• YAKHAK HOEJI
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• v.58 no.1
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• pp.71-79
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• 2014

Although Korean patients with type 2 diabetes mellitus (T2DM) are generally treated by western medicine, many of them strongly believe in the traditional oriental Sasang constitutional classification and depend on it for food, health supplements, and oriental medicines decision making. Sasang constitutional classification is a part of traditional Korean medicine that divides people into four constitutional types (Tae-Yang: TY, Tae-Eum: TE, So-Yang: SY, and So-Eum: SE), which differ in inherited characteristics such as appearance, personality traits, susceptibility to diseases, and drug responses. It is recommended for T2DM patients to control their blood glucose very well from early stages with drugs and diet. However, many T2DM patients respond differently to their drugs, even though they receive the same medicine. Therefore, the present study investigated whether Sasang constitutional type can explain the therapeutic differences between oral hypoglycemic agents (OHAs) therapy (mono, dual and triple drug therapy). Patients of 618 with T2DM diagnosis and Sasang constitutional type known who received both western and oriental medicine treatment in a hospital between April 2006 and April 2013 retrospectively studied. HbA1c (%) and blood glucose (mg/dl) levels before OHAs therapy and 3 month after were collected for metformin (MET) or sulfonylurea (SU) monotherapy, MET+SU dual therapy, MET+except SU (where was either alpha-glucosidase inhibitor, dipeptidyl peptidase-4 inhibitor, meglitinide or thiazolidinedione) dual therapy, and triple therapy, according to Sasang constitutional type. For statistical analysis, ANOVA was used and paired t-test by SPSS 19.0 where P values less than 0.05 were considered statistically significant. Pattern was similar levels of HbA1c and blood glucose and which was decreased in order of mono, MET+SU dual, MET+except SU dual and triple therapy. In all patients comparison, for the So-yang (SY) constitutional type, either monotherapy was less effective; for Te-eum (TE) type, MET+SU dual therapy was less effective while MET+except SU dual therapy was more effective and the triple therapy was less effective; and for So-eum (SE) type, the triple therapy was more effective. For the management of TE type it is recommended to use drugs except SU when dual therapy is needed, restrict triple therapy and consider dual and insulin therapy; for SY type it is recommended to follow current guidelines; and for SE type it is advisable to skip dual therapy and start the triple therapy early. Finally, the therapeutic response to OHAs is different among Korean T2DM patients with different Sasang constitutional types. Taken together, the choice of effective OHAs therapy for each type is necessary in order to minimize the poor control of blood glucose level, the risk of complications, and the costs from a failure of therapy.

• Journal of Society of Preventive Korean Medicine
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• v.23 no.2
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• pp.67-76
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• 2019

Objectives : The publication of systematic reviews (SRs) has increased significantly over the years, and systematic reviews are considered to have the strongest evidence as they are at the top of the hierarchy of evidence pyramid. In this study, a thorough assessment of all SRs published in Journal of Society of Preventive Korean Medicine (JSPKM) was performed to evaluate their reporting quality and methodological quality to better improve the quality of SRs in JSPKM. Methods : JSPKM website was searched to include all SRs published in JSPKM from 1997 to 2018. Two independent researchers assessed the SRs using A MeaSurement Tool to Assess systematic Reviews (AMSTAR, formerly known as Assessment of Multiple Systematic Reviews) tool checklist for methodological quality assessment, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline checklist for reporting quality assessment. Results : Out of 618 published articles published in JSPKM from 1997 to 2018, only 3 SRs were identified as SRs. For AMSTAR methodological quality scoring, the average score of 3 SRs was 3.0 out of 11 which is low quality level. For PRISMA reporting quality items, the 3 SRs reported 17.3 items on average out of 27 items. The 3 identified SRs did not provide information on protocol or registration which is included in both AMSTAR assessment tool and PRISMA guideline. Conclusions : Improvements on reporting quality and methodological quality of SRs using relevant tools or guidelines are needed to assure the quality of SRs published in JSPKM so that their conclusions will be more transparent and reliable for decision-making in healthcare and the best clinical practice.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.89-106
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• 2022

