• 제목/요약/키워드: First clinical practice

검색결과 505건 처리시간 0.034초

NEW ANTIDEPRESSANTS IN CHILD AND ADOLESCENT PSYCHIATRY (소아청소년정신과영역의 새로운 항우울제)

  • Lee, Soo-Jung
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제14권1호
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    • pp.12-25
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    • 2003
  • Objectives:As increasing number of new antidepressants have been being introduced in clinical practice, pharmacological understanding has been broadened. These changes mandate new information and theories to be incorporated into the treatment process of children with depressive disorders. In light of newly coming knowledge, this review intended to recapitulate the characteristics of new antidepressants and to consider the pivotal issues to develope guidelines for the treatment of depression in childhood and adolescence. Methods:Searching the Pub-Med online database for the articles with the key words of 'new', 'antidepressants' and 'children' ninety-seven headings of review articles were obtained. The author selected the articles of pertinent subjects in terms of either treatment guideline or psychopharmacology of new antidepressants. When required, articles about the clinical effectiveness of individual antidepressants were separatedly searched. In addition, the safety information of new antidepressants was acquired by browsing the official sites of the United States Food and Drugs Administration and Department of Health and Human Services. Results:1) For the clinical course, treatment phase, and treatment outcome, the reviews or treatment guidelines adopted the information from adult treatment guidelines. 2) Systematic and critical reviews unambiguously concluded that selective serotonin reuptake inhibitors(SSRIs) excelled tricyclic antidepressants( TCAs) for both efficacy and side effect profiles, and were recommend for the first-line choice for the treatment of children with depressive disorders. 3) New antidepressants generally lacked treatment experiences and randomized controlled clinical trials. 4) SSRIs and other new antidepressants, when used together, might result in pharmacokinetic and/or pharmacodynamic drug-to-drug interaction. 5) The difference of the clinical effectiveness of antidepressants between children and adults should be addressed from developmental aspects, which required further evidence. Conclusion:Treatment guidelines for the pharmacological treatment of childhood and adolescence depression could be constructed on the basis of clinical trial findings and practical experiences. Treatment guidelines are to best serve as the frame of reference for a clinician to make reasonable decisions for a particular therapeutic situation. In order to fulfill this role, guidelines should be updated as soon as new research data become available.

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Study on the Medical Records of ${\ll}$Gup Yu Bang${\gg}$ ((${\ll}$급유방(及幼方)${\gg}$에 수록(收錄)된 의안(醫案)에 대한 연구(硏究))

  • Seo, Young-Min;Ha, Ki-Tae;Kim, June-Ki;Kim, Jang-Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • 제21권1호
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    • pp.18-27
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    • 2007
  • ${\ll}$Gup Yu Bang${\gg}$ is the first korean book that specialized in pediatrics. It was written by Jo Jeong-jun in 1869 and contains 87 medical records. Medical records is one of the best way to develop one’s abilities of curing a disease without clinical practice and understanding medical condition of the time. These days we are fully aware of the importance of medical records, but there is no sufficient paper or study on medical records. On this study, we investigate 87 medical record of ${\ll}$Gup Yu Bang${\gg}$ by statistical methods. It was analyzed on the base of items such as age, sex, disease, method of medical treatment, treating prescription, modified medicinal substance, progress of disease. ${\ll}$Gup Yu Bang${\gg}$ contain 87 medical records and among of them, 84 records were Jo Jeong-jun own writings of clinical case. Systemic division of disease showed the highest in digestive disease and most frequent case was symptom of vomiting and diarrhea. The distribution of age was showed the highest in the age group under 5 years and the number of male case was more than female case. It showed that he considered observation of the patient's expression in diagnosis methods and have used 87 kinds of treating prescription and the external treatment, acupuncture, moxa. It showed that he quoted a lot of treating prescription from ${\ll}$Dong eui bo gam${\gg}$, ${\ll}$Yi-Hak-Yip-Mun${\gg}$ and ${\ll}$Xiao Er Yao Zheang Zhi Jue${\gg}$. The further study on medical records in traditional medical literatures, would reveal the developmental progress of Korean pediatrics and inform more actual proof on medical condition of the time.

