• Title/Summary/Keyword: clinical practice pattern

검색결과 159건 처리시간 0.025초

알레르기 비염의 변증을 위한 설문문항 개발 (Developing Pattern Identification Questionnaire of Allergic Rhinitis)

  • 김민희;윤영희;안진향;고성규;최인화
    • 한방안이비인후피부과학회지
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    • 제30권2호
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    • pp.112-125
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    • 2017
  • Objectives : The prevalence of allergic rhinitis (AR) is 10-40% worldwide and there are many demands for Traditionl Medicine (TM) treatment for AR. Pattern identification (PI) is essential process in diagnosis and treatment of TM, however, objective assessment measurement for PI of AR in TM is lacked. Methods : PI questionnaire for AR was developed in 2008 by specialists in the department of Otolaryngology of TM, based on systemic and nasal symptoms and signs. However, that questionnaire had many problems in application to clinical practice and has since been revised based on several studies and delphi method. Consequently, the PI questionnaire for AR version 3.0 has been developed. Results & Conclusions : This questionnaire classifies patients with AR as possessing lung-heat, lung-cold, or spleen qi deficiency based on nasal symptoms and general conditions of AR patients. This is first questionnaire for pattern identification of AR. We plan to conduct a validation and reliability study, and revise the questionnaire based on the results of this study.

Difference in Muscle Activity of Deltoid Muscle according to Isokinetic Range of Motion Using Proprioceptive Neuromuscular Facilitation Pattern of Upper Extremity

  • Rhee, Min-Hyung;Choi, Su-Hong;Lee, Sang-Yeol;Ha, Kyung-Jin;Yoon, Sung-Young
    • The Journal of Korean Physical Therapy
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    • 제34권5호
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    • pp.278-281
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    • 2022
  • Purpose: This study sought to compare the muscle activity of the deltoid muscle according to the range of motion during the proprioceptive neuromuscular facilitation (PNF) upper extremity D2 pattern exercise performed with an isokinetic exercise device. The aim was to provide basic data for selecting an exercise for the relevant segment of the range of motion to enhance function in clinical practice. Methods: In this study, the relevant measurements of the anterior and middle trapezius of 25 healthy adults were taken using a surface electromyography system. The upper extremity pattern exercise was performed in three ranges (0% to 50%, 50% to 100%, and 25% to 75%) using the upper extremity isokinetic device. Results: There was a statistically significant difference in the muscle activity ratios of the anterior and middle deltoid muscles according to the measurement conditions (p<0.05). There was a statistically significant difference in the activity ratio of the middle deltoid muscle according to the measurement conditions in the ratio from the start range to the end range (p<0.05). There was no significant difference in the muscle onset time difference according to the measurement conditions (p>0.05). Conclusion: The muscle activity of the anterior and middle deltoid muscles was analyzed according to the range of motion during the PNF upper extremity pattern exercise performed with an isokinetic device. The results could be used as a basis for selecting exercises for the relevant segment of the range of motion according to the function to be emphasized.

특발폐섬유증 진단의 최신 지견과 간질성폐이상 (Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality)

  • 남보다;황정화
    • 대한영상의학회지
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    • 제82권4호
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    • pp.770-790
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    • 2021
  • 최신 국제 임상진료지침을 기반으로 한 특발폐섬유증의 진단은 부합하는 임상 소견과 함께 고해상 CT에서 전형적인 상용간질폐렴 소견을 보일 때 조직학적 폐 생검 없이 진단 가능하다. 영상 검사는 특발폐섬유증의 평가 및 진단에 중추적인 역할을 하며, 정확한 진단을 위하여 임상적, 영상의학적 및 병리학적 소견에 대한 다학제 검토의 중요성이 강조된다. 간질성폐이상(interstitial lung abnormality)은 우연히 발견된 영상의학적 이상 소견을 지칭하며, 간질성폐이상과 임상적으로 의미 있는 간질폐질환에 대한 구분은 적절한 임상 평가를 기반으로 이루어져야 한다. 저자들은 이번 종설을 통하여 특발폐섬유증 진단의 최신 지견 및 간질성폐이상에 대한 이해를 도움으로써 미만성 간질폐섬유증 환자의 정확한 진단과 치료 및 예후 증진에 도움이 되고자 한다.

