• Title/Summary/Keyword: foreign patients

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Analysis of the Numeric Rating Scale (NRS) Used in Clinical Studies Based on Randomized Controlled Studies (임상연구에서 사용되고 있는 NRS에 대한 분석 : 무작위대조군연구를 중심으로)

  • Lee, Chan;Cho, Im-hak;Heo, Gi-yoon;Kang, Hee-kyung;Kim, Min-hwa;Han, Chang-woo;Kim, So-yeon;Choi, Jun-yong;Park, Seong-ha;Yun, Young-ju;Hong, Jin-woo;Kwon, Jung-nam;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.510-531
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    • 2021
  • Objectives: The purpose of this study was to review the status of numeric rating scale (NRS) usage and suggest the potential for use in multicenter retrospective studies of various diseases. Methods: Articles published from 2011 to 2021 that used the keywords "NRS", "Multi-center", and "RCT" were identified in foreign databases, including EMBASE, PubMed, CENTRAL. The articles were analyzed according to their use of "NRS" by symptoms and by disease group using the major classifications of the Korean Standard Classification of Diseases (KCD-7). Results: Classification by symptom in a total of 288 articles illustrates that the NRS was not only commonly used in pain evaluation but also for non-pain symptoms. In usage with non-pain symptoms, chief complaint of patients was the most common at 79%, and other factors included treatment satisfaction, evaluation of daily life, and sleep quality. In disease classification according to the KCD-7, the NRS was commonly used in connection with musculoskeletal and connective tissue diseases but was also utilized in various other disease groups. Conclusions: This study confirms usage of the NRS in multi-center RCTs, as the NRS was widely used in all types of diseases and symptoms. Considering the result and the advantages of the NRS, it is recommended for use as a daily evaluation tool for the collection of common data in multicenter retrospective studies.

A Narrative of Medical School Professors' International Medical Experience: Applicability of Medical Humanities Curriculum (의과대학 교수의 국제진료 경험에 대한 내러티브: 의료인문학 교육과정의 적용 가능성)

  • Kim, Yura;Park, Hye jin;Kim, Byunghee
    • Journal of the International Relations & Interdisciplinary Education
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    • v.1 no.1
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    • pp.1-12
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    • 2021
  • This study is a study on the applicability of the medical humanities curriculum through a narrative study on international treatment of foreign patients. Korea's medical system and standards are world-class, and it can be seen that the knowledge and skills for patient care are sufficient, which shows that the competence for patient care emphasized by Korean doctors is sufficient. In terms of social responsibility for doctors in Korea, the importance of volunteering is learned from medical school education, and through medical field experiences in various cultures, it can be seen that volunteering is important to lead to lifelong work as a doctor. In the field of professionalism, professionalism could be expressed as a doctor, and in all processes, the medical staff understood and empathized with the pain of the patient, and it was found that the sincerity was conveyed to the patient. Professionalism is an area that is being emphasized more recently, and it is necessary to provide educational opportunities for professionalism to doctors as well as medical school education. This international medical experience can be applied to the medical humanities curriculum of the medical school, and a harmonized and integrated medical humanities curriculum can be operated throughout the six-year curriculum.

Comparison of One- and Two-Region of Interest Strain Elastography Measurements in the Differential Diagnosis of Breast Masses

  • Hee Jeong Park;Sun Mi Kim;Bo La Yun;Mijung Jang;Bohyoung Kim;Soo Hyun Lee;Hye Shin Ahn
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.431-441
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    • 2020
  • Objective: To compare the diagnostic performance and interobserver variability of strain ratio obtained from one or two regions of interest (ROI) on breast elastography. Materials and Methods: From April to May 2016, 140 breast masses in 140 patients who underwent conventional ultrasonography (US) with strain elastography followed by US-guided biopsy were evaluated. Three experienced breast radiologists reviewed recorded US and elastography images, measured strain ratios, and categorized them according to the American College of Radiology breast imaging reporting and data system lexicon. Strain ratio was obtained using the 1-ROI method (one ROI drawn on the target mass), and the 2-ROI method (one ROI in the target mass and another in reference fat tissue). The diagnostic performance of the three radiologists among datasets and optimal cut-off values for strain ratios were evaluated. Interobserver variability of strain ratio for each ROI method was assessed using intraclass correlation coefficient values, Bland-Altman plots, and coefficients of variation. Results: Compared to US alone, US combined with the strain ratio measured using either ROI method significantly improved specificity, positive predictive value, accuracy, and area under the receiver operating characteristic curve (AUC) (all p values < 0.05). Strain ratio obtained using the 1-ROI method showed higher interobserver agreement between the three radiologists without a significant difference in AUC for differentiating breast cancer when the optimal strain ratio cut-off value was used, compared with the 2-ROI method (AUC: 0.788 vs. 0.783, 0.693 vs. 0.715, and 0.691 vs. 0.686, respectively, all p values > 0.05). Conclusion: Strain ratios obtained using the 1-ROI method showed higher interobserver agreement without a significant difference in AUC, compared to those obtained using the 2-ROI method. Considering that the 1-ROI method can reduce performers' efforts, it could have an important role in improving the diagnostic performance of breast US by enabling consistent management of breast lesions.

