of Hb to normal level and thus enrich our national power, it is earnestly required to improve the general eating habits in the direction of taking enough animal protein (nutrition food) that is required to form Hb and adequate administrative procedures of the nursery school are to be taken at the same time. 2. The genetic amentia's development of skeleton is generally under the normal level. And so their physical condition should be inferior to the standard growth rate of the same age. But the fact is that their physical growth is almost the same as the same age with only few exceptions. Besides, considering the fact that their amount of Hb is less than that of the normal level, I think we can conclude that the majority of the amentia in the nursery school were malnutrition during their prenatal period or during their infancy. We need continuous statistical study concerning many amentia that is scattered all part of our country, to make our amentia's hereditary transmission and the expression clear. And so the Intelligence Quotient of the amentia are from 26 to 80, we consider to need nourishing meal in ordinary times to make more efficient development of intellectual faculties. 3. As to the relation between blood type and disease, there are much debates going on in many countries. To get more apodictic results, however, continuous study is desired to be made in the future.

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A clinical study of deep neck abscess in children (소아 심경부 농양의 임상적 고찰)

  • Lee, Soo Jung;Shin, Mee Yong;Kim, Chang Hwi;Koh, Yoon Woo
    • Clinical and Experimental Pediatrics
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    • v.50 no.4
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    • pp.363-368
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    • 2007
  • Purpose : It has been reported that deep neck abscesses are recently increasing again. We analyzed pediatric cases with deep neck abscesses during the last several years to contribute to the treatment of the disease. Methods : The clinical data of 30 children under 16 years of age with deep neck abscess from February 2001 to July 2006 were analysed retrospectively. Results : The mean age was 9 years (2-16 years), and the male/female ratio was 19/11. Abscesses in the peritonsillar space were most common (57%), followed by the retropharyngeal (30%) and parapharyngeal (13%) spaces. Upper respiratory infection in 10 cases (33%), dental infection in four case (14%), cervical lymphadenitis in three case (10%) and sinusitis in two case (6%) contributed to the development of deep neck infections. The frequent symptoms were fever in 16 case (53%), sore throat in 15 case (50%), poor oral intake in 10 (33%), odynophagia in eight (27%), and neck pain in eight (27%). Unilateral tonsillar hypertrophy and displacement in 15 case (50%) were most common. Neck mass in 13 patients (43%), neck stiffness in three (10%) and trismus in three (10%) were also found. Bacteria were isolated in 8 among 10 pus cultures; Streptococcus species 7 and Micrococcus luteus 1. All of those bacteria except Micrococcus luteus were sensitive to penicillin G. Surgical intervention was applied to 12 cases (40%), and the remaining 18 patients (60%) were treated with antibiotics only. There were no differences between the two groups in the duration of admission and antibiotic treatment. No complicated cases were observed. Conclusion : Peritonsillar abscesses were most frequent. Upper respiratory infection was the most common predisposing factor, followed by dental infection and sinusitis. Symptoms of respiratory tract obstruction were not found. The most common pathogens were Streptococcus species. Deep neck abscesses in children, if diagnosed at the early stage, possibly can be treated by antibiotics only, without surgical intervention.