• Title/Summary/Keyword: outpatient

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The Effects of Medical Service Utilizations on Life Satisfaction among the Elderly: Focusing on the Moderating Effects of the Presence of Chronic Illnesses (노년기 의료서비스 이용이 삶의 만족도에 미치는 영향: 만성질환 유무의 조절효과를 중심으로)

  • Jeon, Hae-Sook;Kahng, Sang Kyoung
    • 한국노년학
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    • v.31 no.4
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    • pp.1247-1263
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    • 2011
  • The rapidly aging society entails the increases of medical service utilizations among the elderly. Medical services utilized by the elderly influence their life satisfaction. However, little is known about the effects of medical service utilizations on life satisfaction. Much less is known about whether the effects of medical service utilizations on life satisfaction tend to vary by the presence of chronic health conditions. Including 3,944 individuals aged 65 and over who participated in the 3rd wave of Korean Welfare Panel Study, the current study aims to examine (1) the relationships between medical service utilizations and life satisfaction and (2) whether the effects of medical service utilizations on life satisfaction vary by the presence of chronic health conditions. Data were processed through structural equation modeling(SEM) and multi-group SEM. Results indicate that (1) levels of both outpatient and inpatient service utilizations are related to life satisfaction, whereas levels of health monitoring service utilizations are not and (2) the effects of medical service utilizations varied by the chronic health condition status of the elderly. These results indicate that, in order to enhance levels of life satisfaction, medical services should be strategically utilized by the elderly depending on their chronic health condition status. Based on the findings, we discussed implications for practice and policy, suggesting future research directions based on the limitations of the current study.

Endophthalmitis after Removal of an Intralenticular Foreign Body in Place without Symptoms for 20 Years (20년 동안 증상없이 잔존한 수정체 내 이물제거 후 발생한 안내염)

  • Choi, Young;Eom, Youngsub;Choi, Soo Youn;Lee, Bo Young;Kim, Eun Jee;Kang, Su-Yeon;Song, Jong Suk;Kim, Hyo Myung
    • Journal of The Korean Ophthalmological Society
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    • v.60 no.5
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    • pp.480-485
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    • 2019
  • Purpose: We report a case of postoperative endophthalmitis in the cataract patient, associated with removal of an intralenticular foreign body that had remained in place without symptoms for 20 years. Case summary: A 45-year-old male visited our outpatient clinic complaining of gradual visual loss in his right eye over the past 3 months. In slit-lamp examinations, anterior capsular opacification, nuclear sclerosis, and posterior subcapsular opacity were observed in the right eye. Twenty years before, a tiny metallic projectile had hit his right eye, but slit-lamp examination at the time of injury did not reveal any intraocular foreign body. We decided to undergo cataract surgery. During phacoemulsification, a metallic foreign body was found in the lens and safely removed; then an intraocular lens was implanted. As hypopyon was evident 3 days later, we injected intravitreal antibiotics and applied fortified antibiotic eye drops to the right eye. The anterior chamber inflammation improved and the best-corrected visual acuity recovered to 1.0. Conclusions: Surgeon should be aware of that endophthalmitis could develop after cataract surgery with removal of an intralenticular foreign body that had been in place for 20 years. But did not trigger inflammation or cause any symptoms as the cataract progressed.

CNN-LSTM-based Upper Extremity Rehabilitation Exercise Real-time Monitoring System (CNN-LSTM 기반의 상지 재활운동 실시간 모니터링 시스템)

  • Jae-Jung Kim;Jung-Hyun Kim;Sol Lee;Ji-Yun Seo;Do-Un Jeong
    • Journal of the Institute of Convergence Signal Processing
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    • v.24 no.3
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    • pp.134-139
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    • 2023
  • Rehabilitators perform outpatient treatment and daily rehabilitation exercises to recover physical function with the aim of quickly returning to society after surgical treatment. Unlike performing exercises in a hospital with the help of a professional therapist, there are many difficulties in performing rehabilitation exercises by the patient on a daily basis. In this paper, we propose a CNN-LSTM-based upper limb rehabilitation real-time monitoring system so that patients can perform rehabilitation efficiently and with correct posture on a daily basis. The proposed system measures biological signals through shoulder-mounted hardware equipped with EMG and IMU, performs preprocessing and normalization for learning, and uses them as a learning dataset. The implemented model consists of three polling layers of three synthetic stacks for feature detection and two LSTM layers for classification, and we were able to confirm a learning result of 97.44% on the validation data. After that, we conducted a comparative evaluation with the Teachable machine, and as a result of the comparative evaluation, we confirmed that the model was implemented at 93.6% and the Teachable machine at 94.4%, and both models showed similar classification performance.

