• Title/Summary/Keyword: Clinical Circumstances

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Clinical Application of Model of Human Occupation on Goals Setting of Elderly person With Dementia: A Case Study (치매노인의 목표수립을 위한 인간작업모델 (Model of Human Occupation)의 적용: 사례연구)

  • Lee, Yu-Na;Jung, Min-Ye
    • Therapeutic Science for Rehabilitation
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    • v.2 no.1
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    • pp.66-76
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    • 2013
  • Objective : Based on the Model of Human Occupation (MOHO), this study was to identifies the goals setting of elderly person with dementia. Methods : For 5 weeks from May to June of 2012, MOHO-based interviews and Occupational Questionnaire(OQ), Interest checklist(IC), Volitional Questionnaire(VQ), The Assessment of Communication and Interaction Skills(ACIS), Occupational Performance History Interview-II(OPHI-II), Occupational Self Assessment(OSA), The Occupational Circumstances Assessment Interview and Rating(OCAIR) assessment were conducted on elderly person with dementia. Further interviews were conducted with case manager and family. Results : After interviews and assessments were conducted, the results of which showed limitations in social and family relationship, financial issues, general well-being. Conclusion : Applying the MOHO forms a basis for judging the subject in a holistic and general way, changes how the subject is viewed, suggests various strategies. For improving the professinoalism and qualities of occupational therapy service, and may help expand the range of other relevant areas.

Possibility of Clinical Philosophical Interpretation of Juyeok through Synchronicity (동시성을 통한 『주역』의 임상철학적 해석가능성)

  • Seok, Young-Jin
    • Journal of Korean Philosophical Society
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    • v.131
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    • pp.223-244
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    • 2014
  • In this paper, the author interprets Juyeok (The Book of Changes) as a philosophical book on self-culture instead of a book on divination. Juyeok, originally, was a book on divination written to tell fortunes; however, it has been a rich source producing the discourse of the humanities. This is because it has a unique system of linguistic symbols. Gwae-Hyo (Hexagrams and Horizontal Lines) system of Juyeok has a number of symbolic features, and there is too much room for new philosophical, cultural interpretations. Thus, Juyeok can be applied to any information and events, and it can, accordingly, help solve the problems of life we are facing. Moreover, Juyeok's unique characteristics are revealed very well in active intervention of persons who read and interpret it. Carl Gustav Jung is the very person who argued that one should interpret Juyeok through this active intervention. In the foreword of Juyeok translated by Richard Wilhelm, he mentions a possibility of the interpretation of Juyeok applying 'synchronicity.' According to him, Juyeok is a material not to predict the future or tell the fate ordained, but to look back on oneself or find the solutions of problems oneself. It allows the inquirer to interpret Gwae-Hyo-Sa (Explanations) not simply through the result of fortune-telling but the act of telling one's fortune. He applies 'synchronicity' to the finding of answers to one's problems in the given Gwae-Hyo-Sa. Synchronicity refers to 'the principle of non-causal relationship explaining a phenomenon of meaningful coincidence.' Here, simultaneity, unlike contingency the principle of causality refers to, means 'meaningful coincidence.' He presents a theory that the divination signs derived from Gwae-Hyo-Sang (Images) through synchronicity is a reflection of the psychology of the unconscious the fortune-teller or a man who receives the results of the divination signs has under certain circumstances on the outside. This is because Jung interprets it like this because the way of communication of Juyeok using symbolic language is not direct but indirect. Juyeok's system of symbolic language aims not at delivering objective knowledge, but the reader's self-transformation. This point can be applied in clinical philosophy. People who suffer from agony and pain in their daily lives may find meaningful and helpful advice for themselves no matter what Gwae-Hyo-Sa they choose in Juyeok. This is because it was originally hidden in their inner space and just revealed concretely through Gwae-Hyo-Sang or Gwae-Hyo-Sa in Juyeok. In this sense, we connect the meaning Gwae-Hyo-Sang or Sa contains from Juyeok to their circumstances, read counsel or advice needed ourselves and make it our own to be able to have power to change and help ourselves. And at this very point may be evaluated as an important role of Juyeok.

