• 제목/요약/키워드: Outpatient clinic

검색결과 452건 처리시간 0.023초

매독진단(梅毒診斷)을 위(爲)한 신속(迅速)한 혈장항체검사법(血漿抗體檢査法)에 관(關)한 연구(硏究) (Studies on the Rapid Plasma Reagin(RPR) Card Test for the Diagnosis of Syphilis)

  • 김주덕;유준;김현주
    • 대한미생물학회지
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    • 제3권1호
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    • pp.15-23
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    • 1968
  • For the effective control of Syphilis, many investigators have developed a more rapid, simple and economical screening serological test which is adequately sensitive and specific. To fulfill the requirements of a more rapid serologic test for syphlis, a substitute for the conventional serum specimen was needed since considerable time and labor are involved in the processing of blood to serum. Burdon suggested the use of plasma in the serologic tests for syphilis as a substitute for serum. He noticed that plasma was more sensitive than serum in the Kline and Kahn tests, and attributed this to the presence of more antibody-like substance, "reagin" in plasma than in serum. However, to make plasma sufficiently sensitive, it was necessary to inactivate plasma by heating at a temperature of $56^{\circ}C$ for about 30 minutes. Heating of plasma resulted in the precipitation of fibrinogen which made centrifugation necessary to obtain dear plasma. Since the chief disadvantage to the use of unheated plasma(or serum) was a reduction in sensitivity of results-which probably was due to a labile factor such as complement-Portnoy et al began to consider rapid chemical methods of inactivation of plasma(or serum). They experienced that choline chloirde was shown to be anticomplementary which suggested its use as an inactivating agent for unheated plasma(or serum). In 1959 Portnoy et al reported the Rapid Plasma Reagin(RPR) Test for syphilis which is a more rapid, economical and simple. But still this test has many disadvantages as a rapid performing, field and office procedure, because it requires the usual laboratory equipments such as centrifuge, rotating machine, microscope etc. To substitute these disadvantages of the RPR test, in 1962, Portnoy et al developed the Rapid Plasma Reagin(RPR) card test for syphilis, which has the following advantages: a) Simplicity and rapidity of performance, b) Requires no laboratory equipments, c) Stable antigen suspension, d) Adequate sensitivity and specificity. This RPR card test can be used as a rapidly performing and screening test in field investigation, outpatient clinics, small laboratories and hospitals doing limited syphilis serology, and predonor in blood bank. Private clinic which has limited laboratory equipment and technic for syphilis serology can also use this RPR card test as a tool in the rapid diagnosis of syphilis. It was thought that this RPR card test is a useful tool in Korea for private physician and mass survey for syphilis diagnosis. But Portnoy patented the reagents needed for the performing the RPR card test. Therefore authors developed newly the reagents and according to Portnoy's method evaluated the newly developed. RPR card test compared with the VDRL, Kolmer CF, and RPCF tests. The RPR card and VDRL tests were performed plasma and serum from the total 1,132 cases. Among these 1,131 cases, 521 were syphilis suspected laboratory specimens, and 611 were syphilis unsuspected healthy young men. After screening with these two tests, the RPR card and VDRL tests, reactive specimens to the above one or both tests were retested by the Kolmer CF and RPCF tests.

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한방병원에 내원한 산후병 환자의 특성 및 증상에 대한 분석 (Analysis on Outpatients with Postpartum Disease at the Korean Gynecology Clinic of Traditional Korean Medicine Hospital)

