• Title/Summary/Keyword: Diagnosis and prescription

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Effective Management of Acute Necrotizing Ulcerative Gingivitis with Proper Diagnosis and Immediate Treatment

  • Kwon, Eun-Young;Choi, Youn-Kyung;Choi, Jeomil;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Korean Dental Science
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    • v.9 no.2
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    • pp.81-89
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    • 2016
  • Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.

A literatual studies on the suppurative osteomylitis(附骨疽) (附骨疽에 關한 文獻的 考察)

  • Hwang, Do-gun;Roh, Sek-seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.99-140
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    • 1998
  • In the literatual studies on the suppurative osteomylitis(附骨疽), the results were as follows. Suppurative osteomylitis(附骨疽) is called 'Mudujur(無頭疽)', is concerned with Pyogenic osteomyelitis in western medicine. The pathogenic factors of Suppurative osteomylitis were caused by exposing to wind-cold-wetness evil, or body weakness, or wound a bodily injury caused by physical means. The symptoms of Suppurative osteomylitis was alternating episodes of chills and fever, pain on buttock or thigh in onset. The differential diagnosis of Suppurative osteomylitis was divided three parts. One was the stagnation of virulent fire-evil. Another was the deficiency of both vital energy & blood. The other was wind-cold-wetness evil. The treatments of Suppurative osteomylitis was clearing away heat-evil and wetness evil, removing blood stasis and promoting meridian. In the frequency of prescription, the most numerous prescription were Osintang(五神湯) and Hwangyunhaidoktang(黃連解毒湯), the next were Neitakganghwaltang(內托羌活湯), Taibangpungtang(大防風湯) etc.

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The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center (의약분업 실시 전후 보건소 내소환자 진료내용 변화)

  • Chun, Jae-Kyung;Kam, Sin;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.75-86
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    • 2002
  • This study was conducted to investigate the changes in patients and medical services before and after the Separation of Prescription and Dispensing in Health Center. For the purpose of this study, prescription data of 5,890 prescribed patients in March 2000(before the Separation of Prescription and Dispensing) and 3,496 prescribed patients in March 2001(after the Separation) in 4 Health Centers located in Gyeongsangbuk-do and Gyeongsangnam-do were collected. For investigation of the change of character of prescribed patients and the disease, sex, age, chief diagnosis, the hind of medical insurance, days of visit, days of prescription were investigated by using National Health Insurance claim data. And for investigation of change of prescription, prescribed drugs per each claim, the use rate of antibiotics, injection, and high-price antiphlogistic drug were investigated for acute respiratory disease and musculoskeletal disease. The major results were as follows: For the changes of prescribed patients of each disease, patients with acute respiratory disease were decreased by 49.7% after the Separation of Prescription and Dispensing than before the Separation of Prescription and Dispensing and patients with hypertension(18.1%), patients with musculoskeletal disease(70.5%), patients with diabetes(8.5%), patients with digestive organ disease(71.2%), patients with chronic respiratory disease(76.4%) were decreased. But patients with urethritis were increased by 66.7%. The mean Health Center visited days of prescribed patients decreased significantly after the Separation of Prescription and Dispensing than before in both male and female(p<0.01) and in health insurance patients(p<0.01). For the each of the disease, hypertension, diabetes, musculoskeletal disease decreased. The mean prescribed days increased after the Separation of Prescription and Dispensing than before(p<0.01). According to the kine of disease, the mean prescribed days increased after the Separation of Prescription and Dispensing than before in all the diseases except the urethritis(p<0.01). For acute respiratory diseases, number of prescribed drugs per each claim decreased significantly after the Separation of Prescription and Dispensing(4.7 drugs) than before(4.9 drugs) and the prescription rate of injection decreased significantly from 63.8% to 7.70%, and the prescription rate of antibiotics decreased significantly from 337% to 19.1%(p<0.01). For musculoskeletal diseases before and after Separation of Prescription and Dispensing, number of prescribed drugs per each claim decreased significantly from 3.7 to 3.2 and the prescription rate of injection decreased significantly from 64.9% to 1.7%, and the prescription rate of high-price antiphlogistic drugs increased significantly from 29.1% to 397%(p<0.01). In consideration of above findings, the mean visited days decreased and on the contrary, the mean prescribed days per each prescription increased after Separation of Prescription and Dispensing than before in health centers. For the prescription pattern of physicians, number of prescribed drugs and the prescription rates of injection and antibiotics per each claim decreased, but the prescription rate of high-price antiphlogistic drugs increased after Separation of Prescription and Dispensing.

