• Title/Summary/Keyword: 근거중심의학

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Arrangement and analysis of multi-isocenter based on 3-D spatial unit in stereotactic radiosurgery (정위적 방사선 수술시 3차원적 공간상의 체적소에 기반한 회전중심점들(Multi-isocenter)의 표적내 자동적 배치 및 분석)

  • Choi, Kyoung-Sik;Oh, Seung-Jong;Lee, Jeong-Woo;Suh, Tae-Suk;Choe, Bo-Young;Kim, Moon-Chan
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2004.11a
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    • pp.75-77
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    • 2004
  • Stereotactic radiosurgery(SRS) is a technique to deliver a high dose to a particular target region and a low dose to the critical organ using only one or a few irradiations while the patient is fixed with a stereotactic frame. The optimized plan is decided by repetitive work to combine the beam parameters and identify prescribed doses level in a tumor, which is usually called a trial and error method. This requires a great deal of time, effort, and experience. Therefore, we developed the automatic arrangement of multi-isocenter within irregularly shaped tumor. At the arbitrary targets, which is this method based on the voxel unit of the space, well satisfies the dose conformity and dose homogeneity to the targets relative to the RTOG radiosurgery plan guidelines

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Clinical Demands for Evidence-based Medical Interventions and Diagnostic Technology in Oriental Medicine (근거중심의학에 기반한 한의치료기술 및 한방진단기기 개발을 위한 임상수요조사)

  • Kim, Gyeong-Cheol;Park, Sang-Woog;Song, Kyung-Hoon;Park, Joo-Yeon;Hong, Sang-Min;Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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    • pp.121-133
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    • 2010
  • Objects : To establish directions to evidence-based medical interventions and diagnosis technology in oriental medicine, we did survey research among oriental medical doctors. Methods : Systematically-organized questionnaires were provided for survey. 105 Oriental medical doctors nationwide participated in the survey. We investigated diseases of their patients, differential diagnosis methods, frequently used medical interventions, needs for diagnosis devices, evidence-based clinical manuals, etc. Results : In oriental medical clinics, the most frequent patient class was patients with musculo-skeletal diseases. Oriental medical doctors assumed that the preparation of care solution for chronic life-style diseases was the most urgent. Dong-Eui-Bo-gam(東醫寶鑑) was the most frequently used reference for their herbal medication prescription. Fixed document for diagnosis and treatment were thought to be the most important in the developing evidence-based clinical manuals. Conclusions : Validity and reliability should be considered as very important in developing oriental diagnosis devices. Evidence-based clinical manuals are needed to build standardized document for diagnosis and treatment and to verify efficacy and safety of oriental medical diagnosis and treatment.

A Trend Analysis of Clinical Studies of Medical Gigong (formerly Journal of the Korean Academy of Medical Gi-Gong) (의료기공(구 대한의료기공학회지)에 실린 임상논문의 경향 분석)

  • Na, Sam Sik;Jeong, Jae Hun;Ahn, Hun Mo
    • Journal of Korean Medical Ki-Gong Academy
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    • v.20 no.1
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    • pp.68-84
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    • 2020
  • Objective : The purpose of this study is to suggest the evidence of traditional Korean medicine by analyzing the clinical research trends of the Korean Academy of Medical Gi-Gong and to use it as reference data for future clinical studies. Methods : The clinical studies published in the Journal of the Korean Academy of Medical Gi-Gong from 2011 to 2019 were reviewed and the study design, yearly trends, patient's disease, therapeutic intervention, and outcome measure were analyzed. Results : Of the 24 clinical studies, there are 13 Case Reports, 9 Case Series Researches, and 2 Case-Control Studies. In terms of disease group, Musculoskeletal Diseases and female Diseases were the most common, followed by neurological Diseases, dermatological Diseases, and rare Diseases. In terms of treatment methods, acupuncture, herbal medicine, and Sugi therapy were mainly used. And cupping, thermotherapy, and Korean medical exercise therapy were used as a supplement. As an evaluation tool, clinical symptom change was the most common, followed by DITI, VAS, survey, and X-ray. In most reports, Korean medical treatment has been effective in treating diseases. Conclusions : More clinical studies including controlled clinical trials should be conducted to provide a basis for verifying the effectiveness of Korean medicine.

