• 제목/요약/키워드: Clinical investigation

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한국 임상진료지침의 개발 현황에 대한 연구 (An Investigation of Current Status of the Korean Clinical Practice Guidelines(CPGs) development)

  • 정미애;안소연
    • 한국콘텐츠학회:학술대회논문집
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    • 한국콘텐츠학회 2016년도 춘계 종합학술대회 논문집
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    • pp.371-372
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    • 2016
  • 본 연구의 목적은 한국 임상진료지침이 개발된 진료분야의 현황, 임상진료지침의 개발자 혹은 기관의 현황, 임상진료지침 정보의 공개와 보급 정도를 파악하기 위하여 진행되었다.

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카리소프로돌 중독사의 치사혈중농도 및 조직분포 (Postmortem Blood and Tissue Concentration of Carisoprodol and Meprobamate)

  • 최혜영;최화경;이주선;우상희;이한선;박유신;정희선
    • 대한임상독성학회지
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    • 제1권1호
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    • pp.34-39
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    • 2003
  • Carisoprodol (CSP) is commonly prescribed as a skeletal muscle relaxant. Recently, we encountered 7 suicidal cases in which carisoprodol was detected. We developed a rugged, sensitive, and specific method for the determination of CSP and meprobamate (MPB) by GC and GC/MS. Postmortem blood concentrations of CSP and MPB ranged 22.9-124.4 ,$\mu$g/ml and its metabolite, 26.8-144.5 ,$\mu$g/ml respectively. Among 7 cases studied, Only CSP was ingested in 4 cases and combination of CSP and dextromethorphan was ingested in 2 cases according to the case history and one case was with ethanol. The order of the tissue concentration of CSP and MPB was liver> kidney > brain, and the concentration of MPB was higher than that of CSP in all tissues. The MPB /CSP concentration ratios of urine, bile juice, liver, kidney, brain and blood were 15.7, 4.0, 1.2, 1.4, 1.4 and 1.0 respectively. There was a big difference in concentration of CSP and MPB in 7 cases due to differences in the amount of dose administered and time to death after dosing.

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자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구 (A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea)

  • 김동일
    • 대한한방부인과학회지
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    • 제19권2호
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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근경련의 신경생리학적 발생기전, 평가 및 치료기법에 관한 연구 (The Investigation of Neurophysiological Mechanisms, Assessment and Treatments on The Muscle Spasm)

  • 김진상;채윤원;최진호;김동대
    • The Journal of Korean Physical Therapy
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    • 제9권1호
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    • pp.185-193
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    • 1997
  • The purpose of this study was to investigate the neurophysiological mechanisms, assessment of muscle spasm and treatments that could apply to clinical field. Spasm is a painful pattern of contraction of muscle caused by chronic or acute trauma, excessive tension, or organic disorders. Aside from pain, muscle spasm creates shortenning of muscles and limits motion. Untreated spasm and protective immobility due to pain lead to decreased local blood flow in the muscles and result in a vicious cycle of muscle spasm and paul. The assessment of muscle spasm involve muscle tone assessment, tissue compliance, and joint ROM. Each of these aessessments utilize as a part of the patient's condition Clinical managements involve drug management and physical therapy. Expecially, physical therapy is one of the most important techniques to reduce muscle spasm. Physical therapy includes applying heat and cold, electrical stimulation, massage, and traction. This investigation should entourage phisical therapists to experiment further with various techniques to reduce muscle spasm.

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Rapid Detection of Bacteria from Blood Culture by an Electronic Nose

  • Lykos, Peter;Patel, Pravin H.;Morong, Christopher;Joseph, Asha
    • Journal of Microbiology
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    • 제39권3호
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    • pp.213-218
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    • 2001
  • The treatment of Patients with bacteraemia and septicemia requires accurate and rapid identification of the pathogen so that the physician can be guided regarding the selection of the proper antimicrobial therapy. The usual procedure is to withdraw an aliquot of the positive blood culture sample for gram staining and subculturing on the media for the growth and subsequent identification, and susceptibility determinations. It was noticed that during the process some microbiologists would sniff the effluent gases that are products of metabolism and in some cases guess the identity of the bacterium. That Prompted us to engage in systematic investigation of two gram positive and two gram negative bacteria using an electronic nose that had been proven successful in distinguishing the aroma of coffee beans from different sources. The investigation was successful in illustrating the efficacy of such a device in this clinical setting to distinguish Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis. A representative set of patterns obtained with this apparatus is displayed as well. A representative set of patterns obtained with this apparatus is displayed as well. No effort was made to determine an optimal set of sensors for some specific set of bacterial metabolism gaseous products.

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Paraquat중독(中毒) 치험(治驗) 3례(例) (Clinical Investigation of Patients with Acute Paraquat Poisoning and Case Reports Who Survived with Oriental Medical Treatment)

  • 박재현
    • 대한한의학회지
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    • 제15권2호
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    • pp.132-142
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    • 1994
  • Paraquat has been widely used as a herbicide in Korea since 1970. Human ingestion results in transient impairment of liver and kidney function and a characteristically respiratory failure with a high mortality rate. Clinical investigation and Oriental Medical Treatment were done on 3 cases of paraquat poisoning admitted to the department of 1st Internal Medicine. Kyung San University Oriental Medical Hospital from August 1991 to December 1992. and following results were obtained. The symptoms of paraquat poisoning can be regarded as Sim hua chi song(心火熾盛), Kan hua sang yom(肝火上炎). um hu hua wang(陰虛火旺), Kan tam sup yol(肝膽濕熱), Yang myong yol tok(陽明熱毒) in Oriental Medicine. and the principle of treatment for paraquat poisoning can be applicable to Chong yol Ii sop(淸熱利濕), Chong yol hae tok(淸熱解毒). Sa ha hae tok(瀉下解毒). Ja um kang hua(滋陰降火) and so on. Three cases were treated by HuangYonHaeTokTang(黃蓮解毒湯) and KamDuTang(甘豆湯): all of them have survived without complications. According to the result above, it suggests that determination of treatment based on the differentiation of symptoms and signs(Pyon jung si chi ;辨證施治) of Oriental Medicine may prove to be helpful in saving lives of patients with paraquat poisoning.

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안와첨부 이물 육아종의 치험례 (Clinical Experience of Foreign Body Granuloma in the Apex of Orbit)

  • 백혜원;최종우;정현권;이백권;안상태
    • Archives of Plastic Surgery
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    • 제32권1호
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    • pp.131-134
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    • 2005
  • It is often difficult to identify and localize intraorbital foreign bodies despite of modern high-resolution imaging investigation. Especially, posteriorly located foreign bodies have increased risks of morbidity that surgical approach is often complicated. No matter how trivial it seems, retained foreign body, particularly organic in nature, may give rise to severe orbital and cerebral complications. High clinical suspicion, proper diagnostic studies, timely referral to a skilled orbital surgeon are mandatory. We report a case of intraorbital wooden foreign body that required two separate exploration for removal. Initial exploration failed to identify and locate the foreign body completely. After the operation, fistula formation and purulent discharge were developed and the imaging investigation results were equivocal, complicating the management. A second exploration yielded multiple intraorbital wooden foreign body in the apex of orbit. The patient fully recovered without complication. The evaluations and the details of management strategy are discussed.

임상진단명에 따른 질병분류체계 구축모형 개발 - 안과를 대상으로 - (Development of Construction Model of Disease Classification on Clinical Diagnosis in Ophthalmology)

  • 서진숙;신희영;기창원
    • 한국의료질향상학회지
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    • 제10권2호
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    • pp.204-215
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    • 2003
  • Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

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