This case study reports the clinical effect of Korean medicine treatment on vascular disease of spinal cord. A 58-year-old female patient was diagnosed as vascular disease of spinal cord and treated with combined Korean medicine treatment such as acupuncture, electro-acupuncture, herbal medication, and physical therapy for 16 days. The patient was assessed for International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI), Berg Balance Scale (BBS), and Numeral Rating Scale (NRS). After treatment, total scores of ISNCSCI, BBS, and NRS were numerically improved. Also symptoms of neurogenic bladder were improved. This study suggests that Korean medicine treatment could be effective treatment for vascular disease of spinal cord.
This review examined recently published (July 2014 to June 2017), randomized controlled trials (RCTs) which investigated the safety and effectiveness of combined Korean medicine/complementary alternative medicine (CAM) and Western medicine, to indicate the direction for integrative medical practice. The Korean Medicine Convergence Research Information Center evidence-based medicine database (KMCRIC EBM DB) was used to retrieve relevant RCTs indexed in the last 3 years. Study design, country, sample size, disease/condition with the Korean Standard Classification of Diseases code, interventions, direction of outcomes, and adverse events were extracted and summarized. A total of 93 RCTs were included in this review. Acupuncture/moxibustion was the most commonly used intervention (n = 47; 51%), and 19% (n = 18) of the studies treated musculoskeletal disorders, followed by circulatory disorders (n = 16; 17%), and mental and behavioral disorders (n = 9; 10%). Integrative treatment was reported as more effective than monotherapy in approximately 83% of these studies. Adverse events were poorly reported in most studies. This review suggests that integrative treatments are feasible, effective, and safe for various diseases/conditions, based on the evidence from recently published RCTs. Future studies on integrative healthcare are warranted.
Bak, Seon-Been;Yeom, Seung-Hee;Kim, Soo-Jin;Han, You-Jeong;Lee, Ji Ho;Kim, Young-Woo;Park, Sun Dong
Herbal Formula Science
/
v.30
no.1
/
pp.19-25
/
2022
Objectives : Huangqintang(⿈芩湯) is a famous herbal prescription in the Traditional Korean Medicine (e.g. Shanghanlun) to treat various chronic disease such as neurological disease and digestive system disease. Its components include Scutellariae Radix(⿈芩), Paeonia lactiflora(芍藥), Glycyrrhizae Radix et Rhizoma(⽢草), Zizyphi Fructus(⼤棗). Methods : In this study, we standardize the name, composition and medical uses of Huangqintang by literature studying and paper searching. Based on the comparison between oriental medicine and modern medicine pharmacology, we linked the medical uses of Huangqintang to Korean Standard Classification of Diseases (KCD). Results and Conclusion : The name of the prescription is unified into "Huangqintang", and its composition ratio between Scutellariae Radix, Paeonia lactiflora, Glycyrrhizae Radix et Rhizoma, and Zizyphi Fructus is 3:2:2:3. Huangqintang is used for enteritis diseases due to its antipyretic and antinflammatory effects. Its medical application was relatied with 'A'code, 'C'code, and 'K'code as indicated by KCD. By standardizing the mixed conceptions of Huangqintang, this review will facilitate the coding of Huangqintang prescription. Therefore, it will make Huangqintang prescription more useful in clinics.
Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis that can affect many organs of the body but usually affects the lungs. The prevalence of TB in Korea is considerably higher than that in other countries with similar economic levels, and is much higher in elderly people. Pharmacotherapy is important in the treatment of TB and requires relatively high compliance for a prolonged duration. Methods: We analyzed sample data of elderly patients obtained from the Health Insurance Review and Assessment Service. We used logistic regression analysis and frequency analysis to identify factors that could affect prevalence of TB in elderly patients, compliance with prescribed medication regimes in these patients, and use of medical institutions. Korean Standard Classification of Diseases, version 7 (KCD-7) was used to diagnose pulmonary TB, and medications were analyzed using Korean standardized drug classification codes. Results: 1,276,331 patients were analyzed in the sample of the elderly population, and 16,658 TB patients were included in the study. The mean age of the TB patients was 76.19 years (SD 6.899). A total of 699 patients were prescribed isoniazid, rifampicin, ethambutol, or pyrazinamide at least once. Of these, 352 (50.4%) were prescribed all four medications and 101 (14.4%) were prescribed only isoniazid, rifampicin, and ethambutol. The mean duration of prescription was 28.75 days (SD 36.13). Conclusion: In the elderly population, old age and poor socioeconomic conditions correlated with TB prevalence. Most patients did not meet the criteria for effective pharmacotherapy of TB.
