• 대한한방부인과학회지
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• 제24권4호
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• pp.126-149
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• 2011

Purpose: KCDO-3(Korean Classification of Diseases(Oriental Medicine)-third edition) being used in January, 2010 accepted the KCD(Korean Classification of Diseases) and added disease pattern and syndrome of oriental medicine. But, the diagnoses of oriental medicine are too uncertain to express in A00-Z99(KCD). In this case, you should choose in U codes under the KCD use guidelines, but U codes are not capable of representing the symptoms too. So, we suggest the use criteria and consider the weakness of the U codes with medical records of patients who visited with amenorrhea or oligomenorrhea. Methods: We referred medical records of patients who visited oriental obstetrics and gynecology from January 1st to December 31st, 2010. From among them, we set up 122 patients who related with emmeniopathy as target group and searched codes distribution based on medical records. And we described that the process of choosing appropriate codes based on the medical records of 49 amenorrhea or oligomenorrhea patients. Results and Conclusions: The emmeniopathy is divided into menstrual disorder, amenorrhea and systemic disorders at the period of menstruation. And emmeniopathy is expressed in some codes such as N91, N92, N93, N94, U321, U77. When a patient visit hospital, a doctor should choose causal codes when there is confirmed diagnosis. Otherwise, a doctor chooses symptom codes. And if there are more than two diagnosis consistent with definition of chief condition, a doctor should code the first listed diagnosis as a chief condition. Because KCD-5 is classified according to western medical diagnosis, it is difficult to choose in KCD-5 when we diagnosed with disease pattern and syndrome of oriental medicine. But U codes are also deficient to express various condition of emmeniopathy. So we should add 'deficiency and detriment of the thoroughfare and conception vessels', 'prolonged menstruation' and various systemic disorders at the period of menstruation.

• Journal of Korean Neurosurgical Society
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• 제29권3호
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• pp.324-329
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• 2000

Objective : Psychological factors may have a major influence on the outcome of treatment for back pain. We investigated the relationship between the outcome and some psychological factors, such as self-reported pain intensity, disability, sleep disturbance and fatigue. Method : The study was conducted as a survey using a questionnaire and telephone interviews. The survey included consecutive 294 patients who visited the neurosurgical out-patient department complaining of low back pain and contacted by telephone on average seven months after the first visit. Pain intensity was measured by visual analog scale, and disability was assessed by Waddell's chronic disability index. Results : The outcome of treatment for back pain was recovered in 36.7%, improved in 30.6%, almost same in 28.6%, and aggravated in 4.1%. Overall rate of improvement was 67.3%. The rate of improvement was related to the duration, patterns and intensity of the symptom, and Waddell index. It was not influenced by the doctors, special studies, and methods of treatment. When the duration was more than 6 months, there were the symptoms of both back and legs, and the self-reported Waddell index was 1-3, the rate of improvement was relatively low. Although the intensity of the pain and disability was closely related to the degree of sleep disturbance, fatigue, appetite, or indigestion, the outcome of treatment for back pain was not always bad in patients with high psychological stress. Actually the outcome of the patients who complained severe pain and disability was better than the outcome of the others. Conclusion : The outcome of the back pain can be predicted by the duration, patterns and intensity of the symptom, and Waddell index. The multidisciplinary treatment will be necessary for the patients whose expected outcome is not good to reduce not only the physical symptoms but also the psychological stress.

• 대한한방소아과학회지
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• 제35권3호
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• pp.43-52
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• 2021

Objectives This study aimed to analyze the clinical characteristics of 63 patients with autism spectrum disorder (ASD) who received Korean medicine treatment. Methods This study identified and retrospectively reviewed the first visit records and clinical characteristics of all of the patients who visited the Kyung Hee University Korean Medicine Hospital and Kyung Hee University Korean Medicine Hospital at Gangdong in South Korea with ASD as their chief complaints. The herbal medicines that were prescribed according to the patient's symptoms were analyzed by separating them into categories. Results The data of 83 children with ASD were collected. Among them, the primary medical record charts of 63 patients were reviewed. Additional analysis was performed for 56 patients who were treated with herbal medicine. Through a retrospective chart review, the patients' clinical characteristics and the tendency of the prescribed herbal medicine was identified. Conclusions This study was conducted to provide preliminary data that proposes Korean medicine as a new alternative medical treatment. Our study is meaningful as it used the demographic and clinical records of 63 patients with ASD in Korea who visited an Korean medicine hospital in the last 11 years to identify tendencies and analyzed the prescriptions of two or more Korean medicine pediatricians.

