• Title/Summary/Keyword: 진료량

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Prevalence of Drug-resistances in Patients with Pulmonary Tuberculosis and Its Association with Clinical Characteristics at One Tertiary Referral Hospital in Pusan, Korea (부산지역 한 3차 병원으로 내원한 폐결핵 환자에서 약제 내성률과 예측인자간의 연관성)

  • Son, Choon-Hee;Yang, Doo-Kyung;Rho, Mee-Sook;Jeong, Jin-Sook;Lee, Hyuck;Lee, Ki-Nam;Choi, Pil-Jo;Lee, Soo-Keol;Chang, Kwang-Yul;Choi, Ik-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.5
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    • pp.416-425
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    • 2001
  • Background : The incidence of drug-resistant tuberculosis has recently decreased in Korea. However, it is still one of the major obstacles in treating pulmonary tuberculosis. This study was performed to determine the prevalence and clinical characteristics associated with drug-resistance in pulmonary tuberculosis at the tertiary referral hospital in Pusan, Korea. Methods : The medical records of 138 patients, who had been diagnosed as active pulmonary tuberculosis were retrospectively reviewed, and results of drug susceptibility from May 1997 to June 2000. The relationships among those with a history of previous tuberculosis treatment, the extent of lung involvement, the presence of cavities on the initial chest X-ray films and patterns of drug resistance were analyzed. Results : The total number of patients who had drug resistance to at least one drug was 55(39.9%). Among them 34(24.6%) had resistance to isoniazid(INH) and rifampin(RFP). There was drug resistance in 20(22%) of 91 patients without previous tuberculosis therapy, and among them 9(9.9%) were multi-drug resistant. Thirty-two(74.5%) out of 47 patients with previous therapy were drug-resistant and 25(53.2%) were multidrug resistant. For all 138 patients, resistance to INH was the most common(34.1%), followed by RFP(26.1%) and ethambutol(EMB)(14.5%). Drug resistance to INH, RFP, PZA and streptomycin(SM) were independently associated with a history of previous treatment(odds ratio; 9.43, 9.09, 8.93 and 21.6 respectively, p<0.01). The extent of lung involvement on the chest films was significantly associated with the drug resistance to INH and RFP(odds ratio; 2.12 and 2.40 respectively, p<0.01). The prevalence of drug resistance to RFP, INH and RFP was significantly more common in patients with a cavitary lesion on the chest films by multivariate analysis(odds ratio; 4.17 and 4.81 respectively, p<0.05). Conclusion : This study revealed that patients with a prior treatment history for pulmonary tuberculosis, and the presence of a cavitary lesion on chest films had a higher prevalence of anti-tuberculosis drug resistance. A very careful clinical and microbiological examination is needed for patients with such characteristics.

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Psychological Characteristics of Psychiatric outpatients with High Suicide Risk : Using MMPI-2-RF (정신건강의학과 외래 환자 중 자살 고위험 집단의 심리적 특성 : MMPI-2-RF를 이용하여)

  • Nam, Jisoo;Kim, Daeho;Kim, Eunkyeong
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.1
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    • pp.8-19
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    • 2020
  • Objectives : The purpose of this study was to examine whether the MMPI-2-RF serves as a useful tool to differentiate between the subtypes of high risk of suicide among psychiatric outpatients. Methods : Patients were recruited from the department of psychiatry of university hospital. Participants were diagnosed using DSM-5 criteria by board certified psychiatrists. Their medical records were reviewed retrospectively. And participants were put into 4 groups (Suicide ideation, Suicide attempt, Non-suicidal self-injury, and general psychiatric diagnosis as a control group). For statistical comparison, the MANCOVA with gender as a covariate was used. Results : The results indicated that as previous research with non-clinical sample suggested, psychiatric outpatients with high suicide risk also have significantly higher Emotional/Internalizing Dysfunction, Helplessness/Hopelessness, Suicidal/Death Ideation, Demoralization, Cognitive complaints, Cynicism, Dysfunctional negative thoughts than general psychiatric patients group. But group differences within the high suicide risk patients have not been observed. However, suicide attempt group and NSSI group has higher Behavioral/Externalizing Dysfunction, RC4, AGG than general psychiatric patients group. But there was no difference between suicidal idea group and general psychiatric patients group. Conclusions : There was no group difference observed between all three subtypes, which mean the MMPI2-RF may not be the useful diagnostic tool to navigate high suicide risk subtypes. Even though there was no difference observed in the suicide ideation group, suicide attempt group and NSSI group have higher aggression and externalization. So those indexes could serve as a useful marker to investigate riskiness of suicide related symptoms.

