• 제목/요약/키워드: Evidence Base Medicine

검색결과 71건 처리시간 0.022초

Malignant aortic body tumor in a Korean Jindo dog

  • Hwang, Du-Na;Kang, Byeong-Teck;Hur, Tai-Young;Chang, Byung-Joon;Park, Hee-Myung;Yhee, Ji-Young;Yu, Chi-Ho;Sur, Jung-Hyang
    • 대한수의학회지
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    • 제47권3호
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    • pp.309-314
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    • 2007
  • A 7-year-old, intact female Korean Jindo dog was referred due to ataxia and pain on palpation of the thorax. Radiograph, echocardiography and computed tomogram revealed a mass on the heart base region and osteolytic change of fifth thoracic (T5) vertebra. At necropsy, a firm, encapsulated and round mass was seen arising from the heart base region surrounding the ascending aorta and pulmonary artery. Histopathologically, nests of cuboidal and polyhedral cells having abundantly granular and eosinophilic cytoplasm with round to oval nucleus were separated by fibrous septa. Immunohistochemistry using chromogranin A revealed that tumor cells were originated from neuroendocrine organ and metastasized into some organs including lung, spleen, liver, kidney and T5 vertebra. By electron microscopy, we found the electron-dense and membrane-bound granules in cytoplasm of the tumor cells. This study provides the uncommon evidence that aortic body tumor metastasized to both multiple organs and bone.

Use of Drug-eluting Stents Versus Bare-metal Stents in Korea: A Cost-minimization Analysis Using Population Data

  • Suh, Hae Sun;Song, Hyun Jin;Jang, Eun Jin;Kim, Jung-Sun;Choi, Donghoon;Lee, Sang Moo
    • Journal of Preventive Medicine and Public Health
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    • 제46권4호
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    • pp.201-209
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    • 2013
  • Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

인터넷 기반 한의진단전문가 시스템(KHU-PIPE) 개발 (Development of Web-based Diagnosis Expert System of Traditional Oriental Medicine)

  • 최승훈
    • 동의생리병리학회지
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    • 제16권3호
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    • pp.528-531
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    • 2002
  • In Traditional Oriental Medicine, there has been a growing needs for computerized diagnosis expert system, which can implement pre-diagnosis and correct the errors of practitioners. Therefore, we developed the expert system (KHU-PIPE : Kyung Hee University - Pattern Identification and Prescription Expert) for diagnosis and treatment. It has three characteristics as following. First. this system has the knowledge base which modified the standardized data designed by Chinese government during 1980s. Second, it provides the objective and standardized diagnosis as the results of pattern identification and their appropriate prescriptions for treatment. Third, it is applied to both LAN system and internet. Furthermore, it can be used as an educational methods for the practices of pattern identification and prescription, and provide the objective criteria for clinical studies and promote the Traditional Oriental Medicine as an evidence-based medicine.

Medical Data Base Controlled By Medical Knowledge Base

  • Chernyakhovskaya, Mery Y.;Gribova, Valeriya V.;Kleshchev, Alexander S.
    • 한국지능정보시스템학회:학술대회논문집
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    • 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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    • pp.343-351
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    • 2001
  • World practice is evidence of that computer systems of an intellectual support of medical activities bound up with examination of patients, their diagnosis, therapy and so on are the most effective means for attainment of a high level of physician\`s qualification. Such systems must contain large knowledge bases consistent with the modern level of science and practice. To from large knowledge bases for such systems it is necessary to have a medical ontology model reflecting contemporary notions of medicine. This paper presents a description of an observation ontology, knowledge base for the physician of general tipe, architecture, functions and implementation of problem independent shell of the system for intellectual supporting patient examination and mathematical model of the dialog. The system can be used by the following specialist: therapeutist, surgeon, gynecologist, urologist, otolaryngologist, ophthalmologist, endocrinologist, neuropathologist and immunologist. The system supports a high level of examination of patients, delivers doctors from routine work upon filling in case records and also automatically forms a computer archives of case records. The archives can be used for any statistical data processing, for producing accounts and also for debugging of knowledge bases of expert systems. Besides that, the system can be used for rise of medical education level of students, doctors in internship, staff physicians and postgraduate students.