Surgical Management and Outcome of Tethered Cord Syndrome in School-Aged Children, Adolescents, and Young Adults

  • Kang, Joon-Ki;Yoon, Kang-Jun;Ha, Sang-Su;Lee, II-Woo;Jeun, Sin-Soo;Kang, Seok-Gu
    • Journal of Korean Neurosurgical Society
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    • v.46 no.5
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    • pp.468-471
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    • 2009
  • Objective : The adolescent presentation of tethered cord syndrome (TCS) is well-recognized, but continues to pose significant diagnostic and management controversies. The authors conducted a retrospective study of clinical outcomes after surgical intervention in 24 school-aged children, adolescents, and young adults with TCS. Methods : All 83 patients with a lipomyelomeningocele (LMMC) underwent untethering surgery for caudal cord tethering between 1987 and 2007. The clinical charts and follow-up data were reviewed. Of these patients, 24 school-aged children, adolescents, and young adults with TCS were studied with respect to the clinical, radiologic, pathologic features, and surgical outcomes. Results : Untethering procedures were performed in 24 patients (age range, 7-25 years) for TCS of various origins (lipoma, lipomyelomeningocele, and tight filum terminale). Specific circumstances involving additional tugging of the already tight conus, and direct trauma to the back precipitated the onset of symptom in 50% of the patients. Diffuse and non-dermatomal leg pain, often referred to the anorectal region, was the most common presenting symptom. Progressive sensorimotor deficits in the lower extremities, as well as bladder and bowel dysfunction, were also common findings, but progressive foot and spinal deformities were noted less frequently. The most common tethered lesions were intradural lipomas, thickened filum and fibrous band adhesions into the placode sac. The surgical outcome was gratifying in relation to pain and motor weakness, but disappointing with respect to resolution of bowel and bladder dysfunction. Of the 24 patients with TCS, pre-operative deficits improved after surgery in 14 (58.3%). remained stable in 8 (33.4%). and worsened in 2 (8.3%). Conclusion : The pathologic lesions of tethered cord syndrome in school-aged children, adolescents, and young adults, are mostly intradural lipomas and tight filum. It is suggested that the degree of cord traction results in neurologic dysfunction in late life due to abnormal tension, aggravated by trauma or repeated tugging of the conus during exercise. Early diagnosis and adequate surgical release might be the keys to the successful outcome in school-aged children, adolescents, and young adults with TCS.

The Predictive Value of Laser Doppler for Flap Survival (재관류손상을 받은 가토의 이개 피판에서 레이저도플러에 의한 피판 생존의 예측)

  • Kim, Seok Kwun;Park, Jung Min;Baek, Chang Yoon;Jung, Gi Hwan;Lee, Keun Cheol;Jung, Jin Suk;Park, Ju In;Park, Byung Ho
    • Archives of Plastic Surgery
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    • v.32 no.4
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    • pp.503-510
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    • 2005
  • If we could predict the necrosis of the flap caused by reperfusion injury, we can minimize the necrosis of the flap by taking appropriate action before necrosis begins. In this study, we examined whether we can predict the survival of flap under reperfusion injury or not, by measuring laser doppler flow meter values. We divided the group into the control and experimental groups corresponding to 6, 8, 9, 10, and 12hours after reperfusion(hours after ligation of auricular central artery). In each group, we examined necrotic change, perfusion unit (PU), serum superoxide dismutase (SOD), glutathione peroxidase, angiography and pathologic findings. No necrosis was observed in the 6 and 8 hours group but 8, 18, 20 hours after ligation, necrosis was observed, Also in each of 9, 10 and 12 hours group (each group consisted of 20 flaps), necrosis were noted. According to the above data, the critical time of necrosis in the auricular skin flap model lies between about 8 to 9 hours. Comparing the PU between the necrosis and non-necrosis groups, the former group showed a mean 39.57 PU increase after 60 min of reperfusion, and the latter group showed a mean increase of 21.21 PU. We can conclude that better flow can dilute oxygen free radical into systemic circulation, and this means less injuries are caused on vessels. Our study implies that if blood flow increase is less than 30 PU, intensive care is needed to save the flap. Additionally, we found significant decrease of serum SOD and glutathione peroxidase in the necrotic group. Therefore, monitoring these serum markers will be helpful in predicting reperfusion injury and supplementing these enzymes could be helpful to save the flap. The laser doppler flow meter is thought to be helpful in clinical circumstances for evaluating the circulation of the flap after the operation. However, more accumulation of clinical studies should be necessary establishing useful clinical data.

