• Title/Summary/Keyword: evidence base medicine

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Ganglion cardiacum or juxtaductal body of human fetuses

  • Kim, Ji Hyun;Cho, Kwang Ho;Jin, Zhe Wu;Murakami, Gen;Abe, Hiroshi;Chai, Ok Hee
    • Anatomy and Cell Biology
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    • v.51 no.4
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    • pp.266-273
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    • 2018
  • The ganglion cardiacum or juxtaductal body is situated along the left recurrent laryngeal nerve in the aortic window and is an extremely large component of the cardiac nerve plexus. This study was performed to describe the morphologies of the ganglion cardiacum or juxtaductal body in human fetuses and to compare characteristics with intracardiac ganglion. Ganglia were immunostained in specimens from five fetuses of gestational age 12-16 weeks and seven fetuses of gestational age 28-34 weeks. Many ganglion cells in the ganglia were positive for tyrosine hydroxylase (TH; sympathetic nerve marker) and chromogranin A, while a few neurons were positive for neuronal nitric oxide synthase (NOS; parasympathetic nerve marker) or calretinin. Another ganglion at the base of the ascending aorta carried almost the same neuronal populations, whereas a ganglion along the left common cardinal vein contained neurons positive for chromogranin A and NOS but no or few TH-positive neurons, suggesting a site-dependent difference in composite neurons. Mixtures of sympathetic and parasympathetic neurons within a single ganglion are consistent with the morphology of the cranial base and pelvic ganglia. Most of the intracardiac neurons are likely to have a non-adrenergic non-cholinergic phenotype, whereas fewer neurons have a dual cholinergic/noradrenergic phenotype. However, there was no evidence showing that chromogranin A- and/or calretinin-positive cardiac neurons corresponded to these specific phenotypes. The present study suggested that the ganglion cardiacum was composed of a mixture of sympathetic and parasympathetic neurons, which were characterized the site-dependent differences in and near the heart.

What Else Is Needed in the Korean Government's Master Plan for People With Developmental Disabilities?

  • Lee, Jin Yong;Yun, Jieun
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.3
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    • pp.200-204
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    • 2019
  • On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a 'welfare society in harmony.' However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals' unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

The Background and Current Research Applied to Development of Korean Cosmetics Based on Traditional Asian Medicine (한국 한방화장품 발달 배경 및 연구 현황)

  • Cho, Gayoung;Park, Hyomin;Choi, Sowoong;Kwon, Leekyung;Cho, Sunga;Suh, Byungfhy;Kim, Namil
    • The Journal of Korean Medical History
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    • v.30 no.2
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    • pp.63-71
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    • 2017
  • Traditional Asian medicine has an extensive evidence base built upon thousands of years of experience within Asia, of curing various diseases. Only recently, within the past two centuries, have modern medical scientists developed interest in traditional Asian medicine. Asian Medicine seems to be regarded only as an adjunctive medicine and viewed as alargely un-proven alternative medicine to complement western medicine, used in some cases to establish a new paradigm of "integrative medicine". This article reviews how Korean herbal cosmetics emerged by applying traditional Asian medicine to the science of cosmetics. The characteristics of Korean herbal cosmetics are examined through examples of history, concepts and traditions. With the advancements in biotechnology, studies are now being conducted on the dermatological effects and processing methods of herbal ingredients, including ginseng. The authors explain the current research on the identification on the active ingredients of herbs, extraction methods, and bio-processing of ingredients to improve the biological efficacies of herbs on the skin. A summary of studies focused on modern reinterpretations of ageing theories, such as 'Seven year aging cycle', are provided. In conclusion, the development of Korean cosmetics products are based on the accumulated knowledge of thousands of years of experience including; 1) practical heritage of traditional Asian medicines such as Donguibogam; 2) excellent medicinal plants, such as ginseng, which are native to Korea; and 3) innovative attempts to modernize materials, processes, and principles.

