• 한방재활의학과학회지
• /
• 제32권4호
• /
• pp.33-45
• /
• 2022

Objectives The purpose of this review was to investigate clinical treatment trends of Achilles tendinopathy. Methods Clinical studies about Korean medicine treatments on Achilles tendinopathy were searched in 5 databases. The included studies were classified according to the authors, published years, study designs, purposes of study, methods, interventions outcome measures and adverse event. Results In 23 studies, total number of patients were 1,135. The included studies consist of 14 randomized controlled trials (RCT), 5 non-RCT, 2 retrospective study and 2 case reports. Patients were conducted with 9 kinds of treatment, which is acupuncture, electro-acupuncture, pharmacopuncture, acupotomy, moxibustion, cupping, Chuna, herbal medicine, physiotherapy. Most studies used visual analogue scale as primary outcome. Conclusions Based on the results of the collected studies, the use of Korean medicine treatment on Achilles tendinopathy seem to be effective. Despite the large number of RCTs, the level of research cannot be guaranteed, so it is considered that more rigorous researches are needed in future studies.

• Journal of Yeungnam Medical Science
• /
• 제40권2호
• /
• pp.136-145
• /
• 2023

Hepatic encephalopathy (HE) is a severe neuropsychiatric abnormality in patients with either acute or chronic liver failure. Typical brain magnetic resonance imaging findings of HE are bilateral basal ganglia high signal intensities due to manganese deposition in chronic liver disease and hyperintensity in T2, fluid-attenuated inversion recovery, or diffusion-weighted imaging (DWI) with hemispheric white matter changes including the corticospinal tract. Low values on apparent diffusion coefficient mapping of the affected area on DWI, indicating cytotoxic edema, can be observed in acute HE. However, neuropsychological impairment in HE ranges from mild deficits in psychomotor abilities affecting quality of life to stupor or coma with higher grades of hepatic dysfunction. In particular, the long-lasting compensatory mechanisms for the altered metabolism in chronic liver disease make HE imaging results variable. Therefore, the clinical relevance of imaging findings is uncertain and differentiating HE from other metabolic diseases can be difficult. The recent introduction of concepts such as "acute-on-chronic liver failure (ACLF)," a new clinical entity, has led to a change in the clinical view of HE. Accordingly, there is a need to establish a corresponding concept in the field of neuroimaging diagnosis. Herein, we review HE from a historical and etiological perspective to increase understanding of brain imaging and help establish an imaging approach for advanced new concepts such as ACLF. The purpose of this manuscript is to provide an understanding of HE by reviewing neuroimaging findings based on pathological and clinical concepts of HE, thereby assisting in neuroimaging interpretation.

• 동의생리병리학회지
• /
• 제38권1호
• /
• pp.1-9
• /
• 2024

Cognitive reserve (CR) is a concept that can explain the discrepancies between the pathologic burden of the disease and clinical manifestations. It refers to the individual susceptibility to age-related brain changes and pathologies related to Alzheimer's disease, thus recognized as a factor affecting the trajectories of the disease. The purpose of this study was to explore the current states of clinical studies on neural substrates of CR in Alzheimer's disease using functional magnetic resonance imaging. We searched for clinical studies on CR using fMRI in the Pubmed, Cochrane library, RISS, KISS and ScienceON on August 14, 2023. Once the online search was finished, studies were selected manually by the inclusion criteria. Finally, we analyzed the characteristics of selected articles and reviewed the neural substrates of CR. Total thirty-four studies were included in this study. As surrogate markers of CR, not only education and occupational complexity, but also composite score and questionnaire-based method, which cover various areas of life, were mainly used. The most utilized methods in resting-state fMRI were independent component analysis, seed-based analysis, and graph theory analysis. Through the analysis, we demonstrated that neuroimaging techniques could capture the neural substrates associated with cognitive reserve. Moreover, functional connectivity of brain regions centered on prefrontal and parietal cortex and network areas such as default mode network showed a significant correlation with CR, which indicated a significant association with cognitive performance. CR may induce differential effects according to the disease status. We hope that this perspective on cognitive reserve would be helpful when conducting clinical researches on the mechanisms of traditional Korean medicine for Alzheimer's disease in the future.

