• 제목/요약/키워드: individualized medicine

검색결과 198건 처리시간 0.028초

진무탕으로 임상적 관해가 유도된 크론병 환자: 증례보고 (Clinical Remission of Crohn's Disease Induced by Herbal Decoction (Jinmoo-tang): A Case Report)

  • 이병희;원지윤;이향숙
    • 동의생리병리학회지
    • /
    • 제35권6호
    • /
    • pp.255-260
    • /
    • 2021
  • Crohn's disease (CD) is an idiopathic inflammatory bowel disease (IBD) with unknown etiopathogenesis. Currently there are no definitive treatment modalities for CD. This case report presents clinical remission and its maintenance of CD induced by Korean herbal medicine treatment. A 56-year-old male patient diagnosed as CD by capsule endoscopy presented to a Korean Medicine clinic with severe abdominal pain as a chief complaint. Despite taking 5-aminosalicylic acid and immunosuppressant for 2 years, his abdominal pain was worsening at the time of visit. Treatment was initiated with Jinmoo-tang based on pattern identification and continued for approximately a year with some modifications according to patient's symptom changes. He was mainly given Jinmoo-Tang for a year and clinical remission was achieved; he could stop taking western medications. For 6 years since then, he took Korean medicine from time to time when he felt his condition went down and he is still maintaining remission. There were no adverse events reported. This case report suggests that individualized Korean herbal medicine treatment may have the potential for induction and maintenance of clinical remission of CD. Further research is warranted to establish an evidence-base for such approach.

퇴행성 슬관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 면접조사 (An Interview Survey for Developing Clinical Trial Protocol on Individualized Acupuncture Treatment for Knee Osteoarthritis)

  • 이상훈;서병관;서정철;이승덕;김선웅;최선미;김용석
    • Journal of Acupuncture Research
    • /
    • 제22권6호
    • /
    • pp.189-199
    • /
    • 2005
  • Objectives : This interview survey was carried out to identify how Korean medical doctors make acupuncture prescriptions for knee osteoarthritis in clinics. Methods : Survey questions were developed based on a consensus of acupuncture professors at Kyung Hee University, Dongguk University, Daegu Haany University. The interviews were conducted to 72 members of the Korea Oriental Medical Association who answered to prefer remote acupuncture prescription at previous telephone survey. Results : Korean medical doctors prefer to use five shu acupuncture points, especially 'hyung' or , 'shu' points, on the contralateral side of lesion and that the first target organ is liver. Five element points theory was mainly based on 'Nanjing' and 'Hwangdi Neijing'. The De-qi sensation of both doctor and patients was emphasized. Diagnosis and evaluation generally depend on subjective evaluation rather than objective scale. Conclusion : This study showed that Koran medical doctors prefer to follow the Korean traditional acupuncture methods respecting the old classic principles. And these results can guide us to develop advanced clinical trial protocols more close to our acupuncture practice.

  • PDF

Predictors of massive transfusion protocols activation in patients with trauma in Korea: a systematic review

  • Dongmin Seo;Inhae Heo;Juhong Park;Junsik Kwon;Hye-min Sohn;Kyoungwon Jung
    • Journal of Trauma and Injury
    • /
    • 제37권2호
    • /
    • pp.97-105
    • /
    • 2024
  • Purpose: Massive transfusion protocols (MTPs) implementation improves clinical outcomes of the patient's resuscitation with hemorrhagic trauma. Various predictive scoring system have been used and studied worldwide to improve clinical decision. However, such research has not yet been studied in Korea. This systematic review aimed to assess the predictors of MTPs activation in patients with trauma in Korea. Methods: The PubMed, Embase, Cochrane Library, Research Information Sharing Service databases, KoreaMed, and KMbase were searched from November 2022. All studies conducted in Korea that utilized predictors of MTPs activation in adult patients with trauma were included. Results: Ten articles were eligible for analysis, and the predictors were assessed. Clinical assessments such as systolic and diastolic blood pressure, shock index (SI), prehospital modified SI, modified early warning system (MEWS) and reverse SI multiplied by the Glasgow Coma Scale (rSIG) were used. Laboratory values such as lactate level, fibrinogen degradation product/fibrinogen ratio, and rotational thromboelastometry (ROTEM) were used. Imaging examinations such as pelvic bleeding score were used as predictors of MTPs activation. Conclusions: Our systematic review identified predictors of MTPs activation in patients with trauma in Korea; predictions were performed using tools that requires clinical assessments, laboratory values or imaging examinations only. Among them, ROTEM, rSIG, MEWS, SI, and lactate level showed good effects for predictions of MTPs activation. The application of predictors for MTP's activation should be individualized based on hospital resource and skill set, also should be performed as a clinical decision supporting tools.