Experience of spinal stenosis, herniation of intervertebral disk patients with low back pain under non-surgical treatment (비수술적 요법을 받는 척추관협착증, 추간판탈출증 환자의 요통 경험)

  • Kang, Myoung-Mi;Kim, Ae-Kyung
    • Journal of Digital Convergence
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    • v.19 no.8
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    • pp.385-396
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    • 2021
  • The purpose of the study was to explore the process of experience of spinal stenosis, herniation of intervertebral disk patients with low back pain under non-surgical treatment. 10 participants attended in-depth individual interview. Data analyzed using the Grounded theory methodology of Corbin and Strauss(2015). A core category emerged as 'Compromise with my body in the swamp of pain'. Central phenomenon was 'Constrained life by severe pain'. The process of the low back pain experience included three phases: 'cognition', 'coping', and 'adaptation'. This finding will be helpful for understanding the low back pain experience and be as fundamental data as for developing and applying nursing intervention program according to the low back pain experience process.

Methodological Quality Evaluation of a Meta-Analysis Study of Rehabilitation Treatment Interventions for Stroke Patients in Korea Applying AMSTAR-2: Focusing on Upper Extremity Function and Recovery of Daily Life (AMSTAR-2를 적용한 국내 뇌졸중 환자의 재활치료 중재 메타분석 연구의 방법론적 질 평가: 상지기능과 일상생활회복을 중심으로)

  • Hwang, Ho-Sung;Ham, Min-Joo
    • The Journal of the Korea Contents Association
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    • v.22 no.8
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    • pp.660-670
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    • 2022
  • This study was analyzed by applying AMSTAR-2, a methodological quality evaluation tool, to evaluate the quality of domestic meta-analysis papers on rehabilitation interventions for stroke patients. The purpose of this study is to provide guidelines for qualitative improvement of evidence-based practice and meta-analysis research by analyzing the qualitative level of the analyzed research. The literature search was conducted using the Research Information Sharing Service, Korean Medical database, and Korean studies Information Service System. Two authors searched, extracted, and reviewed literature using the keywords 'stroke' and 'meta-analysis'. As a result of the AMSTAR-2 quality evaluation of the final 18 studies, 3 studies (16.67%) were 'Moderate', 8 studies (44.44%) were 'Low', and 7 studies (38.89%) were 'Critically Low'. In future research, scientific and objective data selection and extraction process should be performed. It is expected that interest and efforts to improve the quality of meta-analysis research will continue by referring to the contents analyzed in this study as a way to improve the quality of literature.

Analysis of Medical Care Utilization of Allergic Rhinitis Patients in Western Medicine and Korean Medicine between 2010 and 2016 : A Study of the Health Insurance Review and Assessment Service National Patients Sample Database (알레르기 비염 환자의 의과·한의과 의료 이용 현황 분석 : 2010-2016년 청구 데이터 분석)

  • Ryu, Ji-In;Kim, Jeong-Hun;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.21-37
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    • 2021
  • Objectives : Allergic rhinitis(AR) is a common chronic disease that accounts for 10-40% of the world's population. This study aims to analyze the status of claims, prevalence, and medical utilization of allergic rhinitis patients using representative patients sample data. Methods : This study used the National Patients Sample(HIRA-NPS) of the Health Insurance Review and Assessment Service for 7 years(2010-2016). And we defined AR patients as all statements including J30 or a subcategory of J30 as the main disease, using the Korean Standard Classification of Diseases(KCD-7). The trend of AR patients by year was divided into Western medicine(WM) and Korean medicine(KM), and analyzed by subgroup analysis such as inpatient/outpatient, gender, age, insurance type, and care institution. Results : Patients with AR were mainly claimed for first sub diagnosis in WM and major diagnosis in KM, and the number of claims increased about 1.3 times and 1.4 times compared to 2010 in WM and KM, respectively. In addition, the total annual medical expenses in 2016 increased 1.3 times and 1.7 times compared to 2010, respectively. Conclusions : Both WM and KM are showing a steadily increasing trend in medical use due to allergic rhinitis. Further research is needed by considering genetic and environmental factors and individual characteristics, and linking with additional data.

