• Title/Summary/Keyword: outpatient

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A Case of Spontaneously Regressed Endobronchial Sarcoma after Obstructive Pneumonia (폐쇄성 폐렴 후 자연 퇴행을 보인 기관지내 육종 1예)

  • Park, Sun Hyo;Jeon, Yong June;Kwon, Kun Young;Han, Seung Beom
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.94-99
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    • 2007
  • The spontaneous regression (SR) of cancer is defined as the complete disappearance of a malignant disease without adequate treatment. SR is a very rare biological event, particularly in a pulmonary sarcoma. We report the first documented case of an endobronchial sarcoma that regressed spontaneously in Korea. We encountered a rare case of a 72-year-old woman with an undiagnosed intrapelvic cystic mass, who presented with a smooth surfaced endobronchial tumor obstructing the orifice of the right lower lobe bronchus on a bronchoscopic examination. She had a prior history cervical cancer and adenocarcinoma in the right middle lobe lateral segment of her lung for which she had undergone radiation therapy. The tumor was diagnosed as an endobronchial sarcoma by the histopathology findings and immunohistochemistry. It was unclear if the tumor was a primary sarcoma of the lung or a metastatic lesion of an intrapelvic cystic mass because she refused a diagnostic exploratory laparotomy. Two months later, obstructive pneumonia of the right lower lobe with parapneumonic effusion developed with fever above 38.5degrees C for 10 days. After recovering from pneumonia, she was followed up regularly in the outpatient clinic without any specific treatment. One year later after treating the obstructive pneumonia, the follow-up bronchoscopy revealed complete SR of endobronchial sarcoma. It is believed that the obstructive pneumonia accompanied by fever above 38.5degrees C for 10 days might have played a role in this SR.

Dental Treatment of a Patient with Cerebral Palsy under General Anesthesia (뇌성마비 환자의 전신마취 하 치과치료)

  • Chung, Jun-Min;Seo, Kwang-Suk;Yi, Young-Eun;Han, Hee-Jung;Han, Jin-Hee;Kim, Hye-Jung;Shin, Teo-Jeon;Kim, Hyun-Jeong;Yum, Kwang-Won;Chang, Ju-He
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.1
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    • pp.22-28
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    • 2008
  • Background: Cerebral palsy (CP) is non-progressive disorder of motion and posture. In CP patient, there are difficulties in dental treatment because of uncontrolled movement of limb and head, and conjoined disabilities such as cognitive impairment, sensory loss, seizures, communication and behavioral disturbances. It is reported that CP patients have high incidence in caries and a higher prevalence of periodontal disease. But, despite the need for oro-dental care, these patients often are unlikely to receive adequate treatment without sedation or general anesthesia because of uncontrolled movements of the trunk or head. Methods: We reviewed the 58 cases of 56 patients with CP who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 19 (2-54) years. The number of male patient was 40 and that of female was 18. They all had severe spastic cerebral palsy and 22 had sever mental retardation, 15 epilepsy, 8 organic brain disorder, 1 blindness, 2 deafness and cleft palate. For anesthesia induction, 14 cases was needed physical restriction who had sever mental retardation and cooperation difficulty, but 44 cases showed good or moderate cooperation. Drugs used for anesthesia induction were thiopental (37 cases), sevoflurane (14 cases), ketamine (3 cases ) and propofol (4 cases). All patients except one were done nasotracheal intubation for airway management and 4 cases were needed difficult airway management and 1 patient already had tracheostomy tube. Mean total anesthetic time was $174{\pm}56$ min and staying time at PACU was $88{\pm}39$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

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Status and Influencing factors of health behavior in pregnant women in Yanbian area (연변지역 임부의 건강행위 이행실태 및 영향요인)

  • Zhang, Hai-Lian;Li, Chun-Yu;Kim, Hyun-Li
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7863-7869
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    • 2015
  • Purpose: To Examine the status of health behavior and identify the influencing factors of health behavior among pregnant women. Method: The participants were 1011 pregnant women who visited outpatient hospital of in Yanbian, China. Participants were interviewed using Chinese version of Edinburgh Postnatal Depression Scale(EPDS), Perceived Social Supports(PSSS), general self-efficacy, and characteristics. Descriptive statistics, t-test, ANOVA, pearson correlation coefficient, binary logistic regression were used for data analysis with SPSS 19.0. Results: The mean score of health behavior was $28.93{\pm}6.59$ scores(0~45 scores). Antepartum depression(OR=0.94[0.90-0.98]), perceived social supports(OR=1.07[1.05-1.09]), self-efficacy(OR=1.36[1.04-1.79]) were predictor of health behavior among pregnant women, on the contrary to this the characteristics of pregnant women were not statistically significant. Conclusion: The implement of the health behavior among pregnant women was not ideal. It's necessary to develop a health behavior intervention focus on antepartum depression, social support, and self-efficacy for pregnant women.

