• Title/Summary/Keyword: informed consent

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Short Tenn Reactions to Acupuncture Treatment and Adverse Events Following Acupuncture in Korea a Cross-sectional Survey of Patient Reports (침치료 직 후 자가 설문지를 이용한 침반응(針感)과 부작용에 대한 단면적 연구)

  • Park, Seong-Uk;Jung, Woo-Sang;Moon, Sang-Kwan;Ko, Chang-Nam;Cho, Ki-Ho;Kim, Young-Suk;Bae, Hyung-Sup;Park, Jung-Mi
    • The Journal of Korean Medicine
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    • v.28 no.2 s.70
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    • pp.66-79
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    • 2007
  • Objectives : To explore the type and frequency of short term reactions, de Qi associated with acupuncture treatment and to determine the incidence of adverse events following acupuncture in Korea. Subjects and methods : This study is a retrospective and cross-sectional survey of patient reports. 1095 subjects, 585 of out-patients of the Oriental Medicine of Stroke & Neurological Disorders Center, East-West NEO Medical Center of Kyunghee University and 510 of out-patients of the Department of Cardiovascular & Neurologic Diseases (Stoke Center), Hospital of Oriental Medicine, Kyunghee Medical Center, from June through November of 2006, who had acupuncture, gave informed consent and completed one survey form. On this form, patients were asked to report short term acupuncture reactions, de Qi, patient satisfaction measurement (using VAS), and adverse events relating to acupuncture treatment. The acupuncturists of this study are Korean Medicine Doctors (KMD) who had worked as practitioners for 3-30 years or more. Results : The average age of the 1095 subjects was 58 years old. Positive short term acupuncture reactions after treatment were reported by 878 (80.2%), negative short term acupuncture reactions by 75 (6.8%) and no reactions were reported by 142 (13.0%). The most common positive short term acupuncture reactions were feeling 'relaxed', 472 (43.1%), followed by feeling 'less pain' 90 (8.2%), 'energized' 16 ( 1.5%), 'tingling' 16 (1.5%), 'heat feeling or Cold feeling' 10 (0.9%), and others 274 (25.0%), respectively. Negative short term acupuncture reactions were feeling 'pain' 37 (3.4%), tiredness 24 (2.2%), dizziness 9 (0.8%), and others 5 (0.2%), respectively. Traditionally described needling sensations of de Qi refer to a patient's response to distention, pulling, soreness, heaviness, numbness. 39.7% of subjects reported de Qi during needling, experiencing 'distention' 333 (30.4%), 'soreness' 52 (4.7%), 'pulling' 22 (2.0%), 'heaviness' 18 (1.6%), and 'numbness' 10 (0.9%) respectively. Positive short term acupuncture reactions and de Qi rate were the highest in the less than 40 years group (83/96 86.5%, 50/96 52.1%). No acupuncture reactions were highly seen in the over 70 years old group (31/187, 16.6%). Patient satisfaction level using VAS was a comparatively high $72.9{\pm}19.9$. Adverse events were only bleeding in 92 (8.4%) of the total subjects. High sensitive acupoints were 95 points as GV26 (54 times), LI4 (54 times), ST36 (53 times), GB20 (37 times), HT8(34 times), LV3 (29 times), SI3 (29 times), and LI11 (27 times) in order. Main impressions were stroke patients 430 (16.9%), headache 185 (16.9%), hypertension 97 (8.9%), and dizziness 85 (7.8%). Conclusions : Although 8 different Korean Medicine Doctors participated in this research, we obtained similar results from each. There were no significantly different results between the two hospitals. Short term acupuncture reactions and de Qi were most related to age. Except for bleeding there were no adverse events relating to acupuncture treatment in this study. We consider acupuncture treatment as very safe depending on practitioners. Positive short term acupuncture reactions after treatment were 12 times higher than negative short term acupuncture reactions. Subjects were comparatively satisfied with acupuncture treatment.

