• 제목/요약/키워드: Primary care

검색결과 1,580건 처리시간 0.029초

영구치의 선천적 결손을 동반한 복합 치아종 (COMPOUND ODONTOMA WITH CONGENITAL MISSING OF THE PERMANENT TEETH: CASE REPORTS)

  • 김하나;김재곤;백병주;한지혜;양연미
    • 대한소아치과학회지
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    • 제34권4호
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    • pp.679-684
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    • 2007
  • 치아종은 치아조직의 비정상적인 과성장으로 인해 형성되는 외배엽성 상피세포와 중배엽세포로 구성된 혼합종양이다. 양성 치성 종양 중에서 가장 흔하며 신생물이라기보다 과오종으로 보고 있다. 치아종은 악골내 모든 부위에서 발생할 수 있지만 치아와 유사한 복합 치아종은 비교적 상악 전치부에 호발하고, 불규칙한 형태를 나타내는 복잡 치아종은 하악 구치부에 호발한다. 일반적인 증상이 없어 일상적인 방사선 검사에서 주로 발견되며 영구치의 맹출지연이나 매복, 유치의 만기잔존 등의 원인이 될 수 있지만 영구치의 선천적 결손을 동반한 증례는 매우 드물다. 치료는 외과적 제거가 추천되며 완전한 적출시 재발은 드물다. 본 증례는 영구치의 선천적 결손을 동반한 복합 치아종 환자에 대하여 보고하는 바이다.

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일부 도시주부들의 스트레스 생활사건 및 신체증상에 관한 연구 (Stressful Life Events and Somatic Symptoms of Urban Women)

  • 김영희;박형숙
    • 대한간호학회지
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    • 제22권4호
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    • pp.569-588
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    • 1992
  • This study examined the relationship between the experience of stressful life events and somatic symptoms of urban women. Data were collected by interviewing 200 women from June to July 1, 1991. Vsable data work obtained from 162 of the women. Modified version of a stressful life events measurement tool developed p.5. Lee (1984) and the Somatic Discomfort Inventory by Wittenborn were used to measure the variables. Data were processed by an 5.p.5.5. program and analyzed. statistically for percentage, T-test, ANOYA and Pearson Correlation coefficient. Result of the Study are as follows : 1) The group total mean score of stressful life events was 92.66 $\pm$ 10.41. The higher scores in the $\boxDr$Test and school$\boxUl$ of the Extrapersonal factor, in the $\boxDr$Health problems$\boxUl$ of the Intrapersonal factor and $\boxDr$Conflict and differences within the family$\boxUl$ of the Interpersonal factor, factors. which a suggested by Neuman's model. 2) The group total mean score for somatic symptoms was 100.41$\pm$9.74. The higher scores were for the factors of $\boxDr$Fatigue (1.94)$\boxUl$, $\boxDr$Menopause (1.74)$\boxUl$, $\boxDr$Muscular system(1.67)$\boxUl$ and $\boxDr$Sleeping (1.67)$\boxUl$ 3) The mean scores of stressful life events were higher in the 40~60 age group, for middle school graduates(P<.05), career women and those in nuclear families (P>.05). 4) The mean scores of somatic symptoms were higher in the 45~60 age group, for middle school graduates, non career women and women with 5 or more children(P<.05). 5) There was a positive correlation between the scores of stressful life events and somatic symptoms (r=.585 P<.05). The higher the level of stressful life events the higher the score of somatic symptoms, the results were consistent with the Extrapersonal, Intrapersonal and Interpersonal stress factors of Neuman's Health Care Systems. This research assessed the stressful life events of women, who play the most important role in the family for illness prevention and health promotion and suggested the importance of programs in the Primary Health Services to build basic coping resources.

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한국 정신박약아의 실태 조사 연구(교육기관 및 시설을 중심으로) (Study on Institutionalized Mentally Retarded Children in Korea(Particularly Regarding Their Accommodation and Education Facilities))

