• 한국콘텐츠학회논문지
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• 제17권11호
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• pp.435-445
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• 2017

본 연구는 단순 의료이용의 차이를 확인하거나 제한적인 의료필요와 의료이용지표를 활용하여 의료이용의 형평성을 연구한 선행연구의 한계를 극복하기 위하여 수행되었다. 구체적으로 의료필요지표로 활동제한여부, 만성질환이환여부와 수, 주관적 건강상태를 활용하였고 의료이용지표로 외래와 입원, 응급이용횟수와 진료비를 활용하였다. 아울러 의료필요를 고려한 의료이용의 형평성을 분석하기 위하여 집중지수와 집중곡선, Le Grand계수를 활용하였다. 주요 분석결과, 첫째 단순한 의료이용 집중정도로 볼 때 저소득층의 의료이용량이 고소득층에 비해서 많은 것이다. 특히, 저소득층 입원이용이 외래나 응급이용에 비해서 크게 많았다. 둘째, 저소득층에게 의료필요가 집중된 것으로 나타났다. 즉, 저소득층의 건강상태가 좋지 않은 것이다. 셋째, 의료필요를 고려한 의료이용의 형평성을 확인하기 위하여 Le Grand계수를 산출하였다. 의료필요를 고려하더라도 고소득층의 의료이용량이 많았다. 즉, 단순한 양적인 의료이용은 저소득층의 이용이 많았지만, 의료필요를 고려한 의료이용횟수는 고소득층이 많은 것이다. 또한, 전체진료비는 활동제한여부와 만성질환수를 고려했을 때는 고소득층의 의료이용이 많았으며 주관적 건강상태와 만성질환이환여부를 고려하였을 때는 저소득층의 의료이용이 많았다. 따라서 대체로 저소득층이 건강상태에 비해 의료이용을 충분히 하지 못하는 것을 알 수 있었다. 한편, 저소득층의 주관적 건강상태와 만성질환이환여부 관련 의료필요에 비해 의료비지출이 많았는데 이는 저소득층이 스스로의 건강상태와 만성질환이환에 대한 인식을 소극적으로 함으로써 의료필요가 과소평가된 것이 원인으로 사료된다.

• 대한한방내과학회지
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• 제29권4호
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• pp.913-921
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• 2008

Objective : To report the effects of Chengsimyeonjatang-gamibang on tremors. Methods : Seven patients with tremors who visited the Department of Internal Medicine of Sangji Oriental Medical Center were diagnosed as Taeumin by consultation with the Dept. of Sasang Constitutional Medicine. Thus, an oriental medical therapy of Chengsimyeonjatang-gamibang, acupuncture, and moxibustion was carried out. We evaluated symptom progress of seven patients by using several questionnaires such as Unified Parkinson's Disease Rating ScaleIII (UPDRSIII), and Schwab & England activity of daily living (S&E ADL). Results : The scores of UPDRSIII were significantly improved after treatment (p<0.05). The scores of ADL were significantly improved after treatment (p<0.05). Conclusion : This study suggests that Chengsimyeonjatang-gamibang is probably effective in the treatment of tremors.

• 동의신경정신과학회지
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• 제18권3호
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• pp.15-21
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• 2007

This study was done to review problems in terms of statistical description and statistical application and analysis. Methods; The authors reviewed 42 statistical clinical study papers excluding 12 Overview papers, 75 Descriptive papers, 48 Animal studies out of 177 papers in the Journal of Oriental Neuropsychiatry in the 5 years from 2002 to 2006. Results : 1) 3 papers(7.1%) had no description of statistical method, only P-values, 25 papaers(59.5%) had tables without description of statistical method, 1 paper (2.3%) had no description of statistical method in study method. 2) 10 papers(23.8%) contained problems in terms of statistical application and analysis. 6papers (6/23, 26.0%) for Student t-test, 2 papers(2/7 28.6%)for $X^2$- test, 1 paper(1/15 6.7%) for the analysis of variance, 1 paper(1/6 16.7%) for Pearson correlation contained statistical problems. Conclusion : It was suggested that consultation of investigators with statisticians and more extensive statistical refereeing, the form of the guidelines for description and application of statistics are needed.

• 한방비만학회지
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• 제9권1호
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• pp.37-44
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• 2009

The study was to investigate the distribution for the diagnosis of pattern identification questionnaire and agreement rate between diagnosis of pattern identification based on obesity pattern identification questionnaire and the clinical diagnosis of pattern' identification by medical specialist. The distribution for the diagnosis of pattern identification based on obesity pattern identification questionnaire was shown in order of stagnation of liver Gi, retention of undigested food, deficiency of Yang at scale of 5, 3, 2 score and the diagnosis rate of single pattern identification at scale of 5, 3, 2 score was 89.96%, 79.33%, 54.64%, respectively the agreement rate between the diagnosis of pattern identification based on obesity pattern identification questionnaire and the clinical diagnosis of pattern identification by medical specialist was 0.1013. Therefore, the complementary management in CRF questionnaires with consultation from experts and the study for score difference of pattern identification will improve the accuracy and agreement rate, which will will be helpful for pattern identification of obesity by clinical experts.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권1호
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• pp.38-43
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• 2011

Chronic tic disorder or Tourette syndrome is known to be a chronic neuro-behavioral disease for which cognitive behavioral therapy (CBT) strategies have recently been introduced. Here, we report the effectiveness of CBT in a case of childhood chronic tic disorder, which is very common in clinical settings. The DSM-IV clinical diagnosis was applied by a child psychiatrist. The Yale Global Tic Severity Scale, Kovac's children's depression inventory, Spielberger State-Trait Anxiety Inventory, Abbreviated Conners' Rating Scales, and the Dupaul ADHD Rating Scales were used. This case involved a pharmacological treatment-refractory patient over the previous year. Thus, psychiatric consultation was undertaken. Subsequently, we administered five sessions of CBT for four weeks, consisting of symptom evaluation and planning, habit reversal training, and ventilation training. Following four weeks of CBT administration, there were improvements in the scores of the Yale Global Tic Severity Scale and the Clinical Global Improvement scale. Our observations indicate that CBT may be effective in the treatment of childhood tic disorder.

