• Title/Summary/Keyword: Clinical practice

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Effects of Laughter Therapy on Joint Pain, Functional Status of Knee Joint and Depression in Elderly with Degenerative Knee Arthritis (웃음요법이 퇴행성 슬관절염 노인의 관절통증, 관절기능상태, 우울에 미치는 효과)

  • Lee, Yim Sun;Park, Hyo Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.9
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    • pp.440-449
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    • 2020
  • This study examined the effects of laughter therapy in the elderly with degenerative arthritis who had joint pain, joint dysfunction, and depression. Through a single-blind, randomized assignment, an experimental group of 26 subjects and a control group of 26 subjects were recruited among the elderly with degenerative knee arthritis, who were over 65 years of age. From January 8 to March 11 of 2019, a total of 16 laughter therapies were administered two times a week, 60 minutes per session, in eight weeks. The pain threshold (p=.012) and joint function status (p<.001), which represents the pain, joint stiffness, and physical function, and depression (p<.001), in the experimental group improved after the eight weeks laughter therapy compared to the control group. Laughter therapy is a therapeutic intervention that can be delivered through physical or intellectual activities. This therapy is a non-invasive procedure and has the advantage that nurses can practice easily with a little training. It can be used as an intervention within community and clinical settings to relieve pain and improve depression in the elderly with arthritis.

A study on the relationship of general characteristics to behavioral reaction toward oral malodor (영역별 특성에 따른 구취발생시 행동대처에 관한 연구)

  • Jang, Gye-Won;Park, Sung-Suk
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.3
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    • pp.493-506
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    • 2009
  • The purpose of this study was to examine the awareness of people in general characteristics about oral malodor. The subjects in this study are 184 people who visited the clinical practice lab at J health college to get their teeth scaled. After conducting a survey from May 1 to June 3, 2008, we selected four different ares and then analyzed the answer sheets from 179 respondents including smoking/nonsmoking, scaling experience, toothbrushing frequency and the use of oral hygiene supplies. SPSS WIN 12.0 program was used to make a frequency analysis and cross analysis. The findings of the study are as follows: 1. Concerning an intention of treatment for oral malodor, 37.4% didn't intend to receive treatment even in case of having bad breath. 28.5% didn't yet have any definite idea about that, and 20.7% had no mind to do that at all. 10.6% had an intention to receive treatment, and 2.8% want to receive treatment. 2. As for how to cope with oral malodor in case of suffering from it, 47.5% chewed gums or ate candy. 25.1% scarcely care about that, and 15.6% covered their mouth whenever they spoke. 9.5% had little confidence about talking to others, and 2.2% found it difficult to build an amicable interpersonal relationship. 3. Concerning what to do about another person's oral malodor, 40.8% did nothing, and 19% talked to the person about that. 17.3% gave him or her chewing gum. Among their oral health characteristics, toothbrushing frequency made a significant difference to the way they responded to another person's oral malodor(p<.05). 4. As to subjective feelings about another person's oral malodor, 41.9% just found it bearable. 36.9% were a little displeased, and 9.5% never felt bad about another person's bad breath. 8.9% tried to avoid the person, and 2.8% advised him or her to chew gum. 5. Regarding an intention of participating in a oral malodor program, 46.9% had no idea about that. 31.3% intended to participate in the program, and 13.4% wanted to do that without fail. 6.1% had no mind for that, and 2.2% were never going to do that. Among characteristics of the user oral hygiene device made a significant difference whether to participating in the oral malodor program(p<.05).

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Iron Intake During Pregnancy on Serum Concentrations of Trace Minerals in Mothers and Neonates (임신기간 중 철 섭취가 모체와 제대 혈청의 미량 무기질 농도에 미치는 영향)