Virtual reality education program including three-dimensional individualized liver model and education videos: A pilot case report in a patient with hepatocellular carcinoma

  • Jinsoo Rhu;Soyoung Lim;Danbee Kang;Juhee Cho;Heesuk Lee;Gyu-Seong Choi;Jong Man Kim;Jae-Won Joh
    • 한국간담췌외과학회지
    • /
    • 제26권3호
    • /
    • pp.285-288
    • /
    • 2022
  • Three-dimensional (3D) modeling of the liver can be especially useful for both the surgeon and patient to understand the actual location of the tumor and planning the resection plane. Virtual reality (VR) can enhance the understanding of 3D structures and create an environment where the user can focus on contents provided. In the present study, a VR platform was developed using Unreal Engine 4 software (Epic Games, Potomac, MD, USA). Patient's liver based on magnetic resonance image was imported as a 3D model that could distinguish liver parenchyma, vascular structure, and cancer. Preoperative education videos for patients were developed. They could be viewed inside the VR platform. To evaluate the usefulness of VR education program for patients undergoing liver resection for hepatocellular carcinoma, a randomized clinical trial evaluating the knowledge and anxiety of the patient was designed. The case presented in this report was the first experience of performing the VR education program and examining the knowledge and anxiety using questionnaires. When the knowledge score increased, the anxiety score also increased after the education program. Based on findings of this pilot case study, the timing and place where the questionnaire will be answered can be modified for formal initiation of the randomized controlled study to examine the usefulness of VR in patient education.

중족통의 원인 (Cause of Metatarsalgia)

  • 곽희철;하동준
    • 대한족부족관절학회지
    • /
    • 제21권3호
    • /
    • pp.79-82
    • /
    • 2017
  • Metatarsalgia is one of the most common causes of patients complaining of pain in their feet. This pain is the plantar forefoot, including the second to fourth metatarsal heads and arises from either mechanical or iatrogenic causes. On the other hand, it is frequently accompanied by a deformity of the toes as well as of the first and fifth rays. The pain has a variety of causes, and sometimes the cause is difficult to distinguish. The variability of possible causative factors necessitates an individualized approach to treatment. To determine these causes, this paper presents an overview of the gait mechanics, plantar pressure, and the classification according to the etiology.

혈액종양 청소년의 질병 경험 (Illness Experience of Adolescents with Hematologic Malignancies)

  • 손선영
    • 대한간호학회지
    • /
    • 제41권5호
    • /
    • pp.603-612
    • /
    • 2011
  • Purpose: The purpose of this study was to describe the experience process of adolescents with hematologic malignancies. The question for the study was "What is the experience of adolescents with hematologic malignancies like?" Methods: The grounded theory methodology was used for this study. The data were collected through in-depth interview from 10 adolescents with hematologic malignancies. Data collection was done from January to June 2007. Theoretical sampling was used until the data reached saturation. Results: As a result of the analysis, "Reconstructing self-image from deviated and suspended life" was identified as the core category. And 11 subcategories were identified and they were integrated to the core category. 'Establishment of expanded and matured self' was identified as the consequence. Conclusion: The results of the study provide a frame for effective individualized nursing intervention strategies in helping adjustment of the adolescents with hematologic malignancies.

