• 제목/요약/키워드: Clinical adjustment

검색결과 282건 처리시간 0.025초

단삼보혈탕가감과 침구치료를 통한 궤양성 대장염의 후유증에 대한 치험례 1례 (Clinical Case of Symptoms Remaining after Western Medical Therapy in Ulcerative Colitis, with Herbal Medicine Dansamboheol-tang gagam, Acupuncture, and Moxibustion Treatment)

  • 김상헌;김효진;김정은;이상희;홍수현;김원일
    • 대한한방내과학회지
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    • 제28권4호
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    • pp.911-918
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    • 2007
  • This study is a clinical report of one patient with symptoms remaining after western medical therapy for ulcerative colitis. Ulcerative colitis, a diffuse inflammatory disease of the mucosal lining of the colon and rectum, is characterized by a remitting and relapsing course. Therefore treatment is difficult and the proper treatment typically isn't established. We provided acupuncture-moxibustion therapy 28 times and prescribed Dansamboheol-tang gagam, which functions by nourishing the blood (補血), strengthening the spleen (健脾), adjustment of ki (理氣), removal of extravasated blood (祛瘀), and warming of the kidney (溫腎), for 30 days. The patient improved in quality of life and the symptoms disappeared. This study suggests that Dansamboheol-tang gagam, acupuncture, and moxibustion treatment has an effect on improving the symptoms remaining after western medical therapy for ulcerative colitis.

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노인과 중년 당뇨병 환자의 골절의 발생 빈도 위험과 혈당조절의 관계 (Risk of Fracture Prevalence and Glycemic Control in Korean Older and Middle-aged Patients with Diabetes: A Retrospective Analysis of a Cohort Derived from the Korean National Health Insurance Sharing Service Database, 2009-2013)

  • 신혜연
    • 한국임상약학회지
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    • 제28권3호
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    • pp.194-203
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    • 2018
  • Background: Bone fractures are high in elderly patients with type 2 diabetes mellitus (T2DM). Hyperglycemia and chronic kidney disease may increase the risk of fracture prevalence via altered bone metabolism, but whether glycemic control and kidney function are associated with the risk of fracture prevalence remains unclear. This study evaluated the relationship between glycemic control and baseline estimated glomerular filtration rate (eGFR) and risk of fracture prevalence in older and middle-aged patients with T2DM. Methods: Patients who underwent a general medical check-up between 2009 and 2013 were selected from the Korean National Health Insurance Sharing Service records. Chi-square test and multiple logistic regression analysis were used to assess the relationship between glycemic control and eGFR and risk of fracture prevalence. Results: Cumulative fracture prevalence were higher in patients with T2DM, irrespective of whether they had tight or less stringent glycemic control (fasting blood glucose [FBG] ${\geq}110mg/dL$). After adjustment for baseline age and FBG, tight and less stringent glycemic control was significantly associated with increased adjusted risk of fracture prevalence in middle-aged patients with T2DM (OR=1.13, 95% CI, 1.05-1.21, p=0.0005 vs OR=1.13, 95% CI, 1.06-1.20, p=0.0001), but not in older patients. Baseline eGFR was not significantly related to fracture prevalence in either older or middle-aged patients. Conclusion: Less stringent glycemic control significantly increased the adjusted risk of fracture prevalence in middle-aged patients with T2DM. Further studies are needed to confirm the effect of tight glycemic control on fracture prevalence.

최신(最新) 임상연구(臨床硏究)를 중심으로 한 아토피 피부염에 관한 방법론적(方法論的) 연구(硏究) (The Methodological Study on Atopic Dermatitis in the latest clinical study)

  • 민상연;김장현;김기봉
    • 대한한방소아과학회지
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    • 제20권1호
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    • pp.151-164
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    • 2006
  • Objective : The objective of this study is to analyze an increasing rate, difference of attack rate in age, relationship between atopic dermatitis and breast-feeding, the relationship between atopic dermatitis and the Sasang constitution, and various treatments of atopic dermatitis. Methods : This clinical study was carried out with 22 theses which are related with diagnosis, treatments, prognosis and control of atopic dermatitis. The 22 theses are carried on J Korean Oriental Pediatrics, J Korean Oriental Ophthalmology, J Korean Oriental Med, J Korean Academy of Pediatric Allergy and Respiratory Disease, J Korean Acad Fam Med and Korean J Food & Nutr. Results : The prevalence rate, attack rate and diagnosis rate of atopic dermatitis are increased in the year of 2000, compared with those of 1995. Comparing age of patient between the year of 1992 and 2002, the attack rate of atopic dermatitis is increased quickly over 7 years old. Specific immunoglobulin E(IgE) antibodies detected in patients under 1 year old was exclusively caused by food. But for the age over 7 years old, food and inhalant allergen are detected in the year of 2002 in compare with that of 1992. Because of breast-feeding, intemperate diet adjustment during the period of maternity of family history of atopic dermatitis, the attack rate of atopic dermatitis is increased in infant. The types of patients are categorized according to Sasang constitution and Soeumin group was largest. The Oriental medicine treatments of atopic dermatitis are bath & skin hydration, avoidance from antigen, dietetic treatment, external treatment, medication and phototherapy. Conclusion : The atopic dermatitis is associated with breast-feeding, Sasang constitution types. More active approach for the treatment and prevention of Atopic dermatitis in children are needed.

