• Title/Summary/Keyword: 진료실

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Development Protocol of Korean Medicine Clinical Practice Guideline for Myofascial Pain Syndrome (근막통증증후군의 한의표준임상진료지침 개발 프로토콜)

  • Byeonghyeon Jeon;Hyeonjun Woo;Won-Bae Ha;Cheoung Su Kim;Jung-Han Lee
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.203-213
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    • 2023
  • Objectives This study aimed to develop a Korean medicine (KM) clinical practice guideline for myofascial pain syndrome (MPS) via the collaboration of clinical and methodological experts. Methods The study will include an initial survey to establish a common understanding of MPS. To develop the clinical guideline, a multidisciplinary development group was formed. The group will finalize the clinical questions based on a preliminary draft. The GRADE methodology is going to be applied to determine the level of evidence and grading of the recommendations. Finally, approval from the relevant medical societies will be obtained. Results A protocol for developing a KM clinical guideline for MPS was presented. Before finalizing the clinical key questions, a literature search was conducted according to the protocol, and a draft of 19 clinical key questions was established. Conclusions An evidence-based KM clinical guideline for MPS is expected to contribute to the management of MPS. This may also serve as a reference for the development of other KM clinical practice guidelines in the future.

Radiographic Status of the Visited Patients at University Hospital Emergency Room (한 대학병원 응급실 내원환자의 방사선촬영 실태)

  • Ahn, Byeoung-Ju
    • Journal of the Korean Society of Radiology
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    • v.5 no.2
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    • pp.81-92
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    • 2011
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distriution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 1270 emergency outpatients who visit during JAN, 2009at ER of the general hospital in Gwang city. The results is as follows : Emergency radiography rate of simple radiography was 56.6%, special radiography 2. 5%, CT 34.2%, and ultrasonography 6.7%, In simple radiography rate. a high rate was distributed on male(63.6%), thoracicsurgery part(90.0%), admission patient(77.9%), and long stayed patient at ER. In special raiography rate, a high rate was obsurved in urologic part(28.6%), and in CT rate, observed neurosurgerty part(49.2%) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8%) and internal medicine part(15.9%). There are distributed regional radiography rate in radio-graphic type that chest(55.3%) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0%) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neuro surgery, chest(90.0%) in thoracic surgery, abdomen(58.0%) in general surgery, spine(40.0%) in neuro surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiopraphic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transferred patient(2.7) in patient type, and on nurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional party was highly distributed on chest(998 case number.) Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography. Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always sitted with CT room and monitoring patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiopraphy should be established in ER area, and the radioprapher of this room should be stationed radiologic technician who is career and can implement emergency patient care and The disposition of men which is appropriate with emergency patient increase is necessary.

Technical Efficiency of Medical Resource Supply and Demand (의료자원 공급, 수요의 성과 효율성에 대한 실증분석)

  • Chang, Insu;Ahn, Hyeong Seok;Kim, Brian H.S.
    • Journal of the Korean Regional Science Association
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    • v.34 no.2
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    • pp.3-19
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    • 2018
  • The objective of this study is to observe the efficiency of clinical performance on the supply and demand of medical resources in Korea. For the empirical analysis, we constructed the dataset on age standardized mortality rate, the number of physician, specialist, surgery, medical institution, ratio of general hospitals of 16 provinces in Korea from 2006 to 2013. The panel probability frontier model is employed as an analysis method and considered heteroscedasticity and autocorrelation of the error in panel data. In addition, the demographic and socioeconomic characteristics of the 16 provinces, unemployment rate, elderly population ratio, GRDP per capita, and ratio of hospitals in comparison to the general hospitals are used to find the effect on the technical efficiency of clinical performance on supply and demand of medical resources. The results are as follows. First, for the clinical performance, the supply side of human resources such as doctors and specialists and the demand side factors such as chronic illness clinic per unit population have a significant influence, respectively. Second, the technical efficiency of clinical performance on the supply and demand of medical resources of each input component was 59-70% in terms of clinical efficiency in each region. Third. estimates of technical efficiency of inputs that affect clinical performance showed a slight increase in all regions during the analysis period, but the increase trend decreased slightly. Fourth, the ratio of the elderly population and GRDP per capita have a positive influence on the technical efficiency of clinical performance on the supply and demand of medical resources. The difference of each efficiency by region is due to the regional differences of the input medical resources and the combination of them and the demographic and socioeconomic characteristics of the region. It is understood that the differences in technological efficiency due to the complexity of supply and demand of medical resources, demographic structure and economic difference affecting clinical performance by region are different.

