• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1063-1067
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• 2015

Background: Tumor associated fatigue (TAF) or cancer related fatigue (CRF) is not a new concept. Nonetheless, no real headway has been made in the quantitative analysis of its successful treatment via cognitive behavioral therapy. Since 20 to 30% of all breast cancer patients suffer from anxiety and/or depression within the first year of their diagnosis, this issue needs to be addressed and a standard treatment protocol has to be developed. This study focused on developing a simple, reproducible and short (8 weeks) protocol for the cognitive behavioral therapy support of tumor associated fatigue patients. Materials and Methods: Between the year 2011 and 2012, 23 breast cancer patients fulfilled the diagnosis TAF requirements and were introduced into this study. Our method focused on a psycho-oncological support group using a predetermined, highly structured and reproducible, cognitive behavioral therapy treatment manual. Eight weekly, 90 minute sessions were conducted and patients were evaluated before and after this eight session block. Tumor fatigue specific questionnaires such as the multidimensional fatigue inventory (MFI) as well as the hospital anxiety and depression scale (HADS) were used in order to quantitatively evaluate patient TAF. Results: Of the 23 patients enrolled in the study, only 7 patients fulfilled the TAF diagnostic criteria after the psycho-oncological group treatment. This represents a 70% reduction in diagnosable tumor associated fatigue. The HADS analysis showed a 33% reduction in patient anxiety as well as a 57% reduction in patient depression levels. The MFI scores showed a significant reduction in 4 of the 5 evaluate categories. With the exception of the "mental fatigue" MFI category all results were statistically significant. Conclusions: This study showed that a highly structured, cognitive behavioral therapy group intervention will produce significant improvements in breast cancer patient tumor associated fatigue levels after only 8 weeks.

• Journal of Oral Medicine and Pain
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• v.19 no.1
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• pp.33-43
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• 1994

The purpose of this paper was to observe the influence of Ga-As semiconductor-low power generating laser on she appearance and actions of tenascin, extracellular matrix, as healing process of intentional wound on the experimental animals is taking place. 35 rabbits were divided into control and experimental group. ; and on each, 3mm-long and 2mm-deep, surgical wounds were created on buccal oral mucosa and thoracodorsal portion of skin. Ga-As laser was applied to the experimental group starting a day of the day the wounds were created , the laser was applied for 5 minutes every other day. Tissue samples were taken after the 2, 4, 7, 10, and 14 days after wound formation. Then tile healing process of experimental and control groups were observed and compared, using light microscope. Afterwards, the samples were immunohistochemical stained and again observed tenascin by quantitative measuring. The following results were obtained : 1. Tenascin was observed prevalently on epithelial cells, border area of dermis, and interstitial matrix between connective tissue layers in both experimental and control groups. 2. In oral mucosa, the experimental group showed significant increase in the appearance of tenascin after 4 days compared to the control group, but after 10 days, it decreased to a point which is even less than the control group. 3. In the skin samples, the pattern of appearance of tenascin was the same in both groups, but there was some difference concerning when the peak period was shown, In the experimental group, the peak period of tenascin expression was the 7 days after wound formation in epithelium and connective tissue. In the control group, the peak period was 10 days after. 4. In both the experimental and control groups, tenascin first appeared in the epithelium near the wound area and submucosa, and then spread on the underlying connective tissue. In conclusion, appearance of tenascin is closely related to regeneration of epithelium and development of granulation tissue : therefore, low power laser, which fastnes appearance of tenascin, is sure to faciltate healing process of oral mucosa.

• Health Policy and Management
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• v.23 no.1
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• pp.35-43
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• 2013

Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.

• Korean Journal of Psychosomatic Medicine
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• v.20 no.2
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• pp.91-97
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• 2012

Objectives : With the increase in cancer prevalence, the health behavior of cancer survivors has become an important issue. This study was conducted to examine the psychosocial correlates of behavior changes after cancer diagnosis. Methods : 95 patients completed questionnaires assessing depression, anxiety, insomnia, posttraumatic stress symptoms, social constraints, personal beliefs about cancer cause and health-related behavior changes after cancer diagnosis. Results : In the multiple logistic regression analysis, insomnia was the only significant predictor of positive change in physical behavior : normal sleep group(Odds ratio=9.462, 95% CI 1.738-51.509) and subthreshold insomnia group(Odds ratio=10.529, 95% CI 1.701-65.161) showed a larger increase compared to the insomnia group. In psychosocial behavior, low age, religion and causal belief in hormonal factors were independent factors that predicted increase in positive change. Conclusions : This study showed a difference between predictors of physical and psychosocial health behavior change after breast cancer diagnosis. Multi-faceted approaches are required to promote positive change in health behavior in cancer patients.