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Superior Labral Dimension of the Glenohumeral Joint on Direct MR Arthrography (MRA): Relationship with Presence of SLAP (Superior Labrum Anterior to Posterior) Lesion (직접 자기공명 견관절 조영술 상에서 상부 관절순의 크기: 상부 관절순 전후방 파열과의 관계)

  • Im, Tae Seong;Choi, Jung-Ah;Oh, Joo Han
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.193-199
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    • 2014
  • Purpose : To evaluate the relationship between superior labral dimension of the glenohumeral joint on direct MRA and presence of SLAP lesion. Materials and Methods: IRB approval was obtained and informed consent was waived for this retrospective study. Direct MRA studies of the shoulder in 296 patients (300 shoulders) with arthroscopic surgery were analyzed by two radiologists blinded to the arthroscopic results, which were used as gold standard. One of the radiologists reviewed the images twice (session 1 and 2) for the evaluation of intra-observer variability. Transverse and longitudinal dimensions of superior labrum on coronal T1-weighted images were measured as base and height of the inverted triangular-shaped superior labrum and compared between patients with SLAP lesions vs. non-SLAP patients. Presence of meniscoid labrum was noted. Statistical analysis was done using unpaired t-test. Results: Among 279 patients (283 shoulders), 122 patients (43.1%) had SLAP lesions. The mean base/height of superior labrum in SLAP and non-SLAP patients measured on T1-weighted MR image were 8.8 mm / 5.2 mm, 8.5 mm / 4.9 mm for reader 1; 8.2 mm / 4.9 mm, 8.1 mm / 4.5 mm for session 1 of reader 2; 8.0 mm / 4.8 mm, 7.6 mm / 4.3 mm for session 2 of reader 2. In SLAP group, the mean labral height was larger than non-SLAP group with statistically significant difference (p<0.05). Fifteen patients (5.3%) had meniscoid labrum according to operation records. Conclusion: In patients with SLAP lesion, the height of the superior glenoid labrum on oblique coronal image of MRA was slightly larger than non-SLAP patients. A larger height of superior glenoid labrum may be associated with SLAP lesions.

Pseudoradial Tear of the Medial Meniscus: A Relatively Common Potential Pitfall (내측반월상 연골의 가성방사파열: 비교적 흔한 진단상 함정)

  • You, Woo Young;Choi, Jung-Ah;Oh, Kyoung Jin;Min, Seon Jeong;Choi, Jae Jeong;Chang, Suk Ki;Hwang, Dae Hyun;Kang, Ik Won
    • Investigative Magnetic Resonance Imaging
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    • v.18 no.3
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    • pp.219-224
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    • 2014
  • Purpose : To determine the incidence of truncated triangle appearance of anterior horn (AH) to body of medial meniscus (MM) and determine its clinical significance. Materials and Methods: IRB approval was obtained, and informed consent waived for this study. The criteria of "pseudoradial tear" was truncated triangle appearance of the tip of AH to body of MM on one or more coronal images with adjacent fluid signal intensity at the blunted tip. Two musculoskeletal radiologists retrospectively evaluated 485 knee MR images independently for the presence and number of sections with "pseudoradial tear" of AH to body of MM using proton density-weighted coronal MR images. Inter-and intraobserver agreement was calculated using kappa coefficients. Medical records were reviewed for arthroscopic correlation. Results: A pseudoradial tear in the AH to body of MM was present in 381 (78.6%) patients. Locations were 112 in AH (29.4%), 143 in AH to body (37.5%), and 126 in body (33.1%). Number of consecutive sections of pseudoradial tear were 1 in 100 (26.2%), 2 in 164 (43.0%), 3 in 94 (24.7%), 4 in 21 (5.5%), and 5 in 2 (0.5%). Interobserver agreement was 0.99 for presence and 0.43 for number of sections of pseudoradial tear. Arthroscopies were performed in 96 patients and none of the pseudoradial tears were proven as true radial tears on arthroscopy. Conclusion: Pseudoradial tears are frequently seen in AH to body of MM on coronal MR images and may be another pitfall that a radiologist needs to be aware of and be able to differentiate from true radial tear.

