• 대한영상의학회지
• /
• 제84권1호
• /
• pp.92-109
• /
• 2023

갑상선 결절 환자에서 초음파 검사는 일차적 영상 진단법으로 정립되어 있으며 치료 결정을 위한 핵심적인 진단 역할을 갖는다. Korean Thyroid Imaging Reporting and Data System(이하 K-TIRADS)는 초음파 유형에 기초한 암 위험도 분류체계로서 실시간 초음파 검사를 시행하면서 쉽게 결절 진단이 가능하다는 장점을 갖고 있다. 개정된 2021 K-TIRADS는 결절의 초음파 분류 기준을 보다 명확히 하였고, 고위험 갑상선암의 의심 소견이 없는 환자에서 병리진단검사를 결정하는 결절 크기 기준을 개정하여 불필요한 병리진단검사를 최소화하고 적절한 갑상선암 진단 예민도가 유지되도록 개정하였다. 갑상선영상의학진료는 갑상선 결절 환자의 진단 및 비수술적 치료를 수행하는 중요한 임상적 역할을 가지고 있으며, 적절한 환자 진료를 위해서는 표준적 진료 지침에 근거하여 진료가 수행되어야 한다.

• 한국의료질향상학회지
• /
• 제3권1호
• /
• pp.126-143
• /
• 1996

Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

• Childhood Kidney Diseases
• /
• 제25권2호
• /
• pp.71-77
• /
• 2021

Childhood hypertension (HTN) has become a significant public health issue because of the increased risk of cardiovascular disease in adulthood. However, childhood HTN is underrecognized and underdiagnosed in clinical practice. The European Society of Hypertension in 2016 and the American Academy of Pediatrics (AAP) in 2017 published updated guidelines for the screening, prevention, and management of pediatric HTN. There were notable differences between the two guidelines as well as many similarities. The updated AAP guidelines have clarified and simplified the recommendations for screening, diagnosis, and treatment of childhood HTN based on current evidence. This review highlights the important developments in both guidelines, focusing on recent advances in the classification and treatment of childhood HTN.

• 한방재활의학과학회지
• /
• 제31권4호
• /
• pp.129-143
• /
• 2021

Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

• Journal of Korean Dental Science
• /
• 제17권1호
• /
• pp.1-13
• /
• 2024

With the advances of digital scanning technology in dentistry, the interests in facial scanning in orthodontics have increased. There are many different manufacturers of facial scanners marketing to the dental practice. How do you know which one will work best for you? What questions should you be asking? We suggest a clinical guideline which may help you make an informed decision when choosing facial scanners. The characteristics of 7 facial scanners were discussed in this article. Here are some considerations for choosing a facial scanner. *Accuracy: For facial scanners to be of real value, having an appropriate camera resolution is necessary to achieve more accurate facial image representation. For orthodontic application, the scanner must create an accurate representation of an entire face. *Ease of Use: Scanner-related issues that impact their ease of use include type of light; scan type; scan time; file type generated by the scanner; unit size and foot print; and acceptance of scans by third-party providers. *Cost: Most of the expenses associated with facial scanning involve the fixed cost of purchase and maintenance. Other expenses include technical support, warranty costs, transmission fees, and supply costs. This article suggests a clinical guideline to make the right choice for facial scanner in orthodontics.

• Annals of Clinical Neurophysiology
• /
• 제9권2호
• /
• pp.59-62
• /
• 2007

Electroencephalogram (EEG) is an indispensable tool for diagnosis of epilepsy and is the only assisting barometer of complete remission of epilepsy, which means prolonged, persistent suppression of cortical excitement in epileptic focus in addition to the clinical control of epileptic seizure. The specific morphologies or distribution of epileptic form discharges give us good information for the classification of seizure or epilepsy and epileptic syndromes, which consists of "Pros." in terms of diagnostic approach. In contrast, the EEG as a tool for long-term follow up might be limited due to the various clinical situation of each patient, which consists of "Cons." in terms of the usefulness of EEG for clinical decision. "Cons." aspect of EEG, which clinicians are more frequently coped with than those of "Pros", is an obstacle of utilization of follow up EEG in clinical practice. This is an overview about controversies in usefulness of EEG and the detailed aspects of "Pros." and "Cons." of EEG for clinical decision will be discussed following two articles. We tried to make consensus for the usefulness of EEG especially in the situation of "Cons." with plausible guideline.