A Clinical Study on the Relationship between Dental Implant and Systemic Disease (치과 임플란트와 전신질환과의 연관성에 관한 임상적 고찰)

  • Yang-Keum Han;Mi-Sook Yoon;Han-Hong Kim
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.25-35
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    • 2023
  • Background: In order to emphasize the importance of clinical dental hygienists-led dental hygiene management processes for those with systemic diseases, we tried to identify systemic diseases affecting dental implants based on clinical data. Methods: In order to identify systemic diseases affecting dental implants, literature review was conducted from March 1 to May 31, 2023, and the search period was for research papers published in domestic and foreign academic journals from January 2000 to December 2020. Domestic databases used for search use RISS, Nuri Media(DBpia), and Korea Academic Information (http://www.papersearch.net ; KISS), while overseas databases searched Pubmed for dental implant failures, implants, systemic diseases, and Dental implant and system disease. Results: The cumulative survival rate of implants averaged 94.3 percent and the failure rate was 5.7 percent. Clinical analysis of systemic diseases related to implants accounted for the highest frequency with 13 (100.0%), followed by 8 (61.5%) studies on high blood pressure and smoking, 7 (53.8%) cardiovascular diseases, and 5 (38.5%). In addition, liver disease, thyroid abnormalities, blood abnormalities, organ transplants and infectious diseases were confirmed. Conclusion: Since unregulated systemic diseases are a risk factor for implant failure, clinical dental hygienists should continue to maintain healthy oral conditions by sharing information with patients during periodic preventive dental hygiene management processes such as dental hygiene assessment.

The Effects of Using Artificial Sweeteners and Coffee Grounds in Chocolate Filling on Quality Characteristics and Glycemic Index (쉘 초콜릿 filling에 사용한 대체 감미료와 커피박이 품질 특성 및 당지수에 미치는 영향)

  • Kang, Suna;Lee, Jin Sook;Jeong, Areum;Kim, Eunha;Park, Sunmin
    • Journal of Applied Biological Chemistry
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    • v.57 no.4
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    • pp.307-312
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    • 2014
  • Chocolate is restricted for obese and diabetic patients due to high in sugar contents. We investigated shell-chocolate fillings with low calorie content and low glycemic indexes using alternative sweeteners such as tagatose and xylose and adding coffee grounds. Chocolate filling was made with sugar, cacao and butter in the original recipe. Sugar was substituted with tagatose or xylose and 3% coffee ground was added in each chocolate filling and substituted for 3% of the cocoa. Water retention and spreadability of the chocolate filling was significantly higher in the tagatose+coffee ground group in comparison to the sugar. In the chromaticity test, chocolate filling made with tagatose was darker in comparison to that made with sugar: brightness (L) was lower and redness (a) and yellowness (b) were higher than the sugar filling. Sensory evaluation revealed that chocolate filling made with tagatose had high score in 4 categories such as taste, smell, texture of foreign substance, overall acceptance. After consuming 60 g of the chocolate with different fillings, blood glucose levels of subjects at 1 and 2 h were significantly lower in the tagatose and tagatose+coffee ground groups than the other groups. In conclusion, using tagatose as the sweetener in chocolate filling has a beneficial effect on lowering blood glucose levels and increasing water retention, spreadability and sensory scores. Coffee ground did not have additive effect on quality of chocolate filling and blood glucose levels. These results indicate that shell chocolate made with tagatose can be used as a snack for diabetic patients.

