• Journal of Korean Neurosurgical Society
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• 제29권8호
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• pp.1050-1054
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• 2000

Objective : The incidence of head injury has been increasing in the rural area. The author investigated the clinical features and difficulties in care of the acute head-injured patients in this area. Method and Material : The authors performed a retrospective review of radiological data and clinical records in patients with mild to moderate head injury. Cause, type of craniocerebral injury, delayed intracranial lesions, complications, its relation to alcohol abuse, and outcome were analyzed. Results : In total of 68 cases, 20(29.4%) victims were associated with acute alcohol intoxication. Motor vehicle accident was the leading cause of head injury and the most common craniocerebral lesion was basilar skull fracture. Eight(11.8%) patients showed delayed radiological and clinical deterioration and 40(58.8%) were followed-up regularly after discharge. The subdural hygroma was commonly noted in the elderly and alcoholics. Causes of thirty events that resulted in an atypical and difficult neurosurgical practice were as follows : delayed admission, premature discharge against doctor's request, refusal of radiological studies and admission, misunderstanding of disease entity, and unreasonable desire of transfer to tertiary hospitals. Inaccurate initial diagnoses were made by emergency doctors in twenty patients. During the course of treatment, there were a few complications such as alcohol withdrawal, acute otitis media, cerebrospinal fistula, facial weakness, and posttraumatic seizure. Outcome was good in 60(88.2%) patients. Conclusion : Most of minor head trauma patients in this series have shown good results, but we have to consider some possible complications and delayed intracranial lesions in these patients that should be managed with special cautions with various kinds of treatment difficulties.

• 대한예방한의학회지
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• 제19권2호
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• pp.67-74
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• 2015

Objective : The aim of this study was to investigate fatigue-related factors including socio-demographic variables and life styles among workers in the automobile manufacturing industry. Method : The subjects were 22,937 individuals who had received health examination by Korean Medical doctors and responded to questionnaires for 8 months from March to November in 2011. The fatigue index was measured by heart rate variability (HRV) in an automobile manufacturing industry. A multivariate analysis with SPSS version 19.0 was used to examine the relationship between fatigue and other factors including ages, smoke consumption, drinking frequency, exercise frequency, occupational category, conjugal condition. Results : In comparison between normal and very bad level of fatigue, factors of ages, smoking, drinking, and exercise showed significant difference(p<0.05). In addition, when normal and bad fatigue were compared, ages, smoking, exercise also produced significant difference(p<0.05). Furthermore, in normal and good level of fatigue comparison, occupation and smoking yielded significant difference(p<0.05). Finally, in other comparisons between normal and very good fatigue, exercise, smoking and occupation revealed significant difference(p<0.05). Conclusion : The results of this study suggest that age increase affects fatigue negatively, whereas exercise and drinking of once or twice per a week can have positive correlations.

• 대한본초학회지
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• 제27권2호
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• pp.1-16
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• 2012

Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

• 혜화의학회지
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• 제21권1호
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• pp.1-9
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• 2012

Objectives : The aim of this experiment is to find out relationship between the effect of cosmetics and 4 types of pattern identification about fluid-humor, which are based on the general idea of traditional oriental medicine, Qi-Blood and deficiency-excess. Methods : Korean female volunteers in good health (n=25, $23.12{\pm}2.83$) participated in this experiment. Three Korean medical doctors classified them into 4 groups: Blood-deficiency: group A; Blood-excess: group B; Qi-deficiency:group C; Qi-excess:group D). Cosmetics that contains herb extract for Blood deficiency were given to all volunteers and they used the cosmetics for 4 weeks. Volunteers were assessed non-invasively with the skin measuring devices before and after using cosmetics. And we analyzed the correlation of skin physiological parameters with 4 groups. Results : Three doctors diagnosed participants and classified them into 4 groups ; group A(n=8),group B(n=7), group C(n=3), group D(n=5) as highest score. After 4 weeks, facial skin moisture showed no significant difference in comparison between 4 groups. Sebum showed significant increase in Group A and significantly decreased Group B. Measurement of facial skin elasticity tended to increase in Group A, C, D but skin elasticity was decreased significantly in Group B. Conclusions : In case of a group that pattern identification about fluid-humor corresponds to herb extract in cosmetic, skin improving effect was better than the other group that pattern identification oppose to properties of herb in cosmetic. Therefore, from the view of traditional oriental medicine, it is very important to understand user's pattern of identification or physical conditions and properties of herbs in cosmetics on the matter of safety and efficacy.

