• 제목/요약/키워드: clinical practice pattern

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DSM-V 분류에 따른 수면-각성장애의 한의학적 변증 연구 (The Study on Korean Medical Pattern Differentiation of Sleep-Wake Disorders by DSM-V Classification)

  • 나일두;박미선;김영목
    • 동의생리병리학회지
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    • 제31권2호
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    • pp.83-93
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    • 2017
  • This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

Imaging Features of Soft-Tissue Calcifications and Related Diseases: A Systematic Approach

  • Hwang, Zhen-An;Suh, Kyung Jin;Chen, Dillon;Chan, Wing P.;Wu, Jim S.
    • Korean Journal of Radiology
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    • 제19권6호
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    • pp.1147-1160
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    • 2018
  • Soft-tissue calcification refers to a broad category of lesions. Calcifications are frequently identified by radiologists in daily practice. Using a simple algorithm based on the distribution pattern of the lesions and detailed clinical information, these calcified lesions can be systematically evaluated. The distribution pattern of the calcific deposits enables initial division into calcinosis circumscripta and calcinosis universalis. Using laboratory test results (serum calcium and phosphate levels) and clinical history, calcinosis circumscripta can be further categorized into four subtypes: dystrophic, iatrogenic, metastatic, and idiopathic calcification. This pictorial essay presents a systematic approach to the imaging features of soft-tissue calcifications and related diseases.

A Case Note on the Medical Negligence of Traditional Chinese Herbal Medicine in the UK

  • Lee, Hai Woong
    • 대한예방한의학회지
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    • 제18권3호
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    • pp.105-115
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    • 2014
  • Objective : Traditional medicine (TM) has been playing its role in national healthcare system and it is taken as complementary and alternative medicine (CAM) from the viewpoint of modern Western medicine. In the UK, not a few practitioners of Traditional Chinese Medicine (TCM) are working as CAM practitioners using herbal medicine and acupuncture therapy. Cases of dispute in the TCM practice are not rare these days because patients who take TCM service are increasing by year. Method : In the UK, dispute cases of the Traditional Medicine of East Asia can be found these days, however, it is hard to find a reported court case. A medical dispute case of TCM will be analysed to see the legal management and the resolving principle in the alternative medicine practice with some cases of Korean Medicine (KM) being discussed. Results : The usual pattern of clinical negligence can be discussed from the points of a duty of care, breach of that duty by negligence, and the harm to the patient from that breach of duty. The judge followed this procedure In this case to discuss the claims. The department of health proposed to introduce regulation to provide the reasonable quality in TCM practice, and the governmental system would be essential to regulate both the TCM practice and practitioners. Conclusion : The dispute case of traditional Chinese herbal medicine (TCHM) practice is important for the clinical negligence in TCHM practice. Judging the negligence of a TCHM practitioner involves the conventional negligence principle in tort law, and the TCHM practitioners are required to keep up with the up-to-date information on the related medical specialty. The reasoning is almost the same as that shown in the court case of Korea. The TCHM practice in the UK needs to be under the regulation by the government. The standard of care we expect of a TCHM practitioner is a further matter to discuss from the healthcare and social viewpoints.

태양인체질병증 임상진료지침 (Clinical Practice Guideline for Taeyangin Disease of Sasang Constitutional Medicine)

  • 박혜선;주종천;이의주
    • 사상체질의학회지
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    • 제27권1호
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    • pp.71-81
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    • 2015
  • Objectives This research was proposed to present clinical practice guideline (CPG) for Taeyangin Disease of Sasang Constitutional Medicine (SCM). This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods This guideline was performed that search and collection of literature related SCM such as "Dongeuisusebowon", textbook of SCM, clinical guidebook of SCM and fundamental research to standardize diagnosis of Sasang Constitutional Medicine. Journal search related clinical trial or human complementary medicine of SCM was performed domestic and overseas. Finally, 1 article was selected and included in CPG for Taeyangin disease. Results & Conclusions The CPG of Taeyangin disease include classification, definition and standard symptoms of each pattern. Taeyangin disease is classified into exterior-origin lower back (EOLB) disease and interior-origin small intestine (IOSI) disease by region of symptom. EOLB can be replaced with Oegam-yocheok and IOSI can be replaced with Naechok-sojang that is Korean pronuncation. EOLB disease is classified into lower back favorable symptomatology (LBFS) and lower back unfavorable symptomatology (LBUS). Lower back is to say Yocheok, so LBFS can be called Yocheok favorable symptomatology and LBUS can be called Yocheok unfavorable symptomatology. LBUS is to say paraparesis symptomatology or Haeyeok, that is Korean pronunciation, symptomatology. IOSI disease is classified into small intestine favorable symptomatology (SIFS) and small intestine unfavorable symptomatology (SIUS). Small intestine is to say Sojang, so SIFS can be called Sojang favorable symptomatology and SIUS can be called Sojang unfavorable symptomatology. SIUS is to say regurgitation symptomatology or Yeolgeok, that is Korean pronunciation, symptomatology.

Currents in Integrative Biochip Informatics

  • Kim, Ju-Han
    • 한국생물정보학회:학술대회논문집
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    • 한국생물정보시스템생물학회 2001년도 제2회 생물정보 워크샵 (DNA Chip Bioinformatics)
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    • pp.1-9
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    • 2001
  • scale genomic and postgenomic data means that many of the challenges in biomedical research are now challenges in computational sciences and information technology. The informatics revolutions both in clinical informatics and bioinformatics will change the current paradigm of biomedical sciences and practice of clinical medicine, including diagnostics, therapeutics, and prognostics. Postgenome informatics, powered by high throughput technologies and genomic-scale databases, is likely to transform our biomedical understanding forever much the same way that biochemistry did a generation ago. In this talk, 1 will describe how these technologies will in pact biomedical research and clinical care, emphasizing recent advances in biochip-based functional genomics. Basic data preprocessing with normalization and filtering, primary pattern analysis, and machine teaming algorithms will be presented. Issues of integrated biochip informatics technologies including multivariate data projection, gene-metabolic pathway mapping, automated biomolecular annotation, text mining of factual and literature databases, and integrated management of biomolecular databases will be discussed. Each step will be given with real examples from ongoing research activities in the context of clinical relevance. Issues of linking molecular genotype and clinical phenotype information will be discussed.

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팔강변증의 진단율 향상을 위한 형색맥증진단(形色脈證診斷)시스템 설계 - 한열변증을 중심으로 - (Proposal of Form-Color-Pulse-Symptom Diagnostic System for Enhancement of Diagnostic Rate of 8 Principle Pattern Identification - Focusing on Cold Heat Pattern Identification -)

  • 지규용;이인선;전수형;김종원
    • 동의생리병리학회지
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    • 제33권3호
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    • pp.163-168
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    • 2019
  • In order to enhance the 8 principle pattern diagnosis rate comparing with diagnostic method by self-report questionnaire on cold/heat pattern in the clinical practice, a new diagnostic method using form-color-pulse-symptom (FCPS) system is proposed. FCPS system is composed of outputs of cold/heat pattern through the calculation process of contribution degree to the cold, heat pattern and qi, blood, yin, yang deficiency patterns, based on analysis of 16 mechanisms of disease calculated by diagnostic system of oriental medicine (DSOM) first. And second component is an output of differentiated 8 principle patterns in detail through binding and calculating process with digital informations of pulse, color, form, constitution obtained by computerized measurement system. Putting together above two processes consecutively, cold-heat complex or true/false cold/heat patterns and personalized characters of cold/heat patterns of each patient can be subdivided through a computation method of determining each pattern. In conclusion, 8 principle pattern identification can be performed more accurately using FCPS system than existent self report questionnaire method. These hypothetic proposal is needed to be proven by clinical trial for the future and then the accurate numbers used in each calculational function should be revised properly.

Rogers 이론에 근거한 가족양상 사정지침개발 (Development of a Family Pattern Appraisal to Guide a Rogerian Nursing Practice)

  • 이광옥;한영란;김희정
    • 대한간호학회지
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    • 제25권4호
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    • pp.751-773
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    • 1995
  • We, clinical nurse specialists practising and guiding student practice in a Community health nursing clinic, wanted to develop a family pattern appraisal consistent with Rogers' conceptual system, the nursing model guiding our practice. We use Rogers' model because it is harmonious with the traditional Korean view of the one human, natural and cosmic world. The purpose of our research was to contribute to science - based nursing practice, not only, one helpful model, but also a model of how to use, in guiding practice, a conceptual system which reflects nurse practitioners' philosophy of nursing, is intellectually satisfying, and enriches meaning in daily nursing life. The research objectives were to review the literature on Rogers' model and analyse it according to Kim's five - level analytical framework, to explore Rogers' definition of family, to review appraisals based on Rogers' model, and to develop a family appraisal which is culturally appropriate for use in our community. This work including the use of the appraisal and its refinement with families in our practice which was done during 1994 and 1995, in Seoul, in the Capital of the Republic of Korea. At the highest level of analysis, Rogers conceptual system emphasizes acausality and multidimentional meaning ; the world view is characterized by process, movement and wholeness. The epistemology Is one of holism and the knowledge base includes all forms of experience, from sensory to mystical, objective, and subjective. At the metaparadigm level, nursing focuses on the unitary human being and the environment. At the level of nursing philosophy, the model identifies human being, nursing, nurse, and illness and health. At the paradigm level the model assumes the irriducibility of the human to parts, noncausality and continual change. Rogers' practice methodology consists of pattern manifestation appraisal and deliberative mutual patterning. Under-standing patterns and patterning of people is the key to helping them achieve their potential. At the theory level, the basic assumptions, key concepts, and homeodynamic principles were identified. Rogers states the family energy field is an undividable, four-dimensional negentropic energy field which is in a larger envircinmental field show-ing such characteristics as cannot be predicted by knowledge of individual family members. Based on the word of Rogers scholars, we chose Rogers' correlates of patterning to understand the family unit as a whole-frequency, rhythms, motion, time perception, sleeping-waking beyond waking, pragmatic -imaginative-visionary to develop the appraisal. We, also used some of Barrel's (1988) criteria including interpersonal network and professional health care access and use, and Cordon's (1982) criteria including self perception - self concept modified to fit the family. Our family Pattern appraisal included 1. Influencirg data, 2. Professional health care access and use, 3. Family self perception-self concept, 4. Family interpersonal network, 5. Sleep-wake-be-yond waking, 6. Pragmatic-imaginary-visionary, 7. Family frequency and rhythm, 8. Family motion, 9. Family time perception. The appraisal was used with four families and modified to eliminate overlap and to make it possible for the family member to express themselves more easily. We plan to gain more experience with the appraisal toward further development of the tool.

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국내 전자저널에 수록된 월경통 평가지표 및 변증에 대한 한의학적 임상연구 고찰 (Systematic Review of Korean Medicine-related Study on Diagnostic Tools and Pattern Identification registered of Dysmenorrhea in the Korean Journal)

