• 제목/요약/키워드: Outpatient clinic

검색결과 453건 처리시간 0.025초

Diphyllobothrium nihonkaiense Infections in a Family

  • Go, Young Bin;Lee, Eun Hye;Cho, Jaeeun;Choi, Seoyun;Chai, Jong-Yil
    • Parasites, Hosts and Diseases
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    • 제53권1호
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    • pp.109-112
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    • 2015
  • Diphyllobothrium latum and Diphyllobothrium nihonkaiense are morphologically similar to each other, and only genetic method can differentiate clearly between the 2 species. A strobila of diphyllobothriid tapeworm discharged from a 7-year-old boy was analyzed to identify the species by mitochondrial cytochrome c oxidase subunit 1 (cox1) gene sequencing. He and his family (total 4 persons) ate slices of 3 kinds of raw fish 16 days before visiting our outpatient clinic. All family members complained of abdominal pain and watery diarrhea. They all expelled tapeworm strobilae in their stools. They were treated with a single oral dose of praziquantel and then complained of no more symptoms. The cox1 gene sequencing of the strobila from the boy revealed 99.9% (687/688 bp) similarity with D. nihonkaiense and only 93.2% (641/688 bp) similarity with D. latum. Thus, we assigned this tapeworm as D. nihonkaiense. This is the first report of D. nihonkaiense infection in a family in Korea, and this report includes the 8th pediatric case in Korea. The current report is meaningful because D. nihonkaiense infection within a family is rare.

Traumatic Coronary Artery Dissection in a Young Woman after a Kick to Her Back

  • Ipek, Emrah;Ermis, Emrah;Demirelli, Selami;Yildirim, Erkan;Yolcu, Mustafa;Sahin, Bingul Dilekci
    • Journal of Chest Surgery
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    • 제48권4호
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    • pp.281-284
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    • 2015
  • We present the case of a 38-year-old woman admitted to our outpatient clinic with accelerating back pain and fatigue following a kick to her back by her husband. Upon arrival, we detected ST segment elevation in the D1, aVL, and V2 leads and accelerated idioventricular rhythm. She had pallor and hypotension consistent with cardiogenic shock. We immediately performed coronary angiography and found a long dissection starting from the mid-left main coronary artery and progressing into the mid-left anterior descending (LAD) and circumflex arteries. She was then transferred to the operating room for surgery. A saphenous vein was grafted to the distal LAD. Since the patient was hypotensive under noradrenaline and dopamine infusions, she was transferred to the cardiovascular surgery intensive care unit on an extracorporeal membrane oxygenator and intra-aortic balloon pump. During follow-up, her blood pressure remained low, at approximately 60/40 mmHg, despite aggressive inotropic and mechanical support. On the second postoperative day, asystole and cardiovascular arrest quickly developed, and despite aggressive cardiopulmonary resuscitation, she died.

폐나 흉막 병변을 보이지 않는 단독으로 종격동에 발생한 폐흡충증 (Isolated and Ectopic Mediastinal Paragonimiasis without Any Pulmonary or Pleural Lesion)

  • 나용준;안효영;김윤성;최경운
    • Journal of Chest Surgery
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    • 제43권5호
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    • pp.553-556
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    • 2010
  • 55세 여자환자가 좌측 목과 어깨 통증을 주소로 내원하였다. 흉부 전산화 단층촬영상에서 전종격동 종양이 발견되었으며, 폐 혹은 흉강 내에 다른 병변은 보이지 않았다. 감염성 심막 낭종 의심하에 흉강경을 이용하여 종괴 적출술을 시행하였다. 환자는 술 후 2일째에 좌측 횡격막 마비를 제외하고는 특별한 문제 없이 퇴원하였다. 수술 후 병리 소견에서 폐흡충증로 진단 후 프라지퀀탈(praziquantel)을 투여하였고, 이후 특별한 문제 없이 외래 경과관찰 중이다.

