• Title/Summary/Keyword: 주치의

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A Study of Disease Prescription Using Rehmannia glutinosa, Cnidium officinale, Angelica gigas, Paeonia lactiflora in Dongeuibogam (『동의보감(東醫寶鑑)』에서 숙지황(熟地黃), 천궁(川芎), 당귀(當歸), 백작약(白芍藥)이 군약으로 사용된 방제의 주치병증 비교)

  • Keum, Yujeong;Song, Shihoon;Lee, Byungwook;Song, Jichung
    • The Journal of Korean Medical History
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    • v.34 no.2
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    • pp.89-96
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    • 2021
  • This research aims to find a way to utilize the literature to select the herbs to be added or subtracted according to the condition of the patient after determining the basic prescription to be used for the patient. The study is based on data concerning the herbal composition and application of prescriptions described in the Donguibogam. The composition herbs was expressed as a weight ratio, the standard deviation of the weight ratio was calculated for each prescription, and the case where the weight ratio was greater than the base value (highest weight ratio - standard deviation) was designated as a principal herb. The various expressions of applications were changed to representative terms by the researcher and used to calculate the frequency. Of the 4,373 prescriptions for Donguibogam, 3,307 were able to be expressed in terms of weight ratios with 640 prescriptions using Rehmannia glutinosa, Cnidium officinale, Angelica gigas and Paeonia lactiflora as the principle herb. Of the 640 prescriptions, 508 prescriptions included applied information. Rehmannia glutinosa can also be used for symptoms such as fetal leakage(胎漏), short ingestion(食少), fever(發熱), dazed expression(眼花). Cnidium officinale can also be used for symptoms such as migraine(偏頭痛), stroke(中風癱瘓), tetanus(破傷風). Angelica gigas can also be used for symptoms such as forgetfulness(健忘), incontinence of urination(小便不通), palpitations(驚悸). Paeonia lactiflora can also be used for symptoms such as heart pain and abdominal pain(心腹痛), cough(咳嗽).

SUGGESTION OF REGISTERED DENTIST PROGRAM FOR THE DISABLED: BASED ON THE NEEDS OF CONSUMERS AND SUPPLIERS (수요자와 공급자 대상 요구조사를 통한 장애인 치과주치의제도의 제안)

  • Kim, SoYun;Paik, Hye-Ran;Jin, Bo-Hyoung;Lee, Jae-Young;Kim, Jihyun;Kim, Young-Jae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.14 no.2
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    • pp.59-64
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    • 2018
  • This study proposed a registered dentist model for the disabled based on consumer in-depth interview and supplier survey. This study proposed that dental clinics in the community take role as registered dentists for the disabled. Qualification screening and facility prerequisites are required to be selected as the registered dentists for the disabled and patients of the registered dentists were restricted to the disabled who can cooperate to dental treatment services with or without the aid of physical bondage. In order to encourage the participation in the program, subsidies for the registered dentists were necessary. Also, this study proposed financial supports for the medical expenses for patients at the same level as the current dental care center for the disabled. The registered dentist program for the disabled meets the needs of disabled consumers, such as accessibility of medical institutions, expertise of medical staff, and ongoing treatments with familiar medical staff. The registered dentist program for the disabled is expected to provide prevention and ongoing management for oral health promotion of disabled people and it also contribute to lower economic burden of oral health care of the disabled.

Characteristics of Source Acupoints: Data Mining of Clinical Trials Database (데이터 마이닝을 이용한 임상연구 데이터베이스 기반 원혈의 주치 특성)

  • Choi, Dha-Hyun;Lee, Seoyoung;Lee, In-Seon;Ryu, Yeonhee;Chae, Younbyoung
    • Korean Journal of Acupuncture
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    • v.38 no.2
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    • pp.100-109
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    • 2021
  • Objectives : Source acupoint is one of the representative acupoints to treat various diseases in each meridian. We aimed to identify the patterns of selection of Source acupoints and their associations with diseases using clinical trials data. Methods : We extracted the frequency of Source acupoints across 30 diseases from clinical trials database. Acupuncture treatment regimens were retrieved from the Cochrane Database of Systematic Reviews. The frequency of Source acupoint use was calculated as the number of studies using a certain acupoint divided by the total number of included studies. Using hierarchical clustering and multidimensional scaling, the characteristics of Source acupoints were analyzed based on the similarity of the relationships between the Source acupoints and the diseases. Results : A total of 421 clinical trials were included for this analysis. LR3, HT7, KI3, and LI4 acupoints were most frequently used for the treatment of 30 diseases. Cluster analysis showed that LR3 and LI4 acupoints were grouped together and HT7 and KI3 acupoints were grouped together. Multidimensional scaling revealed that LR3, LI4, HT7, and KI3 acupoints have intrinsic properties in the two-dimensional space. Conclusions : The present study identified the selection patterns of the Source acupoints using clinical trials data. Our finding will provide the understanding of the characteristics of Source acupoints.