• Nutrition Research and Practice
• /
• 제16권sup1호
• /
• pp.11-20
• /
• 2022

Research articles were reviewed to validate the estimated energy requirements (EERs) equations developed by the Institute of Medicine of the National Academies (IOM). These equations are based on total energy expenditure (TEE) measured by the doubly labeled water (DLW) method. We subsequently aimed to provide the basis for the suitability to apply the IOM equations as EER equations for Koreans, and develop relevant equations for EER in the Dietary Reference Intake for Koreans (KDRI). Additionally, besides the EER(IOM) equations, other equations were examined for EER estimation. Research papers demonstrating the validation of the EER(IOM) equations based on TEE(DLW) were searched through PubMed (up to September 2019). Of the 637 potentially relevant articles identified, duplicates and unsuitable titles and abstracts were excluded. Furthermore, papers with irrelevant subject and inappropriate study design were also excluded. Finally, 11 papers were included in the review. Among the reviewed papers, 8 papers validated the application of the EER(IOM) equations for EER based on TEE(DLW). These included 3 studies for children (USA 1, Korea 2), 1 for adolescents (Portugal), 2 for adults (Korean), and 2 for the elderly (Korea, USA). EER(IOM) equations were found to be generally acceptable for determining EER by using the DLW method, except for Korean boys at 9-11 yrs (overestimated) and female athletes at 19-24 yrs (underestimated). Additionally, 5 papers include the validation of other EER equations, beside EER(IOM) for EER based on TEE(DLW). In Japanese dietary reference intake and recommended dietary allowance, EER equations are acceptable for determining EER based on TEE(DLW). The EER(IOM) equations is generally acceptable for determining EER using the DLW method in Koreans as well as several populations, although certain defined groups were found to be unfit for the estimation. Additionally, the concept of healthy body mass index of Koreans and physical activity levels need to be considered, thereby providing the basis for developing relevant equations of EER in KDRI.

• 한국간호교육학회지
• /
• 제16권2호
• /
• pp.194-201
• /
• 2010

Purpose: Recently teaching nursing to undergraduate students has been based on the constructive teaching method to achieve the core nursing competency. Therefore, non-traditional teaching methods should be introduced for a stimulated interaction between the lecturer and students and to increase information retention and interest in nursing. The purpose of this paper was to review current issues related to the use of cinema in nursing education. Method: A literature review was conducted to grasp the definition of cinemeducation and to identify the uses, merits, and demerits of using cinema in nursing education. Conclusion: Cinemeducation is an innovative approach to teaching multi-cultural diversity in medicine and nursing. It is possible to conduct cinemeducation to deepen student's understanding of cross-cultural issues and to evoke imagination, empathy, and narrative. Movies are funny, entertaining, and readily enjoyed by learners. Since individuals portrayed in movies are not real, learners can be more honest and objective about their reactions to these characters. In addition, movies as instructional media are economical. I would like to suggest more curriculum development for the use of movies.

• Korean Journal of Radiology
• /
• 제23권5호
• /
• pp.517-528
• /
• 2022

Due to its excellent diagnostic performance, CT is the mainstay of diagnostic test in adults with suspected acute appendicitis in many countries. Although debatable, extensive epidemiological studies have suggested that CT radiation is carcinogenic, at least in children and adolescents. Setting aside the debate over the carcinogenic risk of CT radiation, the value of judicious use of CT radiation cannot be overstated for the diagnosis of appendicitis, considering that appendicitis is a very common disease, and that the vast majority of patients with suspected acute appendicitis are adolescents and young adults with average life expectancies. Given the accumulated evidence justifying the use of low-dose CT (LDCT) of only 2 mSv, there is no reasonable basis to insist on using radiation dose of multi-purpose abdominal CT for the diagnosis of appendicitis, particularly in adolescents and young adults. Published data strongly suggest that LDCT is comparable to conventional dose CT in terms of clinical outcomes and diagnostic performance. In this narrative review, we will discuss such evidence for reducing CT radiation in adolescents and young adults with suspected appendicitis.

• 의학교육논단
• /
• 제13권1호
• /
• pp.25-34
• /
• 2011

Modern medicine has early experienced the absence of mimesis and has been trying to replace the absence with objective grounds and experimental data. However, as medicine became science, the crisis of medicine spread more widely. Microscopic powers and violences are invisible, but individuals are powerless and vainly unable to resist. The anguish or introspection about the situation is sometimes described in stories such as An Engagement by Lee Eung Jun. An Engagement is mentioned in this article due to the writer's attitude, which shows his introspection and desire for harmony through the wounds of each trivial character. The writer is unceasingly talking about suffering people in his story and his seriousness enables readers to find his stronger sympathy over life and death than in any other medical stories. In fact, it is impossible for readers to comprehend the confusing propositions which the writer pours out, and even uncomfortable to read the story. Nevertheless, the propositions are always in contact with reality. Perhaps it is not the writer's confusing propositions that make us uncomfortable. It might be ourselves who are always alienated and starved. We can say that the characters' pains and wounds are phantom pains caused by the absence of mimesis. Since there is no affected area, their pains cannot be measured by only scientific medicine. However, the current medical profession regards objective research evidences as absolute truth and allows them to be the sole criterion. Although scientific skills such as DNA analysis and MRI scan can be the substitutes for doctors' judgment, so much of medicine is still interpersonal relationships. An Engagement. As a person promises to marry another, as all beings together in the world promise to subordinate to one another, every subject is consistently a valuable part of each other for the writer's eyes. He is aware that it is originally impossible to get engaged to the world, but he does not give up the possibility of genuine communication. In today's post-modernism society, where a large number of pathological views define the members and the world itself, endless questioning of existence and digging into pathology will be the only way to reduce the gap between individuals and their world. This article does not say that a literary work will lead the change of medical paradigm. It sprang from a desire for medical humanities to gain more interest of the medical field, where the encounter between literature and medicine is still unfamiliar, and to make medical education recognize the importance of humanities. Starting with this work, I believe that the humanities will help us to find the solution to the age of absence of mimesis and to the crisis of medicine.

