• Journal of Pathology and Translational Medicine
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• v.52 no.6
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• pp.386-395
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• 2018

Background: Previous studies on synchronous colorectal carcinoma (SCRC) have reported inconsistent results about its clinicopathologic and molecular features and prognostic significance. Methods: Forty-six patients with multiple advanced tumors (T2 or higher category) who did not receive neoadjuvant chemotherapy and/or radiotherapy and who are not associated with familial adenomatous polyposis were selected and 99 tumors from them were subjected to clinicopathologic and molecular analysis. Ninety-two cases of solitary colorectal carcinoma (CRC) were selected as a control considering the distributions of types of surgeries performed on patients with SCRC and T categories of individual tumors from SCRC. Results: SCRC with multiple advanced tumors was significantly associated with more frequent nodal metastasis (p=.003) and distant metastasis (p=.001) than solitary CRC. KRAS mutation, microsatellite instability, and CpG island methylator phenotype statuses were not different between SCRC and solitary CRC groups. In univariate survival analysis, overall and recurrence-free survival were significantly lower in patients with SCRC than in patients with solitary CRC, even after adjusting for the extensiveness of surgical procedure, adjuvant chemotherapy, or staging. Multivariate Cox regression analysis revealed that tumor multiplicity was an independent prognostic factor for overall survival (hazard ratio, 4.618; 95% confidence interval, 2.126 to 10.030; p<.001), but not for recurrence-free survival (p=.151). Conclusions: Findings suggested that multiplicity of advanced T category-tumors might be associated with an increased risk of nodal metastasis and a risk factor for poor survival, which raises a concern about the guideline of American Joint Committee on Cancer's tumor-node-metastasis staging that T staging of an index tumor determines T staging of SCRC.

• Journal of Korean Medical Science
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• v.33 no.52
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• pp.337.1-337.14
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• 2018

Background: Mitochondrial heteroplasmy, the co-existence of different mitochondrial polymorphisms within an individual, has various forensic and clinical implications. But there is still no guideline on the application of massively parallel sequencing (MPS) in heteroplasmy detection. We present here some critical issues that should be considered in heteroplasmy studies using MPS. Methods: Among five samples with known innate heteroplasmies, two pairs of mixture were generated for artificial heteroplasmies with target minor allele frequencies (MAFs) ranging from 50% to 1%. Each sample was amplified by two-amplicon method and sequenced by Ion Torrent system. The outcomes of two different analysis tools, Torrent Suite Variant Caller (TVC) and mtDNA-Server (mDS), were compared. Results: All the innate heteroplasmies were detected correctly by both analysis tools. Average MAFs of artificial heteroplasmies correlated well to the target values. The detection rates were almost 90% for high-level heteroplasmies, but decreased for low-level heteroplasmies. TVC generally showed lower detection rates than mDS, which seems to be due to their own computation algorithms which drop out some reference-dominant heteroplasmies. Meanwhile, mDS reported several unintended low-level heteroplasmies which were suggested as nuclear mitochondrial DNA sequences. The average coverage depth of each sample placed on the same chip showed considerable variation. The increase of coverage depth had no effect on the detection rates. Conclusion: In addition to the general accuracy of the MPS application on detecting heteroplasmy, our study indicates that the understanding of the nature of mitochondrial DNA and analysis algorithm would be crucial for appropriate interpretation of MPS results.

• Clinical and Experimental Reproductive Medicine
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• v.36 no.3
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• pp.209-217
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• 2009

Objective: To analyze current issues and to propose alternatives for "the cryopreserved embryos generated before 2005". Methods: The differences in attitude among the stakeholders such as sperm donors, oocyte donors, and IVF clinics were presupposed. We want to forecast the impediments which occur inevitably in the process of "getting the informed consent" and "discarding the cryopreserved embryos generated before 2005". Results: Even though there is a specific guideline for "the cryopreserved embryos generated before 2005" at November 23, 2006, no consensus about the process related to "getting the informed consent" has been made. Conclusion: Unavoidably, it seems to be entering a period of massive discard of "the cryopreserved embryos generated before 2005". This is actually opposed to the intent of the Bioethics and Safety Act, which is to protect human dignity and prevent harm to human beings. We have to make reasonable due process to determine the destiny of "the cryopreserved embryos generated before 2005".

