• Journal of Genetic Medicine
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• v.15 no.2
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• pp.72-78
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• 2018

Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

• Tuberculosis and Respiratory Diseases
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• v.82 no.3
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• pp.234-241
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• 2019

Background: The utility of computed tomography (CT) in the differential diagnosis of patients with chronic obstructive pulmonary disease (COPD) exacerbation remains uncertain. However, due to the low cost associated with CT scan along with the impact of Koreas' health insurance system, there has been a rise in the number of CT scans in the patients with initial diagnosis of COPD exacerbations. Therefore, the utility of CT in the differential diagnosis was investigated to determine whether performing CT scans affect the clinical outcomes of the patients with an initial diagnosis of COPD exacerbation. Methods: This study involved 202 COPD patients hospitalized with an initial diagnosis of COPD exacerbation. We evaluated the change in diagnosis or treatment after performing a CT scan, and compared the clinical outcomes of patient groups with vs. without performing CT (non-CT group vs. CT group). Results: After performing CT, the diagnosis was changed for two (3.0%) while additional diagnoses were made for 27 of the 64 patients (42.1%). However, the treatment changed for only one (1.5%), and six patients (9.3%) received supplementary medication. There were no difference in the median length of hospital stay (8 [6-13] days vs. 8 [6-12] days, p=0.786) and intensive care unit care (14 [10.1%] vs. 11 [16.7%], p=0.236) between the CT and non-CT groups, respectively. These findings remained consistent even after the propensity score matching. Conclusion: Utility of CT in patients with acute COPD exacerbation might not be helpful; therefore, we do not recommend chest CT scan as a routine initial diagnostic tool.

• Journal of the Korean Society of Radiology
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• v.13 no.1
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• pp.9-14
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• 2019

This study aimed to investigate the performance of the S-detect method in breast ultrasonography and to determine how to reduce unnecessary biopsy by comparing the results of the S-detect method and biopsy. Thirty patients who had undergone breast ultrasonography between August and October 2018 and were scheduled to undergo biopsy because of the presence of breast nodules were retrospectively analyzed. The McNemar test was performed to determine whether detection of a malignant breast mass significantly differed between the S-detect method and biopsy. The following results were obtained from the analysis of the S-detect method: sensitivity, 90.9%; specificity, 84.21%; validity, 86.66%; positive predictive value, 76.92%; and negative predictive value, 94.11%. Analysis of the degree of agreement between the S-detect method and biopsy revealed a kappa value as high as 0.724 (p < 0.05), exhibiting good agreement between the two methods. The S-detect method in breast ultrasonography is diagnostically valuable in terms of distinguishing between malignant and benign breast masses, and if used properly before breast biopsy, unnecessary biopsy can be reduced.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.4
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• pp.210-227
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• 2021

Objectives : The purpose of this study is to report the Korean medicine treatment on whole-body nummular eczema. Methods : This case study was conducted with a 66-year-old female patient who has whole-body nummular eczema treated by Korean medicine. She was treated from 2021.3.30 to 2021.6.28. During the treatment, the two herbal medicines were changed depending on the patient's condition. We treated her with herbal medicine, herbal external preparations and acupuncture treatment. For the evaluation of the results, we used photo comparison, VAS, and DLQI. Results : After the treatment, the nummular eczema lesions of patient was remarkably improved. Also, the VAS grade of other symptoms such as pruritus, burning sense, oozing, crusting and erythema were decreased and DLQI score changed from 27 to 2. Conculsions : This study suggests that Korean medicine treatments are effective for patient with recurrent nummular eczema.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.66-81
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• 2021

The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2-6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.2
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• pp.99-107
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• 2020

Fibromyalgia is a disorder characterized by the core symptom of chronic widespread pain, along with fatigue, sleep disturbances, mood changes, and cognitive difficulties. The etiology of fibromyalgia involves a combination of biological factors, such as genetic vulnerability, alterations in pain processing and stress response system ; psychological factors, such as anxiety, depression, anger, and perceived stress ; environmental factors, such as infections, febrile diseases, and trauma. Central sensitization, which is amplified in the process of sensory stimulation, has been emphasized as a key etiological factor, as supported by enhanced wind-up, delayed aftersensation, decreased nociceptive flexion reflex threshold and functional imaging studies. Several guidelines recommend that a multimodal approach be used to treat fibromyalgia, including both pharmacological and non-pharmacological treatments, tailored to each individual, and that clinicians should provide an intellectual framework through sufficient education and emphasis on the importance of self-management. The prevalence of mood disorders, anxiety disorders, and other psychiatric problems is 7-9 times higher in patients with fibromyalgia than in the general population ; moreover, the association between fibromyalgia and certain psychopathologies or sleep problems has also been suggested. Since psychiatric problems, with shared vulnerabilities and risk factors, interact with fibromyalgia bidirectionally and also affect the disease course, an integrated management approach is needed to determine the risk of comorbidities.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.171-179
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• 2020

