• 동의생리병리학회지
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• 제31권2호
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• pp.83-93
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• 2017

This study covers pattern differentiation based on Korean medical references, research trend and modern clinical applications about Sleep-Wake disorders of Diagnostic and Statistical Manual of Mental Disorders(DSM-V) published by American Psychiatric Association. Insomnia disorder is mostly caused by yin deficiency of liver-kidney or liver qi depression and main patterns are heart-kidney non-interaction, deficiency-excess complex pattern containing phlegm-heat due to qi stagnation and blood stasis. Hypersomnolence disorder is more due to yang deficiency rather than yin deficiency and it's major pattern is spleen-kidney yang deficiency. Cataplexy is main feature in narcolepsy and corresponds to depressive psychosis or fainting in terms of Korean Medicine and narcolepsy is assumed to be relevant to liver wind. Breathing-related sleep disorders are related with phlegm-fluid retention brought on spleen deficiency with dampness encumbrance. Pattern of circadian rhythm sleep-wake disorders is combined with yin deficiency of liver-kidney or liver qi depression of insomnia disorder and spleen-kidney yang deficiency or dampness-phlegm of hypersomnolence disorder. Yin deficiency with effulgent fire brought on drugs or alcohol is one of main patterns of substance/medication-induced sleep disorder and combined patterns with yin deficiency of liver-kidney and blood stasis or dampness-phlegm-heat are mostly applied clinically. This study drew major and frequently applied patterns of sleep-wake disorders based on Koran medical literature and modern clinical applications. And that can be the groundwork for the task ahead like clinical practice guideline of sleep-wake disorders containing pattern differentiation, diagnosis and prescriptions.

• 임상간호연구
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• 제18권2호
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• pp.317-328
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• 2012

Purpose: This study was done to provide oncology nurses systemic guidelines designed to perform telephone counseling in outpatient settings treating patients with chemotherapy. Methods: Symptoms which are frequently questioned were identified through case reports recorded by 4 clinical nurse specialists from January 4 to December 31. 2010. Fifteen clinical experts and two hemato-oncologists reviewed the developed draft. Their opinions were synthesized to arrive at consensus on the ideal guidelines. This process confirmed content validity. The two hemato-oncologists also verified the face validity. Results: The six symptoms which were most frequently asked about were identified through 4,644 case reports and concerned pain, fever, skin alteration, nausea/vomiting, stomatitis and diarrhea. Evidence-based telephone triage guidelines for the 6 major symptoms in patients receiving chemotherapy were developed. Conclusion: These guidelines will help oncology nurses from novice to expert incorporate evidence-based telenursing into their practice.

• Clinical and Experimental Pediatrics
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• 제64권11호
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• pp.559-572
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• 2021

The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

• 대한한방내과학회지
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• 제40권1호
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• pp.70-88
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• 2019

Objective: This study investigated the trends in pancreatic cancer research on Korean medicine in order to establish a direction for further study. Methods: Pancreatic cancer research on Korean medicine was reviewed using databases such as OASIS, KoreanTK, KISS, RISS, KISTI, and NDSL. The search terms were "pancreatic cancer" "Korean medicine," and "herbal medicine." There was no restriction on publication dates, and the reviewed studies were analyzed according to the type of research. Results: Nineteen studies were reviewed. The numbers and types of research were as follows: 9 clinical studies including case reports, 2 review studies, and 8 in vitro studies; there was no in vivo study. Among the clinical research were 3 descriptive studies and 6 case reports. The baseline characteristics and quality of life of pancreatic cancer patients were analyzed in the descriptive studies. In the case reports, interventions such as herbal medicine, pharmacopuncture, and acupuncture were used. Research articles on the review of pancreatic cancer were titled "Preliminary Study for Development of Korean Medicine Clinical Practice Guideline for Pancreatic Cancer" and "Systemic Review on the Tumor Dormancy Therapy." Cell lines such as PANC-1, MIA PaCa-2, and AsPC-1 were used for in vitro studies. These studies have reported decreased cell viability, induced apoptosis, and changes in cancer-related gene expression. Conclusion: Through this review, we found that using Korean medicine for treating pancreatic cancer is applicable. However, due to overall limited the number of study, the benefit of Korean medicine for pancreatic cancer may be substantiated to a limited degree. Better methodological quality and large controlled trials are expected to further quantify the therapeutic effect of Korean medicine.