Objectives In this study, a scoping review was conducted to inform decision-making related to traditional Korean medicine for people with disabilities in the future. Methods Seven databases were searched to find previous studies on traditional Korean medicine for people with disabilities. Studies published until August 2021 were considered. Using the methodology of scoping review, research on traditional Korean medicine for people with disabilities was reviewed with the following steps: 1) drawing research questions, 2) searching for related studies, 3) selecting studies, 4) extracting data, and 5) analyzing and reporting results. Results Out of 2,072 studies, 7 research papers and 10 reports were finally selected. The research papers included 5 cases studies, 1 survey study, and 1 chart review. Most studies used herbal medicine and acupuncture treatment, but the reports on the interventions were not detailed. The reports included policy studies, project performance guidelines, and project results reports, and most of the evaluation indicators tended to be standardized. Conclusions This study reviewed the literature on traditional Korean medicine for people with disabilities. It presents future directions for clinical research on traditional Korean medicine for people with disabilities and can be used to inform healthcare policies and clinical practice. In the future, quantitative research such as clinical trials, meta-analysis, and health insurance big data analysis is needed to understand the current status and effects of traditional Korean medicine for people with disabilities. In addition, qualitative research is necessary to identify unmet demands of traditional Korean medicine for people with disabilities.

• Analytical Science and Technology
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• v.22 no.6
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• pp.498-503
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• 2009

Lung cancer is the main cancer on the world today, due to the high case fatality. Lung cancer can devide into two major types, such as small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC). Mutations in the epidermal growth factor receptor (EGFR) have been described in patients with advanced NSCLC. Mutations in the EGFR are associated with clinical and radiographic responses to EGFR tyrosine kinase inhibitors gefitinib and erlotinib. Thus, the detection of EGFR mutation can offer an effective information in clinical decision-making. In this study, We developed very simple, cheep and rapid mutation detection system by chip-based isothermal amplification method. The method described here has shown the advantages of rapid amplification, high sensitivity, and specificity. Also, it will be useful for rapid and reliable clinical diagnosis of EGFR mutation.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.19 no.3
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• pp.141-149
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• 2015

Objectives Recently the fuzzy logic is widely used in the decision making, identification, pattern recognition, optimization in various fields. In this study, we propose the fuzzy logic as the objective method of distinguishing hot and cold, the basis of diagnosis in Korean medicine. Methods We developed fuzzy inference system to distinguish whether the subjects had hot or cold. The cold and hot questionnaire of Korean traditional university textbook, the pulse rate and the DITI value of face used in the system. These three kinds of information were defined as 'fuzzy sets,' and 54 fuzzy rules were established on the basis of clinical practitioners' knowledge. The fuzzy inference was performed by using the Mamdani's method. To evaluate the usefulness of the fuzzy inference system, 200 cases of data measured in the Woosuk university hospital of oriental medicine were used to compare the determining hot, normal, cold results obtained from the experts and from the proposed system. Results As a result, 100 cases of "cold", 54 cases of "normal", and 34 cases of "hot" were matched between the experts and the proposed system. This fuzzy system showed the conformity degree of 94%(${\kappa}=0.853$). Conclusions In this study, we could express the process of distinguishing hot-cold using the fuzzy logic for objectification and quantification of hot-cold identification. This is the first study that introduce a fuzzy logic for distinguish pattern identification. The degree of the heat characteristic of the patients inferred by this system could provide a more objective basis for diagnosing the hot-cold of patients.

• Child Health Nursing Research
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• v.20 no.3
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• pp.176-184
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• 2014

Purpose: The purpose of this study was to investigate pediatric nurse parent partnership and factors associated with this partnership. Methods: A survey was conducted with 158 nurses working in pediatric practice at one of 7 hospitals in Seoul, Incheon, and Chungcheongbuk Province. Data were collected from September to December 2013, and analyzed with SPSS Windows 21.0. Results: In hierarchial multiple regression analysis, self-efficacy (${\beta}$=.19, p=.016), clinical decision making (${\beta}$=.15, p=.046), and empowerment (${\beta}$=.29, p=.001) were associated with pediatric nurse parent partnership, after adjusting for marital status, children, education, position and satisfaction with work unit. These factors accounted for 44.0% of the variance in the pediatric nurse parent relationship. Conclusion: These results suggest that pediatric nurse parent partnership could be influenced by the predictors. Ultimately, intervention programs focusing on these factors should be effective in helping pediatric nurses improve partnership with parents.