A Case Report of Glancing Up Motor Tic Disorder Managed by Temporomandibular Joint Balancing Therapy with Korean Medicine Treatment (위로 치켜뜨는 운동 틱 장애 환자에 대해 턱관절균형요법을 병행한 한방치료 치험 1례)

  • Chang Min Shin;Tae Kyung Kim;Eun Ju Lee;Hyun Seob Park;Young Jun Lee;Cheol Hong Kim
    • Journal of TMJ Balancing Medicine
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    • v.13 no.1
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    • pp.21-26
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    • 2023
  • Objectives: The purpose of this study is to report the effect of Korean medical treatment with Temporomandibular Joint Balancing Therapy (TBT) on Tic disorder patient who often glancing up when feels nerves, frightened or tired. Methods: In this study, Tic disorder patient was treated to △△ Korean medicine Hospital from June 12nd, 2022 to July 26th, 2023 by outpatient way. During the clinic period, the patient was treated by Korean medical treatment (acupuncture, cupping, herb medicine), especially using TBT. YGTSS (Yale Global Tic Severity Scale), NDI (Neck Disability Index) and VAS were used for measuring the Tic disorder and neck pain. Results: After treatment for 46 days, the YGTSS showed a decrease from 17 to 3, the VAS associated with Tic disorder also decreased from 6 to 1 and NDI associated with neck pain decreased from 7 to 4. Conclusions: These results showed that Korean medical treatment especially using TBT may have an effect on reducing symptoms of Tic disorder and neck pain. But the further researches are needed.

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A Case Report of Occipital Neuralgia Treated with Acupuncture in the Occipital Nerve Area (후두신경 영역 침치료로 호전된 후두신경통 증례 1례)

  • Min-hwa Kim;I-rang Nam;Mariah Kim;Ki-beom Ku;Se-yeon Lee;Jung-nam Kwon;In Lee;Jun-yong Choi;Young-ju Yun;So-yeon Kim;Chang-woo Han;So-jung Park;Jin-woo Hong
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1327-1336
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    • 2023
  • This case report presents the effectiveness of Korean medicine in the treatment of occipital neuralgia. The patient with occipital neuralgia was treated with acupuncture. Acupuncture treatment was administered to the occipital nerve area, which is commonly used in occipital nerve blocks by western medicine doctors. The severity of the symptoms was assessed daily using the Numerical Rating Scale (NRS) score of pain. The patient received outpatient treatment a total of 7 times, and only received acupuncture treatment each time. According to the patient, his symptoms decreased by about 90% two days after acupuncture treatment, and the frequency and duration of the symptoms also decreased. Seven days after all acupuncture treatments, the severity of pain was reduced from NRS 6 to NRS 0. The findings of this case report suggest that treatment with Korean medicine can be an effective option for treating occipital neuralgia. Acupuncture can be a good treatment method for occipital neuralgia, along with western drug treatment and occipital nerve block.

Correlation between Patient Satisfaction and Rehabilitation Motivation on Musculoskeletal and Neurological Patients in a Physical Therapy Environment (물리치료 환경에 대한 근육뼈대계 및 신경계 환자의 환자만족도와 재활동기의 상관성)

  • Chung-Yoo Kim;Hyeon-Su Kim;Sung-Ha Kim;Hyun-Jin Do;Mi-Jin Yang
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.1
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    • pp.151-159
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    • 2024
  • Purpose : This study was conducted to investigate correlation between patient satisfaction and rehabilitation motivation in a physical therapy environment. Methods : This study conducted a survey on musculoskeletal and neurological patients receiving rehabilitation treatment at a hospital. The subjects of the study were patients who were currently receiving rehabilitation treatment, either hospitalized or outpatient. 234 people were collected. A questionnaire was consisted of a total of 55 questions, including 27 questions about motivation for rehabilitation, 14 questions about physical therapy service environment, and 14 questions about patient satisfaction and intention to revisit. The detailed items in rehabilitation motivation consisted of 8 questions about task-oriented motivation, 7 questions about change-oriented motivation, 4 questions about obligatory motivation, 4 questions about external motivation, and 4 questions about intrinsic motivation, and in the physical therapy service environment, 4 questions about facility service and therapist service. , 6 questions, 4 questions about services used, 3 questions about friendliness, 4 questions about professionalism, 3 questions about treatment satisfaction, and 2 questions each about repeat visit and recommendation. Results : Facility service (r=.21) was highly correlated for task-oriented motivation, therapist service (r=.22) for change-oriented motivation, therapist service (r=.31) for mandatory motivation, therapist service (r=.19) for external motivation, and facility service (r=.56) for internal motivation. Revisit for task-oriented motivation (r=.47) is kind to change-oriented motives (r=-.13) was highly correlated with kindness (r=.19) for mandatory motives, recommendation (r=.14) for external motives, and expertise (r=.52) for internal motives. There was a high correlation between professionalism (r=.61) for facility services and kindness (r=.53) for therapist services, and revisit (r=.40) for service use. Conclusion : According to the results of this study, it was found that there was a correlation between patient satisfaction and rehabilitation motivation in a physical therapy environment.