  • 김초강
    • 대한간호학회지
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    • 제2권1호
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    • pp.115-129
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    • 1971
  • As the result of a survey conducted by the author on the status of tile 12 educational institutions for mentally retarded children in Korea and their quartering facilities as well as on 934 children accommodated in such institutions, the following conclusion has been reached: 1) More than a half (approximately 58 percent) of the facilities for mentally retarded children are concentrated in Seoul. About eighty-three percent of these facilities are private establishments, of which 70 percent have their proprietors concurrently as their superintendents. Although these facilities were first established as many as 22 years ago, it has been only five or six years since education was actually started for mentally restarted children. 2) Out of a total of 179 employes, teachers number 99, there by constituting approximately 57.6 percent. Out of them, however, only 32 teachers or 2.8 percent have special teachers licenses. Thus, each teachers has to take care of an average of 29 children. This is excessive a number of children per teachers in view of the special nature of this education, there by indication how urgent it would be to secure more teachers lot this field. 3) Out of the mantally retarded children investigated 57.6 percent suffer from physical disorder in addition to mental retardation, 53.0 percent from mental alienation illnesses besides retardation, and 25 pent from physical, mental disorders in addition to retardation. It is therefore necessary to maintain medical and nursing facilities together with educational facilities. however, two places have no medical facilities at all, and four other places, without medical personnel, have to receive medical support from nearby hospitals or clinics. 4) The total number of children in the surveyed facilities is 934, who can be broken down into 58.7 percent boys and 41.3 percent for girls. They are classified into 12.5 percent for idiot, 37.7 percent for imbeciles, 32.7 percent for morons, and 17.3 percent for thoes children on borderline. Their average age is 13.9 years. 5) As the result of education, the illiteracy rate of mentally retarded children has decreased from 78.1 percent to 32.1 percent while the percentage of those taking the primary school course has increased for 12.2 per cent to 33.5 percent. As a result, it has been learned that education is definitely necessary for Retarded children though it may be a difficult task. 6) The children who have mentally retarded children among their brothers or sisters constitute 6.3 percent of the total number. The corresponding rate for boys is 3.5 percent while that for girls is a remarkably higher rate 10.6 percent. Through studies on the causes of their mental retardation, it has been learned that 39.6 percent of them is of the inherent type and 35.3 percent is of the environmental type. Control and improvement of health of mothers and children, early diagnosis and early treatment are believed to be very important because they could prevent or alleviant much of these conditions. 7) The storage age of teachers and employes is 35.3 years, an indication that a great proportion of them is experienced in a way or another as their major difficulty or problems in serving with these special school, 22.5 percent cited inadequate payment 24.5 gave the inadequate public understanding, and 22.5 percent pointed out the lack of understanding on the part of give parents.

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핀란드의 농업보건서비스 사례와 시사점 (Research on Farmers' Occupational Health Services in Finland)

  • 이경숙;;김효철;채혜선
    • 농촌지도와개발
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    • 제21권4호
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    • pp.1007-1028
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    • 2014
  • 핀란드는 한국과 유사하게, 자영농 및 소규모 기업농 위주로 농업구조가 구성되어 있으며, 일반 산업과는 별도의 농업안전보건 체계를 운영하고 있다. 본 연구에서는 핀란드의 농업보건서비스(Farmers' Occupational Health Services, FOHS) 제도를 검토하여 한국 농업 안전보건 체계의 발전 방향을 도출하고자 하였다. 분석결과, 핀란드 농업안전보건체계는 자영농을 대상으로 국립 농업보건센터의 조율 하에 각 지자체의 산업보건 및 농업 전문기관이 농업인에게 농업보건서비스를 제공하고, 비용에 대해서는 사회보장제도에서 지원하는 형태로 운영되고 있다. 이에 따른 시사점은 첫째, 예방방안에 대한 국가 표준을 제시하고 재해통계, 원인연구 등을 수행할 수 있는 국립농업보건센터가 필요하다. 둘째, 저비용, 저난이도의 농작업 환경 평가 및 개선 기술의 개발이 필요하다. 셋째, 보험할인 및 사회보장제도를 활용한 서비스를 통해 농업인의 참여를 유도해야 한다. 넷째, 안전보건 기관 및 전문가의 육성, 지역 및 작목별 맞춤 서비스 등 지역특성에 맞는 안전보건 서비스의 제공이 확보되어야 한다.

일부 농촌지역 시설노인의 건강상태 (Health Status of Institutional Elderly in a Rural Area)

