• Journal of Acupuncture Research
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• 제18권4호
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• pp.55-67
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• 2001

Objective : This study was performed to evaluate result of thoracolumbar compression fracture patient treated with Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴) acupuncture. Methods : This clinical study was carried out 50 cases with thoracolumbar compression fracture, who had been admitted from January, 2000 to February, 2001, in the department of acupuncture and moxibustion, Hanseo University Oriental Medical Hospital. We divided two groups; A group, without using Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴) acupuncture and the other group is B group, by using Hua-Tuo-Jia-Ji-Xue(華佗夾脊穴) acupuncture. Results : 1. The distribution of sex and age, 78% were female, and 84% were most above there sixties. 2. In the duration of symptom, the largest group was over 4 weeks. 3. In the distribution of cause, the largest group was "lifting heavy object"(32%) and the next was "slip down"(26%). 4. In the distribution of injured level was L1 body the most(19.6%) and T12 body was the next. 5. In the distribution of clinical symptoms on the admission, the largest group was lumbosacral pain(18%). 6. The result of treatment due to the duration of admission, 17case(34%) was the most above "Fair" during the 2~3 weeks. 7. The result of treatment, Good and Fair were the same in 24case(48%). 8. The duration of treatment was longer in high grade of clinical symptom. 9. B group discharged above good state 60% higher than A group.

• 대한임상검사과학회지
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• 제46권1호
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• pp.12-16
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• 2014

Tetanus has high lethality and can cause serious complication, so it is very important to have a quick and exact checkup and treatment. In this study, we conducted a study about clinical characteristics and types of tetanus patients in Daegu Emergency Medical Center and we studied possibility of Tetanos Quick Stick (TQS) as a selective check up to treat tentanus by comparing the results of local checkup kit measured from tetanus quick stick developed to check up tetanus antibody titer and results measured from ELISA (Enzyme-Linked Immunosorbent Assay). The result of the study showed that tetanus happens more to males, and by looking at season, tetanus happened most in summer (from June-August) as 19 cases (45.3%), and when patients come to the emergency medical center, the diagnosis name was electrolyte imbalance 14 cases (33.3%), peripheral nerve 11 cases (26.2%), Meningitis 8 cases (19.0%), drug addiction 7 cases (16.7%), and the patients who are diagnosed as tetanus at the beginning of hospitalization was 2 cases (4.8%). The result of TQS usefulness by comparing with ELISA, in TQS, 42 people was positive and 478 people was negative. it was positive when the result was over 0.1 IU/mL, 48 people was ELISA positive while 472 people was negative. TQS checkup has accuracy of 98%, sensitivity of 83.3%, specificity of 99.5%, positive predictability of 95.2% and negative predictability of 98.3%. The evaluation of current immunity statuses of tetanus patients is available for TQS checkup, and it has an advantage of preventing side effects coming from the injection of unnecessary vaccine and immunoglobulin, and it is thought that it can give help to emergency checkup and treatment at the beginning.

• 한방재활의학과학회지
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• 제23권3호
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• pp.87-106
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• 2013

Objectives We will provide basic information on bee venom clinical tests and aid the practical use of bee venom in such tests, through examination of RCT research related to bee venom that was reported domestically. Methods We collected 365 articles on Bee venom study result from the OASIS system using the Keyword 'bee venom, apitoxin, apitherapy, bee sting'. The initially selected theses were primarily screened for clinical research. Out of these, case studies and non randomized controlled trial (non-RCT) were ruled out. As a result, 39 studies of randomized controlled trial (RCT) research were chosen as the subjects of study. Results RCT research related to bee venom was first presented in 2003, and 39 studies have been published until 2012. 18 studies were tests to confirm the effectiveness of bee venom, 7 studies were comparisons between SBV and BV, and 13 studies were comparisons with other types of treatment. Research conducted through appropriate randomization methods were 20 studies, and inappropriate randomization methods were used in 19 studies. In therms of Jadad score, 12 studies received 4~5 points, 15 studies received 1-3 points, and 12 studies received zero point. Conclusions In order to assure good quality RCT research, appropriate guidelines should be provided, and proper evaluation standards should be established. In-depth study is needed concerning the difference of responses to treatment according to the types of treatment received. A standardization of treatment should be reached as a result.