Purpose: The objectives for this study are to produce the comprehensive management indexes and find their application strategies for appropriate medical care in primary care clinics under workers' compensation insurance. Method: Data of this study was workers' compensation insurance medical fees claim's data from July 2006 to June 2007. Data were analyzed using SAS 9.1 version by applying descriptive statistics and Pearson's correlation. The indexes such as costliness index(CI), standard medical fee were calculated based on the fourth revision of korean classification of diseases(KCD-4.). Results: The CI, visiting index(VI), outliers index(OI), and medical review adjustment percentage were positively correlated in the both inpatient and outpatient medical fees in primary care clinics under workers' compensation insurance. The major medical specialities were neurological surgery, general medicine, general surgery, rehabitational medicine, and orthopedic surgery. The CIs were slightly high in rehabitational medicine among major medical specialities. The CIs were mostly high in diagnosis, test, anesthesia, and rehabitational assistive device fees among major medical specialities. The CIs were slightly high in Kwangju, Daegu, Daejeon, and Busan districts among district management centers of Korea Workers' Compensation and Welfare Service. Conclusions: We suggest the continuous development of appropriate disease classification system and medical care quality indicators to successfully take root the comprehensive management for appropriate medical care under workers' compensation.
Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.
The author has conducted survey on the status of physical growth and morbidity of the children for christian children's fund programme, as a means of collecting basic data for the anticipated establishment of a health planning. A total 345 children aged 9 to 16 underwent C.C.F. programme while as a control, a total of 480 children of same ages from the middle-class school children in Jeonju area was also studied. As results of survey conducted for a period of one month (form July 1 to 31, 1974) on a total 429 children in 347 households living in Jeonju area. I. Socio-economic background 1. By educational status of the children, 39.9 per cent of the total children was attending at primary school, 33.8 per cent in middle school and 15.6 per cent in high school. 2. The greatest proportion or 28.8 per cent of the household head were engaged in labor, 17.9 per cent in peddler and 13.2 per cent in retail. 3. As for the living standard of the households, low class constitued 90.1 per cent, middle and high classes only 9.9 per cent. 4. 39.5 per cent of the households had their own house, 39.1 per cent lived in rent deposit house or rooms and 14.6 per cent in monthly rented house and rooms. II. Physical growth and nutritional status 1. The growth of children for C.C.F. programme in terms of height was found to be slightly smaller than the school children. The ages frm 9 to 16 corespond to the 'secondary growth and replenishment period and this period was regarded to be the one most affected by environmental and nutritional factors of all the other periods of growth and developmet. 2. The body weight of the children for C.C.F. presented a quite different pattern from that of the school children. The above findings appeared thin-and-long stature from the famillies with higher living standard while those from the household with low standard of living had a short-and-plump one. 3. According to the values of Rohrer's index, the children of C.C.F carried a higher degree of 'replenishment' than the children in Jeonju area and adolesecence comes later for the girls under C.C.F. programme. III. Morbidity 1. The monthly prevalence rate was 110.0 per thousand persons for the children under C.C.F. programme. 2. The total number of case was classified by timing of the incidence as follws. 40.0 per cent was constituted by diseases carried over from tile previous month and 60.0 per cent by new incidences. 3. The diseases were broken down by W.H.O. disease classification into the greatest proportion or 39.1 per thousand person constituted by disease of the digestive system.