• 한국융합학회논문지
• /
• 제10권12호
• /
• pp.191-197
• /
• 2019

본 연구는 남자 치과위생사의 학업 및 직무관련 스트레스 요인을 파악하고 향후 남자 치과위생사 학업 및 직무스트레스와 이직률을 낮추는데 필요한 기초자료로 제공 하고자 하였다. 연구방법은 치과병원 및 치과의원에 근무하는 경력 1년 이상 5년 이하인 남자 치과위생사 5명을 대상으로 일대일 인터뷰를 실시하였으며 인터뷰는 1시간 정도 소요되었다. 연구결과 학업에서 주된 스트레스의 요인으로는 대인관계 및 많은 과제량으로 응답하였으며, 직무에서 주된 스트레스의 요인으로는 여성직원 및 상사와의 소통 문제, 미래에 대한 불안감으로 응답하였다. 스트레스 해소는 친구와의 만남, 휴식, 취미생활로 해소하고 있었다. 본 연구결과를 통하여 볼 때, 남자치과위생사의 학업생활에서 대인관계 개선, 취업 정보에 대한 정보제공, 남자치과위생사로서 직업에 대한 확신과 미래지향적인 목표를 찾을 수 있는 방안을 제시할 필요성이 있을 것으로 사료된다.

• 의학교육논단
• /
• 제21권1호
• /
• pp.1-12
• /
• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• Journal of Acupuncture Research
• /
• 제27권4호
• /
• pp.147-178
• /
• 2010

Objectives : This study was to propose the improved instruction for authors and research ethic regulations by the comparative analysis of those of the domestic journals, for the purpose of enhancing the citation rate of Journal of Korean Acupuncture and Moxibustion Society. Methods : Narrative review method was used for comparatively analyzing instruction for authors of 34 domestic journals, especially focused on how to write a reference. Thereafter, in order to elucidate the drawbacks of current instruction for authors and research ethic regulations of the acupuncture and moxibustion society, the well prepared instructions and research ethic regulations was selected from them, which were compared with the present instructions for authors and research ethic regulations of the acupuncture and moxibustion society. Results : As a result of the comparative analysis of instruction for authors in the 34 domestic journals, style for references was based largely on that of National Library of Medicine and vancouver at the same time. The number of reference was limited according to types of writings. for example, the original article and case report was frequently limited to 40 and 20 references respectively. Authors were mostly listed up to six. If there are more, the first three or six authors were listed with 'et al'. it was generally recommended that using abstracts as references should be avoided and References to papers accepted but not yet published should be designated as 'in press' or 'forthcoming', and that the names of journals should be set in italics and abbreviated according to the List of Journals Indexed for Medline (formerly Index Medicus) published by the National Library of Medicine or koreanmed or WHO-IST, etc. In addition, citation of electrical literature, English writing of reference and obligational citation of more than two articles in the journals were encouraged. In consequence of comparison between well prepared instructions and research ethic regulations of the selected journals and those of current instructions for authors and research ethic regulations of the acupuncture and moxibustion society, the followings were needed to be added or revised. 1. Requirements for case reports were not mentioned. 2. Reporting Guidelines for Specific Study Designs were not included. 3. Previous Orthography of herbal prescription should be revised. 4. Orthography of authors and guidelines for writing article constituents such as title, abstract, introduction, method, statistics, results, discussions were not presented. 5. How to write a reference was so simplified. 6. Definition of Research Ethical Misconduct was omitted and establishment, management and members of committee for research ehtics were not mentioned, 7. Information, reception and investigative procedures of Research Ethical Misconduct was not specified. Conclusions : For the development of Journal of Korean Acupuncture and Moxibustion Society, apporopriate revision of the instruction for author and research ethic regulations should be made based upon the above findings. English writing of reference were believed to be one of the alternatives enhancing citation rate.