• Title/Summary/Keyword: Clinical standards

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The Study on the Clinical Application of the Methods of Sasang Constitution Diagnosis (사상체질(四象體質) 진단법(診斷法)(용모(容貌), 체형(體形), 심성(心性))의 임상적(臨床的) 적용(適用)에 관한 연구(硏究))

  • Kim, Jong-Weon;Jung, Won-Gyo
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.2
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    • pp.34-42
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    • 2000
  • Background and Purpose ; Sasang Constitutional medicine is dividing individual's constitutions into four categories. Determination of an individual's constitution however, can be different according to what diagnostic standards apply. In this study, We investigated how different the applying results of the three diagnostic standards-the yong-mo(容貌), the body type(體形), and the mind(心性)-are and what the inter-diagnostic standard agreement is. Methods ; 36 patients in cerebral-infarction, admitted into the Dong-Eui Korean hospital from 1. May. 2000 to 12. October. 2000, were diagnosed by three diagnostic standards - the yong-mo(容貌), the body type(體形), and the mind(心性). Each patient was treated by Sasang constitutional medicine. The agreement of the final constitutional diagnosis and the result of each diagnostic standard was analyzed. Results 1. The number of Taeeumin was 13(40.6%), Soyangin was 10(31.3%), Soeumin was 9(28.1%). 2. In terms of analysis on the agreement of the final constitutional diagnosis and the result of each diagnostic standard, the yong-mo(容貌) showed the highest agreement of 93.8%, followed by 68.8% of the mind(心性), and the body type(體形) showed the lowest agreement of 53.1%. 3. The yong-mo(容貌) standard showed high diagnostic rate of the three constitutions(Soyangin, Taeeumin, Soeumin) generally and diagnostic rate of Soeumin was especially high. The body type(體形) standard showed low diagnostic rate of Taeeumin, and high diagnostic rate of Soeumin. The mind(心性) standard showed low diagnostic rate of Soeumin. 4. In terms of analysis on the agreement of inter-diagnostic standard result, the yong-mo(容貌) and the mind(心性) show the highest agreement, the mind(心性) and the body type(體形) showed the lowest agreement. 5. If the results come out that the three diagnostic standards have no concentration on one constitution, it was effective to choose the result of the yong-mo(容貌) standard. If it is the case the result of inter-diagnostic standard agreed more than two, it was better to follow the two agreed result than to follow the result of one specific characteristic standard.

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Acupuncture for Prehypertension and Stage 1 Hypertension in Postmenopausal Women: A Randomized Controlled Pilot Trial (폐경 후 고혈압 전단계 및 1기 고혈압에 대한 침 치료 효과: 무작위 대조 예비연구)

  • Kim, Jung-Eun;Choi, Sun-Mi;Choi, Jin-Bong;Kim, Hyeong-Jun;Kwon, Ojin;Kim, Jae-Hong;Park, Ji-Eun
    • Korean Journal of Acupuncture
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    • v.34 no.3
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    • pp.116-125
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    • 2017
  • Objectives : The aim of this study was to assess the effectiveness of acupuncture in treating prehypertension and stage 1 hypertension in postmenopausal women. Methods : The study was a multi-center, four-arm, non-blinded, randomized clinical trial. Sixty participants were randomly assigned to experimental or control groups. The experimental groups received 10 acupuncture sessions over 4 weeks(Group A, n=20) or 20 sessions over 8 weeks(Group B, n=20) along with usual care. The acupoints were GB20, LI11, ST36, and SP6, bilaterally. The acupuncture groups were followed-up for an additional 12 weeks after acupuncture treatment. The control groups received usual care for 16 weeks(Group C, n=10) or 20 weeks(Group D, n=10). The outcomes were blood pressure, blood pressure control rates, lipid profile, and high-sensitivity C-reactive protein(hs-CRP). Results : After 4 weeks, DBP in the acupuncture groups(A+B) showed no significant decrease compared to the control group(C+D). However, after 8 weeks of acupuncture treatment, group B showed a significant decrease in DBP after acupuncture treatment and follow-up period compared to control group. Although there was no difference between the acupuncture and control groups in SBP after acupuncture treatment, group B showed a significant decrease in SBP compared to control group after follow-up period. Lipid profiles and hs-CRP did not differ significantly between acupuncture and control groups. Conclusions : Acupuncture treatment for 8 weeks showed the effect on prehypertension and mild hypertension. To verify the effect of acupuncture on blood pressure, rigorous trials including more participants are required.

