Responses of Medical Students to Using Smartphone Video at Clinical Performance Examination / 의료커뮤니케이션

BACKGROUND: There are practical difficulties to show exact clinical symptoms such as seizure to medical students at Clinical Performance Examination (CPX). We developed a new CPX case of child's seizure on video using smartphone.METHODS: A total of 356 4th-year students of five universities in Daegue-Gyeongbuk and Gyeongnam area took the clinical skill examination from June 13th to 17th in 2016. Among them, 72 students took the new CPX case in June 15th and 71 students filled out the questionnaire on whether the new CPX with smartphone video is helpful, authentic, difficult, and necessary for other CPX. All the questions were measured on 5-Likert scale.RESULTS: Mean score of the new CPX was 57.1, lower than the mean scores of the other 11 CPX cases, 62.8. For the question “Smartphone videos helped to solve the problem”, 45 students (63.4%) answered ‘Very much’. For the question “Is it realistic compared to other questions?” 30 students (42.3%) and 25 students (35.2%) answered ‘Very much’ and ‘Much’. For the question “Is it difficult compared with other questions?” 18 students (25.4%) and 26 students (36.6%) answered ‘Very much’ and ‘Much’. As for the question “I would like to have more tests using smartphone video”, 26 students (36.6%) answered ‘So and so’.CONCLUSION: A majority of students responded that video presentation was helpful and authentic to figure out the CPX, whereas they assessed smartphone video was more difficult compared with other CPXs. Further, students were negative toward using smartphone video for the other CPXs.

Observations on the Efficacy of Sheng's Six-meridian Diagnosis and Treatment-based Acupuncture in Treating Cervical Spondylotic Arteriopathy / 上海针灸杂志

Objective To investigate the clinical efficacy of Sheng's six-meridian diagnosis and treatment-based acupuncture in treating cervical spondylotic arteriopathy.Method Seventy patients with cervical spondylotic arteriopathy were randomly allocated to treatment and control groups, 35 cases each. The treatment group received Sheng's six-meridian diagnosis and treatment-based acupuncture and the control group, conventional acupuncture. Doppler-detected vertebral artery blood flow velocity was measured, and the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Result The total efficacy rate was 85.7% in the treatment group and 62.9% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in Doppler-detected vertebral artery blood flow velocity, the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score in the two groups (P<0.01,P<0.05).Conclusion Sheng's six-meridian diagnosis and treatment-based acupuncture is an effective way to treat cervical spondylotic arteriopathy.

Observations on the Efficacy of Sheng's Six-meridian Diagnosis and Treatment-based Acupuncture in Treating Cervical Spondylotic Arteriopathy / 上海针灸杂志

Objective To investigate the clinical efficacy of Sheng's six-meridian diagnosis and treatment-based acupuncture in treating cervical spondylotic arteriopathy.Method Seventy patients with cervical spondylotic arteriopathy were randomly allocated to treatment and control groups, 35 cases each. The treatment group received Sheng's six-meridian diagnosis and treatment-based acupuncture and the control group, conventional acupuncture. Doppler-detected vertebral artery blood flow velocity was measured, and the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Result The total efficacy rate was 85.7% in the treatment group and 62.9% in the control group; there was a statistically significant difference between the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in Doppler-detected vertebral artery blood flow velocity, the clinical symptom and sign score and the cervical vertigo symptom and functional assessment scale score in the two groups (P<0.01,P<0.05).Conclusion Sheng's six-meridian diagnosis and treatment-based acupuncture is an effective way to treat cervical spondylotic arteriopathy.

Clinical Therapeutic Observation of Pricking Cupping for Herpes Zoster at AcuteStage / 上海针灸杂志

ObjectiveTo observe the efficacy of pricking cupping in treating herpes zoster at acute stage.MethodSixty patients with herpes zoster at acute stage were randomized into a treatment group and a control group, 30 in each group. The treatment group was intervened by pricking cupping, while the control group was by oral administration of Western medicine. The total effective rate and the improvement of symptoms and pain at different stages were observed afterintervention.ResultThe total effective rate was 90.0% in the treatment group versus 86.7% in the control group, and the difference was statistically insignificant (P>0.05); after the first treatment course, the decreases of symptom score and pain indexin the treatment group were significantly superior to that in the control group (P0.05).ConclusionPricking cupping is an effective approach in treating herpes zoster of the acute stage, as it can produce a comparatively higher total effective rate and also significantly improve the symptoms and pain.