전립선비대증의 진료지침 개발을 위한 한국문헌의 메타분석 (Meta-analysis of the Korean Literatures for Developing Clinical Practice Guidelines of Benign Prostatic Hyperplasia)

  • 유승흠;김춘배;강명근;송재만
    • Journal of Preventive Medicine and Public Health
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    • 제30권3호
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    • pp.643-664
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    • 1997
  • This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.

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건강 증진을 위한 평소 증상 기반의 한열변증 설문지 개발 - 신뢰도를 중심으로 (Development on the Questionnaire of Cold-Heat Pattern Identification Based on Usual Symptoms for Health Promotion - Focused on Reliability Study)

  • 여민경;박기현;배광호;장은수;이영섭
    • 동의생리병리학회지
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    • 제30권2호
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    • pp.116-123
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    • 2016
  • This study was performed to develop questionnaire of cold-heat pattern identification(PI) based on usual symptoms for general people, and we analyzed reliability of the questionnaire. We reviewed cold-heat PI questionnaire of advanced research and selected twenty-three items through three time experts meeting. Three hundred and fifty nine healthy subjects were joined in this study. As a results, Cronbach's α of cold-heat PI questionnaire was 0.79 and 0.83. According to the factor analysis about fifteen-chosen cold-heat PI questionnaires, each cold-heat consisted of two factors and each Convergence was 56.46% and 65.93%. Intra-class Correlation Coefficient was 0.67-0.83. Based on the median of samples of primary source, we classified subjects into four category as Cold, Heat, No Cold-Heat, and Cold-heat complex. We examined agreement of diagnosis and coefficient of kappa, and agreement rate of diagnosis was 64.2%, and coefficient of kappa was 0.51. Based on research result, we expect that validity study about questionnaire of cold-heat PI based on usual symptoms will be continued, and hope to be used as subsidiary diagnosis in clinical practice.

부호화와 정보 엔트로피에 기반한 심방세동 (Atrial Fibrillation: AF) 패턴 분석 (Atrial Fibrillation Pattern Analysis based on Symbolization and Information Entropy)

  • 조익성;권혁숭
    • 한국정보통신학회논문지
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    • 제16권5호
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    • pp.1047-1054
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    • 2012
  • 심방세동(Atrial Fibrillation:AF)은 각종 심장질환에서 비교적 빈번히 발생하는 부정맥으로 알려져 있으며, 그 발병률은 연령의 증가와 더불어 점차 증가한다. 전통적으로 심방세동을 검출하는 방법은 시간 영역 분석법과 주파수 영역분석법이 대부분이었다. 하지만 심전도 신호는 잡음의 영향을 많이 받는 환경에서 검출의 정확도가 떨어지며, 시간 주파수 영역 분석법은 RR 간격에 따라 변화하는 불규칙적 리듬에 관한 정보를 정확하게 얻지 못하는 단점이 있다. 본 연구에서는 부호화와 정보 엔트로피에 기반한 AF 패턴 분석 방법을 제안한다. 이를 위해 먼저 RR 간격 데이터를 차분 분할 방식을 통해 부호 서열화 한 후 그 리듬에 대한 패턴을 분석하고 이를 샤논의 정보 엔트로피를 통해 복잡도를 정량화하여 심방세동을 검출하였다. 성능 평가를 위해 10부터 100까지의 문턱값에 따른 엔트로피를 통해 복잡도를 분석하였으며 MIT-BIH 심방세동 데이터베이스를 이용하여 실험하였다.

만성요통환자의 호흡패턴이상과 통증과의 상관관계 (Relationship between Breathing Pattern Disorder and Pain in Patients with Chronic Low Back Pain)