  • 황영식;박남춘;이진욱;양혜린;박승혁;황덕상;이진무;이창훈;장준복
    • 대한한방부인과학회지
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    • 제31권3호
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    • pp.61-78
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    • 2018
  • Objectives: The purpose of this study was to analyze the current characteristics of outpatients with postpartum disease and provide a treatment instruction in the clinical field. Methods: To analyze characteristics of outpatients with postpartum disease, We searched medical records from January 1, 2015 to December 31, 2017 using Z34 (Supervision of normal pregnancy), O94 (Sequelae of complication of pregnancy), U327 (産後風) and 388 postpartum patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $33.73{\pm}3.62$ years old, 356 (91.75%) patients are full term pregnancy, 201 (51.81%) patients are first delivery, 79 (20.36%) patients had past history of abortion and 63 (16.24%) patients had past history of gynecologic disease. 2. The most subjects visited in April (10.31%). The mean duration from delivery date to visiting date was $131.5{\pm}214.6$ days. The mean number of visits after the initial visit was $1.91{\pm}1.7$. 3. The characteristics related with pregnancy and delivery are as follows. The number of subjects taken assisted reproductive technology was 19 (4.9%) and suffering from gestational disease was 28 (7.22%). The mean body weight difference between full term pregnancy and visiting date was $-8.24{\pm}3.57kg$. The number of subjects discharging lochia on visiting date was 167 (43.04%) and breastfeeding was 262 (67.53%). 4. The most chief complaint was arthralgia in 217 (55.93%) followed by general weakness, cold sensation, edema, sweating disorder, dizziness, lower abdominal pain, digestion disorder, heat sensation, defecation disorder and urination disorder. 5. The most accompanied symptom was arthralgia in 322 (82.99%), followed by sleep disorder, cold sensation, general weakness, sweating disorder, defecation disorder, edema, dizziness, digestion disorder, urination disorder, lower abdominal pain and heat sensation. 6. A total of 356 subjects were taken herbal medicine. The most prescribed herbal medicine to subjects was Gungguijohyeol-eum-gamibang (29.59%). Conclusions: These results could be helpful to diagnose and treat postpartum patients in Korean gynecologic clinical fields.

거위발 건 압통의 원인 (Cause of Pes Anserinus Tenderness)

  • 김정만;이동엽;고인준;김상일
    • 대한정형외과 초음파학회지
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    • 제2권1호
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    • pp.13-17
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    • 2009
  • 목적: 거위발 건 압통의 원인에 대하여 분석하고자 하였다. 대상 및 방법: 거위발 압통이 있었던 24예를 대상으로 하였다. 평균 나이는 65.9세, 여자 23명, 남자 1명 이었다. 외래에서 거위발 압통 여부를 문진 및 진찰 소견으로 확인 후 초음파 검사로 거위발 점액낭염 여부를 검사하였다. 점액낭염이 없는 것을 확인하고 관절내 스테로이드-리도카인 혼합액을 관절내에 주사하고 2~3분 후 압통이 자연 소실되었는지를 확인하였다. 결과: 총 24예의 거위발 압통이 있는 환자에서 초음파 검사 상 점액낭염이 확인된 예는 없었다. 스테로이드-리도카인 혼합액을 관절내 주사 한 후 전 예에서 2-3분 후 거위발 압통이 소실되었다. 6주 후 외래 추시 시에 16예(66.7 %)에서는 모두 거위발 압통의 소실 및 관절 내 삼출액이 감소 또는 소실되었다. 6주 추시 시 압통이 재발된 8예 중에서 4예는 반월상 연골의 파열로 관절경적 수술을 시행하였고, 1예는 슬관절 전치환술을 시행하였다. 수술을 시행한 전 예에서 추시 시 거위발 압통이 소실되었다. 나머지 3예는 Kellgren-Lawrence grade IV로 관절 간격의 완전한 소실을 보였으나 슬관절 전치환술은 시행하지 않은 예들이었다. 결론: 골 관절염에서 거위발 압통의 원인은 거위발 점액낭염이 없어도 발생하며 그 기전은 연관통으로 생각된다.

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건강증진과 삶의 질 구조모형 II-암환자 중심- (A Structural Model for Health Promotion and Quality of Life in People with Cancer)