  • Kim, Hye-Ra;Lim, Hyeon-Sook
    • Journal of Nutrition and Health
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    • v.41 no.3
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    • pp.242-253
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    • 2008
  • It is a common clinical practice to recommend taking iron supplements for pregnant women during gestation. Although it is required to ensure adequate iron stores during pregnancy, there has been some debate over the interference effects of excessive iron load, because it is possible to compete in the transport in the intestine and placenta and in binding to serum proteins of other trace minerals. In this study, maternal and neonatal serum concentrations of Fe, Zn, Cu, Se, Cr, Mn, and Co were assessed along with maternal Fe intakes. A total of 124 pregnant women and their term neonates participated voluntarily in this research. The women were divided into one of the three groups {high Fe intake (HFI), median Fe intake (MFI), and low Fe intake (LFI)} by their total Fe intakes and one of the two groups (Anemic and Normal) by their Fe nutritional status. All the data were compared among the three groups and between the two groups also. Total Fe intakes of HFI, MFI, and LFI groups were 140.8 ${\pm}$ 76.1, 68.0 ${\pm}$ 11.2, and 30.2 ${\pm}$ 8.6 mg/day, respectively. Those of Anemic and Normal groups were 90.1 ${\pm}$ 74.8 and 86.6 ${\pm}$ 46.8 mg/day, respectively. Maternal Hb concentration and Hct were not significantly different among HFI, MFI, and LFI groups but those were significantly different between Anemic and Normal groups. However, neonatal Hb concentration was not significantly different among HFI, MFI, and LFI groups and between Anemic and Normal groups either. Maternal serum Fe concentrations of the three groups, HFI, MFI, and LFI, were similar but that of Anemic group was significantly lower compared to Normal group. However, there was no significant difference in neonatal serum Fe concentrations among the three groups and between the two groups either. Serum concentrations of the other trace minerals in both mothers and neonates were not significantly different among HFI, MFI, and LFI groups and between Anemic and Normal groups. In addition, in the maternal serum, Fe concentration was positively correlated to Zn and Se concentration, respectively. As for the neonatal serum, Fe concentration showed a positive correlation to Zn, Cu, Mn, Se, and Co concentration, respectively. No trace mineral concentration was found to correlate negatively to Fe concentration in both maternal and neonatal serum, The results in this study indicate that Fe intakes of pregnant women, even if it is considerably above the level of estimated average requirement (EAR), may not affect serum Fe concentration in both mothers and neonates. In addition it might not influence adversely on the availability of other trace minerals including Zn and Cu in both mothers and neonates.

Ultrasound Imaging of Normal Cardiac Structures with Convex Scanner in Puppies (강아지에서 컨벡스스캐너를 이용한 정상적인 심장구조물의 초음파상)

  • Jeong Soon-wuk;Park Hee-myung;Han Sook-hee;Yoon Jung-hee;Han Hong-ryul
    • Journal of Veterinary Clinics
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    • v.11 no.2
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    • pp.529-537
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    • 1994
  • Sector scanner which has a conical end is used to image through the intercostal space because heart is protected by the ribs. Cardiac data published all around the world were also obtained by sector scanner. Although scanners being used in every small animal practice and animal hospital at college in Korea include convex ape and linear type, linear type is not appropriate f3r cardiac scan because of a wide contact surface. The purpose of this study is to establish ultrasonographic images of normal cardiac structures by measuring shape, size of reflectable cardiac structure according to restraint position in scanning normal heart of the puppies with 6.5 MHz convex scanner(SonoAce 4500, Medison, Korea) used in our veterinary teaching hospital, Seoul national university. Seventeen male and female puppies considered having healthy hear by X-ray and clinical examination are used feom April to July 1994. Scanning point selection of probe head and the distinction of imaged cardiac structures were accomplished by necropsy and cardiac scanning performed through thoracotomy under general anesthesia. At 10 o'clock position of transducer(at an angle of 30$^{\circ}$ between imaginary line from elbow joint to 3rd sternum and probe head, 60$^{\circ}$ from body surface, 4th intercostal space of right thorax) with the marker of scanner toward the head of dogs right atrium, left atrium and left ventricle were observed in 2, 3, 4, 5 intercostal space(2cm from the sternum) of experimental dog positioned ventrodorsally under general anesthesia. Under these conditions, the numerical values of imaged diastolic hear are as follows : the distance from skin to apex(mean$\pm$S.D) 47.53$\pm$6.94mm, thickness of left ventricular wall 6.00$\pm$1.60mm, length of left ventricle 16.27$\pm$5.31mm, width of left ventricle 15,33$\pm$4.25mm, length of left atrium 12.33$\pm$3.82mm, width of left atrium 11. 33$\pm$3.94mm, length of right atrium 1.00$\pm$2.41mm, width of right atrium 11.21$\pm$2.76mm and the area of left ventricle 270.92$\pm$109.81mm$^2$, area of left atrium 98.00$\pm$41.08mm$^2$, area of right atrium 62.75$\pm$21.04mm$^2$.