Pain Disability of Orofacial Pain Patients (구강안면통증 환자의 통증활동제한)

  • Choi, Se-Heon;Kim, Ki-Suk;Kim, Mee-Eun
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.217-225
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    • 2009
  • As Pain is a comprehensive, biopsy chosocial phenomenon, improved understanding and successful management of pain need assessment of health-related quality of life and psychological states. The purpose of this study was to evaluate pain severity and pain-related interference to daily lives for patients with non-dental, orofacial pain(OFP) and a possible relation of OFP with psychological morbidity. Relation with such factors as gender, age, pain duration and diagnosis was also assessed. Inclusion criteria was all new patients with non-dental OFP attending the oral medicine.orofacial pain clinic of Dankook University Dental Hospital over 3 months' period, who completed the questionnaires of the Brief Pain Inventory (BPI) and Hospital Anxiety and Depression Scale (HADS). Prior to the first consultation, the patients were asked to fill out the questionnaire in the waiting room and were diagnosed through consultation and clinical examination. Total subjects were 163 with M:F ratio of 1:1.5 and mean age of 34.6${\pm}$17.7 years. Mean duration of pain was 13.3${\pm}$26.2 months and all patients were divided into; Trigeminal Neuralgia group (TN, N=8), Neuropathic Pain group (NeP, N=9), Persistent Idiopathic Facial Pain group (PIFP, N=8), and Temporomandibular Disorders group (TMD, N=138), subdivided into muscle problem (TMD-m, N=73), joint problem (TMD-j, N=24) and muscle-joint combined problem (TMD-c, N=41). OFP patients showed moderate pain severity and moderate pain-related interference. There was no gender difference in overall pain severity and interference and levels of anxiety and depression. Elderly patients aged ${\geq}$ 60 years showed higher pain severity (p<0.05). Patients with chronic pain ${\geq}$ 3 months reported more increased level of anxiety and depression than those with acute pain (p<0.05). Compared to TMD patients, patients with TN, NeP and PIFP suffered from higher level of pain and pain-related interference and reported higher level of anxiety and depression (p<0.05). Pain interference was closely correlated with their pain severity and with psychometric properties such as anxiety and depression. Pain severity was weakly correlated with levels of anxiety and depression. The results suggest a need for psychosocial assessment and support for successful management of OFP in addition to control of pain itself.

Effect of Health Promotion and Characteristics of Elderly used Day Care Service in Community Health Practitioner's Post (보건진료소의 주간보호실 이용노인의 특성과 건강증진 정도)

  • Jeong, In-Suk;Cho, Yoo-Hyang;Park, Yoon-Chang
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.127-136
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    • 2002
  • This study was taken to provide data for the approaches of day care service for the elderly in community health practitioner's post through the study on the utilization rate, characteristics and health promotion that the elderly used the day care services. Data collection used three records that case management in take sheet, dementia check list and ADL record during the one year, from June 21, 2001 to June 30, 2002. During the one year, the elderly used day care services were 119 persons that 26.9% of the total elderly population, 1.5 time per used the elderly, and female elderly(88.9%) more used than male elderly. 39.5%of the elderly user have chronic diseases that was arthritis and hypertension and etc. 41.2% of the elderly users have dementia state that score was $17.39{\pm}7.17$(handicapped elderly), $18.43{\pm}7.36$(healthy elderly), but statistically not significant PADL score was $2.18{\pm}0.55$(handicapped elderly), $2.78{\pm}0.30$(healthy elderly), IADL score was $1.78{\pm}0.51$(handicapped elderly), $2.47{\pm}0.60$(healthy elderly) that were statistically significant. One year later, PADL and IADL of the elderly users were improved that statistically significant(p=0.01). The elderly users were wanted rehabilitation service(22.2%), talking service(20.6%), bath service(12.7%), food service(9.5%) of day care services in CHP's post. We are recommended that day care service for the elderly in CHP's post was very useful and contributed to promote ADL functions.

