• 한국전문물리치료학회지
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• 제23권4호
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• pp.71-80
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• 2016

Background: Functional capacity evaluations (FCEs) are designed to systematically assess the capacity to perform work-related tasks and to determine worker's ability to return to the previous job following work-related injuries. These evaluations may be rated either by clinician or worker. There has been a lack of consensus between the two scoring methods. Objects: This study aimed: 1) to confirm if the data are fit to the Rasch rating scale model and 2) to investigate the item-level concordance rate between the ratings of clinician and injured worker of the FCE. Methods: A cross-sectional study was conducted with a sample (n=124) of a rehabilitation program with the Occupational Rehabilitation Data Base for workers with low back pain. The functional capacity evaluation at admission and discharge was administered to clinicians and workers. The data were analyzed using both classical test theory-based Pearson's r and intra-class coefficient followed by item-level analysis with Rasch rating scale model. Results: All items of the FCE, except sitting items rated by clinician at admission and handling items rated by both clinician and worker throughout admission and discharge, were acceptable fit statistics with minor out of ranges for a misfit criterion. This may indicate that the items of the FCE overall fit to the Rasch rating scale model. Few problematic items responding differently to clinician and worker both at admission and discharge were detected with the differential item functioning analysis despite the excellent concordance rate using the two conventional statistics-sitting and handling items at admission and handling item at discharge. Conclusion: The item-level speculations using Rasch analysis of the FCE demonstrate that the ratings of clinician and self ratings of worker were psychometrically acceptable though there was an apparent discrepancy between the raters both at admission and discharge.

• 대한치과기공학회지
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• 제32권1호
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• pp.47-56
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• 2010

As Korea is entering an aging society, the number of elderly people who need new denture or who have problems with their existing denture or adjacent tissue is increasing and it will double in 2018. Therefore, denture clinician system will lessen patients financial burden and introduce market economy to the dental prosthesis field. Therefore, Korea needs to adopt denture clinician system as soon as possible as USA or Canada to increase people s accessibility in quality and quantity. Denture clinician will determine the size and shape of denture after performing oral examination, make impression using various materials, fabricate denture, deliver and adjust completed denture to the patient, repair denture, and carry out financial management in the denture fabricating company or manage human resources. Considering denture clinicians services, American and European education system seems to be close to our system. Therefore, in this study, basic curriculums of several countries in Europe and America were reviewed and curriculum that meets Korean situation was suggested.

• Neonatal Medicine
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• 제17권1호
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• pp.1-12
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• 2010

Graphic monitoring assists the clinician at the bedside in several ways. It can be helpful in fine-tuning or adjusting ventilator parameters. Graphic monitoring may help to determine the patient's response to pharmacologic agents. The clinician also has the ability to trend monitored events over a prolonged period of time. The neonatal patient's self respiration, synchrony to ventilator and respiratory efforts can be well recognized with graphic monitoring. Of all, it may enable detection of complications before they become clinically apparent. This article introduces the basics of real-time graphics.

• 생물정신의학
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• 제8권1호
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• pp.37-46
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• 2001

Whenever a clinician manages the patients with depression, he may meet various problems that make it difficult to treat them. Even though he has good skills and knowledge about depression, some barriers will be appear during his practice. In general, the difficulties in treating depression are treatment-resistance, adverse effects of antidepressants, pregnancy in female patients, comorbid medical conditions, poor compliance, drug-drug interactions, and so on, which are related with pharmacological treatments. Here, only the two of them, the treatment-resistant depression and difficult problems concerned with pregnancy, were discussed. Some level of treatment resistance is the norm rather than the exception. As the treatment failure stems from inadequate treatment, it is important that the clinician should prescribe medications with sufficient doseage and adequate duration. And to overcome the treatment resistant depression the polypharmacy is necessary, in that case, the side effects and toxicities should be explored and managed immediately. So the clinician have to learn more about the pharmacokinetic and pharmacodynamic mechanisms of each drugs used in treatment of depression. When the risk of the fetus by the exposure is higher than the risk of untreated maternal psychiatric disorder, psychotropic medications should be used during pregnancy. Women who are maintained on psychotropics and become pregnant, as well as women with the new onset of psychiatric symptoms during pregnancy, should be carefully reassessed. However, data concerning the potential risk of long-term behavioral changes following prenatal exposure to psychotropics is rare, so further longitudinal follow-up studies are needed.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1998년도 추계학술대회
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• pp.179-180
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• 1998