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Prevalence-based Interpretation of Predictive Values of Diagnostic Tests: An Example for Detection of Canine Heartworm Infection (진단키트 검사결과에 대한 유병율 위주 해석: 개 심장사상충의 예)

  • Park, Choi-Kyu;Pak, Son-Il
    • Journal of Veterinary Clinics
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    • v.26 no.2
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    • pp.130-133
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    • 2009
  • The use of screening tests as part of a diagnostic work-up is common in domestic canine practice, but understanding of the diagnostic test characteristics and factors affecting diagnostic accuracy is not clear among clinicians. This article was aimed to provide clinicians with a better understanding on the selection of test kits and with a proper interpretation of test results using an example from heartworm(Dirofilaria immitis) studies. From the literatures, diagnostic accuracy varied depending on the kits: percent average sensitivity and specificity of ELISA antigen-detecting kits were DiroChek(Synbiotics, USA) 78.1 and 95.2, SNAP(IDEXX, USA) 66.3 and 98.1, and Solo Step(Heska, Switzerland) 69.5 and 97.5, respectively, while the values for three hematological methods(Modified Knott's, direct smear and capillary tube) ranged from 38.4 to 81.8% and from 96.9 to 100%, respectively. Furthermore, it was also reported that the prevalence of heartworm disease in domestic dog populations varied depending on the regions studied: 2.5-22.8% for microfilarial test and 2.2-66.3% by ELISA. The values of predictive values for positive(PPV) and negative(NPV) provide useful information to clinicians on the probability of heartworm infection, but the PPV and NPV are greatly dependent on the heartworm prevalence. This suggests that PPV or NPV values of a test should be interpreted carefully in different clinical settings. Practical methods on the interpretation taking into account heartworm prevalence were discussed.

The Inhibitory Effects of Soamgudamikgitang on the Side Effects of Cyclophosphamide (소암거담익기탕(消癌去痰益氣湯)의 cyclophosphamide 부작용 형성 억제효과)

  • Ryu, Ki-Won;Ryu, Bong-Ha;Yoon, Sang-Hyub;Kim, Jin-Seong;Hong, Jong-Hee
    • The Journal of Internal Korean Medicine
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    • v.23 no.1
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    • pp.123-131
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    • 2002
  • Objective : It is well known that modern chemotherapy against cancer has side effects to a living body, especially hemopoietic and immunologial disfunctions. However, there are no effective ways to reduce them. Recently, traditional Korean herb medicine has been reported to have some biological modifying responses. Therefore, we hypothesized that additional application of herb medicine during chemotherapy is more effective to reduce its side effects. While we were studying the effects, we have observed the inhibitory effect of Soamgudamikgitang on formation of side effects derived from Cyclophosphamide, it has been used in clinical practice at Kyung Hee Medical Center. Methods : We injected 200mg/kg of Cyclophosphamide, one time, to an experimental group, consisting of ten mice. We divided them into eight groups: normal, CPX, SAKT 2mg, SAKT 10mg, SAKT 50mg, SAKT 2mg, CPX, SAKT 10mg+CPX, SAKT 50mg+CPX. We injected Soamgudamikgitang seven days, five days, three days, and one day before we injected CPX. One day, three days, and five days after CPX injection, we injected Soamgudamikgitang again and then killed all the mice. The parameters determined in this experiment were daily body weight liver and spleen weight, RBC, WBC, and platelet for hemopoietic dysfunction and AST, ALT for hepatotoxicity, BUN, creatine for renal toxcity, lymphocyte proliferation activity and lymphocyte subsets for immunological toxcity. Results : We have found that Soamgudamikgitang has inhibitory effects on the formation of Cyclophosphamide's side effects. Significant differences between the group, which contained Cyclophosphamide, and the other group, which contains Cyclophosphamide and 2, 10, 50mg of Soamgudamikgitang respectively were observed. Platelets(2mg of Soamgudamikgitang, p<0.05 ;10mg, p<0.01 ;50mg, p<0.001), liver weight(50mg, p<0.01), spleen weight(10mg, p<0.05), AST(all groups, p<0.01), ALT(2mg, p<0.01 ;10mg, p<0.05 ;50mg, p<0.01), BUN(2mg, p<0.01 ;50mg, p<0.05). Although immunological in both lymphocyte proliferation and its subsets were not observed, which shows that Soamgudamikgitang has a strong effect on T cell activities. Conclusions : From the above results, we can expect that the combined therapy of Soamgudamikgitang and Cyclophosphamide is more effective for treating cancer patients.

