• Title/Summary/Keyword: Patient Visit

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Comparison of Results between Tuberculin Skin Test and QuantiFERON®-TB In-Tube Assay for Diagnosis of Latent Tuberculosis Infection in Children and Adolescents (소아청소년에서의 잠복결핵감염 진단을 위한 결핵 피부반응검사와 QuantiFERON®-TB Gold In-Tube 검사와의 결과 비교)

  • Choi, Jong-Won;Kim, Min-Sung;Kim, Jong-Hyun
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.17-27
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    • 2013
  • Purpose: Recently, two tests are commercially available for the identification of latent tuberculosis infection (LTBI): tuberculin skin test (TST) and interferon-${\gamma}$ release assay (IGRA). Due to its false positiveness, TST tends to be preferred by IGRA until now. In our study, we simultaneously performed both TST and QuantiFERON$^{(R)}$-TB Gold In-Tube (QFT-GIT) and compared their results. Methods: TST and QFT-GIT were done for the diagnosis of LTBI among children who visited pediatric out-patient clinic at St. Vincent's Hospital, The Catholic University of Korea from February of 2007 to May of 2008. The study group was stratified into two groups in terms of whether there was intrafamilial contact or not. Results: Out of total 35 children, 29 were tuberculosis (TB)-exposed cases and the remainders were diagnosed as clinical pulmonary TB. Among these 29 children, TST was positive 38.9% (7/18) for the intrafamilial and 45.5% (5/11) for the nonintrafamilial, and at the same time, the result for QFT-GIT was positive 5.6% (1/18) and 9.1% (1/11), respectively which implies that TST was more sensitive than QFT-GIT. Among 29 TB-exposed cases, 26 initially went through TST and QFTGIT together on their first visit to out-patient clinic, and 15 continued the follow-up tests. Out of total 41 cases collected, the agreement (known as kappa value) was 0.063 which was relatively low. Including 6 cases with pulmonary TB who were all positive for TST and only 5 being positive for QFT-GIT, the final kappa value was 0.334. Conclusion: In our study, the agreement for TST and QFT-GIT was low, and the majorities were almost the cases of positive TST. In current situation with lacking a gold standard test and limited data on children to adolescents, this result is quite alarming that the recent trend tends to replace TST by QFT-GIT when diagnosing LTBI.

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Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: Protocol for a Randomized Controlled Pilot Trial (폐경 후 여성의 전단계 및 1기 고혈압에 대한 침 치료: 다기관 무작위 대조 예비연구)

  • Kim, Jung-Eun;Choi, Jin-Bong;Kim, Hyeong-Jun;Kang, Kyung-Won;Liu, Yan;Jung, Hee-Jung;Lee, Min-Hee;Shin, Mi-Suk;Kim, Jae-Hong;Choi, Sun-Mi
    • Korean Journal of Acupuncture
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    • v.31 no.1
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    • pp.5-13
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    • 2014
  • Objectives : This study aims to evaluate the effectiveness and safety of acupuncture and explore the appropriate number of treatment for postmenopausal women diagnosed with prehypertension and stage 1 hypertension. Methods : A 4-arm randomized open label pilot trial will be performed at 2 centers. Sixty participants will be divided into 2 treatment groups and 2 control groups. Treatment groups will receive acupuncture at 8 points(bilateral GB20, LI11, ST36, SP6) for 4 weeks(treatment group A, 10 total sessions) or 8 weeks(treatment group B, 20 total sessions), while maintaining usual care. Control groups will not receive acupuncture but will be under usual care for 16 weeks(control group C) or 20 weeks(control group D). Each patient's living habits will be corrected and drugs that may affect blood pressure(BP) will be prohibited. Treatment group A and control group C will be evaluated at 4, 8, 12, and 16 weeks after randomization, while treatment group B and control group D will be evaluated at 4, 8, 12, 16, and 20 weeks after randomization. The major outcome variable is the magnitude of change in diastolic BP levels at 4 weeks after randomization; auxiliary outcome variables are (1) diastolic BP change at 8, 16, and 20 weeks, (2) systolic BP change, (3) BP control rate, (4) lipid profiles, and (5) high-sensitivity C-reactive protein. Patient safety will be assessed at every visit. Results and Conclusions : The study findings may help develop evidence for the effectiveness and safety of acupuncture for BP control.

