• Title/Summary/Keyword: Outpatient clinic

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A Case of Microscopic Polyangiitis Initially Suspected with Henoch-Sch$\ddot{o}$nlein Purpura Nephritis (Henoch-Sch$\ddot{o}$nlein 자반병 신염으로 의심했던 현미경적 다발혈관염 1례)

  • Im, Jong Geun;Moon, Kyung Chul;Koo, Ja Wook
    • Childhood Kidney Diseases
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    • v.16 no.2
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    • pp.132-137
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    • 2012
  • Microscopic polyangiitis (MPA) is systemic small vessel vasculitis that is very rare in childhood. MPA is characterized by pauci-immune necrotizing small vessel vasculitis without clinical or pathological evidence of necrotizing granulomatous inflammation. Approximately 90% of patients have glomerulonephritis that is accompanied by a variety of other organ involvement. A 10-year-old girl visited our clinic with clinical manifestations suggestive Henoch-Sch$\ddot{o}$nlein purpura nephritis such as purpuric skin rash, abdominal pain, arthralgia on both knees, massive proteinuria and microscopic hematuria. So initially we suspected Henoch-Sch$\ddot{o}$nlein purpura nephritis. However, later her perinuclear-antineutrophil cytoplasmic antibodies(p-ANCA) test was positive, and her renal biopsy was consistent with microscopic polyangiitis. We began steroid therapy, combined with cyclophosphamide, ACE inhibitor. Currently she is a 12-year old, and until now she has been regularly examined in the outpatient. We report a case of microscopic polyangiitis initially suspected with Henoch-Sch$\ddot{o}$nlein purpura nephritis.

A Clinical Study of Treatment with Scalp Acupuncture for Learning Disorders (학습장애 아동의 두침 병행 치료 효과에 대한 임상적 연구)

  • Lee, Yu-Jin;Yoo, Song-Wun;Lee, Su-Bin;Ko, In-Sung;Park, Se-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.2
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    • pp.145-154
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    • 2013
  • Objectives : The purpose of this study is to examine the effects of treatment with scalp acupunctures for children with learning disorders. Methods : For this study, we evaluated Korea standard progressive matrices test (K-SPM) on 24 children with learning disorders who visited Korean medical center neuropsychiatry outpatient clinic from July 2012 to January 2013. Scalp acupuncture, cognitive enhancement therapy and speech-language therapy were applied. All children were treated 2 times a week for 4 months and we compared K-SPM test scores before treatment and 30 times after the treatment. Results : 1) After the treatment, K-SPM test scores have increased significantly (p<0.05) and the number of children in grade 5 (<5%) have decreased from 14 to 6. 2) Comparing K-SPM test scores between two groups: one with medical history and the other without medical history, the scores in both groups have increased significantly (p<0.05). 3) We also divided the children into two groups according to age: under the age of 13 and over the age of 13, and compared K-SPM test scores. Although the scores in both groups have increased respectively, it is the scores of the former group (under the age of 13) that have increased significantly (p<0.05). Conclusions : The treatments with scalp acupunctures were shown to be an effective intervention when improving K-SPM test scores of children with learning disorders.

Behavior Patterns of Health Care Utilization in Terminal Cancer Patients (말기암 환자들의 의료이용행태)

  • Han, Tae-Hyung;Cho, Byung-Jin;Shin, Baek-Hyo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.101-107
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    • 1999
  • Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.

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Angiomyoma on Face : A Case Report (안면부에 발생한 혈관근종의 치험례 : 증례보고)

  • Choi, Junho;Chang, Hak
    • Korean Journal of Head & Neck Oncology
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    • v.29 no.2
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    • pp.48-50
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    • 2013
  • Angiomyoma is a rare, benign smooth muscle cell tumor. These tumors may be found anywhere in the body. They frequently occur in the lower extremities except venous type. Angiomyoma in the head and neck area is very rare, and only a few cases have been reported. A 63 year-old male patient visited to outpatient clinic due to size-growing nodule-like lesion in the Lt. alar area. Excisional biopsy was done for diagnosis. The lesion was totally excised with 2 mm safety margin. Frozen biopsy of the lesion was requested, and all resection margins were proved negative. To cover the raw surface, full thickness skin grafting was performed. The graft was harvested from Rt. posterior auricular area. Tie over dressing was applyed on Lt. alar area. The graft was well taken and healed without any complication in both short term and long term follow up periods of 2 weeks, 1 month, 2 months, and 6 months. Donor site completed healed without any complications. The leiomyoma is benign tumor originated from smooth muscle, and it can be classified into solid leiomyoma, angiomyoma, and epithelioid leiomyoma. Especially, the angiomyoma consists of smooth muscle cell and blood vessel, and it is originated from the tunica media of blood vessel. Angiomyoma alone frequently occurs in the lower extremities as solitary painless subcutaneous tumor. Venous type of angiomyoma in the oral cavity was reported in other references, but on the facial surface it may be the first case reported as paper. So this report can be very meaningful.

