• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.957-965
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• 2021

Objective : Rapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex. Methods : A total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC. Results : After DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged. Conclusion : In this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.4
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• pp.51-69
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• 2023

Objectives : The purpose of this study is to assess the effect of using Boyanghwano-tang(BYHWT) for diabetic retinopathy. Methods : We searched randomized controlled trials(RCTs) that used BYHWT for diabetic retinopathy in 10 databases(RISS, KISS, ScienceON, KCI, OASIS, DBpia, CNKI, Wanfang Database, PubMed, Cochrane Library) on August 12, 2023. Outcome measurements included total effective rate(TER) and visual acuity as the primary outcome measurements, and the secondary outcome measurements included fasting blood glucose(FBG), 2hPG, HbA1c, ET-1, NO, etc. The indicator of stability included adverse reactions. A meta-analysis was conducted according to TER, visual acuity, FBG. Results : A total of 8 randomized control trials were selected. The treatment group which used BYHWT showed significant improvement effects in TER and visual acuity compared to the control group which used western medicine or chinese patent medicine alone. TER: (RR: 1.22, CI 1.14 to 1.31, P=<0.00001), visual acuity: (RR: 2.06, CI 1.40 to 3.03, P=0.0002). Secondary outcome measurements including FBG also showed improvement in the treatment group compared to the control group. FBG: (MD: -0.15, CI -0.43 to 0.31, P=0.28). Adverse reactions were only mentioned in one study, which showed that no adverse reactions occurred in both the treatment and control groups. Conclusions : This study suggests that BYHWT is effective for diabetic retinopathy. However these findings should be interpreted cautiously due to the insufficient number of studies and unknown or high risk of bias in the included trials.

• Journal of agricultural medicine and community health
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• v.7 no.1
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• pp.74-79
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• 1982

Recently in Korea, integration of F.P. & MCH programs for effective and efficient implementation of the health programs has been discussed actively. In fact, categorical health workers in fields have been trained and changed as an integrated health workers by government. But one of the most important problems that had to be solved for successful integration of F.P. and MCH programs, is that there must be a common indicator for the evaluation of the two health services (integrated indicator). We regarded reproductive efficiency (=R.E.) that had been proposed by Charlotter M$\ddot{u}$ller et al, as the good integrated indicator. The object of this brief article is to introduce the meaning of reproductive efficiency and to illustrate the usefulnesses of R.E. as the integrated health indicator by applying this indicator to the data from preliminary survey of Seosan demonstration project for integration of F.P. & MCH service supported by WHO. The results and conclusions are as follows 1) Definition of R.E. is the percentage of pregnancies that succeed in production normal, surving children after taking into account the frequency of all measurable types of adverse outcomes (End point for evaluation of survival is one year of age). 2) On the basis of the past pregnant history, reproductive efficiency of the 2,484 eligible women (15-44 years) was roughly 75% (But, in the concept of good births, it is not regarded whether the survived infant is normal health or not). 3) Compared with the results of the other two surveys of the rural area in Korea, reproductive efficiency has been slightly decreased than before, in spite of family planning and MCH services for past 20 years. Because the quantity of increased abortion rate overwhelmed that of the decreased infant mortality rate. 4) Reproductive efficiency has the object for measure many events during the period from the conception (Wanted pregnancy) to an normal surviving children as an 1 year of age. So these heterogenous adversities, ie, induced abortion, still births, spontaneous abortion, neonate & infant death, are aggregated as R.E. However, if the information of these important events and reproductive efficiency were given, R.E. is used as the comprehensive evaluation indicator for F.P. and M.C.H. after meticulous analysis the various components of R.E. 5) Economic loss for adverse outcomes of preg were pregnancy were calculated applying the medical cost at the relatively small sized hospital of small city. Economic loss for 100 cases of adverse outcome is 10,420,000 won, and economic loss for infant death is 46.1% of the total loss. So, it is rational to invest much more effort and than before to MCH programs.