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미국, 캐나다, 영국의 재입원율 활용 현황 (Readmission Rate: Experience in USA, Canada and UK)

  • 이상아;주영준;신재용;박은철;이후연
    • 한국의료질향상학회지
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    • 제22권1호
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    • pp.29-37
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    • 2016
  • Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

Association between fish and shellfish, and omega-3 PUFAs intake and CVD risk factors in middle-aged female patients with type 2 diabetes

  • Kim, Hyesook;Park, Seokyung;Yang, Hyesu;Choi, Young Ju;Huh, Kap Bum;Chang, Namsoo
    • Nutrition Research and Practice
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    • 제9권5호
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    • pp.496-502
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    • 2015
  • BACKGROUND/OBJECTIVES: This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS: A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS: In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS: These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D.

The Association between Food Group Consumption Patterns and Early Metabolic Syndrome Risk in Non-Diabetic Healthy People

  • Yeo, Rimkyo;Yoon, So Ra;Kim, Oh Yoen
    • Clinical Nutrition Research
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    • 제6권3호
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    • pp.172-182
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    • 2017
  • We investigated the association between dietary habits/food group consumption patterns and early risk of metabolic syndrome (MetS), a main cause for metabolic disease. Study participants were recruited from the health promotion center in Dong-A University Hospital and public advertisement. Study subjects (n = 243, 21-80 years) were categorized into three groups: Super-healthy (MetS risk factor [MetS RF] = 0, n = 111), MetS-risk carriers (MetS RF = 1-2, n = 96), and MetS (MetS $RF{\geq}3$, n = 27). Higher regularity in dietary habits (breakfast-everyday, regular eating time, non-frequent overeating, and non-frequent eating-out) was observed in the Super-healthy group than in the MetS-risk carriers, and particularly in the MetS subjects. The relationship between food group consumption patterns and MetS-risk related parameters were investigated with adjustment for confounding factors. Fruit consumption was positively associated with HDL-cholesterol, and tended to be negatively associated with waist circumference, triglyceride, LDL-cholesterol, and insulin resistance (IR). The consumption of low-fat meats and fish, and vegetables was negatively associated with hs-CRP. Specifically, the consumption of seafoods belonging to the low-fat fish was negatively associated with fasting glucose, hs-CRP, and interleukin (IL)-6. Anchovy/dried white baits consumption was negatively associated with fasting insulin and IR. Green-yellow vegetables consumption was negatively associated with fasting insulin, IR, and hs-CRP. On the other hand, sugars and fast-foods were positively associated with LDL-cholesterol. Additionally, fast-foods consumption was positively associated with hs-CRP and IL-6 levels. In conclusion, dietary habits/food group consumption patterns are closely associated with MetS-risk related parameters in Koreans. It may suggest useful information to educate people to properly select healthy foods for early prevention of MetS.

The Level of Serum Cholesterol is Negatively Associated with Lean Body Mass in Korean non-Diabetic Cancer Patients