It is becoming increasingly apparent that periodontitis consists of mixture of diseases, most of which respond favorably to traditional mechanical therapy. Among these variants of the disease, some appear to be associated with unusual microbial infections and defective host defenses. Many of these fail to respond to conventional treatment. The recognition that some forms of periodontitis are refractory to standard periodontal therapy has given rise to a new classification of peridontitis. A series of 1692 subgingival microbial samples sent to a diagnostic microbiology laboratory included 738 samples that could be identified as compatible with a clinical diagnosis of refractory or recurrent periodontitis. In descending order of prevalence the associated microbiota included Bacteroides forsythus(85%) ,Fusobacterium species(78%), Spirochetes(67%), Campylobacter rectus(64%), Porphyromonas gingivalis(59%), Peptostreptococcus micros(58%), motile rods(46%), Prevotella intermedia(33%), Eikenella corrodens(13%), Capnocytophaga species(12%) ,and Actinobacillus actinomycetemcomitans(6%). Antibiotic resistance to tetracycline, penicillin G, or metronidazole was particularly noticeable for Fusobacterium species, Capnocytophaga species, and Actinobacillus actinomycetemcomitans. It was largely absent for Campylobacter rectus. No antibiotic data were obtained for Porphyromonas gingivalis or Bacteroides forsythus, as these species were detected by immunofluorescence. The results indicate that a substantial number of microorganisms associated with refractory periodontitis are variably resistant to commonly-used antibiotics. Diagnostic microbiology must be considered an essential adjunct to the therapist faced with periodontal lesions refractory to conventional treatment.
Objectives: This study aims to determine the risk factors predicting rehospitalization by comparing three models and selecting the most successful model. Methods: In order to predict the risk of rehospitalization within 28 days after discharge, 11 951 inpatients were recruited into this study between January and December 2009. Predictive models were constructed with three methods, logistic regression analysis, a decision tree, and a neural network, and the models were compared and evaluated in light of their misclassification rate, root asymptotic standard error, lift chart, and receiver operating characteristic curve. Results: The decision tree was selected as the final model. The risk of rehospitalization was higher when the length of stay (LOS) was less than 2 days, route of admission was through the out-patient department (OPD), medical department was in internal medicine, 10th revision of the International Classification of Diseases code was neoplasm, LOS was relatively shorter, and the frequency of OPD visit was greater. Conclusions: When a patient is to be discharged within 2 days, the appropriateness of discharge should be considered, with special concern of undiscovered complications and co-morbidities. In particular, if the patient is admitted through the OPD, any suspected disease should be appropriately examined and prompt outcomes of tests should be secured. Moreover, for patients of internal medicine practitioners, co-morbidity and complications caused by chronic illness should be given greater attention.
Background: Patients with special health care needs are more likely to develop health problems, including dental problems. Dental treatments require a good level of communication with the patient. Therefore, in these patients, sedation and general anesthesia are an extremely humanistic approach for comfortable and successful treatment. In patients with special needs, there is no standard anesthetic approach due to varying clinical conditions. The aim of this study was to provide literature content about the anesthetic approaches used by us in patients with special needs. Methods: The medical records of 710 patients with special health care needs treated under general anesthesia or sedation were reviewed retrospectively. Demographic data, the American Society of Anesthesiologists classification, Mallampati score, anesthesia duration, anesthesia type, anesthetic and analgesic agents used, dental treatment performed, secondary diseases, and complications in the perioperative period were recorded. Patients were evaluated under five groups: Down syndrome, other syndromes, psychiatric disorders, physical disabilities, and complicated medical story. Results: Among the patients evaluated, 47.5% were females and 52.5% were males (mean age $15.76{\pm}11.17$ years), and general anesthesia and sedation were administered in 72.9% and 22.1% patients, respectively. The mean duration of anesthesia was $43.20{\pm}35.85$ min. Simple dental treatments were performed in all groups, and the most common complications were observed in the other syndromes group. Conclusion: Complications can be reduced by utilizing the appropriate anesthetic approach and taking serious precautions in patients with special needs.
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