• The Journal of Korean Obstetrics and Gynecology
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• v.27 no.3
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• pp.94-103
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• 2014

Objectives: The aim of this study is to identify effects and safety of Korean traditional medicine, especially including Pinelliae Rhizoma, for hyperemesis gravidarum, and to suggest appropriate dosage and treatment duration of Pinelliae Rhizoma. Methods: The study was performed based on the medical records of 19 hyperemesis gravidarum patients treated with Korean traditional medicine including Pinelliae Rhizoma. Change of symptoms, continuance of pregnancy, malformation of infants, and delivery outcomes were analysed. Results: The symptoms of hyperemesis gravidarum were improved in 13 patients. With regards to pregnancy outcome, normal fullterm delivery was 16 case, preterm delivery was 1 case and abortion was 2 case, Infants malformation was not found in any case. The average daily dosage of Pinelliae Rhizoma was 6.53 g/day, and the average treatment duration of Pinelliae Rhizoma was 11.53 (day). Conclusions: In this study, using Korean traditional medicine including Pinelliae Rhizoma for hyperemesis gravidarum patients is considered safe if patients are treated with proper clinical dosage and duration of medication. More cases and studies in the future will be required for the appropriate use of Pinelliae Rhizoma for hyperemesis gravidarum patients.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.3
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• pp.27-37
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• 2021

Purpose: The purpose of this study is to compare the changes in hospital accreditation evaluations, the changes in hospital building design guidelines, and the development of design indicators for reducing medical accidents in the state-of-the-art healthcare providers. Methods: The changes and tools were carefully investigated and compared that had been taken place and used in the building certification standards, design guidelines, and patient safety design standards to reduce accidents in the United States and the United Kingdom. Results: First, medical accidents are recognized as multiple defense layers rather than personal ones, and a public reporting and learning system is created, reporting the accidents in question publicly and suggesting ways to improve them based on the data at a time. Second, for the accreditation institute that secures the service quality of medical institutions, detailed standards for patient safety are continuously updated with focus on clinical trials. The United States is in charge of the private sector, but on the other hand the United Kingdom is in charge of the public sector. Third, the design guidelines are provided as web-based tools that complement various guidelines for patient safety, and are improved and developed as well. Fourth, detailed approaches are continuously developed and provided to secure patient safety and reduce medical accidents through appropriate research, evidence-based design and strict evaluations. Implications: When medical institutions make efforts to strength patient safety methods through valid design standards, accidents are expected to decrease, whereby hospital finances are also to be improved. A higher level of medical quality service will sure be secured through comprehensive certification evaluation.

• The Journal of Korean Medicine
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• v.40 no.1
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• pp.46-62
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• 2019

Objectives: This study was made by Chung Yeon Korean Medicine Hospital in order to perform appropriate East-West integrative medicine. The purpose of this manual is to support decision-making and communication in the implementation of the East-West cooperative treatment of vascular dementia. Methods: In order to carry out this study, it is based on search terms such as 'vascular dementia', 'acupuncture', 'herbal medicine', 'integrative medicine', 'chinese traditional medicine', and 'cognitive function' in databases such as MEDLINE, EMBASE, OASIS and CNKI We collected references. The drafting proceeded with the collaboration of two specialists of the Korean medicine, and the disagreement on the basis of the quotation was determined through a two person agreement. After, The draft was reviewed by a western medical doctor(rehabilitation specialist). Then, The opinions of the entire medical staff of the committee were reflected in the draft and finalized the agreement. Results: Through this study, manuals for diagnosis, treatment, and other considerations in the process of applying East-West integrative medicine to vascular dementia were derived. Conclusions: This study has significance in that it provides manual information about the decision structure, treatment contents, role distribution, etc. of East-West integrative medicine within the medical institution that conducts the vascular dementia consultation. In order for this study to function as a generalized medical guideline, it is necessary to improve the research methodology and carry out professional consensus procedures.

• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.4
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• pp.131-150
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• 2021

Objectives: The purpose of this study is to analyze the domestic study trends on Korean medicine treatment of Sanhupung. Methods: Case studies applying Korean medicine treatment on Sanhupung were searched through 5 domestic journal databases. General characteristics, interventions, outcomes, and results of the selected studies were analyzed. Also, the quality of the case studies was reviewed based on the CAse REport (CARE) guideline and Joanna Briggs Institute (JBI) critical appraisal checklist. Results: 11 studies (16 cases) were found to be analyzed according to their general characteristics, symptoms, interventions, treatment period, outcome, and results. The most common complaint of Sanhupung patients was pain, and the most applied intervention for Sanhupung was herbal medicine and acupuncture. The duration of treatment ranged from 9 days to 4 months. All case studies reported that the Korean medicine treatment was effective in treating Sanhupung. According to the quality assessment, 'Timeline of case', 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', and 'Informed consent' were showed low reporting rates. Conclusions: Further clinical studies are needed to establish the evidence for Korean medicine treatment for Sanhupung.