Clinical report on the improvement of the symptoms of pneumonia by the aqueous extract of Platycodon grandiflorum (24년생 장생도라지 약침액(藥鍼液)의 폐렴 증상 개선효과에 대한 임상례)

  • Kim, Sook-Kyeng;Choi, Sung-Gwun;Lim, Hyi-Jeong;Moon, Ik-Ryoul;Park, Hyeong-Seon;Oh, Su-Jin
    • Journal of Pharmacopuncture
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    • v.4 no.3
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    • pp.59-67
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    • 2001
  • Objective: The purpose of this report is to prove the clinical effect of Platycodon grandiflorum aqueous extract on pneumoniae patients. Methods: We used the aqueous extract of Platycodon grandiflorum to treat two pneumoniae patients. It was injected into five acupuncture points, which was Chondol(天突:CV22) 1 point, Pyesu(肺兪 : BL13) 2 point, and Kworumsu(厥陰兪: BL14) 2 point. Results & conclusions: We have used the aqueous extract of 24-year-old JK for treating the patients suffering from lung diseases, and have experienced the actual effects. Of the treated, two pneumonia-involved patients showed apparent improvement in simple chest X-ray and clinical symptoms. The patients were treated with JK (Jang-saeng platycodon) aqueous extract 25 and 22 times individually. The results were as follows. 1. The symptoms including coughing, phlegm, and fever were improved in two cases. 2. The lung infiltration in simple chest X-ray decreased and the WBC count was kept within normal range in two cases. 3. Side effect such as itching was not found in the process of JK aqueous extract treatment. 4. The criteria for pneumonia are fever, coughing with purulent phlegm, pleural chest pain, the evidence of new infiltration in simple chest X-ray, sign of lung sclerosis in auscultation, increase of WBC count, etc. But they may not be the proper objective diagnostic standards. So we had trouble in statistic process and numerical interpretation. Putting these results together, the JK aqueous extract is considered to be effective in treating patients for pneumonia, and the continuous research and accumulation of data is needed.

Proposal on Guideline for Quality Assurance of Radiation Treatment Planning System

  • Oh, Yoonjin;Shin, Dong Oh;Kim, Juhye;Kwon, Nahye;Lee, Soon Sung;Choi, Sang Hyoun;Ahn, Sohyun;Park, Dong-wook;Kim, Dong Wook
    • Progress in Medical Physics
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    • v.28 no.4
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    • pp.197-206
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    • 2017
  • We develop guidelines for the quality assurance of radiation treatment planning systems (TPS) by comparing and reviewing recommendations from major countries and organizations, as well as by analyzing the AAPM, ESTRO, and IAEA TPS quality assurance guidelines. We establish quality assurance items for acceptance testing, commissioning, periodic testing, system management, and security, and propose methods to perform each item within acceptable standards. Acceptance includes tests of hardware and network environments, data transmission, software, and benchmarking as specified by the system supplier, and apply the IAEA classification criteria. Commissioning includes dosimetric and non-dosimetric items for assessing TPS performance by applying the AAPM classification criteria and the latest technical items from the IAEA. Periodic quality assurance tests include daily, weekly, monthly, yearly, and occasional items by applying the AAPM classification criteria. System management and security items include the state and network connectivity of TPS, periodic data backup, and data access security. The guidelines for TPS quality assurance proposed in this study will help to improve the safety and quality of radiotherapy by preventing incidents related to radiotherapy.