A Review of the Systemic Analysis Method on Dental Sedation for Children (소아 치과환자에 대한 진정법의 체계적 분석 방법 고찰)

  • An, Soyoun;Lee, Jewoo;Kim, Seungoh;Kim, Jongbin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.4
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    • pp.331-339
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    • 2015
  • The first priority of sedation for incorporative children in pediatric dentistry is a safety. Therefore, evidence-based practices in health care are needed for preventing medical accidents. In accordance with the rise of the evidence based medicine, the interest in Evidence-Based Dentistry is increasing in the field of dentistry. However, systematic research about Evidence-Based sedation in Korea has rarely been done. As such, the purpose of this systematic review is to critically analyze the available scientific literature regarding dental sedation and to seek the next developmental strategies about evidence based pediatric dental sedation. A broad search of the 5 databases of the systematic reviews manual of the National Evidence-based Healthcare Collaborating Agency in Korea were referenced: 1) Core search database- KMbase, KISS; 2) Academic information and portal; 3) the National Assembly Library; 4) DBpia, and 5) RISS. Of a total 470 themes limited to the search term of "dental sedation", in accordance with the PRISMA statement for reporting systematic reviews of health sciences interventions, a literature selection process, which includes the removal of overlapping down the flow chart, was performed. Of the remaining 31 articles, two authors read through articles independently and added or removed articles using the exclusion criteria. Finally, twenty published papers of acceptable quality were identified and reviewed. This systemic review of Korean pediatric dental sedation practices for the last twenty-five years was based on the objective criteria defined in the GRADE process and identified consistent evidence. The results were evidence of moderate quality. Therefore, more systemically well-designed clinical studies are needed about the safe use of a sedative medicines (drugs).

Variation of Practice in Prophylactic Protocol to Reduce Prosthetic Joint Infection in Primary Hip and Knee Arthroplasty: A National Survey in the United Kingdom

  • James Morris;Lee Hoggett;Sophie Rogers;John Ranson;Andrew Sloan
    • Hip & pelvis
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    • v.35 no.4
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    • pp.228-232
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    • 2023
  • Purpose: Prosthetic joint infection (PJI) has an enormous physiological and psychological burden on patients. Surgeons rightly wish to minimise this risk. It has been shown that a standardised, evidence-based approach to perioperative care leads to better patient outcomes. A review of current practice was conducted using a cross-sectional survey among surgeons at multiple centers nationwide. Materials and Methods: An 11-question electronic survey was circulated to hip and knee arthroplasty consultants nationally via the BOA (British Orthopaedic Association) e-newsletter. Results: The respondents included 56 consultants working across 19 different trusts. Thirty-four (60.7%) screen patients for asymptomatic bacteriuria (ASB) preoperatively, with 19 (55.9%) would treating with antibiotics. Fifty-six (100%) screen for methicillin-resistant Staphylococcus aureus and treat if positive. Only 15 (26.8%) screen for methicillin-sensitive S. aureus (MSSA) or empirically eradicate. Zero (0%) routinely catheterize patients perioperatively. Forty-one (73.2%) would give intramuscular or intravenous gentamicin for a perioperative catheterisation. All surgeons use laminar flow theatres. Twenty-six (46.4%) use only an impervious gown, 6 (10.7%) exhaust pipes, and 24 (42.3%) surgical helmet system. Five different antimicrobial prophylaxis regimens are used 9 (16.1%) cefuroxime, 2 (3.6%) flucloxacillin, 19 (33.9%) flucloxacillin and gentamicin, 10 (17.9%) teicoplanin, 16 (28.6%) teicoplanin and gentamicin. Twenty-two (39.3%) routinely give further doses. Conclusion: ASB screening, treatment and intramuscular gentamicin for perioperative catheterisation is routinely practiced despite no supporting evidence base. MSSA screening and treatment is underutilised. Multiple antibiotic regimens exist despite little variation in organisms in PJI. Practice varies between surgeons and centers, we should all be practicing evidence-based medicine.