• 한국엔터테인먼트산업학회논문지
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• 제15권8호
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• pp.423-432
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• 2021

본 연구에서는 노인의 라이프케어 및 삶의 질향상을 위해 도입되어 시행되고 있는 통합돌봄사업의 미래 가치성 확대와 방향성 제시를 위하여 현황과 문제점들을 알아보고 이를 통해 다음과 같은 연구적 결론을 제시하였다. 첫째, 서비스 수혜 노인의 욕구분석은 조사자 중심이 아닌 환자 중심으로 구성하며, 특히 의료진의 진료방문을 통한 의학적관리 부분이 강화되어야 하며, 성별과 연령, 장애유형과 개인적 욕구취향에 따른 특화된 서비스 항목 부분이 점진적으로 강화되어야 할 것이다. 둘째, 서비스 항목에 대한 만족도 및 중복성 그리고 효과성 등을 분석하여 예산을 절감하며 수요자 중심의 서비스 항목구성과 신규 서비스 필요 항목 적용 등을 고려해 나간다. 셋째, 통합 스케줄관리시스템 도입을 통하여 서비스 제공 직역단체와 수혜자 간의 사전예약 및 방문 스케줄 관리의 전문화가 필요하다. 넷째, 재원 문제해결을 위한 노력으로, 보건의료 재정과 장기요양보험제도 그리고 사회복지재정사업 등과 합리적 재원공유 제도마련이 필요하며, 서비스 관련 산업분야와의 재원의 연계나 순환, 지방 공공의대 출신 인력투입 방안을 고려할 수 있다. 이상의 제안을 통해 통합돌봄사업은 보편적 노인 케어시스템으로의 완성과 미래 가치를 지닐 수 있게 될 것이다.

• 대한소아치과학회지
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• 제31권3호
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• pp.459-473
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• 2004

본 연구는 보다 효과적인 치료계획 수립과 행동조절을 시행하는데 도움을 얻고자, 1999년 1월 1일부터 2002년 12월 31일까지 강릉대학교 치과병원 소아치과에 내원한 환아를 진료기록부를 통해 조사하고, 진정치료를 받은 환아들 및 보호자의 특성을 진료기록부 및 초진시 설문지를 통해 진정치료를 받지 않은 환아들과 비교, 분석하여 다음과 같은 결과를 얻었다. 1. 내원 환아수 증가와 함께 진정치료환아들의 수가 1999년부터 2002년의 4년 동안 계속적으로 증가하였다. 2. 진정환아군은 비진정환아군에 비해 어린 연령 대에 집중되어 유의할만한 분포의 차이를 보였다(p<0.001). 3. 월별 내원경향에 있어서 진정환아군은 3, 7, 11월에 높은 비율을 보여 전체 환아에 비해 내원빈도 분포에 유의할 만한 차이를 보였다(p<0.001). 4.보호자 직업의 분포에서도 추후 계속된 연구가 필요하지만, 진정환아와 비진정환아군 간에 통계적으로 유의한 차이가 있었다(p<0.001). 5. 진정환아군은, 비진정환아군에 비해 예방, 교정적인 치료보다는 충치치료를 주소로 내원하는 비율이 높아 내원동기의 분포에 유의할만한 차이가 있었다(p<0.001). 6. 이전 치과치료시 진정환아군에서 부정적 반응을 보인 비율이 더 높았고, 보호자 기대치에서도 진정환아군에서 부정적 반응을 기대한 비율이 더 높았다(p<0.001). 7. 진정환아군의 31.2%는 소개를 통해 소아치과에 내원하였으며, 치과의사에 의한 소개가 가장 높은 58.3%를 차지하였다. 8. 달래도 치료를 거부할 경우, 진정환아군의 보호자들은 50.9%가 진정치료를 선호한 반면, 비진정환아군의 보호자들은 물리적 방법을 54.6%로 선호하여 유의할만한 분포의 차이를 보였다(p<0.001).