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Study on Diagnosis by Facial Shapes and Signs as a Disease-Prediction Data for a Construction of the Ante-disease Pattern Diagno-Therapeutic System - Focusing on Gallbladder's versus Bladder's Body and Masculine versus Feminine Shape - (미병학(未病學) 체계구축을 위한 질병예측자(疾病豫側子)로서의 형상진단연구 - 담방광체(膽膀胱體)와 남녀형상(男女形象)을 중심으로 -)

  • Kim, Jong-Wan;Kim, Kyung-Chul;Lee, Yang-Tae;Lee, In-Seon;Kim, Kyu-Kon;Chi, Gyoo-Yang
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.3
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    • pp.540-547
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    • 2009
  • There needs disease-predictable signs in order to enable preventive diagnosis and therapy. Then traditional Chinese medicine applies various medical diagnostic equipments used in western medicine to diagnosing sub-healthy state. But such data are not originated from inherent oriental medicine, and not obtained easily in ordinary clinical practice. This paper is to provide synopsis of the ante-disease diagno-therapeutics partly and to show predictable data based on the facial shapes and signs, especially of gall bladder's versus bladder's body and masculine versus feminine shape. Ante-disease means not only the complete healthy state, but also the state unseen any symptoms in macrographically in the course of outbreak of disease. It contains two stages, first one is the former state of disease and second one is untransmitted state of disease. The patterns of ante-disease consist of latent disease, pre-disease, transmission type like senescent syndrome, abnormal reactive syndrome(變證), syndrome of transmission and transmutation. The classification with gall bladder and bladder type manifests the differences of shape, color and size of each organ in comparison of the universal and standard figures of the human being. On the other hand, the classification with masculine and feminine shape contrasts the innate sexual difference and the shape, characteristics originated from in itself. These two classification theories have their own pathologic types and syndrome types with each disease so that disease-predictable data can be constructed based on such a relationship. In addition, this diagnostic method by facial shapes and signs is able to be applied to whole stages from prenatal to present state of disease even if the cause and inducement are not clear. Ante-disease diagno-theraputic system by Gall Bladder's versus Bladder's Body and Masculine versus Feminine Shape is getting more important in the chronic and internal disease in comparison of the acute and traumatic disease. So this study is able to make up for the limit of diagnosis on ante-disease in the field of oriental medicine clinic.

An Analysis and Assessment of Diagnostic and Therapeutic Process in Some Frequent Admissions and Operations (일부 다빈도 입원 및 수술례의 진단과 치료과정에 대한 연구)

  • Kim, Chang-Yup;Kim, Yoon;Kwon, Young-Dae;Kim, Yong-Ik;Shin, Young-Soo;Ahn, Hyeong-Sik
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.3 s.43
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    • pp.400-411
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    • 1993
  • The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

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A Nationwide Survey on the Hand Washing Behavior and Awareness (전 국민의 손씻기 이행 및 인식 실태)

  • Jeong, Jae-Sim;Choi, Jun-Kil;Jeong, Ihn-Sook;In, Hye-Kyung;Park, Ki-Dong;Paek, Kyong-Ran
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.3
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    • pp.197-204
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    • 2007
  • Objectives : This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. Methods : Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. Results : Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. Conclusions : This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to promote adherence to hand washing.

Diagnosis of Chronic Kidney Disease using Sonography (초음파 영상을 이용한 만성 콩팥병의 진단)

  • Ahn, Yu-Ji;Ye, Soo-Young
    • Journal of the Korean Society of Radiology
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    • v.11 no.3
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    • pp.153-159
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    • 2017
  • Chronic kidney disease can be treated if it is detected early, but as the disease progresses, it becomes impossible to recover. Finally, renal replacement therapy such as transplantation or dialysis should be used. Ultrasonography is used to diagnose kidney cancer, inflammatory disease, nodular disease, and chronic kidney disease. It is used to identify information about degree of inflammation using information such as kidney size, internal echo characteristics. Currently, the degree of disease in the clinic uses the value of glomerular filtration rate. However, even in ultrasound, changes in the degree of inflammation and disease can be observed. In this study, we used ultrasound images to quantify the changes in brightness, size, cortex, and subclinical changes of the kidney with progression of the disease, and compared them with the glomerular filtration rate used in clinical practice. In 105 cases, we performed 35 cases of normal kidney, 35 cases of early kidney disease, and 35 cases of terminal kidney. The brightness of the cortex of the image was obtained and the difference in brightness between the cortex and the proximal portion was obtained by the slope. The graph of the portion which was not smooth due to the ultrasonic characteristics was used as the function regrass. The size reduction was obtained from the original data. The results were as follows: It was proportional to the glomerular filtration rate. It is considered that the algorithm can be applied to the disease if the algorithm study continues.