• 대한한의학방제학회지
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• 제22권2호
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• pp.1-13
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• 2014

Objectives : ShangHanLun is a clinical guideline, and its core is in the part of Six-meridian Diseases. In recent philological sutdies, independent textual analysis of Shanghanlun is essential to define the scope of research. Methods : By the textual study, I defined the Shanghanlun clinic model. And I researched about medical range of Shanghanlun, and relations between Shanghanlun and JinGuiYaoLue, and between Shanghanlun and Huangdineijing. Results : In six topic sentences, the word '-之爲' means 'a process'. In provisions following topic sentences, the word '者' means 'a person'. So Shanghanlun is describing processing factors of Six-meridian Diseases and related human changes with clinical therapy. In the philological studies, meaning of '傷寒' was possibly just the 3rd provision of the greater yang disease part. Practically Shanghanlun's study range is over the concept of Cold damage today. Additionally Jinguiyaolue deals diseases, but Shanghanlun deals human. Gangpyeong-Shanghanlun's phrases can be separated into five part, and oldest part is independent of Huangdineijing. Conclusions : So we need to set a new and independent clinic model of Shanghanlun to verify it. The Shanghanlun's clinic model has a 3 steps. 1st step is to find 6 type defined symptoms, which act as processing factors of Six-meridian Diseases. 2nd step is to confirm a human changes after a Disease appeared. 3rd step is to treat a patient as a provision suggests. Philologically Shanghanlun's clinic range is not limited by the word '傷寒'. And many concepts in Shanghanlun should be independent of Huangdineijing.

• Tuberculosis and Respiratory Diseases
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• 제56권4호
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• pp.356-363
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• 2004

2002년도 제주도내 폐결핵 발생자로 등록된 262명에 대한 조사를 실시한 결과 보건소의 관리실태와 비교해 볼 때, 의원급의 진단 및 추구검사 시행이 제대로 되지 않고 있는 것을 확인하였다. 이런 상황에서 의원 및 병원의 치료 성공률은 각각 38.5%, 63.3%로, 이를 합친 민간의료기관에서의 치료 성공률은 59.8%로 조사되어 보건소의 치료 성공률 80%에 비하여 낮은 수준을 보였다. 민간의료기관에서 치료 실패의 주 원인은 임의의 치료중단 이라는 점에서, 현재 국가결핵관리사업의 이원화된 체계 하에서 민간의료기관에 대한 시급한 시스템보완이 필요하다.

• 여성건강간호학회지
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• 제10권1호
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• pp.32-41
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• 2004

Purpose: The purpose of this study was to explore and describe the process of life adaptation in women with cervical cancer. Method: A grounded theory method with guided data collection and analysis was used. Fifteen women with cervical cancer who had some kind of treatment at the hospital were asked open-ended and descriptive questions with a guideline. All interviews were tape-recorded and transcribed verbatim. Result: The core category that emerged from the comparative analysis was "overcoming cancer" named as a process of life adaptation in the participants. The process of overcoming cancer evolved three stages - "admitting reality", "attempting health-care" and "continuing health-care". Depending on the paradigm model, the central phenomena of the experiences was "powerlessness". The internal factors motivating women to overcome cancer were "denial of cancer" and "desire for life". Strategies of overcoming cancer included "living as a cancer patient," "selective food eating," "steady exercising," "getting rid of stress," and "preparing for death". The intervening conditions, "supportive system," "forms of life," and "burden on family," influenced overcoming cancer. Conclusion: The results of this study could help clinical nurses to understand life adaptation in cervical cancer patients and establish efficient coping strategies in dealing with the problems they face.

• Investigative Magnetic Resonance Imaging
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• 제23권4호
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• pp.316-327
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• 2019

Cardiovascular magnetic resonance imaging (CMR) is expected to be increasingly used in Korea due to technology advances and the expanded national insurance coverage of these tests. For improved patient care, it is crucial not only that CMR images are properly acquired but that they are accurately interpreted by well-trained personnel. In response to the increased demand for CMR, the Korean Society of Cardiovascular Imaging (KOSCI) has issued interpretation guidelines in conjunction with the Korean Society of Radiology (KSR). KOSCI has also created a formal Committee on CMR Guidelines to write updated practices. The members of this Committee review previously published interpretation guidelines and discuss the patterns of CMR use in Korea.