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대한한방부인과학회지(大韓韓方婦人科學會誌) 수재(收載) 논문(論文) 분석(分析) (Analytic Study on Treatises of the Journal of Oriental Obstetrics & Gynecology)

  • 윤영진;이진무;이창훈;조정훈;장준복;이경섭
    • 대한한방부인과학회지
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    • 제24권2호
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    • pp.97-103
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    • 2011
  • Objectives: Recently, high attention has been drawn towards evidence based medicine(EBM). However, there is little follow study after Park's analysis research (2002) in the journal of oriental gynecology. Therefore, there is a need to conduct analyzed research on the topic, due to the increasing interest about EBM. Methods: To analyze the treatises of the journal of oriental gynecology, we examined 56 journals published from 1987 to 2010. we followed the way of Park, classifying treatises into bibliographic, experimental and clinical categories. Results: Analytic research, as a part of clinical treatises, increased rapidly from 2001. As a result, it took 53.3% of whole study in general after 2002 and it reached up to 70.0% in 2004. Most part of clinical treatises until 2002 was about case report of patients, but the amount of clinical trial started to increase since 2003. Case report and case series showed dramatic increase after 2001, and clinical trial started to increase after 2003. As a result, 43.8% of the analyzed research was due to clinical trial by 2009. Conclusions: On the base of this research, quality evaluation of clinical treatises using guality assessment tool is needed for EBM in the part of oriental obstetrics & gynecology.

뉴로피드백의 최신 연구 동향 (A Review of Neurofeedback Studies)

  • 이혁재;박영배;박영재;오환섭
    • 대한한의진단학회지
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    • 제11권2호
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    • pp.13-26
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    • 2007
  • Background: Neurofeedback is an electroencephalographic biofeedback technique for training individuals to alter their brain activity via operant conditioning. Also neurofeedback is a form of behavioural training aimed at developing skills for brain activity. Within the past decade, several neurofeedback studies have been published that tend to overcome the methodological shortcomings of earlier studies. This research describes the methodical basis of neurofeedback and reviews the evidence base for its clinical efficacy and effectiveness in attention-deficit hyperactivity disorder (ADHD). Methods: In neurofeedback training, self-regulation of specific aspects of electrical brain activity is acquired by means of immediate feedback and positive reinforcement. In frequency training, activity in different EEG frequency bands has to be decreased or increased. Slow cortical potentials (SCPs) training is focused on the regulation of cortical excitability. Results: Neurofeedback studies revealed training-specific effects on, for example, attention and memory processes and performance improvements in real-life conditions, in healthy subjects as well as in patients. In several studies it was shown that ADHD symptomatology was reduced after frequency training or SCP(Slow cortical potentials) training. Moreover a decrease of impulsivity errors and an increase of the contingent negative variation. Conclusions: This research provides evidence for both positive behavioural and specific neurophysiological effects of neurofeedback training. Also there is growing evidence for neurofeedback as a valuable module in neuropsychiatric disorders. Further, controlled studies are warranted.

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금연/흡연예방 프로그램의 방법에 따른 효과성 평가: 최근 3년 간 국내학술지 논문에 대한 체계적 문헌고찰 (Efficacy of Smoking Cessation and Prevention Programs by Intervention Methods: A Systematic Review of Published Studies in Korean Journals during Recent 3 Years)

  • 김혜경;박지연;권은주;최승희;조한익
    • 보건교육건강증진학회지
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    • 제30권5호
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    • pp.61-77
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    • 2013
  • Objectives: The purpose of this study was to evaluate program methods for effective smoking cessation and prevention through systematic review of studies published during recent 3 years in Korea. Methods: Electronic searches were conducted in DBPIA, RISS, KISS and other databases looking for studies published from 2010 to 2012 that dealt with the effects of intervention on smoking prevention and cessation. A total of 25 studies were included in the final analysis. Three independent reviewers critically evaluated the study quality and evidence of effectiveness based on The Community Guide methodology. Results: Multi-component intervention showed strong evidence of effectiveness for adolescents and sufficient evidence for patient smokers. Cognitive-behavioral intervention for adolescents and child-parent interaction program for adults demonstrated sufficient evidence of effectiveness on the smoking cessation and its determinants. There was insufficient evidence showing effectiveness of smoking prevention programs. Conclusion: Improving the quality and quantity of the intervention studies on smoking could help to expand evidence base for effective intervention methods and strategies on smoking.