A Literature Review on the Public Program of Walking Promotion for Active Living (활동적 생활을 위한 걷기증진 공공사업에 관한 고찰)

  • Kim, Dong Ha;Kang, Jaewook;Yoo, Seunghyun
    • Journal of agricultural medicine and community health
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    • v.46 no.2
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    • pp.98-108
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    • 2021
  • Objectives: This study aimed to describe the current public programs for community walking in Korea and to discuss their challenges. Method: We identified the literature related to community walking including five laws, 22 white papers from government departments and 84 program reports from the Seoul Metropolitan Government. Results: Korean law guarantees legal rights and validity to create safe, convenient and equitable environments for community walking. The government department, which has jurisdiction over legislation relating to community walking, has dominated community walking programs, and the role of public health department has been insufficient. Almost all sectors in the department of Seoul Metropolitan Government were involved in community walking programs. However, inter-sectoral cooperation system for community walking was insufficient. Conclusion: It is necessary to revise the condolences of the National Health Promotion Act to establish the role and perspective of public health in community walking promotion. Institutional efforts should be made to expand the network structure between sectors of community walking programs by establishing an organizational, budget, and performance sharing system for inter-sectoral approach.

MANAGEMENT OF THE CHILD WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDERS (ADHD) (주의력 결핍장애아동의 치료)

  • Ahn, Dong-Hyun;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.77-88
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    • 1990
  • Management of the child with Attention-Deficit Hyperativity Disorder(ADHD) reguires a comprehensive approach of cognitive-behavioral, educational, and pharmacological interventions. Establishing the valid diagnosis is the first step of management. After the diagnosis is made, the clinician must then interpret the diagnosis and its impliations to the child, parents, and teachers. The pharmacotherapy is most effeceive, and the CNS stimulants (methylphenidate) is drug of choice. Although generally not as effective as stimulants, triacyclic antidepressants, clonidine, antipsychotics offer the alternatives to stimulants therapy. Additional treatments, including psychotherapy, cogntive-behavioral approach, educational infervention, parental counseling are also essential in managing the child with ADHD. Finally, controversial approaches-diet therapy, mineral therapy, hypoglycemia, megavitamin therapy, refined sugars, neurophysiological retraining approaches are reviewed.

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The Study of an Improvement of Clinical Competency through Evidence Based Learning (근거 중심의 학습을 통한 학생들의 임상 실무 능력 개선에 관한 연구)

  • Lee, Dongyup
    • Journal of The Korean Society of Integrative Medicine
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    • v.2 no.2
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    • pp.1-12
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    • 2014
  • Purpose : The purpose of this study was to investigate the effect that the academic achievement of the students about the evidence based learning investigates the learning utility value about and the request. Method : The agreement of college students explaining the purpose of research for 12 weeks against 17 students and investigate through a questionnaire. The level of academic achievement according to the sex and claim showed a characteristic with a percentage. An utility investigate the descriptive epidemiologic characteristic about the class of the evidence based learning. Result : The most of college students the level of academic achievement and requests the expected grade of the students about the evidence based learning wanted the 'high' grade of 9 persons, 'middle' grade of 8 persons in the part and the expectation for the class taken so much was high(p<.05). There was the significant different in the utility aspect in the need of the evidence based learning, homework solution, learning synergy effect improvement, and reference search ability improvement(p<.05). Conclusion : These finding revealed that the evidence based learning the satisfaction with class raises the improvement and utility value, and provided the need and the has to develop the educational model which the college students contentment raises an improvement after this opportunity for the new recognition.

남녀(男女)의 차이(差異)에 근거(根據)한 남녀형상(男女形象)의 의학적(醫學的) 운용(運用)에 대한 연구(硏究)