• 대한통합의학회지
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• 제12권2호
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• pp.197-210
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• 2024

Purpose : This study aimed to analyze research trends in the field of integrative medicine through a bibliometric analysis of articles published in Integrative Medicine Research (IMR) journal from 2017 to 2022. Methods : Articles published in IMR journal between 2017 and 2022 were searched using the Web of Science database on August 22, 2023. The analysis was performed using the Bibliometrix and Biblioshiny tools in R (version 4.3.1) and VOSviewer (version 1.6.19). Results : The key findings were as follows: average citations per article (9.41), total authors (1,142), single-authored articles (12), average articles per author (0.27), average co-authors per article (5.27), and rate of international co-authorships (15.69 %). The most-cited article was on the cryopreservation of cells or tissues and their clinical applications. The top keyword analysis by author keywords showed that "acupuncture" was the most frequently used keyword (33 times). Co-occurrence network analysis showed 85 high-frequency keywords that appeared five or more times, and the top five keywords by total link strength were "acupuncture," "herbal medicine," "prevalence," "alternative medicine," and "complementary." The study found that, contrary to the trend in complementary and alternative medicine research in Korea, the IMR journal actively conducts intervention studies to provide clinical evidence. Conclusion : In the IMR journal, "acupuncture" was the most frequent of author keywords. The analysis of keyword trend topics over time showed that the keyword "systematic review" continued to appear from 2020 to 2022, and the keyword "clinical practice guideline" appeared for the first time in 2021. In particular, the co-occurrence network analysis highlighted keywords related to intervention research, in contrast to domestic research trends. While this study analyzed only one journal, future studies expanding the category of integrative medicine and increasing the number of journals analyzed may provide further insights.

• 의료법학
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• 제17권2호
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• pp.125-144
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• 2016

모든 형태의 임상시험은 시험 자체가 불확실하며, 리스크가 다양하므로 피험자를 보호하기 위한 제도가 완비되어 있어야 한다. 그럼에도 불구하고 현행 임상시험에 관한 법률은 약사법과 의료기기법에서 일정한 규정을 두고 있으나 이는 '의약행정'을 원활하게 수행하기 위한 법목적에 비추어 피험자 보호에는 일정한 한계가 있다. 더 나아가 미성년 피험자를 대상으로 하는 임상시험은 약사법 등에서 직접적인 규정을 두지 않고, '소아를 대상으로 하는 임상시험 평가 가이드라인'이나 '의약품임상시험관리기준' 등에서 일정 부분 규율하고 있으나 이는 법적 효력이 없는 권고사항이라는 점에서 일정한 한계가 있다. 미성년자 대상 임상시험에 대한 법흠결 문제는 인체침습의 정도 면에서 통상적인 의료행위의 경우보다 강한 장기이식법상의 미성년자 취급제도와 기타 외국법상의 미성년자 임상시험 제도를 검토함으로서 입법적 해결이 가능하다고 할 것이다. 그러나 근본적으로는 현행법 체계상 약사법, 의료기기법 기타 가이드라인을 중심으로 이루어지고 있는 임상시험 규율체계를 이른바 "피험자보호법"이라는 법률제정을 통해 해결하는 것이 바람직하다고 본다.

• 대한예방한의학회지
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• 제23권2호
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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.

• 동의신경정신과학회지
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• 제24권spc1호
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• pp.89-100
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• 2013

Objectives : The purpose of this study is to investigate the researches about regarding Emotional Freedom Technique (EFT) and to understand the trends of Meridian-based Psychotherapy. Methods : Every article relevant to EFT was obtained from 'Pubmed' and Korean journal databases. Keywords used for searching included 'EFT' and 'Emotional freedom technique'. Results : 1) 5 reviews, 11 randomized controlled trials, 3 controlled trials, 1 single group comparative study and 4 case studies were searched. 2) Anxiety disorders were most frequently studied with EFT. Other studies included insomnia, depression and pain symptoms. EFT interventions were attempted in many different protocols and assessed with various tools. 3) Review articles indicated that meridian-based psychotherapies, such as EFT, are based on the meridian theory of oriental medicine. They evaluate EFT positively for its effectiveness on psychiatric diseases. Conclusions : EFT is increasingly studied and used in clinical practice of various fields. Objective evaluation tools and standardized intervention protocols are needed for the development of a new guideline for EFT.

• 성인간호학회지
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• 제24권1호
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• pp.20-30
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• 2012

Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

• 임상간호연구
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• 제21권3호
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• pp.355-365
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• 2015

Purpose: The purpose of this study was to evaluate nursing protocols for superficial cryotherapy in different medical institutions. Methods: The study was conducted with a cross-sectional descriptive design. The medical institutions including general hospitals, hospitals, and geriatric hospitals were randomly selected. A total of 435 nurses from 126 institutions completed a questionnaire. Data were collected from December 2014 to June 2015. Results: Forty-two institutions (39.5%) had nursing protocol for cryotherapy. The nurses reported that durations of cold application were 2 minutes to 5 hours. Frequently used cold therapy devices in order of frequency were frozen gel packs, ice packs, and frozen IV fluid bags. There were variances in the duration of cold application according to the types of institution ($x^2=7.78$, p=.020) and nursing units ($x^2=26.42$, p<.001). In addition, intervals of cold application were different according to the nursing units (x=12.23, p=.032). There were differences in cold application instruments by regional groups (x=70.38, p<.001). Most of the nurses (95.6%) responded that national nursing protocol for superficial cryotherapy were needed. Conclusion: There were difficulties in providing consistent nursing interventions because of the practical differences and absence of evidence-based guidelines for cryotherapy. The researchers recommend that basic studies with various instruments be conducted and proper nursing protocols be developed for cryotherapy.