Relationship between Maternal Work Activity and Congenital Muscular Torticollis (어머니의 직업활동이 선천성 근육사경에 미치는 영향)

  • Kim, Ki-Jeon;Song, Brian Byung
    • The Journal of the Korea Contents Association
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    • v.13 no.9
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    • pp.270-280
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    • 2013
  • The Purpose of this study was to investigate the relationship between congenital muscular torticollis and maternal work activity. This study was conducted with a total of 89 outpatient pregnant women whose child presented congenital muscular torticollis at the Department of Rehabilitation of "C" Hospital in Suwon within the period from 2006 to April 30, 2011. The results were as followings: (1) The mean age at the time of giving birth was 30.09years; the proportion of pregnant women with college education or higher was high; the proportion of first delivery was 82.0%; the most common way of delivery was natural childbirth, followed by Cesarean section and vacuum extraction; the proportion of breech delivery was 20.2%; and in 82.0% of the women, the first child had congenital muscular torticollis. (2) 59.6% of the women had a career; 45.3% had engaged in professional practice or had a related job; 75.5% had worked until the third trimester of their pregnancy; 54.7% had worked for seven hours or more in a seated position; and the mean number of working hours was 8.75 (3) The level of work-related stress was a low 25% or less, and in the subdivisions of work-related stress, only the level of strained relations belonged to the upper 50% or higher. (4) For the correlation between the survey respondents' job stress and job features, stress (full score: 100 points) showed a strong positive correlation with job demand, strained relations, inadequate reward, and workplace culture. Workplace also showed a strong positive correlation with inadequate reward. Mean daily working hours showed a strong positive correlation with mean weekly working hours.

Changes in the trends of dental caries patients in Korea -Based on patient survey data from 1990 to 2008- (1990년대 이후의 한국인 치아우식증 외래환자 수 변화 -1990~2008년 환자조사 자료에 근거하여-)

  • Choi, Yong-Keum;Do, Sei-Rok;Park, Deok-Yong
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.4
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    • pp.489-497
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    • 2011
  • Objectives : Based on data collected from patients who suffered from dental caries during the period between 1990 and 2008, the number of patients and their trends were analyzed as a source of evidence to conduct the oral health plan. Methods : A population of sample design for patient survey data was derived from computerized data saved at medical institutions accredited by National Health Insurance Corporation. Large institutions such as dental hospitals were included for the complete enumeration test, while the rest of medical institutions, for example, dental clinic, relatively small institutions, were used for the sample survey. Most of patients with dental caries were outpatients and their disease was treated at the dental hospital or dental clinic in general, therefore, main analysis was carried out at those institutions. Results : The rate of patients who suffered the dental caries has decreased to 56.8% in 2008 from 78.5% in 1990. The rate of patients who visited the dental hospital for treatment has increased to 4.8% in 2008 from 0.5% in 1990, whereas the percentage of those who visited the dental clinic has fallen to 97.9% from 99.5% during the same period. The ratio by age, in the meantime, it showed that patients aged 40s has increased to 13.5% in 2008 from 7.2% in 1990, and the number also has risen in 50s from 5.6% in 1990 to 9.9% in 2008. However, the number of children aged 0 to 9 who visited hospital for treatment of dental caries has fallen to 17.0% in 2008 from 33.9% in 1990. Conclusions : By figuring out the trends of patients with the dental caries during the period between 1990 and 2008, fundamental data for the oral health policy have been collected. As a result, the necessity of a new medical treatment system for managing the dental caries in terms of patient ages as well as the oral health policy and campaign was taken into consideration.