A Study on Clinical Korean Medicine Book 『JeSeBoGam』 during the Period of Japanese Occupation - with Focus on the Comparison with 『BangYakHapPyeon』 - (일제강점기 임상한의서 『제세보감』 연구 - 『방약합편』과의 비교를 중심으로 -)

  • Ku, Hyun-Hee
    • The Journal of Korean Medical History
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    • v.29 no.2
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    • pp.35-47
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    • 2016
  • "JeSeBoGam (濟世寶鑑)" was a medical document authored by Moon Gi-hong during the Japanese colonial rule in 1933, and the author acted as a Korean medicine doctor, an acupuncturist, a medicine practitioner and an apothecary. Since its first publication in 1933, it has been published three times in 1966 and 1975, from the Japanese colonial period to the liberation period. "JeSeBoGam" is largely divided into Preface part, "List of drugs according to symptoms [隨症用藥目錄]", "JeSeBoGam-Gap (濟世寶鑑甲)", and the Appendix includes "Key points for diagnosing the disease [察病要訣]" "Key points of acupuncture and pulse [脈訣]" "Key points of acupuncture and moxibustion treatment [針灸訣]" in the back of the book. In 1933, there are attached exam books and license application forms related to Korean medicine doctor and pharmacist, so strict regulations on them during the Japanese occupation period can be confirmed. "JeSeBoGam-Gap" contains 208 prescriptions from 143 prescriptions taken from "BangYakHapPyeon" and 65 prescriptions from other books. It divided into Gap (甲) Eul (乙) Byung (丙) Jung (丁). These prescriptions were placed in "List of drugs according to symptoms [隨症用藥目錄]" according to a symptom 1,286 times. Considerable parts of organization and prescription drug composition of "JeSeBoGam" are closely related with "BangYakHapPyeon", but there were adjustments in all medicinal ingredients and capacity for the rest of them except 23 prescription drugs. Compared to "BangYakHapPyeon", there was a tendency to substitute the basic prescription in "JeSeBoGam" for prescriptions used for the same disease. Though only 65 prescriptions were taken from books other than "BangYakHapPyeon", 575 times were reflected in "List of drugs according to symptoms [隨症用藥目錄]", and the rate of utilization is high compared with the number of prescriptions of "BangYakHapPyeon". It is thought that the circumstances of the Japanese occupation period, limits in medicinal ingredients composition due to regional characteristics, and changes in a patient's condition and the treatment method might have an influence on the author's drug use tendency. "JeSeBoGam" is similar to "BangYakHapPyeon" in composition, but it is a new practical medical book in which the author's clinical records are concentrated.

A Study of Huh-Im(許任)'s ChimGuKyungHumBang(『鍼灸經驗方』) (허임(許任) 『鍼灸經驗方』 연구(硏究))