SIALOLITHIASIS ON THE MOUTH FLOOR IN A CHILD (소아의 구강저에 발생한 타석증)

  • Lee, Hyo-Seol;Choi, Byung-Jai;Choi, Hyung-Jun;Kim, Seong-Oh;Son, Heung-Kyu;Song, Je-Seon;Lee, Jae-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • 제36권1호
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    • pp.114-118
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    • 2009
  • Sialolithiasis is the formation of calcific concretions within the ductal system of major or minor salivary glands. The submandibular gland is most involved because of its high viscosity of the saliva and the long, curved duct. It may occur at any age but, it is most common in middle-aged adults and rare in childhood. Clinical symptoms in sialolithiasis are variable but, swelling is the most common, followed by the pain. Clinical examination and radiographic examination(panoramic and mandibular occlusal radiographs, sialography, intraoral-, extraoral- ultrasound, CT scan, MRI and sialoendoscopy) can help to confirm a diagnosis and localize a stone. The treatment is surgical intervention, either removal of the sialolith or sialoadenectomy. However, non-invasive techniques including shock-wave lithotripsy, $CO_2$ laser and endoscopic treatment used in selected cases. A 5-Year-old girl referred from private practice for evaluation of a yellowish mass on the floor of the mouth. She complained that it had became three times bigger than four months ago when it was found for the first time and she had some pain on submandibular gland area occasionally. On physical examination, a firm and yellowish mass could be seen at the orifice of the submandibular duct. Diagnosis is the submandibular sialolithiasis in the anterior Wharton`s duct. Under local anesthesia, stone was removed.

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Comparative Study About Academic Thoughts of Xu Lingtai and Yoshimasu Todo (II) - Analysis of the Cause of Similarities and Differences in their Academic Thoughts - (서영태(徐靈胎)와 길익동동(吉益東洞)의 학술사상 비교 연구 (II) - 학술 사상이 같고 다른 원인에 대한 분석 -)

  • Yoon, Cheol-Ho;Huang, Huang
    • The Journal of Internal Korean Medicine
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    • 제32권1호
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    • pp.87-99
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    • 2011
  • In the 18th century, Xu Lingtai (徐靈胎) and Yoshimasu Todo (吉益東洞) were medical revolutionaries. They emphasized researches about synthesis of formulae, efficacy of medication and observation and then classification of clinical phenomena, so they assumed a modern scientific character. But, there were clear differences between their academic thoughts. In this paper, we examine the causes of difference in three fields, i.e. traditional culture, viewpoints of talented people and academic personality. The first, difference was due to traditional culture. Chinese medicine has a long history and heavy traditional culture. Yin-Yang (陰陽) theory, Five Phase(五行) theory, Viscera and Bowels (臟腑) theory and Meridian and Collateral (經絡) theory stemmed from everyday practice, and Chinese people learn these theories from experience and observation. From the standpoint of Chinese people, particularly scholarly doctors [儒醫] such as Xu Lingtai, it was easy to debate medical theories. In contrast, Japanese traditional culture didn't have as long a history as China. Thus as a necessity, it was harder to disseminate traditional Chinese medicine theories in Japan. Yoshimasu Todo simplified it by cutting out the superfluous traditional Chinese medicine theory, so at that time it must have been shocking to the Japanese medical world's trends. The second, difference was due to viewpoints of talented experts. From the standpoint of Xu Lingtai, above all, medicine is just a learning, only a kind of technique, even more not a means of living. Xu Lingtai was concerned with the appearance of very talented experts such as 'great man' (偉人), and 'exceptional man' (奇士) who carried out medical research. Instead of cultivating a few talented people, Yoshimasu Todo tried to produce a large number of clinicians quickly who could treat ordinary people. The third was due to personality difference. As Xu Lingtai threw away Confucianism and studied medicine in his youth, although he had a critical attitude, he was always mild-mannered. Yoshimasu Todo always had a clearly critical and rebellious nature. Personality influenced their literary spirit and learning style, so although both advocated reactionism, the academic thought of Xu Lingtai was reformative and mild, while that of Yoshimasu Todo was revolutionary and fierce. Xu Lingtai and Yoshimasu Todo had considerably similar research domains and academic thought, so it is proper for them both to serve as examples for making a comparative study of medical history in China and Japan in 18th century.