  • 남해성;박경수;이정애
    • 농촌의학ㆍ지역보건
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    • 제24권2호
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    • pp.291-299
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    • 1999
  • 일부 농촌지역의 시설노인의 인지기능과 일상생활 수행능력을 중심으로 건강상태를 측정하고자 하였다. 전라남도 10개의 노인복지시설에 수용된 485명 중 466명(96.1%)을 대상으로 조사를 하였다. 조사내용은 사회인구학적 특성, MMSE, ADL, IADL, 및 COOP chart이었다. 남자가 148명(31.8%)이었고 여자는 318명(68.2%)이었다. 평균연령은 남자 $73{\pm}8.2$, 여자 $79{\pm}8.5$세였다. 인지기능은 남자 45명(30.4%), 여자 115명(36.2%)에서 중증 인지기능장애를 나타내었다. ADL은 6항목 전체를 독립적으로 수행하는 경우가 남자 74명(50.0%), 여자 136명(42.8%)으로 나타났고, 6항목 전체를 수행하지 못하는 경우는 남자 46명(31.1%) 여자 83명(26.1%)으로 나타났다. IADL은 남자에서는 교통수단 이용 불가가 78명(52.7%)으로 다른 항목에 비해서 높았고, 여자에서는 빨래하기 항목이 가장 낮은 수행률을 보였다. COOP 차트로 살펴본 건강상태는 남녀 모두에서 신체기능에 비해서 감정상태와 사회활동에서 좋은 점수를 보였다.

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재난 시 소아청소년 정신건강 평가 및 치료의 주요 요소: 전문가 델파이 예비 조사 (The Major Elements of Psychological Assessment and Intervention for Children and Adolescents after a Disaster: A Professional Delphi Preliminary Survey)

  • 박장호;이미선;장형윤;황준원;이주현;김지연;이철순;김은지;배승민;방수영
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제27권3호
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    • pp.164-172
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    • 2016
  • Objectives: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. Methods: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. Results: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. Conclusion: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

칼슘채널차단제, 레닌-안지오텐신시스템 차단제, 이뇨제의 잠재적 간독성 평가 (The Evaluation of Potential Hepatotoxicity by Calcium Channel Blockers, Renin-Angiotensin System Blockade and Diuretics)

  • 김재윤;이옥상;정선회;이혜숙;이창호;김상건;임성실
    • 한국임상약학회지
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    • 제22권4호
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    • pp.330-339
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    • 2012
  • Background : Hypertension is treated with both lifestyle modification and pharmacotherapy. The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7), published in 2003, provides a streamlined management approach to hypertension for the primary care physician. The JNC-7 is the gold standard also in Korea. According to the JNC-7, special therapeutic considerations are recommended for high-risk individuals with compelling indications. The presence of compelling indications in any given patient should be considered when selecting specific pharmacotherapy to treat hypertension. However, in patients with compelling indications, it is unknown that hepatotoxicity is caused by Calcium Channel Blocker (CCB), one of 1st anti-hypertensive drugs. Now, the CCB is the most used 1st anti-hypertensive drug in Korea Therefore, we evaluated the changes in blood liver function parameters (ALT, AST, Total bilirubin, serum albumin) for the study group. Methods : We randomly collected and retrospectively analyzed Electronic Medical Record data (n=28,788) of patients, and who took calcium channel blockers(non-dihydropyridines; diltiazem, verapamil, dihydropyridines; amlodipine, barnidipine, benidipine, clinidipine, efonidipine, felodipine, isradipine, lacidipine, lercanidipine, nicardipine, nifedipine, nimodipine), with having liver function tests (LFTs) from July 1st 2009 to June 30th 2010 at the Seoul National University Hospital in Korea. Control groups are two antihypertensive agents: RAS blockade (ARB; candesartan, irbesartan, losartan, olmesartan, telmisartan, valsartan, ACE-I; cilazapril, enalapril, fosinopril, imidapril, perindopril, ramipril) and, Diuretics (loop; furosemide, torsemide, thiazide; hydrochlorothiazide[HCTZ], indapamide). Patients not having LFT results at these three standard points of time(baseline, during, medication, and after finishing medication) were excluded. The collected data were analyzed by using the SPSS (Version12.0) and Microsoft Excel (Version2007). Results : 711 patients who were treated CCB (297), RAS blockade (232) or Diuretics (182) monotherapy were selected for the study. In selected patients, liver damage degree(changes of each LFTs value) was higher in diuretics group than other groups, followed by RAS blockade and CCB. In diuretics group's was loop-diuretics group was higher than thiazide-diuretics group. In CCB group, Nondihydropyridine-CCB's damage degree was higher than Dihydropyrine-CCB's that. Conclusions : Despite the limitations due to the retrospective study, among patients with abnormal LFTs, the use of CCBs led to a less liver damage than other 1st anti-hypertensive agents. It can be recommended CCBs as one of the initial treatments of hypertension in patients with liver disease.