Literature Analysis of Radiotherapy in Uterine Cervix Cancer for the Processing of the Patterns of Care Study in Korea (한국에서 자궁경부알 방사선치료의 Patterns of Care Study 진행을 위한 문헌 비교 연구)

  • Choi Doo Ho;Kim Eun Seog;Kim Yong Ho;Kim Jin Hee;Yang Dae Sik;Kang Seung Hee;Wu Hong Gyun;Kim Il Han
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.61-70
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    • 2005
  • Purpose: Uterine cervix cancer is one of the most prevalent women cancer in Korea. We analysed published papers in Korea with comparing Patterns of Care Study (PCS) articles of United States and Japan for the purpose of developing and processing Korean PCS. Materials and Methods: We searched PCS related foreign-produced papers in the PCS homepage (212 articles and abstracts) and from the Pub Med to find Structure and Process of the PCS. To compare their study with Korean papers, we used the internet site 'Korean Pub Med' to search 99 articles regarding uterine cervix cancer and radiation therapy. We analysed Korean paper by comparing them with selected PCS papers regarding Structure, Process and Outcome and compared their items between the period of before 1980's and 1990's. Results: Evaluable papers were 28 from United States, 10 from the Japan and 73 from the Korea which treated cervix PCS items. PCS papers for United States and Japan commonly stratified into $3\~4$ categories on the bases of the scales characteristics of the facilities, numbers of the patients, doctors, Researchers restricted eligible patients strictly. For the process of the study, they analysed factors regarding pretreatment staging in chronological order, treatment related factors, factors in addition to FIGO staging and treatment machine. Papers in United States dealt with racial characteristics, socioeconomic characteristics of the patients, tumor size (6), and bilaterality of parametrial or pelvic side wail invasion (5), whereas papers from Japan treated of the tumor markers. The common trend in the process of staging work-up was decreased use of lymphangiogram, barium enema and increased use of CT and MRI over the times. The recent subject from the Korean papers dealt with concurrent chemoradiotherapy (9 papers), treatment duration (4), tumor markers (B) and unconventional fractionation. Conclusion: By comparing papers among 3 nations, we collected items for Korean uterine cervix cancer PCS. By consensus meeting and close communication, survey items for cervix cancer PCS were developed to measure structure, process and outcome of the radiation treatment of the cervix cancer. Subsequent future research will focus on the use of brachytherapy and its impact on outcome including complications. These finding and future PCS studies will direct the development of educational programs aimed at correcting identified deficits in care.

A study of the Medical System in the Early Chosun-Dynasty (조선시대(朝鮮時代) 전기(前期)의 의료제도(醫療制度)에 대한 연구(硏究))

  • Han, Dae-Hee;Kang, Hyo-Shin
    • Journal of Korean Medical classics
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    • v.9
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    • pp.555-652
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    • 1996
  • Up to the present the scholastic achievements in the history of the medical system have been rather scare despite its importance in the Korean History. Hence, this dissertation attempts to examine the significance of the institute in the Korean History, covering the period from the ancient times through the early Chosun-Dynasty. In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(巫堂), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(medical doctor), Chaeyaksa(pharmacist), and Jukeumsa(medicine man) within Yakbu(department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science on ancient Japan. After the unification of the three countries, Shilla had their own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo and became the backbone of the future ones. In the ancient time religion and medicine were closely related. The curative function of the shaman was absolute. Buddhism played a notable part in medical practice, too, producing numerous medical monks. The medical system of Koryo followed the model of Dang with some borrowings from Song(宋). Sangyakkuk(尙藥局) was to deal exclusively with the diseases of the monarch whereas Taeeuigam(太醫監) was the central office to handle the national medical administration and the qualification test and education for doctors. In addition, Dongsodaebiwon(東西大悲院), Jewibo(濟危寶), and Hyeminkuk(惠民局) were public hospitals for the people, and a few aristocrats practiced medicine privately. In 987, the 6th year of Songjong(成宗), local medical operations were installed for curing the sick and educating medical students. Later Hyonjong(顯宗), established Yakjom(clinics, 藥店) throughout the country and officials were sent there to see patients. Foreign experts, mainly from Song, were invited frequently to deliver their advanced technology, and contributed to the great progress of the science in Korea. Medical officials were equipped with better land and salary than others, enjoying appropriate social respect. Koryo exchanged doctors, medicine and books mainly with Song, but also had substantial interrelations with Yuan(元), Ming(明), Kitan(契丹), Yojin(女眞), and Japan. Among them, however, Song was most influential to the development of medicine in Koryo. During Koryo Dynasty Buddhism, the national religion at the time, exercised bigger effect on medicine than in any other period. By conducting national ceremonies and public rituals to cure diseases, Taoism also affected the way people regarded illness. Curative shamanism was still in practice as well. These religious practices, however, were now engaged only when medication was already in use or when medicine could not held not help any more. The advanced medical system of Koryo were handed down to Chosun and served the basis for further progress. Hence, then played well the role to connect the ancient medicine and the modern one. The early Chosun followed and systemized the scientific and technical achievement in medicine during the Koryo Dynasty, and furthermore, founded the basis of the future developments. Especially the 70 years approximately from the reign of Sejong(世宗) to that of Songjong(成宗) withnessed a termendous progress in the field with the reestablishment of the medical system. The functions of the three medical institute Naeeuiwon(內醫院), Joneuigam(典醫監), Hyeminkuk(惠民局) were expanded. The second, particualy, not only systemized all the medical practices of the whole nation, but also grew and distributed domestic medicaments which had been continually developed since the late Koryo period. In addition, Hyeminso(惠民局, Hwarinwon(活人院)) and Jesaenwon(濟生院)(later merged to the first) played certain parts in the curing illness. Despite the active medical education in the capital and the country, the results were not substantial, for the aristocracy avoided the profession due to the social prejudice against technicians including medical docotors. During the early Chosun-Dynasty, the science was divided into Chimgueui (acupuncturist), Naryogeui(specialist in scrofula) and Chijongeui (specialist in boil). For the textbooks, those for the qualification exam were used, including several written by the natives. With the introduction on Neoconfucianism(性理學) which reinforced sexual segregation, female doctors appeared for the female patients who refused to be seen by male doctors. This system first appeared in 1406, the sixth year of Taejong(太宗), but finally set up during the reign of Sejong. As slaves to the offices, the lowest class, female doctors drew no respect. However, this is still significant in the aspect of women's participation in society. They were precedents of midwives. Medical officials were selected through the civil exam and a special test. Those who passed exams were given temporary jobs and took permanent posts later. At that time the test score, the work experience and the performance record of the prospective doctor were all taken into consideration, for it was a specialized office. Most doctors were given posts that changed every six months, and therefore had fewer chances for a goverment office than the aristocracy. At the beginning the social status of those in medicine was not that low, but with the prejudice gradully rising among the aristocracy, it became generally agreed to belong to the upper-middle technician class. Dealing with life, however, they received social respect and courtesy from the public. Sometimes they collected wealth with their skills. They kept improving techniques and finally came to take an important share in modernization process during the late Chosun-Dynasty.