A Study on Diagnosis Support using Knowledge of Diseases from Literature (문헌 내 병명 정보를 활용한 진단 지원 방안 연구)

  • Oh, Yong-Taek;Kim, An-Na;Kim, Sang-Kyun;Jang, Hyun-Chul
    • Journal of Haehwa Medicine
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    • v.23 no.1
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    • pp.13-20
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    • 2014
  • Objectives : Clinical data in traditional medicine, such as Korean medicine, traditional Chinese medicine have a long history of accumulating evidence and these rich data are recorded in classic literature. We have conducted a study of developing an algorithm that support clinical diagnosis with composing both users knowledge and data obtained from literature. In order to define necessary information and required steps in diagnosis procedure, we have established a clinical diagnostic procedure including a step of collecting patients symptoms, a step of determining candidates, a step of diagnostic decisions, a step of deciding of treatment and a step of adjusting medicinal treatment. Methods : Our study have been based on the following premises. 1. Using data obtained from literature contributes to accurate diagnosis 2. Displaying the data before users request contributes to accurate conclusion. Displaying before users request enable users to recognize their overlooking a fact on purpose or not. 3. Checking symptoms that are commonly accompanied with a group of diseases that accompany symptoms appealed by a patient contributes to accurate conclusion. These symptoms are worthy of checking. 4. Comparing more than two candidates contributes to accurate conclusion. Users can compare their accompanied symptoms with patients symptoms and this helps users to make a decision. Results : Based on the above premises, we have developed an literature based algorithm to provide various functions, such as recommending symptoms to check, comparing groups of symptoms, differential diagnosis, recommending medicinal materials to prescribe, and more. Conclusions : By the results of simulation with virtual diagnostic scenario, we concluded this algorithm is useful helping clinician in diagnosis procedure.

Recognition of Transmembrane Protein 39A as a Tumor-Specific Marker in Brain Tumor

  • Park, Jisoo;Lee, Hyunji;Tran, Quangdon;Mun, Kisun;Kim, Dohoon;Hong, Youngeun;Kwon, So Hee;Brazil, Derek;Park, Jongsun;Kim, Seon-Hwan
    • Toxicological Research
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    • v.33 no.1
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    • pp.63-69
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    • 2017
  • Transmembrane protein 39A (TMEM39A) belongs to the TMEM39 family. TMEM39A gene is a susceptibility locus for multiple sclerosis. In addition, TMEM39A seems to be implicated in systemic lupus erythematosus. However, any possible involvement of TMEM39A in cancer remains largely unknown. In the present report, we provide evidence that TMEM39A may play a role in brain tumors. Western blotting using an anti-TMEM39A antibody indicated that TMEM39A was overexpressed in glioblastoma cell lines, including U87-MG and U251-MG. Deep-sequencing transcriptomic profiling of U87-MG and U251-MG cells revealed that TMEM39A transcripts were upregulated in such cells compared with those of the cerebral cortex. Confocal microscopic analysis of U251-MG cells stained with anti-TMEM39A antibody showed that TMEM39A was located in dot-like structures lying close to the nucleus. TMEM39A probably located to mitochondria or to endosomes. Immunohistochemical analysis of glioma tissue specimens indicated that TMEM39A was markedly upregulated in such samples. Bioinformatic analysis of the Rembrandt knowledge base also supported upregulation of TMEM39A mRNA levels in glioma patients. Together, the results afford strong evidence that TMEM39A is upregulated in glioma cell lines and glioma tissue specimens. Therefore, TMEM39A may serve as a novel diagnostic marker of, and a therapeutic target for, gliomas and other cancers.