약사국가고시 실기시험 영역 선별을 위한 전문가 조사 (Selection of Tasks for Assessment of Pharmacy Clinical Performance in Korean Pharmacist Licensure Examination: Results of an Expert Survey)

  • 한나영;이주연;곽혜선;이병구;이영숙;이숙향;용철순;김주희;오정미
    • 한국임상약학회지
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    • 제27권3호
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    • pp.119-126
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    • 2017
  • Background: As the demands of pharmacist's role and quality performance have increased, the verification of pharmacist's ability has been required. In this study, we aimed to select appropriate items for assessment of pharmacist's knowledge, attitude and performance. Methods: Based on the pharmacist job analysis, we selected duties and tasks in consideration of applying pharmacy practical examination through brainstorming of internal researchers and group discussion with experts. Survey was conducted to evaluate the tasks according to the criteria detailed below: Realistic, Understandable, Measurable, Behavioral and Achievable (RUMBA). The subjects included professors at colleges of pharmacy and instructors of institutional or community pharmacy settings. Results: Nine duties including 41 tasks were drawn for the survey through primary internal researchers. Of the 90 respondents, 95.6% were professors or preceptors who was engaged in practical training, and 62.2% had more than five years of practical experience. As a result of survey and discussion with expert panel, selected seven duties were selected as followings: 'Patient (customer) reception', 'Drug preparation and distribution', 'Patient care', 'Administration', 'Patient counseling', 'Non-prescription medication counseling', and 'Provision of drug information'. The final 20 tasks from seven duties were chosen to assess skills that a pharmacist should be able to perform. Conclusion: This is the first study to select the items that can be included in pharmacist practical examination in the future, based on the RUMBA criteria. As a next step, it is necessary to study how to implement these items.

교통사고 환자 77례에 대한 임상적 고찰 (The Clinical Study on 77 Traffic Accident Patients)

  • 황희상;정기훈;전재천;박재연;김민석;이태호;노정두;이은용
    • 척추신경추나의학회지
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    • 제4권2호
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    • pp.85-98
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    • 2009
  • Objectives : The purpose of this study was to find out tendency of traffic accident patients treated in korean medicine hospital. Methods : We investigated 77 patients who were treated in Semyung University Korean Medicine Hospital from 1 st, January, 2007 to the 30st September, 2009. Results and Conclusions : 1. In distribution of gender and age, the rate of male was 36.4%, that of female was 63.6% and majority of patients were twenties, thirties and forties. 2. In the traffic accident patterns, the most was car crash from behind(49.4%) and after traffic accident, 42 patients(54.6%) visited our hospital in less than 5 days. 3. 22 patients(28.6%) choose the oriental medical treatment for primary care. And 35 patients(45.4%) visited our hospital due to preference of oriental medicine. 4. In partial pain, most was the neck(76.6%), followed by low back(61.0%). 5. In radiation test(excluded sprain and straightening), the most was HIVD of L-SPINE(14.0%). 6. In the periods of admission, less than 7 days was the 1st(36.4%), 14 days was the 2nd(27.3%). 7. The treatment was effective to 67 patients out of 77 patients who had been hospitalized.

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비수술적 처치가 시행된 장중첩증의 임상적 고찰 (A Clinical Analysis of Intussusception by Non-operative Management)

  • 한동현;정기량
    • 한국방사선학회논문지
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    • 제1권2호
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    • pp.5-11
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    • 2007
  • 장중첩증은 2세 이하의 소아, 특히 남자 환아의 장폐쇄를 일으키는 가장 흔한 질환이다. 이에 저자들은 2005년 6월 1일부터 2007년 5월 31일까지 만 2년 동안 응급실로 내원하여 소아 복부 초음파를 통해 장중첩증으로 진단을 받고 비수술적 정복술을 시행한 환아 54명에 대해 임상 분석하여 다음과 같은 결과를 얻었다. 1) 연령별 분포는 13~24개월 사이가 40.7%였고, 성별분포는 남아가 72.2%, 여아가 27.8%로 남녀의 비는 2.6:1이었다. 2) 임상증상은 복통 및 보챔(100.0%), 구토(66.7%), 설사(33.3%)등 이었고, 설사증상을 나타낸 환아에서 장중첩증 정복성공이 유의하게 감소하였다(p<0.05). 혈액상 특성으로 백혈구수는 10,000~15,000개 사이가 29.6%였다. 3) 개인병원의 1차 진료 후 본원에 내원한 환아는 42.6%였고, 증상발현에서 처치까지의 소요시간은 6~12시간이 37.0%로 많았다. 4) 장중첩증의 유형은 회장-결장형이 98.1%였고, 장중첩증의 위치는 간만곡부가 68.5%였다. 5) 공기압정복술의 성공률은 88.0%였고, 바륨정복술은 86.2%였다(p>0.05).

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