  • 오복자
    • 대한간호학회지
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    • 제26권3호
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    • pp.632-652
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    • 1996
  • It has been noted that a genetic alteration of cells influenced by unhealthy lifestyle in addition to a series of other carcinogens increases the incidence of various neoplasmic diseases. Therefore the importance of a lifestyle that minimizes such an impact on health should be emphasized. Since stomach cancer, the most common neoplasmic disease in Korea, is related to personal lifestyle and as there is a possibility of its recurrence, patients with stomach cancer need to lead a healthy lifestyle. Also the quality of life which patients experience is negatively affected by the side effects of treatments and the possibility of recurrence. Therefore an effective nursing intervention to enhance quality of life and encourage healthy lifestyle is needed. The purpose of this study is to provide a basis for nursing intervention strategies to promote health and thus enhance quality of life. A hypothetical model for this purpose was constructed based on Pender's Health Promotion Model and Becker's Health Belief Model, with the inclusion of some influential factors such as hope for quality of life and health promoting behavior. The aims of study were to : 1) evaluate the effectiveness of patient's cognitive-perceptual factors on health promoting behaviors and quality of life ; 2) examine the causal relationships among perceived benefit, perceived barrier, perceived susceptibility and severity, internal locus of control, perceived health status, hope, health concept, self efficacy, self esteem health promoting behaviors & quality of life ; 3) build and test a global hypothetical model. The subjects for this study were 164 patients who were being treated for stomach cancer were approached in the outpatient clinic on a University Hospital. The data from the completed questionnaires were analyzed using Linear Structural Relationships (LISREL). The results of research are as follows : 1) Hypothetical model and the modified model showed a good fit to the empirical data, revealing considerable explanational power for health promoting behaviors(54.9%) and quality of life(87.6%) 2) Self efficacy and hope had significant effects on health promoting behaviors. Of these, hope was affected indirectly through self efficacy and self esteem. 3) Perceived health status, hope and self esteem had significant direct effect on the quality of life. Of these variables, perceived health status was the most essential factor affecting general satisfaction in life. 4) Self-efficacy, as a mediating variable, was positively affected by perceived benefit and hope. 5) Self-esteem, as a mediating variable, was positively affected by perceived health status and hope. 6) Hope was the main variable affecting self efficacy, self esteem, health promoting behaviors and quality of life. The derived model in this study could effectively be used as a reference model for further study and could suggests a direction for nursing practices

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폐 자궁내막 증식증 1예 (Pulmonary Endometriosis)

  • 김기중;조윤형;최병기;최의영;장윤수;김형중;안철민;조상호;유진아
    • Tuberculosis and Respiratory Diseases
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    • 제47권3호
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    • pp.389-393
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    • 1999
  • 자궁내막 증식증은 일차적으로 골반내에 국한된 질환이나 드물게 폐실질에서 발견될 수 있다. 폐 자궁내막 증식증의 진단은 임상적 양상과 월경기간 동안의 객혈이 있으면서 조직학적 확진을 통해서 진단될 수 있다. 폐 자궁내막 증식증은 1956 년 Lattes등에 의해 처음으로 조직학적으로 확진한 후에 전세계적으로 드물게 보고되고 있다. 저자들은 25세 미혼 여성에게서 월경과 연관된 객혈을 한 여성에게서 흉부 전산화 단층촬영과 기관지 내시경을 통해서 병소를 확인한 후에 수술적 치료를 함으로 조직학적으로 확진한 폐실질 자궁내막 증식증 1예를 보고하는 바이다.

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천식환자 및 만성 폐쇄성 폐질환환자군에서 연간 최대 호기유속의 변화량 (Annual Change of Peak Expiratory Flow Rate in Asthma and COPD)

  • 홍성철;이초이;한장수;김원동;이계영;김순종;김희정;하경원;전규락;유광하
    • Tuberculosis and Respiratory Diseases
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    • 제72권1호
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    • pp.24-29
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    • 2012
  • Background: Measurement of peak expiratory flow rate (PEFR) in a follow-up examination for a chronic airway disease is useful because it has the advantages of being a simple measurement and can be repeated during examination. The aim of this study was to examine the annual decrease of PEFR in asthma and chronic obstructive pulmonary disease (COPD) patients and to confirm the factors which influence this decrease. Methods: From May, 2003 to September, 2010, the annual decrease of PEFR was obtained from asthma and COPD patients attending an outpatient pulmonary clinic. PEFR was measured using a Mini-Wright peak flow meter (Clement Clarke International Ltd. UK), and we conducted an analysis of factors that influence the change of PEFR and its average values. Results: The results showed an annual decrease of $1.70{\pm}12.86$ L/min the asthmatic patients and an annual decrease of $10.3{\pm}7.32$ L/min in the COPD patients. Age and $FEV_1$ were the predictive factors influencing change in asthma, and $FEV_1$ and smoking were the predictive factors influencing change in COPD. Conclusion: We confirmed the annual decreasing PEFR in patients with chronic airway disease and identified factors that work in conjunction with $FEV_1$ to influence the change.