• 지역사회간호학회지
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• 제25권3호
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• pp.170-179
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• 2014

Purpose: This study investigated medication status by examining the effects of a medication management education program on the knowledge of medications and medication misuse behaviors in the elderly in a local community. Methods: This study used a non-equivalent control group quasi-experimental design. For the study, 116 subjects were assigned to the control group and another 116 subjects were assigned to the experimental group. The medication management education program consisted of 1:1 education, practice in medication management, consultation, and discussion. Data were analyzed using the SPSS 21.0 program. Results: Statistically significant differences were found between the experimental and control groups in terms of their knowledge of medications and medication misuse behaviors. Conclusion: The results indicate that the medical management education program is effective in improving the knowledge of medications and decreasing medication misuse behaviors. Therefore, this education program can be used as an intervention to improve the medication behaviors of the elderly in local communities.

• 대한방사선기술학회지:방사선기술과학
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• 제20권1호
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• pp.43-49
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• 1997

Purpose of this paper is to extend help for clinical application in balloon cholangiography on patients who have undergone endoscopic sphincterotomy, impacted stones of intrahepatic duct, and missed bile duct because of other diseases in operating endoscopic retrograde cholangiopancreatography. This study was done for the patients who had clinical signs of biliary diseases from January to December In 1996. We studied 45 patients who had endoscopic sphincterotomy, re-examination after interventional treatment of the endoscopic retrograde cholangiopancreatography, and uncertain diagnosis due to common bile duct and intrahepatic duct those are not filled with contrast media. Balloon cholangiography was performed in case of uncertain diagnosis while operating endoscopic retrograde cholangiopancreatography. First of all, we insert balloon catheter Into the working channel of treatment jejunofiberscope and remove treatment Jejunofiberscope after ballooning, and lastly take biliary tract X-ray after Injection and changing position of patient. The results of this study were as follows. (1) In classification of diseases, stones of gall bladder, those of common bile duct, and those of intrahepatic duct were 30 cases, fistula was 1 case. (2) In total cases of 45, only diagnosis were 25 cases, interventional treatment were 20 cases. (3) In case of interventional treatment, endoscopic sphincterotomy and endoscopic nasobiliary drainage, and stone removal were about the same, 7, 7, 6 respectively. Balloon cholangiography will be useful to prevent patients from having repeated and unnecessary studies for the cases above explained. It is considered that this study will be useful for clinical application in terms of reducing medical expenses, pain while examination, and consultation hours.

• 정신신체의학
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• 제16권2호
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• pp.75-80
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• 2008

섬망은 일반 의학 상태와는 독립적으로 입원 기간 및 사망율을 증가시켜 환자의 전반적 예후에 부정적인 영향을 미친다. 다양한 내, 외과적 치료 환경에서 보고된 섬망의 발생 빈도는 15~70%로 알려졌으며, 정신신체 의학적 중재가 요구되는 흔한 정신과 의뢰 사유 중 하나이다. 섬망의 치료는 1) 위험 인자와 촉발 요인의 확인, 2) 지남력 회복 및 기능 유지를 위한 적절한 치료 환경의 구성과 환자 가족 및 치료진에 대한 교육을 제공하는 비약물적 중재, 그리고 3) 심한 초조, 환각, 그리고 행동 상의 문제 등을 조절하기 위한 약물학적 중재로 구분될 수 있다. 본고를 통해, 섬망에 대한 정신신체의학적 중재의 전반에 대해 기술하고 실제 임상에서 섬망치료 시에 흔히 접하게 되는 문제에 대해서도 논의하고자 한다.

• 한국멀티미디어학회논문지
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• 제16권3호
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• pp.290-301
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• 2013

의료 치료를 지원하는 병원 전산망에서 PACS 데이터의 효과적인 전송이 요구된다. 그러나 한정된 전산망과 PACS 데이터의 크기 증가에 따라 진료 시간에 네트워크 과부하가 자주 발생되며, 이는 진료를 방해하는 주요 요소가 된다. 네트워크 트래픽 문제는 적응적인 QoS에 의하여 해결될 수 있다. 본 논문에서는 병원 전산망 상에서 멀티미디어 PACS 데이터를 효과적으로 전송하기 위한 QoS 아키텍쳐 기반의 미들웨어를 설계한다. 가상 시뮬레이션을 통하여 제안한 QoS 기반 미들웨어가 기존의 병원 네트워크에 비하여 음성, 영상 우선순위 데이터의 QoS를 보장할 수 있음을 확인하였다.

• 대한치과마취과학회지
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• 제11권1호
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• pp.45-50
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• 2011

Bell's palsy is an isolated facial paralysis of sudden onset caused by a neuritis of the seventh nerve within the facial canal. It occurs often in the adult man with a history of recent exposure to local cold, such as sleeping next to an open window, or in some cases it occurs after infections of the nasopharynx or masticator spaces. Especially, this neuropathy have linked with the major collagen disorders (diabetes mellitus). A segmental demyelination develops rapidly, with vascultitis in microinfarcts and ischemia to the nerve segment. The authors experienced about the bizarre neurological symptom of Bell's palsy after inferior alveolar nerve block anesthesia and TMJ dislocation in diabetic mellitus. The early and correct consultation with the multiple medical and dental departments was important to prevent the inadequate care & medicolegal problems.