mRNA Expression and Clinical Significance of ERCC1, BRCA1, RRM1, TYMS and TUBB3 in Postoperative Patients with Non-Small Cell Lung Cancer

  • Han, Yi;Wang, Xiao-Bin;Xiao, Ning;Liu, Zhi-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2987-2990
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    • 2013
  • Background: To explore mRNA expression and clinical significance of ERCC1, BRCA1, RRM1, TYMS and TUBB3 genes in tumor tissue of postoperative patients with non-small cell lung cancer (NSCLC). Materials and Methods: Sixty NSCLC patients undergoing radical operation in our hospital from Nov., 2011 to Jun., 2012 were selected. Plasmid standards of ERCC1, BRCA1, RRM1, TYMS and TUBB3 were established and standard curves were prepared by SYBR fluorescent real-time quantitative PCR analysis. Samples from tumor centers were taken to detect mRNA expression of ERCC1, BRCA1, RRM1, TYMS and TUBB3 genes in cancerous tissue during operation. The total mRNA expression quantities were compared according to different clinical characteristics. Results: The total expression quantities of 5 genotypes from high to low were ERCC1>RRM1>TUBB3>TYMS>BRCA1 in turn. By pairwise comparisons, other differences showed statistical significance (p<0.05 or p<0.01) except for TYMS and TUBB3 (p>0.05); the low expression rates from high to low were ERCC1>TYMS>TUBB3>TUBB3>RRM1>BRCA1 in turn. The expression quantities of BRCA1, RRM1 and TYMS in males, smokers and patients without adenocarcinoma were all significantly higher than that in females, non-smokers and patients with adenocarcinoma, and significant differences were present (p<0.05 or p<0.01). In terms of pathological staging, the expression quantities of BRCA1, RRM1 and TYMS in phases IIa~IIb and IIIa~IIIb had a tendency to be greater than in phases I and IV. Conclusions: Resistance to chemotherapy and sensitivity to targeted therapy differ among patients with NSCLC. Differences in gene expression in different individuals were also revealed. Only according to personalized detection results can individualized therapeutic regimens be worked out, which is a new direction for oncotherapy.

When Are Circular Lesions Square? A National Clinical Education Skin Lesion Audit and Study

  • Miranda, Benjamin H.;Herman, Katie A.;Malahias, Marco;Juma, Ali
    • Archives of Plastic Surgery
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    • v.41 no.5
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    • pp.500-504
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    • 2014
  • Background Skin cancer is the most prevalent cancer by organ type and referral accuracy is vital for diagnosis and management. The British Association of Dermatologists (BAD) and literature highlight the importance of accurate skin lesion examination, diagnosis and educationally-relevant studies. Methods We undertook a review of the relevant literature, a national audit of skin lesion description standards and a study of speciality training influences on these descriptions. Questionnaires (n=200), with pictures of a circular and an oval lesion, were distributed to UK dermatology/plastic surgery consultants and speciality trainees (ST), general practitioners (GP), and medical students (MS). The following variables were analysed against a pre-defined 95% inclusion accuracy standard: site, shape, size, skin/colour, and presence of associated scars. Results There were 250 lesion descriptions provided by 125 consultants, STs, GPs, and MSs. Inclusion accuracy was greatest for consultants over STs (80% vs. 68%; P<0.001), GPs (57%) and MSs (46%) (P<0.0001), for STs over GPs (P<0.010) and MSs (P<0.0001) and for GPs over MSs (P<0.010), all falling below audit standard. Size description accuracy sub-analysis according to circular/oval dimensions was as follows: consultants (94%), GPs (80%), STs (73%), MSs (37%), with the most common error implying a quadrilateral shape (66%). Addressing BAD guidelines and published requirements for more empirical performance data to improve teaching methods, we performed a national audit and studied skin lesion descriptions. To improve diagnostic and referral accuracy for patients, healthcare professionals must strive towards accuracy (a circle is not a square). Conclusions We provide supportive evidence that increased speciality training improves this process and propose that greater focus is placed on such training early on during medical training, and maintained throughout clinical practice.