악관절증의 동통에 대한 국소마취제의 관절강내 Pumping에 의한 감별법 (DIFFERENTIAL DIAGNOSIS BY JOINT CAVITY PUMPING WITH LOCAL ANESTHETIC FOR PAIN OF TEMPOROMANDIBULAR JOINT ARTHROSIS)

  • 정훈;정학;키노 코지
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제14권1_2호
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    • pp.146-153
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    • 1992
  • In the outpatient clinic, we have many patients who suffer from temporomandibular joint disorders. These vary from MPD syndrome to osteoarthrosis, and many cases have tender spots or areas on the temporomandibular joint region and/or masticatory muscles. Further, they frequently have masticatory muscle pain when opening the jaw. This paper presents the results of our research on the differential diagnosis for tendernesses and pain on opening the jaw in the temporomandibular joint region and the masticatory muscles by joint cavity pumping with local anesthestic. The areas of tenderness and jae-opening paw in 65 patient suffering from temporomandibular joint disorder were examined and recorded before and after anesthetizing the upper joint cavity with 2% lidocaine. Maximum interincisal distance was similarly recorded. The results were as follows : In the area surrounding the upper joint cavity including the lateral pterygoid muscle, the tenderness and jaw-opening pain vanished almost entirely after anesthesia. This was considered a direct infiltrative effect of the local anesthesia. After the anesthesia, 86% of the tendernesses on the sternocleidomastoid muscles, and 66% of those on the posterior belly of the diagstric muscles vanished, while the disappearance rates on the masseter, temporal, and medial pterygoid muscles were 50~60%. Apart from the temporomandibular region, pain on opening the jaw was found on the masseter, temporal, posterior belly of the digastric muscles, and medial pterygoid muscles before anesthesia. The disappearance rates after anesthesia were 90~100% except for the pain of the posterior belly of the digastric muscles, for which the rate was 66%. These results suggest that more than 88% of the tendernesses on the sternocleidomastoid muscle, more than 60% of the tendernesses and jaw-opening pains on the digastric muscle, and more than half of the tendernesses and almost all of the jaw-opening pains in the jaw-closing muscles are referred pains from the temporomandibular joint. The tendernesses that had no change after anesthesia were considered to be derived from spasms of the muscles proper. Generally, maximum interincisal distance increased after anesthesia. The average distance was 34mm before anesthesia, but increased to 41mm after anesthesia. In a few cases, however little or no change was found in those distances. In these cases, pathological changes were found in the joint cavities arthrographically or arthroscopically.

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Elucidation of Bacterial Pneumonia-Causing Pathogens in Patients with Respiratory Viral Infection

  • Jung, Hwa Sik;Kang, Byung Ju;Ra, Seung Won;Seo, Kwang Won;Jegal, Yangjin;Jun, Jae-Bum;Jung, Jiwon;Jeong, Joseph;Jeon, Hee-Jeong;Ahn, Jae-Sung;Lee, Taehoon;Ahn, Jong Joon
    • Tuberculosis and Respiratory Diseases
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    • 제80권4호
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    • pp.358-367
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    • 2017
  • Background: Bacterial pneumonia occurring after respiratory viral infection is common. However, the predominant bacterial species causing pneumonia secondary to respiratory viral infections other than influenza remain unknown. The purpose of this study was to know whether the pathogens causing post-viral bacterial pneumonia vary according to the type of respiratory virus. Methods: Study subjects were 5,298 patients, who underwent multiplex real-time polymerase chain reaction for simultaneous detection of respiratory viruses, among who visited the emergency department or outpatient clinic with respiratory symptoms at Ulsan University Hospital between April 2013 and March 2016. The patients' medical records were retrospectively reviewed. Results: A total of 251 clinically significant bacteria were identified in 233 patients with post-viral bacterial pneumonia. Mycoplasma pneumoniae was the most frequent bacterium in patients aged <16 years, regardless of the preceding virus type (p=0.630). In patients aged ${\geq}16years$, the isolated bacteria varied according to the preceding virus type. The major results were as follows (p<0.001): pneumonia in patients with influenza virus (type A/B), rhinovirus, and human metapneumovirus infections was caused by similar bacteria, and the findings indicated that Staphylococcus aureus pneumonia was very common in these patients. In contrast, coronavirus, parainfluenza virus, and respiratory syncytial virus infections were associated with pneumonia caused by gram-negative bacteria. Conclusion: The pathogens causing post-viral bacterial pneumonia vary according to the type of preceding respiratory virus. This information could help in selecting empirical antibiotics in patients with post-viral pneumonia.