Experience of Self-Management Health Information in Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환자의 자가관리 건강정보에 관한 경험)

  • Choi, Ja-Yun;Jin, Xin;Ryu, Eui-Jeong
    • The Journal of the Korea Contents Association
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    • v.22 no.9
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    • pp.461-472
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    • 2022
  • Purpose: This study aimed to acquire a better understanding of experiences about health information (HI) for self-management in patients with chronic obstructive pulmonary disease (COPD). Method: The thirty patients with COPD participated in in-depth interviews, until data saturation was reached. The data was analyzed using the content analysis method. Results: Four major themes emerged from the analysis of the self-management HI in patients with COPD such as "self-management practice based on HI", "difficulty in adhering to self-management based on HI", "various attempts to obtain self-management HI" and "satisfaction with provided HI". Conclusion: The majority of patients had no specific educational experience for self-management HI from other staff except for their doctors. Thus, it is necessary to prepare a hospital environment in which various medical staff can provide self-management HI of COPD while also ensuring that accurate and continuous HI could be easily obtained through various media types, family, and acquaintances.

Awareness of Patient-Centeredness and Transitional Care Services for Older Patients Among Primary Care Physicians in Korea (일차진료 의사들의 환자중심성 및 노인환자 대상 전환기 돌봄서비스 인식)

  • Dronina, Yuliya;Kim, Su Kyoung;Jo, Heui Sug
    • Journal of agricultural medicine and community health
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    • v.47 no.3
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    • pp.143-153
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    • 2022
  • 목적: 병원에서 재가 및 시설로 퇴원한 환자가 지역사회에서 건강을 유지하기 위해서는 전환기 돌봄서비스(Transitional care services)가 필요하다. 이를 위해 지역사회 내 의료서비스와 자원을 연계하는 주치의의 역할이 중요시된다. 본 연구에서는 선행연구를 바탕으로 일차진료 의사들의 환자중심성에 대한 인식을 파악하여 환자중심 기반의 서비스 제공을 위해 필요한 정책을 제시하였다. 또한 Transitional Care Service에 대한 일차진료 의사들의 인식을 확인하고 인구사회학적 요인과의 관계를 확인함으로써 서비스 우선순위를 도출하고자 하였다. 방법: 본 연구는 전국의 가정의학과, 내과, 신경과 등 노인 질환과 관련 있는 과의 전문의 자격증이 있으며 자발적으로 온라인 설문조사에 참여할 의사를 표현한 일차진료 의사 259명을 대상으로 수행되었다. 환자중심성 및 전환기 돌봄서비스에 대한 인식을 살펴보기 위해 구조화된 설문지를 개발하였으며, 조사전문업체를 통해 2019년 10월 28일부터 2019년 11월 22일까지 온라인으로 설문조사를 수행하였다. 결과: 본 연구에 대한 주요 결과는 다음과 같다. 첫째, 일차진료 의사들을 대상으로 9가지 전환기 돌봄서비스 인식에 대해 살펴본 결과 "입원 시 진단, 건강상태, 치료계획 및 결과 에 대한 설명(4.4)"과 "퇴원 후 자가 건강관리를 위한 정보 및 훈련 (4.2)"에 대한 필요성이 높게 나타났다. 둘째, 35세 이상 일차진료 의사가 34세 이하 일차진료 의사보다 전환기 돌봄서비스에 대한 인식이 높게 나타났다(F=7.3, p<0.01). 또한, 환자중심성에 대한 인식이 높을수록, 연령이 높을수록, 서울 외 지역에서 근무할수록 전환기 돌봄서비스에 대한 인식이 높게 나타났다. 결론: 본 연구에서는 일차의료를 제공하는 의료진들을 위한 교육프로그램과 지역사회에서 일차의료 의사들을 중심으로 하는 지역 연계 방안을 제시하였다는 점에서 의의가 있다.