• Communications for Statistical Applications and Methods
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• 제25권4호
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• pp.341-354
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• 2018

The one of the principles described in ICH E9 is that only results obtained from pre-specified statistical methods in a protocol are regarded as confirmatory evidence. However, in multi-regional clinical trials, even when results obtained from pre-specified statistical methods in protocol are significant, it does not guarantee that the test treatment is approved by regional regulatory agencies. In other words, there is no so-called global approval, and each regional regulatory agency makes its own decision in the face of the same set of data from a multi-regional clinical trial. Under this situation, there are two natural methods a regional regulatory agency can use to estimate the treatment effect in a particular region. The first method is to use the overall treatment estimate, which is to extrapolate the overall result to the region of interest. The second method is to use regional treatment estimate. If the treatment effect is completely identical across all regions, it is obvious that the overall treatment estimator is more efficient than the regional treatment estimator. However, it is not possible to confirm statistically that the treatment effect is completely identical in all regions. Furthermore, some magnitude of regional differences within the range of clinical relevance may naturally exist for various reasons due to, for instance, intrinsic and extrinsic factors. Nevertheless, if the magnitude of regional differences is relatively small, a conventional method to estimate the treatment effect in the region of interest is to extrapolate the overall result to that region. The purpose of this paper is to investigate the effects produced by this type of extrapolation via estimations, followed by hypothesis testing of the treatment effect in the region of interest. This paper is written from the viewpoint of regional regulatory agencies.

• Journal of Korean Neurosurgical Society
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• 제30권2호
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• pp.180-185
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• 2001

Objectives : We retrospectively studied the efficacy of anterior cervical discectomy and interbody fusion without plate fixation in degenerative cervical disease. Methods : Thirty two consecutive patients with degenerative cervical disease treated by decompression and interbody fusion(Smith-Robinson technique) without anterior cervical plating were studied for postoperative complication rate as well as the clinical and radiologic outcomes and were compared the result of ours with other reported series where the anterior cervical plating was used. Results : All cases were reviewed after average period of 13 months for the purpose of this study. There were 4 postoperative complications related to grafting. A solid fusion was obtained in all cases with single-level fusion(n=21) and 81.8 % of the cases with a two-level fusion(n=11). The overall fusion rate was 93.8 % and fusion rate per level fused was 95.3%. The clinical outcome of the patients was comparable with that in the literature, with one patient having a poor result. Comparing the result of this study with others of the anterior cervical plating, clinical outcome and fusion rate were not superior in plate fixation group in single-level fusion, but increased fusion rate and decreased graft-related complication rate were noted in multilevel fusion with plate fixation. However, the clinical outcome was not superior to noninstrumented fusion group of this study. Conclusion : These results demonstrate that anterior cervical discectomy and interbody fusion(Smith-Robinson technique) without instrumentation is safe and reliable method of single-level fusion in degenerative cervical disease. Plate fixation system doesn't seem necessary in single level fusion in degenerative cervical disease.

• 간호행정학회지
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• 제8권4호
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• pp.669-689
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• 2002

Purpose : The purpose of the present study is to develop a clinical pathway applied with activity-based management methodology for efficient clinical management to cope with rapid changing medical environments. Method : After making a preliminary pathway based on which a conceptual frame of reference was established to develop a clinical pathway, the final one was confirmed by verifying experts validity and clinical validity. The ultimate activity-based clinical pathway was restructured after clarifying, schematizing and analyzing the whole activities of clinical pathway in accordance with the conducting process of activity-based management. Result : A clinical pathway for total hip replacement was developed, in which the vertical axis consisted of assessment, examination, consultation, medication, treatment, diet, activity, and education, and the horizontal axis was composed of six days of hospitalization. Then, on the basis of the development, the clinical pathway including the improved contents and information was restructured after making the reform measure by analyzing each of activities in the pathway. And the list of contents related to the clinical management activity was made, which was described its main contents and the pre-activities that ought to be completed before conducting each of activities in the pathway. Conclusion : The clinical pathway applied with activity-based management may be used as a standard guidance for providing continuous and consistent patient care. It will provide the information for nursing activities to nurses and the management information about hospital and nursing activities to the hospital administrators. It will also be used as a tool for communication between medical staff. Besides, it will contribute to creating profits for the hospital by shortening the length of stay in patients.