직접 대면 방식과 병행한 전화를 이용한 복약상담이 제 2형 당뇨병 환자의 치료성과에 미치는 영향 (The Effects of Follow-up Telephone Calls Combined with Face-to-face Meetings on Clinical and Humanistic Outcomes in Patients with Type 2 Diabetes Mellitus)

  • 곽은정;신현정;천부순
    • 약학회지
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    • 제59권6호
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    • pp.270-277
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    • 2015
  • There is a lack of evidence on the impact of pharmacist interventions in diabetes care in South Korea. The aim of this study was to investigate the effects of pharmacist counseling on clinical and humanistic outcomes in patients with type 2 diabetes. An uncontrolled before-and-after study was conducted at the outpatient diabetes clinic in a teaching hospital in Gyeongnam, South Korea between January 2 and November 30, 2014. A total of 37 patients were enrolled. During the study periods, the participants and pharmacists met every 2 weeks via follow-up telephone calls in addition to face-to-face meetings upon returning for care visit. At each meeting, a structured patient counseling was performed and the average duration of each meeting was 15~30 minutes. The participants were requested to record daily self-care activities. At the end of this study, patients' satisfaction on pharmacist care was evaluated using the questionnaire developed by us. Compared to baseline, significant reductions (mean${\pm}$standard deviation, p<0.05) in HbA1c were observed at each follow-up period: $-0.32{\pm}0.72%$ from baseline to 3 months; $-0.52{\pm}0.76%$ from baseline to 6 months; $-0.72{\pm}0.76%$ from baseline to 9 months. Over the same follow-up period, the proportions of patients achieving target HbA1c (defined as HbA1c<6.5%) were 3.1%, 10.3%, and 20%, respectively. The proportions of patients who never missed a dose during the same follow-up period were 43.8%, 31.0%, and 20.0%, respectively. The results from the patient satisfaction survey indicated that pharmacist counseling improved patients' knowledge about diabetes and possible drug interactions. Especially, the information on a healthy diet and lifestyle was the most satisfying. To conclude, follow-up telephone calls combined with face-to-face meetings improved clinical and humanistic outcomes in patients with type 2 diabetes mellitus.

치과 내원 환자의 치아 이상(dental anomaly)에 관한 연구 (A study on the prevalence of dental anomalies in Korean dental-patients)

  • 이주희;양병호;이상민;김영희;심혜원;정현숙
    • 대한치과교정학회지
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    • 제41권5호
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    • pp.346-353
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    • 2011
  • 본 연구는 본원에 내원한 환자에 있어서 결손치, 매복치, 과잉치의 빈도 및 형태적 이상 등을 관찰하고자 하였다. 연구대상으로는 2009년 1월부터 2010년 6월까지 한림대학교 성심병원 치과에 내원한 환자를 대상으로 조사하였으며 의무기록지, 파노라마 방사선사진을 토대로 치아 이상에 대하여 성별, 치아 이상의 종류와 발생위치별로 조사하였다. 본 연구에서는 치아의 선천적 결손, 과잉치, 왜소치, 매복치, 변위치에 대한 치아 이상을 연구하였다. 연구기간동안 전체 내원하여 파노라마 방사선사진을 찍은 환자 3,133명 중 치아 이상을 가진 환자의 비율은 11.55%였다. 그 중 선천적 결손치를 가진 환자의 내원율은 5.71%로 가장 높았고, 매복치를 가진 환자는 3.09%였다. 과잉치, 왜소치, 변위치를 가진 환자의 비율은 각각 1.79%, 1.66%, 0.45%를 차지하였다. 치아의 수나 형태의 변화는 환자의 치료시 고려해야 할 필수적인 요소이다. 그러므로 치료를 위해 치과에 내원한 환자뿐만 아니라 구강검진으로 내원한 환자에서도 파노라마 방사선사진을 채득한다면 국민 구강보건 향상에 큰 도움이 될 것으로 생각된다.