  • Park, Mun-Hyun
    • The Journal of Korean Medical History
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    • v.15 no.1
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    • pp.63-146
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    • 2002
  • Huh-Im(許任, 1570~1647) was an acupuncture doctor of Chosun(朝鮮) era through the late 16th century and early 17th century. Even though he was a person of low birth, he participated in the loyal medication through three loyal generations, Sunjo(宣祖), Kwanghaegun(光海君) and Injo(仁祖). He was recognized of his services and became an official, 'Dangsanggwan'(堂上官) and Kyunggi(京畿) district official several times. In the early Chosun era, acupuncture medicine was focused. During the late 16th century, Imjin(壬辰) war aroused more needs about acupuncture medicine, and acupuncture doctors showed remarkable work. Under these circumstances, Huh-Im(許任)'s fame spread throughout the country. Huh-Im(許任) wrote ChimGuKyungHumBang("鍼灸經驗方") in 1644 based on his lifetime clinical acupuncture & moxibustion experience. It was the first specialized book of acupuncture in Chosun era. This event took place 30 years after DongEuiBoGam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") was published. But it was not influenced much by DongEuiBoGam - Acupuncture Chapter("東醫寶 鑑-鍼灸篇") in the form or contents. ChimGuKyungHumBang("鍼灸經驗方") and Huh-Jun(許浚)'s DongEuiBo- Gam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") were the fruits of the middle Chosun, and they are complementary to each other in theory and practice. The chief distinctions of ChimGuKyungHumBang("鍼灸經驗方") are in it's compact and practical edition and a lot of his clinical acupuncture prescriptions mentioned in the book. Huh-Im(許任) not only accepted the existing books such as NaeKyung("內經"), DongInSuHyulChimGuDoKyung and Shin- Eung Kyung("神應經") with his point of view and clinical experience, but also showed creative operation of studies. Indicating incorrect acupuncture points(訛穴), acupuncture remedy based on the visceral pathogenesis(臟腑病機) and the channel pathogenesis, research on new acupuncture points, sorting out plenty of outer meridian acupuncture points(經外奇穴), creating supplementary and purging acupuncture method(鍼補瀉法) which is a change of hand treatment of KiHyoYangBang("奇效良方"), operating variety of acupuncture and moxibustion treatments, and application of acupuncture treatments on surgery field such as intumescences and emergency cases are the examples. Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") influenced on the folk remedy books(民間經驗方書) in the late Chosun era. Compact and practical characteristics of the book let acupuncture treatment be freindly to the people. It can be confirmed in JeungBoSanRimKyungJe-Emergency Chapter("增補山林經濟-救急篇") or the formation of SaAmChimBob(舍巖鍼法). ChimGuKyungHumBang("鍼灸經驗方") was introduced to Japan in 18th century and published twice. ChimGuJibSung("鍼灸集成"), known as an acupuncture medical book of late Qing dynasty(淸末, 1874), is confirmed to be an plagiarization of DongEuiBoGam-Acupuncture Chapter("東醫寶鑑-鍼灸篇") and ChimGuKyungHum- Bang("鍼灸經驗方") of 17th century Chosun. Confusions and errors arouse from mistaken editional trend of ChimGuJIbSung("鍼灸集成") which had not disclosed it's original author and the title of the book must be reformed. In this way, fruits of acupuncture of the middle Chosun era including Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") will take a right place in acupuncture medicine history.

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Data mining Algorithms for the Development of Sasang Type Diagnosis (사상체질 진단검사를 위한 데이터마이닝 알고리즘 연구)

  • Hong, Jin-Woo;Kim, Young-In;Park, So-Jung;Kim, Byoung-Chul;Eom, Il-Kyu;Hwang, Min-Woo;Shin, Sang-Woo;Kim, Byung-Joo;Kwon, Young-Kyu;Chae, Han
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1234-1240
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    • 2009
  • This study was to compare the effectiveness and validity of various data-mining algorithm for Sasang type diagnostic test. We compared the sensitivity and specificity index of nine attribute selection and eleven class classification algorithms with 31 data-set characterizing Sasang typology and 10-fold validation methods installed in Waikato Environment Knowledge Analysis (WEKA). The highest classification validity score can be acquired as follows; 69.9 as Percentage Correctly Predicted index with Naive Bayes Classifier, 80 as sensitivity index with LWL/Tae-Eum type, 93.5 as specificity index with Naive Bayes Classifier/So-Eum type. The classification algorithm with highest PCP index of 69.62 after attribute selection was Naive Bayes Classifier. In this study we can find that the best-fit algorithm for traditional medicine is case sensitive and that characteristics of clinical circumstances, and data-mining algorithms and study purpose should be considered to get the highest validity even with the well defined data sets. It is also confirmed that we can't find one-fits-all algorithm and there should be many studies with trials and errors. This study will serve as a pivotal foundation for the development of medical instruments for Pattern Identification and Sasang type diagnosis on the basis of traditional Korean Medicine.