Surgery in Pediatric Crohn's Disease: Indications, Timing and Post-Operative Management

  • Kim, Seung
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제20권1호
    • /
    • pp.14-21
    • /
    • 2017
  • Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients. Surgery can affect a patient's clinical course, especially for pediatric CD patient who are growing physically and mentally, so the decision should be made by careful consideration of several factors. The complex and diverse clinical conditions hinder development of a systemized treatment algorithm. Therefore, timing of surgery in pediatric CD patients should be determined with individualized approach by an experienced and well organized multidisciplinary inflammatory bowel disease team. Best long-term outcomes will require proactive post-operative monitoring and therapeutic modifications according to the conditions.

정신과 영역에서 벤조다이아제핀계 약물의 사용과 문제점 (Practice Guideline of Use of Benzodiazepines in Psychiatric Field)

  • 오강섭
    • 대한불안의학회지
    • /
    • 제1권1호
    • /
    • pp.37-42
    • /
    • 2005
  • Benzodiazepines are widely used for a variety of conditions in psychiatric field. In this article, the author reviewed the indications, the effects on anxiety and sleep disorders, the side effects, the drug-drug interactions, and the tapering strategies. Benzodiazepines were relatively safe and useful for the treatment of anxiety and sleep disorders. However, used clinically, benzodiazepines can induce many adverse effects (e. g. over-sedation, cognitive impairments, paradoxical effects, dependence and withdrawal symptoms, and so on). Currently available informations about their effects on the developing fetus is controversial. For this reason, pregnant women and nursing mother should be cautioned against the use of benzodiazepines. Drug-drug interactions have to be considered in combination treatments. For the tapering issues, gradual tapering was important to prevent the withdrawal symptoms. Especially, the tapering schedules have to be individualized for the each long-term benzodiapzepine users.

  • PDF

혈액종양이 있는 청소년의 사회심리적 적응:이탈되어진 삶에서 자아통합 해나가기 (Psychosocial Adjustment of Adolescents with Hematologic : Self-integration from Deviated Life)

  • 손선영
    • Child Health Nursing Research
    • /
    • 제15권3호
    • /
    • pp.282-290
    • /
    • 2009
  • Purpose: The main purpose of this study was to observe the adaptation experience process of adolescents with hematologic malignancies. Methods: The Grounded Theory Method, developed by Strauss & Corbin (1998), was used in this study. The data were collected through in-depth. interviews with 10 adolescents with cancer. Data collection and analysis occurred concurrently. Theoretical sampling technique was used until the data reached saturation. Results: "A deviated life" was verified as the central phenomenon for adolescents with cancer. The adaptation experience process was divided into 3 steps: "Self-confusion", "Reinterpretation", and "Regeneration of self". Through these 3 steps, the adolescents with hematologic malignancies fitted a new life by self-integration. Conclusion: The results of this study provide a frame for individualized nursing intervention strategies in helping with the psychosocial adaptation of adolescents with hematologic malignancies.

  • PDF

Sex-Gender Differences in Irritable Bowel Syndrome

  • Kim, Young Sun;Kim, Nayoung
    • Journal of Neurogastroenterology and Motility
    • /
    • 제24권4호
    • /
    • pp.544-558
    • /
    • 2018
  • Because of the sex-gender differences that are shown in a diversity of physiological and psychological factors, it can be speculated that the clinical presentation of symptoms as well as treatment strategies in women and men with irritable bowel syndrome (IBS) may differ. Studies have revealed that IBS is more common in women than men. As for the IBS subtype, IBS with constipation is significantly more prevalent among women than men. Sex hormones and gender differences may play important roles in the pathophysiology of IBS. However, its pathophysiologic mechanisms still remain largely unknown, and therapeutic implications are limited. Moreover, women IBS patients have been reported to feel more fatigue, depression, anxiety, and lower quality of life than men IBS patients. Furthermore, there has been evidence of differences in the appropriate treatment efficacy to IBS in men and women, although relatively few men are enrolled in most relevant clinical trials. A more sex-gender-oriented approach in the medical care setting could improve understanding of heterogeneous patients suffering from IBS. An individualized and multicomponent approach including sex and gender issues might help improve the treatment of IBS.