Gastrotomy Approach Retrieval of Esophageal Foreign Body using Long Forceps Technique in Five Dogs (위 절개술 접근과 긴 겸자를 이용한 식도 내 이물 제거 5례)

  • Yoon, Hun-Young;Kang, Myung-Gon;Jeong, Soon-Wuk
    • Journal of Veterinary Clinics
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    • v.26 no.6
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    • pp.628-631
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    • 2009
  • Five dogs presented to the Veterinary Medical Teaching Hospital of the Konkuk University and Hangang Animal Hospital with a history of foreign body ingestion. On physical examination, five dogs showed lethargy, anorexia, or vomiting. Plain radiographs revealed that radiopaque foreign bodies lodged in the heart base or caudal thoracic esophagus. Positive contrast esophagogram revealed that large foreign bodies severely expanded the esophagus and there was no evidence of leakage of the contrast agent from the esophagus into the thoracic cavity. Gastrotomy for retrieval of esophageal foreign bodies using long forceps technique was performed. Esophageal foreign bodies were successfully retrieved in all dogs. The follow-ups were completed 10 days to 2 years after surgery. The follow-up information was based on physical examination by veterinarians and telephone interview with owners. The owners reported that there was no evidence of complications related to surgery such as vomiting, regurgitation, dysphagia, gagging, hyper-salivation, or anorexia in all dogs.

Comparative Analysis of COVID-19 Infection Prevention Control Guidelines from Seven Countries: Implications on COVID-19 Response and Future Guidelines Development

  • Jeong, Yoolwon;Lee, Sun-Hee
    • Health Policy and Management
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    • v.32 no.3
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    • pp.304-316
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    • 2022
  • Background: As prevention of coronavirus disease 2019 (COVID-19) transmission in healthcare settings has become a critical component in its effective management, COVID-19 specific infection prevention and control (IPC) guidelines were developed and implemented by numerous countries. Although largely based on the current evidence-base, guidelines show much heterogeneity, as they are influenced by respective health system capacities, epidemiological risk, and socioeconomic status. This study aims to analyze the variations and concurrences of these guidelines to draw policy implications for COVID-19 response and future guidelines development. Methods: The contents of the COVID-19 IPC guidelines were analyzed using the categories and codes developed based on "World Health Organization guidelines on core components." Data analysis involved reviewing, appraising and synthesizing data from guidelines, which were then arranged into categories and codes. Selection of countries was based on the country income level, availability of COVID-19 specific IPC guideline developed at a national or district level. Results: The guidelines particularly agreed on IPC measures regarding application of standard precautions and providing information to patients and visitors, monitoring and audit of IPC activities and staff illnesses, and management of built environment/equipments. The guidelines showed considerable differences in certain components, such as workplace safety measures and criteria for discontinuation of precautions. Several guidelines also contained unique features which enabled a more systematic response to COVID-19. Conclusion: The guidelines generally complied with the current evidence-based COVID-19 management but also revealed variances stemming from differences in local health system capacity. Several unique features should be considered for benchmark in future guidelines development.

Report on Two Cases of Gilbert's Syndrome Found in the Process of Administering Herbs (단미 한약 복용중 발견한 Gilbert's syndrome 2예 임상고찰)

  • Lee, Jong Deok;Kim, Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.6
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    • pp.657-661
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    • 2014
  • Gilbert's syndrome is one that shows a benign course with intermittent unconjugate hyperbilirubinemia without any evidence of hepatobiliary tract disease or hemolysis. It is often found in a health examination or blood laboratory test by chance. In particular, patients who are taking drugs, including herbal medicine should be careful for their medication due to the possibility of associations with changes in liver function because of drug metabolism, sometimes they have to quit the use of the medication for a certain period and often they should get an additional test. Two male patients increased serum total bilirubin level without other systemic symptoms in screening test for clinical herb medicine pharmacokinetics study. Therefor they was diagnosed with suspected Gilbert's syndrome. They had been calory deprivation test with 24 hours fasting state. They also performed liver function test and ultrasonogram for evaluation of hepatobiliary tract disease. Total serum bilirubin was markedly increased, especially unconjugate bilirubin level higher over the two times than base line after they had been calory deprivation for 24 hours, They was not found another abnormality all laboratory results and physical examination. This study is a report on two cases of hyperbilirubinemia, diagnosed as Gilbert's syndrome, which were found in the process of a clinical pharmacokinetic study of a decoction of medicinal herbs.