A Study on the Environmental Condition and Safety in Dental Radiographic Room (치과 방사선 촬영실의 촬영실태와 방사선 안전관리 실태에 관한 조사 연구)

  • Kang, Eun-Ju;Lee, Kyung-Hee;Ju, On-Ju
    • Journal of dental hygiene science
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    • v.5 no.2
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    • pp.83-88
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    • 2005
  • In spite of relatively low level of radiation dose used at dental clinics, long term exposure may be harmful, so radiation workers at dental clinics must be well aware of its danger. This study was radiation safety management by dental hygienists in order to take preventive measures for dental hygienists and suggest ideas to develop radiation safety training programs. For this, we contacted dental hygienists working at the local dental clinics for 4 months from December of 2003 to march of 2004 and obtained the following findings. 1. Regarding the intraoral radiographic method, the average daily photographing frequency of standard films stood at one to five pieces (47.5%), and the average weekly photographing frequency of digital radiation medicine stood at less than one piece (69.8%), and the average weekly photographing frequency of bitewing films stood at less than one piece (67.7%), and and the average weekly photographing frequency of occlusal films stood at less than one piece (95.5%), and the dentistries whose average weekly photographing frequency of pediatric films stood at one to five pieces accounted for 47.1 percent. 2. Regarding the extraoral radiographic method, the average weekly photographing frequency of panorama film stood at one to five pieces (63.7%), and less than one piece (20.9%), the average weekly photographing frequency of cephalometric film stood at less than one piece (72.3%), and one to five pieces (20.1%). 3. Concerning the radiation safety management training program, only 18.7% of total 278 surveyed attended the training progra., Attendance tendency of the training program by general characteristics showed statistically significant difference according to age (p<0.01), working experience (p<0.001), and marital status (p<0.01). 4. When asked about the protective equipments against radiation exposure, 40.6% of them said "modest", and 71.1% appeared equipped with led apron as a protective tool.

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Analysis of the Correlation of Job Satisfaction to Turnover Among Dental Hygienists in the Region of J (J지역 치과위생사의 직무만족과 이직의 상관관계 분석)

  • Ju, On-Ju;Kim, Kyeong-Seon;Lee, Hyun-Ok
    • Journal of dental hygiene science
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    • v.7 no.4
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    • pp.251-256
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    • 2007
  • The purpose of this study was to examine what induced dental hygienists to take up another employment and whether their job satisfaction had anything to do with it in an attempt to help curtail their turnover rate. The subjects in this study were approximately 200 dental hygienists who worked in dental institutions. A survey was conducted from July 24 through September 24, 2006, by using structured, self-administered questionnaires. For data analysis, SPSS 11.5 program was employed to see if their turnover experience was linked to their general characteristics, why they took up another employment, how long they wanted to do that and how their job satisfaction was related to that. The findings of the study were as follows: 1. In regard to turnover experience by age, marital status and career, those who had ever changed their employment accounted for 36.2 percent of the age group from 24 to 26, 83.0 percent of the unmarried ones and 50.0 percent of those whose career was less than one to three years (p < 0.001). By monthly mean income, 50.0 percent of the dental hygienists whose monthly mean income ranged from 1.0 to 1.29 million won had that experience(p < 0.05). The gap between these groups and the others was statistically significant. 2. As for the reason of turnover, working environments were cited most often(28.1%), followed by possibilities(18.0%), relationship with supervisors and colleagues(12.4%), and compensation(4.5%). 3. Concerning a preferred new workplace, 66.2 percent of the dental hygienists who worked in dentist's offices hoped to be newly hired by public dental clinics(p < 0.001). By education, 64.3 percent of the college-educated dental hygienists wanted to work at public dental clinics as well(p < 0.01). 4. The change of employment was under the greatest influence of the possibilities of workplace, followed by workload, pay and relationship with colleagues. All the factors had a negative impact on their turnover. Those who were less satisfied sought new employment more often, and job satisfaction made a statistically significant difference to that. The job satisfaction factors made a prediction of their turnover intention ($R^2=.254$).