A study on the development of hospital rounds information system utilizing NFC (NFC를 활용한 병원 회진 안내 시스템 개발에 관한 연구)

  • Lee, Hyo Seung;Oh, Jae Chul
    • Smart Media Journal
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    • v.5 no.3
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    • pp.67-73
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    • 2016
  • Now, Korean health technology and health service is proud to be world class one at a level of not falling behind anywhere in the world. However, this health service has been provided, centering on hospital or medical staff, not patient so far. And there is a tendency to gradually change into patient-centered health service. According to the results of survey performed by Korea Institute for Health and Social Affairs, it was reported that, as of 2016, 30% or more of inpatients were not sufficiently given information relating to hospital rounds, and in particular, 50% or more of inpatients in their twenties to thirties expressed discontent, and approximately 17% of inpatients in their seventies and beyond expressed discontent. In the light of these data, especially inpatients in their twenties to thirties want information relating to hospital rounds and the like. And taking into consideration that they are characterized by being accustomed to using a smartphone, it is intended to design and implement a hospital rounds information smartphone application. Now, in some of medium and large hospitals, information about hospital is provided through smartphone application. However, the main purpose is hospital information or outpatient's appointment to see a doctor and so on. Even in case of providing information about hospital rounds, only information about approximate time to make rounds is provided. This paper is intended to design and implement hospital rounds information system making it possible to check their turn when rounds are made by utilizing NFC function in smart phone.

Rational Use of Antimicrobial Agents in Traumatic Simple Wounds (외상으로 인한 상처의 치료에 있어서 선택적 항균제의 효과 및 적응증에 관한 연구)

  • Kim, Jae Eun;Suh, Joo Hyun;Choi, Yoon Hee;Bae, Hyun A;Jung, Jin Hee;Eo, Eun Kyung;Cheon, Young Jin;Jung, Koo Young
    • Journal of Trauma and Injury
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    • v.20 no.1
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    • pp.40-46
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    • 2007
  • Purpose: The primary goal of wound management is to avoid infection. Wounds in all patients presenting to the Emergency Department are contaminated with bacteria. Despite this, there is a low incidence of infection. Unfortunately, physicians continue to use antimicrobial agents indiscriminately. The authors intended to determine the effect of selective antimicrobial agents and the indications for appropriate antimicrobial agent use in traumatic simple wounds. Methods: This prospective study was performed from Jul. 2005 to Aug. 2005. A pilot study had been performed from Nov. 2003 to Jul. 2004 at the Ewha Woman's University Mokdong Hospital. Structured data sheets were completed at the times of the patient's visits to the Emergency Department and to the Outpatient Department for follow-up. Infection was determined at the time of follow-up. The indications of antimicrobial agent use are immunocompromised patients, wounds contaminated for 3 hours or longer, devitalized tissue, and extremity wounds except hand wounds caused by sharp objects. Results: The study enrolled 216 injured patients. The general characteristics of patients and wounds between the two groups were not significantly different. The antimicrobial agent use and infection rate of the pilot study were 227 cases (90.4%) and 10 cases (4.0%), and those of this study were 100 cases (46.3%) and 9 cases (4.1%). In this study, antibiotic use was reduced to almost half compared with the previous study, but the infection rate was similar (p<0.001). Conclusion: Rational use of antimicrobial agents in simple wounds reduced the use of antimicrobial agents in the Emergency Department without increasing the infection rate.

Coagulase Thping and Antibiotic Resistance of Methicillin Resistant Staphylococcus aureus (MRSA) Isolated form Patients in Pusan (부산지역 환자로부터 분리된 Methicillin Resistant Staphylococcus aureus(MRSA)의 응고효소형 및 항균제 내성에 관한 연구)

  • 류지한;이훈구
    • Korean Journal of Microbiology
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    • v.36 no.3
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    • pp.216-220
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    • 2000
  • Eighty-eight strain3 o~methicillin resistant Stopllylococcus awecis were Isolated from pus (64.7%); spuhm (26.2%), blood, fluid, andurine of 83 patients at Dong-A Hospital in P~~san to invesligate theil-coagulase typ- Ing, and multi-drug resistaut ppattems. The presence of niec A gene confe~~ing melhicillin resistance was tested by polymerase chain reaction (PCR) with uwo mec A gene specific primers using purified clromosonlal DNA as templates. DNA fragments of expected size wel-e detected frorn 86 strains, but not from two strains. !i coagulase typmg, the 86 isolates were assigned to 5 coagulase lypes, I, 11, lll. 1V, VI, VII, VIlI, but there was no isolate helong lo type V. The most abundant coagulase type was type TI(50 %), lollowed by type IV Rest ofthe coagulase types were ininor; ranging fmm 4.5 to 12.5 '% Most of the type I1 ~netlucillin resistant Stapl\ulcorneryiococcus nwem (MRSA) strams were isolated from the generd sulzely ward, but major strains of type IV were Isolated from the otorhinolq~ngology of the hospital's outpatient clinic center. All of the 88 st~nins were sensitive to vancomycin and teicoplanin, but 71 (81%) strains showed multi-drug resitant to penicillin, cephalotl~n, eiythroinycin, gentan~ycin, imipenem, clindamycin, ciprofloxacin and ooxacillin. Yo relationship was found between the antibiotic resistance pattems aud the coagulase typing patterns.