  • 김지혜;김종열;전영주
    • 동의생리병리학회지
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    • 제29권5호
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    • pp.434-442
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    • 2015
  • The purpose of this review was to survey the Korean Medicine related papers about women with primary dysmenorrhea in order to develop the clinical protocol of the diagnostic medical device. We searched the literature from 2000 through April 2015 using 5 online databases including Oriental Medicine Advanced Searching Integrated Sysptem (OASIS), Research Information Sharing Service (RISS), DataBase Periodical Information Academic (DBpia) and Korean Medical Database (KMBase). We selected papers to meet the following inclusion criteria: the papers involved dysmenorrhea (excluding secondary dysmenorrhea), published papers (excluding textbook, educational materials, conferences, etc.) and the papers matched search keywords or scope, but excluded papers to meet the following exclusion criteria: the duplicative papers, get out of the keywords and scope and not in english or korean language. Finally we found 17 papers and classified the papers according to the three search purposes which were diagnostic tools for evaluating the menstrual pain, dysmenorrhea' pattern identification and menstrual phase. Out of the 16 studies, 4 studies were focused on the diagnostic tools including Visual Analogue Scale (VAS), Measurement of Menstrual Pain (MMP) and etc. Other 5 studies were aimed at menstrual phase, and the other 7 studies were studied for pattern identification. The VAS has been widely used in research and in clinical practice for the detection of the menstrual pain. Treatments for patients with primary dysmenorrhea can be prescribed in consideration of their patterns of sasang constitution or body constitution as following: Qi stagnation-Blood deficiency, cold dampness, Qi deficiency-blood deficiency and liver-kidney deficiency etc. This results of research will be used as a useful material during plan a clinical study of primary dysmenorrhea and acquisition of good clinical data.

Clinical practice pattern on hematuria and proteinuria in children: the report of a survey for the Korean Society of Pediatric Nephrology

  • Jeesu Min;Naye Choi;Yo Han Ahn;Hee Gyung Kang
    • Childhood Kidney Diseases
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    • 제27권1호
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    • pp.26-33
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    • 2023
  • Purpose: Hematuria and proteinuria have various causes and consequential outcomes in children. Immunosuppressants are needed in some children with biopsy-proven glomerulonephropathy but have many adverse effects. Since the clinical practice patterns of Korean pediatric nephrologists are diverse, we surveyed their opinions. Methods: Using a clinical vignette, the survey was emailed to all Korean Society of Pediatric Nephrology members. The questionnaires included diagnosis, examination, medications, and dietary recommendations for patients with hematuria and proteinuria. Results: A total of 32 clinicians (5.48%, 22 pediatric certificated nephrologists) responded to the survey. Most responders (87.5%) suspected immunoglobulin A nephropathy, and 68.8% replied that kidney biopsies were a diagnostic tool. Renin-angiotensin system inhibition (62.5%) or steroids (18.8%) were selected as the treatment. Salt and protein intakes were usually encouraged as dietary reference intakes (34.4% and 65.6%, respectively). Conclusions: Children with abnormal urinalysis have various causes, treatments, and prognoses. As treatments such as immunosuppressants can have many adverse effects, it is necessary to confirm an accurate diagnosis and indications of treatments before starting the treatment. Recommendations for a diet should not hinder growth.

태소음양(太少陰陽)과 팔강(八綱)의 분석에 근거한 사상인 변증분류체계 연구 (Analysis of Differential Diagnosis System in Sasang Typology on the Basis of Greater-Lesser-Yin-Yang and Eight Principle Pattern Identification)

  • 강철민;강정수;김병수
    • 동의생리병리학회지
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    • 제22권5호
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    • pp.1125-1131
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    • 2008
  • The purpose of this study is to evaluate the clinical implication of Eight Principle Pattern Identification, EPPI in Sasang Typology. Although EPPI is considered as the most basic differential diagnosis in Oriental Medical Science, it has not been used actively enough in clinical practice owing to the presumption that EPPI is not sufficient for the analysis of complex clinical symptoms. In Zhang Jiebin's Jingyuequanshu, he separates Yin-Yang with Six-identification in EPPI when explaining them. This implies that it is difficult to talk about each of EPPI in same perspective. Thus, for the active clinical usage of EPPI it is necessary to study in hierarchical perspective. Lee Je-ma's Sasang typology could be a good example that uses the hierarchical perspective of EPPI. In the book Dongeuisoosebowon Lee Je-ma talks about differentiating Yin with Yang by constitution, Exterior with Interior and Cold with Heat accordingly, to apply in prescriptions. After differentiation, Yin and Yang are placed in higher level from the rest of EPPI, thus Yin and Yang can influence the rest of EPPI. This study showed the importance of EPPI in understanding the differential diagnosis system of Sasang typology in clinical perspectives.