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A study of $Smartpeg^{TM}'s$ lifetime according to sterilization for implant stability (임플랜트 안정성을 위한 자기공명막대의 소독방법에 따른 수명에 관한 연구)

  • Won, Ho-Yeon;Cho, In-Ho;Lee, Joon-Seok
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.42-52
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    • 2008
  • Purpose: Resonance Frequency Analysis(RFA) technique can be used as an effective method in measuring the implant stability and documenting the clinical results. This technique also determines how stable the implant is before performing a prosthetic practice. Having become one the guidelines of the implant therapy whose final objective is the immediate loading, the $Osstell^{TM}$ mentor is giving a lot of information to the clinicians recently. In this communication, experiments were performed to investigate how reliable the measured ISQ values by $Osstell^{TM}$ mentor are, and to see if those are also stable even after sterilization. As five objectives: 1) How stable measured ISQ values after fixation $Smartpeg^{TM}s$ for 400 times. 2) How stable measured ISQ values after 'attach-detach'$Smartpeg^{TM}'s$ for 400 times. 3) How stable measured ISQ values after clinical sterilization methods. 4) How stable measured ISQ values after repeatedly sterilization in autoclave for 10 times. 5) What is the critical temperature which is lost the magnetism of $Smartpeg^{TM}$. Materials and Methods: Clinical sterilization methods(Autoclave sterilization, Dentistar sterilization, Ultra violet sterilization, Vacuum dry unit sterilization, Boiling water sterilization, combined $H_{2}O_{2}$ and Alcohol sterilization).$Smartpeg^{TM}s$. D3 Block bone($3{\times}9{\times}2cm$). Osstem implant(${\emptyset}4.1$-10mm).$Osstell^{TM}$ mentor. Individual experiment was used 8 number of $Smartpeg^{TM}s$ and they had measured to ISQ values of before experiment and after experiment. Results: 1. The measured ISQ values did not change after fixation $Smartpeg^{TM}s$ for 400 times. 2. There was no significant changes in the measured ISQ values of 'attach-detach $Smartpeg^{TM}s'$ for 400 times. 3. The measured ISQ values did not change after the usual clinical sterilization methods. 4. The measured ISQ values did not change after sterilization in autoclave for 10 times. 5. It was impossible to exactly measure the critical temperature which is lost the magnetism of $Smartpeg^{TM}s$. But, the results was resulted to lost its magnetism in higher temperature than $150^{\circ}C$/10 minute. Conclusion: The measured ISQ values showed insignificant differences in case of no changes in the magnetism of the $Smartpeg^{TM}s$. It seems that the $Smartpeg^{TM}s$ can be used repeatedly in every measurement if the original magnetisms of the $Smartpeg^{TM}s$ can be recognized. There seems to be no significant changes in the measured ISQ values of 'attach-detach $Smartpeg^{TM}s'$ only if the screw pitches were unimpaired. The clinical sterilization methods seems acceptable because the result was resulted to lost its magnetism in higher temperature than $150^{\circ}C$/10minute.