• 한방안이비인후피부과학회지
• /
• 제30권4호
• /
• pp.75-96
• /
• 2017

Objectives : The purpose of this study was to investigate the treatment trend for allergic rhinitis in Korean Medicine. Methods : We conducted an online survey for Korean Medicine Doctors who were registered in the association of Korean Medicine. The questionnaire was consisted of patient characteristics, diagnosis status, treatment status, and future research needs. Results : Data from total of 396 respondents were analyzed. More than 70% of the patient came to the Korean Medicine Clinic after visiting the Western Medicine Clinic in 43.9% of the respondents. 55.6% of the respondents performed combination therapy. History taking, nasal examination, x-ray, and Korean Medicine diagnostic test were used for diagnosis. The mean duration of treatment ranged from $4.9{\pm}2.91$ to $15.2{\pm}8.45$ for pediatric and early childhood patients and from $17.5{\pm}16.15$ to $5.3{\pm}3.85$ weeks for adolescents and adult patients. The mean number of treatment times was from $9.8{\pm}7.00$ to $33.5{\pm}24.45$ for pediatric and early childhood patients and from $10.8{\pm}11.55$ to $40.4{\pm}48.18$ times for adolescents and adult patients. 64.5%, 48.0%, and 91.2% of the respondents used herbal medication in national health insurance coverage, herbal medication uninsured in health insurance and herbal prescription filled at each medical institution, respectively for pediatric and early childhood patients and 67.6%, 42.8% and 86.1% for adolescents and adult patients. 36.9% and 36.4% of respondents answered that the study of acupuncture and herbal medicine are needed preferentially. Conclusions : The results of this survey will be used to develop clinical practice guideline that reflect actual clinical practice.

• 대한한방부인과학회지
• /
• 제30권2호
• /
• pp.93-106
• /
• 2017

Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.

• 대한한방부인과학회지
• /
• 제35권1호
• /
• pp.75-90
• /
• 2022

Objectives: The purpose of this study protocol is firstly to investigate the status of Korean medical treatment of dysmenorrhea, and secondly to investigate effectiveness of the Clinical Pathway (CP) of dysmenorrhea and review the applicability. Methods: This is a multi-center observational study. The data will be prospectively collected from 14 Korean medicine clinics. 45 patients for each of the CP-applied and non-applied groups will be recruited to compare the degree of improvement in menstrual pain. All the diagnosis records, treatment methods, treatment results, adverse events, and medical expenses of patients with dysmenorrhea will be collected. We will investigate the proportion of patients who could be applied with CP, and the actual number of CP applications, and CP completion rate to evaluate the applicability. Additionally, the satisfaction survey will be used to collect feedback from medical staff members and patients. Results: The results of this study will be disseminated through peer-reviewed publications and scientific presentations. Conclusions: This study is expected to provide valuable data for application of standard Korean medicine clinical pathway for dysmenorrhea.

• Clinical and Experimental Pediatrics
• /
• 제58권9호
• /
• pp.341-346
• /
• 2015

Purpose: To evaluate the practical applications of the diagnosis algorithms recommended by the American Academy of Pediatrics urinary tract infection (UTI) guideline. Methods: We retrospectively reviewed the medical records of febrile UTI patients aged between 2 and 24 months. The patients were divided into 3 groups: group I (patients with positive urine culture and urinalysis findings), group II (those with positive urine culture but negative urinalysis findings), and group III (those with negative urine culture but positive urinalysis findings). Clinical, laboratory, and imaging results were analyzed and compared between the groups. Results: A total of 300 children were enrolled. The serum C-reactive protein level was lower in children in group II than in those in groups I and III (P<0.05). Children in group I showed a higher frequency of hydronephrosis than those in groups II and III (P<0.05). However, the frequencies of acute pyelonephritis (APN), vesicoureteral reflux (VUR), renal scar, and UTI recurrence were not different between the groups. In group I, recurrence of UTI and presence of APN were associated with the incidence of VUR (recurrence vs. no recurrence: 40% vs.11.4%; APN vs. no APN: 23.3% vs. 9.2%; P<0.05). The incidence of VUR and APN was not related to the presence of hydronephrosis. Conclusion: UTI in febrile children cannot be ruled out solely on the basis of positive urinalysis or urine culture findings. Recurrence of UTI and presence of APN may be reasonable indicators of the presence of VUR.