• Journal of Korean Neurosurgical Society
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• v.67 no.2
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• pp.137-145
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• 2024

In adult spinal deformity (ASD) surgery, mechanical failure (MF) has been a significant concern for spine surgeons as well as patients. Despite earnest endeavors to prevent MF, the absence of a definitive consensus persists, owing to the intricate interplay of multifarious factors associated with this complication. Previous approaches centered around global spinal alignment have yielded limited success in entirely forestalling MF. These methodologies, albeit valuable, exhibited limitations by neglecting to encompass global balance and compensatory mechanisms within their purview. In response to this concern, an in-depth comprehension of global balance and compensatory mechanisms emerges as imperative. In this discourse, the center of gravity and the gravity line are gaining attention in recent investigations pertaining to global balance. This narrative review aims to provide an overview of the global balance and a comprehensive understanding of related concepts and knowledge. Moreover, it delves into the clinical ramifications of the contemporary optimal correction paradigm to furnish an encompassing understanding of global balance and the current optimal correction strategies within the context of ASD surgery. By doing so, it endeavors to furnish spine surgeons with a guiding compass, enriching their decision-making process as they navigate the intricate terrain of ASD surgical interventions.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.6
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• pp.1089-1094
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• 2011

We examined the decision-making capacity of seniors of consent to oriental clinical research. This study was performed in order to improve the quality of ethical aspects before obtaining informed consent. Oriental investigators interviewed 251 seniors who participated in Sasang clinical research. The questionnaire was about the capacity of consent and the subjective awareness of informed consent. Two hundred fifteen out of 250 questionnaires were collected. One hundred thirty four(62.3%) seniors had the capacity of consent to research and 81(37.7%) seniors did not pass. The subjective awareness of informed consent in having the capacity group is $78.02{\pm}12.92$ and not having group is $72.17{\pm}9.17$. The investigation of senior capacity of consent was aimed at protecting seniors' interests and completing investigators' ethical responsibilities. This study found that only 62.3% of senior participants had the capacity of consent. This investigation will be expected to raise the importance of seniors' capacity of consent. Also we expect methods and procedures for capacity assessment of informed consent to be followed for increasing quality of clinical research.

• The Journal of Pediatrics of Korean Medicine
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• v.34 no.2
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• pp.75-85
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• 2020

Objectives Although clinical practice guidelines (CPGs) are becoming crucial in medical decision-making worldwide, there are very few development guidelines for children. Therefore, this preliminary study aimed to assess the status of worldwide except east asia-CPGs recommending complementary and alternative medicine interventions (CAM-i) in children worldwide except east asia in order to help developing Korean medicine CPGs (KMCPGs) for children. Methods To identify the current status of CPGs including CAM-i that have been developed so far, the author searched the related databases, and selected CPGs for children. The data related to the status of evidence-based CPGs, the materials related to the characteristics of CAM-i, and the details of recommendations for CAM-i were selected from the obtained findings. Results A total of 106 CPGs were identified based on the searches, of which 11 were finally selected as pediatric CPGs. These pediatric CPGs have been developed since 2007 to target various diseases. The countries developing these CPGs include the United Kingdom, Scotland, Australia, and the United States, with the U.K. having the largest share. The majority of CPGs used MEDLINE, Embase, and Cochrane library as databases. The most frequently recommended topic was acupuncture, followed by herbal medicine. Many CPGs suggested that more research was needed. Conclusions Through this study, the author was able to identify the characteristics of the developed pediatric CPGs that include CAM-i. More preceding studies are needed for the development of pediatric KMCPGs. It is hoped that this report can be used as the foundation for future development of pediatric KMCPGs.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.327-339
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• 2015

Purpose: This study was done to identify the experiences of ethical issues and needs for ethics education in clinical nurses. Methods: A cross-sectional survey was used and data were collected in 2013. Participants were 428 clinical nurses working in the general units of seven medical hospitals. The Ethical Issues in Clinical Practice Tool was used. Data analysis was performed using SPSS/WIN 19.0. Results: 'Providing care with a possible risk to your health' was the most frequent and disturbing ethical problems for nurses. The highest helpful ethical topic was 'the patients' right, autonomy and informed consent'. The ethical issue experience was significantly different according to education level, work units, and type of employment. The necessity of ethics education was statistically different according to age, religion, level of education, duration of working as RN, position, shift type, and continuing education about nursing ethics. Conclusion: The results of this study show that nursing educators need to provide practical ethics education based on frequent ethical issues and helpful education topics. These findings can be used in developing effective education strategies for clinical nurses and nursing organizations to improve nurses' ethical decision-making abilities.