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Controversial issues in the legal restriction for prenatal genetic testing in Korea (산전검사 대상 질환에 대한 법적 규제의 문제점에 대한 고찰)

  • Choi, Ji-Young;Jeong, Seon-Yong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.4 no.2
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    • pp.186-189
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    • 2007
  • More than 6,000 rare disorders including genetic diseases have been reported. Of them, 1,500 diseases (1,211 for clinical diagnosis and 289 for research only) are technically possible for genetic testing. In Korea, since 2005, only 63 genetic diseases is permitted for prenatal genetic testing by the "Bioethics and Biosafety Law". The article 25 in the law prescribes 63 genetic diseases without clear indication for its selection and inclusion criteria. In EU, USA, and other foreign countries, however, there is no provision in the statute on prenatal genetic testing; it is not restricted by a law. Recently, a woman (Mrs. L, 38y) who is a carrier for Menkes disease made an appeal to a government for an amendment of the "Bioethics and Biosafety Law" prohibiting the prenatal diagnosis of her pregnancy at risk for Menkes disease. Menkes disease (MNK) is an X-linked recessive disorder characterized by neurodegeneration, connective tissue defects and hair abnormalities, and no effective treatment is available yet. The prevalence rate of MNK is one in about 250,000 live births. Menkes syndrome patients fail to absorb copper from the gastrointestinal tract in quantities adequate for meeting nutritional needs. These needs seem particularly acute during the initial 12 month of life, when the velocity of brain growth and motor neurodevelopment. Most of pts. die around 3yrs. of age. Mrs. L had a boy with Menkes disease who died at 2y.o. in 2001. Subsequent pregnancy in 2003, she was able to have prenatal genetic testing for mutation of the Menkes (ATP7A) gene and delivered a healthy baby boy. Now, She is pregnant again and wants to have prenatal diagnosis. however, this time, she was not allowed to have any more because Menkes disease is not included in 63 genetic diseases permitted by the law for prenatal genetic testing, in spite of the fact that she is a Menkes disease carrier and her pregnancy is at risk to have an affected baby. This case shows the practical problem of the legal restriction for prenatal genetic testing in Korea. In this study, we report a arguable case and discuss the controversial issues in the legal restriction for prenatal genetic testing in Korea.

