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A Qualitative Research on the Treatment Experiences of Patients with Serious Injury in Traffic Accidents Treated with Traditional Korean Medicine (교통사고 중상자의 한방치료 경험에 대한 질적 연구)

  • Kim, Seon Hye;Jo, Hyo Rim;Bong, Sung Min;Sung, Won Suk;Cho, Hyun Seok;Kim, Eun Jung
    • The Journal of Korean Medicine
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    • v.40 no.2
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    • pp.72-88
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    • 2019
  • Objectives: The purpose of this study is to understand the experience of traffic accident patients with serious injury treated with Traditional Korean Medicine (TKM). Methods: This study was conducted on the basis of grounded theory. We recruited 10 participants who had been hospitalized in Dongguk University Bundang Oriental Hospital after traffic accident. Raw data was collected by in-depth interview, and analyzed by using constant comparison. The coding(open-axial-selective) was performed in order to create paradigm and theoretical model, which can explain main theme of this study. Results: Core phenomenon of this study was 'Experiencing TKM treatment as an alternative' and core category was 'Searching for the answer to the management of traffic accident sequela through TKM treatment' Conclusions: For patients with serious injury, 'Experiencing TKM treatment as an alternative' has meaning as the following: First, The absence of accurate radiography and surgical management makes it hard for patients to choose Korean medicine hospital immediately after traffic accident. Second, Effectiveness of TKM treatment should be evaluated in the long term. Third, TKM treatment is superior to Western medicine treatment in managing long-term patients who suffered from serious injury involved in traffic accident. Finally, Cooperative service of the Western medicine and TKM will provide more satisfactory medical care for traffic accident patients.

A Patient with Guillain-Barre Syndrome Treated with Combined Korean Medicine Treatments

  • Cha, Hyun Ji;Kim, Beom Seok;Lee, Ye Ji;Kim, Hyo Bin;Sung, Ki Jung;Lee, Young Rok;Kim, Jin Youp;Kim, Eun Seok;Jeon, Ju Hyun;Kim, Young Il
    • Journal of Acupuncture Research
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    • v.38 no.2
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    • pp.170-174
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    • 2021
  • A patient diagnosed with Guillain-Barre syndrome (GBS) suffering from numbness in the toes and fingers, paralysis in the face, and back pain received intravenous immunoglobulin on December 28, 2019. Without an improvement in symptoms the patient was admitted to a Korean medicine hospital on January 1, 2020 to receive combined Korean medicine treatment including herbal medicine (Sipjeondaebo-tanggami and Hyangbujasunkipalmul-tang), acupuncture treatment, moxibustion, cupping treatment, and physical therapy. Treatment was administered over 51 days, of which 17 days were during hospitalization. Paralysis of facial muscle, and numbness in fingers and toes were evaluated using the Yanagihara score and numeric rating scale (NRS) score, respectively. Facial paralysis improved (21 to 40 based on Yanagihara score) and paresthesia of the hands and feet disappeared (NRS score 6-7 to NRS score 0). There were no side effects or sequela. This study suggested combined Korean medicine treatment may be effective for the treatment of GBS.

A Systematic Review of Placenta Pharmacopuncture for Neuropsychiatric Diseases in Practice (자하거 약침의 신경정신과 임상 응용에 관한 체계적 문헌 고찰)