  • Han, Ji Eun;Lee, Jun Yeup;Bu, So Young
    • Clinical Nutrition Research
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    • 제5권2호
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    • pp.126-136
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    • 2016
  • Due to poor nutrition and abnormal energy metabolism, cancer patients typically experience the loss of muscle mass. Although the diabetic conditions or dyslipidemia have been reported as a causal link of cancer but the consequence of such conditions in relation to gain or loss of skeletal muscle mass in cancer patients has not been well documented. The purpose of this study was to investigate the relationship of lean body mass and systemic parameters related to lipid metabolism in non-diabetic cancer patients using data from the Korean National Health and Nutrition Examination Survey (KNHANES) 2008-2011. As results the level of serum total cholesterol (total-C) was negatively associated with both total lean body mass and appendicular lean body mass in cancer patients after adjustment for sex, physical activity, energy intake and comorbidity. The associations between consumption of dietary factors (energy, carbohydrate, protein and fat) and lean body mass were disappeared after adjusting comorbidities of cancer patients. Multivariate-adjusted linear regression analysis by quartiles of serum total-C showed that higher quartile group of total-C had significantly lower percent of lean body mass than reference group in cancer patients. The data indicate that serum lipid status can be the potential estimate of loss of skeletal muscle mass in cancer patients and be referenced in nutrition care of cancer patients under the onset of cachexia or parenteral/enteral nutrition. This data need to be confirmed with large pool of subjects and should be specified by stage of cancer or the site of cancer in future studies.

CAD/CAM을 이용하여 기존 국소의치에 맞는 지대치 보철물 제작 증례 (The fabrication of abutment crowns for existing removable partial denture using CAD/CAM: A clinical report)

  • 채민정;이청희
    • 대한치과보철학회지
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    • 제57권4호
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    • pp.490-494
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    • 2019
  • 국소의치 장착자에서 2차 우식 등의 문제가 발생하여 지대치 치료 후 크라운 재수복이 필요한 경우가 있다. 기존 국소의치가 잘 기능하고 있고 환자가 여러 가지 원인으로 국소의치를 새로 제작할 수 없을 경우에는 기존 국소의치에 맞도록 지대치 보철물을 제작해야 한다. 그러나 이 과정은 기술적으로 난이도가 높고, 기공과정이 복잡하다. 국소의치를 지지하는 지대치에 합병증이 발생하기 전의 원본 모형이 있고 참고점이 될 수 있는 다른 치아들을 포함하고 있다면, CAD/CAM을 이용하여 retrofitting 보철물을 매우 간단하고 효율적으로 제작할 수 있다. 본 증례는 지대치의 포스트, 코어 및 보철물이 복합적으로 탈락하여 내원한 환자에서, computer-aided design and computer-aided manufacturing (CAD/CAM)을 이용해 기존 국소의치에 맞는 보철물을 제작하였고 높은 적합도와 조정 과정의 최소화 등 만족스러운 결과를 얻어 이를 보고하는 바이다.

Prostatectomy Provides Better Symptom-Free Survival Than Radiotherapy Among Patients With High-Risk or Locally Advanced Prostate Cancer After Neoadjuvant Hormonal Therapy

  • Kim, Sung Han;Song, Mi Kyung;Park, Weon Seo;Joung, Jae Young;Seo, Ho Kyung;Chung, Jinsoo;Lee, Kang Hyun
    • 대한비뇨기종양학회지
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    • 제16권3호
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    • pp.126-134
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    • 2018
  • Purpose: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT). Materials and Methods: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003-2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test. Results: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p<0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013). Conclusions: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.

A CAD/CAM-based strategy for concurrent endodontic and restorative treatment

  • Escobar, Patricia Maria;Kishen, Anil;Lopes, Fabiane Carneiro;Borges, Caroline Cristina;Kegler, Eugenio Gabriel;Sousa-Neto, Manoel Damiao
    • Restorative Dentistry and Endodontics
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    • 제44권3호
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    • pp.27.1-27.12
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    • 2019
  • This case report describes a technique in which endodontic treatment and permanent indirect restoration were completed in the same clinical appointment with the aid of a computer-aided design/computer-aided manufacturing (CAD/CAM) system. Two patients were diagnosed with irreversible pulpitis of the mandibular first molar. After access preparation, root canals were located, irrigation was performed until bleeding ceased, and the coronal tooth structure was prepared for indirect restoration. Then, utilizing an interim 3-mm build-up of the endodontic access cavity, a hemi-arch digital scan was performed with an intraoral scanner. Subsequent to digital scanning, restoration design was performed simultaneously with the endodontic procedure. The root canals were shaped using the Race system under irrigation with 2.5% sodium hypochlorite followed by root canal filling. The pulp chamber was subsequently filled with a 3-mm-thick composite resin restoration mimicking the interim build-up previously utilized to facilitate block milling in the CAD/CAM system. Clinical try-in of the permanent onlay restoration was followed by acid etching, application of a 5th generation adhesive, and cementation of the indirect restoration. Once the restoration was cemented, rubber dam isolation was removed, followed by occlusal adjustment and polishing. After 2 years of follow-up, the restorations were esthetically and functionally satisfactory, without complications.