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The Etiologic Diseases and Diagnostic Usefulness of Color Doppler Ultrasonography in Children with Chronic Coughs (소아 만성 기침의 원인 질환과 컬러 도플러 초음파 검사의 진단적 유용성)

  • Park, Sun Young;Lee, Joon Sung
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.489-497
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    • 2002
  • Purpose : The objectives of this study were to investigate the causes of chronic cough and to establish the appropriate diagnostic approach to chronic cough in children. Methods : One hundred and thirty two cases of chronic cough were prospectively evaluated. They visitors to pediatric chronic cough clinics at Kang-nam saint Mary's Hospital of Catholic University from August 2000 to July 2001 for 12 months. Careful history taking by questionnaire, physical examination, radiologic studies of chest and sinus, hematologic and immunologic studies, allergic skin tests, and methacholine challenge tests were performed. Color doppler(CD) ultrasonography were performed and compared with simultaneous 24 Hr. esophageal pH monitoring to diagnose gastroesophageal reflux disease(GERD). Results : Age distributions were demonstrated that nine in infants, 82 in early childhood, 38 in late childhood, and three in adolescence. Common causes of chronic cough were bronchial asthma in 40 cases, chronic sinusitis in 22 cases, GERD in seven cases, bronchial asthma combined with sinusitis in 28 cases, bronchial asthma combined with GERD in 14 cases, psychogenic cough in two. cases, foreign body in one case, chronic bronchitis in one case, and bronchiolitis in one case. Comparing with 24 Hr. pH monitoring, sensitivity, specificity, positive predictive value and negative predictive values of CD ultrasonography were 88%, 69%, 85 %, and 73% respectively. Conclusion : The most common causes of chronic cough in children were bronchial asthma, sinusitis and GERD in order. We suggest that CD ultrasonography can be used as a good, convenient screening method for patients with suspected GERD in outpatient settings.

A Study on the Outlook of Dentists on Dental Coordinators and Their Job (치과의사의 치과 코디네이터 업무 및 인식에 관한 조사연구)

  • Yoo, Jung-Sook;Jang, Mi-Hwa;Jung, Jae-Yeon;Cho, Myung-Sook;Choi, Bu-Geun;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.2
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    • pp.201-218
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    • 2005
  • The purpose of this study was to examine how dentists perceived dental coordinators including their education, hiring criteria, working condition and job. It's basically attempted to help define the job and role of 5 and to suggest how they should be nurtured. The subjects in this study were dentists at dental hospitals and clinics where dental coordinators were employed among approximately 200 dental institutions in Seoul, Cyeonggi province and Incheon. After a survey was conducted in June 2005, answer sheets from 99 respondents were analyzed. The findings of the study were as follows: 1. Regarding education for dental coordinators, 99.9% of the dentists investigated felt the need for separate education programs for dental coordinators, 42.4% knew what would-be dental coordinators learned about, and 81.8% considered it necessary for them to take intermediate or higher courses. An organization affiliated with the Korea Dental Hygienists Association was viewed as the best institute to educate dental coordinators, and educational institutes that included a department of dental hygiene was looked upon as the second best one. 68.7% believed that dental coordinators should take an official examination to test their qualifications, and concerning educational subsidy, the largest group of the dentists thought that a certain amount of subsidy should be provided. 2. As for coordinator hiring, the top priority was the impression(look) of applicants(55%), followed by adjustability to existing employees(24.5%) and professional competency(17.3%). As to the route of hiring, 41.4 percent, the largest group, reeducated some of existing employees, and dental hygienists were regarded as the best personnels to serve as a coordinator. Concerning job performance, they put the most emphasis on interpersonal relationship, which was followed by executive ability, impression and career, 58.6% the largest group, believed that dental coordinators should have a three-year or higher career to work at a dental institute. 3. As to working conditions, 75.7%, the largest group, paid dental coordinators based on their job performance, and 23.2%, the second largest group, had their pay equal to that of dental hygienists, 88.9% allowed them to determine their own retirement age. 4. In regard to their perception of dental coordinators, the largest number of the dentists considered it necessary for them to keep receiving education(4.29), and the second largest group felt that they served to enhance the image of dental institutes(4.18). The third largest group thought that they contributed to letting patients more satisfied with the quality of dental services. But they tended not to agree that their turnover rate was low(3.04), and they didn't find them to receive appropriate education, either(3.10). 5. The current major job of coordinators associated with customer services was handling appointments with customers(91.9%), treating unsatisfied customers(85.9%), and controling waiting time(84.8%). Regarding self-management, coordinators directed their energy into having good manners(89.9%), acquiring fundamental dental knowledge(84.8%), and learning how to treat customers(83.8%). Concerning hospital affairs handling, they were most responsible for information desk(87.9%), which was followed by receiving(86.9%). As a result of investigating what type of job the dentists hoped dental coordinators to fulfill in consideration of their career, their age and type of investment, the dentists wanted them the most to speak a foreign language, which belonged to the field of self-management.

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