A Study on the Development of a Korean Medicine Clinical Pathway for Primary Care of Patients with Dementia Based on Clinical Pathway Methodology (한의표준임상경로에 기반한 치매 안심 한의주치의 모형 개발 연구)

  • Doyoung Kwon;Kee-Tae Kweon;Young-Jin Hur;Dongsu Kim;Seung-Hun Cho
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.4
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    • pp.359-368
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    • 2023
  • Objectives: This study aims to establish a Korean medicine doctor's range of services in the dementia relief primary care system based on the previously developed dementia clinical practice guidelines (CPGs). Developing a dementia relief primary care Clinical Pathway (CP) can aid clinically when the Korean medicine primary care doctor conducts treatment. Methods: We analyzed Dementia Korean Medicine Primary Care Model Data and then applied CP Methodology to develop the configuration of the Korean Medicine Primary Care Model. For patients with Alzheimer's dementia (AD), vascular dementia (VD), and mild cognitive impairment (MCI), the Korean Medicine Primary Care Model focuses on improving cognitive function, everyday living abilities and easing symptoms through interventions described in CPGs. The contents of the draft model later include references to already-existing CPs. Results: The study sites were chosen as Korean medical clinics connected to primary care physicians in the dementia-friendly model. The CP used a time task matrix version to arrange the clinical chronology, which included all examinations, diagnoses, and treatment procedures, from the initial appointment to follow-ups and the end of therapy. Conclusions: It anticipates that Korean primary care doctors familiar with dementia can use the offered therapies for the first time by creating the dementia Korean medicine primary care model in this study. This is expected to maximize the range of medical services provided by Korean medicine and improve the standard of medical treatment.

Automatic Notification System for Nuclear Medicine Blood Test (핵의학 혈액 검사의 경고치 자동통보 시스템)

  • Sim, Seong-Jae;Yoon, Pil-Young;Lim, Soo-Yeon;Cheon, Jun-Hong;Shin, Young-Kyoon;Yu, Seon-Hui;Cho, Si-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.159-164
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    • 2009
  • Purpose: The automatic notification system for alarm values on blood tests conducted by this hospital is designed to immediately inform the attending physician of the result of a blood test, to help the relevant patient to promptly receive proper treatment, and furthermore, to reduce the likelihood of a fatal influence to the patient. From 2004, the clinical pathology department of this hospital has been operating an automatic notification system for blood tests, in relation to the items of WBC, Hb, Plt, PB cell morphology, Malaria, PT, aPTT, BT, fibrinogen, Ca, K, Na, Cl, Mg, Glucose, Ketone, Digoxin, PKU, Homocystinuria, 17-OHP, Neonatal TSH, and Galactosemia. Recently, the blood test room of the nuclear medicine department has been operating an automatic notification system for the alarm values of a blood test, in relation to three items of TSH, FT4, and 17-${\alpha}$-OH-PGR, and the details of its operation will be described here. Materials and Methods: The subjects were newborn babies that were receiving TSH, FT4, and $17{\alpha}$-OH-PGR prescriptions from February $19^{th}$ to May $11^{st}$, 2009, and who met with the following criteria: N2340 Thyroid-Stimulating Hormone: >$10{\mu}IU/mL$ (Reference value: 0.4~5.0). N2360 Free-Thyroxine: <$0.8{\mu}g/dL$ (Reference value: 0.8~1.9), N2444 $17{\alpha}$-OH-Progesterone: >$30\;{\mu}g/mL$ (Reference value: Male (0.6~3.42), Female follicular phase (0.19~1.8). The automatic notification system was operated by entering test items, relevant treatment departments, and standard values for reporting alarm values into the OCS program, and then transmitting results that met with the input conditions to the PDAs of the prescription and the attending physician by SMS. Results: Reporting an alarm value of the nuclear medicine blood test, which can have a fatal influence on the lives of patients, will help cure patients, improve the quality of the test, and furthermore, will increase the patient's satisfaction with the prescription and treatment of the test.

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ICU nurses' ethical attitudes about DNR (중환자실 간호사들의 DNR에 대한 윤리적 태도)

