• Progress in Medical Physics
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• v.8 no.1
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• pp.53-67
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• 1997

General hospitals have being under the influence of various and specific environment of electromagnetic field. The factors are development of medical electric equipment and device with enlarged functional demands, in high power and multi-frequency. It has all of both faces, EMI(electromagnetic interference) and EMS(electromagnetic susceptibility). In additional, expansion of personal communication system(cellular phone) has many unreliable factor of using time and area, making noise of electromagnetic fields. We studied actual conditions of EMI in the medical site, where is numerous medical equipment, especially central operation room and ICU(intensive care unit), AKR(artificial kidney room : hemo-dialysis unit), etc. The influence, most of medical equipments made electromagnetic nosie has various factors in its band of frequency, harmonics and strength. In the experimental use of electro-surgical unit and cellular phone, noticeable and considerable noise of eletromagnetic fields were measured. All of that can make trouble and errors on the steadiness of bioelectrical devices. In conclusion, It is necessary to reconsiderations of reallocating EMI source vs. EMS factor, and set to definite forbiding area of using cellular phone. For maintenance of steady normal conditions, in spite of existing any other legal standards of safty level, it need considering all of alternative electromagnetic situations on a case-by-case basis.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.68-84
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• 1995

Background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists, responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, laboratory examination and decision making about time of pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

• Journal of Korean Traditional Oncology
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• v.23 no.1
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• pp.1-14
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• 2018

Objectives: This study was conducted towards developing guidelines of herbal medicine treatment for gastric cancer. Methods: We performed a systematic review and meta-analysis designed to investigate the efficacy of herbal medicine treatment for gastric cancer on four cancer questions; survival rate, metastasis, immune function, and quality of life. Based on the findings, we utilized a two-round delphi process with panel of 22 experts for their level of agreement. Results: Combined therapy group, herbal medicine treated with chemotherapy, was significantly higher in the 1-year survival rate (RR=1.27, 95% CI: 1.14 to 1.40, P=0.005, $I^2=71%$) and 3-years survival rate (RR=1.41, 95% CI: 1.16 to 1.71, P=0.91, $I^2=0%$) than chemotherapy group. The suppression of metastasis was higher in the combined therapy group (RR=0.62, 95% CI: 0.45 to 0.84, P=0.09, $I^2=54%$). The immunology function was higher in the combined therapy group compared with the chemotherapy group (MD=16.43, 95% CI: 13.25 to 29.61, P<0.001, $I^2=99%$). The quality of life score was higher in the combined therapy group compared with the chemotherapy group (RR=1.55, 95% CI: 1.21 to 2.00, P<0.66, $I^2=0%$). Conclusions: Among the Randomized controlled trials (RCT) included, the levels of survival rates, suppression of metastasis, immune function, and quality of life of the group treated with chemotherapy were lower compared to those treated with herbal medicine in addition to chemotherapy.

• Journal of Korean Medicine Rehabilitation
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• v.27 no.4
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• pp.67-74
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• 2017

Objectives This study is aimed to identify and evaluate the already developed clinical practice guidelines (CPGs) of temporomandibular disorders (TMD) and contribute to making decisions in developing Korean medicine CPG of TMD. Methods We searched electronic database and selected CPGs of TMD according to the inclusion and exclusion criteria. Then, we made appraisal of selected CPGs by using AGREE II (Appraisal of Guidelines for Research & Evaluation II). Results Four CPGs are included and appraised with AGREE II. Among 6 domains of AGREE II, all CPGs failed to score over 60% in four domains. Only one CPG mentioned acupuncture as an adjunctive treatment for myofascial TMD. Conclusions It is difficult to indicate that included CPGs are with sufficient quality to recommend and it appears not to be appropriate to apply these already developed CPGs in Korean medicine clinical fields. Therefore, developing a new Korean medicine clinical practice guideline of TMD is required.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.189-193
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• 2010

Purpose: This study was aimed to investigate the frequency of different classes of partial edentulism and the most frequently used design components of conventional removable partial dentures. Materials and methods: 63 patients who were treated with removable partial denture in Kyungpook National University hospital for 2003-2006 were selected. A total of 76 removable partial denture frameworks were investigated. Kennedy classification was used to identify the class of partial edentulism. Results: Results indicated that Kennedy class I removable partial dentures were the most frequently constructed. Most patients' cases were designed without modification areas. Conclusion: The most common type of direct retainer were the RPI clasp and RPA clasp in both maxilla and mandible. Lingual bar, linguoplate and anterior posterior palatal straps were the more frequently used mandibular and maxillary major connectors respectively. We did not have any case about Kennedy class IV patients.

• Korean Journal of Biological Psychiatry
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• v.14 no.1
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• pp.5-13
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• 2007

Objectives : Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. Methods : The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. Result : Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. Conclusion : Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as "Feeling Good" in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.