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.

Effects of Hospital-based Home Care for the Patients with Arthritis (재가 관절염 환자에 대한 가정 간호의 효과)

  • Lim, N.Y.;Kim, S.Y.;Lee, E.O.;Lee, I.S.
    • Journal of muscle and joint health
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    • v.2 no.2
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    • pp.185-196
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    • 1995
  • The purposes of this study are to identify effectiveness of the hospital-based home care project, to manage patients' problems in comprehensive way, to decrease the patients' economical burden to the arthritis patients. The design is nonequivalent control group pretest-posttest design with matched samples in terms of age, sex and disease severity. Fifty two patients were assigned in each of the experimental and control groups in Seoul, Kyunggi, Kangwon and Kwangju. Before the experiment and after 3-month period of experiment of home care, level of pain, duration of morning stiffness, Richie Index, ADL, self-efficacy and depression were measured. Nine patients were excluded from the control group because of denial of participation. Contents of home care provided to the experimental group include distribution of prescribed drugs, assessment of patient's condition and side-reactions of drug, pain control, depression control, nutrition guide, exercise teaching, and family counselling. Patients assigned to the control group visited the outpatient clinic once a month as usual. Null hypotheses were selected because physicians concerned about the ineffective change of patients' conditions due to indirect communication with patients through nurses. Level of pain, Richie Index, ADL, self-efficacy, depression and duration of morning stiffness did not significantly different between two groups as expected. In the experimental group, level of pain, ADL, Richie Index and duration of morning stiffness changed to the positive direction from the pretest to the posttest. However, level of depression and self-efficacy did not show any changes. Ninety percent of patients in the experimental group satisfied with the home care provided to them. Since this is the intermediate report, more detailed and long-term report will be prepared.

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Effects of Tai Chi Self-help Program on Glucose Control, Cardiovascular Risks, and Quality of Life in Type II Diabetic Patients (제 2유형 당뇨환자를 위한 타이치 자조프로그램이 혈당조절, 심혈관 위험효소, 삶의 질에 미치는 효과)

  • Song, Rha-Yun;Lee, Eun-Ok;Bae, Sang-Cheol;Ahn, You-Hern;Lam, Paul;Lee, In-Ok
    • Journal of muscle and joint health
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    • v.14 no.1
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    • pp.13-25
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    • 2007
  • Purpose: The purpose of the study was to identify the effects of Tai Chi self-help program on glucose control, cardiovascular risks, and quality of life in patients with type II diabetes. Method: The study subjects were 95 adults with type II diabetes recruited from five primary health centers and one outpatient clinic. The Tai chi self-help program was provided twice a week for 6 months. Outcome measures included blood glucose(HbA1c), cardiovascular risk checklist, and quality of life(SF36). Result: At the completion of 6-month program, HbA1c for Tai Chi group dropped from 6.79 to 6.59 without significant group differences. However, cardiovascular risk scores for Tai Chi group has been significantly reduced compared to the control group. In 6 months, quality of life (SF36) was significantly better for Tai Chi group especially in the areas of physical and social functioning. Conclusion: Tai Chi self-help program applied for type 2 diabetes patients has been partially effective to control cardiovascular risk factors, and some dimensions of quality of life. Tai Chi self-help program can be safely and easily applicable to primary care centers for diabetic patients and other people with chronic disease for their symptom management, and health promotion.