  • Yu, Eun-Yeong;Yang, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.4
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    • pp.2691-2703
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    • 2015
  • This research aims to provide basic materials for assisting DNR patient cares by understanding ICU nurses' awareness and ethical attitude regarding DNR. A total of 154 results were analyzed which were collected from Aug. 1st to Sep. 5th in 2014 by surveying nurses working in ICU (from 1 advanced general hospital in G metropolitan city and other general hospitals of more than 700 beds in Cheolla provinces). (1) For the decision attitudes of DNR, there were both consent and objection. Consent for the patient's opinion of rejecting further treatment and life extension despite of bad prognosis. And objection for no conducting DNR in the case of the patient's wish, treatment requested by the guardian, and CPR for the patient who has no chance. (2) Objection for artificial respirator and other treatment requested by the patient's family and the entrance of guardians into ICU. Consent for the passive use of artificial respirator by the doctor and the decrease of basic care to stabilize patients physically and mentally. No specific opinion for treatment not following aseptic techniques. Objection for frequent reports to primary care physician requested by the family. (3) Acknowledging less interest by the doctor, while supporting the health care team in the case of the guardian's complaint, objection for the DNR decision mede by the primary care physician. Objection for the DNR decision by the guideline. Objection or neutrality for straightforward explanation to the patient of bad prognosis. Objection for straightforward explanation of the patient's status (even near to death) to the patient him/herself or the guardian. In conclusion, the subject of DNR is the patient and the patient's opinion should be fully reflected. The conflict arising from the scope of medical practice and decision processes should be minimized. The standard and guideline for DNR decision is required for the ethical decision making for the patient along with agreements based on full explanations.

9 Provinces and 5 Secondary Capitals, Myeong-ju(Haseo-ju) - Revolve Around Urban Structure - (구주오소경과 명주(하서주) - 그 도시구조를 중심으로 -)

  • Takahumi, Yamada
    • Korean Journal of Heritage: History & Science
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    • v.45 no.2
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    • pp.20-37
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    • 2012
  • After withdrawal of military troops of Chinese Tang dynasty in the 18th year of King Moon-moo's reign(678), the Silla Kingdom had actually unified the Korean peninsula and had divided the territory into 9 states benchmarking the China's local administrations adjustment system. He had established local administrative units by deploying secondary capitals, counties and prefectures in the nine states. The so-called "9 Provinces and 5 Secondary capitals" are what constitutes the local administrations system. The provinces can be compared to current provinces of the Republic of Korea(hereinafter Korea), and secondary capitals to megalopolises. According to a chapter of the Samkuksaki(三?史記) which had recorded the achievements of king Kyoungdeok in December in his 16th year on the throne(757), the local administrative units had amounted to 5 secondary capitals, 117 counties and 293 prefectures. There are still lots of ambiguous points since there have never been any consultation on locations of provinces and secondary capitals' castles, and on structures of cities because the researches for local cities inside the 9 Provinces and 5 Secondary capitals in the Unified Silla Kingdom has been conducted centering on the historic literatures only. The research for restoring structures of cities seen from an archeological perspective are limited to the studies of Taewoo Park("A study on the local cities in the Unified Kingdom Age" 1987) and that of the author("A study on the restoration of planned cities for the Unified Silla Kingdom in terms of the structures and realities of the castles in the 9 Provinces and 5 Secondary capitals" 2009). The Gangneung city of Gangwon province was originally called Haseoryang(河西良) of the Gogureo Kingdom as an ancient nation of Ye(濊). According to "Samkuksaki", it had evolved from Haseoju(河西州) to a secondary capitals in the 8th year of King Seonduk(639). Afterwards, it had been renamed as Myeongju(溟洲) in the 16th year of King Kyoungduk(757), and then several other names were given to it after Goryo dynasty. Taewoo Park claims that it is being defined as a sanctuary remaining in Myoungjudong because of the vestige of bare castle, and this cannot be ascertained due to the on-going urbanization processes. Also, the Kwandong university authority is suggesting an opinion of regarding Myeongju mountain castle located 3 Kms southwest of the center of Gangwon city as commanding post for the pertinent state. The author has restored the pertinent area into a city composed of villages within a lattice framework like Silla Keumkyoung and many other cities. The structure is depicted next. The downtown of Gangneung is situated on a flat terrain at the west bank of Namdaecheon stream flowing southwest to northeast along the inner area of the city. Though there isn't any hill comparatively higher than others in the vicinity, hills are continuously linked east to west along the northern area of the downtown, and the maximum width of flat terrain is about 1 Km and is not so large. Currently, urbanization is being proceeded into the inner portion of Gangneung city, the lands in all directions from the hub of Gangneung station have been readjusted, and thus previous land-zoning program is almost nullified. However, referring to the topographic chart drawn at the time of Japanese colonial rule, it can be validated that land-zoning program to accord the lattice framework with the length of its one side equaling to 190m leaves its vestige about 0.8Km northwest to southeast and about 1.7Km northeast to southwest of the vicinity of Okcheondong, Imdangdong, Geumhakdong, Myeongjudong, and etcetera which comprize the hub of the downtown. The land-zoning vestige within the lattice framework, compared to other cases related with the '9 states and 5 secondary capitals', is very much likely to be that of the Unified Silla Kingdom. That the length of a side of a lattice framework is 190m as opposed to that of Silla Geumkyoung and other cities with their 140m or 160m long sides is a single survey item in the future. The baseline direction for zoning the lands is tilting approximately 37.5 degrees west of northwest to southeast axis in accordance with the topographic features. It seems that this phenomenon takes place because of the direction of Namdaecheon and the geographic constraints of the hills in the north. Reviewing minimally, a rectangular size of zoned land by 4 Pangs(坊) on the northwest to southeast side multiplied by 7 Pangs(坊) on the northeast to southwest side had been restored within a lattice framework. Otherwise, considering the extent of expansion of the existing zoned lands in the lattice framework and one more Pang(坊) being added to each side, it is likely that the size could have been with 5 Pangs(坊) on the northwest to southeast side multiplied by 8 Pangs(坊) on the northeast to southwest side(950 M on the northwest to southeast side multiplied by 1,520m on the northeast to southwest side). The overall shape is rectangle, but land-zoning programs reminiscent of rebuilt roads(red phoenix road) like Jang-an castle(長安城) of Chinese Tang dynasty or Pyoungseong castle(平城城) in Japan is not to be validated. There are some historic items among the roof tiles and earthen wares excavated at local administrative office sites or Gangneung's town castle in Joseon dynasty inside the area assumed to be containing municipal vestiges even though archeological survey for the vestige of Myeongju has not been made yet, and these items deserve dating back to the Unified Silla Kingdom age. Also, all of the construction sites at local administrative authorities of the Joseon dynasty are showing large degrees of slant in the azimuth. This is a circumstantial evidence indicating the fact that the inherited land-zoning programs to be seen in Gangneung in terms of the lattice framework had ever existed in the past. Also, the author does not decline that Myeongju mountain castle had once been the commanding post when reviewing the roof tiles at the edge of eaves in this stronghold. The ancient municipal castles in the Korean peninsula are composed of castles on the flat terrain as well as hilly areas and the cluster of strongholds like Myounghwal, Namhan, Seohyoung mountain castles built around municipal castle of Geumkyoung based on a lattice framework program. Considering that mountain castles are spread in the vicinity of municipal vestiges in other cities other than the 9 states and 5 secondary capitals, it is estimated that Myeongju was assuming the function of commanding post incorporating cities on the flat terrain and castles on the hills.

