• Title/Summary/Keyword: Standardized patients

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A Research of School Refusal on Adolescent with Psychiatric Disorders (정신병리를 가진 청소년의 등교거부 사례보고)

  • Heo, Eun-Jung;Lee, Sang-Eon;Lyu, Heui-Yeong
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.4
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    • pp.219-231
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    • 2010
  • Objectives : School refusal is usually considered as individual's behavioral problem. These days. however. the adolescents' school refusal needs some kind of medical approaches because it is related to mental disorder of the adolescents. Due to too much pressure and stress from the competition between classmates and from good performance in school. the number of adolescents who refuse to go to school is increasing. Despite this circumstance. school refusal is neither regarded as a single independent disorder nor endorsed as an officially classified disease. which makes difficult to conduct research on this issue and to establish standardized treatment for it. In addition. there is a lack of research on this topic. especially in oriental medicine. so there is no a case report or study on school refusal. This study is trying to comment on school refusal from the perspective of oriental medicine. Methods : We tried to examine the effect of oriental medicine treatment for school refusal with four adolescent cases. The patients commonly have at least more than one mental disorder (including depression disorder. anxiety disorder. and anorexia nervosa). have some problem with the relationship with their family. in particular with mother. do not have father or not be loved by their father. and have irregular eating habits. Thus. we diagnosed them as qi transforming into fire (氣鬱化矢) spleen-stomach deficiency cold (脾胃虛寒) and heart blood deficiency (心血虛) due to stress from the family issues and unhealthy eating habits. The patients received supportive therapy. family therapy. etc among many oriental mental treatments and their progress had been observed through hospitalization and outpatient treatment. Results : All four cases were reported positive progress on their symptoms and started coming back to school. We also examined whether they were well fitting into the school while they received outpatient treatment. and the results show that all four patients continue to settle down in normal school life. Conclusions : This study closely reviewed the mental disorder of school refusal cases and showed that the Oriental medical treatment was effective in helping the patients come back to school. More future research is required to better treatment for school refusal cases in oriental medicine.

The Usefulnesssof Cultured Allogenic Keratinocyte for Burn Treatment (화상치료에 있어서 동종유래표피세포의 유용성)

  • Yoon, Sean Hyuck;Shim, Jeong Su;Jung, Jae Min;Park, Dae Hwan;Song, Chul Hong
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.413-418
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    • 2008
  • Purpose: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. Methods: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5 - 7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1 - 5), and degree of pain and patient satisfaction by visual analogue scale(0 - 10). Results: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were $3.29{\pm}0.529$(mean ${\pm}$ S.D.). Without the application, the mean score of epithelization were $2.86{\pm}0.655$(mean ${\pm}$ S.D.). The degree of pain was $7.71{\pm}1.419$(mean ${\pm}$ S.D.) and $2.35{\pm}0.950$(mean ${\pm}$ S.D.) before and after the application, respectively. The patients' satisfaction score was $6.45{\pm}0.850$(mean ${\pm}$ S.D.) and $8.45{\pm}0.961$(mean ${\pm}$ S.D.) before and after the application, respectively. Conclusion: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.

A Association between Physical Activity and Risk of Breast Cancer (신체활동량과 유방암 발생과의 관계)

  • Kim, Myeong-Seong;Nam, Young-Hee
    • The Journal of the Korea Contents Association
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    • v.20 no.3
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    • pp.671-677
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    • 2020
  • The number one female cancer in Korea is breast cancer, and the incidence rate continues to increase. There are many opinions that this is due to the impact of increased sedentary life along with economic growth. In this study, the international standard exercise status questionnaire was administered to patients and normal group who visited to the specialized cancer hospital in Korea, and to standardized scores of the exercise status (MET score) obtained from questionnaire were used to compare the impaction on breast cancer risk and difference of the MET score between the patients and control group. The ages of the study subjects were selected as subjects without statistical differences between the patients group and the normal group. also done with survey the family history, BMI, the menarche, age at birth of first child, the degree of education to exclude impaction on breast cancer risk depending on physical activity. In general, the breast cancer patients showed lower MET scores than the normal group, and the effect of activity on breast cancer was greater in post-menopausal women than in pre-menopausal women. Also BMI was similar to breast cancer risk. Maintaining proper weight through exercise can reduce the accumulation of carcinogens in breast cancer in the body, thereby reducing the incidence of breast cancer.

Research on plaque removal by sonic toothbrush for patients with a fixed orthodontic appliance (고정식 교정장치 부착환자에서 음파칫솔의 치면세균막 제거 효과에 관한 연구)

  • Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.34 no.2 s.103
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    • pp.189-195
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    • 2004
  • The purpose of this research is to evaluate and compare the plaque removal ability of sonic brushing and manual brushing in order to present a method for continuous and effective oral hygiene control during orthodontic treatment. Nonextracted adolescent patients (male: 23 persons, female: 37 persons) and adult patients (male: 15 persons, female: 45 persons) outfitted with a fixed orthodontic appliance from their incisors to second molar, in both the maxilla and mandible, were divided into manual brushing and sonic brushing groups. A Philips oral healthcare HX-4401 sonic toothbrush was used, and the application of brushing for the two groups was standardized at two minutes. After brushing, the plaque score was measured with a modified Wilkin's PHP. The following results were achieved after comparing each group's plaque score. 1. In patients with a fixed orthodontic appliance when age was not accounted for, the application of sonic brushing exerted a beneficially decreased effect on the plaque score. (adolescents : p<0.01, adults: p<0.05) 2. When comparing the adolescent and adult groups in regard to plaque score, the adolescent group showed a more decreased effect. 3. When using the same toothbrush type, there was no difference between the adolescent and adult groups.

The effect of Chiljehyangbuhwan on the abdomial & palmar temperature in the primary dysmenorrhea patients (칠제향부환(七製香附丸)이 원발성(原發性) 월경통(月經痛) 환자(患者)의 복부(腹部) 및 수장부(手掌部) 온도(手掌部 溫度)에 미치는 영향(影響))

  • Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Yoon, Young-Jin
    • Journal of Oriental Medical Thermology
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    • v.5 no.1
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    • pp.46-58
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    • 2006
  • Purpose: We intended to observe the relations between Chiljehyangbuhwan and abdominal & palmar temperature according to primary dysmenorrhea severity. Methods: We selected the 100 primary dysmenorrhea patients by the screening tests (first screening test-inquiry, second screening test-clinical test. additionally WHR (Waist-to-Hip ratio) by Inbody 2.0). By the fixed blocked randomization and double blind method, Chiljehyangbuhwan or placebo was administered for 1 menstration period. Finally, 69 patients remainded. Before and after administration, we measured 4 points abdominal temperature (Chon-jung (CV17), Chung-wan(CV12), Kwan-won(CV4). Chung-guk(CV3)) by DITI(DOREX Inc., USA). And then we checked the difference of temperature $({\Delta}T)$ between CV17 and CV12/CV17 and CV4/CV17 and CV3/CV12 and CV4/CV12 and CV3. Also, we measured 2 points (palmar region, upper front of forearm) for the difference of palmar temperature $({\Delta}T)$. Then, we checked palmar temperature minus upper front of forearm temperature and took an average of right and left ${\Delta}T.$ After that. we compared ${\Delta}T$ with primary dysmenorrhea severity evaluated by VRS (verbal rating scale) and MVRS (multidimensional verbal rating scale). In dysmenorrhea severity. we standardized scale score and 3-group-severity by score (mild, moderate. severe). Besides, we compared palmar ${\Delta}T$ with abdominal ${\Delta}T$. For statistics, we used ANOVA and Spearman's rho correlations. SPSS 13.0 for windows. Results: In case of MVRS, though Chiljehyangbuhwan was correlated to abdominal ${\Delta}T$(CV12 and CV3/CV12 and CV4). it was not correlated to palmar ${\Delta}T$. In case of VRS, though Chiljehyangbuhwan was not correlated to abdominal ${\Delta}T$. it was correlated to palmar ${\Delta}T$. However. palmar ${\Delta}T$ was not correlated to abdominal ${\Delta}T$. Statistically they showed significant result (p<0.05). Conclusion: The primary dysmenorrhea patients showed that severity by MVRS was connected with abdominal ${\Delta}T$ (CV12 and CV3/CV12 and CV4) and severity by VRS was connected with palmar ${\Delta}T$ after Chiljehyangbuhwan administration. So we can consider Chiljehyangbuhwan partially effects the abdominal & palmar temperature according primary dysmenorrhea severity. However, palmar temperature was not correlated to abdominal temperature. Therefore, we need further study.

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The Hypoglycemic Effect of Supungsunkihwan on Impaired Glucose Tolerance & Mild NIDDM Patiens (수풍순기환(搜風順氣丸)이 내당능장애 환자와 경증 당뇨병환자의 혈당조절에 미치는 영향)

  • Kwon, Young-Gu;Choi, Ki-Lim;Lee, Jin-Sin;Ahn, Young-Min;Ahn, Se-Young;Doo, Ho-Kyung;Lee, Byung-Cheol
    • The Journal of Internal Korean Medicine
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    • v.22 no.3
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    • pp.285-290
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    • 2001
  • Purpose : Impaired glucose tolerance (IGT) was standardized in 1979 by the National Diabetes Data Group and the World Health Organization as a risk factor for type 2 diabetes, replacing groups such as 'borderline' and 'chemical' diabetes. The main clinical significance of IGT is as a risk factor for type 2 diabetes and as a risk factor for cardiovascular disease and as a component of the metabolic syndrome. In 1997 the American Diabetes Association(ADA) was proposed the new classification and diagnostic criteria for diabetes, which is strict with the diagnostic baseline of Diabetes from 140mg/dl to 126mg/dl. And it's main purpose is to prevent chronic complications by early diagnosis and treatments. In the oriental medicine, Supungsunkihwan has been used in treatments of Diabetes including IGT & NIDDM, however there is not enough studies about the its objective hypoglycemic effect. so in order to investigate whether there is hypoglycemic effect of Supungsunkihwan, clinical studies were performed with IGT and mild NIDDM patients. Methods : Prior to the study, fasting blood sugar(FBS) and postprandial 2hrs(PP2hrs) glucose were checked. In addition, ECG, cholesterol, TG, HbA1c levels were measured, and the dinical characteristics of patients that can be influence to the blood sugar level such as age, gender, rest type, diet type were surveyed. Supungsukihwan was administered for 7 days, and FBS & PP2hrs were measured again after the therapy. Result : PP2hrs glucose levels were decreased by the administration of Supungsunkihwan. And It's hypoglycemic effects has the correlation with age. That is, the more age increase, the more hypoglycemic effect decrease. Conclusion : Supungsukihwan has hypoglycmic effects on IGT & mild NIDDM patients and it is more effective when administrated to young patients relatively.

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A Study on the Clinical Effects of Group Therapy for Panic Disorder Patients Based on Mindfulness & Li-Gyeung-Byun-Qi Therapy (마음챙김 명상과 이정변기요법을 이용한 공황장애 그룹치료 효과에 대한 임상적 고찰)

  • Lee, Seong-Yong;Lyu, So-Jung;Choi, Sung-Youl;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.25 no.4
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    • pp.319-332
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    • 2014
  • Objectives: This study was conducted to evaluate the clinical effects of group therapy for Panic disorder patients based on Mindfulness & Li-Gyeung-Byun-Qi therapy. Methods: The FFMQ, BDI, STAI, STAXI, Panic attack, Anticipatory anxiety and subjective improvement of three Panic disorder patients were compared pre- and post-treatment when given Mindfulness & Li-Gyeung-Byun-Qi therapy. Results: 1) After the patient in case 1 underwent 5 weeks of group therapy for Panic disorder, the Mindfulness meditation score was slightly improved, anxiety and depression were significantly decreased, and expression of anger was also improved. In addition, the Panic attack and Anticipatory anxiety became more stable in the objective evaluation, while 'Extreme improvement' was shown in the subjective evaluation. 2) After the patients in case 2 and 3 underwent 5 weeks of group therapy for Panic disorder, Mindfulness meditation scores were slightly improved, anxiety and depression were significantly decreased, and expression of anger was also improved. In addition, the Panic attack and Anticipatory anxiety became more stable in the objective evaluation, while 'Moderate improvements' were shown in the subjective evaluation. Conclusions: As per the results in these cases, it was shown that group therapy for Panic disorder utilizing Mindfulness & Li-Gyeung-Byun-Qi therapy was effective to maintain meditation and control the emotions of anxiety, depression, anger and so on. Therefore, it was considered that expansion of clinical utilization through the standardization of a group therapy program for Panic disorder is needed. Furthermore, it was also considered that a comparative study of the effects of previous cognitive programs for Panic disorder according to the objectified and standardized manual is needed in the future.

Causative Substance and Time of Mortality Presented to Emergency Department Following Acute Poisoning: 2014-2018 National Emergency Department Information System (NEDIS) (급성 중독으로 응급실에 내원하여 사망한 환자의 원인물질 및 시간 분포)

