• Title/Summary/Keyword: Clinical observation

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An Analysis of Physicians' Online Information Search Process at the Point of Care (의사의 임상질문 해결을 위한 온라인 정보검색과정 연구)

  • Kim, Soon;Chung, EunKyung
    • Journal of the Korean Society for information Management
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    • v.33 no.3
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    • pp.177-193
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    • 2016
  • This study aims to analyze physicians' online information search process to solve the clinical questions at the point of care. To achieve this purpose, ten university hospital-based physicians participated in-depth interviews and observation studies. Based on Wilson's problem solving process, this study analyzed the characteristics of each information search stage and efficiency of online searching. The results showed that participants tend to relatively immediately formulate their clinical questions. However, basic searching strategies were only used and a few preferred information sources were chosen. However, average satisfaction degree of online searching appeared high with 5.7 (7 Likert-scale) and problem-solving index increased after searching. As physicians are likely to use well organized and evidenced-based credible information easily, it implies the needs for an integrated search system within the electronic medical record (EMR). In addition, as other online resources' awareness is lower comparing Google and PubMed, active promotions and training of other resources are needed.

A clinical observation for 25 cases of patients who are taken by chiefly complained of neck pain (항통(項痛)을 주소(主訴)로 입원(入院) 치료(治療)한 환자(患者) 25례(例)에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee Eun-Yong;Lee Byung-Ryul
    • Journal of Acupuncture Research
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    • v.15 no.2
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    • pp.393-406
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    • 1998
  • Twenty five cases of the patient admission-treatment from chiefly complained of neck pain observed clinically from first January 1997 to thirty first December 1997 in the Dept. of Acupuncture and Moxibustion, Oriental Hospital, Taejon University, Taejon, Korea. And the results were obtained as follows; 1. The distribution of sex was male 13(52%) cases, female 12(48%) cases and the male to female ratio was 1.1 : 1. The distribution of age was the most predominant as the fifties 6(24%) cases. 2. The contributing factors were the most predominant as the reason unknown 9(36%) cases, unstable position 5(20%) cases. 3. The distribution of duration was the most predominant of 9(36%) cases in a week. 4. The distribution of before admission-treatments were the most predominant as west-medication 13(32.5%) cases. 5. The distribution of patient's condition of first treatment was the most predominant as Gr.III 13(52%) cases. 6. The distribution of duration for admission was the most predominant as 13(52%) cases in a week. 7. The distribution of radiological studies were the nust predominant as the HIVD 26(63.4%) cases. 8. The distribution of clinical symptoms were the most predominant as neck pain 25(21.0%) cases, radiating pain to the upper extremities 23(19.3%) cases. 9. The distribution of located on clinical syrnptoms were the most predominant as neck-shoulder and back-upper extremities 11(44%) cases. 10. The distribution of clinical diagnosis was the most predominant as HIVD 16(45.7%) cases. 11. The distribution of methods of treatment were the most predominant as Acupuncture -­ Herb Medication - Electro Acupuncture treatment 8(32%) cases. 12. The effect of treatment by discharge was the most predominant of 11(44%) cases as Good result.

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A literature review on clinical/ laboratory misfit evaluation on implant-prosthesis (임플란트와 상부보철물의 임상적/실험적 부적합 평가에 관한 문헌고찰)

  • Kim, Jong-Hoi;Cho, Woong-Rae;Ko, Kyung-Ho;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • The Journal of the Korean dental association
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    • v.56 no.9
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    • pp.462-478
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    • 2018
  • The presence of implant-prosthesis misfits can cause various complications. It is very important to detect misfits to prevent such complications. There are various evaluation methods for misfit assessment including clinical methods and laboratory in vitro methods. The clinical misfit evaluation includes radiographic analysis, visual observation, probing, Sheffield test, evaluation with disclosing materials, and screw resistance test. The laboratory in vitro evaluation method includes indirect modelling evaluation and direct metrological visualization. Of the indirect modelling methods, photoelastic stress analysis, finite element analysis, strain gauge analysis, and microbial colonization analysis were reviewed. Of the direct metrological visualization, microscopic analysis, 3-D photogrammetric analysis, coordinate measuring analysis, and radiographic analysis were reviewed. In this review, the characteristics, advantages and disadvantages of each method were evaluated.

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Dose range finding study of KOB03, a new polyherbal medicine for the treatment of allergic rhinitis, by oral administration for four weeks in Sprague-Dawley rats (한약제제 KOB03의 랫드에서의 4주 반복 경구투여에 의한 독성 연구)

  • Jung, Jin-Ki;Park, Yong-Ki
    • The Korea Journal of Herbology
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    • v.27 no.3
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    • pp.101-106
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    • 2012
  • Objectives : To evaluate the toxicity of KOB03, polyherbal medicine for the treatment of allergic rhinitis, we performed the dose-range finding test of KOB03 by oral supplementation for 4 weeks in Sprague-Dawley rats. Methods : The water extract of KOB03 consisting of five different herbs was supplied from GLP company. KOB03 was supplemented by gavage at 0, 500, 2,500 and 5,000 mg/kg/day for 4-week consecutive days. We recorded the clinical signs of toxicity, body weight, organ weights, hematology, gross and histological changes in target organs of rats, and clinical chemistry analysis. Results : KOB03 at all doses was shown no mortality or abnormal clinical signs in rats during at the observation period. Furthermore, there was no difference in body weight and food-take consumption, organ weight, gross pathological findings, and urine analysis among the groups of rats treated with different doses of KOB03. The hematological analysis and clinical blood chemistry data were revealed no toxic effects from KOB03-supplemented rats. Conclusions : The results suggest that KOB03 is a wide margin of safety on dose-range toxicity in rats. The no observable adverse effect level (NOAEL) of the test, KOB03 in rats is no less than 5,000 mg/kg/day.