• Journal of Nutrition and Health
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• 제41권2호
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• pp.147-155
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• 2008

우리나라의 경제적 발달과 문화 수준의 향상으로 질병 양상과 사망 원인에 많은 변화가 있는데, 그 중에서도 최근 당뇨병의 유병률의 상승 현상이 두드러지게 나타나고 있으며, 사망 원인의 수위를 차지하고 있다. 그러므로 이를 예방하고 당뇨병 합병증을 예방하기 위한 구체적이고 근거중심인 영양치료 방법의 제시가 절실한 실정이다. 미국영양사협회에서는 지속적으로 증가하는 당뇨병 유병율을 낮추기 위하여 생활습관의 개선을 목표로 임상영양치료의 표준화 지침을 제시하고 이에 따른 치료 효과 연구가 활발히 진행되고 있으나, 아직 국내에서는 많은 연구가 진행되고 있지 않은 현실이다. 따라서 본 연구에서는 이미 국외에서 사용되고 있는 지침에 근거하여 심층영양교육 방법을 실시하여 그 효과를 1회 교육만으로 시행되는 기본교육 방법과 비교하여 다음과 같으나 결과를 얻었다. 심층 및 기본영양교육 즉, 두 가지 교육 방법을 비교하였을 때 심층영양치료 방법을 실시한 경우 기본영양교육을 실시한 경우보다 혈당, 혈압 및 체중 강하 효과 면에서 유의적으로 개선효과가 있는 것으로 나타났다. 비용효과 면에서 장기간의 혈당변화 상태를 알 수 있는 당화혈색소의 경우 1%를 낮추기 위하여 소요되는 비용은 심층영양교육군에서 더 적었으며, 교육의 잠재 효과를 고려하였을 경우, 모든 혈당 검사 지표의 영양치료 비용 대비 효과 면에서 심층영양교육 방법이 기본영양교육 방법보다 앞서는 것으로 나타났다. 저비용 고치료 효과를 보여주고 있는 임상영양치료는 당노병과 같은 만성질환의 중요한 기본치료로 주목되고 있는 현 시점에서 영양치료행위의 의료 보험 급여화는 국민의 건강을 증진시키고, 국가적으로는 의료비 지출을 감소시키며 국민의 건강을 증진시키는데 큰 기여를 하는 합리적인 방안이라 생각된다. 따라서 현 비급여 수가로 되어 있는 교육수가를 급여화하여 많은 환자들에게 의료 혜택을 주는 일이 필요하리라 사료된다.

• Pediatric Infection and Vaccine
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• 제20권1호
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• pp.17-27
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• 2013

목 적 : 잠복결핵감염(LTBI)을 진단하는 방법은 결핵 피부반응검사(TST)와 interferon-${\gamma}$ releasing assay(IGRA)이다. 그런데 TST의 위양성 문제 때문에 TST 대신 IGRA로 대치하려는 경향이 있다. 이에 결핵 접촉자 조사를 시행함에 있어 TST와 QuantiFERON$^{(R)}$-TB Gold In-Tube (QFT-GIT) 검사를 동시에 시행하여 결과를 비교하였다. 방 법 : 2007년 2월부터 2008년 5월까지 가톨릭대학교 성빈센트병원 소아청소년과 외래에 LTBI 여부의 확인을 위해 방문한 소아를 대상으로 TST와 QFT-GIT 검사를 동시에 시행하였다. 연구대상은 감염원이 같은 집에 거주하는 경우를 동거 접촉, 아닌 경우를 비동거 접촉으로 구분하였다. 결 과 : 연구대상은 총 35명으로 폐결핵 노출 후 접촉자 조사 대상이 29명, 폐결핵으로 진단된 경우가 6명이었다. 접촉자 조사 대상에서 동거 접촉군은 18명(62.1%), 비동거 접촉군이 11명(37.9%)이었다. 최종 접촉자 조사 결과로 TST 양성은 동거 접촉군 38.9% (7/18), 비동거 접촉군 45.5% (5/11)이었고, QFT-GIT 검사 양성은 각각 5.6% (1/18), 9.1%(1/11)로 TST의 양성률이 더 높았다. 접촉자 조사에서 두 검사를 모두 시행한 경우는 1차 검사의 26건과 2차 추적검사의 15건을 합하여 총 41건으로 두 검사의 일치율(kappa값)은 0.063으로 매우 낮았다. 6명의 폐결핵 환자에서 TST는 모두 양성, QFT-GIT 검사는 5명이 양성으로, 이들까지를 포함했을 때의 일치율은 0.334이었다. 결 론 : 본 연구에서 TST와 QFT-GIT 검사 결과의 일치율은 낮았는데, 대부분이 TST 양성인 경우이었다. 두 검사 결과 중 어떤 것이 정확한 것인지 판단할 수 있는 표준 검사법이 없고, 소아청소년에 대한 자료가 충분치 않은 상황에서 민감도가 낮은 IGRA에 의한 결과만을 신뢰하여 LTBI 진단에 IGRA만 사용하는 것은 적절치 않다고 사료된다.