  • Lee, Hyeonjae;Choa, Minhong;Han, Eunah;Ko, Dong Ryul;Ko, Jaiwoog;Kong, Taeyoung;Cho, Junho;Chung, Sung Phil
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.2
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    • pp.65-71
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    • 2021
  • Purpose: The purpose of this study was to investigate the cause of acute fatal poisoning and the time of death by analyzing the National Emergency Department Information System (NEDIS) of South Korea. Methods: The NEDIS data from 2014 to 2018 excluding non-medical visits were used for this study. The patients with acute poisoning were extracted using diagnostic codes. The toxic substances were classified into pharmaceuticals, pesticides, gases, artificial poisonous substances, and natural toxic substances. Patients were classified according to the time of death, place of death, and region. In each case, the most causative substances of poisoning were identified. Results: There were 380,531 patients including poisoning-related diagnoses, of which 4,148 (1.1%) died, and the WHO age-standardized mortality rate was 4.8 per 100,000. Analysis of 2,702 death patients whose primary diagnosis was acute poisoning, the most common cause of poisoning death was pesticides (62%), followed by therapeutic drugs, gas, and artificial toxic substances. Herbicides were the most common pesticides at 64.5%. The proportion of mortality by time, hyperacute (<6 h) 27.9%, acute (6-24 h) 32.6%, subacute (1-7 d) 29.7%, and delayed period (>7 d) were 9.8%. Conclusion: This study suggests that the most common cause of poisoning death was pesticides, and 60% of deaths occurred within 24 hours. The 71% of mortality from pesticides occurred within 6-24 hours, but mortality from gas was mostly within 6 hours. According to the geographic region, the primary cause of poisoning death was varied to pesticides or pharmaceuticals.

Validity and reliability of the Korean version of the Quality of Recovery-40 questionnaire

  • Lee, Jun Ho;Kim, Deokkyu;Seo, Donghak;Son, Ji-seon;Kim, Dong-Chan
    • Korean Journal of Anesthesiology
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    • v.71 no.6
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    • pp.467-475
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    • 2018
  • Background: The Quality of Recovery-40 (QoR-40) is a widely-used, self-rated, and self-completed questionnaire for postoperative patients. The questionnaire is intended to elicit information from each patient regarding the quality of recovery during the postoperative period. It is noteworthy, however, that an official Korean version of the QoR-40 (QoR-40K) has not been established. The purpose of this study was to develop the QoR-40K by translation and cultural adaptation process and to evaluate the validity and reliability of the QoR-40K. Methods: After pre-authorization from the original author of the QoR-40, the translation procedure was established and carried out based upon Beaton's recommendation to create a QoR-40K model comparable to the original English QoR-40. Two hundred surgical patients were enrolled, and each completed the questionnaire during the preoperative period, on the third day, and 1 month after surgery. The QoR-40K was compared with the visual analogue scale (VAS) and another health-related questionnaire, the Short-form Health Survery-36 (SF-36). The method of validation for QoR-40K included test-retest reliability, internal consistency, and level of responsiveness. Results: Spearman's correlation coefficient for test-retest reliability was 0.895 (P < 0.001), and Cronbach's alpha of the global QoR-40K on the third day after surgery was 0.956. A positive correlation was obtained between the QoR-40K and the mental component summary of SF-36 (${\rho}=0.474$, P < 0.001), and a negative correlation was observed between QoR-40K and VAS (${\rho}=-0.341$, P < 0.001). The standardized responsive mean of the total QoR-40K was 0.71. Conclusions: The QoR-40K was found to be as acceptable and reliable as the original English QoR-40 for Korean patients after surgery, despite the apparent differences in the respective patients' cultural backgrounds.

A Case of Multiple System Atrophy with Antecollis and Gait Disturbance Treated with Korean Medicine (경전굴 및 보행장애를 주소로 하는 다계통 위축증 환자의 한의 치료 증례 1례)

  • Kim, Seo-young;Choi, Jeong-woo;Jeong, Hye-seon;Lee, Sang-hwa;Yang, Seung-bo;Cho, Seung-yeon;Park, Jung-mi;Ko, Chang-nam;Park, Seong-uk
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.851-864
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    • 2019
  • Multiple system atrophy is a neurodegenerative disease that causes diverse bodily dysfunctions (cerebellar, pyramidal, automatic, and urological, in any combination), as well as Parkinsonism. Patients with multiple system atrophy commonly display antecollis, a condition where the patient's head tilts forward more than 45 degrees. Despite its common occurrence in these patients, no current standardized therapies are effective for treating antecollis. In this study, Korean medicinal treatments, including Chuna manual therapy, pharmaco-acupuncture, bee venom acupuncture, acupuncture, herbal medicine, and moxibustion therapy, were administered to the patient over a 27-day period. After the treatment, assessments of the head position on the EPIS-PD scale (Part I) and at a standing position from the side (Part II) both revealed improvements. As the head flexion angle decreased, the patient's head posture improved, as determined by a decrease in angle from 80 degrees to 30 degrees in the upright, standing position. As a result, patients who previously were unable to walk without the support of walking frames could now roam freely and independently, with significant increases in both walking speed and distance. In essence, this study suggests that Korean medicine is an effective treatment for patients with multiple system atrophy who suffer from antecollis and gait disorders.