• Asian Pacific Journal of Cancer Prevention
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• 제13권6호
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• pp.2749-2752
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• 2012

Background: Breaking bad news to cancer patients is a delicate and challenging task for most doctors. Better understanding of patients' preferences in breaking bad news can guide doctors in performing this task. Objectives: This study aimed to describe the preferences of Malaysian cancer patients regarding the communication of bad news. Methodology: This was a cross-sectional study conducted in the Oncology clinic of a tertiary teaching hospital. Two hundred adult cancer patients were recruited via purposive quota sampling. They were required to complete the Malay language version of the Measure of Patients' Preferences (MPP-BM) with minimal researcher assistance. Their responses were analysed using descriptive statistics. Association between demographic characteristics and domain scores were tested using non-parametric statistical tests. Results: Nine items were rated by the patients as essential: "Doctor is honest about the severity of my condition", "Doctor describing my treatment options in detail", "Doctor telling me best treatment options", Doctor letting me know all of the different treatment options", "Doctor being up to date on research on my type of cancer", "Doctor telling me news directly", "Being given detailed info about results of medical tests", "Being told in person", and "Having doctor offer hope about my condition". All these items had median scores of 5/5 (IQR:4-5). The median scores for the three domains were: "Content and Facilitation" 74/85, "Emotional Support" 23/30 and "Structural and Informational Support" 31/40. Ethnicity was found to be significantly associated with scores for "Content and Facilitation" and "Emotional Support". Educational status was significantly associated with scores for "Structural and Informational Support". Conclusion: Malaysian cancer patients appreciate the ability of the doctor to provide adequate information using good communication skills during the process of breaking bad news. Provision of emotional support, structural support and informational support were also highly appreciated.

• 생물정신의학
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• 제7권1호
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• pp.46-54
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• 2000

외상성 뇌손상으로 외상 후 스트레스 장애, 범불안장애, 공황장애, 강박장애, 공포장애 등의 불안장애가 비교적 흔히 발생할 수 있다. 그러나 빈발하는 불안장애인데 비해 의사들로부터 적절하게 관심을 받지도 못했으며 치료받지도 못하였다. 외상성 뇌손상 후 불안장애는 뇌손상 자체에 의해, 뇌손상과 기능상실에 대한 환자 또는 간호인의 반응에 의해 증상이 발생하기도 하고 지속되기도 한다. 의사는 이들 환자들을 진단하고 치료하기 위해서는 우선 뇌손상의 기전과 양상에 대해 지식이 있어야 하며, 불안증상을 호소하는 외상성 뇌손상 환자를 이해하고 수용하고 지지해주는 태도를 취해야 하며, 불안증상이 뇌손상에 의한 것인지 통상적인 불안 증상인지 확인해야 한다. 이들 뇌손상 환자들은 약물의 부작용에 아주 취약하기 때문에 약물치료시에는 약물의 작용기전은 말할 것도 없고 부작용에 대해 잘 알고 있어야 한다.

• 보건행정학회지
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• 제22권3호
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• pp.315-346
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• 2012

The legal relationship between patient and physician is legally equal relationship. But, in times past, patients be compelled to sign an unequal contract, substantially. Because of the imbalance between supply and demand in the health care market. Today, the law of supply and demand in the health care market is running well. And as the cognition of citizens' rights grows, the relationship between patient and physician can also get a lot of changes. Patients have the right to know the information about medical care, and to decide whether or not to get treatment including invasions against their own bodies. In other words, Doctors have an obligation to explain to their patients. If doctors did not provide patients sufficient explanation or information, it violates the right of patients. This is a tort, or a breach of contract. To improve the remedy for violation of patient's right, patient is able to be protected by status as consumer. If patient is a kind of consumer in terms of medical consumption, he/she as consumer can enjoy supplementally the consumer's right. The patient as a consumer can exercise now a consumer's right as a constitutional right. In addition, with respect to consumer's rights, Framework Act on Consumers was enacted. This Act is based on constitutional provisions of Article 124 and the Act can be seen as a law that embodies consumer right because the provision of the constitutional law delegates specific contents. In the health care field, patients need to win recognition the statue of the consumer to hold the sovereignty of the consumer. In particular, if patients are consumers, they may be able to make good use of the quickly and efficiently collective dispute resolution and association lawsuit to rescue their damage, the Alternative Dispute Resolution(ADR) of Framework Act on Consumers.