성대결절 환자에 대한 10년간 임상 경험 (Ten years of clinical experience with the patients with vocal nodule)

  • 임혜진;김정규;최철희;최성희
    • 말소리와 음성과학
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    • 제9권4호
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    • pp.99-106
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    • 2017
  • Clinical data about vocal nodules have seldom been reported, even though vocal nodules are commonly diagnosed in outpatient speech and voice clinic. This study aims to investigate clinical characteristics of the patients who are diagnosed with vocal nodules. This study analyzed the data for 10 years from the 319 patients diagnosed with vocal nodules (45 males and 274 females with the mean age of 39.4 ranging from 2 to 83) in terms of gender, age, occupation, voice change initiation pattern, change with time, throat clearing, smoking history, type of voice abuse, acoustic analysis, maximum phonation time, GRBAS, and VHI. Thirteen patients (4.08%) had unilateral vocal nodule and 306 patients (95.9%) had bilateral vocal nodule, the majority of which had a pattern of asymmetry (73.9%). The glottal closure pattern was hourglass in 72.1% of patients, posterior chink in 17.9% of patients, and irregular in 7.9% of patients. The most common occupational category was professional voice users (43.4%). The voice abuse pattern included excessive talking in 96 patients (76.8%), loud voice in 78 (62.4%) patients, and excessive singing in 17 patients (21.6%). The patients showed worse scores in G, B, and S than in R and A for the GRBAS evaluation. The most recommended treatment for vocal nodules was voice therapy. The current clinical data will be helpful for treatment planning for the patients of vocal nodule.

제 2형 당뇨환자에서 지질이상 유형 및 관리 (Pattern and Management of Dyslipidemia in Type 2 Diabetes Patients in Korea)

  • 정경주;최승기
    • 한국임상약학회지
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    • 제16권1호
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    • pp.46-51
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    • 2006
  • Dyslipidemia is an important CHD risk factor in diabetic patients. We conducted this study to assess the pattern of dyslipidemia in type 2 diabetes patients, to examine the demographic and clinical factors associated with dyslipidemia and to evaluate attaining within the lipid target goals and treatment strategies. A retrospective analysis was conducted among patents diagnosed type 2 diabetes at outpatient clinic in endocrinology between January 2003 and December 2004. Clinical history and physical examination were reviewed and laboratory data including blood glucose, HbAlc, lipid levels were recorded sequentially at least 1 year. In 882 patients with type 2 diabetes, 437 patients (49.6%) have dyslipidemia and 73% of them (319 patients) received lipid-lowering agents. 244 patients (94 males, 150 females, mean age 60 years old) were susceptible to analyses. The most frequent pattern of dyslipidemia is high LDL level and high TG levels (28%). Metabolic syndrome and macrovascular complication were significant negative independent association with lipid levels within the target goals (p<0.05). Only 15.2% (19 males, 18 females) attained within the lipid tar- get goals. Patients with diabetic dyslipidemia need maximization of lipid-lowering agents, increasing the fibric acid derivatives prescription and the effort to correction of low HDL and/or high TG.

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치과기공사의 직업병인식에 영향을 미치는 요인분석 (A analysis of Factors Influencing Dental Technicians Recognition Level of Their Occupational Disease)

  • 이희경
    • 대한치과기공학회지
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    • 제15권1호
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    • pp.43-61
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    • 1993
  • This study was conducted to determine factors influencing dental technicians recognition level of their occupational disease. After self-administered questionnaire were distributed by mail to 540 technicians clustered samplely semplely selected from dental laboratories resistered in seoul and pusan Korean Dental Laboratory Association 395 technicians responded from march 29 through April 27, 1993. The results are as follows. 1. The recognition level of an occupational disease of the total 395 respondents by sex is higher among male than female. The difference was found to be meaningful(p <.05). 2. When the recognition level of an occupational disease being tested with 45 as the highest point possible, the average point 31.41 $\pm$ 6.50 of the total respondents reflected a high level of recognition. The highly recognized items were stress, bronchial disease, hearing loss. 3. With the highest points in Wallston and Wallstons' health locus of control in personality being 54, the average points of the dental technicians in the study was 35.41 $\pm$ 4.93. 4. As for the medical care patterns, the rate was higher among local medical insurance 64.4% than none 16.8%, company medical isurance 9.2%, medical aide 6.7%, others 2.6%. As for the experience of utilization of outpatient servelies, Yes was 40.4% and 59.6%, showing a meaningful difference(t=.80, p<.05).01) accounted total variance of the factors influencing dental technicians recognition level of their occupational disease(p<.0.000), R-squaire is 0.08.