• The Journal of the Korean dental association
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• v.52 no.3
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• pp.153-163
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• 2014

3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1077-1082
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• 2016

Background: The three standard biomarkers used in breast cancer are the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). The Ki-67 index, a proliferative marker, has been shown to be associated with a poorer outcome, and despite absence of standardization of pathological assessment, is widely used for therapy decision making. We aim to study the role of the Ki-67 index in a group of Asian women with breast cancer. Materials and Methods: A total of 450 women newly diagnosed with Stage 1 to 3 invasive breast cancer in a single centre from July 2013 to Dec 2014 were included in this study. Univariable and multivariable logistic regression was used to determine the association between Ki-67 (positive defined as 14% and above) and age, ethnicity, grade, mitotic index, ER, PR, HER2, lymph node status and size. All analyses were performed using SPSS Version 22. Results: In univariable analysis, Ki -67 index was associated with younger age, higher grade, ER and PR negativity, HER2 positivity, high mitotic index and positive lymph nodes. However on multivariable analysis only tumour size, grade, PR and HER2 remained significant. Out of 102 stage 1 patients who had ER positive/PR positive/HER2 negative tumours and non-grade 3, only 5 (4.9%) had a positive Ki-67 index and may have been offered chemotherapy. However, it is interesting to note that none of these patients received chemotherapy. Conclusions: Information on Ki67 would have potentially changed management in an insignificant proportion of patients with stage 1 breast cancer.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.31-37
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• 2016

Background: The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. Methods: The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. Results: A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. Conclusions: As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2805-2810
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• 2016

Background: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. Materials and Methods: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed. Associations between potential clinical prognostic factors and remission were tested by Cox proportional-hazards analysis in 852 patients (development cohort). The prediction score was created by summation of score points weighted from regression coefficients of independent prognostic factors. Risks of disease remission were estimated and the derived score was then validated in the remaining 365 patients (validation cohort). Results: During the median follow-up time of 58 months, 648 (76.1%) patients in the development cohort had disease remission. Five independent prognostic factors were identified with corresponding score points: duration from thyroid surgery to $^{131}I$ treatment (0.721), distant metastasis at initial diagnosis (0.801), postoperative serum thyroglobulin level (0.535), anti-thyroglobulin antibodies positivity (0.546), and adequacy of serum TSH suppression (0.293). The total risk score for each patient was calculated and three categories of remission probability were proposed: ${\leq}1.628$ points (low risk, 83% remission), 1.629-1.816 points (intermediate risk, 87% remission), and ${\geq}1.817$ points (high risk, 93% remission). The concordance (C-index) was 0.761 (95% CI 0.754-0.767). Conclusions: The clinical prognostic scoring model developed to quantify the probability of disease remission can serve as a useful tool in personalized decision making regarding treatment in differentiated thyroid cancer patients.

• Korean Journal of Veterinary Service
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• v.44 no.3
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• pp.163-168
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• 2021

The rapid and reliable detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays a key role in isolating infected patients and preventing further viral transmission. In this study, we evaluated the clinical diagnostic performances of a commercial real-time reverse transcription loop-mediated isothermal amplification (RRT-LAMP) assay (Isopollo^® COVID-2 assay, M-monitor, Daegu, Korea) using eighty COVID-19 suspected clinical samples and compared these with the results of a commercial real-time reverse transcription polymerase chain reaction (RT-qPCR) assay (Allplex^TM 2019-nCoV rRT-QPCR Assay, SeeGene, Seoul, Korea). The results of the RRT-LAMP assay targeting the N or RdRp gene of SARS-CoV-2 showed perfect agreement with the RT-qPCR assay results in terms of detection. Furthermore, the RRT-LAMP assay was completed in just within a 20-min reaction time, which is significantly faster than about the 2 h currently required for the RT-qPCR assay, thus enabling prompt decision making regarding the isolation of infected patients. The RRT-LAMP assay will be a valuable tool for rapid, sensitive, and specific detection of SARS-CoV-2 in human or unexpected animal clinical cases.

• Korean Circulation Journal
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• v.52 no.12
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• pp.890-900
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• 2022

Background and Objectives: Some individuals exhibit discrepancies between risk classifications assessed using clinical factors and those obtained by vascular imaging. We aimed to evaluate whether statins provide clinical outcome benefits in patients classified as having low to moderate cardiovascular risk but with carotid plaque. Methods: This was a retrospective propensity score matching study. A total of 12,158 consecutive patients undergoing carotid ultrasound between January 2012 to February 2020 were screened. Individuals with low to moderate cardiovascular risk who were not currently recommended for statin therapy but had carotid plaques were included. Among 1,611 enrolled individuals, 806 (statin group: 403, control group: 403) were analyzed. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCEs: cardiovascular death, myocardial infarction, coronary revascularization, and ischemic stroke or transient ischemic attack) and all-cause mortality. Results: During the median follow-up of 6.0 years, the incidence of MACCEs did not differ between the groups (6.1 and 5.7/1,000 person-years in the control and statin groups, respectively; adjusted hazard ratio [HR], 0.95; p=0.90). The incidence of all-cause mortality did not differ (3.9 and 3.9/1,000 person-years, respectively; adjusted HR, 1.02; p=0.97). Kaplan-Meier curves revealed similar rates of MACCEs (log-rank p=0.72) and all-cause mortality (log-rank p=0.99) in the 2 groups. Age and smoking were independent predictors of MACCEs. Subgroups exhibited no differences in clinical outcomes with statin use. Conclusions: Benefit of statin therapy was likely to be limited in low to moderate risk patients with carotid plaques. These results could guide physicians in clinical decision-making regarding cardiovascular prevention.