• Clinical and Experimental Pediatrics
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• v.54 no.6
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• pp.234-240
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• 2011

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI) are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS). Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

• Clinical and Experimental Pediatrics
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• v.61 no.9
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• pp.291-300
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• 2018

Purpose: Understanding changes in pathogen and pneumonia prevalence among pediatric pneumonia patients is important for the prevention of infectious diseases. Methods: We retrospectively analyzed data of children younger than 18 years diagnosed with pneumonia at 117 Emergency Departments in Korea between 2007 and 2014. Results: Over the study period, 329,380 pediatric cases of pneumonia were identified. The most frequent age group was 1-3 years old (48.6%) and the next was less than 12 months of age (17.4%). Based on International Classification of Diseases, 10th revision diagnostic codes, confirmed cases of viral pneumonia comprised 8.4% of all cases, pneumonia due to Mycoplasma pneumoniae comprised 3.8% and confirmed cases of bacterial pneumonia 1.3%. The prevalence of confirmed bacterial pneumonia decreased from 3.07% in 2007 and 4.01% in 2008 to 0.65% in 2014. The yearly rate of pneumococcal pneumonia also decreased from 0.47% in 2007 to 0.08% in 2014. A periodic prevalence of M. pneumoniae pneumonia (MP) was identified. Conclusion: The increased number of patients with pneumonia, bacterial pneumonia, pleural effusion, and empyema in 2011 and 2013-2014 resulted from an MP epidemic. We provide evidence that the frequency of confirmed cases of bacterial pneumonia and pneumococcal pneumonia has declined from 2007 to 2014, which can simultaneously reflect the effectiveness of the pneumococcal conjugate vaccine.

• Archives of Plastic Surgery
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• v.47 no.3
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• pp.242-249
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• 2020

Background The Exoscope is a novel high-definition digital camera system. There is limited evidence signifying the use of exoscopic devices in microsurgery. This trial objectively assesses the effects of the use of the Exoscope as an alternative to the standard operating microscope (OM) on the performance of experts in a simulated microvascular anastomosis. Methods Modus V Exoscope and OM were used by expert microsurgeons to perform standardized tasks. Hand-motion analyzer measured the total pathlength (TP), total movements (TM), total time (TT), and quality of end-product anastomosis. A clinical margin of TT was performed to prove non-inferiority. An expert performed consecutive microvascular anastomoses to provide the exoscopic learning curve until reached plateau in TT. Results Ten micro sutures and 10 anastomoses were performed. Analysis demonstrated statistically significant differences in performing micro sutures for TP, TM, and TT. There was statistical significance in TM and TT, however, marginal non-significant difference in TP regarding microvascular anastomoses performance. The intimal suture line analysis demonstrated no statistically significant differences. Non-inferiority results based on clinical inferiority margin (Δ) of TT=10 minutes demonstrated an absolute difference of 0.07 minutes between OM and Exoscope cohorts. A 51%, 58%, and 46% improvement or reduction was achieved in TT, TM, TP, respectively, during the exoscopic microvascular anastomosis learning curve. Conclusions This study demonstrated that experts' Exoscope anastomoses appear non-inferior to the OM anastomoses. Exoscopic microvascular anastomosis was more time consuming but end-product (patency) in not clinically inferior. Experts' "warm-up" learning curve is steep but swift and may prove to reach clinical equality.

• Journal of Oriental Neuropsychiatry
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• v.23 no.4
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• pp.11-36
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• 2012

