• Title/Summary/Keyword: 진료 지침

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Climatological Characteristics in the Variation of Soil temperature in Korea (우리나라 지중온도 변동의 기후학적 특성)

  • Kim Seoung-Ok;Suh Myoung-Seok;Kwak Chong-Heum
    • Journal of the Korean earth science society
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    • v.26 no.1
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    • pp.93-105
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    • 2005
  • Climatological characteristics in the variation of soil temperatures in Korea were investigated using Korea Meterological Administration's observation data. And the impacts of soil moisture on the variation of soil temperature were examined using observed precipitation data. The climatological averages of soil temperatures are ranged from 14.4 to $15.0^{\circ}C$ regardless of depths. And they showed an latitudinal gradient with a warm temperature at the southern region and 'U' shape as in the air temperature with a high value along the coastal region. The relatively higher heat capacity and low conductivity of soil compared to those of the air resulted in the significant delay of the maximum and minimum date with depth. As a results, soil acts as a heat source during winter while a heat sink during summer. Global warming and urban heat island have increased the soil temperatures with an average rate $0.3\~0.5^{\circ}C/10-year$ as in the air temperature during last 30 years $(1973\~2002)$. However, the warming rate is maximized during spring contrary to the winter in the air temperature. The temporal variation of soil temperatures is strongly affected by that of soil moisture through an modification of the heat capacity and heat convection. In general, the increased soil moisture clearly decreased the temporal variations and increased the deep layer soil temperatures during cold season.

Evaluating and managing hypertension in children: a survey of Korean cardiologists and nephrologists (소아 고혈압의 평가와 관리 방법; 한국 소아심장 전문의와 소아신장 전문의 설문)

  • Lee, Eun Hee;Yim, Hyung Eun;Jang, Gi Young;Yoo, Kee Hwan;Son, Chang Sung;Hong, Young Sook;Lee, Joo Won
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.992-997
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    • 2008
  • Purpose : Hypertension (HTN) is no longer an exclusively adult disease; the prevalence of pediatric HTN is increasing. To understand the evaluation and treatment of childhood HTN in Korea, we investigated, via a questionnaire, how hypertensive children are currently assessed and managed by pediatric cardiologists (CA) and nephrologists (NE). Methods : We surveyed 82 pediatric CA and 77 NE, regarding how they manage hypertensive children in Korea. Results : A total 75 replies were received to our questionnaire request (response rate: 47.15%). Routine blood pressure (BP) checks were more frequently performed by NE (CA: 5.7%, NE: 25%, P=0.03), but most respondents (86%) did not check BP routinely. Mercury sphygmomanometers were the most commonly used devices and ambulatory blood pressure monitoring was not frequently used. The goal BP in treated patients was set at the 95th percentile by 61% of respondents. NE used a lower BP goal in hypertensive children with renal disease (CA: 24%, NE: 64%, P=0.004) or DM (CA: 12.5%, NE: 50%, P=0.003). Angiotensin converting enzyme (ACE) inhibitors were the most commonly used agents (mean: 59%); following ACE inhibitors, CA preferred diuretics for hypertensive children with renal disease or cardiovascular disease, and NE preferred calcium channel blockers, regardless of underlying disease. Self-monitoring was the most frequent method for BP monitoring at home. Conclusion : In Korea, BP measurement is not yet a routine examination in treating hypertension. There are some differences in management strategies vis-$\grave{a}$-vis hypertension, between pediatric cardiologists and nephrologists. For the appropriate management and prevention of secondary disease in long-term studies, standard guidelines and education are needed for pediatricians.

Prevalence of Antibodies to Hepatitis A in the Healthy Children in Inchon-Kyunggi Prefecture (경인 지역 소아의 A형 간염 항체 보유율)

  • Kwon, Young Se;Hong, Young Jin;Choe, Yon Ho;Kim, Soon Ki;Son, Byong Kwan;Kang, Moon Su;Pai, Soo Hwan;Hong, Kwang Sun
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.239-244
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    • 1998
  • Purpose : The incidence of hepatitis A virus infection in Korea has decreased recently. However, the prevalence in children and young adults is on an increasing trend in Inchon-Kyunggi prefecture. Economic development that leads to better living conditions and improves hygiene facilities has reduced the rate of HAV infection. This study was designed to evaluate the recent seroprevalence rate of hepatitis A in children and adolescents. Methods : Study population consisted of 612 children and adolescents aged 1 to 17 years in Inchon-Kyunggi prefecture. Serum samples were collected between 1996 and 1997 and tested for anti HAV by Microparticle Enzyme Immunoassay(MEIA). Results : According to age, the seropositive rates were 10.5%(male 13%, female 6.7%) in 1 year-old group, 0% in 3, 5, 11 and 13 year-old group, 6%(male 8%, female 4%) in 15 year-old group, and 11%(male 14%, female 8%) in 17 year-old group. Conclusion : This study showed that seropositive rate of HAV infection increased with age. While it revealed extremely low incidence of HAV infection in children less than 13 years old, they are also likely 10 be exposed 10 the infection. Our findings suggest that the effective administration of vaccination is needed in selected and high risk groups.