• Journal of Convergence for Information Technology
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• v.10 no.3
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• pp.48-57
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• 2020

This study focuses on the development of simple qualitative indicators for evaluating and selecting innovation leading companies that challenge National Award. Another purpose of this study is to complement the aspect in which the innovative or value of the companies' products, technologies, and services is only quantitatively evaluated. Existing evaluation indicators of national award have too many evaluation items and were not suitable for innovation-based company evaluation. The research approach is to select category for developing qualitative indicators based on previous studies and TF discussion. From the input-process-output-outcome point of view, we have set up an indicator system as a series of flows. Finally, five categories such as creativity, system excellence, customer value, performance, and ripple effects are selected as qualitative indicator. For these selected indicators, conceptual definitions and the main points of evaluation are described. And the system level evaluation and the ADLI approach are presented for reference. The appendix also includes examples of qualitative and quantitative evaluation of real companies using these indicators. However, this study implies the possibility that the evaluation results may vary depending on the level and perspective of the evaluator. We hoped that detailed research on candidate indicators that can be used as qualitative indicators and research on the development of mixed indicators(qualitative and quantitative) will continue in the future.

• Health Policy and Management
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• v.26 no.4
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• pp.315-324
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• 2016

Underserved area is a region that has a lack of healthcare resources. In the context of Korea, however, there are not enough detailed criteria for underserved areas. In this study, we aimed to develop indicators for underserved area through Delphi technique. We systematically reviewed the existing measure of underserved area. Sixty indicators were extracted as candidates across four domains in secondary medical care. Four domains are demand, medical resource, quality of care, and health outcome. To develop indicator, two round Delphi survey was conducted among 15 professional experts such as professionals and public administrators. In conclusion, 2 final indicators (accessibility, medical utilization) was determined as an appropriate measure in order to designate underserved area for secondary medical services. Using our criteria from Delphi technique, 36 areas were found as underserved areas for the secondary medical care.

• The Korean Journal of Health Service Management
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• v.8 no.4
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• pp.47-55
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• 2014

The purpose of this study was to analyze the differences in the outcome for CABG according to whether hospitals provided heart related surgeries. The 2011 National Inpatient Sample (NIS) and inpatient quality indicator principles from the Healthcare Research and Quality (AHRQ) were used for analysis. Hospitals were divided into three groups according to the surgeries they provided. The length of stay and in-hospital deaths were adjusted for the differences in risks. ANOVA was performed to examine the differences for the risk-adjusted in-hospital mortality rate and risk-adjusted length of stay among the three groups. The analysis results showed that hospitals providing CABG, PTCA, and PHS had lower risk-adjusted in-hospital mortality rates or similar risk-adjusted lengths of stay compared to those of hospitals providing only CABG. However, the three groups did not have statistically significant differences in outcome indicators. Another study will be needed with a larger sample.

• Journal of Yeungnam Medical Science
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• v.36 no.2
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• pp.124-135
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• 2019

Background: We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT). Methods: Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated. Results: The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS and CSS, irrespective of subgrouping according to downstage (non-downstage, p<0.001 and p<0.001; downstage, p=0.002 and p=0.002) or lymph node metastasis (non-metastasis, p<0.001 and p=0.001; metastasis, p<0.001 and p<0.001). Conclusion: CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.

• Health Policy and Management
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• v.13 no.4
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• pp.1-27
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• 2003

The purpose of this study was to develop the evaluation indicator for the health promotion programs of the Community Health Centers and to test its validity. The modified logic model was used as the evaluation model based on the literature reviews. Using this model, four dimensions, eleven sub­dimensions, and forty­one individual indicators were developed. These evaluation indicators are superior in reflecting the distinctiveness of the community health promotion programs, and also flexible enough to accommodate diverse programs. These indicators also emphasize the role of process evaluation, and the diversity of outcomes. To test content validity, survey method of experts in the community health promotion field was conducted. Eleven in three expert groups(professionals, practitioners in Community Health Centers, and policy makers) generally agreed with the validity of evaluation indicators. To examine criteria and construct validity, these indicators were used to evaluate the health promotion programs conducted by the 18 Key Community Health Centers. The data came from the interview surveys of the main health promotion practitioner and 30 visitors from each center. The ranks of these eighteen Community Health Centers were computed from these data. There was no significant difference in ranking either by these indicators or by the existing indicators, which was developed by Technical Support and Evaluation Team for criteria validity. There was no statistically significant difference in ranking between input, process and outcome dimensions. Based on these study results, evaluation indicators developed in this study are valid to evaluate Community Health Center's health promotion program. It can be used both by the Community Health Center for internal evaluation, and by the stakeholders for external evaluation.

