• The Journal of Pediatrics of Korean Medicine
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• v.35 no.3
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• pp.67-88
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• 2021

Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

• Korean Journal of Clinical Pharmacy
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• v.19 no.2
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• pp.105-109
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• 2009

In July 2008, The National Police Hospital has developed the CPOE system(Computerized Physician Order Entry system) which links the medicine master and introduced the new program for the injectable antimicrobial agents. After introducing new system, we wanted to check the management of oral antimicrobial agents. Because new system has limitation that new system control only the use of the injectable antimicrobial agents. So we tried to evaluate the use of oral levofloxacin, which was chosen by a medical specialist of the infection. We retrospectively analyzed the appropriateness of oral levofloxacin through EMR(Electric Medical Record) of 72 inpatients who received oral levofloxacin in National Police Hospital in December 2008. We applied the modified ASHP(American Society of Health- System Pharmacists) DUE(Drug Use Evaluation) criteria, which is composed of justification of drug use, critical indicators, complications and outcome measures. Acceptable cases of use of levofloxacin were 67(93.01%) and 57cases(79.2%) showed good outcome. However critical indicators were not performed very well. We want to suggest the new system for the management of the medical therapeutics by the pharmacist in charge.

• Journal of Chest Surgery
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• v.57 no.1
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• pp.44-52
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• 2024

Background: Visceral pleural invasion (VPI) is a poor prognostic factor that contributes to the upstaging of early lung cancers. However, the preoperative assessment of VPI presents challenges. This study was conducted to examine intraoperative pleural carcinoembryonic antigen (pCEA) level and maximum standardized uptake value (SUVmax) as predictive markers of VPI in patients with clinical T1N0M0 lung adenocarcinoma. Methods: A retrospective review was conducted of the medical records of 613 patients who underwent intraoperative pCEA sampling and lung resection for non-small cell lung cancer. Of these, 390 individuals with clinical stage I adenocarcinoma and tumors ≤30 mm were included. Based on computed tomography findings, these patients were divided into pleural contact (n=186) and non-pleural contact (n=204) groups. A receiver operating characteristic (ROC) curve was constructed to analyze the association between pCEA and SUVmax in relation to VPI. Additionally, logistic regression analysis was performed to evaluate risk factors for VPI in each group. Results: ROC curve analysis revealed that pCEA level greater than 2.565 ng/mL (area under the curve [AUC]=0.751) and SUVmax above 4.25 (AUC=0.801) were highly predictive of VPI in patients exhibiting pleural contact. Based on multivariable analysis, pCEA (odds ratio [OR], 3.00; 95% confidence interval [CI], 1.14-7.87; p=0.026) and SUVmax (OR, 5.25; 95% CI, 1.90-14.50; p=0.001) were significant risk factors for VPI in the pleural contact group. Conclusion: In patients with clinical stage I lung adenocarcinoma exhibiting pleural contact, pCEA and SUVmax are potential predictive indicators of VPI. These markers may be helpful in planning for lung cancer surgery.

• Journal of Physiology & Pathology in Korean Medicine
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• v.27 no.5
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• pp.587-593
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• 2013

Exhaustion syndrome(虛勞) became broadly experienced symptoms in Korean population. In this work, we carried out a systematic literature review on exhaustion syndrome(ES) and chronic fatigue. We searched through the databases Koreanstudies Information Service System, Oriental Medicine Advanced Searching Integrated System, DataBase Periodical Information Academic for the articles published between 1994 and 2013, with the keywords 'exhaustion syndrome(虛勞)', 'consumption(虛損)', 'overexertion syndrome(勞倦)', 'fatigue', 'chronic fatigue' and 'degree of fatigue'. Among the first-run rough-searched 602 articles, we narrowed down the scope within the field of Oriental medicine (126 articles), and finally selected 28 articles appropriate to the intended research field; the selected articles were categorized by literature study(7 papers), clinical treatment (7), clinical diagnosis (5), treatment effects of herbal medicine (2), diagnosis in Sasang medicine and treatment effect of dry cupping therapy (2), and questionnaire-based diagnosis (5). We found that the overall research level on ES remained in the preliminary stages, and more efforts are needed in the field of terminology definition and standardization of diagnosis, and treatment efficacy validation beyond muscle fatigue. Finally, to develop reliable diagnostic devices on ES, we proposed a study design that included the development of objective ES diagnostic indicators and a clinical validation procedure.

• Clinical and Experimental Pediatrics
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• v.60 no.11
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.312-320
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• 2016

This study analyzed the distribution of the blood glucose level according to the fasting status. Moreover, a relationship was analyzed between fasting blood glucose level and glycemic control indicators. A total of 707 outpatients, who visited Dankook University Hospital, were included and classified into either the fasting group and the non-fasting group. The mean blood glucose level of each group was calculated and analyzed by sex, age, and clinic. In addition, blood glucose, HbA1c, fructosamine, and 1,5-AG were measured in 153 fasting health check-up patients, and the correlation between the blood glucose level and glycemic control indicators was evaluated. Blood glucose averages between the two groups (non-fasting 111.9 vs. fasting 103.6 mg/dL) were different (p<0.05); and the mean difference was lower in women (4.8 mg/dL) than in men (12.2 mg/dL). A significant difference of the median glucose values among the age groups was only observed in the non-fasting group (Kruskal-Wallis test, p<0.01), and not in the fasting group. A 1,5-Anhydroglucitol was estimated to be significantly correlated with the fast blood glucose level in the range of the criteria of impaired fasting glucose (IFG). We presented an assessment of the distribution of blood glucose level in accordance with the fasting status among outpatients, and estimated that 1,5-anhydroglucitol was well correlated with the fasting blood glucose than fructosamine and HbA1c, through the analysis of results of health screening subjects. It is suggested that the use of glycemic indicators that reflect short-term blood glucose control can be used together with the blood glucose measurement in the screening of diabetes mellitus.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.1
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• pp.25-31
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• 2008