Evaluation of sleep quality and stress response in patients requiring dental prosthetic treatment (치과보철치료를 요하는 환자에서의 수면질과 스트레스 반응 평가)

  • Jeon, Hye-Mi;Jung, Kyoung-Hwa;Choi, Na-Rae;Song, Jae-Min;Lee, So-Hyoun;Kim, So-Yeun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.2
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    • pp.181-189
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    • 2021
  • Purpose: The purpose of this study is to investigate the stress response and sleep state of the new patients who visit the hospital for prosthodontic treatment due to tooth loss to make reference to further treatment direction. Materials and methods: Examinations, consultations, and surveys were conducted on 236 patients (94 males, 142 females, and 24-86 years old), who newly registered at the department of prosthodontics at Pusan national university hospital, for 2 years from 2018. The number of remaining teeth, edentulous arch, possibility of mastication, and future prosthetic treatment directions were recorded. The visual analogue scale (VAS), stress response inventory (SRI) and Insomnia severity index (ISI) were used as tools to measure patient's subjective discomfort, stress response, and sleep status. Results: Among the entire prosthodontic patient group, the average value of 'fatigue' was significantly higher among the 7 items of SRI, and the value of 'aggression' was significantly lower (P<.001). There are a significant difference between the edentulous and full dentition in the oral discomfort value measured by VAS (P=.004). In cases where less than 20 teeth remain, mastication is impossible, and patients who are planning treatment with removable prostheses, VAS value and 'depression' and 'fatigue' values in SRI were higher than those in the reverse case (P<.05). The patients showed severe level in VAS value have high value of 'tension', 'somatization', 'depression', 'fatigue'and 'frustration'in SRI than non-serious patients (P<.05). Clinical insomnia occurred in 11.4% of all patients, and women had significantly lower sleep quality than men (P=.044). Patients with insomnia showed significantly higher scores on the VAS value and all 7 SRI items than those of normal sleepers (P<.05). Conclusion: The new prosthetics had high 'fatigue' value among the 7 items of SRI. The oral condition, number of residual teeth and mastication function and clinical insomnia affected oral discomfort and the stress response.

A Study on the Characteristics of Intentional Self-Poisoning Patients : Comparison between Non-Prescription and Prescription Drugs (일반의약품과 전문의약품 의도적 음독 자살 시도자 특성 분석 연구)

  • Cho, Eulah;Cho, Ji Hyun;Jho, Kyeng Hyeng;Sim, Hyun-Bo
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.116-125
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    • 2020
  • Objectives : Self-poisoning is the leading cause of visits to the emergency departments after a suicide attempts. This study is aimed to compare the patient characteristics according to the category of drugs ingested by the patients who attempted suicide. Methods : All medical charts were retrospectively reviewed from patients who visited the emergency center, at Seoul Medical Center, due to intentional self-poisoning from April of 2011 to July of 2019. We investigated the information regarding the subtype and quantity of the intoxication drug, how it was obtained, suicidal history, and psychiatric history, as well as, sociodemographic information. Variables were compared between prescription drug (PD) and non-prescription drug (NPD) poisoning groups. Results : The mean age of the NPD poisoning group was significantly lower than that of the PD poisoning group. The patient ratio of those enrolled in national health insurance and living with spouses were significantly higher in the NPD poisoning group. Compared to the NPD poisoning group, the PD poisoning group had a higher incidence of mental illnesses, underlying diseases and ratio of involuntary visit to the emergency department. Among the prescription drugs, the benzodiazepine poisoning group had a higher rate of self-prescription than the non-poisoning group, while the zolpidem poisoning group had a higher rate of the using someone else's prescription than other drugs. Each single drug poisoning group (benzodiazepine, zolpidem, and antidepressant single-agent) had a higher rate of no mental illness than each of the mixed-poisoning group. Conclusions : Guidelines for regulating non-prescription drugs are needed as a matter of suicide prevention. Also, this study suggests that clinicians need to be careful when issuing prescriptions and should suicidal risk according to patients' characteristics, duration of follow-up and type of drug packaging.

A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

Clinical and Bacteriologic Efficacy of Cefprozil on Pharyngitis and Pharyngotonsilitis caused by Group A Beta Hemolytic Streptococci in Children (Group A-beta Hemolytic Streptococci에 의한 소아 인두편도염에 있어서 Cefprozil의 항균력과 임상적 및 세균학적 효과에 관한 연구)