Objectives : Sleep Disorders are very common in clinical stages and there are many reports and papers regarding this subject. I try to understand the present state of sleep research in JON (The Journal of Oriental Neuropsychiatry) for the benefits of clinical practice. Methods : We searched and read every article on JON from 1990 to 2012 and selected ones that are related to Sleep Disorder; then analyzed the data to 5 categories, like literature study, case study, Clinical Data-Analysis study, experimental study, and clinical trial. Results : 1. We Found 41 articles relating to sleep disorder in JON form 1999 to 2012, and there were 9 literature studies, 13 case studies, 13 Clinical Data-Analysis studies, 4 experimental studies, and 2 clinical trials. 2. There were Sa-Am Acupuncture Method, Pharmacopuncture, electroacupuncture, and Auricular acupuncture to treat Sleep Disorder. 3. There were many additional treatments like Purgative Therapy, etc. 4. They reported the ordinary sleep pattern of Soeumin and Soyangin, too. 5. In the experimental study, they reported several herbs, herbal prescription on the expression of melatonin receptors, and Punsimgeimgamibang on insomnia, anxiety, emotionality in rats. 6. There were 2 clinical trials, one for Hwabyung-patient with insomnia by acupuncture treatment and another for insomnia in the elderly by ETF-I program. 7. There were 2 case of other sleep disorder (enuresis, sleepwalking) and 2 literature study of dream. Conclusions : In JON regarding sleep disorder, the majority was due to insomnia. Therefore, we also have to expand our sight into other sleep diseases. We need more clinical trials and experimental researches for the construction of EBM Sleep Disorder in Oriental Neuropsychiatry.

• Korean Journal of Pharmacognosy
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• v.49 no.3
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• pp.203-218
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• 2018

It has been extensively known in the high temperature regions such as southern China and south east Asia that Korean ginseng(Panax ginseng) intake raises body heat, while American ginseng(Panax quinquefolium) lowers it, based upon oriental medicine. This is likely due to the misunderstanding of the conception that Korean ginseng shows a warm property, resulting in enhanced blood circulation and stimulation of metabolism. It's further supported by the fact that current scientific studies have shown no notable side effects. Moreover, it has been demonstrated in animal experimental test that Korean ginseng shows a complementary effect in a high temperature environment, together with scientific evidence of a preventive effect of ginseng saponin against cold conditions, suggesting it to exhibit an adaptogenic effect normalizing the body under abnormal body conditions. However, there is a shortage of studies published concerning comparative clinical and animal studies of Korean and American ginsengs, and also, on natives of high temperature countries. Therefore, a further placebo-controlled clinical study has to be considered to elucidate scientifically clinical evaluation of Korean and American ginsengs on the body heat. In this article, we summarize the scientific publications reporting the clinical comparative study of Korean and American ginsengs on body heat response.

• Health Policy and Management
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• v.26 no.4
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• pp.333-342
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• 2016

Background: The use of therapeutic materials based on new health technology has increased in recent years in the field of medicine, raising concerns for medical practitioners regarding increased spending on the new therapeutic materials amid the rapid population ageing and increase of chronic diseases in Korea. While therapeutic materials have significant importance in the health care system, they have not been given appropriate attention in the academic world of Korea. The purpose of this study is to identify factors that affect the growth of expenditure on therapeutic materials and to derive implications for an effective management considering the diversity of therapeutic materials. Methods: Using the claims data of the National Health Insurance Services, specific utilization patterns of groups of therapeutic materials in the middle classification level of Health Insurance Review and Assessment Service from 2007 to 2014 were analyzed. Four categories (J5083: drug eluting coronary stent, D0302: nonmetallic anchor, K6014: gauze, K6023: gauze) that exhibit unique patterns with respect to price and volume were selected. Then, decomposition analysis was performed to identify the largest contributor to the spending growth by dividing the products into existing, new, and abandoned products for the period between 2010 and 2013. Results: The effect of new products had larger impact on spending growth than the effect of core items in drug eluting coronary stent (J5083) and nonmetallic anchor (D0302). In addition, existing products in general included items priced relatively lower when compared with another item manufactured by the same company. In the gauze category, however, existing products had the largest impact on expenditure and the effect of volume was greater than that in other categories. Conclusion: This study provides evidence that appropriate management measures classified by the characteristics of therapeutic materials are required for therapeutic materials pricing and reassessment in Korea.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.5
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• pp.2133-2141
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• 2012

The Purpose of this study was to report magnetic resonance imaging(MRI) changes of six cases of Lumbar herniated disc which was treated with spinal decompression therapy, oriental medical therapy. 'Disc heights' were measured on sagittal view of $T_2$-weighted MRI. Size of the herniated disc was measured by MRI and 'disc herniations index'. The grading system and algorithm for 'disc degeneration' were based on MRI signal intensity, disc structure, distinction between nucleus and anulus, and disc height. Data for disc height, disc herniations index and disc degeneration grade were collected before and after the treatment together with calculation from the MRI. Case studies were showed that decompression therapy for the herniated disc has an positive effect on disc herniations index, disc regeneration, not disc heights. The clinical evidence for the use of decompression in herniated disc remains inconclusive because of limited researches. Further trials, which give attention to these areas, are needed before any firm conclusions may be made.