The Clinical Effect of Oxiracetam in Patients with Organic Brain Syndrome-Double Blind, Placebo-Controlled Study (기질성 뇌증후군에서 Oxiracetam의 임상적 효과에 대한 이중맹검 대조연구)

  • 이병철;권기한;권기한;송홍기;김성민;유경호;이현미;강경수;윤여훈
    • YAKHAK HOEJI
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    • v.37 no.5
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    • pp.442-452
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    • 1993
  • Previous experimental and clinical investigations suggest a possible role of new nootropic drug, oxiracetam, in improving cognitive performances in patients affected by organic brain syndrome. In this study, the cognitive and behavioral effects of oxiracetam treatment in patients with clinical symptoms of organic brain syndrome were evaluated. Sixty-six patients were enrolled and assigned to either oxiracetam or placebo, according to a randomized, double-blind design between two patient-groups. Either oxiracetam or placebo was orally given bid for 8 weeks ; daily dose of oxiracetam was 1600mg. All the patients, enrolled in this study, were diagnosed as having mild to moderate cognitive dysfunction as defined by a baseline Mini Mental State ExaminationKorean version (MMSE-K) score between 14 and 25. The patients under-went, at baseline, 4 weeks and 8 weeks after, routine laboratory study (CBC, SMA12, U/A, EKG) and the following neuropsychological tests ; MMSE-K, modified Korean Wechsler Intelligence Scale(MKWIS), Nurses' Observation Scale for Geriatric patients(NOSGER). Fifteen patients of whom were dropped out or excluded from the analysis because of poor compliance or violation of the protocol. Fiftyone patients (aged 54~78 years, male 25, female 26) were analyzed (vascular dementia, 30 ; senile dementia of Alzheimer type, 9 ; mixed type, 5 ; other cause, 7). Statistical analysis of the data demonstrated that the two groups were comparable at baseline. At the end of each study period the oxiracetam group scored significantly better on the majority of the tests evaluating cognitive function, psychometricity and the improvement rating scale of subjective symptoms than placebo group, in which worsening trends or no changes were seen on the whole. No side effects were noted during oxiracetam treatment. The present study, showing positive clinical findings after oxiracetam therapy, confirmed that this drug can be useful pharmacological treatment in organic brain syndrome.

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A CLINICAL AND RADIOGRAPHIC STUDY OF THE CONSERVATIVE TREATMENT OF THE NECROTIC AND INFECTED PRIMARY MOLARS (괴사유치(壞死乳齒)의 보존적 처치에 관한 연구)

  • Hur, No-Jeong;Yang, Joung-Kang
    • Journal of the korean academy of Pediatric Dentistry
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    • v.2 no.1
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    • pp.67-75
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    • 1975
  • The conserative treatment of the necrotic and infected primary molars is often necessary in order to avoid extractions which may lead to inability to masticate or loss of space and subsequent problems concerning the development of the occlusion in the permanent dentition. The purpose of this study was to evaluate the clinical significance of the conservative treatment of the infected primary molars with necrotic pulps employing the formocresol pulpotomy technique same as in vital teeth and surgical intervention in the cases with a parulis, fistula or cellulitis. The materials consisted of 25 primary molars of 9 boys and 4 girls ranging in age from 4 to 7 years. This study included clinical and radiographic observation at 3-month intervals postoperatively. The following results were obtained. 1. Clinically, 20 cases of 25 were successful, exhibiting no clinical problems such as fistula, mobility, toothache and tenderness to percussion, etc. 5 cases were regarded as failures. 2. Radiographiclly, 14 cases revealed normal features, in 6 cases slight rarefaction was observed in the periapical and interradicular region, and marked periapical and interradicular rarefaction was observed in 5 cases. 3. Marked bony deposition was observed in the periapical and interradicular regions in all the remainder except for 5 failurese. 4. Pathologic root resorption was observed in 2 cases. 5. No alveolodental ankylosis was observed. 6. Regeneration of the dental sac of the permanent tooth was observed in 1 case of 2 cases which had revealed loss of the dental sac.