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Evaluation of an Automated Liquid-Handling System with Fixed Pipetting Tips in Radioimmunoassay (고정용 팁을 사용하는 Automated Liquid-Handling System의 RIA적용의 평가)

  • Shin, Sun-Young;Kim, Hee-Sun;Lee, Hyun-Ju;Jang, Hyun-Young;Woo, Jae-Ryong;Lee, Ho-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.190-196
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    • 2010
  • Purpose: This study was undertaken to investigate the feasibility of using automated liquid-handling systems equipped with reusable fixed tips in Radioimmunoassays and to demonstrate that the use of an automated pipetting instrument can decrease in the typical daily workload. Materials and Methods: The precisions of the automated pipettor and the manual pipettor were determined gravimetrically (n=30). A total of 30 specimens for HBs Ag were repeatedly pipetted (three replicates) with the automated pipettor and then retested. PSA samples were simultaneously pipetted with either the automated pipettor or the manual pipettor and then analyzed (n=40). Sample carryover test assessed for CA19-9, AFP and HCG when the automated pipettor was used. Pipetting speed of the automated pipettor and the manual pipettor were compared by evaluation of each workload. Results: The precisions coefficients of variation (CV) were 2.1% for the automated pipettor and 1.6% for manual pipettor. The mean cpm and CV for each group of replicates were 41,203 cpm and 3.7% for HBs Ag positive specimens, and 99 cpm and 7.9% for HBs Ag negative specimens, respectively. PSA results showed no significant differences between automated pipettor and manual pipettor (p=0.15, r=0.999). Carryover for CA19-9, AFP and HCG analytes was <0.1 ppm or below the assay limit of detection. Pipetting speed was significantly improved by using the automated instrument. Conclusion: There was no evidence that the use of an automated pipettor adversely affected any of the performance characteristics of the assay. Indeed, routine use of the Tecan automated pipettor has resulted in a decrease in the typical daily workload.

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An Experimental Study on Internal Decontamination Radiocobalt (Radiocobalt의 체내 오염(汚染)에 대(對)한 제염효과(除染效果))

  • Chung, In-Yong;Kim, Tae-Hwan;Chung, Hyun-Woo;Chin, Soo-Yil;Yun, Taik-Koo
    • Journal of Radiation Protection and Research
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    • v.13 no.1
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    • pp.31-41
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    • 1988
  • In case of the acute intake of radionuclide, an early medical treatment may be necessary, but the little is established the procedures to decontaminate the victims of internal contamination in Korea. The purpose of the present investigation is to study chemical agents to remove radiocobalt from the victims and to provide a more reliable procedure for the treatment. The removals of radiocobalt from the NIH-CGP)mice injected intraperitoneally with $1{\mu}Ci$ of $^{58}Co$ as $CoCl_2$ were investigated with doses of either $CaNa_3$ DTPA 8.4mg/0.2ml saline, $CoNa_3$ DTPA 8.4mg/0.2ml saline, or saline 5ml. The radioactivity was determined by MCA and Ge-detector on 4, 8, 12, 48 hours and 7 days for the whole body, organ distribution and urine excretion. Six mice per each group were sacrificed for the measurement of cobalt retention in the parenchymal tissue. The cobalt trisodium chelate had a pronounced effect on reducing the whole body retention and increasing the excretion rate. Regarding to the systemic protective effects, $CoNa_3$ DTPA, $CaNa_3$ DTPA and saline were effected significantly in order. In conclusion, the extrapolations from these results to human were suggested that the rapid administration of cobalt trisodium chelate and an amount of saline to the contaminated person after internal contamination of radiocobalt were markedly increasing the decontamination effects.

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Evaluating and managing hypertension in children: a survey of Korean cardiologists and nephrologists (소아 고혈압의 평가와 관리 방법; 한국 소아심장 전문의와 소아신장 전문의 설문)

  • Lee, Eun Hee;Yim, Hyung Eun;Jang, Gi Young;Yoo, Kee Hwan;Son, Chang Sung;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.992-997
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    • 2008
  • Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

Eating Habits of Children Under 4 Years with Poor-Feeding (식욕부진이 있는 4세 이하 영.유아의 식이 습관에 대한 조사)