The Current Status and Educational Requirements for Genetics Curriculum at Nursing Institutions (간호교육에서의 유전학 교육과정 현황과 요구)

  • Hong, Hae-Sook;Byeon, Young-Soon;Na, Yeon-Kyung
    • Journal of Korean Biological Nursing Science
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    • 제5권1호
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    • pp.13-22
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    • 2003
  • The purpose of this study was to investigate and analyze current educational requirements related to genetics curriculum(from June 2002 to September 2002) established at nursing institutions and to provide the basic data for the development of genetics science program at the undergraduate. Subjects of this study were comprised of twenty-three colleges of nursing in 4-year baccalaureate and thirty colleges in 3-year diploma programs. The results of this study were as follows : 1) 32 colleges offer courses related to genetics. 29 among 32 colleges have that integrated. Three schools have established completely independent courses of genetics. 21 colleges do not have any courses dealing with genetics. 2) The contents of courses related to genetics include: Congenital abnormalities, chromosomal aberrations, congenital metabolic disease, prenatal diagnosis and genetic counseling, genes and chromosomes, immune genetics, blood type and genetics, rule of genetics, variation in gene expression, the map of the human gene, gene linkage genetics, interaction of genes, single inheritance in order and genetic biochemistry. 3) For course credit, 14colleges(48.3%) offered at most 1 credit per course. The grade of student who can take the course, 51.7% were in their second year while 37.9% were in their third year. The majors of nursing faculty who taught the course were nursing(51.7%) and basic nursing science(17.2%). 4) As far as the need of opening the courses related to genetics, 36 colleges(67.0%) have made a 'need', 12 schools(22.6%) state 'dose not need'. 711e reason for need were the following development of bio engineering, increase number of patients who are related to genetics, recognition of the need in clinical nursing. 7 schools(13.2%) agreed to offer independent course in genetics but 39 schools(73.6%) are in disagreement with that. When the school offers the course with other courses, 27 schools(50.0%) are opening basic nursing science and 14 schools(26.4%) are opening nursing as an integrated courses. If the name of course was either genetic nursing(34.0%) or genetics(28.3%), the credits for the course was one or 2 credits. 33 schools(62.3%) students were in the first or second years. 41 schools(84.9%), the majors of the faculty who had taught the course were either basic nursing science(35.8%), nursing(28.3%) or basic medicine(24.5%). The contents of the course should include in that order: Chromosome aberrations, prenatal diagnosis and genetic counseling, congenital metabolic disease, congenital abnormalities, genes and chromosomes, the rules of genetics, immune genetics, interaction of genes, variation in gene expression, etc. The results and discussions of the study indicate that the entire curriculums need to be investigated with respect to contents of education, nursing curriculums and name of courses because of the increasing need of knowledge related to genetics in the clinical practice.

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The Future Direction of Learning Objectives and National Nurse's Licensing Examination in Adult Health Nursing (성인간호학 교육의 학습목표와 국가고시 문제 개선방안)

  • Song, Rha-Yun;Shin, Su-Jin;Suh, Yeon-Ok;Shin, Sung-Rae;Park, Yeon-Hwan;Kang, Youn-Hee;Kim, Yeong-Kyeong
    • Korean Journal of Adult Nursing
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    • 제23권5호
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    • pp.503-513
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    • 2011
  • Purpose: The purpose of this study was to identify a model based on f the learning objectives in adult health nursing curriculums. The model can be eventually reflected in Korean National Nurse's Licensing Examination (KNNLE). Methods: The model was developed through a series of practical analysis by the task force team from June to October, 2011. The research team conducted the data synthesis and analysis from the learning objectives of adult health nursing drawn from selected national and international universities, from the adult health nursing areas in KNNLE, and from the current disease prevalence from clinical data in the representative university hospitals in Korea. Results: The current disease prevalence and mortality rates are on the increase especially for malignant neoplasm, heart diseases, suicide and diabetes. The items on the KNNLE of adult nursing are categorized by body systems into digestive system (15%), introduction (13.8%), respiratory system (11.3%), and cardiac system (11.3%). While the current system-based learning objectives covers extensive areas of adult health nursing, the core items are required to be selected based on core competences and core learning objectives to restructure the items of KNNLE. The first revised model is to consolidate and restructure the items microscopically in the subjects of adult health nursing by system. The second proposed model from macroscopic perspective is to build a comprehensive scheme of nursing curriculum by encompassing 8 subjects under current KNNLE and adjust the number of items accordingly. Conclusion: The items of KNNLE need to be gradually redesigned by considering the intervention need at clinical practice and the modified learning objectives of adult health nursing. Based on the job analysis on core competences for newly employed nurses performed by the Korean Accreditation Board of Nursing, it is necessary to establish the core learning objectives of adult health nursing and set up standards for core items in KNNLE.