Gaussian Filtering Effects on Brain Tissue-masked Susceptibility Weighted Images to Optimize Voxel-based Analysis (화소 분석의 최적화를 위해 자화감수성 영상에 나타난 뇌조직의 가우시안 필터 효과 연구)

  • Hwang, Eo-Jin;Kim, Min-Ji;Jahng, Geon-Ho
    • Investigative Magnetic Resonance Imaging
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    • v.17 no.4
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    • pp.275-285
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    • 2013
  • Purpose : The objective of this study was to investigate effects of different smoothing kernel sizes on brain tissue-masked susceptibility-weighted images (SWI) obtained from normal elderly subjects using voxel-based analyses. Materials and Methods: Twenty healthy human volunteers (mean $age{\pm}SD$ = $67.8{\pm}6.09$ years, 14 females and 6 males) were studied after informed consent. A fully first-order flow-compensated three-dimensional (3D) gradient-echo sequence ran to obtain axial magnitude and phase images to generate SWI data. In addition, sagittal 3D T1-weighted images were acquired with the magnetization-prepared rapid acquisition of gradient-echo sequence for brain tissue segmentation and imaging registration. Both paramagnetically (PSWI) and diamagnetically (NSWI) phase-masked SWI data were obtained with masking out non-brain tissues. Finally, both tissue-masked PSWI and NSWI data were smoothed using different smoothing kernel sizes that were isotropic 0, 2, 4, and 8 mm Gaussian kernels. The voxel-based comparisons were performed using a paired t-test between PSWI and NSWI for each smoothing kernel size. Results: The significance of comparisons increased with increasing smoothing kernel sizes. Signals from NSWI were greater than those from PSWI. The smoothing kernel size of four was optimal to use voxel-based comparisons. The bilaterally different areas were found on multiple brain regions. Conclusion: The paramagnetic (positive) phase mask led to reduce signals from high susceptibility areas. To minimize partial volume effects and contributions of large vessels, the voxel-based analysis on SWI with masked non-brain components should be utilized.

Relationship Between Carotid Intima-Media Thickness Using Ultrasonography and Diagnostic Indices of Metabolic Syndrome (초음파를 이용한 경동맥 내-중막 두께와 대사증후군 진단지표의 연관성)

  • Ko, Kyung-Sun;Heo, Kyung-Hwa;Won, Yong-Lim;Lee, Sung-Kook;Kim, Ki-Woong
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.285-291
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    • 2009
  • The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipments and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was $0.739{\pm}0.137\;mm$ and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

Outcomes of Patients with COPD Requring Mechanical Ventilation (만성폐쇄성폐질환 환자의 기계호흡시 생존 예측 인자 분석)

  • Baik, Jae-Joong;Kim, Sang-Chul;Lee, Tae-Hoon;Chung, Yeon-Tae
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.2
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    • pp.179-188
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    • 2000
  • Background : The decision to institute mechanical ventilation for patients with COPD is very difficult. The accurate information regarding weaning success and long-term survival will improve communication with patients and family and enhance informed consent. The aims of this study are to describe outcomes and identify variables associated with survival for patients experiencing mechanical ventilation with an acute respiratory failure of COPD. Methods : The 53 cases of mechanical ventilation in the intensive care unit in the National Medical Center from 1989 to 1998 were included. Data were collected retrospectively from medical records. Weaning success rate and 3 month and 1 year survival rates were estimated. Factors associated with weaning success and survival were determined. Results : Weaning sucess was 55%. For success group with 29 cases, 3 months survival rate was 61% and 1 year survival rate 37%. APACHE II scores in weaning success group were significantly lower than those in the failure group. Factors such as age, sex, comorbid-illnes. previous steroid use, causes of respiratory failure, RVH or arrhythmia on EKG, serum albumin level, arterial blood pH, $PaO_2$, $PaCO_2$, $FEV_1$ duration of mechanical ventilation and steroid use during mechanical ventilation were not associated with weaning success. Only age and serum albumin level were associated with 3 month and 1 year survival. No COPD patients of age more than 75 years and serum albumin level less than 3g/dl had survived at 1 year after weaning success. Conclusion : While weaning success from mechanical ventilation can be predicted by APACHE II score in COPD patients, long-term outcomes of survivors may be influenced by nutritional status and age.

