• 제목/요약/키워드: clinical practice pattern

검색결과 159건 처리시간 0.02초

청소년들의 약물남용 실태와 예방대책(1992) (Drug abuse among adolescence and puevention(1992))

  • 주왕기;서정혜;주진형;김형준
    • 한국임상약학회지
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    • 제3권1호
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    • pp.89-104
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    • 1993
  • The use of drug or substance for altering consciousness among adolescence is a practice in modern society, especially in Korea. The choice and pattern of use are strongly influenced by the user6s personality and expectations. The goverment and society institute must be declared the emergency of Drug abuse, for the purpose of protecting adolescence from pscychotropic agents.

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조기 위암의 진단에 있어서 확대 내시경을 동반한 협대역 내시경의 역할 (Clinical Role of Magnifying Endoscopy with Narrow-band Imaging in the Diagnosis of Early Gastric Cancer)

  • 최수인
    • Journal of Digestive Cancer Research
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    • 제10권2호
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    • pp.56-64
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    • 2022
  • Narrow-band imaging (NBI) is the most widely used image-enhanced endoscopic technique. The superficial microanatomy of gastric mucosa can be visualized when used with a magnifying endoscopy with narrow-band imaging (ME-NBI). The diagnostic criteria for early gastric cancer (EGC), using the classification system for microvascular and microsurface pattern of ME-NBI, have been developed, and their usefulness has been proven in the differential diagnosis of small depressed cancer from focal gastritis and in lateral extent delineation of EGC. Some studies reported on the prediction of histologic differentiation and invasion depth of gastric cancer using ME-NBI; however, its application is limited in clinical practice, and further well-designed studies are necessary. Clinicians should understand the ME-NBI classification system and acquire appropriate diagnostic skills through various experiences and training to improve the quality of endoscopy for EGC diagnosis.

음양변증(陰陽辨證)의 정의와 기능 및 판별방법 연구 (Definition, Role and Method of Yinyang Pattern Differentiation)

  • 지규용;박신형
    • 동의생리병리학회지
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    • 제35권2호
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    • pp.47-55
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    • 2021
  • In order to ensure the fact that eight principle pattern differentiation is used clinically as a basic guideline for Korean medicine practice, the definition, role and method of yin-yang pattern differentiation with its case report were explored at first. Yinyang Pattern Differentiation is a method of discriminating human tendencies or morbidity based on the yin and yang characteristics expressed in living bodies. And yin and yang are the two contrasting characteristics and aspects of the interaction when certain physical conditions that have a lasting effect on the human physiological metabolic function are correlated with the morbidity. Specific methods of yinyang pattern differentiation can be divided into several types of yin and yang indicators. First, time and space factors like day and night, hot and cold seasons, above and below, topographical districts. Second, colors and pulse and their/or relative clearness and muddiness, hardness and softness, moving and resting. Third, diagnose yin and yang patterns through distinguishing the true and false of a fever and cold in an emergency phase such as increase of brain pressure and shock state. Fourth, general characteristics of the propensity and constitution of a subject such as body type, speech, behavior, and physiological metabolism. And for clinical use, these were summarized again as a symptom indicators of physical signs and color, pulse, tongue and questionnaire indicators of propensity, body type, and space-time characteristics. Conclusively, it was confirmed that yinyang pattern differentiation has its own diagnostic significance which is distinct from exterior-interior, cold-heat and deficiency-excess pattern differentiation.

의문보감(醫門寶鑑), 제중신편(濟衆新編), 방약합편(方藥合編)에 나타난 동의보감(東醫寶鑑)의 부인과(婦人科) 관련 처방(處方)과 조문(條文)에 관한 연구(硏究) (Study on the Theory and Prescriptions in Gynecology of "Dongeuibogam" Presented in "Euimunbogam", "Jaejungshinpyeon" and "Bangyakhabpyeon")

  • 전영주;김동일
    • 대한한방부인과학회지
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    • 제21권3호
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    • pp.179-199
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    • 2008
  • Purpose: To clarify the influence of "Dongeuibogam" on three important medical books "Euimunbogam", "Jaejungshinpyeon" and "Bangyakhabpyeon", in Chosun Dynasty. Methods: To examine and compare the three medical books, with "Uterus" and "Gynecology" part in "Dongeuibogam" to investigate effects of theories and prescriptions of "Dongeuibogam" upon gynecology. Results: Firstly, "Dongeuibogam" positively and practically reestablished the medical books existing at that time and made the high use of them in practice. Secondly, the three medical books mostly follows the formation of "Pomun" and "Buinmum" in "Dongeuibogam". thirdly, the three medical books inclusively accepted the theory and prescriptions of "Dongeuibogam" and made use of them actively in practice. Furthermore they developed other points of view in 'disease pattern identification and treatment'(辨證施治). Conclusion: "Dongeuibogam" had great influence upon gynecology in the medical books at the latter term of Chosun dynasty. "Dongeuibogam" also have had huge influence upon the clinical practice in gynecology until now by making the foundation of gynecology in traditional Korean medicine.