Impact of Cellular Immune Function on Prognosis of Lung Cancer Patients after Cytokine-induced Killer Cell Therapy

  • Jin, Congguo;Li, Jia;Wang, Yeying;Chen, Xiaoqun;Che, Yanhua;Liu, Xin;Wang, Xicai;Sriplung, Hutcha
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권15호
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    • pp.6009-6014
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    • 2014
  • Aims: To investigate changes in cellular immune function of patients with lung cancer before and after cytokine-induced killer (CIK) cell therapy and to identify variation effects on overall survival (OS) and progression-free survival (PFS). Materials and Methods:A total of 943 lung cancer patients with immune dysfunction were recruited from January 2002 to January 2010, 532 being allocated to conventional therapy and 411 to CIK therapy after a standard treatment according to the NCCN Clinical Practice Guidelines. All the patients were investigated for cellular immune function before and after therapy every three months. and clinical prognostic outcomes were analyzed. Results: After six courses of treatment, immune function was much improved in patients receiving CIK cells therapy as compared to controls. The percentages of recurrence and/or metastases for patients undergoing CIK cell therapy was 56.2% and 49.1% respectively but 78.6% and 70.3% among controls (p<0.001). The median OS times for CIK cell therapy and control groups were 48 and 36 months respectively. The OS rates at 12, 36, 60, 84 months in CIK treated patients were 97.8%, 66.9%, 27.7%, and 4.1% while they were 92.3%, 44.5%, 9.2%, and 1.5% in controls. OS and PFS were significantly different by log rank test between the two groups and across the three immune improvement classes. Conclusions: The immune function of lung cancer patients was improved by CIK cell therapy, associated with an increase in the OS rate and extension of the time to recurrence and/or metastasis.

Comparison of the gut microbiota profile in breast-fed and formula-fed Korean infants using pyrosequencing

  • Lee, Sang A;Lim, Ji Ye;Kim, Bong-Soo;Cho, Su Jin;Kim, Nak Yon;Kim, Ok Bin;Kim, Yuri
    • Nutrition Research and Practice
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    • 제9권3호
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    • pp.242-248
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    • 2015
  • BACKGROUND/OBJECTIVES: Feeding in infancy is the most significant determinant of the intestinal microbiota in early life. The aim of this study was to determine the gut microbiota of Korean infants and compare the microbiota obtained between breast-fed and formula-fed Korean infants. SUBJECTS/METHODS: We analyzed the microbial communities in fecal samples collected from twenty 4-week old Korean (ten samples in each breast-fed or formula-fed) infants using pyrosequencing. RESULTS: The fecal microbiota of the 4-week-old Korean infants consisted of the three phyla Actinobacteria, Firmicutes, and Proteobacteria. In addition, five species, including Bifidocbacterium longum, Streptococcus salivarius, Strepotococcus lactarius, Streptococcus pseudopneumoniae, and Lactobacillus gasseri were common commensal intestinal microbiota in all infants. The predominant intestinal microbiota in the breast-fed infants (BFI) included the phylum Actinobacteria (average 70.55%), family Bifidobacteriacea (70.12%), genus Bifidobacterium (70.03%) and species Bifidobacterium longum (69.96%). In the microbiota from the formula-fed infants (FFI), the proportion of the phylum Actinobacteria (40.68%) was less, whereas the proportions of Firmicutes (45.38%) and Proteobacteria (13.85%) as well as the diversity of each taxonomic level were greater, compared to those of the BFI. The probiotic species found in the 4-week-old Korean infants were Bifidobacterium longum, Streptococcus salivarius, and Lactobacillus gasseri. These probiotic species accounted for 93.81% of the microbiota from the BFI, while only 63.80% of the microbiota from the FFI. In particular, B. longum was more abundant in BFI (69.96%) than in FFI (34.17%). CONCLUSIONS: Breast milk supports the growth of B. longum and inhibits others. To the best of our knowledge, this study was the first attempt to analyze the gut microbiota of healthy Korean infants according to the feeding type using pyrosequencing. Our data can be used as a basis for further studies to investigate the development of intestinal microbiota with aging and disease status.