인간 게놈의 단일염기변형 (Single Nucleotide Polymorphism; SNP)에 대한 이해 (UNDERSTANDING OF SINGLE NUCLEOTIDE POLYMORPHISM OF HUMAN GENOME)

  • 오정환;윤병욱
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권4호
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    • pp.450-455
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    • 2008
  • A Single Nucleotide Polymorphism (SNP) is a small genetic change or variation that can occur within a DNA sequence. It's the difference of one base at specific base pair position. SNP variation occurs when a single nucleotide, such as an A, replaces one of the other three nucleotide letters-C, G, or T. On average, SNP occur in the human population more than 1 percent of the time. They occur once in every 300 nucleotides on average, which means there are roughly 10 million SNPs in the human genome. Because SNPs occur frequently throughout the genome and tend to be relatively stable genetically, they serve as excellent biological markers. They can help scientists locate genes that are associated with disease such as heart disease, cancer, diabetes. They can also be used to track the inheritance of disease genes within families. SNPs may also be associated with absorbance and clearance of therapeutic agents. In the future, the most appropriate drug for an individual could be determined in advance of treatment by analyzing a patient's SNP profile. This pharmacogenetic strategy heralds an era in which the choice of drugs for a particular patient will be based on evidence rather than trial and error (so called "personalized medicine").

Diagnosis of Persistent Right Aortic Arch with an Aberrant Left Subclavian Artery using CT in a Poodle Dog

  • Ryu, Chan-Young;Lee, Sang-Gwan;Lee, Kija
    • 한국임상수의학회지
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    • 제35권1호
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    • pp.26-29
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    • 2018
  • A 6-month-old, female poodle presented with a three-month history of persistent regurgitation immediately after eating. On physical examination, the patient was emaciated and dehydrated. Thoracic radiography showed ventral displacement of the trachea and increased radiopacity in the mediastinum, cranial to the heart base. A severely dilated esophagus was identified cranial to the heart on esophagram. Computed tomography (CT) revealed the esophagus was filled with gas, fluid and a little of contrast and dilated from caudo-cervical to cranio-thoracic part. The esophageal diameter was markedly decreased at the heart base. In addition, the trachea was displaced to the left-ventral side of the right aortic trunk and an aberrant left subclavian artery originating from the aorta was identified. There was no evidence of abdominal vascular anomaly. Based on diagnostic imaging, persistent right aortic arch (PRAA) with an aberrant left subclavian artery was diagnosed. The patient did not undergo surgery and died at 15 days after diagnosis. This report describes imaging diagnosis, including CT and radiography in a weaned dog with regurgitation due to esophageal obstruction by PRAA. When PRAA is suspected and conventional radiography or contrast study is insufficient for diagnosis, CT may be helpful for diagnosing PRAA.

국내 거주 외국인의 침 치료 경험과 한의학에 대한 인식: 질적연구 (Perceptions and Experiences of Acupuncture among Expatriates Living in Korea: A Qualitative Study)

  • 이승민;박인효;데이비드 밀러;이상재
    • Korean Journal of Acupuncture
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    • 제37권3호
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    • pp.172-182
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    • 2020
  • Objectives : In this study, we conducted a focus group interview among expatriates living in Korea, to investigate their experiences and perceptions of acupuncture and Korean Medicine in order to improve the usage of Korean Medicine in the medical tourism market. Methods : The inclusion criteria for the focus group interview was: (1) participants between the age of 20 to 75 years old; (2) those who had lived in Korea for more than 90 days, and (3) those who were able to express their thoughts freely in English. The participants were informed that the interviews will be recorded and transcribed. We ended recruitment once saturation of materials was met. Semi-structured interviews were conducted, and the data was analyzed after each interview. Results : The interviews were held between June to December 2016. Twenty-four participants were recruited but four dropped out and a total of twenty participants successfully finished the interviews. Six focus group interviews were conducted. Analysis revealed that Korean Medicine was relatively less known compared to Traditional Chinese Medicine or Complementary and Alternative Medicine. Participants automatically associated acupuncture with the management of pain or stress and replied that these were the areas that they thought acupuncture would be most effective. Positive experiences with acupuncture and with the acupuncture practitioners were factors that promoted the use of acupuncture whereas lack of awareness, accessibility and accreditation were factors that hindered its use. Other factors that hindered the use of acupuncture was needle phobia and the perception that acupuncture lacks scientific evidence. Conclusions : Awareness on Korean Medicine and acupuncture is low. Participants lack awareness on what diseases acupuncture can treat, the scientific evidence behind the mechanism of action, and the rigorous education system that Korean Medicine doctors must go through to get their license. Rigorous marketing should be encouraged, which includes greater exposure in the media, more honest reviews from patients, and promotion of the scientific evidence base.