  • Yoon, Young-Hun;Park, Yeung-Bong;Yang, Eun-Seok;Rho, Young-Ill;Kim, Eun-Young;Moon, Kyung-Rye;Lee, Chul-Gab
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.167-173
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    • 2003
  • Purpose: To find out the differences in eating habits between poor feeding and non-poor feeding children. Methods: We performed questionnaires on 504 children under four years of age who visited hospitals in Gwangju city and JaollaNamdo from May to August, 2002. Results: 138 (27.4%) children were included in poor feeding group, and 366 (72.%) children were in non-poor feeding group. Breast feeding rate was 18.8% in the poor feeding group and 20.3% in the non-poor feeding group. Duration of breast feeding for less than six months were noted in 70.5% of poor feeding group, and 58.5% of non-poor feeding group. The time at starting solid food in the poor feeding group was as follows; 15.9% of infants started on solid food when they were 2~4 months old, 32.7% during 4~6 months, 38.1% during 6~8 months and 18.8% over one year of age. Solid food was given in wrongly manners in both groups by nursing bottles, including 80.4% in poor feeding group and 66.6% in non-poor feeding group. Conclusion: This study demonstrated close relationships among poor feeding children under four years of age with history of low rate and short duration of breast feeding, inappropriate time to start on solid food, less interest in food during mealtime, and unbalanced diet. Pediatricians should make an effort to play an important role in nutritional education and treatment in children.

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Causes of Childhood Injuries Observed at the Emergency Rooms of Five Hospitals in Taegu (대구시내 종합병원 응급실에 찾아온 소아사고 환아의 사고원인)

  • Park, Jung-Han;Bae, Yeong-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.224-237
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    • 1988
  • To determine the causes of and related factors to childhood injuries, the emergency room records and inpatient medical records were reviewed for 4,849 injured children out of 15,790 pediatric patients(<15 years old) who visited the emergency rooms of 3 university hospitals and 2 general hospitals in Taegu from 1 January to 31 December 1987. Out of total injured children, 54.675 were 3-8 years old and the male to female ratio of the total injured children was about 2:1. The leading causes of injury were falls and slips (29.1%) and traffic accident(28.2%). The frequency of injury was higher in May-October than the rest of months and 51.6% of the injuries occurred between 15 and 20 o'clock. Falls and slips took place most frequently at the stairway(25.7%). The most common interpersonal violence was inflicted injuries(85.6%) and there were 11 child rapes. Dog bites accounted for 67.6% of all biting injuries and it occured 2.9 times more in male than in female. CO intoxication was the most common cause of poisoning (45.3%) and scalding accounted for 85.2% of all burns. Common places of drownings were river (32.2%), swimming pool (22.6%) and construction site(19.3%). To prevent childhood injuries, it is recommended to eliminate the hazardous environmental factors, to provide safe playgrounds, to educate the children for safety from kindergarten and the general public through mass communication, to establish a strict safety standard for houses, public buildings and facilities, and playgrounds.

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Correlation between Caloric Intake and Lung Function Parameters in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 환자에서 열량섭취와 폐기능지표와의 상관관계)

  • Yoon, Ho Il;Park, Young Mi;Choue, Ryowon;Kang, Yeong Ae;Kwon, Sung Youn;Lee, Jae Ho;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.5
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    • pp.385-389
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    • 2008
  • Background: There are reports that food deprivation causes emphysematous changes in the lungs of rats and humans. However, the meaning of this phenomenon in patients with chronic obstructive pulmonary disease has not been evaluated. The aim of this study was to determine the correlations between the caloric intake and parameters of the lung function in patients with chronic obstructive pulmonary disease. Methods: Patients with chronic obstructive pulmonary disease who had visited the respiratory clinic from March, 2006 for one year were enrolled in this study. The patients underwent pulmonary function tests, and a dietitian evaluated their nutritional intake using a food record method. Results: There was no correlation between the total caloric intake and forced vital capacity (FVC, %predicted) or forced expiratory volume in one second ($FEV_1$, %predicted). The total caloric intake showed a positive correlation with the diffusing capacity of carbon monoxide (DLCO %predicted, DLCO/VA %predicted), and a negative correlation with the total lung capacity (TLC, %predicted). Of the calories taken, only calories from protein intake correlated with the diffusing capacity of carbon monoxide (DLCO %predicted, DLCO/VA %predicted). Conclusion: The total caloric intake of patients with chronic obstructive pulmonary disease showed a positive correlation with the diffusing capacity of the lung, and a negative correlation with the total lung capacity. Further study on the linkage between the caloric intake and severity of emphysema is needed.