  • 임재길
    • 한국엔터테인먼트산업학회논문지
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    • 제14권4호
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    • pp.355-363
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    • 2020
  • 이 연구는 만성요통환자의 호흡패턴이상과 통증관의 상관관계를 알아보기 위해 실시하였다. 104명의 만성요통환자의 날숨끝 이산화탄소농도(EtCO2)와 호흡률을 카프노그래프를 통해 측정하였고, 호흡유지시간과 Nijmegen Questionnaire, 가슴우리 움직임거리, 시각적사상척도를 추가로 평가하였다. Pearson's 검사로 상관관계를 분석하였으며, 결과는 EtCO2와 BHT, 가슴우리 움직임거리에서 통계적으로 유의한 상관관계를 보였으며(r=.302, r=.281)(p<.01), RR과 VAS에서 낮은 음의 상관관계(r=-.253,-.200)(p <.05)를 보였다. RR과 NQ에서도 유의한 상관관계를 보였으며(r=.237)(p<.05). 가슴우리 움직임거리와 VAS사이에서는 낮은 음의 상관관계를 보였다(r=-.370)(p<.01). 가슴 호흡과 가로막호흡 사이의 EtCO2, RR, BHT, 가슴우리 움직임거리, 그리고 VAS에서 통계적으로 유의한 차이가 있었으며(p<.05), NQ에서는 유의한 차이가 없었다(p>.05). 만성요통환자의 EtCO2, BHT, 가슴우리움직임거리, RR, 그리고 VAS 사이에는 상관관계가 있었다. 또한, RR과 NQ, 흉부 소풍과 VAS 사이에는 상관관계를 보였다. 결과적으로 호흡패턴이상과 통증 사이에는 밀접한 관계가 있었으며, 가슴호흡과 가로막호흡의 비교에서 EtCO2, RR, BHT, 가슴우리 움직임거리 및 VAS에서 유의한 차이가 있었다. 이것은 만성요통환자의 재활 및 통증 관리에서 호흡패턴중재가 기초자료로 사용될 수 있을 것으로 사료된다.

자기공명분석기를 이용한 통증관리 (Clinical Study of Acute and Chronic Pain by the Application of Magnetic Resonance Analyser $I_{TM}$)

  • 박욱;진희철;조명현;윤석준;이진승;이정석;최석환;김성열
    • The Korean Journal of Pain
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    • 제6권2호
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    • pp.192-198
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    • 1993
  • In 1984, a magnetic resonance spectrometer(magnetic resonance analyser, MRA $I_{TM}$) was developed by Sigrid Lipsett and Ronald J. Weinstock in the USA, Biomedical applications of the spectrometer have been examined by Dr. Hoang Van Duc(pathologist, USC), and Nakamura, et al(Japan). From their theoretical views, the biophysical functions of this machine are to analyse and synthesize a healthy tissue and organ resonance pattern, and to detect and correct an abnormal tissue and organ resonance pattern. All of the above functions are based on Quantum physics. The healthy tissue and organ resonance patterns are predetermined as standard magnetic resonance patterns by digitizing values based on peak resonance emissions(response levels or high pitched echo-sounds amplified via human body). In clinical practice, a counter or neutralizing resonance pattern calculated by the spectrometer can correct a phase-shifted resonance pattern(response levels or low pitched echo-sounds) of a diseased tissue and organ. By administering the counter resonance pattern into the site of pain and trigger point, it is possible to readjust the phase-shifted resonance pattern and then to alleviate pain through regulation of the neurotransmitter function of the nervous system. For assessing clinical effectiveness of pain relief with MRA $I_{TM}$ this study was designed to estimate pain intensity by the patient's subjective verbal rating scale(VRS such as graded to no pain, mild, moderate and severe) before application of it, to evaluate an amount of pain relief as applied the spectrometer by the patients subjective pain relief scale(visual analogue scale, VAS, 0~100%), and then to observe a continuation of pain relief following its application for managing acute and chronic pain in the 102 patients during an 8 months period beginning March, 1993. An application time of the spectrometer ranged from 15 to 30 minutes daily in each patient at or near the site of pain and trigger point when the patient wanted to be treated. The subjects consisted of 54 males and 48 females, with the age distribution between 23~40 years in 29 cases, 41~60 years in 48 cases and 61~76 years in 25 cases respectively(Table 1). The kinds of diagnosis and the main site of pain, the duration of pain before the application, and the frequency of it's application were recorded on the Table 2, 3 and 4. A distinction between acute and chronic pain was defined according to both of the pain intervals lasting within and over 3 months. The results of application of the spectrometer were noted as follows; In 51 cases of acute pain before the application, the pain intensities were rated mild in 10 cases, moderate in 15 cases and severe in 26 cases. The amounts of pain relief were noted as between 30~50% in 9 cases, 51~70% in 13 cases and 71~95% in 29 cases. The continuation of pain relief appeared between 6~24 hours in two cases, 2~5 days in 10 cases, 6~14 days in 4 cases, 15 days in one case, and completely relived of pain in 34 cases(Table 5~7). In 51 cases of chronic pain before the application, the pain intensities were rated mild in 12 cases, moderate in l8 cases and severe in 21 cases. The amounts of pain relief were noted as between 0~50% in 10 cases, 51~70% in 27 cases and 71~90% in 14 cases. The continuation of pain relief appeared to have no effect in two cases. The level of effective duration was between 6~12 hours in two cases, 2~5 days in 11 cases, 6~14 days in 14 cases, 15~60 days in 9 cases and in 13 cases the patient was completely relieved of pain(Table 5~7). There were no complications in the patients except a mild reddening and tingling sensation of skin while applying the spectrometer. Total amounts of pain relief in all of the subjects were accounted as poor and fair in 19(18.6%) cases, good in 40(39.2%) cases and excellent in 43(42.2%) cases. The clinical effectiveness of MRA $I_{TM}$ showed variable distributions from no improvements to complete relief of pain by the patient's assessment. In conclusion, we suggest that MRA $I_{TM}$ may be successful in immediate and continued pain relief but still requires several treatments for continued relief and may be gradually effective in pain relief while being applied repeatedly.