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Correlation between lumbar spinal stenosis and bone mineral density : a clinical survey of 9 cases (요추관 협착증과 골밀도와의 상관성에 관한 임상례 보고)

  • Song, Joo-Hyun;Kang, In;Im, Myung-Jang;Kim, Ha-Neul;Lee, Je-Kyun;Jang, Hyoung-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.1 no.1
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    • pp.105-111
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    • 2006
  • Objective : The aim of this study was to evaluate association between lumbar spinal stenosis, one of degenerative diseases, and bone mineral density. Methods : We monitored 9 lumbar spinal stenosis patients in women above 50 years, visiting outpatient clinic of the Jaseng Oriental Medicine Hospital between January 5 2006 and March 31, 2006. They were diagnosed by radiologist ist after taking Magnetic Resonance Imaging(MRI). The cases were Investigated the bone mineral density using Dual Energy X-ray Absorptiomerty(DEXA). and then Picture Archiving Communication System(PACS) were used to assess correlation between lumbar spinal stenosis and bone mineral density. Results : 1. In comparison of the spinal canal area and lumbar spine 2 level bone mineral density, the data showed a significant result 2. The data, between spinal canal area and lumbar spine 1-2 level bone mineral density, indicated a significant result. 3. Also, the result of comparison between spinal canal area and the lowest value of bone mineral density showed significance. Conclusions : It showed that there is a statistically significant correlation between lumbar spinal stenosis and bone mineral density.

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The Effect of Oral Environment and Self-care Behavior on Oral Health-related Quality of Life in the Elderly with Diabetes (당뇨병노인의 구강환경과 자가간호행위가 구강건강관련 삶의 질에 미치는 영향)

  • Sung, Kiwol
    • Journal of Korean Biological Nursing Science
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    • v.22 no.3
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    • pp.192-203
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    • 2020
  • Purpose: The purpose of this study was to identify the influencing factors of oral environment and self-care behavior on the oral health-related quality of life in the elderly with diabetes. Methods: The participants were 110 elderly patients with diabetes and follow-up care on their outpatient clinic in D and G city. Data were collected September-December 2018, using questionnaires of the Oral Health Impact Profile (OHIP-49) and Kim's Self-care Behavior, measuring with the tooth-pick (Premiers Dental), Halitosis Checker (HC-212M), and Moisture Checker for Mucus (MCM) for oral environments. The data were analyzed the by independent t-test, oneway ANOVA, Pearson's correlation, and stepwise multiple regression analysis using an IBM SPSS Statistics 25.0 Program. Results: There was positive correlation between oral health-related quality of life and self-care behavior (r= .61, p< .001), negative correlations among halitosis (r = -.34, p< .001), gingival index (r = -.31, p= .001) and plaque index (r = -.32, p= .001). Self-care behavior (β= .46, p< .001), subjective health status (good) (β= .23, p= .002), halitosis (β= -.16, p= .030), and plaque index (β= -.15, p= .041) explained 46.0% of the variance in the oral health-related quality of life. Conclusion: It is necessary to develop nursing care for elderly patients with diabetes that can enhance the self-care behavior and subjective health status, and lower halitosis and plaque index, the factors influencing the oral health-related quality of life in elderly patients with diabetes.

The Development of Multidisciplinary Cancer Patient Education·Counseling Questionnaire and Satisfaction Survey (다직종 암환자 교육·상담에 대한 설문 개발과 환자 만족도 조사)

  • Lee, Min Jeong;Geum, Min Jung;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun;Lee, Sang Geul;Song, Su Kyung;Choi, Hye Jin
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.138-145
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    • 2018
  • Background: Presently, a multidisciplinary team of doctors, pharmacists, nurses, and dietitians provides patient education to impart information on chemotherapy. However, studies on multidisciplinary education satisfaction are inadequate. In this study, we aimed to contribute to the improvement of quality of multidisciplinary education counseling for patients with cancer by developing a satisfaction questionnaire and analyzing the satisfaction survey. Methods: A questionnaire was developed by an expert group, and the responses were recorded using the 5-point Likert scale. After conducting a pre-test, factor analysis was performed to evaluate validity. The reliability of the questionnaire was measured by Cronbach's alpha coefficient. A satisfaction survey was conducted by self-administration method. Results: Based on the results of factor analysis, factors can be divided into two parts: "overall education" and "each team member's education" (total 14 questions). The construct validity and reliability of the questionnaire are sufficiently high. Fifty-one patients took the survey between January 2, 2018 and January 20, 2018. Twenty-six (51%) patients responded that they were "very satisfied" and 22 (43.1%) patients responded that they were "satisfied". Conclusion: By developing a questionnaire on multidisciplinary education counseling for patients with cancer, it is possible to perform evaluation and research of cancer patient education. This study will contribute to the management and improvement of quality of multidisciplinary education.