  • Shin, Haegue;Lee, Jae-Hyok;Kang, Hyung Won
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.2
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    • pp.157-180
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    • 2022
  • Objectives: To perform a systematic review of placenta pharmacopuncture for treating neuropsychiatric diseases, focusing on its efficacy and the safety so that evidence on its clinical use could be obtained, thus contributing to further studies. Methods: Through Korean, English, and Chinese databases (OASIS, Korean TK, KISS, RISS, ScienceON, Pubmed, Cochrane, EMBASE, CINAHL, AMED, CNKI, and Wanfang), combinations of keywords (placenta, pharmacopuncture, etc.) were used to select clinical studies published until January 2021 about placenta pharmacopuncture for neuropsychiatric diseases. Interventions included combined treatments. Study design included cases studies, series, and clinical trials. Cohort studies, literature reviews, in vitro and animal experiments were excluded. The primary outcomes involved measurements of symptoms, Visual Analogue Scale, or questionnaires. Data extracted from databases were imported to Endnote X7 to remove duplicates. The quality of the literature was assessed based on CAse REports Guidelines and Cochrane's Risk of Bias (ROB). Results: Twenty-one studies were selected, including ten case reports, three case series, two one-armed clinical trials, one non-randomized clinical trial, and five randomized clinical trials. There were six studies on sleep disorders, five studies on stroke sequela, two on mood disorders, two on enuresis, two on Guillain-Barré syndrome, two on multiple sclerosis, one on neurocognitive disorder, and one on vertigo. The most frequent combined treatment was acupuncture in both the experimental group (n=10) and the control group (n=3). Acupoints were ST36, SP6, BL23, CV4, GB20, GV20, N-HN54, and so on. All studies reported improvement of symptoms. The quality of case studies was relatively high. Assessment of ROBs resulted in low risks. Conclusions: Placenta pharmacopuncture is effective for neuropsychiatric diseases such as sleep disorders, mood disorders, enuresis, and neurocognitive disorders. Regarding insomnia, several studies have reported significant improvements with placenta pharmacopuncture. There was no adverse event associated with placenta pharmacopuncture.

Development and Psychometric Evaluation of the Ischemic Stroke Distress Scale (ISDS) (허혈성 뇌졸중 환자의 디스트레스 측정도구 개발 및 평가)

  • Kang, Jaejin;Yoo, Yang-Sook
    • Journal of Korean Academy of Nursing
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    • v.53 no.1
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    • pp.12-27
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    • 2023
  • Purpose: This study aimed to develop a scale to measure distress in patients with ischemic stroke and verify its validity and reliability. Methods: Preliminary items were developed from literature review and in-depth interviews. The final preliminary scale was confirmed through a content validity test of eight experts and a preliminary survey of 10 stroke patients. The participants for psychometric testing were 305 stroke patients in the outpatient clinic. Validity and reliability analyses included item analysis, exploratory and confirmatory factor analysis, convergent validity, known-group validity, and internal consistency of the scale. Results: The final scale consisted of 17 items and 3 factors. The three distinct factors were 'self-deprecation, worry about future health, and withdrawal from society' and this structure was validated using a confirmatory factor analysis. Convergent validity was supported by comparison with the Center for Epidemiologic Studies Depression Scale (r = .54, p < .001) and Brief Illness Perception Questionnaire (r = .67, p < .001). Known-groups validity was verified by dividing groups according to 'duration since diagnosis' (t = 2.65, p = .009), 'presence of sequela' (t = 10.16, p < .001), and 'awareness of distress' (t = 12.09, p < .001). The internal consistency of the scale using Cronbach's α for the total items was .93. Conclusion: The Ischemic Stroke Distress Scale is a valid and reliable tool that reflects stroke distress effectively. It is expected to be used as a basic tool to develop various intervention strategies to reduce distress in ischemic stroke patients.

Effects of Intensive Care Experience on Post-Intensive Care Syndrome among Critical Care Survivors : Partial Least Square-Structural Equation Modeling Approach (집중치료 경험이 중환자실 생존자의 집중치료 후 증후군에 미치는 영향: PLS-구조모형 적용)

  • Young Shin, Cho;Jiyeon Kang
    • Journal of Korean Critical Care Nursing
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    • v.17 no.1
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    • pp.30-43
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    • 2024
  • Purpose : Post-intensive care syndrome (PICS) is characterized by a constellation of mental health, physical, and cognitive impairments, and is recognized as a long-term sequela among survivors of intensive care units (ICUs). The objective of this study was to explore the impact of intensive care experience (ICE) on the development of PICS in individuals surviving critical care. Methods : This secondary analysis utilized data derived from a prospective, multicenter cohort study of ICU survivors. The cohort comprised 143 survivors who were enrolled between July and August 2019. The original study's participants completed the Korean version of the ICE questionnaire (K-ICEQ) within one week following discharge from the ICU. Of these, 82 individuals completed the PICS questionnaire (PICSQ) three months subsequent to discharge from hospital. The influence of ICE on the manifestation of PICS was examined through Partial Least Squares-Structural Equation Modeling (PLS-SEM). Result : The R2 values of the final model ranged from 0.35 to 0.51, while the Q2 values were all greater than 0, indicating adequacy for prediction of PICS. Notable pathways in the relationship between the four ICE dimensions and the three PICS domains included significant associations from 'ICE-awareness of surroundings' to 'PICS-cognitive', from 'ICE-recall of experience' to 'PICS-cognitive', and from 'ICE-frightening experiences' to 'PICS-mental health'. Analysis found no significant moderating effects of age or disease severity on these relationships. Additionally, gender differences were identified in the significant pathways within the model. Conclusion : Adverse ICU experiences may detrimentally impact the cognitive and mental health domains of PICS following discharge. In order to improve long-term outcomes of individuals who survive critical care, it is imperative to develop nursing interventions aimed at enhancing the ICU experience for patients.