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국내 만성 B형 간염 환자의 경구용 항바이러스제 사용 현황 분석 (Analysis of Drug Utilization in Patients with Chronic Hepatitis B)

  • 이유정;배성진;제남경
    • 한국임상약학회지
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    • 제26권3호
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    • pp.220-229
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    • 2016
  • Background: The treatment goal for patients with chronic hepatitis B infection is to prevent progression of the disease to cirrhosis and hepatocellular carcinoma. Current therapies include standard and pegylated interferon-alfa and nucleoside/nucleotide analogues: lamivudine, adefovir, entecavir, telbivudine, clevudine, and tenofovir. This study aims to analyze changes in the prescribing patterns of chronic hepatitis B (CHB) medications in South Korea between 2013 and 2014. Methods: A cross-sectional study was conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service from 2013 and 2014. Patients with CHB were identified with Korean Standard Classification of Diseases code-6 (B18.0 and B18.1) and those who were maintaining active prescriptions with CHB medications covering the index date (December $1^{st}$, each year) were included. The utilization of antiviral therapy was investigated during 2013 and 2014. Results: A total of 4,204 and 4,552 patients in 2013 and 2014 respectively, were included in the analysis. The proportion of male patients was two of third and the patients 41-60 years old accounted for 60% of all analyzed patients. The most utilized drug was entecavir (55.1% in 2013 and 44.8% in 2014) and the second most utilized drug was tenofovir in both years (18.8% in 2013 and 29.0% in 2014). The percentage of combination therapy was 13.6% and 13.1% in 2013 and 2014, respectively. The proportion of tenofovir prescriptions was increased in 2014 compared with 2013. Conclusion: With the development of new drugs and the changes in clinical practice guidelines, the prescription pattern of the antiviral agents for patients with CHB has changed. The rate of utilization of tenofovir has increased.

Mid-Term Performance of Clinical LINAC in Volumetric Modulated Arc Therapy

  • Rahman, Mohammad Mahfujur;Kim, Chan Hyeong;Kim, Seonghoon
    • Journal of Radiation Protection and Research
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    • 제44권1호
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    • pp.43-52
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    • 2019
  • Background: The mid-term performance of clinical linear accelerator (LINAC) during volumetric modulated arc therapy (VMAT) treatment period is not performed in clinical practice and usually replaced with one-time plan quality assurance (QA). In this research we aim to monitor daily reproducibility of VMAT delivery from tracking individual leaf movement error and dosimetric error to evaluate the mid-term quality of the machine used. Materials and Methods: First, multileaf collimator (MLC) information was imported into MATLAB program to determine which of the MLC leaves in the leaf bank had the maximum RMS position error (maxRMS). We estimated where the maximum positional errors (maxPE) of the chosen leaf occur along its path length and tracked its daily variations over the entire treatment period. Secondly, picture information of dosimetric error from portal dosimetry was imported into MATLAB where representative high gamma index region (HGR) was determined as HGR with length of > 1 cm and their centers were daily tracked. Results and Discussion: The maxPEs in the brain and tongue cases were distributed broader than in other cases, but all data were found located within ${\pm}0.5mm$. From first day to last day all of five cases show the similar visual pattern of HGRs and Centers of the longest HGRs remained within ${\pm}1mm$ of that in first day. These findings prove excellent mid-term performance of the LINAC used in VMAT treatments over a full course of treatment. Conclusion: Tracking the daily location changes of leaf movement and dosimetric error can be a good indicator of predicting the daily quality like stability and reproducibility of beam delivering in VMAT treatment.