• Safety and Health at Work
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• v.3 no.2
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• pp.140-145
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• 2012

Objectives: To understand the personal experiences of mine workers that have experienced job relocation due to silicosis at the Andina Division of Corporaci$\acute{o}$n Nacional del Cobre (CODELCO), Chile. The purpose of the study was to provide useful information for the development of new local, business and public policies for the care of workers with silicosis. Methods: A qualitative study based on a practical case study of 5 workers. The information was collected by means of structured individual interviews. The method of analysis was phenomenology. Results: The corporal axis was the most commented upon. It included awareness of the illness, body pains, fatigue, and antagonistic mood disorders (sadness, or the difficulty in finding meaning in life). As far as personal relationships, there was evidence of strong relationships with family, coworkers and friends, as well as extended family. Over all, the experience of relocation was positive with periods of impatience and uncertainty. The job reassignment provided a new and pleasant context for the relocated workers and in the process improved their perception of their quality of life. Conclusions: A multidisciplinary team should attend mine workers relocated because of silicosis by addressing the mental and physical aspects of their disease, along with the integral participation of close family members. It is suggested that this investigation be maintain over time to record the personal experiences in the medium-term, adding new cases with the intention of shedding more light on the phenomenon being studied. As a preventive measure, continual workshops are needed on the proper use of respiratory protection in addition, a group of monitors is required.

• Korean Journal of Veterinary Research
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• v.38 no.1
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• pp.53-63
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• 1998

Total of 1085 swine sera (1996-1997) from nation-wide were tested for the presence of antibodies to influenza A virus. Fifty nine percent of the tested sera showed seropositive by HI test. Positive sera consisted of 24--- of H3, 15--- of H1, and 20--- of the sample had both antibodies, respectively. Sera collected from various region represented 7~27--- seropositivity to H1N1, 15~25--- to H3N2, respectively. Swine influenza field isolate from nasal swab was characterized antigenically and genetically to elucidate its relatedness with other known strains of influenza A virus. The study was focused on the HA gene which is related to pathogenecity and antigenic variability of the influenza virus. By RT-PCR using influenza A/H1N1 specific primers, influenza virus H1N1 specific DNA fragment was amplified from A/Swine/Iowa/15/30(H1N1), US field isolate but not in H3N2 strain. PCR products were sequenced by dideoxy chain termination method to determine nucleotide homology with other strains of influenza A virus. The US field isolate and A/Swine/Indiana/1726/88 strain had 97--- of nucleotide homology and 98--- of amino acid homology. Based on the results obtained from this experiment, the field isolate was genetically related to A/Swine/Indiana/1726/88 and had higher homology with A/Swine/Indiana/1726/88 than with classical swine influenza virus, A/Swine/Iowa/15/30. The field isolate had no amino acid changes at the antigenic site compare to that of the A/Swine/Indiana/1726/88. The proteolytic enzyme cleavage site between HA1 and HA2 had no alteration and the amino acid arginine was intact. There is no evidence has been found that the field isolate has genetic shift or genetic drift which might altered antigenic determinant.

• Journal of Biomedical Engineering Research
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• v.41 no.1
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• pp.35-41
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• 2020

In this study, we examined whether the systematic literature review method used in the field of evidence-based medicine could be used for post-market clinical evaluation of medical devices by modifying them to fit the regulatory perspective of medical devices in Korea. For this purpose, systematic literature review was modified and applied to conduct a clinical literature survey on the ophthalmic electrosurgical system(Trabectome^®, NeoMediX Corp) used for the treatment of glaucoma. A total of six documents were finally selected, and clinical safety and efficacy information on the indications of the ophthalmic electrosurgical system were effectively presented. In addition, general safety information and unexpected safety information could be distinguished through comparison with medical device adverse event reporting cases. The method used in this study is expected to be used in various ways throughout post-market medical device safety management system and for the purpose of regulation improvement, especially in the field of ophthalmic electrosurgical system.