• Pediatric Infection and Vaccine
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• 제8권2호
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• pp.206-212
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• 2001

최근 소아의 인두염 및 인두편도염에서 EM-resistant group A streptococci가 15~40%까지 보고가 되고 있으며, 같은 계통의 macrolide제제들의 대한 내성도 점차 증가하고 있는 양상이 나타나고 있다. 따라서 세균성 인두편도염이 의심되는 환아의 치료에 있어서 경구용 항생제를 선택할 때는 항생제에 대한 내성과 경제성 및 환아의 순응도를 고려하여 항생제를 선택하여야 하겠다.

• 지역사회간호학회지
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• 제9권1호
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• pp.143-162
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• 1998

This is a study for the construction of nursing care based upon the Korean attitude toward medicine. Factors which were investigated include the source of nursing care, the reason for choosing care, the type of heath care chosen, the accessability of caregivers, and the desired location of death. The population examined in this study consisted of 517 adults distributed in six large cities and 191 adults from five rural communities. Data was analyzed using frequency, percent, Cronbach alpha, $X^2$ - test, t - test, F - test and scheffe post hoc contrast with an SAS program. The results of this study are summarized as follows: 1. Among sources of nursing care used, first rank rated-pharmacy(54.4), private hospital(18.2), general hospital(8.4), folk remedies in house (5.0), chinese hospital(2.8), prayer(2.8) and others(8.4), and the reasons for choosing nursing care rated 'the easiest method' (63.6), 'the best method'(15.7), 'reliable'(10.8) and 'lower cost burden'(4.6) in order of preference. 2. The type of nursing care chosen rated western medicine(6.80), chinese medicine(6.15), folk remedies(5.46), faith remedies(3.51) and divination remedies (1.41). There were significant differences in the effect recognition degree to various kinds of medicine. 3. The difference of the type of nursing care chosen according to general characteristics showed that urban residents were higher than rural community residents(t=2.15, p=0.0320) in western medicine, and urban residents, women, and singles were higher than rural community residents(t=2.04, p=0.0414), men (t= -2.89, p=0.0039), and married(t=2.50, p= 0.0126) on folk remedies. With repect to age and education those 21-30, under 20 and 31-40, graduated from college and graduate school were higher than above 51, above 61 (F = 7.76, p = 0.0001), graduated from elementary school(F=4.39, p=0.0006) on folk remedies. In other categories, rural community residents, women, younger people. Christians were higher than urban residents ( t = -2.73, p=0.0305), men(t= -4.15, p=0.0001), older people (F=2.48, p=0.0307), Catholic, Buddhist, or atheist (F= 70.18, p=0.0001) on faith remedies. Those graduated from high school and Buddhist were higher than unschooled, graduated from middle school(F=3.18, p= 0.0075), atheist, Catholic or Christian(F=18.32, p=0.0001) on divination redemies. There were significant differences concerning age and education level. 4. The accessibility of caregivers rated 'caregivers should be nearby if the patients need them' (50.0), 'caregivers must be there all day (24 hours)' (39.6), 'caregivers must be there at night only'(5.0), 'caregivers must be there during the day only'(2.6), 'caregivers always should visit during visiting hours' 0.4), 'caregivers don't need to be there at all' (1.2). The frist rank of suitable caregivers were rated as spouse(66.6), mother(24.2), daughter (3.6), daughter-in-law(1.9), and the reasons of thinking thus were rated as 'the most comfortable' (81.5), 'people should correctly with regards to family they'(7.1), 'the easiest' (5.4), 'take good care of the patient' (5.1) and 'lower cost burden' (0.4). 5. The desired location of death rated as the following: his/her house (91. 6) to the hospital(8. 4). A person going to encounter death in the hospital wanted his house(78.5) over the hospital(21.5), and a person dieing in the hospital prefered his house(52.9) over the hospital(47.1) as a funeral ceremony place. The following suggestions are made based on the above results. 1. A sampling method that enhances the re presentativeness should be used in regional and/or national related research and replicated to confirm the result of this study. 2. This study should be used to understand the Korean view of medical centers and to meet the expectations of patients in Korean nursing. 3. Research on the Korean traditional view of humans and expectations of the sick, health and illness, and health behavior, the perception of dying, the decision to heal, and the view of general medicine should continue to be conducted continuosly so that Korean nursing theory can be advanced on these concepts.