• CELLMED
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• v.6 no.3
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

• Korean Journal of Biological Psychiatry
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• v.12 no.2
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• pp.151-158
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• 2005

Background:Clozapine is a unique atypical antipsychotic medication. It is considered to be superior, even amongst the newer agents, in treatment-resistant schizophrenia. However, de novo emergence or exacerbation of obsessive-compulsive(OC) symptoms during treatment with clozapine has been reported. We prospectively evaluated 19 cases which newly developed OC symptoms during clozapine treatment and discussed the treatment of OC symptoms induced by it. Methods:We recruited 19 patients(8 males, 11 females) with a DSM-IV diagnosis of schizophrenia and schizoaffective disorder who had developed OC symptoms during clozapine treatment. OC symptoms were assessed using the Padua-ICMA and YBOCS on a monthly basis over three months. Results:Eleven female and eight male patients were enrolled and the average age of patients was 32.8 years. At baseline, no patients showed OC symptoms. Moderate to severe OC symptoms appeared with mean daily dose of 298.68 mg of clozapine. There were no significant differences in improving OC symptoms between the clozapine dose reduction group and the OC treatment group. Conclusion:We noticed the possibility that the appearance of OC symptoms is connected with the effect of clozapine. The clozapine-induced OC symptoms were improved both by reducing clozapine daily doses, and by adding OC treatment drugs. With other atypical antipsychotics now available, to know and treat the side effects of clozapine would be of considerable value, offering clinical guidance in making a decision on treatment-resistant schizophrenia.

• Journal of Trauma and Injury
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• v.31 no.1
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• pp.6-11
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• 2018

Purpose: The diagnosis of pelvic fractures pattern has become to be essential in the decision making of treatment modality and reducing morbidity and mortality in multiple trauma patients. Sacroiliac joint (SIJ) disruption can cause life-threatening massive arterial bleeding. This study aimed to determine a method of predicting the prognosis and treatment direction with pelvis X-ray alone in the emergency room. We investigated whether SIJ disruption can be used alone as a poor prognostic factor. Methods: We analyzed the medical records and radiologic examination results of 167 patients with pelvic fractures from January 1, 2015 to December 31, 2016 retrospectively. Patients with pathologic fractures, thoraco-abdominal bleeding, and acetabulum fractures and pediatric patients (n=63) were excluded. Factors related to the clinical manifestations and treatments, such as transfusion and surgery, were statistically compared. Results: The cross-sectional analysis showed that there was no correlation between SIJ injury and sex; there were statistically significant relationships between occurrences of shock, conjoined fractures, transfusion, and surgeries. The hospitalization period and partial thromboplastin time and prothrombin time values increased. The logistic regression analysis showed that when an SIJ injury occurred, blood transfusion and hypotension possibilities increased. Conclusions: When pelvic fractures occur near the SIJ, blood transfusion and shock possibilities increase. Physicians must be aware of the high severity and poor prognosis of such fractures when these are diagnosed in the emergency room. And furthermore, the physician has to predict and prepare the intensive care and multidisciplinary approaches.

• The Korean Journal of Physiology and Pharmacology
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• v.22 no.6
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• pp.705-712
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• 2018

The tube formation assay is a widely used in vitro experiment model to evaluate angiogenic properties by measuring the formation of tubular structures from vascular endothelial cells (ECs). In vitro experimental results are crucial when considered the advisability of moving forward to in vivo studies. Thus, the additional attentions to the in vitro assay is necessary to improve the quality of the pre-clinical data, leading to better decision-making for successful drug discovery. In this study, we improved the tube formation assay system in three aspects. First, we used human endothelial colony forming cells (ECFCs), which are endothelial precursors that have a robust proliferative capacity and more defined angiogenic characteristics compared to mature ECs. Second, we utilized a real-time cell recorder to track the progression of tube formation for 48 hours. Third, to minimize analysis error due to the limited observation area, we used image-stitching software to increase the microscope field of view to a $2{\times}2$ stitched area from the $4{\times}$ object lens. Our advanced tube formation assay system successfully demonstrated the time-dependent dynamic progression of tube formation in the presence and absence of VEGF and FGF-2. Vatalanib, VEGF inhibitor, was tested by our assay system. Of note, $IC_{50}$ values of vatalanib was different at each observation time point. Collectively, these results indicate that our advanced tube formation assay system replicates the dynamic progression of tube formation in response to angiogenic modulators. Therefore, this new system provides a sensitive and versatile assay model for evaluating pro- or anti-angiogenic drugs.