• Title/Summary/Keyword: Hospital outpatients

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The Effect of Meridian Tendino-musculature Acupuncture and Release Therapy on acute lumbar Sprain (요부(腰部) 경근(經筋)의 급성(急性) 염좌(捻挫)에 경근자침(經筋刺鍼) 및 경근이완요법(經筋弛緩療法)이 미치는 영향(影響))

  • Song Ho-Sueb;Kang Mi-Jung;Lim Jeong-Eun;Kwon Soon-Jung;Kang Mi-Suk;Lee Seong-No;Byun Im-Jeung;Hwang Hyeon-Seo;Kim Kee-Hyun
    • Journal of Acupuncture Research
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    • v.18 no.6
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    • pp.1-13
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    • 2001
  • Objective : To broaden understanding about relationship between Meridian Tendino-musculature and muscles in a lumbar area and to evaluate the effect of Meridian Tendino-musculature acupuncture and release therapy on acute lumbar sprain. Materials and Methods : From Oct. 1st, 2000 to Mar. 31th, 2001, 692 outpatient's chart of Kyung Won University Hospital were reviewed. Out of them, 39 outpatients were selected. they had low back pain, were diagnosed with acute lumbar sprain, showed only straightened curvature on lateral view of lumbar spine X-ray and get the Tendino-musculature acupuncture and release therapy. Results : 1. On patients' first visit, 72% had GrIII and Gr.IV predominantly. 2. Major muscles related with low back pain were divided into two groups. One was Quadratus lumborum group and the other was Rectus abdominis group. In the correlation with Meridian Tendino-musculature, the former was mainly related with Chok-taeyang(B) and slightly related with Chok-soyang(G), Chok-taeum(SP), the latter was mainly related with Chok-taeyum(SP), Chok-yangmyong(S) and slightly related with Chok-taeyang(B), Chok-soyang(G). 3. In the evaluation of treatment effect, Exellent was 27(69%), Good was 10(6%), Fair was 2(5%) and Bad was 0(0%). Fair rate reached 100% eventually. 4. Most of Gr.Ⅲ, Gr.Ⅳ patients who had severe conditions that almost every R.O.M. was limited and Milgram test positive was shown on the physical examination, were fully recovered and lived normal daily life without admission by Meridian Tendino-musculature acupuncture and release therapy within 3 to 5, 4 to 7 days, respectively, since they had started to get their outpatient treatment. 5. Two patients was troubled with pain induced, by twitching response and acupuncure stimuli, which lasted around acupunctured muscle for about a day after treatment, so they coudn't endure the pain and quitted treatment in spite of Fair condition. conclusion : Meridian Tendino-musculature acupuncture and release therapy was found to be helpful to patients who wish to recover from their back pain induced by acute lumbar sprain as soon as possible, but the treatment actually had some problems to be overcome such as pain during or after the treatment. therefor, in order to make this treatment method more available, we should pay more attention to improving treatment appliance and acupuncture technique.

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The Pain Behavior of Patients with Back Pain (요통환자의 통증행위에 대한 조사연구)

  • 이은옥;임난영;김달숙;김순자;한윤복;김주희;김광주;박점희;이선옥
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.184-194
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    • 1987
  • The purposes of this study were; 1) to gather data relevant to demographic features. major main management practices, and the level of impairment of the activities of daily living (ADL) of patients with back pain, 2) to test the sensitivity of the Korean Pain Rating Scale and the Graphic Rating Scales, and 3) to identify indirect indicators of back pain by analysing pain related-behaviors. The level of pain was measured by Korean Pain Rating Scale(KPRS) and Graphic Rating Scales(GRS) developed by the reserchers. The GRS consists of two dimensions; the pain intensity (sensory) and unpleasantness (affective) measures. Of the 1,650 diagnosed back pain patients, from January 4 through June 30, 1987 by visiting outpatients' clinics of orthopedic and neurosurgical departments at 11 university hospitals in different districts of Korea, 330 men and women patients were self-selected by responding to the mailed questionnaires. The results were summarised as follows: Male exceeded female patients in number and onset of back pain were more prevalent in the age groups of 20s and the 30s. The average duration of suffering from the pain were 11 months, sixty three (19.1%) of the subjects retired from their jobs, one third(36.7%) have teen hospitalized for the treatment of back pain. In two thirds(64.8%) of the cases pain was characterized as lower back pain. The average sleep hour was 6.8 hours per 24 hours and the average rest hour during the day was 3.3 hours. The mean percentage of pain measured by GRS was higher than that of KPRS. The level of sensory intensity as well as the affective level of pain measured by KPRS and GRS were not highly correlated (sensory intensity r=0.4986, affective r=0.5029) which indicated low discriminative power. On the other hand, intercorrelation between sensory and affective dimension measured by KPRS and GRS showed moderate interrelation(r=0.7247; r=0.7899). One-third(32.5%) of the subjects complied with the hospital prescribed treatment while the other one-third(31.5%) depended on self-remedy and traditional practices, and the last one-third did not imply any pain management practices. The following 6 pain-related behaviors such as length of hospitalization, rest hour during day hours, varieties of pain management practice implied, number of pain sites, need for ADL and discomfort accompanied by ADL revealed to be important indicators of back pain. An investigation of sociodemographic features of patients with back pain in a larger context, i.e. with bigger number of respondents is recommended. Tests for construct validity of KPRS, i.e. factor analysis is further recommended.