Purpose: In Korea, seasonal influenza is an important respiratory illness afflicting children every year. We aimed to investigate the childhood epidemiology in Jeju during the 2017-2018 and 2018-2019 seasons. Methods: Children aged <13 years, who were tested for influenza at the Jeju National University Hospital during the 2017-2018 and 2018-2019 influenza seasons, were included. Demographics and the influenza test results were retrospectively reviewed from their medical records. Results: This study included 5,219 cases of influenza-like illness (ILI) (2017-2018: n=2,279; 2018-2019: n=2,940). The mean age of the eligible children was 2.85±2.79 years, and the most common age among ILI patients in each season was 1 year group. There were 902 (17.3%, 902/5,219) confirmed influenza cases during the 2 seasons. The rate of influenza confirmed by rapid influenza diagnostic test or polymerase chain reaction among ILI patients in the 2017-2018 and 2018-2019 seasons was 10.4% (236/2,279) and 10.3% (303/2,940) for influenza A, and 9.1% (208/2,279) and 5.3% (155/2,940) for influenza B, respectively. The mean age of influenza-confirmed cases was 4.09 years and 5.05 years in the 2017-2018 and 2018-2019 seasons, respectively (P<0.05). Weekly distribution of influenza was similar to that of ILI in the clinical sentinel surveillance system in both seasons. Conclusion: The difference in the influenza epidemic trend and age-group distribution between the 2017-2018 and 2018-2019 seasons was distinct in Jeju. Steady epidemiological studies on influenza in Jeju are needed for comparison with other regions of Korea.

• Journal of Korea Entertainment Industry Association
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• v.15 no.4
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• pp.325-335
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• 2021

Chronic diseases have been increasing recently as the average life expectancy of humans has been extended, and this trend has caused problems such as the widespread demand for health and rehabilitation services and rising medical costs. In order to solve this problem, the community-based rehabilitation has been developed and strengthened in Korea and gradually promoted since 2019. It is important to secure access to clients who want to use services to revitalize community-based rehabilitation. So in this study, as part of the community-based rehabilitation, intends to devise smartphone applications designs and develop a prototype to secure access to community-based occupational therapy services based on occupation and activities. For Occupational Therapy Practice Framework (OTPF), International Classification of Functioning, Disability and Health (ICF), and Allen Diagnostic Module-2 (ADM-2) were used to devise and categorize occupation and activity based application content, and link OTPF, ICF, and ADM-2 through prior research analysis and expert meetings. The derived content was visualized through literature review and activity analysis, and was implemented to enable direct playback within the application using the YouTube API, and finally developed a prototype application. The Android Studio 3.5.2 for Windows 64-bit was used to build the application prototype. In further research, converging various digital technologies for user convenience and additionally researching community-based occupational therapy service providers opinions and service user satisfaction will improve accessibility to community-based occupational therapy services for clients who have difficulty occupational performance in the community.

• Journal of Acupuncture Research
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• v.38 no.3
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• pp.192-199
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• 2021

Background: In this retrospective study, we aimed to determine which diagnostic tests were associated with an improvement in Bell's palsy symptoms. Methods: There were 30 patients who visited Kyung Hee University Korean Medicine Hospital from April 1, 2017 to February 29, 2020, and who received East-West collaboration treatment for Bell's palsy. The tests included electroneurography (ENoG), electromyography (EMG), hematology, and heart rate variability (HRV) results which were used to determine if any test correlated with improvement of Bell's palsy symptoms. Results: The initial severity of symptoms did not correlate with the tests performed, with the exception of mean corpuscular hemoglobin concentration (p = 0.013). For both ENoG for oculi degeneration and mean EMG tests, the rate of nerve degeneration showed a significant negative correlation with the improvement of Bell's palsy symptoms. Amongst the HRV test indicators, the square root of the mean of the sum of the squares of differences between the adjacent normal R-R wave interval, the standard deviation of intervals, total power, very low frequency, and high frequency of the wave was negatively correlated with improvement of Bell's palsy symptoms. Similarly, glycosylated hemoglobin Type A1c (HbA1c) and erythrocyte sedimentation rate (ESR) showed a negative correlation with improvement of symptoms of Bell's palsy. With the exception of HbA1c and ESR, the remaining hematology test results showed no significant difference when comparing before and after treatment. Conclusion: ENoG, EMG, HRV test, HbA1c, and ESR negatively correlated with improvements in Bell's palsy symptoms and may determine the prognosis of Bell's palsy.

• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.2
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• pp.70-86
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• 2022

Objectives: This study attempted to provide prescriptions that can be used according to the classification of menopausal disorders in order to increase the clinical utilization of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification). Methods: Delphi method survey was conducted for expert consensus on the Pattern Identification that could be used for each prescription by selecting frequent prescriptions based on the literature researched on the prescription of Korean medicine used for women with menopausal disorders. 11 experts participated in the questionnaire for posterity and 7 experts for sasang constitution. The survey was divided into the main prescription that can be mainly used for the patterns and the minor prescription that can be used although the suitability is somewhat low. Expert consensus was obtained through the second survey, and the pattern classification of prescriptions that were not confirmed here was confirmed through a face-to-face meeting. Results: There were 56 prescriptions mainly used for treatment for menopause, 45 for posterity and 11 for Sasang constitution. There were 69 identifications of 45 posterity prescriptions and 17 classifications of 11 Sasang constitutional prescriptions including major and minor patterns. By pattern identifications, the number of major/minor prescriptions was as follows. 肝鬱 14/5, 腎陰虛 8/2, 腎陽虛 4/1, 肝腎陰虛 2/7, 腎陰陽兩虛 3/1, 心腎不交 6/3, 心脾兩虛 15/2, 心火 7/6. Conclusions: In the future, by accumulating and analyzing the data on the diagnosis and treatment using CaPSPI, the clinical status of Korean medicine for menopausal disorders can be reviewed, and it can be used as the basis for the clinical practice guidelines for menopausal disorders. In addition, it is thought that analyzing the results of the diagnosis of pattern identifications and the prescription of Sasang constitution can be helpful in research on the posterity and Sasang constitution.