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Traditional Korean Medicine Diagnosis System Based on Basic Ontology (기초 온톨로지 기반 한의 진단 시스템)

  • Kim, Sang-Kyun;Jang, Hyun-Chul;Kim, Jin-Hyun;Oh, Young-Taek;Kim, Chul;Yea, Sang-Jun;Song, Mi-Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.24 no.6
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    • pp.1111-1116
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    • 2010
  • We in this paper design and implement a traditional korean medicine diagnosis system based on basic ontology. If doctors put the symptoms or tongues or pulses of a patient in the diagnosis system, they can be recommended for the diagnosis results. To support the doctors decision, the diagnosis system make the inference based on the basic ontology and compute the similarity between symptoms of patient and those of ontology. The diagnosis systems also provide the learning mechanism about diagnosis results which save the results in the ontology and reuse them in the next diagnosis. Thus, doctors can share their knowledge for the diagnosis by exchanging their ontology each other. In future, we will expand the knowledge of the basic ontology continuously so that doctors can get the more accurate diagnosis results. We also implement the prescription function and integrate it to the diagnosis system.

Drug Utilization Review of Antiulcerative Agents in Korean Elderly Inpatients (노인 입원환자에 대한 항궤양약물 처방양상 분석)

  • Lee, Won-Sik;Lee, Seung-Mi;Koo, Hye-Won;Park, Byung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.1
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    • pp.41-48
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    • 2002
  • Objectives : To review the drug prescription pattern of antiulcerative agents for elderly inpatients, Methods : The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1594. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription, Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. Results : The number of patients prescribed antiulcerative agents was 1,059 (64,9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by $H_2$ antagonist (16.0%), Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the fetal omeprazole prescriptions. Conclusions : Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulceratiye agents.

Changes in Psychotropic Prescription Patterns in Patients Admitted to an Open Psychiatric Ward : Eleven-Year Comparison in a University Hospital in Gyeonggi-Do (정신건강의학과 개방병동 입원 환자의 진단군별 약물 처방 경향 변화 : 경기도 소재 일 대학병원에서의 11년 비교 연구)

  • Byun, Seonjeong;Kim, Euitae;Yoo, Hee Jeong;Ha, Tae Hyon;Yoon, In-Young;Kim, Ki Woong
    • Korean Journal of Biological Psychiatry
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    • v.22 no.4
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    • pp.195-204
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    • 2015
  • Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.

Study on The Origin, Explanation and Application of Jihwangeumja(地黃飮子) (지황음자(地黃飮子)의 기원(起源), 방해(方解) 및 활용(活用)에 대한 고찰(考察))

  • Hong Seung-Heon;Kim Yun-Kyung;Kwon Dong-Yeul
    • Herbal Formula Science
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    • v.11 no.1
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    • pp.37-44
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    • 2003
  • The source of prescription of Jihwangeumja to treat the mental confusion due to phlegm caused by kidney 'deficiency and Yin and Yang deficiency is found in 'Hwangjesomunseonmyeongronbang $\ll$黃帝素問宣明論方$\gg$'. The source of prescription of Jihwangeum is found in 'Seongjechongnok $\ll$聖濟總錄$\gg$'. Therefore, it seems reasonable to change the prescription to 'Jihwangeum' from 'Jihwangeumja' and to change the source of prescription to 'Seongjechongnok $\ll$聖濟總錄$\gg$' from 'Hwangjesomunseonmyeongronbang $\ll$黃帝素問宣明論方$\gg$'. In addition, 'Jihwangeum' is influenced by 'Naebosan' in 'Cheongeumbang $\ll$千金方$\gg$'. Jihwangeumja gave the substantial influence on the treatment of 'Endogenous wind due to hyperactivity' of Yeopcheonsa. Jihwangeumja supplements the true Yuan, smooths the circulation of the flow inside a body and coordinates the interaction between heart and kidney so that it ultimately eliminates sputum and activates circulation inside a body. If the guideline of diagnosis is accurate, many kinds of diseases can be effectively treated through the principle of treating different disease with the same therapy. In addition, it will be also effectively used for headache after cerebral hemorrhage, trigeminal neuralgia(sore tongue), diabetes insipidus, nervous breakdown, hyperthyroidism, chronic glomerulonephritis, infertility and anemia.