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The E-mail Survey on the Neck Pain for Acupuncture and Moxibustion Clinical Guideline (경항통에 관한 침구임상 진료지침 개발을 위한 전자우편 설문조사)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Nam, Dong-Woo;Kim, Eun-Jung;Hong, Kwon-Eui;Kim, Sung-Chul;Kim, Sun-Woong;Lee, Jae-Dong;Kim, Kap-Sung;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.67-80
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    • 2009
  • Objectives : The purpose of this survey is the development on the neck pain for acupuncture and moxibustion clinical guideline. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results and Conclusions : 1. The first selected pattern identification on the neck pain This study shows that the meridian pattern identification was selected 35 times(61.4%), the pattern identification based on cause of disease was selected 8 times(14.0%), the visceral pattern identification was selected 7 times(12.3%), the other pattern identification was selected 4 times(7.0%), Qi blood yin yang pattern identification was selected 2 times(3.5%), according to symptoms was selected 1 time(2.4%). 2. Meridian pattern identification Small intestine meridian of hand Taeyang was used 39 times(18.1%), Large intestine meridian of hand Yangmyeong and Bladder meridian of foot Taeyang was used 34 times(15.7%), Gall-bladder meridian of foot Soyang was 32 times(14.8%), Tripple energizer meridian of hand Soyang was used 31 times(14.4%), Governor meridian was used 30 times(13.9%), Lung meridian of hand Taeeum was used 8 times(3.7%), Heart meridian of hand Soeum and Pericarduim meridian of hand Gworeum was used 4 times(1.9%). 3. Pattern identification based on cause of disease Wind-Cold-Dampness was used 31 times(17.5%), Accumulation of the collateral by Phelgm-Dampness was used 16 times(14.0%), affection by exopathogen Wind-Cold(stiff neck, sprain of cervical) was used 13 times (11.4%), Defecient-Cold was used 10 times(8.8%), affection by exopathogen Wind-Dampness was used 9 times(7.9%), Deep Invasion by Wind-Cold was used 8 times(7.0%), Wind-Cold was used 7 times (6.1%), Wind-Cold was used 6 times(5.3%), Accumulation in the Center by Phelgm-Dampness, Imparement of bou fluid by Pathogenic Heat, Wind-Heat with Dampness was used 5 times(4.4%), affection by exopathogen Wind-Dampness and Accumulation of the collateral by Wind-Cold was used 4 times(3.5%), Invasion of Dampness-Heat was used 2 times(1.8%). 4. Visceral pattern identification Rising of the Liver yang was used 16 times(41%), Yin deficiency of Liver and Kidney+pathogens was used 15 times(38.5%), Yin deficiency of Liver and Kidney was used 8 times(20.5%) on this survey.

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Clinical Courses of Cavitary Lesions in Pulmonary Tuberculosis (폐결핵에서 공동성 병소의 임상적 경과)

  • Park, Seung-Kyu;Kweon, Eun-Soo;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.4
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    • pp.484-492
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    • 2001
  • Background : Pulmonary tuberculosis with a remaining cavitary lesion is considered to be a problem with the course of treatment. In particular, re-treatment cases tend to respond poorly to current anti-tuberculosis agents. Therefore the factors that are related with the poor closure of a cavitary lesion in pulmonary tuberculosis during treatment were evaluated. Methods : A retrospective review of the medical records and chest X -ray films of 68 patients who had chemotherapy for the pulmonary tuberculosis with cavitary lesions was made. All the patients had been followed up for more than 12 months at National Masan Tuberculosis Hospital as of Aug. 2000. Results : The male to female ratio was 3.9:1.72.4% of the patients were between 20 to 50 years of age. 66.2% of the cavitary lesions on the chest X-ray films were confined to the upper lung fields : 36.8% in the right upper lung field and 29.4% in the left upper lung field. 82.4% of the cavities were less than 40 mm in their size, and 83.8% were less than 6 mm thick. The cavitary lesions were closed in 48 cases and remained in 20 cases during a follow-up period of more than 12 months. The factors that are thought to affect to the outcomes of the cavities were age, past medication history, the number of unused drugs, and the number of sensitive drugs. Conclusion : In the treatment courses of pulmonary tuberculosis with cavitary lesions, the following factors are associated with less desirable outcome:an age over 45, a past medication history of more than 2 courses of treatment, The number of unused drugs not exceeding average 6 and the number of sensitive drugs not exceeding average 7.