A Study on Tonsillectomy of the Elemeniary School Children in Busan Area (도시(都市) 국민학생(國民學生)의 편도선(扁桃腺) 절제율(切除率) 및 학부모(學父母)의 인식도(認識度))

  • Kim, Kyung Hee;Park, Jae Yong
    • Journal of the Korean Society of School Health
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    • v.4 no.2
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    • pp.78-89
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    • 1991
  • In order to understand how the parents who have the children of elementary school actually recognising their children's tonsillectomy, and then, analyze its motivation, and how many children was treated tonsillectomy in our country, we hereby analyzed and intended for 3,882 of the children of elementary school in Susan area from 1st grade to the 6 years grade by the questionnaire through the parents of students. The viewpoint about the requirement of tonsil in the human body, the only 25.1 percent had responded: absolutely necessary. The respondents who responded absolutely necessary were highly ranked according to the urban, medium urban and then outskirt area. The advisory person who whishes, to be tonsillectomised was physicians 76.2 percent of the highest point. Operation had performed mostly the age of 6 year and had appeared the questionnaire through 6-9 year old, and they utilized their operational period was at the time of summer vacation of August 31.5 percent and winter vacation of December and January 16.7 percent respectively, and place of implementation was accounted for 87.0 Opercent at the hospitals and the motivation of tonsillectomy had motivated during one had been medical examination and advisory of the physician was appeared highest rate of 51.9 percent. In the case who's symptom of the cold and high fever somewhat improved was appeared as 79.6 percent and the other hand, 5.6 percent of them have responded not knowing they got better. The case that otitis media or chronic nasal inflammation had restored was 13.0 percent respectively, but 18.5 percent had responded their ailment was not knowing their improvement so well that ailed before operation. The sequela by aftermath of the tonsillectomy, seeing collectively, it appeared 16.7 percent of the person was responded they had sequela and the idea of operational result, 90.7 percent responded they had favoured their operation, and 3.7 percent regret their carelessness. As above mentioned, it is advisable to be operated by the degree of its symptoms and there is any complication existed or in case of absolutely necessary case.

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Clinical review of acute seizures among children who visited the emergency room in Masan Samsung hospital from 2004 to 2006 (최근 3년간(2004-2006년) 응급실로 내원한 소아환자 중 급성 발작으로 인한 환자들에 대한 임상적 고찰)