• Journal of Acupuncture Research
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• 제30권3호
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• pp.135-140
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• 2013

Objectives : The purpose of this study is to investigate the repeatability and reproducibility of the Ryodoraku acupuncture device. For such device to be accepted as a good apparatus for clinical diagnosis, the score it provides should be stable no matter who measure it or when it is measured, assuming all other conditions equal. Materials and Methods : Three oriental medical doctors who were well trained and fully aware of the usage of the Ryodoraku acupuncture device examined ten randomly selected patients three times. Each doctor measured the Ryodoraku scores three times from each of the 10 selected patients. Three doctors were involved in this experiment to investigate the reproducibility and each of them measured the Ryodoraku scores three times from each patient to investigate the repeatability. Data was analyzed with Friedman test, Spearman correlation test, and intra-class correlation coefficient(ICC) in SPSS ver. 18. Results : 1. The Friedman test showed that there is no statistically significant difference between the 1st, 2nd and 3rd Ryodoraku scores measured by the same examiner. It indicates that the Ryodoraku acupuncture device provides the repeatability. 2. Spearman correlation test confirmed the results obtained by the Fiedman test by showing that there exists a strong positive correlation between the three Ryodoraku scores measured by the same examiner. 3. A very high ICC among the three examiner assured that the Ryodoraku acupuncture device achieves the reproducibility. Conclusions : The Ryodoraku acupuncture device achieves the repeatability and reproducibility. However, we still recommend that a doctor trained to a certain level use the Device to carry out the diagnosis. Also, to improve the device in terms of Reproducibility even more, it should be considered to provide a manual for the exact usage.

• 대한예방한의학회지
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• 제12권2호
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• pp.73-83
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• 2008

The rapid change of the health and medical environment and the globalization of medicine has driven doctors to converge and analyse of new and up-to-date medical information and decide to what to make decision for diagnosis and treatments in clinical practice. Medical environment goes with the changes with social environment such as rapid increase of aging population, changes of disease pattern, formation of new area of experts except doctors, government intervention for the medical system, medical insurance of the charges of medical treatment, a increased desire for human rights. These trends should be adopted rapidly to the education system for the students of medical school. The learning objectives of the preventive medicine was developed in 1995 and underwent necessary revision of the contents to create the first revision in 2006. However, the required educational contents of health promotion and disease prevention have been changed by the new trends of medical education such as PBL and integrated curriculum and the 2006 revision does not satisfy these needs. We formed a task force which surveyed all the Western and Traditional Korean medical colleges to describe the state of preventive medicine education in Korea, analyzed the changing education demand according to the change of health environment and quantitatively measured the validity and usefulness of each learning objective in the previous curriculum. With these results, for the good education for preventive medicine, each Traditional Korean medicine schools need more preventive medicine faculties and teaching assistants and opening of some required subjects such as Yangsaeng and Qigong. And future studies of the learning process and ongoing development of teaching materials according to the new learning objectives should be undertaken with persistence in order to ensure the progress of preventive medicine education.

• 대한예방한의학회지
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• 제23권3호
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• pp.31-39
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• 2019

Objectives : The study aimed to investigate the satisfaction, reasons for the progress, and the advantages of the school doctor of Korean Medicine (SDKM) program in the applied Korean Medicine doctors. Methods : The school doctor of Korean Medicine (SDKM) program has been conducted in 21 schools in Seoul since March 2018. The program was varied by school, included the introduction of Korean Medicine, sex education, and anti-smoking/drinking session. This survey was conducted as a paper-based questionnaire after the SDKM. Results : The SDKM results evaluation was better in the Korean doctors who applied for SDKM. The factors for negative progression of SDKM were 'Bad cooperation of the schools', 'Lack of personal capabilities', and 'Lack of motivation'. The factors for the positive progression of SDKM were 'Good cooperation of the schools', 'Support of Seoul Korean Medicine Association'. The question of prerequisites for activation SDKM Program included 'Active cooperation of school', 'Expand teaching materials and programs', 'Support of Seoul Korean Medicine Association'. Conclusions : In order to activate the SDKM, it is necessary to cooperate with the schools, to support of Seoul Korean Medicine Association, and to expand the education program.