• The Journal of Pediatrics of Korean Medicine
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• v.32 no.3
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• pp.131-140
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• 2018

Objectives The purpose of this study is to assess the quality of case reports from the Journal of Pediatrics of Korean Medicine. Methods Case reports were selected from the Journal of Pediatrics of Korean Medicine from January 2015 to April 2018, by utilizing Oriental Medicine Advanced Searching Integrated System (OASIS). The quality of the reports were reviewed based on the Consensus-based Clinical Case Reporting Guideline Development (CARE) guideline. Results Total of 13 case reports were finally selected for the assessment. 73.08% of the case reports included necessary information based on the CARE guideline but the rest of the reports did not. More than 50% of the reports were missing data regarding 'Timeline', 'Diagnostic challenges', 'Intervention adherence and tolerability', 'Adverse and unanticipated events', or 'Patient perspective or experience'. Also, the reports did not include 'Key word', 'Introduction in abstract', 'Case presentation in abstract', or 'The rationale for conclusions' information. Conclusions Case reports from the Journal of Pediatrics of Korean Medicine have important role in pediatrics. Efforts are needed to improve the quality of the case reports as well as to develop reporting guidelines for the Journal of Pediatrics of Korean Medicine.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.182-186
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• 2010

Purpose: Intramuscular stimulation (IMS) shows good results in the treatment of chronic pain patients who did not respond to other treatments such as oral analgesics, trigger point injection, nerve block and epidural steroid injection. But, IMS procedure especially, patients with diabetes mellitus (DM) has sometimes serious problem. So, we present a very rare case of intramuscular abscess in the sternocleiomastoid muscle after IMS with literature review. Methods: A 66 year old male visited our department 7 days after IMS in the neck. His premorbid conditions and risk factors of deep neck infection was DM and old age. Computed tomographic scans of the head and neck region were performed in this patient: signs of deep neck infection, were seen enhanced abscess in the sternocleidomastoid muscle, cellulitis overlying tissue of the neck, and air bubbles involved muscle. Necrotic wound was excised serially and we treated this with the Vacuum-assisted closure (VAC, Kinetics Concepts International, San Antonio, Texas) system device. After appropriately shaping the sponge in the pockets, continuous negative pressure of 125 mmHg was applied. The VAC therapy was utilized for a period of 12 days. Results: We obtained satisfactory results from wide excision, drainage of the abscess with the VAC system, and then primary closure. The postoperative course was uneventful. Results: We suggest that many of the infectious complications may be preventable by strict adherence to aseptic techniques and that some of the other complications may be minimized by refining the techniques with a clear understanding of the medical disorders of patients. And, the refined technique using the VAC system can provide a means of simple and effective management for the cervical intramuscular abscess, with better cosmetic and functional results.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.216-223
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• 2018

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2949-2954
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• 2013

Background: This study was conducted to determine the relationship between lifestyle behavior and quality of life (QoL) among cancer survivors in Korea. Materials and Methods: Data for a total of 471 (173 men, 298 women) cancer survivors (CS) over 40 years old were obtained from the database of the $4^{th}$ Korean National Health and Nutrition Examination Survey (KNHANES IV). An identical number of subjects of the same age, sex, and education who had no restrictions in physical activity were randomly selected from the database and represented the control group (CG). Drinking, smoking, and exercise behavior were assessed. Results: The number of heavy drinkers was lower in CS (9.4%) than in CG (15.8%) (p<0.01); similarly, there were fewer smokers in CS (9.1%) than in CG (14.0%) (p<0.05). The percentage of individuals engaging in vigorous, moderate, and low-intensity exercise did not differ between CS (13.6%, 14.7%, and 50.0%) and CG (14.3%, 13.4%, and 49.7%, respectively). No differences in Euro QoL Questionnaire 5-Dimensional Classification (EQ-5D) scores on both drinking and smoking behaviors were noted. Compared to the non-exercisers, the low-intensity exercisers in CG ($0.91{\pm}0.10$ vs. $0.94{\pm}0.09$), vigorous-intensity exercisers in CS ($0.84{\pm}0.62$ vs. $0.91{\pm}0.11$), and low-intensity exercisers in CS ($0.82{\pm}0.22$ vs. $0.88{\pm}0.13$) scored higher on the EQ-5D. Conclusions: Although cancer survivors practiced more conscious health behavior in drinking and smoking, their engagement in exercise did not differ from that of non-cancer survivors. Since exercise engagement increases QoL in general, implementation of an educational program that promotes exercise engagement in cancer survivors may be required.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.121-126
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• 2004