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암환자가 지각한 원인지각 차원별 동질집단 분석 (Clusters Analysis According to Causal Attribution in Patients with Cancer)

  • 류은정;최소영;최경숙
    • 종양간호연구
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    • 제3권1호
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    • pp.66-74
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    • 2003
  • Purpose: This study is designed to identify clusters according to the causal attribution that people make about the cancer and to determine influences of coping behavior and depression as output of causal attribution. Method: The subjects were 192 patients who had been diagnosed cancer one year ago and attended an outpatient clinic. For cancer patients to be classified homogenious groups according to causal attribution, cluster analysis of subjects' ratings on the Causal Dimension Scale was been made. Results: Cluster 1(n=71) had patients with having external, stable and uncontrollable attribution. Cluster 2(n =70) had patients with having unstable and external controllable attribution regarding cause of cancer. They were not important whether cause of cancer was self or other. Cluster 3(n=51) had patients with having internal, unstable and internal controllable attribution. Coping behaviors between cluster 1 and 3 were significant difference. However, depression was not significant difference among clusters. Conclusion: Based upon these results, it is recommended that the developing training program to be changed to the more positive attribution is necessary.

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Acute Urinary Retention in a 47-month-old Girl Caused by the Giant Fecaloma

  • Park, Ji Sook;Park, Tae-Jin;Hwa, Jung Seok;Seo, Ji-Hyun;Park, Chan-Hoo;Youn, Hee-Shang
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권3호
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    • pp.200-205
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    • 2013
  • We present a case of a 47-month-old female suffering from acute urinary bladder neck obstruction and bilateral hydronephrosis secondary to a fecaloma. Fecaloma is defined as an accumulation of inspissated feces in the colon or rectum giving the appearance of an abdominal mass. A fecaloma can be developed by diverse causes and the causes of the fecaloma in this case were septum reformation after the Duhamel procedure and long-term constipation. Chronic constipation is very common at outpatient clinic. However, acute urinary retention and voiding difficulty caused by fecaloma in the giant Duhamel pouch has never been reported in Korea. We would like to present our case with acute urinary retention due to a fecaloma and suggest that fecaloma might be considered as one of the causes for acute urinary retention, especially in cases with previous Duhamel operation for repair of Hischsprung disease.

마음챙김 기공이 소아청소년의 주의집중력에 미치는 영향 (Effects of mindfulness-based qigong for children's concentration ability)

  • 홍순상;조성훈
    • 동의신경정신과학회지
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    • 제23권2호
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    • pp.49-58
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    • 2012
  • Objectives : The purpose of this study is to examine the effects of Mindfulness-based concentration qigong for children (MBCQ-C) in healthy children with subjective poor attention. Methods : This study examined the effects of MBCQ-C on healthy children with subjective poor attention, who vistied Korean medicine hospital neuropsychiatry outpatient clinic. The MBCQ-C was practiced with 11 participants, 2 of them quit in the middle of the program, and hence, they were excluded for data analysis. MBCQ-C consisted of 8 sessions, and each session took about 60 minutes. The outcome measurement was Frankfurter Aufmerksamkeits-Inventar (FAIR), which measured selective attention, self-control and sustained attention. Results : The results of this study showed that selective attention, and sustained attention were significantly improved. Self-control also improved, but without any statistical significance. These results indicate MBCQ-C was effective for the improvement of attention abilities, but self-control, including upper cognition area needs more consistent exercise. Conclusions : The MBCQ-C consisting of 8 sessions were shown to be an effective intervention in improving the attention abilities of healthy children with subjective poor attention.

의과대학 임상실습에서의 학생평가방법: 과거, 현재 및 제언 (Assessment of Medical Students in Clinical Clerkships)

  • 이상엽;임선주;윤소정;백선용;우재석
    • 의학교육논단
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    • 제15권3호
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    • pp.120-124
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    • 2013
  • The clinical clerkship focuses students on developing their ability to perform comprehensive diagnosis and management of patients with common undifferentiated problems by the integration of knowledge and clinical reasoning. Therefore, the clerkship evaluation system should assess their actual problem solving and professional behavior. However, concern remains that clerkship evaluations are imprecise and highly variable. This review is designed to provide faculty members with concepts, options, and a methodology to actively teach and evaluate the clinical clerkship, as well as offer encouragement and inspiration to medical students. We reviewed past and current clinical clerkship evaluations and discuss several tips to improve clinical excellence such as continuity, transparency of the evaluation process, a faculty development program, practical examination of clinical skills, implementation of a checklist for recording exposure and skills, providing prompt and constructive feedback to students, self-evaluation of professional performance, varying multi-faceted assessment combinations, being outpatient clinic-centered, and having dedicated faculty members who give students one-on-one contact with a preceptor.