• The Journal of Korean Physical Therapy
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• 제24권5호
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• pp.377-382
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• 2012

Purpose: The purpose of this qualitative study was to understand the application of clinical reasoning throughout clinical and therapeutic knowledge of clinical pediatric physical therapists under physician prescriptions. Methods: Purposive sampling techniques were used in selection of nine clinical pediatric physical therapists in South Korea. Open and semi structured interviews were conducted, and were thoroughly examined and reviewed, followed by analysis of the clinical reasoning portion. Results: Pediatric physical therapists have been influenced by information gathering, physical function and evaluation of their patients, hypothesis-orientation, and re-evaluation and self-monitoring. Novice physical therapists were more dependent on physician prescriptions and parent's hope than the result of their own evaluation and critical pathway. Middle experienced pediatric physical therapists were more dependent on rapport with children and their parents. Highly experienced pediatric physical therapists were more reliant on hypothesis-orientation and self-monitoring. As reports on clinical experience of pediatric physical therapists have accumulated, clinical reasoning of pediatric physical therapists has been influenced by their experience, such as education, clinical pathology conference, their own clinical experience and rapport with patients and their parents than physicians' prescriptions. Conclusion: The findings of the current study are generally consistent with existing research on clinical reasoning. The results of the current study may be used by educators for enhancement of clinical reasoning abilities and knowledge of students or novices as well as development of a guide for use by suitable novices or students, and could provide important information for use in physical therapy practice and research.

• 중환자간호학회지
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• 제3권1호
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• pp.1-13
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• 2010

Purpose: This study was designed to evaluate ICU nurses' clinical competence according to clinical ladder by job analysis tool for the evaluation tool development of clinical ladder development program, Methods: Data was collected using the ICU nurses job analysis tool from 148 ICU nurses who work for 6 ICUs of A hospital in S city, Results: The mean clinical competence score of the subjects was 3.03 on a 4 point scale, Competence score was increasing as ICU clinical ladder was higher (F=35.18, p<.001). Step_1 was the lowest and step_4 was higher than step_3 from Scheffe post hoc test, Result of multiple regression showed that ICU clinical ladder and ICU clinical nursing education explained 52.1% (F=38.83, p<.001) of ICU nurse's clinical competence. Conclusion: ICU nurses' clinical competence can be evaluated using ICU nurse's job analysis tool. Further researches is needed on job description according to clinical ladder for performance and evaluation.

• 한국간호교육학회지
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• 제11권2호
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• pp.151-160
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• 2005

Purpose: The purpose of this study was to identify the levels of stress, anxiety and fatigue of nursing students in clinical practice, and the relationship among these variables. Method: Data was collected by structured questionnaires from 223 nursing students who have practiced at the hospital in Gwangju. Data was analyzed by using descriptive statistics, ANOVA, t-test and Pearson's correlation coefficient. Result: The mean score for stress was 3.87. The mean score for anxiety was 44.88. The mean score for fatigue was 30.79. There was a significant difference of stress according to student grade, practice unit, practice time, satisfaction of clinical practice. There was a significant difference of anxiety according to religion, health status, satisfaction of clinical practice, satisfaction on nursing. There was a significant difference of fatigue according to religion, health status, practice time, satisfaction of clinical practice, selective motivation on nursing, satisfaction on nursing. Conclusion: This study revealed that there was a significant correlation among stress, anxiety and fatigue of nursing students in clinical practice.

• 한국간호교육학회지
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• 제19권3호
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• pp.341-350
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• 2013

Purpose: This study was done to identify the relationship among ego resilience, the problem solving process and clinical competency in nursing students. Methods: Data were collected by questionnaires from 265 nursing students in D city. Measures were ego resilience, problem solving process and clinical competency. Data was analyzed using frequency analysis, t-test, one-way ANOVA, person's correlation coefficients, and multiple regression analysis with SPSS/WIN 19.0 version. Result: The Ego resilience score of subjects was 2.80 out of a perfect score of 4, the problem solving process score of subjects was 3.12, and the clinical competency score of subjects was 3.49 out of a perfect score of 5. There was a significant positive correlation among ego resilience, problem solving process and clinical competency. The significant predictors of problem solving process and clinical competency were ego resilience. Conclusion: These findings indicate that there is a need to increase ego resilience to improve the problem solving process and clinical competency of nursing students. The results should be reflected in the development of effective curricula.