• 제목/요약/키워드: Clinical guideline

검색결과 842건 처리시간 0.024초

치과임플란트 치료와 관련된 상악구치부의 임상적 연구 (CLINICAL STUDY ON KOREAN POSTERIOR MAXILLAE RELATED TO DENTAL IMPLANT TREATMENT)

  • 이두한;이성현;황주홍;이정근
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제32권1호
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    • pp.27-31
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    • 2010
  • Purpose of study: The purpose of this study was to provide adequate diagnostic guideline for the maxillary sinuses prior to dental implant treatment for edentulous posterior maxillary areas. For this purpose, our procedure involves the estimation of the remaining alveolar bone height, the examination of the anatomical variation in the maxillary sinuses (e.g. sinus septum), and the evaluation of the incidence of preoperative pathological conditions in the maxillary sinuses. Materials and Methods: We selected 189 patients to undergo computerized tomography (CT) in order to account for the posterior maxillary anatomy found in patients of Korean ethnicity. We evaluated the following using Dentascan software: Remaining alveolar bone height, incidence of sinus septum, and rate of preoperative pathologic conditions in the maxillary sinus. The average amount of remaining alveolar bone height was analyzed using the student's t-test for differences according to anatomical site, and the ANOVA was used for the differences according to age group with the level of significance set at 0.05. Results: Alveolar bone heights of upper first premolar, second premolar, first molar, and second molar was 12.24 mm, 10.37 mm, 7.16 mm, and 7.15 mm, respectively with statistical significance (P < 0.05). Incidence of sinus septum as an anatomic variation was 17 out of 189 cases (9.0%). Incidence of mucosal thickening as a pathologic variation was 82 out of 189 cases (43.4%). Conclusion: In treatment planning of posterior maxillary edentulous area of Koreans, the consideration of augmentation surgery for maxillary sinus is required in maxillary molar area before dental implant installation, and preoperative screening of the asymptomatic maxillary sinuses can be regarded as a reasonable preoperative procedure in the planning of dental implant treatment on the posterior maxillary edentulous area.

경주, 포항, 울산지역 보건.환경성 질환 위해 인자 (Risk Factors for Health and Environmental Disease in Gyeongju, Pohang, and Ulsan)

  • 정종현;최봉욱;문기내;석성자;김현규;손병현
    • 한국환경보건학회지
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    • 제36권2호
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    • pp.82-94
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    • 2010
  • This study was undertaken in an attempt to provide scientific grounds in explaining the causes of environmental and respiratory diseases resulting from air pollutants in Gyeongju and its neighboring areas. In relation to heavy metals, lead (Pb) was $0.0135{\sim}0.1744\;{\mu}g/m^3$ and high in order of Pohang, Ulsan, and Gyeongju while nickel (Ni) was $0.0023{\sim}0.0115\;{\mu}g/m^3$. The concentrations of heavy metals in the investigated areas did not exceed the environmental standards or Guideline Value of Korea or other countries. However, it is considered necessary to apply intensive control to some heavy metals including cadmium (Cd) that show a relatively high level of hazard. Based on the responses to the survey, measured personal interest in environmental pollution and the basic knowledge of the causes of the respiratory diseases was higher in those with a family history of allergic reactions to metals and bronchial asthma. The incidence of allergic disease was higher in those who are currently in poor health state. In addition, the general knowledge of environmental pollutants was higher in those with higher educational level and those with a higher interest in environmental pollution. Personal interest in environmental pollution was higher in those with higher basic knowledge of environmental pollutants. Therefore, it is necessary to increase the awareness through better education and campaigns on environmental pollution.