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Effects of Social Support, Sleep Quality, and Oral Health Impact Profile on Depression among Pregnant Women (일부 임신부의 사회적 지지, 수면의 질 및 구강건강영향지수가 우울수준에 미치는 영향)

  • Han, Se-Young;Han, Yang-Keum
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.134-141
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    • 2017
  • This study examined 191 pregnant women before delivery in an obstetrics and gynecology clinic in North Gyeongsang Province from May to September 2016 by using a questionnaire after obtaining informed consent for voluntary participation in the study. The study was performed to investigate the association of depression with sociodemographic characteristics, pregnancy-related characteristics, social support, sleep quality and Oral Health Impact Profile (OHIP) in pregnant women. The prevalence of depression among the pregnant women was 25.1% in the healthy group and 74.9% in the depression group. The depression level was significantly higher in women in the depression group who were unsatisfied with their marriage life, had no occupation, had lower social support, had poor sleep quality and had higher OHIP scores. The results of the logistic regression analysis indicated that, the risk ratio for more severe depression was significantly higher in the group with no experience of miscarriage and induced childbirth than in the group with childbirth experience. Conversely, the risk ratio for more severe depression was significantly lower in the group with high social support than in the group with low social support. Depression in the respondents significantly positively correlated with sleep quality and OHIP score but significantly negatively correlated with social support. The multiple regression analysis revealed that the depression level was significantly higher by 22.3% among pregnant women with lower marital satisfaction, no childbirth experience, lower social support and higher OHIP scores. In summary, depression was related to marital satisfaction, childbirth experience, social support, and OHIP score, among others, in pregnant women in this study. Therefore, further investigation is warranted to construct programs and measures that will help build positive thinking by designing and verifying a three-dimensional study model by taking into consideration various variables to reduce the incidence of depression in pregnant women.

Effects On Labor Pain and Duration of Delivery Time for Primipara Women treated by Hob-Gog(Li-4) Pressure (합곡(合谷 LI-4)지압이 초산부의 분만 통증정도와 소요 시간에 미치는 효과)

  • Kim, Young-Ran;Lee, Sun-Hye;Kang, Jin-Sun;Jung, Geum-Ok;Ju, Young-Ah
    • Women's Health Nursing
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    • v.7 no.3
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    • pp.331-347
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    • 2001
  • The purpose of this study was to compare the effects on labor pain and duration of delivery time for primipara women treated by Hob-Gog (LI-4) pressure. 1. The proposed hypothesis was that 'the score of labor pain could be lower in the group which had LI-4 pressure applied than in the control group'. 1-1. The sub hypothesis was that the score of subjective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 1-2. Another sub hypothesis was that the score of objective labor pain would be lower in the group which had LI-4 pressure applied than in the group which did not have LI-4 pressure applied. 2. The proposed hypothesis was that 'the score of duration of delivery time could be shorter in the group which had LI-4 pressure applied than in the control group'. The design of this study was a nonequivalent control group non-synchronized post test only design to verify the effect on labor pain for primipara women treated by LI-4 pressure and to evaluate the benefits of using LI-4 pressure on some women and judging the degree of their labor pains in comparison with other primipara women not treated with LI-4 pressure. The subjects included 63 primipara women who underwent vaginal delivery, who were between 38-41 weeks intra uterine pregnancy; who did not have any complications; and who were under pitocin augmentation or induction. They were recruited with informed consent; 34 were in the control group and 29 were in the experimental group. The study was measured with a structured questionnaire consisting of general characteristics, knowledge related to delivery, subjective (Johnson, 1974) and objective(McLachlan, 1974) labor pain scale, data collection was done by research during the period from April, 2000 to July, 2000 and data was analyzed by descriptive statistics, $x^2$-test, and t-test. The results were as follows: 1. The scores of total labor pain in the group which had LI-4 pressure applied were lower($347.62{\pm}49.84$) than in the group($411.02{\pm}55.79$) which did not have LI-4 pressure applied; And these differences were statistically significant(t=4.7193, p=.000). 1-1. The scores of subjective labor pain in the group which had LI-4 pressure applied were lower($203.44${\pm}33.88$)$ than in the group ($$233.82{\pm}31.31$$) which did not have LI-4 pressure applied(t=3.6953, p=.000). 1-2. The scores of objective pain in the group which had LI-4 pressure applied were lower ($144.18{\pm}29.12$) than in the group which did not have LI-4 pressure applied($177.20{\pm}35.01$). but there were no statistically significant differences found in regard to the scores of objective pain(t=4.0271, p=.000). 3. The duration of delivery time in the group which had LI-4 pressure applied was shorter ($390.51min{\pm}111.91$) than in the group ($460.44min{\pm}190.78$)which did not have LI-4 pressure applied and the duration of delivery time in the experimental group was statistically more significant than that in the control group. therefore this thesis was adapted(t=1.734, p=.0879). It could be concluded that LI-4 pressure is effective in relation to labor pain and duration of delivery time for primipara women. Therefore it is necessary to increase the number of subjects to generalize this result.

