Background : Asthma is one of the most prevalent diseases in Korea. Although the guidelines of asthma management were reported in Korea, the present pattern of asthma management by primary physicians has not been studied. The purpose of this study is to elucidate the pattern of asthma management by primary physicians. Methods : In November 2002, 710 primary physicians specializing in internal medicine in Seoul, Korea were provided with two scenarios of asthmatic patients, one mild and the other severe. By mail or interview, the physicians were asked several questions about their present pattern of asthma management for the patients in each scenario. Results : Among 710 primary physicians, we obtained the answers from 325 physicians (response rate 46%). The most preferred prescription was oral theophylline. 71% and 81% of the physicians answered that they would prescribe oral theophylline for the mild and severe asthmatics, respectively. The next prescription preferred were mucolytics and oral ${\beta}_2$-agonist, in that order. However, 36% and 56% of the physicians answered that they would prescribe inhaled steroids for the mild and severe asthmatics, respectively. Among diagnostic tests, physicians preferred pulmonary function test to the rank next to chest radiography. Conclusion : The primary physicians in Seoul prefer oral bronchodilators to inhaled steroids in asthma management. More efforts should be made to reduce the difference between the present pattern of asthma management by primary physicians and the asthma guidelines.
The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.
Ham, Jeong-Sik;Cha, Wung-Seok;Ahn, Sang-Woo;Kim, Na-Mil
Korean Journal of Oriental Medicine
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v.14
no.3
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pp.155-171
/
2008
This study examined from "SangHanChangHwaHunJiJip" how medical exchange between doctors of Joseon and Japan affected medical science of Japan. "SangHanChangHwaHunJiJip" is a record that organized the written conversation between doctors and scholars of the Joseon and Edo period when the delegation so-called Joseon Tongsinsa visited Japan in 1719. Even though "SangHanChangHwaHunJiJip" was written by Japanese, but it was comprised of Joseon's advanced medical ideology, especially "DongEuiBogam" that has occupied an important part of the Joseon medical ideology. As a matter of fact, "SangHanChang HwaHunJiJip" contains general theme and medical subject. But until now, it has been hardly studied by medical historians. Many studies were generally made related to Joseon Tongsinsa, a governmental delegation, focused on literary and cultural exchange between Joseon and Japan by historians. "SangHanChangHwaHunJiJip" is no exception to this trend. We can find that doctors of the Joseon and Edo period entered into colloquium, a form of group discussion, about the clinical theme in "SangHanChangHwaHunJiJip". Concretely, the conversation between doctors of Joseon and Japan was about infant disease, infectious disease, folk remedies, medical herbs, moxa cautery, acupuncture, the study of nature, the study of medical books, etc. For example, when doctors of Japan ask a confirmed disease, doctors of Joseon explained it particularly. They had a great effect on in every cultural aspect of Japan, especially its medical field. Through this study of the medical questions and answers in "SangHanChangHwaHunJiJip", I came to know that the doctors of GiHae envoys gave great influence to the medical knowledge of Japan and the GiHae inherited and developed the medical tradition of SinMyo envoys. Through the examination of this study, I could deduct that "JeongJeongDongEuiBogam" which was published by the government of the Edo period is due to not only the contents of DongEuiBogam's advanced medical thought, but also the doctors of GiHae envoy. Also, "SangHanChangHwaHunJiJip" gives us an idea that doctors of GiHae envoys have medical trend of the OnBoHakFa and a group of Japanese doctors has medical trend of the study of nature. I am confident that the improvement of medical science and natural history of the Edo period is due to influence of medical exchange between Joseon and Japan. "SangHanChangHwaHunJiJip" confirms that medical exchange between two countries affected doctors and scholars of the Edo period.
Lee, Won Kee;Kim, Shin-Woo;Kim, Hye-In;Chang, Hyun-Ha;Lee, Jong-Myung;Kim, Yoon-Joo;Lee, Mi-Young
Journal of the Korean Data and Information Science Society
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v.25
no.2
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pp.337-347
/
2014
There is no known publication about assessment of quality of life (QOL) in Korean HIV patients. We aimed to assess the QOL of HIV patients. We developed Korean version of the WHOQOL-HIV BREF (short forms of WHOQOL-HIV, 31 questions with 6 domains). Survey data from 220 HIV-positive adults were obtained in 14 centers in South Korea. Male were dominant (202/220, 91.8%). Mean age was $40.6{\pm}12.1$. Mean CD4+ T-cell count was $414.9{\pm}226.6/ml$. Overall of WHOQOL-HIV BREF were $53.2{\pm}14.9$ (perfect score=100) (Cronbach's ${\alpha}$ = 0.942). It is similar score comparing to another country (Portugal: 54.75/100, measured by WHOQOL-HIV). Correlations of WHOQOL-HIV BREF score with patients' subjective QOL and with subjective satisfaction were 0.747 (p <0.01) and 0.651 (p <0.01), respectively. WHOQOL-HIV BREF have internal reliability. There is in need of monitoring for QOL of HIV patients in the clinical practice and trials. This survey tool could be used to assess the effect of intervention. Additionally, comparison across countries would be possible and promising.