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The Distribution and Treatment of Outpatients with General Anesthesia in Chonbuk National University Dental Hospital for 9 Years (최근 9년간 전북대학교 치과 병원 외래 전신마취 환자 분포 및 치료)

  • Moon, Yujin;Lee, Daewoo;Kim, Jaegon;Baik, Byeongju;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.158-163
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    • 2015
  • General anesthesia (GA) for dental care in handicapped patients is necessary to facilitate the provision of safe, efficient, and effective quality treatment. The aims of this study were to determine the anesthetic characteristics of handicapped patients in need of dental treatment in these day care units, and to establish for plan to provide better services. 325 patients who had outpatient general anesthesia from January 2005 to March 2014 were assessed for this study. Patients' distribution and treatment patterns were examined. The proportion of male patients (202, 62.2%) was higher than female patients (123, 37.8%) and the largest group of patients were 5 to 10 years old (85, 26.2%). The reasons for general anesthesia included mental and physical disabilities (207, 63.7%), behavior management (84, 25.8%), parent needs (14, 4.3%), and so on. Restorative treatment was the most common procedure with the average of 4.2 teeth treated per one patient and 43 (13.2%) patients underwent general anesthesia for dental treatment more than once. To expand and improve access to the dental care of the disabled, improvement of the health care system, enhancement of their training for dental care by professionals, and enlarging caregivers'understanding of the importance of oral care in the early stages are required.

A Study on Cancer Patients' Quality of Life, Perceived Health Status and Susceptibility.Severity for Cancer Recurrence (암환자의 삶의 질, 지각된 건강상태 및 암재발 인지에 관한 연구)

  • Shin, Im-Sik;Han, Sang-Sook
    • Journal of East-West Nursing Research
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    • v.11 no.2
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    • pp.146-154
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    • 2005
  • Purpose: This study was designed to identify the relationship between quality of life, perceived health status, perceived susceptibility severity to recurrence of cancer and character of object in cancer patients to provide the basic data of effective nursing interventions. Method: The subject of this study was randomly chosen from the patients diagnosed of cancer and being hospitalised or receiving chemotherapy as outpatients, at a Division of Hemato-Oncology, Department of Internal Medicine of a university hospital located in Seoul. The tool used in this study was a measurement tool for quality of life (${\alpha}=.829$), perceived health status (${\alpha}=.903$), and perceived susceptibility and severity for cancer recurrence (${\alpha}=.860$). The collected data were analysed using SPSS PC 12.0 Programme for real number, percentage, average, standard deviation, Pearson's Correlation, t-test and ANOVA, according to the purpose of this study. Result: 1) The score of quality of life in cancer patients was 3.64 point, perceived health status was 2.62 and perceived susceptibility severity to recurrence of cancer was 2.41. 2) There was a significant difference in the quality of life according to general characteristics, such as level of education, occupation, level of activity, pain, medication period, diagnosis, disease stage, purpose of medication, and recurrence. There was a significant difference in perceived health status according to age, level of activity, pain, diagnosis, purpose of medication, and recurrence. There was a significant difference in perceived susceptibility severity to recurrence of cancer according to age, level of education, and pain. 3) The cancer patients' quality of life showed significant correlation with perceived health status, perceived susceptibility severity to recurrence of cancer, pain, job, treatment purpose, relapse. The perceived health status showed significant correlation with perceived susceptibility severity to recurrence of cancer, pain, treatment purpose, relapse. The perceived susceptibility severity to recurrence of cancer showed significant correlation with pain. The relapse showed significant correlation with treatment purpose. The cancer patients' quality of life, perceived health status, and perceived susceptibility and severity for cancer recurrence, as confirmed above, showed differences according to the related factors of each subject, and it was also confirmed that those factors were significantly related with general characteristics. Upon these results, I suggest further studies on the factors that affect the cancer patients' quality of life.