Purpose: Acute organophosphate (OP) poisoning may be monitored by measuring the acetylcholinesterase (AChE). It is important to assess severity and establish prognostic tests in the early stage of OP poisoning. The aim of this study was to look at the relationship between various clinical aspects of the OP poisoning, prognostic indicators of OP poisoning including Simplified Acute Physiology Score (SAPS) 3, and the associated changes in AChE levels. Methods: Clinical data and initial AChE levels from thirty-seven patients with OP poisoning were prospectively reviewed from 12 teaching hospitals in South Korea from August 2005 to July 2006. Clinical manifestations at the time of arrival such as miosis, respiratory abnormality, salivation, urinary incontinence, GCS score, AVPU scale, need for intubation, and mechanical ventilation requirements were recorded. SAPS 3 was calculated using clinical data and laboratory results. Results: The median level of AChE was 9.8 (1.3-53.6) U/gHb. There was no significant difference in AChE levels between the groups with and without cholinergic symptoms. The median level of AChE of the patients who required intubation and those who did not were 3.5 U/gHb and it 19.7 U/gHb respectively (Mann-Whitney test; p<0.001). The AChE levels were also significantly different (p=0.007) in patients who needed mechanical ventilation compared to those who did not with AChE levels found to be 3.1 U/gHb and it was 14.8 U/gHb, respectively. Level of consciousness assessed using the AVPU scale was correlated with AChE levels (Kruskal-Wallis test; p=0.013). GCS score were correlated with AChE levels (p=0.007, Spearman's rho = 0.454). In addition, the lower the level of initial AChE, the longer the ICU stay (p=0.029, Spearman's rho=-0.380). SAPS 3 was inversely correlated with the initial AChE (p<0.001, Spearman's rho=-0.633). Conclusion: In the acute OP poisoning, low AChE levels appear to help indicate the severity of poisoning. The initial AChE level may be a useful prognostic parameter for acute OP poisoning.

• Journal of Preventive Medicine and Public Health
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• v.45 no.3
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• pp.127-136
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• 2012

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.83-89
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• 2007

Purpose: This research was performed to determine which clinical signs and symptoms of brain injury are sensitive indicators of skull fracture (SF) and intracranial injury (ICI) in head injured children. Methods: We conducted a prospective study of minor head trauma in children younger than 2 years of age for a 1-year period. Skull radiographs, brain computed tomography (CT), and data forms, including mechanism of injury, symptoms, physical findings, and hospital course, were completed for each child. Results: Of 137 study subjects, 17 (12.4%) had SF/ICI. Falls were the most common mechanism of injury, and heights of fall above 1 meter were associated with incidence of SF/ICI (p<0.05). Scalp abnormalities were not associated with incidence of SF/ICI. As for clinical symptoms, lethargy and a grouping of features (irritability & vomiting) were associated with incidence of SF/ICI (p<0.05). The incidence of seizure, loss of consciousness, vomiting, irritability, and scalp abnormality did not differ significantly between those with normal radiologic findings and those with SF/ICI. Among asymptomatic patients, 11 (14.5%) patients had SF/ICI, and among patients with normal scalp findings, 9 (12.7%) patients had SF/ICI. Conclusion: Clinical signs and symptoms, except for lethargy and a grouping of features (irritability & vomiting), were not sensitive predictors of SF/ICI. Nevertheless, SF/ICI occurred among normal children. In such a case, a liberal policy of CT scanning is warranted.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.37 no.2
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• pp.58-73
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• 2024

Objectives : This study was designed to review and analyze domestic research trends of Korean medicine treatment on otitis media, and present data for further research and treatment of otitis media. Methods : Two researchers used six search engines to search for papers on Korean medicine treatment for otitis media published from January 1, 2000 to December 31, 2023. A total of 16 papers were searched, and bibliographic information, main and accompanying symptoms, treatment period, treatment method, evaluation scale, and treatment results of each study were analyzed. Scottish Intercollegiate Guidelines Network was used to evaluate the evidence level. Results : The most common otitis media symptom was hearing loss (12 times). The most frequently mentioned herbs were Ledebouriella seseloides (22 times) and Angelica gigas (20 times), which are the ingredients of the most commonly used prescriptions, Hyunggyeyungyo-tang (5 times), Takrisodok-yeum (4 times), and Bojungikgi-tang (3 times). All the clinical trial papers were conducted on Kamihyunggyeyungyo-tang, which showed improvement in otitis media-related indicators. The most frequently mentioned meridians were the Triple Energizer (44 times), Clinical trials were conducted on the Triple Energizer, the Gall Bladder, and the Small Intestines meridians. The most frequently used acupoints were SI19 (10 times), TE21 (9 times), TE17 (9 times). In clinical trials, acupuncture treatment with TE05, GB15, TE06, SI05, GB38, and KI02 showed a significant improvement in otitis media symptoms. Conclusions : It is believed that more efficient otitis media treatment and follow-up research can be performed by using the above-mentioned research results.