Yun, Hyun Jin;Choi, Eun Jeong;Choi, Eun Jin;Hong, Su Young
Clinical and Experimental Pediatrics
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v.51
no.8
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pp.820-826
/
2008
Purpose : This study was conducted to evaluate the red cell indices and frequency of iron deficiency anemia based on the feeding patterns of nine-month-old infants. Methods : Blood tests were performed on 253 nine-month-old infants, who visited Il Sin Christian Hospital for health check-ups from January to December 2007. Their parents answered telephonic questions regarding their feeding patterns and weaning foods. Results : Three infants groups were created according to feeding patterns before they started weaning foods. One group was exclusively breast-fed (48.6%), another had mixed feeding (27.3%), and the third had artificial milk feeding (24.1%). Red cell indices (hemoglobin, hematocrit, MCV, MCH) of the breast-fed group were comparatively lower than those of the other two groups (P<0.05). Twenty-five infants (9.9%) were diagnosed with iron-deficiency anemia. According to feeding patterns, the frequency of anemia was highest in the breast-fed group. Six infants who started weaning foods before six months of age (113 infants) were diagnosed with iron-deficiency anemia (5.3%), and nineteen who started after six months of age (140 infants) were diagnosed with iron-deficiency anemia (13.6%). Conclusion : When nine-month old infants visit hospitals for health check-ups, pediatricians must consider their feeding pattern and weaning foods histories, and then recommend screening blood tests for iron-deficiency anemia.
Background: Since cervical cancer can be prevented and controlled through human papillomavirus (HPV) vaccination, it is important to train health care providers and provide them with appropriate knowledge. This study aimed to understand the level of HPV related knowledge among medical students and correlates in Southwest China in order to address any potential gap in their knowledge base. Methods: We conducted a cross-sectional survey among medical students in six selected universities across Southwest China based on a pretested questionnaire regarding HPV infection, cervical cancer, and HPV vaccines. Results: We successfully surveyed 1, 878 medical students, of whom 32.1% were males and 67.9% were females. Their mean age was 20.8 (standard deviation: 1.3) years. 91.8% of them were ethnic Han Chinese, and 43.8% were students in clinical medicine. While 76.5% had heard of HPV only 48.8% knew that the prevention of cervical cancer was possible through HPV vaccination. Only 42.9% of the male and 49.2% of the female students correctly answered over 10 out of 22 questions on HPV related knowledge. Female students appeared to know more about HPV and HPV vaccination (OR: 1.39; 95% CI: 1.11-1.75). In addition, the student knowledge improved with the grade (p<0.001). University courses were the most selected source of knowledge about HPV vaccination (66.4%). 83.6% of males and 91.4% of females were willing to have more HPV related education by experts (p<0.001). Only 10.1% of the students acknowledged that people had asked for their advice regarding HPV vaccination. Conclusions: Our survey indicates that medical students from Southwest China have poor knowledge of HPV and HPV vaccination, but are willing to receive more relevant information. Targeted education should be incorporated into school courses to inform these future health care providers and ensure success of programs for cervical cancer control and prevention.
Bed rest is recommended to prevent postlumbar puncture headaches(PLPHA), but the period of bed rest varies in the literature from 6 hours to 24 hours. In clinical practice the period of bed rest varies but nursing methods for adults and children have little difference. In Seoul National University Hospital, children have been given at least 6 hours bed rest after a lumbar puncture. Pediatric oncology patients require a lumbar puncture for an initial diagnosis, follow up treatment or administration of chemotherapeutic agent. But it is difficult for young children to lie supine or to refrain from their usual activities in any way, and unpleasant problems related to a shortage of beds often occurs during discharge or in an outpatient setting. The purpose of this study is to substantiate the preventive effect of PLPHA by the period of bed rest, to identify the other factors that influence PLPHA, and to use the nursing methods proper to children. The subjects were 65 children, ages 1-17, undergoing treatment in the children's cancer center at SNUCH during the period June 1, 1995, to Aug. 31, 1995. The team nurses asked questions about PLPHA of the parents and children in order to fill out a questionnaire. The data were evaluated by percent, t-test, Chi-square test and Mann-Whitney U test. Result; 1. There was no significant difference relating the bed rest time spent to the occurrence of postspinal headaches (t-test). 2. There was a significant risk of PLPHA in the children who were irritable before procedure and/or had experienced previous PLPHA(p<0.05, ${x^2}-test$). 3. The following factors were not found to be associated with increased risk of PLPHA: previous puncture experience, giving analgesics, the choice of puncturist, inpatient/outpatient status, gauge of needle, purpose, the amount of CSF removed, gender, diagnosis, the number of peripheral WBCs, previous lumbago experience after LP, position after bed rest, age, the number of aural puncture at the time. A longer period of bed rest is unlikely to be more effective to prevent PLPHA and seems impractical. A shorter period will save time and effort. Perhaps it will also allay some of the fears which surround LP. So 1 hour bed rest after LP is suggested and nursing methods for emotional support should be investigated to reduce PLPH.