• Tuberculosis and Respiratory Diseases
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• v.66 no.2
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• pp.141-151
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• 2009

Background: There is limited data on the epidemiology and relative frequency of idiopathic interstitial pneumonia (IIP) worldwide. This survey was performed to assess the epidemiology and relative frequency of IIP in Korea. Methods: The patients with IIP and who were confirmed by lung biopsy, except those patients with idiopathic pulmonary fibrosis, (IPF) over a 5 year period (from Jan. $1^{st}$, 2003 to Dec. $31^{st}$, 2007) were registered by a web-base questionnaire. Results: A total of 3,156 cases were registered, but 970 cases were excluded due to duplicative registration, inadequate data and the unmet ATS/ERS diagnostic criteria. A total of 2,186 cases were analyzed. The male to female ratio was about 2 : 1 and their mean age was 65 (range: 11-94). The most frequent disease was IPF (77.1%), followed in decreasing order by nonspecific interstitial pneumonia (NSIP) (11.9%), cryptogenic organizing pneumonia (COP) (8.5%), acute interstitial pneumonia (AIP) (1.1%), desquamative interstitial pneumonia (DIP) (0.9%), respiratory bronchiolitis-interstitial lung disease (RB-ILD) (0.4%) and lymphocytic interstitial pneumonia (LIP) (0.1%). The mean age of the patients with IPF, NSIP and COP was 67.8, 57.1 and 57.7 years old, respectively. The most frequent symptom was dyspnea on exertion (69%) followed by coughing (61%) and sputum (33%) for the whole population. The three year survival rate was 62% for the patients with IPF and the five year survival rate was 85% in both the NSIP and COP patients. Conclusion: This survey provides helpful information for the management of IIP and to produce management guidelines for this illness in Korea.

• Journal of Nutrition and Health
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• v.47 no.5
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• pp.321-329
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• 2014

Purpose: The aim of this study was to determine the relationship between serum concentrations of 25-hydroxyvitamin D [25(OH)D] and chronic obstructive pulmonary disease (COPD) prevalence. Methods: The analysis was performed using data from the Fifth Korean National Health and Nutrition Examination Survey, a cross-sectional survey of the Korean civilian population conducted from 2010 to 2012. The analyses were restricted to males who were 40 years of age and above. Complex sample multiple logistic regression analyses were used to examine the associations of COPD prevalence with 25(OH)D and other factors. Results: $FEV_1/FEV_6$ varied significantly with smoking status, age, household income, education level, occupation, body mass index (BMI), and physical activity (p < 0.05). In univariate analysis, smoking status, BMI, household income, education level, and occupation showed association with COPD (p < 0.05), but vitamin D was not associated with COPD (p = 0.078). However, when adjusted with smoking status, household income, education level, occupation, BMI, age, and smoking index, the lowest quartile of 25(OH)D showed OR 1.643 (95% CI 1.161-2.236) compared to 3rd quartile (p = 0.024). Conclusion: A significant relationship was observed between serum concentration of 25(OH)D and COPD.

• Journal of Acupuncture Research
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• v.26 no.3
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• pp.115-131
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• 2009

Objectives: This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating low back pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.57 Korean medical doctors selected meridian pattern identification based on the course of the meridians(44.6%), visceral pattern identification(32.1%), pattern identification based on cause of disease(14.3%) as the most commonly used pattern identification methods for acupuncture prescription when treating low back pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, gallbladder meridian of hypochondriac region(13.0%), bladder meridian of lateral low back region(11.2%), governer vessel of central low back region(11.7%) were selected 3. In visceral pattern identification, yang deficiency of kidney(20.2%), deficiency of kidney(19.3%), liver(16.7%), yin deficiency of kidney(14.0%), violence qi of kidney(8.8%), small intestine(7.9%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, meridian pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for low back pain diagnosis in real clinical practice.

• Journal of Acupuncture Research
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• v.26 no.3
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• pp.59-65
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• 2009

Objectives : This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating knee pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.54 Korean medical doctors selected meridian pattern identification based on the course of the meridians(52.5%), visceral pattern identification(27.1%), pattern identification based on cause of disease(8.5%) as the most commonly used pattern identification methods for acupuncture prescription when treating knee pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, liver meridian of the medial knee region(13.2%), bladder meridian of the posterior knee region(12.0%), spleen meridian of the lateral knee region(11.7%), stomach meridian of the anterior knee region(9.8%) and kidney meridian of the medial knee region(8.6%) were selected. 3. In visceral pattern identification, blood stasis of sinews due to liver and kidney deficiency(5.3%), damp joint with yang deficiency of liver and kidney(4.9%), kidney qi deficiency with congealing cold(4.5%), yin deficiency of liver and kidney(4.1%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for knee pain diagnosis in real clinical practice.