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Clinical Analysis of 21 Cases of Spinal Cord Ependymoma : Positive Clinical Results of Gross Total Resection

  • Kaner, Tuncay;Sasani, Mehdi;Oktenoglu, Tunc;Solmaz, Bilgehan;Sarioglu, Ali Celin;Ozer, Ali Fahir
    • Journal of Korean Neurosurgical Society
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    • v.47 no.2
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    • pp.102-106
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    • 2010
  • Objective : To evaluate the clinical results of gross total resection in the surgical approach to spinal ependymoma. Methods : Between June 1995 and May 2009,13 males and 8 females (mean age 34) diagnosed with intramedullary or extramedullary spinal ependymoma were surgically treated at our centre. The neurological and functional state of each patient were evaluated according to the modified McCormick scale. Results : The average follow-up duration was 54 months (ranging from 12 to 168 months). The locations of the lesions were : thoracic region (4, 19%), lumbar region (7, 34%), cervical region (4, 19%), cervicothoracic region (3, 14%) and conus medullaris (3, 14%). Four patients (19%) had deterioration of neurological function in the early postoperative period. The neurological function of three patients was completely recovered at the 6th postoperative month, while that of another patient was recovered at the 14th month. In the last assessment of neurological function, 20 patients (95%) were assessed as McCormick grade 1. No perioperative complications developed in any of our patients. In one patient's 24-month assessment, tumour recurrence was observed. Re-operation was not performed and the patient was taken under observation. Conclusion : Two determinants of good clinical results after spinal ependymoma surgery are a gross total resection of the tumour and a good neurological condition before the operation. Although neurological deficits in the early postoperative period can develop as a result of gross total tumour resection, significant improvement is observed six months after the operation.

Mapping Tool for Semantic Interoperability of Clinical Terms (임상용어의 의미적 상호운영성을 위한 매핑 도구)

  • Lee, In-Keun;Hong, Sung-Jung;Cho, Hune;Kim, Hwa-Sun
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.60 no.1
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    • pp.167-173
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    • 2011
  • Most of the terminologies used in medical domain is not intended to be applied directly in clinical setting but is developed to integrate the terms by defining the reference terminology or concept relations between the terms. Therefore, it is needed to develop the subsets of the terminology which classify categories properly for the purpose of use and extract and organize terms with high utility based on the classified categories in order to utilize the clinical terms conveniently as well as efficiently. Moreover, it is also necessary to develop and upgrade the terminology constantly to meet user's new demand by changing or correcting the system. This study has developed a mapping tool that allows accurate expression and interpretation of clinical terms used for medical records in electronic medical records system and can furthermore secure semantic interoperability among the terms used in the medical information model and generate common terms as well. The system is designed to execute both 1:1 and N:M mapping between the concepts of terms at a time and search for and compare various terms at a time, too. Also, in order to enhance work consistency and work reliability between the task performers, it allows work in parallel and the observation of work processes. Since it is developed with Java, it adds new terms in the form of plug-in to be used. It also reinforce database access security with Remote Method Invocation (RMI). This research still has tasks to be done such as complementing and refining and also establishing management procedures for registered data. However, it will be effectively used to reduce the time and expenses to generate terms in each of the medical institutions and improve the quality of medicine by providing consistent concepts and representative terms for the terminologies used for medical records and inducing proper selection of the terms according to their meaning.

Clinical presentation and specific stabilizing exercise management in Lumbar segmental instability (요추분절의 불안정성에 대한 임상적 소개와 안정성 운동관리)

  • Jung Yeon-Woo;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.155-170
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    • 2003
  • Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

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Safety Evaluation of LB10522, a New Cephalosporin Antibiotic

  • Kim, Seong-Il;Raffi Mikaelian;Kwak, Jin-Hwan;Kim, In-Chull;Lee, Chang-Ho
    • Biomolecules & Therapeutics
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    • v.3 no.4
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    • pp.316-321
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    • 1995
  • All the pharmacological studies of LB17522 described here were carried out with high doses (fifteen to sixty times of the therapeutic dose) to determine an indication of potential side effects in clinical use in terms of the acute clinical signs, cardiovascular and central nervous system. LB10522 does not produce any observable clinical signs except for the symptoms such as moist eye, skin rash, slight salivation, vomitting, and slightly reduced activity. The effects of LB10522 on the hemodynamics and cardiac function of anesthetized beagle dogs are as follows; heart rates and mean arterial blood pressure had a tendency to increase mildly, which is a normal finding in anesthetized dogs. All the animals except for one showed relatively stable respiratory rates throughout the observation period. Each animal treated with LB10522 showed slight increase in the left cardiac work and left ventricular stroke work which are mainly related to corresponding increases in cardiac output. Femoral blood flow were shown to be increased in some animals treated with LB10522. The epileptogenic activities of various cephalosporins were assessed by a direct intracerebral injection of appropriate concentration of test articles. The CD$_{50}$ values (nmol) obtained from the analysis of the dose-response data are as follows; 78.2, 175.3, 156.3, and 53.5 for cefazolin, cephaloridine, ceftazidime, and LB 10522, respectively. LB10522 seems to be equipotent with cefazolin or to be three times more potent than cephaloridine and ceftazidime in causing adverse CNS stimulation. Taken into consideration all the information obtained, LB10522 is not supposed to induce much changes in the functions examined in these studies in man at therapeutic doses.s.

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