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Dentists' Opinions in The Dental Field of Present Health Insurance Claim and Review (건강보험중 구강요양급여의 청구 및 심사에 관한 치과의사의 견해)

  • Chang, Yong-Seog;Ahn, Yong-Woo;Park, June-Sang;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.215-230
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    • 2005
  • The study was intended to investigate how dentists in private dental clinic thought on the present claim and review of dental insurance to reflect it in future establishing dental insurance policies. 1,465 dentists who were running own dental clinic in Pusan Metropolitan City and the south part of Kyungsang province were surveyed in February, 2004. A total of 406 copies of finished questionnaire were finally retrieved and analyzed. The findings are as follows. 1. About insurance claim affairs : Most of the subject of insurance claim was by dentist himself or dental hygienist(nurse). Agency claiming was carried under 20% of total insurance claim. 2. The degree of attendance on insurance lecture : The degree of attendance on insurance lecture was relatively low. 3. Filing a protest against insurance claim : Filing a protest against insurance claim was reavealed about half-and-half for "have been" or "have not been". 4. Private clinic dentist,s opinion about the regulations affecting review of dental insurance : Private clinic dentists opinion about current guide for insurance review of dental fee was“the guidance is difficult and unfair cutback of claim fee may be carried”. 5. The affairs about health insurance review agency : About 70% of private clinic dentists have dissatisfaction on health insurance review agency. 6. Standpoint of private clinic dentists about issuance of receipt for dental fee : About 70% of private clinic dentist have an difficulty in issuance of receipt for dental fee. 7. The affairs about change insurance noncoverage treatment to insurance coverage treatment : Most of private clinic dentists hoped that insurance coverage about full mouth scaling, pit and fissure sealant, fluoride application. But they do not hoped that insurance coverage about geriatric denture, prothodontic treatment except precious metal, photopolymerization resin treatment.

Assesment of Bone Strength Using a New Quantitative Ultrasound Device in Children with Renal Diseases (신질환 환아에서 초음파 골량측정법을 이용한 골상태 평가)

  • Kang Ju-Hyung;Shin Yun-Hye;Cho Nam-Han;Pai Ki-Soo
    • Childhood Kidney Diseases
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    • v.9 no.1
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    • pp.21-30
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    • 2005
  • Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.

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Effect of the Changing the Lower Limits of Normal and the Interpretative Strategies for Lung Function Tests (폐기능검사 해석에 정상하한치 변화와 새 해석흐름도가 미치는 영향)

  • Ra, Seung Won;Oh, Ji Seon;Hong, Sang-Bum;Shim, Tae Sun;Lim, Chae Man;Koh, Youn Suck;Lee, Sang Do;Kim, Woo Sung;Kim, Dong-Soon;Kim, Won Dong;Oh, Yeon-Mok
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.2
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    • pp.129-136
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    • 2006
  • Background: To interpret lung function tests, it is necessary to determine the lower limits of normal (LLN) and to derive a consensus on the interpretative algorithm. '0.7 of LLN for the $FEV_1$/FVC' was suggested by the COPD International Guideline (GOLD) for defining obstructive disease. A consensus on a new interpretative algorithm was recently achieved by ATS/ERS in 2005. We evaluated the accuracy of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases, and we also determined the effect of the new algorithm on diagnosing ventilatory defects. Methods: We obtained the age, gender, height, weight, $FEV_1$, FVC, and $FEV_1$/FVC from 7362 subjects who underwent spirometry in 2005 at the Asan Medical Center, Korea. For diagnosing obstructive diseases, the accuracy of '0.7 of LLN for the $FEV_1$/FVC' was evaluated in reference to the $5^{th}$ percentile of the LLN. By applying the new algorithm, we determined how many more subjects should have lung volumes testing performed. Evaluation of 1611 patients who had lung volumes testing performed as well as spirometry during the period showed how many more subjects were diagnosed with obstructive diseases according to the new algorithm. Results: 1) The sensitivity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases increased according to age, but the specificity was decreased according to age; the positive predictive value decreased, but the negative predictive value increased. 2) By applying the new algorithm, 34.5% (2540/7362) more subjects should have lung volumes testing performed. 3) By applying the new algorithm, 13% (205/1611) more subjects were diagnosed with obstructive diseases; these subjects corresponded to 30% (205/681) of the subjects who had been diagnosed with restrictive diseases by the old interpretative algorithm. Conclusion: The sensitivity and specificity of '0.7 of LLN for the $FEV_1$/FVC' for diagnosing obstructive diseases changes according to age. By applying the new interpretative algorithm, it was shown that more subjects should have lung volumes testing performed, and there was a higher probability of being diagnosed with obstructive diseases.