The relevance between the clinical manifestion and operation of lumbar dise herniation / 中国基层医药

Objective To analyze the experience of 745 cases of lumbar disc herniation(LDH) and investigate the relevance between the clinical symptoms,signs and operative observation.Methods From 1982 to 2003,745 cases of LDH were treated operatively.In order to investigate the relationship between clinical presentations and operative results,a statistic analysis was conducted using the clinical symptoms,signs and operative observations.Results As the predominant manifestions,the pain in the low back and leg was seen in 96.4% of LDH,the pain aggravated by belly pressure in 93% of LDH,local tenderness and radicular pain around the lumbat spinous process in 70.8% of LDH,rectoleg elevation test(+) in 91.6% of LDH.operation observation:77.6% of LDH was classified as lateral type,10.9% as medial type and 11.5% as rupture or sequestration type.Weakness of extensor hallucis longus could seen in 65.6% of LDH of L_4,L_5,in 32.3% of LDH of L_5S_1.Conclusions Although the extensive usage of computed tomography(CT) and magnetic resonance imaging(MRI) provides a prompt and accurate basis for diagnosis of LDH,the physical examination remains the most important routine way to make a diagnosis.It is suggested that during the diagnosis and treatment of LDH,besides the common features of the disease,some individual presentations should not be neglected in few rare atypical cases,so as to diagnose and treat correctly.

Analysis of chief complaint, diagnosis and mortality of 230,000 cases, admitted in Seoul National University Hospital / 대한내과학회지

BACKGROUN: Chief complaint is the primary history, quoted from patient, and the starting point of medical service. Physicians need to know what complaints are in the society and how they would be going. We to described what symptoms patients had, what diagnoses were made, and how was the mortality of patients admitted in Seoul National University Hosptial (SNUH) during the past 7 years (1991.1~1997.12). METHODS: In the past 7 years, 235,426 admitted cases were in SNUH. We computerized demographic factors, chief complaints, diagnoses at discharge, and mortality of patients. We categorized chief complaints as 93 major groups, dissected further with modifiers. The diagnoses were coded as ICD-10 and the mortality data was gathered through access to the annual police mortality data. We figured out the estimated mortality rate according to the chief complaint and/or diagnosis, using life table analysis through SSPS version 10.0. RESULTS: The most frequent chief complaint was pain, followed by chemotherapy, mass, dyspnea, bleeding and so on. Upper 20 symptom-groups occupied over 80 percents. We described specific symptoms, demographic factors, diagnoses, and rates of mortality in a certain chief complaint group. For example, abdominal pain, chest pain, lumbar pain, pain on lower extremity, and headache were seen frequently in the pain category. Symptom which had the worst prognosis was swallowing difficulty because almost half of patients with it had malignancy. We showed descriptive data of liver cirrosis, diabetes mellitus, angina pectoris, chronic renal failure, and pulmonary tuberculosis. For example, we found the painless angina pectoris had worse prognosis than the painful cases. We also discussed the usefulness of these data to education, medical service, medical research, and quality improvement in medicine. CONCLUSION: We figured out clinically important chief complaints, their diagnoses, and their mortality rate of patients admitted in SNUH. We hope nation-wide survey like this study would be planned in near future. We could use it's data in many fields, such as educational renovation, medical reseasrch, medical quality control and so on.

Clinical Diagnosis of Meniscus Injury of Knee Joint / 대한정형외과학회잡지

PURPOSE: To report the differences between previous articles in Korea on the common occurence of lateral meniscus tears and our cases, and also which clinical symptoms and signs are the most reliable for diagnosis of meniscal tear. MATERIALS AND METHODS: We analysed 118 patients who were confirmed to have a meniscal tear by arthroscopy from May 1996 to May 1998. The Chi-Square test was used for statistical analysis. RESULTS: There is no statistical difference of frequency between tears of the medial meniscus and those of the lateral meniscus. The most frequent clinical symptom is feeling of subluxation and sign is McMurray test. A combination of McMurray and squatting test is the most frequent positive sign of meniscal tear in our cases. CONCLUSIONS: In our cases, the frequency of medial meniscus tears is more common than those of the previous articles in Korea. To increase the accuracy of clinical diagnosis of meniscal tear, repeated and accurate history taking and physical examination, including above symptoms and signs are very important.