• 대한치과교정학회지
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• 제47권3호
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• pp.195-206
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• 2017

Facial asymmetry can be classified into the rolling-dominant type (R-type), translation-dominant type (T-type), yawing-dominant type (Y-type), and atypical type (A-type) based on the distorted skeletal components that cause canting, translation, and yawing of the maxilla and/or mandible. Each facial asymmetry type represents dentoalveolar compensations in three dimensions that correspond to the main skeletal discrepancies. To obtain sufficient surgical correction, it is necessary to analyze the main skeletal discrepancies contributing to the facial asymmetry and then the skeletal-dental relationships in the maxilla and mandible separately. Particularly in cases of facial asymmetry accompanied by mandibular yawing, it is not simple to establish pre-surgical goals of tooth movement since chin deviation and posterior gonial prominence can be either aggravated or compromised according to the direction of mandibular yawing. Thus, strategic dentoalveolar decompensations targeting the real basal skeletal discrepancies should be performed during presurgical orthodontic treatment to allow for sufficient skeletal correction with stability. In this report, we document targeted decompensation of two asymmetry patients focusing on more complicated yaw-dependent types than others: Y-type and A-type. This may suggest a clinical guideline on the targeted decompensation in patient with different types of facial asymmetries.

• 약학회지
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• 제57권2호
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• pp.101-109
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• 2013

Depressive disorders are the most common psychiatric problem in the elderly. Most depression treatment guidelines emphasize treatment with antidepressant medication and recommend that benzodiazepine use be minimized for limited period, particularly to elderly patients. In order to evaluate appropriate use of antidepressants and benzodiazepine, retrospective review of prescriptions was performed. The study population are older than 65 years who had been newly diagnosed with major depressive disorder in specialty mental health at a community general hospital from January $1^{st}$, 2007 to October $31^{th}$, 2012 (N=373). Initial antidepressant accounted for 89.5% with SSRI, and escitalopram accounted for 60.9% of SSRI group. 79% or more of the patients were prescribed the recommended dosage. The maintenance rate for 4 weeks of initial antidepressant was 48% and 6 weeks was 39%. Treatment-discontinuation rate was 68% at 3 month. Alprazolam (short acting benzodiazepine) was prescribed the most, followed by clonazepam (long acting benzodiazepine) and then diazepam. 55% of patients received a duplicated prescription for short acting plus long acting benzodiazepine. 61% of patients used long acting benzodiazepines. Prescribed dosages of benzodiazepines were commonly within a recommended range, while no one was prescribed a appropriate period (up to 2 weeks) except for the early discontinued patients. Appropriate use of zolpidem was only 16.2%. The depressed elderly treated in specialty mental health mostly received long-term treatment with benzodiazepines in combination with antidepressants, guideline recommendations was not followed. Multidisciplinary interventions like audit and feedback of benzodiazepine use are needed and education for the elderly is needed to properly maintain antidepressant treatment.

• Safety and Health at Work
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• 제7권1호
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• pp.18-31
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• 2016

Background: A job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps should be taken to determine the content of a job-specific WHS for hospital physicians and outlines that content. Methods: Based on four questions, decision trees were developed for physical and psychological job demands and for biological, chemical, and physical exposures to decide whether or not to include work-related health effects related to occupational exposures or aspects of health reflecting insufficient job requirements. Information was gathered locally through self-reporting and systematic observations at the workplace and from evidence in international publications. Results: Information from the decision trees on the prevalence and impact of the health- or work-functioning effect led to inclusion of occupational exposures (e.g., biological agents, emotionally demanding situations), job requirements (e.g., sufficient vision, judging ability), or health effects (e.g., depressive symptoms, neck complaints). Additionally, following the Dutch guideline for occupational physicians and based on specific job demands, screening for cardiovascular diseases, work ability, drug use, and alcohol consumption was included. Targeted interventions were selected when a health or work functioning problem existed and were chosen based on evidence for effectiveness. Conclusion: The process of developing a job-specific WHS for hospital physicians was described and the content presented, which might serve as an example for other jobs. Before implementation, it must first be tested for feasibility and acceptability.

• Journal of Chest Surgery
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• 제40권9호
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• pp.629-632
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• 2007

심근교는 증상과 관련없이 우연히 발견되는 경우가 대부분이지만 드물게 협심증, 심근 경색, 심실성부정맥 등의 증상을 유발한다. 증상이 있는 심근교 환자에서 약물치료가 효과적이지 않을 경우 스텐트 삽입술, 동맥상부 심근 절개술 혹은 관상동맥우회술 등을 시행하고 있으나 명확한 치료지침은 없는 상태이다. 저자들이 경험한 심근교에 대한 수술 증례 2예를 문헌고찰과 함께 보고하는 바이다.

• 대한치과교정학회지
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• 제49권6호
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• pp.413-426
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• 2019

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

• 대한한방내과학회지
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• 제42권4호
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• pp.532-546
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• 2021

Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS. Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires. Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed. Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.