Clinical Characteristics of Influenza B Virus in Children and the Efficacy of Oseltamivir: Data from Two University Hospitals (소아에서 B형 인플루엔자 바이러스의 감염에서 oseltamivir 치료의 유용성: 2개 병원에서 조사된 환자들을 대상으로)

  • Youn, Song Ee;Chun, Ji Hye;Lee, Kyung Suk;Rha, Yeong Ho;Choi, Sun Hee
    • Pediatric Infection and Vaccine
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    • v.21 no.3
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    • pp.199-206
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    • 2014
  • Purpose: There has been little research regarding the effectiveness of oseltamivir for influenza B infections. We sought to identify the different clinical manifestations between patients treated with and without oseltamivir. Methods: We retrospectively studied the medical records of 72 inpatients or outpatients from two medical centers diagnosed with influenza B infections by either a rapid antigen test or multiplex reverse transcriptase PCR between January 2012 and July 2012. We compared gender, age, past medical history, admission period, total fever duration, fever duration after hospitalization, post-oseltamivir medication peak temperature, laboratory test, chest X-ray, antibiotic medication, and the presence of concomitant viral or bacterial infections. Results: The number of subjects in our study was 72 who were diagnosed with influenza B pneumonia, acute bronchitis, acute bronchiolitis, croup, and mean age was $3.6{\pm}2.8$ year old. The demographic characteristics and clinical manifestations of oseltamivir and the non-oseltamivir groups, including hospitalization period ($4.18{\pm}2.10$ vs $4.79{\pm}1.49$ days, P=.17) and total fever duration ($5.32{\pm}2.07$ vs $6.41{\pm}3.25$ days, P =.09), demonstrated no significant differences. Notably, the oseltamivir group did have significantly reduced usage of antibiotic treatment than the non-oseltamivir group (P=.04). When we limited our patient group to patients under the age of three, similar results were seen. The group prescribed oseltamivir within 48 hours of fever onset had less antibiotic usage, in addition to a shorter fever duration. Conclusion: Oseltamivir appeared to have no benefit in improving the clinical course. However, if it is prescribed within the first 48 hours of symptoms, it may be more effective.

Outcomes of the arterial switch operation in complete transposition of the great arteries (완전 대혈관 전위에서 대혈관 치환술 후의 예후)

  • Cho, Min-Jung;Park, Ji-Ae;Lee, Hyoung-Doo;Sung, Si-Chan;Choo, Ki-Seok
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.910-916
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    • 2009
  • Purpose : The arterial switch operation (ASO) has become the preferred procedure for the surgical management of transposition of the great arteries (TGA). We conducted a retrospective evaluation of our experience in 30 patients seen from January 2003 to July 2008, in order to determine outcomes and related risk factors after the arterial switch operation. Methods : Patients charts, surgical reports, and echocardiograms were retrospectively reviewed. And they were analyzed in 2 different groups: complex (n=16) versus simple TGAs (n=14). Complex TGAs are TGAs with VSD or the Taussig-Bing anomaly with or without aortic arch anomalies. Simple TGAs are defined as TGAs with intact ventricular septum having no such anomalies. Median follow-up time was 44 months (3-63 months). Results : Hospital mortality was 0%. However, follow-up echocardiographies revealed potential complications, including stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, and right or left ventricular outflow tract obstructions. Great arterial relationship (side-by-side), association of aortic arch anomalies, and the existence of the Taussig- Bing anomaly were assessed as significant risk factors of neo-aortic and/or neo-pulmonary valvar regurgitation in this series. On the other hand, right or left ventricular outflow tract obstructions were more frequently found in patients demonstrating VSD, side-by-side positioned great arteries, or associated coronary anomalies. Conclusion : The ASO is the procedure of choice in the treatment of TGA. However, special attention and follow-ups are needed to detect residual problems like the stenosis of the branch pulmonary arteries, neo-aortic and/or neo-pulmonary valvar regurgitation, as well as ventricular outflow tract obstructions.