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Considerations of Countermeasure Tasks in the Fields of Forest and Forestry in Korea through Case Study on "The Nagoya Protocol (Access to Genetic Resources and Benefit Sharing)" ("유전자원의 접근과 이익공유(ABS)" 사례연구를 통한 국내 산림·임업분야 대응과제 고찰)

  • Lee, Gwan Gyu;Kim, Jun Soon;Jung, Haw young
    • Journal of Korean Society of Forest Science
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    • v.100 no.3
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    • pp.522-534
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    • 2011
  • The aim of this study is to draw forth the tasks for establishing the right of native biology in Korea through the case study on 'Access on genetic resources and Benefit Sharing'. For this purpose, this study decided on its research subject by selecting Hoodia, on which ABS treaty was made the most recently, through the examination of the representative ABS precedents on plant species. This study analyzed the process background of ABS on Hoodia, and compared & analyzed the ABS procedures of 'Bonn Guidelines' adopted by the 6th Conference of the Parties of the Convention on Biological Diversity in 2002 and Hoodia case. Together with the ABS major issues in common drawn as a result of this analysis, and "Nagoya Protocol" adopted by the 10th Conference of the Parties of the Convention on Biological Diversity, this study intended to shed a light on the impending tasks which Korea faces at present and its role relationship. The research results are as follows: 1. It is required that species habitats should be divided based on biological classification and its subsequent community should be established with the development of infrastructure such as a community's independent production, management and monitoring of bio-species. 2. There needs to be a designation of ABS National Focal Point for sharing of ABS-related general information, boosting of implementation of the relevant convention. 3. There needs to be the establishment of ABS convention system consequent on legislative, administrative, political procedures, and designation of the Competent National Authorities for the provision of the format of Prior Informed Consent (PIC) and Mutually Agreed Terms (MAT) and their contents assessment and confirmation. 4. There should be the establishment of integrated management system of ABS-related research and development of forest biological resources and its relevant research projects. 5. There should be information development through the distribution of responsibility and role between the ministries and offices concerned according to bio-resources, and there needs to be efforts in aiming for opening a working group of academic-industrial institutions for developing a mutually interchangeable system. 6. It's required that the efficient access between industrial circles and the people should be promoted by setting up ABS support center of biological resources in ministry and office's charge. 7. There should be a selection of a national supervisory organization for securement of the right of a local community and monitoring of ABS convention implementation, and a countermeasure system for preventing outflow of forest bioresources. Conclusively, it's judged that it will be possible to inquire into the countermeasures for the establishment of the native forest biology dominion through such research results.