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A Pilot Study of Brief Eye Movement Desensitization and Reprocessing(EMDR) for Treatment of Acute Phase Schizophrenia (급성기 정신분열병의 치료로서 단기적인 안구운동 민감소실 및 재처리요법에 대한 예비연구)

  • Kim, Daeho;Choi, Joonho;Kim, Seok Hyeon;Oh, Dong Hoon;Park, Seon-Cheol;Lee, Sun Hye
    • Korean Journal of Biological Psychiatry
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    • v.17 no.2
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    • pp.94-102
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    • 2010
  • Objectives : Eye movement desensitization and reprocessing(EMDR) is a novel, time-limited psychotherapy originally developed for treatment of psychological trauma. The effectiveness of this therapy has been validated only for posttraumatic stress disorder ; however, EMDR is often applied to other psychiatric illnesses, including other anxiety disorders and depression. This pilot study tested the efficacy of EMDR added to the routine treatment for individuals with acute stage schizophrenia. Methods : This study was conducted in the acute psychiatric care unit of a university-affiliated training hospital. Inpatients diagnosed with schizophrenia were randomly assigned to either three sessions of EMDR, three sessions of progressive muscle relaxation(PMR) therapy, or only treatment as usual(TAU). All the participants received concurrent typical treatments(TAU), including psychotropic medication, individual supportive psychotherapy and group activities in the psychiatric ward. The Positive and Negative Syndrome Scale(PANSS), the Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were administered by a clinical psychologist who was blinded to the patients' group assignment. Results : Forty-five patients enrolled and forty patients(89%) completed the post-treatment evaluation. There were no between-group differences in the withdrawal rates of patients during the treatment or at the three-month follow-up session. All three groups improved significantly across each of the symptomatic domains including schizophrenia, anxiety, and depressive symptoms. However, a repeated measures ANOVA revealed no significant differences among the groups over time. Effect size for change in total PANSS scores was also similar across treatment conditions, but effect size for negative symptoms was large for EMDR(0.60 for EMDR, 0.39 for PMR and 0.21 for TAU only). Conclusion : These findings supported the use of EMDR in treating the acute stage of schizophrenia but the results failed to confirm the effectiveness of the treatment over the two control conditions in three sessions. Further studies with longer courses of treatment, more focused target dimensions of treatment, and a sample of outpatients are necessary.

A Comparison of Lovastatin and Simvastatin in Treatment of Hyperlipidemia (Lovastatin과 Simvastatin의 고지혈증 치료 비교)