심박변이도 및 SCL-90-R 측정을 통한 자율훈련법과 과일 명상의 효과 비교 분석 (An Analysis of Comparison between Autogenes Training and Imaginary Meditation by Heart Rate Variability and SCL-90-R)

  • 서진우;김종우;정선용;김지영;황은영
    • 동의신경정신과학회지
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    • 제19권3호
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    • pp.35-44
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    • 2008
  • Objective: There are many meditation methods used in clinical field. But the effect of meditation may be different to people's mind, and meditation itself. Now we investigate this subject with two different meditation methods which has been analyzed by heart rate variability. Method: We tried to check people's heart rate who educated meditation, before educated and during the meditation. The meditation was educated differently for each group. One is the auto genes traning, and the other is the imaginary meditation by thinking about eating and smelling favorite fruits. All of them are used to oriental psychiatry clinic patients. And we simultaneously conduct people's emotional state by SCL-90-R. Result: The result in Autogene traning group has significant difference in total power and HRV-index score between before and during the training but in imaginary meditation group has no significance: Autogene traning group has a significance in low frequency score and has increased tendency with increasing tendency of Heart rate index and Total power. Through the SCL-90-R score, the higher depression t-score, the anxiety t-score, and the hostility score is, the HRV scores such as total power, low frequency, and HRV-index much increase. and so on. Conclusion: We can guess that the Autogenes training has more significant effect than the imaginary meditation. And we can also guess that as the emotional problem is getting more severe, the effect of meditation would be much better. And we finally suggest that we should make a standard guideline of imaginary meditation, cause the imaginary meditation has so many variation.

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관상동맥우회술 시행환자의 중증도 보정 재원일수 변이에 관한 연구 (The Variation Factors of Severity-Adjusted Length of Stay in CABG)

  • 김선자;강성홍;김원중;김유미
    • 품질경영학회지
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    • 제39권3호
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    • pp.391-399
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    • 2011
  • Our study was carried out to analyze the variation factors of severity-adjusted length of stay(LOS) in coronary artery bypass graft(CABG). The subjects were 932 CABG inpatients of the Korean National Hospital Discharge In-depth Injury Survey from 2004 through 2008. The data were analyzed using $x^2$ test and the severity-adjusted model was developed using data mining technique. The results of the study were as follows: male(71.1%), older than 61 years of age(61.6%), more than 500 beds(92.8%) and admitting via ambulatory care(70.0%) appeared to have higher rate than otherwise. In-hospital mortality of CABG inpatients was 2.8%. In addition, 46.4% of the patients received their care in other residence. The angina pectoris(45.6%) was found to be the highest in principle diagnosis, followed by chronic ischemic heart disease(36.9%) and acute myocardial infarction(12.0%). We developed severity-adjusted LOS model using the variables such as gender, age and comorbidity. Comparison of adjusted values in predicted LOS revealed that there were significant variations in LOS by location of hospital, bed size, and whether patients received the care in their residences. The variations of LOS can be explained as the indirect indicator for quality variation of medical process. It is suggested that the severity-adjusted LOS model developed in this study should be utilized as a useful method for benchmarking in hospital and it is necessary that national standard clinical practice guideline should be developed.

항암화학요법의 구토유발 수준별 예방적 항구토제 프로토콜의 이행정도 (Compliance with the Protocol Considered Emetogenic Potential for Prophylaxis of Chemotherapy Induced Nausea and Vomiting)

  • 최자윤;오현정;강지영;김민경;김지은;김진하;김희숙;박소라;변정선;안정희;조민경
    • 종양간호연구
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    • 제11권1호
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    • pp.58-64
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    • 2011
  • Purpose: The purpose of this study was to identify the compliance with the protocol, which was developed considering the emetogenic potential for prophylaxis of chemotherapy. Methods: Data was collected from 144 patients who received chemotherapy from June 15 to August 31, 2010 in C University Hospital in Jeollanamdo, Korea. The level of chemotherapy-induced nausea and vomiting (CINV) and the compliance with the protocol for prophylaxis of CINV were measured. Results: There was statistically significant difference of CINV in morning sickness and anticipatory nausea of general and clinical characteristics. Also, the compliance with the protocol developed according to emetogenic potential of chemotherapy was statistically significant. There was no difference in CINV in regard to the compliance with the protocol. Conclusion: There was a good compliance with the protocol for prophylaxis according to emetogenic potential. But it should be recommended to use antiemetics for prophylaxis aggressively to relieve CINV for the patients who already experienced morning sickness and anticipatory nausea. In addition, the oncology nurses should respond sensitively to the complaints of nausea and vomiting no matter what the emetogenic potentials of chemotherapy regimen are.