  • Kim, Min-Woo;Ahn, Young-Min;Jang, Seong-Hee;Ma, Sang-Hyuk;Ahn, Byung-Moon;Kim, Jong-Duk;Lee, Jong-Kook;Kim, Mi-Lan;Chang, Jin-Kun;Park, Jin-Young;Bae, Jong-Woo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.206-212
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    • 2001
  • Objective : To determine the clinical and bacteriologic efficacy and safety of Cefprozil in acute pharyngitis and pharyngotonsilitis caused by Group A beta hemolytic streptococci in pediatric patients. Methods : Any patient of 3 to 14 age who visited the hospitals enrolled in this study with the signs and symptoms of pharyngitis or pharyngotonsilitis since July, 2000 to March, 2001, was taken throat culture and given Cefprozil(15 mg/kg/day, in two divided doses) for 10 days. 138 patients of whom showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Any undesirable effect was reported to determine the safety of the drug. Follow up cultures were done at the end of the study and bacteriologic efficacy was determined. Results : 138 of 256 patients who visited the hospitals with the signs and symptoms of pharyngitis or pharyngotonsilitis showed positive growth on throat culture. Mean age of the patients was $6.1{\pm}2.5$ and males and females were equally numbered. 129 of them complained fever on the first visit and 112(86.6%) of them were improved at the end of the study. Cervical lymphadenitis was seen in 58 patients and 44(75.9%) of them improved at the end of the study. Exudative pharyngitis was seen in 96 patients and 81(84.3%) of them improved. The overall clinical effcacy based on this results showed that 110(79.7%) of the patients were cured and 17(12.3%) of them improved. On the cultures and bacteriologic efficacy, 24.6% of them showed documented eradication after treatment and 62.3% of them showed presumptive eradication. Sensitivity test was done by agar dilution method and Cefprozil showed 100% sensitivity. Erythromycin, Clarithromycin and azithromycin showed 87%, 85.6 %, 90.6% sensitivity, respectively. Conclusion : Cefprozil is proved to be effective in controlling group A streptococcal pharyngitis and pharyngotonsilitis in children and showed good sensitivity. Cefprozil can be used as an effective oral cephalosporin in the patients showing penicillin hypersensitivity or patients who other drugs have failed.

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Clinical Analysis of the Pediatric Patients Seen in the Emergency Medical Center (응급의료센터 소아 환자들의 경향 분석)

  • Lee, Hee Jung;Park, So Yoon;Lee, Young Hwan;Do, Byung Soo;Lee, Sam Bum
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1061-1067
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    • 2005
  • Purpose : We studied a clinical analysis of pediatric patients who visited the emergency medical center of Yeungnam University Hospital to compare the characteristics of pediatric emergency patients after year 2000 with the previous studies. Methods : We reviewed 7,034 children under the age of 15 years who visited the emergency medical center of Yeungnam University Hospital during the 2 year period from January 2001 to December 2002, and then we performed a clinical and statistical analysis. We analyzed the pediatric patients according to gender, age, season, day of the week, time of the visit, the disease classification and the final disposition of the patients. Results : Among the patients who visited the emergency room, 15.6% of the total emergency patients were under the age of 15. The male to female ratio was 1.6 : 1. Among the 7,034 pediatric patients, the most common age group was between 1 year and under 3 years of age(26.9%). The peak seasonal incidence was early summer and spring, especially during June(11.2%) and May(10.6 %). The peak incidence day of the week was Sunday(24.8%) and the peak time when the emergency pediatric patients visited the emergency room was between 20 and 24 o'clock(28.8%). The distribution of diseases, according to ICD-10 system, were injury and poisoning(30.4%), diseases of the respiratory system(22.8%), and diseases of the digestive system(14.6%). 30% of total pediatric patients were admitted to the hospital. Conclusion : After year 2000, as compared with the previous studies, the proportions of emergency pediatric patients has decreased. The distribution of diseases was not much different from the previous studies and the proportions of non-urgent diseases, such as acute nasopharyngitis or acute gastroenteritis, were still high. These result have come about due to the declining birth rate and changes of the medical system in Korea.

A study on the implementation of Medical Telemetry systems using wireless public data network (무선공중망을 이용한 의료 정보 데이터 원격 모니터링 시스템에 관한 연구)

  • 이택규;김영길
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2000.10a
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    • pp.278-283
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    • 2000
  • As information communication technology developed we could check our blood pressure, pulsation electrocardiogram, SpO2 and blood test easily at home. To check our health at ordinary times is able though interlocking the house medical instrument with the wireless public data network This service will help the inconvenience to visit the hospital everytime and will save the individual's time and cost. In each house an organism data which is detected from the human body will be transmitted to the distance hospital and will be essentially applied through wireless public data network The medical information transmit system is utilized by wireless close range network It would transmit the obtained organism signal wirelessly from the personal device to the main center system in the hospital. Remote telemetry system is embodied by utilizing wireless media access protocol. The protocol is embodied by grafting CSMA/CA(Carrier Sense Multiple Access with Collision Avoidance) protocol falling mode which is standards from IEEE 802.11. Among the house care telemetry system which could measure blood pressure, pulsation, electrocardiogram, SpO2 the study embodies the ECC(electrocardiograph) measure part. It within the ECC function into the movable device and add 900㎒ band wireless public data interface. Then the aged, the patients even anyone in the house could obtain ECG and keep, record the data. It would be essential to control those who had a health-examination heart diseases or more complicated heart diseases and to observe the latent heart disease patient continuously. To embody the medical information transmit system which is based on wireless network. It would transmit the ECG data among the organism signal data which would be utilized by wireless network modem and NCL(Native Control Language) protocol to contact through wireless network Through the SCR(Standard Context Routing) protocol in the network it will be connected to the wired host computer. The computer will check the recorded individual information and the obtained ECC data then send the correspond examination to the movable device. The study suggests the medical transmit system model utilized by the wireless public data network.