Nutritional Status of the Elderly Living in Cheongju - II. Anthropometric, Biochdemical and Clinical Assessment - (청주지역 노인의 영양실태조사 - II. 신체계측, 생화학적 검사 및 건강상태 조사 -)

  • 현태선;김기남
    • Korean Journal of Community Nutrition
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    • v.2 no.4
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    • pp.568-577
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    • 1997
  • To assess the nutritional and health status of the elderly, anthropometric measurements and blood test for analyzing biochemical indices were carried out from August to September in 1996. Data on the incidence of a specific disease and clinical symptoms were also collected by interviews with a questionnaire. Among the total of 169 free-living elderly interviewed(91 men, 78 women), 86 elderly(57 men, 29 women) participated in the anthropometric measurements, and 73 elderly(52 men, 21 women) in blood tests. Average heights and weights were much lower than the standards established in the Korean Recommended Dietary Allowances. While average triceps skinfold thickness of men and women were above the 50 percentile of the reference data, mid-arm muscle circumferences were lower than the 50 percentile. Prevalences of anemia, assessed by hemoglobin using WHO definition, were 38.5% for men and 33.3% for women. Blood levels of total protein and albumin were above the normal limit for all participants. Mean blood cholesterol levels of men and women were 163.9mg/dl and 185.8mg/dl, and triglyceride levels were 138.2mg/dl and 161.9mg/dl, respectively. Women older than 75 years generally had high levels of BMI, total cholesterol and triglyceride. Health status assessed by clinical symptoms generally showed no significant difference by age, and their smoking, and drinking habits. Males and the elderly who exercised regularly had better health status. It was suggested that exercise was a good way to improve health status. (Korean J Community Nutrition 2(4) : 568-577, 1997)

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The Development of Korean Rehabilitation Patient Group Version 1.0 (한국형 재활환자분류체계 버전 1.0 개발)

  • Hwang, Soojin;Kim, Aeryun;Moon, Sunhye;Kim, Jihee;Kim, Jinhwi;Ha, Younghea;Yang, Okyoung
    • Health Policy and Management
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    • v.26 no.4
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    • pp.289-304
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    • 2016
  • Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

A Study on the Severity Classification in the KDRG-KM (Korean Diagnosis-Related Groups - Korean Medicine) (한의 입원환자분류체계의 중증도 분류방안 연구)

  • Ryu, Jiseon;Kim, Dongsu;Lee, Byungwook;Kim, Changhoon;Lim, Byungmook
    • The Journal of Korean Medicine
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    • v.38 no.3
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    • pp.185-196
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    • 2017
  • Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.

The Analysis of Item Management on Foreign Pharmacists Examination (외국 약사 국가시험 문항관리 분석연구)

  • Kwon, Kyenghee;Lim, Sung Cil;Sohn, Uy Dong
    • YAKHAK HOEJI
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    • v.59 no.5
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    • pp.235-244
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    • 2015
  • The goal of this study is to help for the utilization the national pharmacists test through the analysis of item development management to the foreign pharmacists examination. The United States is going to NABP (National Association of Boards of Pharmacy) initiative under the curriculum in question on the basis of this assessment and develop standards and unified, systematic system to conduct tests pharmacist. Practice oriented (patient scenario, the participation of a pharmacist or perform work, clinical practice) examination is doing in Canada, The UK is asking the for more than 70 percent and the prescription needed for actual calculation in practice prior to testing program, and by the including that allows references use. Our country may introduce the job as a clinical pharmacist, positively. Item management system is integrated into four regions based on the six-year curriculum should be done in harmony proportion of each region. Integration of fusion of each region in accordance with the duties should be come out. It has gradually been able to item management system developed by the United States or Canada. This item notice pharmacist judging the results of the work must be carried out for management upgrading to a form of management with an emphasis on clinical practice in developed countries. Foundation design, development, production and management and test after actively reviewing ways to improve management system for to management systems, a pharmacist to improve the quality of the national examination could be contributing are involved.