  • Cho, Jeong Ju;Lee, Suk Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.12 no.1
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    • pp.39-50
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    • 2002
  • Hypercholesterolemia is one of main causes of coronary heart disease(CHD). Clinical trials demonstrated that lowering serum cholesterol levels would reduce incidence of new cardiovascular events and mortality by primary or secondary preventions. The objective of this retrospective study was to compare efficacy and side effects of lovartatin and simvastatin in treatement of hypercholesterolemia. In Boramae Hospital, patients were included when they have taken lovastatin 20 mg or simvastatin 10 mg for 52 weeks with laboratory monitoring for cholesterol at baseline, 3, 6 and 12 month period. As results, total 128 outpatients were included with their total cholesterol level <240 mg/dl and triglyceride level <400 mg/dl at baseline. Total cholesterol and LDL cholesterol of lovastatin group (n=60) and simvastatin group (n=68) were significantly reduced from baseline (p=0.001). Lovastatin maximally reduced total cholesterol by $23.9\%,\;triglyceride\;by\;12.3\%$, LDL cholesterol by $36.1\;\%$ and increased HDL cholerterol by $7.8\%$ and simvastatin reduced by $24.1\%,\;20.5\%,\;34.3\%\;respectively$ and HDL increased by $11.2\%$. There were no significant differences between lovastatin and simvastatin in mean percent change of lipid levels at 12, 24 and 52 weeks from baseline. Cumulative percentage of patients reaching the target LDL cholesterol concentration by 24 weeks was $61.7\%$ in lovastatin and $64.7\%$ in simvastatin. Average time to reach the target LDL goal was 100.1 days in lovastatin and 99.8 days in simvastatin. Both lovastatin and simvastatin also significantly reduced total cholesterol and LDL cholesterol in all subgroups (diabetes mellitus, hypertension, and coronary heart disease). In this study, treatment efficacy in patients with coronary heart disease was lower than other patients. Considering clinical importance of secondary prevention, more intensive treatment is necessary to decrease LDL cholesterol level of 100 mg/dl or lower in patients with coronary heart disease or other clinical atherosclerotic disease. There were no serious side effects during the study period. Digestive side effects were most frequently reported (lovastatin $8.3\%\;vs\;simvastatin\;8.8\%$). In conclusion, both lovastatin and simvastatin were similar in lipid lowering effects and there was no difference in incidence of side effects.

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The Relationships between Self-care Knowledge and Compliance of Ischemic Stroke Patients with Diabetics (당뇨병을 가진 허혈성 뇌졸중 환자의 자가간호 지식과 이행 간의 관계)

  • Park, Ha-Na;Kim, Myung-Hee;Park, Jung-Ha
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7513-7523
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    • 2015
  • The purpose of this study was to investigate relationships between self-care knowledge and compliance of ischemic stroke patients with diabetic. The participants were 117 ischemic stroke patients with diabetics who were outpatients at the P university hospital. Data were collected from July 1 to August 31, 2013. Data were analyzed using SPSS 18.0., specifically descriptive statistics, t-test, ANOVA, and Pearson's correlation analysis. Total mean score and correct answer ratio of self-care knowledge were 14.69 points, 63.9%. Total mean score and compliance ratio of self-care compliance were 2.24 points, 44.8%. The correlation coefficient between self-care knowledge and compliance was a significant positive correlation (r=.54, p<.001). Among sub-elements, diet(r=.24, p=.011), medication(r=.43, p<.001), living habits(r=.19, p=.042) and cautions and warnings(r=.45, p<.001) were significant positive correlations. Based on the results of this study, we need to develop integrated nursing intervention education programs for self-care knowledge and compliance promotion of ischemic stroke patients with diabetic.

A Preliminary Study on Method for Evaluation and Diagnosis of Late Luteal Phase Dysphoric Disorder in Women - Focusing on Psychiatric Outpatients - (후기 황체기 불쾌기분 장애의 평가 방법 및 진단에 관한 예비 연구 - 정신과 외래환자를 대상으로 -)

  • Yi, Sang-Kyu;Joe, Sook-Haeng;Kwak, Dong-Il
    • Korean Journal of Psychosomatic Medicine
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    • v.3 no.2
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    • pp.115-125
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    • 1995
  • Reports about the prevalence of premenstrual symptoms state that occurs in 20 to 100% of most reproductive-age women. There is a close association between premenstrual syndrome and affective disorders as well as same some other psychiatric disorders. Late luteal phase dysphoric disorder (LLPDD) is a premenstrual condition defined in DSM-III-R by severe mood changes and other symptoms that repeatedly occur only in the luteal phase of the menstrual cycle. However, DSM-III-R does not specify how to compute the change from the follicular to the luteal phase or how to determine when the amount of change is great enough to warrant the diagnosis nor how to determine occupational or social functional impairment. This study was conducted to evaluate the nature, severity and magnitude of premenstrual syndrome in women with current psychiatric disorders by using prospective Daily Rating Form(DRF), and to measure symptom changes according to three scoring methods for diagnosing LLPDD. Our study obtains the data about premenstrual changes estimated by DRF from 22 women with psychiatric disorders who had met criteria for major depressive syndrome on the Premenstrual Assessment Form (PAF). The data was scored by each three methods and was determined to meet criteria A for LLPDD. The results are as follows: 1) the subjects, when scored according to the percent change method, effect size method and absolute severity method, met the DSM-III-R criteria A for LLPDD in 36.4% (8 subjects), 14% (3 subjects) and 4.5% (1 subject) of the cases respectively. 2) The items of irritability, anger and impatience were occurred most frequently on the DRF, when it was scored according to the three scoring methods. And the item of breast pain was next frequent according to the effect size method and the percent change method but according to the absolute severity method. 3) The PAF item of impaired social functioning was reported by 16 (73%) of the subjects. 4) 4 (18%) of the subjects met criteria A for LLPDD and reported impaired social functioning. The prevalency of LLPDD according to each method varied. The percent change method yielded the greatest (36.4%), and the absolute seventy method yielded the laest (4.5%), The effect size method yielded an intermediate frequency (14%). Therefore, for maximizing the diagnostic accuracy of LLPDD, a diagnostic procedure including a measure of change (e.q., effect size method, percent change method) as well as confirmed diagnosis by DRF, will be needed. Also, an accurate tool to evaluate impaired social functioning will be required.