• Journal of Korean Neurosurgical Society
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• v.50 no.4
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• pp.370-376
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• 2011

Objective : Posttraumatic cerebral infarction (PTCI), an infarction in well-defined arterial distributions after head trauma, is a known complication in patients with severe head trauma. The primary aims of this study were to evaluate the clinical and radiographic characteristics of PTCI, and to assess the effect on outcome of decompressive hemicraniectomy (DHC) in patients with PTCI. Methods : We present a retrospective analysis of 20 patients with PTCI who were treated between January 2003 and August 2005. Twelve patients among them showed malignant PTCI, which is defined as PTCI including the territory of Middle Cerebral Artery (MCA). Medical records and radiologic imaging studies of patients were reviewed. Results : Infarction of posterior cerebral artery distribution was the most common site of PTCI. Fourteen patients underwent DHC an average of 16 hours after trauma. The overall mortality rate was 75%. Glasgow outcome scale (GOS) of survivors showed that one patient was remained in a persistent vegetative state, two patients were severely disabled and only two patients were moderately disabled at the time of discharge. Despite aggressive treatments, all patients with malignant PTCI had died. Malignant PTCI was the indicator of poor clinical outcome. Furthermore, Glasgow coma scale (GCS) at the admission was the most valuable prognostic factor. Significant correlation was observed between a GCS less than 5 on admission and high mortality (p<0.05). Conclusion : In patients who developed non-malignant PTCI and GCS higher than 5 after head injury, early DHC and duroplasty should be considered, before occurrence of irreversible ischemic brain damage. High mortality rate was observed in patients with malignant PTCI or PTCI with a GCS of 3-5 at the admission. A large prospective randomized controlled study will be required to justify for aggressive treatments including DHC and medical treatment in these patients.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4661-4664
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• 2016

Background: Artificial light at night (ALAN) has been linked to increased risk of cancers in body sites like the breast and colorectum. However exposure of ALAN as an environmental risk factor and its relation to cancers in humans has never been studied in detail. Objective: To explore the association of ALAN with all forms of cancers in 158 countries. Materials and Methods: An ecological study encompassing global data was conducted from January to June 2015, with age-standardized rates (ASR) of cancers as the outcome measure. ALAN, in the protected areas, as the exposure variable, was measured with reference to the Protected Area Light Pollution Indicator (PALI) and the Protected Area Human Influence Indicator (PAHI). Pearson's correlations were calculated for PALI and PAHI with ASR of cancers for 158 countries, adjusted for country populations, electricity consumption, air pollution, and total area covered by forest. Stratified analysis was conducted according to the country income levels. Linear regression was applied to measure the variation in cancers explained by PALI and PAHI. Results: PALI and PAHI were positively associated with ASR of all forms of cancer, and also the four most common cancers (p < 0.05). These positive correlations remained statistically significant for PAHI with all forms of cancer, lung, breast, and colorectal cancer after adjusting for confounders. Positive associations of PALI and PAHI with cancers varied with income level of the individual countries. Variation in all forms of cancers, and the four most common cancers explained by PALI and PAHI, ranged from 3.3 - 35.5%. Conclusion: Artificial light at night is significantly correlated for all forms of cancer as well as lung, breast, colorectal, and prostate cancers individually. Immediate measures should be taken to limit artificial light at night in the main cities around the world and also inside houses.