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The Long-term Results of a Modified Maze Procedure with Using Cryoablation (냉동 절제를 이용한 변형된 Maze술 식의 중장기 결과)

  • Park, Kwon-Jae;Woo, Jong-Soo;Bang, Jung-Hee
    • Journal of Chest Surgery
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    • v.41 no.6
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    • pp.710-717
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    • 2008
  • Background: Atrial fibrillation is associated with several complications such as cerebro-vascular accidents and peripheral arterial embolism. Most of the patients who have this arrhythmia chronically feel their heart beating and so they are frightened; therefore, the quality of a patient's life is decreased. The purpose of this article is to determine the long term results of a modified Maze procedure and the factors that influence the success of the procedure. Material and Method: This study enrolled 88 patients who underwent the modified Maze with using cryoablation between June, 2001 and February, 2007. The 88 consecutive patients were divided into two groups ac cording to how the pulmonary veins were isolated, that is, with or without cryoablation. There were 58 patients who were isolated by cutting and sewing in the right pulmonary veins and by cyroablation in the left pulmonary veins in group 1 (group 1, n=58), and 30 patients who underwent isolation by cryoablation in the right & left pulmonary veins were placed in group 2 (group 2, n=30). The ECG was checked at discharge to determine the sinus conversion rate and we followed up the patients to determine whether or not the patients maintained sinus rhythm. We also checked the ECG at the last visit to determine the patients' heart rhythm. Result: The mean follow up time was $44.3{\pm}19.2$ months. At discharge, 72.4% of the patients in group 1 were in proper sinus rhythm and 66.7% of the patients in group 2 were in proper sinus rhythm. At the last follow up, 81% of the patients in group 1 were in normal sinus rhythm and 60% of the patients in group 2 were in normal sinus rhythm. When we analyzed the data via the Kaplan-Meier method, 86.5% of the patients were free from atrial fibrillation (% free from AF) at 1 year, 80% of the patients were free from atrial fibrillation at 5 year in group 1 and 70% of the patients were free from atrial fibrillation at 1 year and 51 % of the patients in group 2 were free from atrial fibrillation at 5 year. Conclusion: The modified Maze technique using cryoablation was a simple and effective procedure. But the success rate of the Maze technique using cryoblation is lower than that of the standard Maze III. The method using cryoablation shorten the operation time, but we must conduct more studies to get a better result of the modified Maze technique with using cryoablation.

A Study on the Oral Health Status, PHP Index and Oral Health Behavior of Patients in 'S' College Dental Clinic (S대학 치위생과 실습실에 내원한 환자의 치아우식상태와 구강위생관리능력, 구강건강행위 실태)

  • Kim, Jin;Woo, Hee-Sun;Jung, Moon-Hee
    • Journal of dental hygiene science
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    • v.9 no.1
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    • pp.145-151
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    • 2009
  • The purpose of this study was to examine the correlation of oral health behavior, oral health state and PHP in an effort to facilitate the promotion of oral health and improve oral health care. The subjects in this study were patients who got a scaling at the oral hygiene practice lab in the department of dental hygiene in S college dental clinic from September 5 to December 1, 2007. The collected data were analyzed with SPSS WIN 12.0 program. The findings of the study were as follows: 1. The younger patients had a smaller number of FT index, and the older patients excelled the younger ones in oral health behavior involving the use of oral hygiene supplies, regular visit to dental clinics and dietary control. 2. The patients got 2.62 out of possible five points on oral health behavior, which indicated that their oral health behavior wasn't good enough. Those whose oral health behavior was better had a smaller number of DT index and a larger number of FT index. A better oral health behavior led to a lower PHP index. 3. There was a negative(-) interrelationship between oral health behavior and DT index, and oral health behavior had a positive(+) correlation with FT index. The oral health behavior had a negative(-) correlation to PHP index, which showed that a better oral health behavior led to a lower PHP index. The above-mentioned findings seem to suggest that oral health behavior is one of integral factors to affect oral health status and PHP index, and the kind of oral health education that could change oral health care attitude should be provided during scaling practice after grasping the actual oral health behavior of patients.

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