An Enlarged Perivascular Space: Clinical Relevance and the Role of Imaging in Aging and Neurologic Disorders (늘어난 혈관주위공간: 노화와 신경계질환에서의 임상적의의와 영상의 역할)

  • Younghee Yim;Won-Jin Moon
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.538-558
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    • 2022
  • The perivascular space (PVS) of the brain, also known as Virchow-Robin space, consists of cerebrospinal fluid and connective tissues bordered by astrocyte endfeet. The PVS, in a word, is the route over the arterioles, capillaries, and venules where the substances can move. Although the PVS was identified and described first in the literature approximately over 150 years ago, its importance has been highlighted recently after the function of the waste clearing system of the interstitial fluid and wastes was revealed. The PVS is known to be a microscopic structure detected using T2-weighted brain MRI as dot-like hyperintensity lesions when enlarged. Although until recently regarded as normal with no clinical consequence and ignored in many circumstances, several studies have argued the association of an enlarged PVS with neurodegenerative or other diseases. Many questions and unknown facts about this structure still exist; we can only assume that the normal PVS functions are crucial in keeping the brain healthy. In this review, we covered the history, anatomy, pathophysiology, and MRI findings of the PVS; finally, we briefly touched upon the recent trials to better visualize the PVS by providing a glimpse of the brain fluid dynamics and clinical importance of the PVS.

Present Situation of Korean Nursing (한국간호의 현재)

  • Choi, Euy-Soon
    • Women's Health Nursing
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    • v.10 no.3
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    • pp.190-199
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    • 2004
  • This thesis explores the actual circumstances of Korean nursing by investigating its present situations. Ultimately, the intent of this study aims to establish a future direction of Korean Nursing. As such, the current conditions of Korean nursing is analyzed in the following categories: education, practice, research, nursing policy, expansion of nursing field, and entrepreneurship. In the final conclusion, an appropriate orientation of the future of Korean nursing is discussed. There are two primary Nursing programs, a three-year(63) and a four-year(53), in Korean Nursing education. Master's programs are available at 32 nursing schools or 32 professional graduate schools. A total of 15 nursing schools have a doctoral program in Korea. The ratio of graduates between the three-year and four year programs is 76:24. Hence, it is highly encouraged to expand four-year nursing programs, because it will help raise the social status of nursing professionals as well as the quality of nursing. In the clinical nursing field, independency and self regulation are critical. As such, organizational change, implementation of a standardized nursing m information system, appropriate workforce, and improvement of the reimbursement system in nursing is recommended. In community nursing, the following should be resolved to provide better nursing services: improvement of working condition and benefits, establishment of a law enforcing the hiring of nurses, and providing continuing education. The number of nursing research has increased and nursing studies are in great quantity. However, research in practices and theories are more in demanded. Hence, research that integrates theories and practices are very significant. Ultimately, it is critical to support nursing studies that will influence nursing policy. The Korean Nurses Association(KNA) is an organization that supervises the nation's nursing policy. The primary focus of KNA is to combine the three and four year undergraduate education systems into 4 years and to establish the Nursing Practice Act. The Ministry of Health and Welfare has adapted a system to educate and certify nurse specialists in 10 nursing areas in 21 nursing graduate schools expecting high-quality nursing services and a decrease of cost. The government also allowed nurses to operate facilities for health management or welfare agencies.

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Prostate Cancer: A Hospital-Based Survival Study from Mumbai, India

  • Balasubramaniam, Ganesh;Talole, Sanjay;Mahantshetty, Umesh;Saoba, Sushama;Shrivastava, Shyam
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2595-2598
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    • 2013
  • Background: Prostate cancer is common in elderly men, especially in western countries, and incidences are rising in low-risk populations as well. In India, the age-standardized rates vary between registries. Under these circumstances we have estimated the survival of prostate cancer patients based on age, family history, diabetes, hypertension, tobacco habit, clinical extent of disease (risk group) and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India. During years 1999-2002, some 850 prostate cancer cases, including 371 new cases, treated in TMH were considered as eligible entrants for the study. Five-year survival rates using actuarial and loss-adjusted (LAR) method were estimated. Results: The patient population was distributed uniformly over the three age groups. A larger proportion of the patients were diagnosed at 'metastatic stage' and hormone treatment was most common. 20% patients had history of diabetes and 40% with hypertension. The 5-year overall survival rate was 64%. Survival was 55%, 74% and 52% for '<59 years','60-69 years' and '>70 years' respectively. Non-diabetic (70%), hypertensive (74%), with family history (80%) of cancer, with localized-disease (91%) and treated with surgery, either alone or in combination, (91%) had better survival. Conclusions: The present study showed that prostate cancer patients with localized disease at diagnosis experience a better outcome. Local treatment with either surgery or radiation achieves a reasonable outcome in prostate cancer patients. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies available now.