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Korean Herbal Medicine on Liver Function : A Systematic Review in Korean Literature (한약 복용이 간기능에 미치는 영향 : 국내 문헌에 대한 체계적 고찰)

  • Yun, Young-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Cho, Sung-Il;Shin, Woo-Jin;Park, Hi-Joon;Lee, Hye-Jung
    • The Journal of Internal Korean Medicine
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    • v.30 no.1
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    • pp.153-172
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    • 2009
  • Background : The safety of Korean herbal Medicine (KHM: prescribed herbal medicine by doctors of traditional Korean medicine) is an important issue in Korea. Although both fields. western medicine and traditional Korean medicine. have been studied on the safety of herbs and KHM, their results were not concordance with each other. Objectives : This study aims to review the influence of KHM on liver function in Korean literature systematically. Additionally, we tried to estimate the change of data of liver function test (LFT) and the incidence of liver injury (LI) after the use of KHM. Methods : Systematic literature searches were performed on 4 major databases of Korea from their inception to May 2008. Screening and selection of the studies and the extraction of data were performed independently by two authors. There were no restrictions on the types of publication including grey literatures. Results : Forty studies were included. Only sixteen studies were performed prospectively and fifteen studies collected data from outpatients. Only 8 studies reported the occurrence of LI after the use of KHM. Nineteen cases of LI showed no or mild symptoms and the elevation of LFT was not high. All of LI patients used conventional western drug and KHM concomitantly. and causality of LI was not assessed properly. The incidence of LI related to the use of KHM was estimated as 0.59%-0.76% from all data of these studies. The conflicting results were shown on the change of alanine aminotransferase (ALT) and total bilirubin (TB) after the use of KHM. Conclusions : KHM might be a minor cause of LI in Korea. However the results are not strongly supported as enough to make the safety issue clear because of the limitations of original studies. More rigorous studies are required for answering the safety issue of KHM with the cooperative investigation of both fields of Korean traditional medicine and western medicine.

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Usefulness of Clinical Scoring System in the Diagnosis of Group A Streptococcal Pharyngitis (인두염 환아에서 A군 연구균 검출의 임상적 점수제의 유용성)

  • Kim, Eun-Seong;Jung, Ji-Young;Cha, Sung-Ho;Lee, Hee-Joo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.74-78
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    • 2002
  • Purpose : Proper diagnosis of group A streptococcal pharyngitis that may cause chronic diseases in childhood is not easy because its signs and symptoms would be nonspecific. Because results of classical throat culture delays for one to two days, we'd like to determine whether early antibiotics would be introduced with according to the clinical score system. This study was undertaken to evaluate of clinical usefulness of scoring system based on the clinical and laboratory findings. Methods : From Jan. 1998 to Dec. 2000, 10 clinical items based on modified 9 items by Breese in 1977 were checked in patients with pharyngitis who visited on outpatients clinic of pediatrics, Kyunghee University Hospital. We compared the results of throat culture with the points of clinical score system. Results : Out of 45 cases, the positive culture for Group A Streptococcus was 20 and negative culture was 25. When we applied more than 30 points of score, which correspond to 70 percentile of study population, the sensitivity and specificity were 35.0% and 96.0%, respectively. Conclusion : Although sensitivity was relatively low this scoring system, but the high specificity may be useful diagnostic tool in the areas where the rate of isolation of Group A Streptococcus is low.

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