공중보건 활동에서의 '사전 동의' 문제 - 유네스코 <생명윤리 및 인권에 관한 선언>을 중심으로 - (Informed Consent' in Public Health Activities: Based on the Universal Declaration on Bioethics and Human Rights, UNESCO)

  • 맹광호
    • Journal of Preventive Medicine and Public Health
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    • 제41권5호
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    • pp.339-344
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    • 2008
  • Objectives : The objective of this paper is to discuss the importance of obtaining informed consent for conducting epidemiological studies and public health activities, based on the Report of the UNESCO's Working Group on Informed Consent. Methods : The Report of the UNESCO's Working Group on Informed Consent was reviewed and discussed in connection with the ethical considerations of public health activities and epidemiological research. Results : It was at the Nuremberg Trial for the German war criminals of the Second World War that the principle of 'consent' was first stated as a consequence of the medical abuses carried out during the War. As a result of the Trial, the Nuremberg Code came out in 1947. Since then, various international declarations or ethical principles on 'informed consent' have been developed and published. These ethical principles on 'informed consent' have mostly to do with the clinical research that involves human subjects, and not with epidemiological studies and public health activities. However, UNESCO recently issued a comprehensive Report on Informed Consent based on the Universal Declaration on Bioethics and Human Rights adopted in 2005, and this included detailed guidelines on informed consent in epidemiological studies and public health activities. Conclusions : Universal Declaration on Bioethics and Human Rights emphasizes the principle of autonomy to protect the human rights of the human subjects involved in any public health activities and epidemiological research. As a practical guideline, obtaining informed consent is strongly recommended.

하부 요추 방출 골절의 수술방법 결정시 고려 요인들 (Factors in Selection of Surgical Approaches for Lower Lumbar Burst Fractures)

  • 장태안;김종문
    • Journal of Korean Neurosurgical Society
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    • 제29권8호
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    • pp.1055-1062
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    • 2000
  • Objectives : Burst fracture of the lower lumbar spine(L3-L5) is rare and has some different features compare to that of thoracolumbar junction. Lower lumbar spine is flexible segments located deeply, and has physiologic lordosis. All of these contribute to making surgical approach difficult. Generally, lower lumbar burst fracture is managed either anteriorly or posteriorly with various fixation and fusion methods. But there is no general guideline or consensus regarding the proper approach for such lesion. We have tried to find out the influencing factors for selecting the surgical approach through the analysis of lower lumbar burst fractures treated for last 4 years(1994.3-1998.3). Method : This study includes 15 patients(male : 10, female : 5, age range 20-59 years with mean age of 36.7 years, L3 : 8 cases, L4 : 5 cases, L5 : 2 cases). Patients were classified into anterior(AO) and posterior operated(PO) groups. We investigated clinical findings, injured column, operation methods, and changes in follow-up radiologic study (kyphotic angle) to determine the considerable factors in selecting the surgical approaches. Results : There were 5 AO and 10 PO patients. Anterior operation were performed with AIF with Kaneda or Z-plate and posterior operation were done with pedicle screw fixation with PLIF with cages or posterolateral fusion. Canal compression was 46.6% in AO and 38.8% in PO. The degree of kyphotic angle correction were 10.7 degree(AO) and 8.5 degree(PO), respectively. There was no statistical difference between anterior and posterior operation group. All patients showed good surgical outcome without complications. Conclusion : Anterior operation provided good in kyphotic angle correction and firm anterior strut graft, but it difficulty arose in accessing the lesions below L4 vertebra. While posterior approach showed less correction of kyphotic angle, it required less time and provided better results for accompanied adjacent lesion and pathology such as epidural hematoma. The level of injury, canal compression, biomechanics, multiplicity, and pathology are considered to be important factors in selection of the surgical approach.