A Study on Four-year College Curriculum for the Education of Radiological Technology in Korea (방사선학과(放射線學科)의 4년제(年制) 대학(大學) 교육과정(敎育課程)에 대한 연구(硏究))

  • Choi, Jong-Hak;Lee, Sang-Suk;Kim, Young-Il;Kwon, Dal-Gwan;Kim, Heung-Tae;Lim, Han-Young
    • Journal of radiological science and technology
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    • 제18권2호
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    • pp.87-102
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    • 1995
  • The education of radiologic technology began in the regular institute of higher education in Korea in 1963. Up to now from then, our education to bring up the radiologic technologists has developed greatly in quality and quantity, and now departments of radio-technology are founded in the 16 junior colleges in March, 1995. This study was done to verify the necessity and propriety to reform the education system of radiologic technology which was run as two or three year system of college curriculum for 32 years since 1963, and to search for the method to reform in the future. We got the following results from this research. 1. In the survey, on the desirable education year for radiologic technologists, 63.9 % of professors of department of radio-technology and 63.0 % of radiologic technologists chose the 4 year system, 27.9 % of professors and 34.6 % of radiologic technologists chose the 4 year system added to graduate school. 2. In the survey, on the future development of radiologic equipments and technique, 67.2 % of professors of department of radiologic technology and 86.4 % of radiologic technologists have a view of "revolutional development". Also, on the future tasks or roles of radiologic technologists 95.1% of professors and 94.9% of radiologic technologists have a view that "They will increase". 3. On the necessity of extension of education year to 4 years from 3 years, the factor is that development of medical technique and machinery and tools, advance of qualification of radiologic technologists, enlargement and specialization of the business of the radiologic technologists, ballance of education year with other medical sciences, international competitive power and cooperation of radiologic technology, and education continuation of the graduates of department of radiologic technology. 4. They suggested that in the 4 year curriculum of department of radiologic technology, clinical medicine, quality control of radiation and radiologic equipment, related subjects to the radiologic application and computer application should be enforced and clinical practice should be extended more. 5. On the device to found the 4 year college curriculum of radiologic technology, they suggested that first, 4 year curriculum should be founded through the variety of educational year, secondly, department of radiologic technology should be founded in the 4 year health sciences college, thirdly, educational continuation of the radiologic technologists should be systematized on the basis of life-long education.

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Correlation of the Berg Balance Scale and Smart Balance Master System for Chronic Hemiparetic Stroke (만성 편마비 뇌졸중 환자의 버그균형척도(Berg Balance Scale)와 Smart Balance Master System의 상관성)

  • Song, Chiang-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제12권12호
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    • pp.5741-5747
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    • 2011
  • The purpose of this study was to find correlation between the Berg Balance Scale which is most commonly used and the equilibrium scores from Smart Balance Master System which is used for the test of the balance ability for the patients with chronic hemiparetic stroke to predict their falling risk though examining the postural control. Twenty-two subjects who had first stroke participated in this study. Participants were measured the Berg Balance Scale and the Smart Balance Master System. The study found that there was a significant correlation between the Berg Balance Scale and the equilibrium scores from Smart Balance Master System. And there was no significant correlation at all "eye-closed and sway of surfaces" in the 6 conditions of Smart Balance Master System and there was a significant correlation with over median in the other 5 conditions. The study was uncovered that there was no meaningful correlation between the Berg Balance Scale and "eye-closed and sway of surfaces" because chronic hemiparetic stroke patients heavily relied on their vision to maintain their balance ability and the Berg Balance Scale did not properly exam it. Thus to predict their falling risk in clinical practice for the patients with chronic hemiparetic stroke, it would be more efficient ways for us to consider all the effects of sensory organs with more than one clinical evaluation method.