Social Welfare Approaches for Patients with Diabetes and Stroke / 임상당뇨병

Patients with diabetes who experience a stroke can face sudden physical and mental changes after the stroke occurs. Also, these changes not only aggravate from the family feeling of responsibility for care burden to patient, but also affect the patient's blood sugar control. The social welfare approach to this disease-related issue, psychosocial issue, economic issue and rehabilitation issue is for the diabetic patient with stroke to improve their self management ability, and to ultimately lead to integrated health management and a healthy life.

A Case of Pheochromocytoma Associated with Diabetic Ketoacidosis and Infective Endocarditis / 임상당뇨병

Pheochromocytoma is a rare neuroendocrine tumor that is usually derived from adrenal medulla or chromaffin cells along with sympathetic ganglia. In Western countries, the prevalence of pheochromocytoma is estimated to be between 1:6,500 and 1:2,500, compared with an incidence in the United States of 500 to 1,100 cases per year. Despite this low incidence, pheochromocytoma should always be considered for differential diagnoses because previous studies have shown that this condition can be cured in approximately 90% of cases. However, an untreated tumor is likely to be fatal due to catecholamine-induced malignant hypertension, heart failure, myocardial infarction, stroke, ventricular arrhythmias or metastatic disease. Symptoms that result primarily from excess circulating catecholamines and hypertension include severe headaches, generalized inappropriate sweating and palpitations (with tachycardia or occasionally bradycardia). Pheochromocytoma, however, has highly variable and heterogeneous clinical manifestations, including fever, general weakness and dyspepsia, and can be observed in patients who are suffering from infectious diseases. Several of such case reports have been presented, but most of these included infectious patients with high blood pressure and severe fluctuations. In this study, we presented the case of a 53-year-old male who showed normal blood pressure, but had a sustained fever. He was diagnosed with diabetic ketoacidosis, infective endocarditis and asymptomatic adrenal incidentaloma. Despite treatment with antibiotics and valve replacement, the fever persisted. After the patient underwent evaluation for the fever, adrenal incidentaloma was identified as pheochromocytoma. After removal of the abdominal mass, his fever improved.

Social Welfare Approach for the Patient with Diabetic Nephropathy / 임상당뇨병

Patients with diabetic nephropathy have psychological, financial, family and social problems. Given the problems faced by many patients, it is important to understand individual & family characteristics as both the patient and family face a series of adaptive tasks in relation to the illness. Trained social workers can offer tangible ways to help a patient maintain his or her individual integrity and dignity. In addition, a qualified social worker provides services that support and maximize the psychosocial functioning & adjustment of patients with chronic kidney disease and their families. This paper aims to increase diabetes educators' understandings of the social welfare approach for patients with diabetic nephropathy.

Walking Inability in a Patient with Darier Disease and its Sociomedical Care / 대한피부과학회지

The patient was a 38-year-old man suffering from walking inability due to Darier's disease mainly involving both soles. The plantar areas showed persistent painful keratotic plaques and erosive fissures. Continuing dermatological treatment did not give him relief from the plantar pain and the actual physical inability. We approached the illness sociomedically to get him relief from the painful soles and helped him get a disability license from the social welfare department of his city, by which he could get an economical automobile for his purpose. We think that dermatologists shoulds try to help the patients with intractable dermatoses not only by medical treatment but also by a social welfare approach.