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8년 동안 진행된 만성치열(Chronic anal fissure) 환자에게 치자시탕과 상담요법을 사용하여 호전된 치험 1례 (A Case Study of Chronic Anal Fissure Treated With Chijasi-tang and Counseling)

  • 이숭인;조민석;이성준;정종길
    • 대한한의학방제학회지
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    • 제23권1호
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    • pp.161-169
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    • 2015
  • Objectives : This study is aimed to report the outcomes of the treatment of a patient with chronic anal fissure during a 8-year period. Methods : Basic patient’s data was analyzed as a CARE guideline. And related psychological state was measured with BAI, STAI-X-II test. Results : The treatment is based on Shanghanlun and the patient reported better outcomes. The main symptoms of the patient were chronic constipation, blood in the stool. The main clinical findings were that the patient’s symptoms got worse during the examination period because of the anxiety of the exam. And loss of appetite and digestive disorders are due to Jue-Yin-Bing(厥陰病) and the clue of bleeding can be found in article 375 in Shanghanlun. The main diagnoses was chronic anal fissure and main interventions were Chijasi-tang according to article 375 in Shanghanlun and counseling on anxiety. As a results bleeding has stopped after taking herbal medicine and constipation has been treated at the same time. After 6 months, the patient performed BAI, STAI-X-II test and scores got lowered indicating decreasing anxiety level. Conclusion : Chijasi-tang with counseling achieved valid positive results to the patient with chronic anal fissure.

A 14-Day Repeated Dose Toxicity of Epimedii Herba Aqueous Extract Administered by Oral Gavage in F344 Rats

  • Han, Hyoung-Yun;Yang, Young-Su;Kim, Soo Nam;Han, Su-Cheol;Han, Kang-Hyun;Lee, Jong-Hwa;Jeong, Ja Young;Roh, Hang-Sik;Seok, Ji Hyeon;Kim, Jeong-Ah;Min, Byung-Sun
    • Natural Product Sciences
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    • 제21권1호
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    • pp.34-41
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    • 2015
  • The objective of this study is to characterize a toxicity of Epimedii Herba (EH) in F344 rats and to find a dose levels for the 13 weeks toxicity study. EH is well known as medicinal herb in many Asian countries for traditional medicines of antibacterial and antiviral effects, estrogenic and antiestrogenic effects, and for treatment of osteoporosis, hypotensives, fatigue, kidney disorders, and related complications. However, the indispensable and basic information of toxicological evaluation of EH extract is insufficient to support its safe use. Therefore, we conducted toxicological evaluation of this drug in compliance with OECD and MFDS guideline in this study. The extract of EH was administered orally to F344 rats at dose levels of 0, 500, 1000, 2000, 3500, and 5000 mg/kg/day for 2 weeks. Each group was composed of 5 male and female rats. In this study, there were no treatment of EH-related adverse changes in clinical observations, mortality, body weights, food consumption, urinalysis, gross finding at necropsy, and organ weight examination. Total red blood cell count, hematocrit, mean corpuscular hemoglobin concentration, total cholesterol, and phospholipid were decreased in males and females at 5000 mg/kg/day compared to the control animals. Mean corpuscular volume and reticulocyte counts were increased in males and females at 5000 mg/kg/day compared to control animals. Therefore, we recommend that dose level of 5000 mg/kg/day is a highest treatment group in 13-week EH extract exposure study for further toxicity assessment.

보중익기합대칠기탕(補中益氣合大七氣湯) 추출물의 ICR마우스에서 경구 단회투여독성 평가 (Single Dose Toxicity Test of Bojungikkeehapdaechilkitang water extract in Male and Female ICR Mice)

  • 배영철;최빈혜;김동우;허진일;김대준;변준석
    • 대한한방내과학회지
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    • 제26권2호
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    • pp.369-378
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    • 2005
  • An herbal water extract of Bojungikkeehapdaechilkitang(BDT) was prepared to test it for single-dose and repeated-dose toxicity, genotoxicity and reproductive toxicity, and to obtain a 50% lethal dose$(LD_{50})$, approximated lethal dose(ALD), and approximated target organs for BDT. The extract was tested on female and male ICR mice according to KFDA Guideline 1999-61 at doasge level of 2000, 1000, 500, 250 and 125mg/kg/10mL In this study, clinical signs, mortalities and gross findings of principal organs were observed for 14 days of single dosing, and afterwards in some cases. The ALD and $LD_{50}$ of BDT extract obtained in this study was>2000mg/kg for both male and female ICR mice. Also, any possible digestive toxicity of BDT extract was found to be above 1000mg/kg in both male and female ICR mice. The results of this study strongly suggest that BDT extract has no toxic effect at dosage level below 500mg/kg.

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