• Health Policy and Management
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• v.29 no.4
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• pp.482-495
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• 2019

Background: An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI. Methods: Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects. Results: The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=-2.554, p<0.05), and the population of regional public hospital location (t =-2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=-1.322, total effect=-0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05). Conclusion: It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.

• Journal of Acupuncture Research
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• v.18 no.1
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• pp.1-13
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• 2001

The Background and Purpose : Most diagnostic method for the facial palsy were invasive and complex. And we don't know very well prognosis for the recovery of facial palsy in the first stage after the onset. But the Digital Infrared Thermal Image(DITI) isn't invasive and complex diagnostic method for the facial palsy. So we should study on the clinical prognostic diagnosis of Bell's palsy among facial palsy with the DITI. Objective and Methods : This study researched into the clinical statistics for 89 case who are in Bell's palsy, and they are treated with oriental medical care at the Woosuk university during 2 years form November 1998 to October 2000. All objectives have the Grade 6(Zero state) of Bell's palsy in first week after the onset. It takes a patient's facial temperature after the onset. Group A is taken from 1 day to 4 days after the onset. Group B is taken from 5 day to 8 days after the onset. And group C is taken from 9 day to 12 days after the onset. Results and Conclusions : The Digital Infrared thermal image technique showed the more high temperature, the more rapid cure and short treatment period on TE23, B2, S3, S6 in abnormal site of Bell's palsy. But it showed the more low temperature, the more rapid cure and short treatment period on TE17 of abnormal site of Bell's palsy. As a conclusion, we could think that the prognostic diagnosis of Bell's palsy closely related with the thermal difference normal and abnormal site of Bell's palsy that were took picture after the onset.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5869-5873
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• 2015

Background: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. Materials and Methods: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. Results: The mean age of the study group was $32.8{\pm}6.9$ years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". Conclusions: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

• The Journal of Internal Korean Medicine
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• v.28 no.3
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• pp.560-569
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• 2007

Objectives : Ryodoraku is a physiological function test using electric current, and is closely related to skin sympathetic tone. Pulse analysis is known to reflect cardiovascular reactivity. There has been no report on the correlation between ryodoraku and pulse analysis in respiratory diseases. The present study examined the diagnostic values of ryodoraku and pulse analysis for respiratory disease patients Methods : For this study, we conducted ryodoraku and pulse analysis in 103 people including 79 respiratory disease outpatients who visited the $5^{th}$ Internal Department of the Oriental Medicine Hospital of Kyung Hee University during the period from January 1, 2003 to July 25, 2006, and 24 volunteers who did not have any respiratory symptoms or disease history. The respiratory disease patients were divided into five sub-groups according to their symptom: cough-sputum group, wheezing-dyspnea group ' nasal symptoms group. cold-prone group, and fatigue prone group. We compared the disease groups with the control group in six items as follows : mean ryodoraku, mean H1, mean elastic index, the percentage of those with mean ryodoraku below $40{\mu}A$, the percentage of those with HI beyond the physiological range, and the ratio of left : right of elastic index Results and Conclusions : Ryodoraku and pulse analysis were found to have a high value as quantitative diagnosis tools reflecting individuals' weakness and firmness. The results of this research suggest that ryodoraku and pulse analysis have value as tools for diagnosing respiratory diseases.

• The Journal of Korean Medicine
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• v.40 no.3
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• pp.1-20
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• 2019

Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

• Journal of Sasang Constitution and Immune Medicine
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• v.20 no.2
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• pp.21-29
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• 2008

1. Objectives and Methods It has been examined 703 papers of Sasang Constitution Society published from 1989 to 2007. Among them, the study methods have been classified focused on 332 papers related to clinical research and the method of constitution diagnosis and subjects have been researched to research the reality of the clinical research of Sasang Constitutional Medicine. 2. Results 1. The rest studies are the most which can not be classified by existing study method among 332 clinical studies. 2. The study of patient control group is 17 cases and the clinical experiment is one case, so highly well-grounded studies have not been performed. 3. The most method of constitution diagnosis is the constitution diagnosis by experts and by QSCC. 4. The number of constitution diagnosis method performed in the research institution is within 2. They are 254 cases(89.5%). 5. The studies which utilize more than 3 constitution methods are 22 cases and the studies that use medical rash are 7cases(31.8) 6. The 215 cases that subjects are less than 100 are the most and 100${\sim}$500 subjects are 71 cases. 500${\sim}$10000 subjects are 33 cases and more than 1000 subjects are 15 cases. 3. Conclusions Therefore, it is needed to increase the rate of highly well-grounded studies and set the standard criteria by providing constitution diagnosis guideline.