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A Study of Eight Cases According to Hyeongsang Diagnosis Applying Sa-am Acupuncture Therapy (8증례를 통한 사암침법(舍巖鍼法)의 형상의학적(形象醫學的) 운용에 관한 고찰)

  • Choi, Jun-Young;Nam, Sang-Soo;Kim, Yong-Suk;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.29 no.1
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    • pp.139-150
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    • 2012
  • Objectives : The puropse of this study was to report the availability of Hyeongsang diagnosis compensating for visceral pattern identification in applying Sa-am acupuncture therapy. Methods : Eight cases was presented to substantiate the above. Results : According to the characteristic diagnostic method of Hyeongsang medicine by feature such as face, ears, eyes, nose and mouth shape, There are 8 pattern differentiations, including essence family, Qi family, spirit family, blood family, fish type, bird type, beast(running) type and crust(crustacea) type which are correlated with essence deficiency, heat harassing the heart spirit, Qi stagnation, blood stasis, kidney essence deficiency, intense heart fire, liver blood deficiency and lung Qi deficiency in the established visceral pattern identification, respectively. Eight patients was diagnosed by the above Hyeongsang 8 pattern differentiations, of whom Sinjeonggyeok(kidney reinforcing prescription) was applied to a patient with fish type and essence family to nourish kidney essence, and Giul prescription(Qi stagnation prescription) was given to a patient with Qi family for regulating Qi, and Sanghwa priscription(ministerial fire prescription) was delivered to a patient with Spirit family to clear the heart fire and tranquilize, and Sojangjeonggyeok(small intestine reinforcing prescription) was used for a patient with blood family to nourish blood and remove blood stasis, and Sinjeonggyeok(kidney reinforcing prescription), Simhangyeok(heart heat clearing prescription), Ganjeonggyeok(liver reinforcing prescription) and Pyejeonggyeok(lung reinforcing prescription) were utilized for fish type, bird type, beast(running) type and crust(crustacea) type respectively to reinforce the relevant visceral function. Conclusions : It was suggested that characteristic diagnostic method of Hyeongsang medicine should be helpful for enhancing the accuracy of the established visceral pattern identification, applying Sa-am acupuncture therapy more appropriately.

Standardization and unification of the terms and conditions used for diagnosis in oriental medicine III (한의진단명과 진단요건의 표준화 연구III - 3차년도 연구결과 보고 -)

  • Choi, Sun-Mi;Yang, Ki-Sang;Choi, Seung-Hoon;Park, Kyung-Mo;Park, Jong-Hyun;Shim, Bum-Sang;Kim, Sung-Woo;Roh, Seok-Seon;Lee, In-Seon;Cheong, Jin-Hong;Lee, Jin-Yong;Kim, Dal-Rae;Im, Hyeong-Ho;Kim, Yun-Beom;Park, Seong-Sik;Song, Tae-Won;Kim, Jong-U;Lee, Seung-Gi;Choe, Yun-Jeong;Sin, Sun-Sik
    • Korean Journal of Oriental Medicine
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    • v.3 no.1
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    • pp.41-65
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    • 1997
  • The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.

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A Study on the Pulse Diagnosis of the Medical Charts of Youksimanpil (의안(醫案) 『역시만필(歷試漫筆)』의 맥진(脈診) 실행(實行)에 대한 연구)

  • Jeon, Jongwook
    • Journal of Korean Medical classics
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    • v.30 no.2
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    • pp.59-81
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    • 2017
  • Objectives : This paper studies the pulse diagnosis as found in Youksimanpil, which is a series of medical charts containing 150 diagnosis records of Yi Suki, a doctor who was active in Joseon during the 17-18th centuries. Through this effort, the paper aims to shed light on how pulse was utilized in the Korean medicine, and in process tries to reveal the essence of Korean medicine's treatment method. Methods : 60 charts where pulse method was used are selected in Youksimanpil and a table is created with them. Figures are drawn to explain four steps of pulse-sensing from the simple method to highly advanced method. Charts are presented with the corresponding original texts and their translations. With these efforts, the paper attempts to reveal the broad understanding of the doctor of Joseon period who consistently kept to the most basic principle of pulse diagnosis. Results : The efficiency of pulse diagnosis depends on the unity and simplicity in diagnosis and prescription. There were continued efforts between the doctors in Joseon to collect and compare the experiences they gained from clinical practices in order to organize their findings and form a system. These are: (1) individual pulse, (2) patternized pulse, (3) balance between left and right pulses, (4) balance between pulse and body, and (5) the doctor's extemporaneous diagnosis. In that efforts, they protect the principle of holistic diagnosis, which is one of Korean medicine's core principles. Conclusions : Thanks to the existence of medical charts that presents in detail how the texts of Donguibogam were applied in real clinical practices, today we can see Korean medicine's highly advanced synergy between textual knowledge and clinical experiences as recorded in the form of charts.