  • Lee, Won Deok;Yoo, Jae Wook;Lee, Ju Suk;Lee, Jun Hwa;Cho, Kyung Lae
    • Clinical and Experimental Pediatrics
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    • v.51 no.4
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    • pp.420-425
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    • 2008
  • Purpose : The purpose of this study was to evaluate acute childhood seizures, one of the most important causes of emergency room visits, to provide appropriate medical services. Methods : We reviewed the medical records of 433 (4.6%) pediatric patients with acute seizures that visited the emergency room at Masan Samsung hospital from 2004 to 2006. Results : The male to female ratio was 1.4:1 and the mean age was $40.9{\pm}34.9$ months range. The order of geographical distribution was Masan, Changwon, Haman, and others. Fever was present in 40.6% of patients; December (14.8%) was the most frequent month for visits and generalized tonic clonic seizures (62.7%) were the most common type of seizure. The average frequency and duration of the seizure was $1.5{\pm}1.0$ and $6.7{\pm}13.2$ minutes respectively. Febrile seizures were present in 69.7% of patients and afebrile seizures in 30.3%. The causes of the febrile seizures were acute pharyngotonsillitis (44.6%), acute bronchitis, gastroenteritis, pneumonia, urinary tract infection, and unknown origin, in order of frequency. The most common cause of an afebrile seizure was epilepsy (71.5%) followed by a benign convulsion with mild gastroenteritis (BCwMG), sequela of a perinatal brain injury or brain malformation, and acute CNS infection. Evaluation of the causes of an acute seizure according to age showed that febrile seizures, epilepsy, and the sequela of perinatal brain injuries were more common between 2 and 6 years of age and epilepsy, febrile seizures and acute CNS infection, in order of frequency, were common between 6 and 15 years of age. Many patients, 49.4%, were discharged without admission. Conclusion : The common characteristics of pediatric patients presenting to the emergency room were male gender, an age between 2-6 years, presenting during the month of December, with generalized tonic clonic seizures due to acute pharyngitis. The most common presentation for the group less than 6 years of age was a febrile seizure and in the group more than 6 years of age, it was epilepsy. In many cases, the seizures stopped by the time the family presented to the emergency room.

Analysis of Clinical and Radiographic Outcome of the Reconstructive Surgery for the Cavovarus Foot Deformity (요내반족 변형에 대한 재건수술의 임상적 및 방사선학적 결과 분석)

  • Jung, Hong-Geun;Park, Jae-Yong;Lee, Dong-Oh;Eom, Joon-Sang;Chung, Seung-Hee
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.2
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    • pp.62-67
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    • 2014
  • Purpose: Reconstructive surgeries for equinocavovarus foot deformities are quite variable, including hind-midfoot osteotomy or arthrodesis, soft tissue procedure, tendon transfers, etc. Comprehensive evaluation of the deformity and its etiology is mandatory for achievement of successful deformity correction. Few studies in this field have been reported. We report on the clinical and radiographic outcome of reconstruction for cavovarus foot deformities. Materials and Methods: The study is based on 16 feet with cavovarus foot deformities that underwent bony and soft tissue reconstructive surgery from 2004 to 2008. We evaluated the etiologies, varieties of surgical procedures performed, pain score, functional scores, and patient satisfaction and measured the radiographic parameters. Results: The average age at the time of surgery was 39.4 years old, with a male/female ratio of 9/4 and an average follow-up period of 23.9 months (range, 12~49 months). The etiologies of the cavovarus deformity were idiopathic 7 feet, residual poliomyelitis 5 feet, Charcot-Marie-Tooth disease 2 feet, and Guillain-Barre syndrome and hemiplegia due to cerebrovascular accident sequela 1 foot each. Lateral sliding calcaneal osteotomies were performed in 12 feet (75%), followed by Achilles tendon lengthening and plantar fascia release in 11 feet (69%), and first metatarsal dorsiflexion osteotomy/arthrodesis and tendon transfer in 10 feet (63%). Visual analogue scale pain score showed improvement, from an average of 4.2 to 0.5 points. American Orthopaedic Foot and Ankle Society ankle-hindfoot score showed significant improvement, from 47.8 to 90.0 points (p<0.05). All patients were satisfied. Ankle range of motion improved from $27.5^{\circ}$ to $46.7^{\circ}$. In radiographic measurements, calcaneal pitch angle improved from $19.1^{\circ}$ to $15.8^{\circ}$, Meary angle from $13.0^{\circ}$ to $9.3^{\circ}$, Hibb's angle from $44.3^{\circ}$ to $37.0^{\circ}$, and tibio-calcaneal axis angle from varus $17.5^{\circ}$ to varus $1.5^{\circ}$ Conclusion: We achieved successful correction of cavovarus foot deformities by performing appropriate comprehensive reconstructive procedures with improved functional, radiographic measures and high patient satisfaction.