The primary goal of six sigma is to improve patient satisfaction, and thereby profitability, by reducing and eliminating defects. Defects may be related to any aspect of customer satisfaction: high product quality, schedule adherence, cost minimization, process capability indices, defects per unit, and yield. Many six sigma metrics can be mathematically related to the others. Literally, six means six standard deviations from the mean or median value. As applied to quality metrics, the term indicates that failures are at least six standard deviations from the mean or norm. This would mean about 3.4 failures per million opportunities for failure. The objective of six sigma quality is to reduce process output variation so that on a long term basis, which is the customer's aggregate experience with our process over time, this will result in no more than 3.4 defect Parts Per Million(PPM) opportunities (or 3.4 Defects Per Million Opportunities. For a process with only one specification limit (upper or lower), this results in six process standard deviations between the mean of the process and the customer's specification limit (hence, 6 Sigma). The results of applicative six sigma experiment studied on 18 items TP, ALB, T.B, ALP, AST, ALT, CL, CK, LD, K, Na, CRE, BUN, T.C, GLU, AML, CA tests in clinical chemistry were follows. Assessment of process performance fits within six sigma tolerance limits were TP, ALB, T.B, ALP, AST, ALT, CL, CK, LD, K, Na, CRE, BUN, T.C, GLU, AML, CA with 72.2%, items that fit within five sigma limits were total bilirubin, chloride and sodium were 3 sigma. We were sure that the goal of six sigma would reduce test variation in the process.

• Imaging Science in Dentistry
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• v.43 no.4
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• pp.253-259
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• 2013

Purpose: Radiographs is an integral part of patient management in dentistry, despite their detrimental effects. As the literature pertaining to radiation protection among Indian dental practitioners is sparse, exploring such protection is needed. Materials and Methods: All private dental practitioners in Mangalore, India were included in the study. A structured, pre-tested, self-administered questionnaire was employed to assess the knowledge, attitudes, practices, previous training, perceptions towards the need to spread awareness, and willingness to gain and implement knowledge about radiation hazards and protection. Information regarding each respondent's age, gender, education, and type and duration of practice was collected. Results: Overall, 87 out of 120 practitioners participated in the study. The mean knowledge, attitude, and practice scores were $9.54{\pm}2.54$, $59.39{\pm}7.01$, and $5.80{\pm}3.19$, respectively. Overall, 25.3% of the respondents had undergone training in radiation protection, 98.9% perceived a need to spread awareness, and 94.3% were willing to improve their knowledge. Previous training showed a significant correlation with age, sex, and duration of practice; attitude was significantly correlated with education and type of practice; and knowledge scores showed a significant correlation with type of practice. Conclusion: Although the knowledge and practices of respondents were poor, they had a positive attitude and were willing to improve their knowledge. Age, sex, and duration of practice were associated with previous training; education and type of practice with attitude scores; and type of practice with knowledge scores. The findings of this study suggest a policy is needed to ensure the adherence of dental practitioners to radiation protection guidelines.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.353-363
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• 2011