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일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로- (The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research)

  • 박종구;강명근;이성수;김달래;최서영;한창호;유준상;김민기;김춘배
    • 대한한방내과학회지
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    • 제22권4호
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    • pp.691-702
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    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

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의료기관 종류별 진료내역 비교 -정상분만과 급성 충수염을 중심으로- (A Comparison of Medical Care Services by Type of Medical Care Facility -In cases of normal spontaneous vaginal delivery and acute appendicitis-)

  • 이영두
    • Journal of Preventive Medicine and Public Health
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    • 제18권1호
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    • pp.41-50
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    • 1985
  • To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

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Novel Systemic Therapies for Advanced Gastric Cancer

  • Kim, Hong Jun;Oh, Sang Cheul
    • Journal of Gastric Cancer
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    • 제18권1호
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    • pp.1-19
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    • 2018
  • Gastric cancer (GC) is the second leading cause of cancer mortality and the fourth most commonly diagnosed malignant diseases. While continued efforts have been focused on GC treatment, the introduction of trastuzumab marked the beginning of a new era of target-specific treatments. Considering the diversity of mutations in GC, satisfactory results obtained from various target-specific therapies were expected, yet most of them were unsuccessful in controlled clinical trials. There are several possible reasons underlying the failures, including the absence of patient selection depending on validated predictive biomarkers, the inappropriate combination of drugs, and tumor heterogeneity. In contrast to targeted agents, immuno-oncologic agents are designed to regulate and boost immunity, are not target-specific, and may overcome tumor heterogeneity. With the successful establishment of predictive biomarkers, including Epstein-Barr virus pattern, microsatellite instability status, and programmed death-ligand 1 (PD-L1) expression, as well as ideal combination regimens, a new frontier in the immuno-oncology of GC treatment is on the horizon. Since the field of immuno-oncology has witnessed innovative, practice-changing successes in other cancer types, several trials on GC are ongoing. Among immuno-oncologic therapies, immune checkpoint inhibitors are the mainstay of clinical trials performed on GC. In this article, we review target-specific agents currently used in clinics or are undergoing clinical trials, and highlight the future clinical application of immuno-oncologic agents in inoperable GC.

Association of dietary patterns with overweight risk and all-cause mortality in children with cancer

  • So, Eunjin;Kim, Jeeyeon;Joo, Sehwa;Lee, Jisun;Joung, Hyojee
    • Nutrition Research and Practice
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    • 제11권6호
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    • pp.492-499
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    • 2017
  • BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The "spicy & fried meat and fish" dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The "fish, egg, meat, and fruits & vegetables" dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.

갱년기장애 사용처방과 변증분류에 관한 전문가 합의 연구 (A Study on the Experts' Agreement on the Patterns Classification of the Prescription for the Use of Menopausal Disorder)

  • 전수형;박영희;김종원;지규용;이지연;이인선
    • 대한한방부인과학회지
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    • 제35권2호
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    • pp.70-86
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    • 2022
  • Objectives: This study attempted to provide prescriptions that can be used according to the classification of menopausal disorders in order to increase the clinical utilization of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification). Methods: Delphi method survey was conducted for expert consensus on the Pattern Identification that could be used for each prescription by selecting frequent prescriptions based on the literature researched on the prescription of Korean medicine used for women with menopausal disorders. 11 experts participated in the questionnaire for posterity and 7 experts for sasang constitution. The survey was divided into the main prescription that can be mainly used for the patterns and the minor prescription that can be used although the suitability is somewhat low. Expert consensus was obtained through the second survey, and the pattern classification of prescriptions that were not confirmed here was confirmed through a face-to-face meeting. Results: There were 56 prescriptions mainly used for treatment for menopause, 45 for posterity and 11 for Sasang constitution. There were 69 identifications of 45 posterity prescriptions and 17 classifications of 11 Sasang constitutional prescriptions including major and minor patterns. By pattern identifications, the number of major/minor prescriptions was as follows. 肝鬱 14/5, 腎陰虛 8/2, 腎陽虛 4/1, 肝腎陰虛 2/7, 腎陰陽兩虛 3/1, 心腎不交 6/3, 心脾兩虛 15/2, 心火 7/6. Conclusions: In the future, by accumulating and analyzing the data on the diagnosis and treatment using CaPSPI, the clinical status of Korean medicine for menopausal disorders can be reviewed, and it can be used as the basis for the clinical practice guidelines for menopausal disorders. In addition, it is thought that analyzing the results of the diagnosis of pattern identifications and the prescription of Sasang constitution can be helpful in research on the posterity and Sasang constitution.

무릎 관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 전자우편 설문 조사 (E-mail Survey for Developing Clinical Trial Protocol on Individualized Acupuncture Treatment for Knee Osteoarthritis)

  • 이승덕;김선웅;최선미;서정철;이상훈;김용석
    • Journal of Acupuncture Research
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    • 제22권4호
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    • pp.197-204
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    • 2005
  • Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture prescriptions for knee osteoarthritis in real clinical practice. Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. The questionnaires were distributed via e-mail to 3,306 members of Korea Oriental Medical Association from March 15th to March 23rd in 2005.84 members completed answers, and the computerized data were analyzed by ISP statistical program. Results : 1. 68 out of 84 Korean medical doctors used pattern diagnosis. 2. 61 out of 84 Korean medical doctors used both local and remote points, 20 doctors remote points only, and 3 doctors local acupuncture points only. 3. In case of doctors who use remote acupuncture points only, the acupuncture prescription principle was Saam or five element acupuncture (66%), along the meridian pathway (14%), Eight constitutional acupuncture (11%), Taegeuk acupuncture (2%), and miscellaneous (18%). Conclusion : In our e-mail survey, Korean medical doctors who experienced more than 10 year practice answered that they use five element acupuncture or Saam acupuncture according to meridian pathway theory as the most common principle of their acupuncture treatment prescription.

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