• Title/Summary/Keyword: 내원환자

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Obesity Prevalence in Pediatric Headaches (소아청소년 두통 환자에서 비만 유병률)

  • Han, A-Luem;Shin, Chan Ok;Cho, Kyoung Soon;Bin, Joong Hyun;Jung, Min Ho;Suh, Byung-Kyu
    • Journal of the Korean Child Neurology Society
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    • v.26 no.4
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    • pp.263-268
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    • 2018
  • Purpose: Obesity and headache are two highly prevalent diseases both in childhood and adolescent. In this study, we assessed the prevalence of obesity in pediatric headaches patients in a single institution in Korea, and differences according to age, sex, headache type, frequency, intensity, and disability. Methods: We retrospectively reviewed the medical records of 340 subjects (6-18 years of age) who visited the Pediatric Headache Clinic of Bucheon St. Mary's Hospital during the period from January 2015 through March 2018. Data on age, sex, height and weight, as well as headache type, frequency, intensity and disability, were collected. Body Mass Index (BMI) percentile was calculated based on the 2017 Korean Children Adolescence Growth Chart. Results: 17.6% of the pediatric headache patients were obese. The prevalence of obesity in male patients was higher than females (Male 23.8% VS Female 11.6%, P=0.002). There were no significant differences in obesity rate according to age, headache type, frequency, intensity, and disability. Conclusion: The prevalence of obesity in the pediatric headache population was 17.6% which is higher than 10.1% in general population (Korea National Health and Nutrition Examination Survey, KNHANES, 2013).

The evaluation of properties for radiation therapy techniques with flattening filter-free beam and usefulness of time and economy to a patient with the radiation therapy (Flattening filter-free beam을 이용한 방사선 치료 기법의 특성 및 환자의 시간적.경제적 유용성 평가)

  • Goo, Jang Hyeon;Won, Hui Su;Hong, Joo Wan;Chang, Nam Jun;Park, Jin Hong
    • The Journal of Korean Society for Radiation Therapy
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    • v.26 no.2
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    • pp.363-368
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    • 2014
  • Purpose : The aim of this study was to appraise properties for radiation therapy techniques and effectiveness of time and economy to a patient in the case of applying flattening filter-free (3F) and flattening filter (2F) beam to the radiation therapy. Materials and Methods : Alderson rando phantom was scanned for computed tomography image. Treatment plans for intensity modulated radiation therapy (IMRT), volumetric modulated arc therapy (VMAT) and stereotactic body radiation therapy (SBRT) with 3F and 2F beam were designed for prostate cancer. To evaluate the differences between the 3F and 2F beam, total monitor units (MUs), beam on time (BOT) and gantry rotation time (GRT) were used and measured with $TrueBeam^{TM}$ STx and Surveillance And Measurement (SAM) 940 detector was used for photoneutron emitted by using 3F and 2F. To assess temporal and economical aspect for a patient, total treatment periods and medical fees were estimated. Results : In using 3F beam, total MUs in IMRT plan increased the highest up to 34.0% and in the test of BOT, GRT and photoneutron, the values in SBRT plan decreased the lowest 39.8, 38.6 and 48.1%, respectively. In the temporal and economical aspect, there were no differences between 3F and 2F beam in all of plans and the results showed that 10 days and 169,560 won was lowest in SBRT plan. Conclusion : According as the results, total MUs increased by using 3F beam than 2F beam but BOT, GRT and photoneutron decreased. From above the results, using 3F beam can decrease intra-fraction setup error and risk of radiation-induced secondary malignancy. But, using 3F beam did not make the benefits of temporal and economical aspect for a patient with the radiation therapy.

Clinical Study of Rhabdomyolysis After Exercise (운동 후 발생한 횡문근 융해증의 임상적 고찰)

  • Ahn, Young-Joon;Yi, Seung-Rim;Yoo, Jae-Ho;Zoo, Min-Hong;Kim, Seong-Wan;Park, Ji-Man;Yang, Bo-Kyu
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.110-114
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    • 2007
  • Purpose: This study evaluate clinical findings & management of rhabdomyolysis after strenuous activities in military police recruit. Materials and Methods: This study was carried out from June $1^{st}$, 2004 and May $23^{nd}$, 2005. The study subjects were 13 military police recruit patients who were admitted to our hospital with intractable muscle pain and swelling, and had suspicions of Rhabdomyolysis. The patients were given various blood tests (CPK, CK-MB, AST, BUN/Cr, and Electrolyte) and clinically observed. The patients were all males, and their average age was 20 $(19\sim21)$ years. Seven cases were due to push-up exercises, 5 was due to a soccer game, and 1 was due to riot control activities. The patients complained of swelling and tenderness in various parts of the extremities. Four complained of swelling and tenderness in forearm, 3 in upper arm, 1 in shoulder, and 5 in lower extremity. The diagnosis of rhabdomyolysis was made if the patient complained clinical symptom and had a blood CPK level of above 1,000 IU/L at the time of admission. Patients who took medication or had medical problem were excluded from this study. Bone scans were taken of all patients 4 hours after giving 99mTc-MDP 20mCi intravenously. Treatment was bed rest and fluid therapy. Patients who complained of excessive pain were given splint immobilization. Results: The average hospitalization day for the 13 patients was 20 days ($14\sim42$ days). Excluding one patient who exhibited ARF at time of admission, all patients showed a decrease of blood CPK below 1000 IU/L at an average hospitalization time of 8 days ($2\sim11$ days). The patient with ARF recovered after hemodialysis and fluid therapy. Conclusion: Patients complaining of swelling and severe muscle pain after excessive exercise or training should be suspicious of exercise induced rhabdomyolysis, and should be given blood tests and fluid therapy immediately.