In this paper, we propose an algorithm to detect fetal movements using M-mode ultrasonography. To do this work automatically, we find the crosscorrelation between the current data vector of the depth direction of M-mode image and the previous one. In the crosscorrelation estimator, the variations of time lag $\tau$ at maximum crosscorrelation value means fetal movements. A woman in the 37th week of pregnancy was monitored and the ultrasonic image of fetus was recorded over 20-minute period to detect fetal movements using B-mode and M-mode ultrasonography simultaneously. And the presented method was compared with maternal perception and B-mode ultrasonography observed by clinician. The maternal perception method detected only 57% of all fetal movements observed by clinician. The detection of the presented method corresponds to the clinician's detection result.

• 아동간호학회:학술대회논문집
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• 아동간호학회 1999년도 동계 학술세미나 및 정기총회
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• pp.21-24
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• 1999

${\cdot}$ Comprehensive behavioral assessment scale ${\cdot}$ Caregiving program for the parents ${\cdot}$ Quality of the parent-clinician relationship

• 대한의용생체공학회:의공학회지
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• 제14권4호
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• pp.341-348
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• 1993

Automated system to analyze liver function test results is presented based on fuzzy logic knowledge. Clinician's knowledge and experience was first expressed in linguistic terms fol- lowed by conversion to numerical values to create membership functions of disease possibility for each test item and liver disease. Membership functions were then compensated for different relative importances of test items. Liver diseases considered were acute viral hepatitis (AVH), chronic persistent hepatitis(CPH), chronic active hepatitis(CAH), and liver cirrhosis(LC), Liver function test results of alanine aminotransferase(ALT), aspartate amino- transferase(AST) , glutamate dehydrogenase(GDH), ornithine carbamyltransferase(OCT) , ALT/AST, and 10* GDH/ALT in 218 patients were analyzed by the present system, welch resulted in 80% accuracy. AVH and CAH showed the highest 93 % and the lowest 58% ac- curacies, respectively, which was similar to the clinician's expectation. The simple mathemat- ical formulation of the present system would enable an easy implementation in commercial analysis instruments. Also, the identical fuzzy logic can be applied to similar diagnostic envi- ronments in general.

• 대한수의학회지
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• 제38권2호
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• pp.413-418
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• 1998

Intracardiac velocities were determined and the wave-forms described for 4 flow areas of the normal canine heart following administration of chemical restraint drugs including xylazine HCl, ketamine HCl, and thiopental sodium using pulsed wave Doppler echocardiography. The result was that xylazine HCl and thiopental sodium reduced intracardiac flow velocities through mitral, tricuspid, aortic and pulmonary valves. It is also thought that precautions are required before using these drugs. Patterns of wave-forms had no changes between control and treatment groups. Doppler echocardiography allows the clinician to determine flow velocities across the different valves and within the various chambers of the heart. It is shown that establishing normal values and those related to chemical restraint administrations and knowing what influences them should allow the clinician to non-invasively diagnose a variety of pathological cardiac conditions.

• 생물정신의학
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• 제7권1호
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• pp.21-33
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• 2000

As the clinical practice of using more than one drug at a time increase, the clinician is faced with ever-increasing number of potential drug interactions. Although many interactions have little clinical significances, some may interfere with treatment or even be life-threatening. This review provides a better understanding of drug-drug interactions often encountered in pharmacotherapy of depression. Drug interactions can be grouped into two principal subdivisions : pharmacokinetic and pharmacodynamic. These subgroups serve to focus attention on possible sites of interaction as a drug moves from the site of administration and absorption to its site of action. Pharmacokinetic processes are those that include transport to and from the receptor site and consist of absorption, distribution on body tissue, plasma protein binding, metabolism, and excretion. Pharmacodynamic interactions occur at biologically active sites. In this review, emphasis is placed on antidepressant medications, how they are metabolized by the P450 system, and how they alter the metabolism of other drugs. When prescribing antidepressant medications, the clinician must consider the drug-drug interactions that are potentially problematic.

• 대한핵의학회지
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• 제35권4호
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• pp.224-230
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• 2001

EBM is "the conscientious, explicit and judicious use of current best evidence in mating decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures.