• Journal of The Korean Society of Integrative Medicine
• /
• v.7 no.2
• /
• pp.77-84
• /
• 2019

Purpose : Elastic taping is a therapeutic method, used for treatment of various musculoskeletal and neuromuscular deficits. However, there is limited evidence, of the effects of ankle elastic taping in neurologic patients. The purpose of this study, was to investigate the effect of elastic taping on gait, in the affected ankle area of chronic stroke patients. Methods : Subjects were randomized to receive 30 chronic stroke patients, who were 6 months old from the date of onset according to screening criteria. Group I showed ankle joint taping, and Group II had ankle muscle taping. Dynamic balance and temporal and spatial gait, were measured before taping application, and after 30 minutes of taping application. Results : Dynamic balance was measured using the Time up & Go test (TUG). There was statistically significant difference, between Group I and Group II (p<.05). There was no statistically significant difference, between Group I and Group II. Temporal and spatial gait were measured using GaitRite. In Group I, there was significant difference, before and after taping (p<.05). In Group II, there was no significant difference, before and after taping (p>.05). There was significant difference in Group I, between Group I and Group II (p<.05). Conclusion : Results suggest that intervention using elastic taping, may have a positive effect, on rehabilitation diversity and function in stroke patients. Based on this, it can be used for rehabilitation of stroke patients. Various studies on the application method, and effect of the application site as well as application time, should be continued with stroke patients.

• Tuberculosis and Respiratory Diseases
• /
• v.73 no.4
• /
• pp.231-233
• /
• 2012

Tadalafil is a phosphodiesterase-5 inhibitor (PDE5I), which is widely used to treat erectile dysfunction. Although PDE5Is have excellent safety profiles, and most of the side effects are mild, rare serious adverse events have been reported in association with PDE5Is. Thrombosis is one of those events, and a few previous reports have suggested the association of PDE5Is with thrombosis. We report the case of a 61-year-old male who developed pulmonary embolism combined with pulmonary infarction directly after taking tadalafil. Both the patient and the physician suspected tadalafil as the culprit drug, as the patient was in an otherwise healthy condition. However, after extensive evaluation, we noticed that factor VIII levels were elevated. Prior reports suggesting the association between thrombosis and PDEIs either lack complete information on coagulation factors, or show inconsistencies in their results. Physicians should operate caution prior to accepting the diagnosis of adverse drug reaction.

• The Korean Journal of Emergency Medical Services
• /
• v.7 no.1
• /
• pp.5-28
• /
• 2003

The purpose of this study which was conducted by framing of standardized advanced emergency care instructor qualification course outline and training competent instructor Course development based on following educational principle and it would be expected more improved aspect. Advanced Emergency care Instructor Qualification Course Development (1) based on advanced emergency care instructor job analysis and paramedic job description. (2) Learning of emergency care instructor qualification course is continuous. It is important to begin at the learner's level of knowledge and to relate new learning to information the learner needs. (3) Learning of emergency care instructor qualification course is purposeful and must make sense to the learner. Progress in learning must make sense to the learner. Progress in learning must be constantly appraised through feedback. The purpose of learning BLS information and skills must be kept in sharp focus. (4) Learning involves as many senses as possible. The more stimulating a learner activity is to the senses, the longer the information will be retained. Conservative figures indicate that 75% of what is heard is for-gotten after 2 days. It has been said that learners remember (5) Learning activities must be appropriate for the emergency situation through the PBL educational method. In BLS lecture skill learning, the greatest proportion of class time should be spent in manikin practice, using performance sheets as a learning tool or guide. (6) Learning must be stimulating. Instructors can motivate learners by helping them achieve higher levels of proficiency and encouraging other levels of course completion, such as instructor and instructor trainer. (7) Learning is affected by the physical and social environment. The physical environment should be conducive to both the kind of learning taking place and the activities used for learning. Advanced emergency care instructor qualification course organized educational psychology, educational methodology I,II,III, educational material making skill, lecture & conversational skill, BLS theory & pratice lecture skill, minic lecture designed PBL module. test of minic lecture & pratice lecture skill. Advanced emergency care instructor qualification course continued to active instructor training and motivated to active EMS system.

• Journal of Nutrition and Health
• /
• v.33 no.8
• /
• pp.890-900
• /
• 2000

The aim of this investigation was to collect the baseline data about growth, dietary behaviors, nutrient intakes and dietary quality of children at child care centers for planning nutritional management program. The dietary intakes were measured by weighing method for intakes at child care centers and by dietary records by children\\`s mothers for intakes at home. The weight and height were measured and calculated z-scores by using standard of the same age groups. The children were 163 boys and 168 girls and the mean age were 55.6 months(12-78 months) and 56.0 months(16-78 months). respectively. The Z-score for height(0.33) and weight(0. 11) showed that the growth of children were above average. Nutrients intakes such s energy, protein, fiber, iron, sodium, potassium, vitamin A, vitamin B$_1$, vitamin C, niacin of boys from lunch and snack at day care centers were significantly higher than those of girls, and the meals at child care centers provided 20-37% of RDAs. The daily energy intakes were 1332.2kcal(83.1% RDA), protein 44. 26g(109.3% RDA), calcium 437.73mg(72.4% RDA), iron 7.24mg(72.4% RDA), vitamin A 459.6RE(113.1% RDA),vitamin B$_1$ 0.74mg(93.4% RDA), vitamin B$_2$0.79mg(79.7% RDA), niacin 7.66mg(69.9% RDA) and vitamin C 56.84mg(142.1% RDA). The nutrients which more than 50% of subjects ate less than 75% RDA were calcium, iron, niacin, and vitamin B$_2$.The average mean adequacy ratio was 0.80 and mean dietary variety score was 22.42, and those are positively correlated to % RDA of nutrient intakes. In summary, the children using child care centers consumed most nutrients below level of RDA and the nutritional management program at child care center is required to enhance the nutritional status of them. (Korean J Nutrition 33(8) : 890-900, 2000)

• Journal of Trauma and Injury
• /
• v.21 no.1
• /
• pp.1-7
• /
• 2008

When man first walked on this planet, injury must have been a close encounter of the first kind. The outbreak of World War I, during a period of rapid scientific growth in the basic sciences, demonstrated the need to develop better methods of care for the wounded, methods that were later applicable to the civilian population. Trauma is a multisystem disease and, as such, benefits from almost any advance in medical science. As we learn more about the physiology and the biochemistry of various organ systems, we can provide better management for trauma victims. Improved imaging techniques, better appreciation of physiologic tolerance, and increased understanding of the side effects of specific surgical procedures have combined to reduce operative intervention as a component of trauma patient care. On the other hand, because of this rapid development of medical science, only a few doctors still have the ability to treat multisystem injuries because almost doctor has his or her specialty, which means a doctor tends to see only patients with diagnoses in the doctor's specialty. Trauma Surgeons are physicians who have completed the typical general surgery residency and who usually continue with a one to two year fellowship leading to additional board certification in Surgical Critical Care. It is important to note that trauma surgeons do not need to do all kinds of operations, such as neurosurgery and orthopedic surgery. Trauma surgeons are not only a surgeon but also general medical practitioners who are very good at critical care and coordination of patient. In order to achieve the best patient outcomes, trauma surgeons should be involved in prehospital Emergency Medical Services, the Trauma Resuscitation Room, the Operating Room, the Surgical Intensive Care and Trauma Unit, the Trauma Ward, the Rehabilitation Department, and the Trauma Outpatient Clinic. In conclusion, according to worldwide experience and research, the trauma surgeon is the key factor in the trauma care system, so the trauma surgeon should receive strong support to accomplish his or her role successfully.

• Tuberculosis and Respiratory Diseases
• /
• v.48 no.4
• /
• pp.428-437
• /
• 2000

Background : Five year survival rate of postoperative stage I non-small cell lung cancer(NSCLC) reaches to 66%. In the remaining one third of patients, however, cancer recurs and the overall survival of NSCLC remains dismal. To evaluate clinical and pathologic characteristics of recurred NSCLC, the patterns and factors for postoperative recurrence in patients with staged I and II NSCLC were studied. Method : A retrospective analysis was performed in 234 patients who underwent radical resection for pathologic stage I and II NSCLC. All patients who were followed up for at least one year were included in this study. Results : 1) There were 177 men and 57 women The median age was 63. The median duration of the follow up period was 732 days (range 365~1,695 days). The overall recurrence rate was 26.5%, and the recurrence occurred $358.8{\pm}239.8$ days after operation. 2) The ages of recurred NSCLC patients were higher ($63.2{\pm}8.8$ years) than those of non-recurred patients ($60.3{\pm}9.8$ years)(p=0.043). The recurrence rate was higher in stage II (46.9%) than in stage I (18.8%) NSCLC p<0.001. The size of primary lung mass was larger in recurred ($5.45{\pm}3.22\;cm$) than that of non-recurred NSCLC ($3.74{\pm}1.75\;cm$, p<0.001). Interestingly, there were no recurrent cases when the resected primary tumor was less than 2cm. 3) Distant recurrence was more frequent than locoregional recurrence (66.1% vs. 33.9%). Distant recurrence rate was higher in females and in cases of adenocarcinoma. Brain metastasis was more frequent in patients with adenocarcinoma than in those with squamous cell carcinoma (p=0.024). Conclusion: The tumor size and stage were two important factors for determining the possibility of a recurrence. Because distant brain metastasis was more frequent in patients with adenocarinoma, a prospective study should be conducted to evaluate the effectiveness of preoperative brain imaging.

• Journal of Acupuncture Research
• /
• v.28 no.3
• /
• pp.55-71
• /
• 2011

Objectives : The purposes of this preliminary study was to examine the feasibility of recruiting women into a clinical trial designed to examine the effects of acupuncture in treating urinary incontinence (UI) in premenopausal women with delivery history and the feasibility of performing the study procedures. We also tried to determine if there was preliminary evidence to suggest that acupuncture may be effective in reducing UI and improving disease-specific quality of life. Methods : This study was a pragmatic randomized clinical trial. Subjects between the ages of 20 and 49 years were randomly assigned to a treatment(n=11) or control group(n=11) and analyzed. Both groups were supposed to do Kegel exercise at home during 4 weeks and acupuncture was applied to the treatment group twice a week(8 sessions) additionally. Subjects performed 1 hour pad test and completed a 3-day urination diary, international consultation on incontinence modular questionnaire(ICIQ), and incontinence - quality of life(I-QOL) at base line and 5 weeks. Results : Both group showed improvement in 1 hour pad test and the reducing amount of UI was significantly larger in treatment group(p=0.0182). The significant improvements in ICIQ and I-QOL were also observed in treatment group and sustained until the follow-up measurement at 16 weeks. Any adverse reaction related to acupuncture did not happen. Conclusions : It was feasible to recruit subjects and perform the study procedures. The positive results of this study support the requirement for additional research investigating the efficacy of acupuncture in the treatment of UI in women.

• Journal of Korean Public Health Nursing
• /
• v.4 no.2
• /
• pp.15-23
• /
• 1990

This study was carried out to explore the illness-related activities of the menopaused women. To achieve such a purpose, sixty-six cases of the middle aged women were sampled the naturally and the artificially menopaused group respectively from 1st, Aug. to 31th, Aug. in 1988. For the collection of data, 1, 140 women aged between 45-54 were selected through stratified sampling techniques in urban and rural area. Among them the final subjects for analysis were restricted to only those who had experienced menopause naturally or artificially. And then, after control for age and education analysis was performed. The data was analysed by use of frequency, percentage, $X^2-test,$ t-test, Pearson correlation coefficiency and stop-wise multiple regression. The obtained results were as follows. I. As for the se1f-perception on menopausal symptoms, it was revealed than Korean women, neithe in naturally and artificially, accepted the change of menstruation itself as serious. This shows us that middle-aged women had positively receptive attitudes that the change of menstruation is follwed by amenorrhea. 2. The artificially menopaused group scored more than the naturally one: (I) on the self-control activities such as self-assessment, lay-consultation, fever check, pulse check and observation of vagina discharge, (2) on the self-decision activities such as hospital and pharmacy utilization, (3) on the self maintenance activities such as walking, aerobic, weight check, skin care, skin protect, calori control diet control, milk intake, vegetable intake, cold water drinking before meal, parasol use and BP check The above results lead us that the self care practices of the menopaused women revealed' coping wit I menopausal symptoms at the first level in community and must be developed by the adequate nursin intervention.

• Quality Improvement in Health Care
• /
• v.4 no.2
• /
• pp.280-284
• /
• 1997

Since the start of the Korean Society of Quality Assurance in Health Care in 1994, QA has improved, but it is time to develop our own policies that are more appropriate for Korean hospitals. American Quality Assurance policies are difficult to apply to the Korean medical community due to the differences in health insurance policies, and hospital structure between the two countries. Methods : I would like to propose more efficient organization and management of Quality Assurance according to the specific structures of hospitals in Korea. All of the hospital departments and committees should report to the Quality Assurance office, which in turn should report to the director. I would like to suggest that the current insurance review staff be used for the Quality Assurance office. A nurse should be in charge of the Quality Assurance department. The Quality Assurance department should have three sections: Medical Inssurance Review, QA records for the different Medical Departments, and QA records for the Ancillary Departments. A staff physician should be the chairman of the hospital QA committee, which should serve as the advising body to the QA Department. The QA Committee should be organized into eight subcommittees so that all departments thought the hospital are represented. The current Medical Insurance Review offices in Korea have similar responsibilities to the QA Department: therefore I would like to recommend that the Medical Insurance Review office be changed the the QA office. If there are presently two separate Medical Insurance and QA offices, these should be combined into one office. Conclusion : These changes would surely benefit hospitals and strengthen the efficiency of both Insurance Review and Quality Assurance.

• Korea Journal of Hospital Management
• /
• v.9 no.3
• /
• pp.128-142
• /
• 2004

To evaluate the effects of critical pathway on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a tertiary care academic medical center. The basic research design is a retrospective case-control comparative study. 470 patients of gastrectomy were included in the study; 180 before pathway development (control), 163 right after pathway implementation (path group I) and 127 one year after pathway implementation (path groupII). 476 patients of modified radical mastectomy were also analyzed to examine whether the reduction of the length of hospital stay is from the hospital-wide trend or due to the critical pathway. Death after operation, ICU stay, unplanned re-operation, readmission after discharge, the length of hospital stay and cost were analyzed. 2-test, one-way ANOVA, Bonferroni and Turkey's test were used for statistical analysis. (1) There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. (2) The length of hospital stay was 13.0 days in control group, 12.2 days in path group I and 10.0 days (p<0.01) in path groupII. (3) The total costs during the hospital stay were reduced. However the cost per day was significantly increased from reduction of hospital stay (358,488won in control, 366,017won in path group I and 413,220won (p<0.01) in path groupII). Critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care.