Study on the Origins and Main Treatments of Grub Used in Experiments, and Research Directions on the Efficacy of Grubs (실험에 사용된 제조의 기원과 주치증에 대한 고찰 및 제조의 약효에 대한 연구방향)

  • Han, Kyu-Jo;Kim, Myung-Dong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.158-165
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    • 2009
  • The aim of this study was to clarify the origins of grubs which were used in the experiments, and to determine many other effects that are now written in the classical medical and herbal books. We compared the efficacy of grubs written in the herbal and medical books on the one hand, and studied the origins of grubs used in the experiments, on the other hand. The following results were obtained. There are three kinds of grub species for medicinal uses. Holorichia diomphalia Bates mainly produced in China, Cetoniidae species mainly produced in Korea, and Protaeria brevitarsis in Korean folk remedy are three species. Grubs were used in 25 experiments. Of these experiments, Holotrichia diomphalia were used 12 times, Larve of Protaeria brevitarsis 3 times, and Protaetia orientalis was used once. So, of total 25 experiments, 36%(9 experiments) did not clarify the origins of grubs used in the experiments. Currently, the grubs, which are imported from China and used in Korea, are Holotrichia diomphalia Bates from China. Current experimental study shows that grubs have efficacy for protecting liver. So the use of grubs in folk medicine is believed to be based on the scientific evidence. Efficacy of grubs, though it is not recorded in the medical books, has the effects of anti-cancer(anti-tumor), antioxidant, and anti-diabetes mellitus. The ingredients of Holotrichia are protein, peptide, fat, enzyme, mineral, and other several nutrients. Study on the grubs so far has a tendency to be done with little focus on the differen of origin of grubs. So, from now on, it needs that the origin of grubs be clarified, and the study on the efficacy from each origin be done. Considering the effects that the classical herbal books have recorded, it is necessary that more profound study proceed to prevent and treat diseases on eyes and ears, on the basis of the fact that grub has multiple ingredients to replenish the vital essence.