Clinical Observation and Diagnosis in Leukemia (백혈병의 임상관찰 및 변증에 대한 연구)

  • Shim Sang jib;Noh Jung Eun;Lee Jae Ho;Kim Myung Dong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.5
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    • pp.1242-1253
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    • 2004
  • Leukemia is a blood disease that occurs in the abnormal process of leukocyte maturation. Its main medical treatment is chemical therapy and bone medical transplant. But its treatments give rise to ill effects and sequela. At present, the cause of leukemia is not fully understood. But oriental concept of curing leukemia is the holistic thinking that emphasizes the unity, wholeness, and the relationship between the human organs, including western medical concept of blood cause. So it is estimated that holistic medical treatment in oriental medicine could present new medical way of curing leukemia. I read over the diary on struggles against leukemia, survey on the leukemia patients, and, medical charts in the oriental clinics that treated in the holistic way, and I interviewed the leukemia patients. With these materials, I classified the early main attacking symptoms according to the chief complaints of one hundred leukemia patients. With these results collected, I present new alternative treatment by oriental medical diagnosis. The chief early complaints that leukemia patients give are fatigue, enervation, cold, contusion, fever, high fever, sweating at sleep, myalgia, arthralgia, and dizziness, in order of main symptoms. Fatigue occurs mainly by spleen and stomach weakness and marrow shortage. So it is estimated that It is important to treat the spleen that is responsible for supplementing the marrow. Because the leukemia patients have anemia and hemorrhage, to treat the spleen is important for hematopoiesis and controlling blood. In case of cold, it penetrates into the body when the body is weak. So its treatment is to increase body's health. But the cause of fever is difficult to classify into outer cause and inner cause. But in case of children under 14 years old, fever is the main sypmptom. I think this is because children have the body with pure vital energy. Hemorrhage is thought to be the result of yin-lack and heat-miasma of spleen and stomach channels. Contusion occurs from the qi-weakness and the not-controlling-blood. Sweating at sleep is from the yin-weakness. It is found with all weak symptoms. Dizziness is from the yin-blood impairment. Weight-loss is from the marrow shortage. Myalgia and arthralgia is mainly from inner weakness, not outer maisma. Most leukemia patients have the idea that holistic treatment of leukemia could be of assistance and give help to the low immunity. So it is expected that holistic medical treatment could contribute to knowing the cause and treatment of leukemia, and give people reliability on oriental medical treatment, through the profound diagnosis of leukemia.

Exercise Treatment of Knee Joint After Anterior Cruciate Ligament Reconstruction Operation (전방십자인대 재건술 후 슬관절 운동치료 접근에 관한 고찰)

  • Kim, Yeun-Jung;Jung, Jae-Min;Han, Jin-Tae
    • Journal of the Korean Society of Physical Medicine
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    • v.3 no.1
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    • pp.27-37
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    • 2008
  • Purpose : Today, it enjoys a sports and a leisure where the anterior cruciate ligament(ACL) injury patient increase. The knee joint is important means of human body movement and to do an important duty when it encounters ACL injuries of the knee joint and the many restriction follows in the life which is ordinary. When it is damaged ACL, it comes to determinate that ACL reconstruction and preservation treatment that the according to condition of ligament and knee joint. After ACL reconstruction, that is the fact which already becomes known the exercise treatment advances a recovery and to reduce a sequela. Methods : we researched the method of exercise treatment after anterior cruciate ligament reconstruction operation by journal of science direct and KISS in daecu university. Results : The representative exercise treatment is isometric exercise, isokinetic exercise isotonic exercise and complex exercise but what kind of exercise treatment most is effective, it revealed and support it was not. The method of exercise treatment is very various, so It causes a confusion made to the therapist and patients. So it executes once again it sought the kinetic therapeutic method which is efficient from this research and it tried to observe preceding research after ACL reconstruction. To operation a various the exercise treatments, operation only the treatment which is general compared to it was effective in muscular power and muscle functional improvement. But this like improve despite with the exercise treatment consequence which is continuous from research of most the pain leg compares to the health leg, it appeared the discrepancy which is a muscular power, a muscular endurance and a hypertrophy muscle etc, to the health leg or before operating 100% of muscular power to having gets the many therapy time was the recovery rate. Conclusion : Therefore after ACL reconstruction, it will become the many research continuously which is improve the muscle functional and ROM of the exercise treatment method and From therapeutic site of the patients it does to memorizes knowledge in advance about ACL injuries and the application the isokinetic treatment or exercise program are the set of necessary, frequency and amusement that considers complex what kind of therapeutic exercise becomes accomplished with the patient take care of attention.

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