Assessment of modifiable lifestyle factors for obese children and adolescents through questionnaires (소아청소년 비만상담에서 설문지를 이용한 중재 가능한 행동요인 탐색)

  • Seo, Jeong Wan;Jung, Ji A;Park, Hye Sook;Ko, Jae Sung;Kim, Yong Joo;Kim, Jae Young;Ryoo, Eell;Bae, Sun Hwan;Sim, Jae Geon;Yang, Hye Ran;Choe, Byung Ho;Cho, Ky Young
    • Clinical and Experimental Pediatrics
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    • v.51 no.6
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    • pp.576-583
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    • 2008
  • Purpose : The identification of specific behaviors conducive to overeating or inactivity is the cornerstone of obesity management. The Committee on Nutrition of the Korean Pediatric Society developed parent and self-reporting questionnaires about eating behavior and physical activity in 2006. The aim of this study was to evaluate the usefulness of the questionnaires in assessing modifiable lifestyle factors related to obesity. Methods : A retrospective chart review was performed for 177 children (6-11 years old) and 134 adolescents (12-16 years old) from 10 hospitals between May 2006 and January 2007 who had completed parent or self-reporting questionnaires. Cases were divided into normal and overweight groups at or above the age-gender-specific 85th percentile based on 2007 Korean national growth charts. Results : Compared to children, the adolescents tended to have a significantly more sedentary lifestvle and inappropriate dietary behaviors significantly (P<.05). Overweight mothers were significantly associated with overweight children and adolescents (P<.05). Being overweight was significantly associated with a family history of adult diseases for children and adolescents (P<.05). Inappropriate eating behaviors (strong appetite, eating fast, eating until they were full, binge eating, favoring greasy foods) were associated with being overweight in children and adolescents. Sedentary activity such as TV viewing and using a computer were significantly associated with overweight in children and adolescents (P<.05). Conclusion : Intervention to modify obesity-related lifestyle factors is needed before adolescence. These questionnaires are useful in identifying modifiable lifestyle factors and in individual counseling for overweight children and adolescents in pediatric clinics.

Chromosomal analyses of 4,500 cases of the peripheral blood : An experience in a single hospital for 25 years (말초혈액을 이용한 핵형 분석 4,500례 : 단일기관에서의 25년간의 경험)

  • Seo, Hye-Eun;Lee, Ji Hye;Kim, Ji Yoon;Lee, Dong Ha;Lee, Heung Kyo;Lee, Kun Soo
    • Clinical and Experimental Pediatrics
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    • v.50 no.9
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    • pp.875-881
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    • 2007
  • Purpose : Chromosome analysis is important in genetic study and genetic counseling. This study was performed to evaluate the type and incidence of chromosome abnormalities in a single hospital for 25 years. Methods : Chromosome analyses were performed on peripheral blood lymphocytes, obtained from 4,856 patients with suspected chromosomal aberrations, referred to cytogenetic laboratory in Department of Pediatrics, Kyungpook National University Hospital from May 1981 to October 2005. Results : We analyzed 4,567 cases. Children were 3,014 cases (66.0%) and adult were 1,553 cases (34.0 %). The most common purpose of the chromosomal analysis was growth and developmental abnormality in children and infertility in adults. Total chromosomal aberration rate was 16.9% (770/4,567). Among those cases, the numerical abnormalities were 12.2% (558 cases), the structural abnormalities were 4.1% (187 cases), and others were 0.5% (25 cases). The relative frequencies of autosomal abnormalities were 6.4% (294 cases) in Down syndrome; 0.2% (7 cases) in Edwards syndrome; 0.1% (4 cases) in Patau syndrome; 0.2% (10 cases) in other abnormalities, of sex chromosome, 2.9% (131 cases) in Klinefelter syndrome; 2.2% (99 cases) in Turner syndrome; 0.2% (8 cases) in 47, XXX; 0.1% (3 cases) in 47, XYY. Among the structural abnormalities, translocation was 1.8% (84 cases), inversion was 0.8% (37 cases), deletion was 0.4% (17 cases), and insertion was 0.3% (13 cases), in order of frequency. Conclusion : In this study, the type, incidence and distribution of cytogenetic abnormalities by karyotype were reviewed. We hope that our study could be used as a basic information on the diagnosis, treatment and genetic counseling for chromosome abnormalities in Korea.