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The study on outpatient-clinic practice by shift system at a hospital in Taegu (대구지역 한 중소병원의 교대제 근무에 의한 외래진료에 관한 연구)

  • Song, Jung Hup;Kim, Jing Kyun;Ha, Young Ae;Yeh, Min Hae
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.44-59
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    • 1994
  • Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospital's economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of patients at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours. there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.

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Database study for clinical guidelines of children with pneumonia who visited an emergency department (응급의료센터에 내원한 소아 폐렴의 진료 지침을 위한 기초 자료 연구)

  • Hong, Dae Young;Lee, Kyung Mi;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik;Lim, Dae-Hyun;Son, Byoung Kwan;Lee, Hun Jae;Lee, Kyung-Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.757-762
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    • 2006
  • Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.

A Study on Perception by Examinees of the Health Promotion Center Institutions about Exposure to Radioactivity (건강검진센터에 내원한 환자의 방사선피폭에 대한인지도 조사)

  • Yeo, Jin-Dong;Jeon, Byeong-Kyu
    • Journal of the Korean Society of Radiology
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    • v.10 no.6
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    • pp.457-468
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    • 2016
  • The purpose of this study was to investigate factors of perception by inpatients of the Medical Examination institutions about exposure to radioactivity at the time of radioactive examination, providing basic information for making educational materials aimed to change their perception. Most of those patients, 72.0% responded that CT was a type of radioactive examination bringing highest exposure to radiosensitivity. Most of the subjects, 63.5% said that a body part most vulnerable to exposure to radiosensitivity was the genital gland at the time of radiosensitivity examination. And most of the participants, or 29.0% responded that they obtained information about radiation from TVs or newspapers. Among the surveyed patients, men were higher in scores for factors of the perception of radiation such as recognition of radiation, harmfulness of radiation, psychological state at the time of radioactive examination, prevention of exposure to radioactivity and necessity of radiation that women were, with statistically significant differences between the two groups. These findings suggest that it is urgently needed to develop an education program which helps patients better perceive exposure to radioactivity and that radiologists should be very careful to reduce the does of that exposure. If patients better perceive radiation, they would be less anxious and less exposed to radioactivity when receiving the radioactive examination.

The Relationship of Periodontal Health Recognition and Self Oral Hygiene Behaviors of Dental Clinic Inpatient (치과내원 환자의 치주건강인식도와 자기구강위생관리행위의 관련성)

  • Jang, Ji-Eon
    • Journal of dental hygiene science
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    • v.15 no.5
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    • pp.666-672
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    • 2015
  • This paper was trying to investigate the periodontal health recognition and self oral hygiene behaviors and figure out that relationship. The results having analyzed 592 questionnaires returned patient who had visited the dental clinic which is selected randomly were following. There were relationships between the periodontal health recognition and self oral hygiene behaviors. Self oral hygiene behaviors were significantly high when, women did than men did, education level, subjective oral health status, and periodontal health recognition about managements were higher and periodontal health recognitions about treatment were lower. It was the periodontal health recognition that was influential the most in the independent variables. Therefore, knowledge related to the periodontal health should be educated to the patients visiting the dental clinic, and the patients should receive helps to perform self oral hygiene behaviors by inducing the transition of attitude to periodontal health.

Retrospective Study of Traumatic Dental Injuries among Children Aged 0 - 15 Years in Wonju (원주세브란스기독병원 응급실로 내원한 0 - 15세 어린이의 치과적 외상에 관한 후향적 분석)

  • Bae, Doo-Hwan;Kim, Ji-Hun
    • Journal of the korean academy of Pediatric Dentistry
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    • v.44 no.1
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    • pp.64-71
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    • 2017
  • This study was designed to evaluate the age, gender, location of trauma, etiology, injury site, types of treatment, elapsed time after trauma, and arrival time of children who visited trauma center of Wonju Severance Christian Hospital. Records of a total of 841 patients who were 0 - 15 years old and received care in the period from March 2011 to October 2015 at the Trauma Center, Wonju Severance Christian Hospital were analyzed. This study showed that traumatic dental injuries were more common in boys and patients between 0 - 3 years old. Under 6 years old, fall was the most common etiology and home was the most common place of trauma. However, fall decreased, and sports and etc increased largely in etiologic factors over 6 years old. Besides, home decreased, and road and kindergarten school increased largely in the place of trauma. Etiology and location of trauma were statistically influenced by the age (p < 0.05). The most commonly affected injury sites were maxillary incisors and lips. The most patients visited trauma center between 18 - 24 o'clock (53.3%), and the least patients visited between 0 - 6 o'clock (4.6%). 51.5% of patients visited the trauma center within 1 hour of sustaining trauma, and 26.8% and 11.5% of patients visited between 1 - 2 hours and 2 - 3 hours respectively. The most common treatment of traumatic dental injuries was observation, and the second most common treatment was suture. Traumatic dental injuries in children exhibit specific epidemiological features according to children's gender, age, and other conditions. These result from combination of social, developmental, and physiologic factors.