The definition of edible ice is frozen water for the use of food manufacturing, processing, or cooking, as well as for the direct eating. It has been reported that in the process of ice manufacturing and its selling, edible ice is contaminated with some microorganisms, which causes food poisoning and gastroenteritis. It was shown that besides in the edible ice, germ growth caused by various reasons occurred in the mineral water, tap water, water filtering system, and water purifier. With public awareness, in order to examine the sanitary conditions of edible ice in the Northern area of Daegu metropolitan city, 15 places were randomly selected. As a result, 14 places were found to be contaminated with microorganisms. After incubating on the Brain Heart Infusion (BHI) agar plate, 80% of Gram-negative bacilli, 17% of Gram-positive cocci, and 3% of Gram-negative cocci were cultured. Enterobacter cloacae, Chryseomonas luteola, Pantoea spp., Klebsiella pneumoniae, Acinetobacter baumannii, Acinetobacter calcoaceticus or Providencia rettgeri were detected. Gram-positive cocci cultured in BHI agar plate from 5 specimens were identified as Staphylococcus aureus or Staphylococcus xylosus, which is well known bacteria causing strong food poisoning. This present paper raises questions on the importance and awareness of sanitary conditions of edible ice and the identification of pathogenic microorganisms living in the edible ice in relation to their distribution. The examination of sanitary conditions of edible ice in other areas in Daegu seems to be also needed to find out if there are similar cases.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.12
/
pp.747-757
/
2019
This study examined the reliability and validity of the Korean version of the Nurse-Patient Interaction Scale (K-NPIS) for the elderly, at long-term care hospitals in Korea. The original NPIS was developed to identify important characteristics of elderly patient experiences regarding nurse-patient interactions in nursing homes. Totally, 202 hospitalized elderly patients at 4 long-term hospitals in Jinju-si, Suncheon-si, and Namwon-si, were enrolled in the study and completed the questionnaire. For internal consistency, Cronbach's α of K-NPIS was 0.96 after item analysis. K-NPIS was validated using the confirmatory factor analysis and content validity. The content validity score was more than 0.80, establishing the appropriateness and readiness of the tool through group discussions between clinical experts and elderly patients. The K-NPIS is a 10-point scale comprising 12 questions. K-NPIS scores between different residential groups were significantly different, and showed no ceiling or floor effect. The internal consistency reliability, construct validity, and discriminative validity of K-NPIS was adequate. However, criterion validity requires further examination. Our findings suggest that K-NPIS serves as an appropriate measure of nurse-patient interaction when applying the nursing care intervention for elderly.
Kim, Sang-Ho;Lyu, Seung-Jun;Kim, Tae-Heon;Kang, Hyung-Won;Lyu, Yeoung-Su
Journal of Physiology & Pathology in Korean Medicine
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v.19
no.4
/
pp.982-992
/
2005
Acupuncture as a therapeutic intervention is widely used for the treatment of many functional disorders such as substance abuse and mental dysfunction. Clinical trials are currently underway to determine the effectiveness of acupuncture in the treatment of drug addiction. Yet, there are still many unanswered questions about the basic mechanism of acupuncture. Studies have shown that both the psychomotor stimulant effects and rewarding properties of addictive drugs, including morphine, are sensitized by repeated drug administration and raised the possibility that both of these effects may De linked to the same or closely overlapping the mesolimbic dopamine systems. Neiguan (PC6) point on the pericardium channel which is associated with the brain and its mental function, has been used to treat mental, psychosomatic disorders and gastroenterological disorders. The present study was designed to investigate the effect of acupuncture on repeated morphine-induced changes in extracellular dopamine levels using in vivo microdialysis and to measure the effect of acupuncture on repeated morphine-induced behavioral changes. Male Sprague-Dawley rats were treated twice a day for three days with increasing doses of morphine (10, 20 and 40 mg/kg, s.c.) or with saline. After 15 days of withdrawal, rats were challenged with morphine hydrochloride (5 mg/kg, s.c.). Acupuncture was applied at bilateral Neiguan (PC6) points for 1min after the morphine challenge. Results showed that acupuncture at the specific acupoint PC6, but not at control points (tail and HE8) significantly decreased both dopamine release, behavior induced by a systemic morphine challenge or a single s.c. morphine injection in the morphine-repeated animals. These results suggest that reduction in sensitization may be one mechanism whereby acupuncture alleviates morphine craving in addicts. Moreover, in a more general sense these results suggest that acupuncture can be used as a therapeutic intervention for correcting reversible malfunction of the body by direction of brain pathway and thus acupuncture can contribute to the biochemical balance in the central nervous system by regulating neurotransmitters.
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