• Journal of Korean Clinical Nursing Research
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• v.27 no.2
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• pp.165-178
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• 2021

Purpose: To analyze nurses' shift work according to the government guidelines for night work and their perceptions of their work schedules. Methods: The study sample included 487 nurses who provided information on their schedules, including the normal working hours of each shift, and overtime per shift during September 2020. Nurses' perceptions were measured in terms of satisfaction, appropriateness for work-life balance, and fairness to their work schedule. Results: One-third of the respondents worked more than 40 hours per week. The average overtime hour was 1.14 hours per shift. Unsocial hours (8 pm to 6 am on weekdays, midnight to midnight on weekends and public holidays) accounted for 56.4% of all working hours. During their last night shift, on average, nurses worked 9.62 hours and had a break of 39 minutes, although 20.5% reported no break. Sixty-eight percent of nurses had at least one between-shift break shorter than 48 hours after a consecutive night shifts. Fifty-seven percent were satisfied with their schedule. One-third perceived their schedule as appropriate for work-life balance, and two-thirds perceived that days off on weekends and nights were fairly distributed within the unit. Working and overtime hours had an inverse relationship with all three aspects of nurses' perceptions. A higher proportion of unsocial hours and having no breaks during the night shift were associated with lower perceptions of fairness. Conclusion: Reducing working hours, ensuring breaks during night shifts, and increasing rewards for unsocial hours are required to improve nurses' perceptions and reduce turnover due to shift work.

• The korean journal of orthodontics
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• v.52 no.1
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• pp.53-65
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• 2022

Objective: Planning of incisal position is crucial for optimal orthodontic treatment outcomes due to its consequences on facial esthetics and occlusion. A systematic summary of the proposed parameters is presented. Methods: Studies on Google Scholar^©, PubMed^©, and Cochrane Library, providing quantitative information on optimal central incisor position were included. Results: Upper incisors supero-inferior position (4-5 mm to upper lip, 67-73 mm to axial plane through pupils), antero-posterior position (3-4 mm to Nasion-A, 3-6 mm to A-Pogonion, 9-12 mm to true vertical line, 5 mm to A-projection, 9-10 mm to coronal plane through pupils), bucco-lingual angulation (4-7° to occlusal plane perpendicular on models, 20-22° to Nasion-A, 57-58° to upper occlusal plane, 16-20° to coronal plane through pupils, 108-110° to anterior-posterior nasal spine), mesio-distal angulation (5° to occlusal plane perpendicular on models). Lower incisors supero-inferior position (41-48 mm to soft-tissue mandibular plane), antero-posterior position (3-4 mm to Nasion-B, 1-3 mm to A-Pogonion, 12-15 mm to true vertical line, 6-8 mm to coronal plane through pupils), bucco-lingual angulation (1-4° to occlusal plane perpendicular on models, 87-94° to mandibular plane, 68° to Frankfurt plane, 22-25° to Nasion-B, 105° to occlusal plane, 64° to lower occlusal plane, 21° to A-Pogonion), mesio-distal angulation (2° to occlusal plane perpendicular on models). Conclusions: Although these findings can provide clinical guideline, they derive from heterogeneous studies in terms of subject characteristics and reference methods. Therefore, the optimal incisal position remains debatable.

• Journal of Physiology & Pathology in Korean Medicine
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• v.35 no.2
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• pp.47-55
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• 2021

In order to ensure the fact that eight principle pattern differentiation is used clinically as a basic guideline for Korean medicine practice, the definition, role and method of yin-yang pattern differentiation with its case report were explored at first. Yinyang Pattern Differentiation is a method of discriminating human tendencies or morbidity based on the yin and yang characteristics expressed in living bodies. And yin and yang are the two contrasting characteristics and aspects of the interaction when certain physical conditions that have a lasting effect on the human physiological metabolic function are correlated with the morbidity. Specific methods of yinyang pattern differentiation can be divided into several types of yin and yang indicators. First, time and space factors like day and night, hot and cold seasons, above and below, topographical districts. Second, colors and pulse and their/or relative clearness and muddiness, hardness and softness, moving and resting. Third, diagnose yin and yang patterns through distinguishing the true and false of a fever and cold in an emergency phase such as increase of brain pressure and shock state. Fourth, general characteristics of the propensity and constitution of a subject such as body type, speech, behavior, and physiological metabolism. And for clinical use, these were summarized again as a symptom indicators of physical signs and color, pulse, tongue and questionnaire indicators of propensity, body type, and space-time characteristics. Conclusively, it was confirmed that yinyang pattern differentiation has its own diagnostic significance which is distinct from exterior-interior, cold-heat and deficiency-excess pattern differentiation.