  • Lee, In-Su;Yun, Chang-Ryeol
    • Journal of Korean Medical classics
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    • v.19 no.1 s.32
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    • pp.47-109
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    • 2006
  • 서양의학상인위남녀근근시재생식기부동적인(西洋醫學上認爲男女僅僅是在生殖器不同的人). 최근(最近), Legato, Marianne J.박사창립료(博士創立了)‘성인지의학(性認知醫學)’학(學), 개시인식도남녀적차이(開始認識到男女的差異), 주장남녀재치료방법상역부동법(主張男女在治療方法上亦不同法), 종이저일연구진입도료신적단계(從而這一硏究進入到了新的段階). 단시한의학종(但是韓醫學從)${\ulcorner}$황제내경(黃帝內經)${\lrcorner}$개시(開始), 취인위남녀재구조상유근본적차이(就認爲男女在構造上有根本的差異), 이차재생리(而且在生理), 병리(病理), 진단(診斷), 치료상야부동(治療上也不同). 기록한의학기본원리적주역적상관서적화(記錄韓醫學基本原理的周易的相關書籍和)${\ulcorner}$황제내경(黃帝內經)${\lrcorner}$, 이급역대적주요한의서적급종사임상적한의사적서적상(以及歷代的主要韓醫書籍及從事臨床的韓醫師的書籍上), 역도인위남녀유차이(亦都認爲男女有差異). 관어남녀적생성(關於男女的生成), 재(在)${\ulcorner}$보제방(普濟方) 방맥총론(方脈總論)${\lrcorner}$적변남녀형생신육론중제출료(的辨男女形生神毓論中提出了男女的形成有異). ${\ulcorner}$동의보감(東醫寶鑑)${\lrcorner}$여기타한의서부동(與其他韓醫書不同), 불시이질병위주(不是以疾病爲主), 이시이신위중심(而是以身爲中心), 즉목차안형상진행료배열(卽目次按形象進行了排列), 차상세지언급료남녀(且詳細地言及了男女). 나요남녀시고정불변적마 불시적(不是的). ${\ulcorner}$동의보감(東醫寶鑑) 신형장부론(身形臟腑論)${\lrcorner}$인위(認爲)‘인적형색유차이(人的形色有差異), 장부이유이(臟腑易有異), 고외증수동(故外症雖同), 치법인인이이(治法因人而異).’ 안형상선용부동적치법적관점(按形象選用不同的治法的觀点), 이통과주단계지언이표명(已通過朱丹溪之言而表明). 불변관점상여자체격소이동(不變觀点上女子體格小易動), 남자체격대이와(男子體格大易臥). 남자속양기이산(男子屬陽氣易散). 여남자정서초차(如男子情緖稍差), 즉음주해수(卽飮酒解愁), 불이득우울증(不易得憂鬱症). 응보기정기(應補其精氣). 여자속음기이울체(女子屬陰氣易鬱滯), 다유인기지성질(多有忍氣之性質), 이득우울증(易得憂鬱症), 고다용산기약(故多用散氣藥). 간단이언(簡單而言)‘남자위병허증(男子爲病虛證), 여자위병실증(女子爲病實證).’ 종변화적관점래용약(從變化的觀点來用藥), 예여남자수소가용여자약적사물탕(例如男子瘦小可用女子藥的四物湯). 여자비가용남자약적사군자탕(女子肥可用男子藥的四君子湯). 여자골장가용남자약적육미지황환(女子骨壯可用男子藥的六味地黃丸). 위료갱용역이해(爲了更容易理解)‘남녀불변화변화적관점재의학적운용(男女不變和變化的觀点在醫學的運用)’, 이임상병례진행설명(以臨床病例進行說明). 재임상상통과형색맥증적합일화변증론치결정처방(在臨床上通過形色脈證的合一和辨證論治決定處方). 즉불능단순적인위(卽不能單純的認爲), 인위시남자취용육미지황환(因爲是男子就用六味地黃丸), 여자취용사물탕(女子就用四物湯). 남자약소가용사군자탕(男子若小可用四君子湯) 사물탕(四物湯) 육미지황탕(六味地黃湯), 이여자약대가용사군자탕(而女子若大可用四君子湯) 이진탕(二陳湯) 평위산(平胃散) 육군자탕(六君子湯). 인차(因此) 남녀재구조(男女在構造) 생리(生理) 병리유근본성차이(病理有根本性差異), 불이형상래구분(不以形象來區分), 용약상시지불변적입장(用藥上是持不變的立場), 이이형상용약(而以形象用藥), 시종변화적입장래고려적(是從變化的立場來考慮的). 인위이남녀위기준종사임상(認爲以男女爲基準從事臨床), 시부합한의학기본원리지음양관(是符合韓醫學基本原理之陰陽觀).

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