The World Health Organization (WHO) declared the outbreak of H1N1 pandemic in 2009. South Korea also had outbreaks of H1N1 virus and used oseltamivir in large volume with increased reports of adverse drug reaction(ADR). The present study was aimed to investigate the ADR frequency, the factors related to ADR, and characteristics of oseltamivir's ADR. Participants for the study were patients randomly drawn from those who were prescribed oseltamivir for treatment from CHA Bundang Medical Center during October 1 and October 30. The information examined as factors related to ADR were collected by a subsequent cross-sectional telephone survey. The factors are the following; a) age; b) gender; c) patient medical history; d) diagnosis of H1N1 virus; e) adherence; f) whether taking other medication with oseltamivir or not; and g) the number of combined medications. We also asked ADR after taking oseltamivir. Total subjects were 86 patients. The average age is $22.6{\pm}18.48$ years old. The gender was 45.3% women and 54.7% men. Half (50%) of all respondents showed one or more ADR, 67.4% were positively diagnosed for H1N1 virus, and 54.7% were completed the full course of oseltamivir (i.e. twice daily x 5days). The most frequently reported ADR symptoms were: dizziness (15.1%), nausea (11.6%), lethargy (10.4%), diarrhea (10.4%), abdominal pain (8.1%), headache and vomiting (6.9%). ADR classifications by categories are gastro intestinal (44.2%), neuropsychiatric events (22.1%), systemic symptom (20.9%), skin events (5.8%), eye events (4.7%), and other cases (2.3%). The onset of ADR 'after taking 1~3 doses' was 69.7%. No increase in neuropsychiatric events was detected in children and adolescents. No factors examined for the study do have significant influence on the presence of ADR. This study showed that ADR of oseltamivir have occurred in half of the patients. The use of oseltamivir is essential for treatment and prophylaxis of influenza A(H1N1). But mass treatment should be properly monitored for ADR.

• Korean Journal of Clinical Pharmacy
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• v.21 no.4
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• pp.332-338
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• 2011

This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.

• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.255-264
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• 2014

Objective: The aims of this study are to investigate the total volume of prescribed medicines against Alzheimer's disease (AD) and the trends of usage by analyzing the claims-data from the Korea National Health Insurance Service. Method: The demographic and claims-data were included the major AD treating medicines such as donepezil, galantamine, rivastigmine and memantine, and analyzed during the period of 2010~2012. The assessing criteria were gender, age, habitation, types of medical institution, code of ingredients, outcomes of treatment, volume and amount of claims, and the numbers of patients with dementias. After trimming the data, it were analyzed by the market size, demographic traits, characteristics of medical service, characteristics of each anti-AD medicine, etc. Results: Among the chosen 4 medicines, donepezil had the top prescription volumes. Most prevalent prescribing preparations of donepezil were conventional types. However, among the non-conventional types, oro-dispersible formulation is the fast increasing one in both volume and growth rate. This specialized preparations to improve both toleration and adherence, tend to being prescribed generally at the tertiary medical institutions. While the younger patients with mild-to-moderate AD mostly treated by expensive medicines in resident at the tertiary hospitals, the rest older patients with severe AD have been treated non-expensive one at long-term care facilities. Conclusion: AD is a chronic illness therefore, long-term use of therapeutic medications are highly important. If an anti-AD treatment was applied steadily in the earlier stages, it would be achieved not only improving the quality of life of patient but also reducing the expenses in the medical and nursing cares. As the socioeconomical impacts of AD is expanding, healthcare professionals need to aware the importance of pharmacotherapy and to improve sociopolitical fundamentals.

• Journal of Chest Surgery
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• v.51 no.6
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• pp.390-394
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• 2018

Background: The nonsurgical treatment of chest wall deformity by a vacuum bell or external brace is gradual, with correction taking place over months. Monitoring the progress of nonsurgical treatment of chest wall deformity has relied on the ancient methods of measuring the depth of the excavatum and the protrusion of the carinatum. Patients, who are often adolescent, may become discouraged and abandon treatment. Methods: Optical scanning was utilized before and after the intervention to assess the effectiveness of treatment. The device measured the change in chest shape at each visit. In this pilot study, patients were included if they were willing to undergo scanning before and after treatment. Both surgical and nonsurgical treatment results were assessed. Results: Scanning was successful in 7 patients. Optical scanning allowed a visually clear, precise assessment of treatment, whether by operation, vacuum bell (for pectus excavatum), or external compression brace (for pectus carinatum). Millimeter-scale differences were identified and presented graphically to patients and families. Conclusion: Optical scanning with the digital subtraction of images obtained months apart allows a comparison of chest shape before and after treatment. For nonsurgical, gradual methods, this allows the patient to more easily appreciate progress. We speculate that this will increase adherence to these methods in adolescent patients.