• 동의생리병리학회지
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• 제23권2호
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• pp.512-519
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• 2009

Among patients who visited each clinical department for oriental medical treatments, anthropometric measurement, blood pressure, fasting blood glucose and blood lipid profile level were measured at their first initial visit. 55 subject patients who were diagnosed as having metabolic syndrome and 150 mg/dL or more of triglyceride were selected as subjects whose fasting blood glucose, triglyceride, total cholesterol, HDL cholesterol and LDL cholesterol were measured after fasting. According to each patient's disease, the subject received treatments such as herb medicine, acupuncture, moxibustion, cupping therapy, physical therapy and rehabilitation therapy from each clinical department, and after an average of 4.10${\pm}$0.31 weeks, another test was performed yielding the following results. Serum triglyceride was 243.72${\pm}$13.05 mg/dL before the oriental medical treatment and 188.11${\pm}$12.17 mg/dL after the treatment where although it continued to show an abnormal value even after the treatment, there was statistically significant decrease compared to pre treatment(P<0.05). Serum total cholesterol was 207.50${\pm}$5.89 mg/dL before the oriental medical treatment and 192.37${\pm}$5.53 mg/dL after the treatment which was statistically insignificant compared to pre treatment(P>0.05). Serum HDL cholesterol was 51.19${\pm}$3.95 mg/dL before the oriental medical treatment and increased to 52.53${\pm}$1.49 mg/dL after the treatment although it was statistically insignificant compared to pre treatment(P>0.05). Serum LDL cholesterol was 110.66${\pm}$5.86 mg/dL before the oriental medical treatment and decreased to 106.12${\pm}$4.82 mg/dL after the treatment although it was statistically insignificant compared to pre treatment(P>0.05). In regards to the change of triglyceride for each sex, it was 221.84${\pm}$14.01 mg/dL before the treatment and 187.00${\pm}$15.47 mg/dL after the treatment for men, and it was 271.50${\pm}$22.78 mg/dL and 189.53${\pm}$19.76 mg/dL respectively for women where even though men and women showed the decrease of 34.84${\pm}$12.79 mg/dL and 81.96${\pm}$20.01 mg/dL respectively, both men and women continue to show abnormal values after the treatments. However, there was statistically significant decrease compared to pre treatment(P<0.05). In regards to the change of total cholesterol for each sex, with 198.24${\pm}$7.60 mg/dL for men before the treatment and 188.93${\pm}$7.45 mg/dL after the treatment, values for both before and after the treatment were within the normal range where the change value was 9.30${\pm}$5.86 mg/dL and statistically insignificant(P>0.05). For women, it was 219.26${\pm}$8.87 mg/dL and 196.73${\pm}$8.43 mg/dL respectively for women where with 22.53${\pm}$7.60 mg/dL, it decreased to the normal level after the treatment, and there was a statistically significant decrease compared to pre treatment(P<0.05). With such results, serum triglyceride and cholesterol levels of patients who have been diagnosed as having metabolic syndrome were observed to decrease after the oriental medical treatment. Especially, for both men and women, abnormally high triglyceride level decreased while the effect of lipid profile improvement for women was more significant compared to men.