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Oriental Medical Treatment Pattern of Korean Patients with Sleep Disorders (한국인 수면장애 환자의 최근 3년간 한방 진료 양태)

  • Jeong, Seon-Yeong;Kim, Jae-Yeong;Kho, Young-Tak;Ahn, Keon-Sang;Lee, Cha-Ro
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.4
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    • pp.389-400
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    • 2014
  • Objectives: Though there are many studies about sleep disorder, no research has been performed on the utilization of oriental medicine as a treatment. Therefore, the oriental medical treatment pattern of Korean patients with sleep disorders was examined herein using the Health Insurance Review and Assessment Service (HIRAS). Methods: The medical records of patients with sleep disorders (G47) or nonorganic sleep disorders (F51) as a main diagnosis were adopted from the HIRAS database from 2011 to 2013. Analysis was performed on the number of patients and cost per patient, with comparison between oriental and western medicine in terms of gender, age, patient care service type, and hospital type. Results: 1) Regarding sleep disorders, the medical visits and insurance charges have been increasing. Western medicine was utilized 8 times more often than oriental medicine during 3 years. 2) There were 2.5 times more women than men. 3) Among all ages, the 50~59 year group had the highest representation. 4) In comparison of average portions of patient care type over 3 years, outpatients were the majority, while the number of visits of outpatients and hospitalization has been increasing. 5) Comparison of average portion of oriental hospital type over 3 years revealed oriental clinics to be used most. The use of general hospitals was higher in western medicine treatment, while public health centers used oriental medicine more. 6) Regarding average oriental medical cost per patient over 3 years, the total was 88,000 won, with 353,000 won for hospitalization and 85,000 won for outpatients. The outpatient cost has been increasing. 7) In line with 6, oriental medical hospitals cost 126,000 won, local clinics were 85,000 won, and etc. was 95,000 won. Average costs of all types have increased during 3 years, except oriental medical hospitals in 2013. Conclusions: This study provided objective information about the epidemiologic characteristic of oriental medicine used for treatment of sleep disorder. For expansion of oriental medical demand for sleep disorder, this study would be helpful in understanding the recent status.

Prevalence of Toxocariasis and Its Risk Factors in Patients with Eosinophilia in Korea

  • Song, Hyun Beom;Lee, Deokho;Jin, Yan;Kang, Jinwoo;Cho, Shin-Hyeong;Park, Min Sun;Park, Jin-Ho;Song, Woo-Jung;Kang, Hye-Ryun;Lee, Sang Hyub;Hong, Sung-Tae;Choi, Min-Ho
    • Parasites, Hosts and Diseases
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    • v.58 no.4
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    • pp.413-419
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    • 2020
  • Eosinophilia occurs commonly in many diseases including allergic diseases and helminthic infections. Toxocariasis has been suggested as one cause of eosinophilia. The present study was undertaken to examine the prevalence of toxocariasis in patients with eosinophilia and to identify the risk factors for toxocariasis. This prospective cohort study recruited a total of 81 patients with eosinophilia (34 males and 47 females) who visited the outpatient clinic at Seoul National University Hospital from January 2017 to February 2018 and agreed to participate in this study. The prevalence of toxocariasis was examined by T. canis-specific ELISA, and the various risk factors for toxocariasis were evaluated by a questionnaire survey. Among 81 patients with eosinophilia, 18 were positive for anti-T. canis antibodies (22.2%); 88.9% were male (16/18) and 11.1% were female (2/18). Multivariate statistical analysis revealed that males (OR 21.876, 95% CI: 1.667-287.144) with a history of consuming the raw meat or livers of animals (OR 5.899, 95% CI: 1.004-34.669) and a heavy alcohol-drinking habit (OR 8.767, 95% CI: 1.018-75.497) were at higher risk of toxocariasis in patients with eosinophilia. Toxocariasis should be considered a potential cause of eosinophilia when the patient has a history of eating the raw meat or livers of animals in Korea. A single course of albendazole is recommended to reduce the migration of Toxocara larvae in serologically positive cases with eosinophilia.