A Study on the Treatment Status and Treatment Compliance of Diabetics Who Visited the Health Centers of Daejeon City (대전시 보건소 내원 당뇨병환자들의 치료실태 및 치료 순응도에 관한 연구)

  • Lee, Tae-Yong;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.5
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    • pp.1141-1147
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    • 2009
  • This study has been conducted from July 30, 2007 to February 24, 2008 on 677 patients who were receiving diabetic treatment at the Health Centers of Deajeon City to find out their blood sugar level adjustment and their treatment compliance. As a result, 58.5% of them showed less than 200mg/dl of blood sugar level, and 67.9% showed their HbA1C of less than 7%, meaning that many of diabetic patients did not have their blood sugar level properly adjusted. And their after-meal blood sugar level and HbA1C adjustment varied depending upon the Health Centers. 88.0% of them were taking medicines for diabetic treatment regularly, and many of them were recognizing the need of dietary and exercise therapies to treat their diabetes. In conclusion, patients were recognizing that regular intakes of medicines, dietary and exercise therapies were very helpful to treatment of diabetes, but their treatments of HbA1C and blood level adjustment were not properly done as shown by their after-meal blood sugar level. The results were greatly different between the Health Centers, so there is a great need to cope with this situation.

A Clinical Study on the Prevalence of Skin Diseases in Adult Patients - focused on an ageing society (성인 피부질환 발생빈도에 대한 임상적 연구 - 고령화 사회를 중심으로)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.19 no.2
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    • pp.242-248
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    • 2006
  • 배경 : 의과학과 사회-경제학의 발전은 인간 수명 연장에 지대한 공헌을 해 왔다. 그러나 결과적으로 피부 질환으로 고생하는 노인 인구도 증가하였다. 본 연구에서는 동국대학교 한방 안이비인후피부과에 피부질환을 주소증으로 내원한 성인 환자들을 대상으로 임상 양상을 조사해 보고 고령사회에서 어떻게 한방 피부과 의료 수요 변화에 대처하고 발전해 나아갈 수 있을지 그 방법을 모색해 볼 수 있는 근거 자료로 활용하기 위해 수행하였다. 연구방법 : 2002년 1월부터 2004년 12월 까지 3년 동안 동국대학교 한방 안이비인후피부과에 피부 질환을 주소증으로 내원한 319명의 환자를 대상으로 하였다. 그들을 내원시기, 연령, 성별로 나누어 질환별 분포를 조사하였다. 통계분석은 $X^2$ test(Window, SPSS 11.0)를 사용하였고 p <.05를 유의수준으로 하였다. 결과 : 2002년부터 2004년 까지 질환별 분포를 살펴보면 습진 21.9%, 소양증 20.4%. 여드름 16.9%,로 나타났다. 2002년에는 습진 17.0%, 소양증 16.0%, 여드름이 14.9%였다. 2003년에는 소양증 34.2%, 두드러기가 23,3%, 습진이 17.1%였다. 2004년에는 습진 61.4%, 여드름 21.1%, 소양증 15.8%였다. 이들 결과는 통계적으로 유의한 차이를 보였다($X^2\;=\;54.135^{***}$, p = .000, df : 20). 남자에서는 습진이 25.0%로 가장 많았고 소양증 19.5%, 두드러기 12.5%, 지루성 피부염 11.7%로 나타났다. 여자에서는 여드름이 22.0%로 가장 많았고 소양증 20.9%, 습진 19.9%였다. 이들 결과는 통계적으로 유의한 차이를 보였다($X^2\;=\;19.839^*$, p = .031, df : 10). 20대 환자에서는 여드름이 24.1%로 가장 많았고 습진과 소양증이 각각 19.5%였다. 30대 환자군에서는 습진이 30.3%였고 소양증이 19.1%였다. 40대에서는 소양증이 28.8%였고 지루성 피부염이 16.0%였다. 50대에서는 습진이 26.7%였고 60세 이상의 그룹에서는 습진이 50.0%, 바이러스 질환과 소양증이 각각 15.0%였다. 이들 결과는 통계적으로 유의한 차이를 보였다($X^2\;=\;74.995^{**}$, p = .001, df : 40). 결론 : 상대적으로 50세 이상 연령충의 대상 환자 수가 많지 않은 원인은 여리 가지 분석이 가능할 것으로 생각된다. 연령에 따라 피부질환이 다른 양상을 보임을 고려할 때 노인층의 신체적, 경제적, 사회적 특성을 이해하고 이에 따른 효과적이고 사회-경제학적 부담을 최소할 수 있는 한방 치료 영역의 확대 및 개발이 필요할 것으로 사려된다.

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