A Case of Diffuse Large B-cell Lymphoma transformed from Primary Thyroid MALT Lymphoma (갑상선 MALT 림프종으로부터 전환된 미만성 거대 B세포 림프종 1예)

  • Young Rok Jo;Youn Jin Cho;Ju Yeon Pyo;Hye Ran Lee
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.13-17
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    • 2023
  • Diffuse large B cell lymphoma (DLBCL) is main subtype of primary thyroid lymphoma and can be histologically transformed from a low-grade B-cell lymphoma. The characteristics and treatment guidelines of these particular DLBCL have not been fully established. The mainstay of treatment of primary thyroid DLBCL is multimodality treatment with chemotherapy and radiotherapy. Meanwhile, surgery can be considered only for diagnosis or alleviation of airway compressive symptoms. A 57-year-old female visited our outpatient clinic for recently enlarged long-held anterior neck mass. A thyroid mass compressing the airway and esophagus was identified on imaging, which was diagnosed as MALT lymphoma by excisional biopsy. After staging, the patient underwent total thyroidectomy with regional lymph node dissection for treatment of stage IIE MALT lymphoma and relieving airway compromise symptoms. The final diagnosis was DLBCL transformed from MALT Lymphoma, and chemotherapy was additionally performed. We report this rare experience with a review of literature.

Trends in behavioral management techniques for dental treatment of patients with autism spectrum disorder: a 10-year retrospective analysis

  • Gahee Son;Sohee Oh;Jaehee Lee;Saeromi Jun;Jongbin Kim;Jongsoo Kim;Joonhaeng Lee;Miran Han;Jisun Shin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.3
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    • pp.187-193
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    • 2024
  • Background: Patients with autism spectrum disorder (ASD) present challenges in dental treatment cooperation owing to deficits in communication skills and social interaction. Behavioral guidance, sedation, and general anesthesia may be employed to ensure the quality of dental care for individuals with ASD. This study aimed to examine the trends in dental treatment for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital, an oral health center for the disabled in the Gyeonggi region, over the past 10 years. Methods: This study utilized the order communication system to gather data on sex, age, cooperation level, number of quadrants treated, and administration of sedation or general anesthesia for patients with ASD who visited the Department of Pediatric Dentistry at Dankook University Jukjeon Dental Hospital between January 2013 and December 2022. Results: The total number of patients with ASD increased annually, possibly due to an increase in ASD prevalence and the hospital's designation as a center for disabled oral health. General anesthesia was predominant before 2017, with a shift towards N2O-O2 sedation. The most common age group for sedation or general anesthesia was 6-9 years, with a higher prevalence in males than in females. Notably, N2O-O2 and midazolam sedation resulted in better cooperation and fewer treated teeth than general anesthesia. Conclusion: This study highlights the evolving trends in dental treatment for individuals with ASD, indicating a shift towards outpatient methods, particularly N2O-O2 sedation. The sex distribution aligns with national statistics, emphasizing a higher prevalence of ASD in males than in females. These findings underscore the need for further research to establish evidence-based guidelines for optimal dental care strategies tailored to the unique needs of individuals with ASD.

Case Report on NTBC Treatment of Type 1 Tyrosinemia Diagnosed through Newborn Screening (신생아 선별검사를 통해 진단된 1형 타이로신혈증의 NTBC 치료 사례 보고)

  • Ji Eun Jeong;Hwa Young Kim;Jung Min Ko
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.23 no.2
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    • pp.39-44
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    • 2023
  • Hereditary tyrosinemia type 1 (HT-1) is a metabolic disorder caused by biallelic pathogenic variants in the fumarylacetoacetate hydrolase (FAH) gene, which impairs the function of the FAH enzyme, resulting in the accumulation of tyrosine's toxic metabolites in hepatocytes and renal tubular cells. As a consequence, individuals with HT-1 exhibit symptomatic manifestations. Rapid diagnosis and treatment of HT-1 can prevent short-term death and long-term complications. A 15-day-old boy presented to the outpatient department with elevated levels of tyrosine on his newborn screening tests conducted at the age of 3 and 10 days, respectively. Further blood tests revealed increased levels of alpha-fetoprotein and amino acids including tyrosine and threonine. Urine organic acid tests indicated a significant elevation in tyrosine metabolites, as well as the presence of succinylacetone (SA), which led to the diagnosis of HT-1. Two pathogenic and likely pathogenic variants of FAH compatible with HT-1 were also detected. He began a tyrosine-restricted diet at one month old and received nitisinone (NTBC) at two months old. With continued treatment, the patient's initially elevated AFP level, detection of SA in the urine, and mild hepatomegaly showed improvement. During four years and seven months of treatment, there were no exceptional complications apart from an increase in tyrosine levels and a delay in speech. We report a case of tyrosinemia type 1 detected through newborn screening, treated with dietary restriction and NTBC, with a good prognosis.

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Changes in interpersonal violence and utilization of trauma recovery services at an urban trauma center in the United States during the COVID-19 pandemic: a retrospective, comparative study

  • Kevin Y. Zhu;Kristie J. Sun;Mary A. Breslin;Mark Kalina Jr.;Tyler Moon;Ryan Furdock;Heather A. Vallier
    • Journal of Trauma and Injury
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    • v.37 no.1
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    • pp.60-66
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    • 2024
  • Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.