• 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.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.23-26
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• 2005

Bruxism is defined as 'diurnal or nocturnal parafunctional activity including clenching, bracing, gnashing, and grinding of the teeth'. Bruxism and clenching are two of the most common contributing factors in patients with temporomandibular disorders and craniofacial pain disorders. Even though many studies report the high prevalence of bruxism, its cause is still not clear. Occlusal interference has been regarded as a major etiologic factor. Nowadays, psychological stress and sleeping disorders are generally regarded as major possible etiologic factors. More than likely, the cause is multifactoral and overlapping, which makes it difficult for the practitioner to apply comprehensive and effective management strategies. Although dentists and psychologists generally believe that effective treatment is best achieved with a better understanding of the etiology of a given disorder, for now treatment for this type of disorder must proceed without a clear understanding of etiology. To overcome this obstacle, evidence-based comprehensive management protocols based on accumulated scientific findings should be provided. In this presentation, epidemiology, etiology, and the characteristics of bruxism are reviewed. Diagnostic procedures and management strategies focused on occlusal appliances and behavioral approaches are also discussed.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2137-2139
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• 2013

Breast cancer is the most common cancer among females, worldwide, accounting for 22.9% of all cancers (excluding non-melanoma skin cancer) in females. Mammography is a sensitive (77-95%) and specific (94-97%) screening method for breast cancer. Previously, females between the 40-50 years old were recommended to have mammograms every one to two years. However, based on current evidence, in 2009, USPSTF recommended that the decision to start regular, biennial screening mammography for females younger than 50 years should be an individual decision and take patient context into account, including the patient's values regarding specific benefits and harms. This decision was based on findings regarding radiation exposure, false-positive and false-negative rates, over-diagnosis, and pain and psychological responses. The goal of this paper is to focus on evidence for updating the U.S. Preventive Services Task Force (USPSTF) recommendation against routine mammography for females between 40-49 years of age.

• The Korean Society of Law and Medicine
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• v.8 no.1
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• pp.215-234
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• 2007

The mission of the doctors is to take care of human life, body and health through the medical behaviors such as diagnosis and treatment. Under this job propensity, the doctors have care duty to take the best actions required to prevent the risk according to the patients' specific disease status. Such care duty of the doctor may be evaluated based on the medical behavior level at the medical institution and clinical medical study field. Such medical level should be understood in the normative level, considering the treatment environment, condition and specialty of the behavior, because it means the medical common sense known and acknowledged to the normal doctors. While the criminal suit requires the evidence for no doubt conviction, the civil suit requires more eased different standard. The results between the criminal and civil sentence may be different, because the confirmed former case may lead to long-term imprisonment and even death penalty, while the latter case puts only monetary penalty on the defeated party.

• Journal of Korean Neurosurgical Society
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• v.66 no.3
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• pp.308-315
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• 2023

Recent updates in genomic-integrated glioma classification have caused confusion in current clinical practice, as management protocols and health insurance systems are based on evidence from previous diagnostic classifications. The Korean Brain Tumor Society conducted an electronic questionnaire for society members, asking for their ideas on risk group categorization and preferred treatment for each individual diagnosis listed in the new World Health Organization (WHO) classification of gliomas. Additionally, the current off-label drug use (OLDU) protocols for glioma management approved by the Health Insurance Review and Assessment Service (HIRA) in Korea were investigated. A total of 24 responses were collected from 20 major institutes in Korea. A consensus was reached on the dichotomic definition of risk groups for glioma prognosis, using age, performance status, and extent of resection. In selecting management protocols, there was general consistency in decisions according to the WHO grade and the risk group, regardless of the individual diagnosis. As of December 2022, there were 22 OLDU protocols available for the management of gliomas in Korea. The consensus and available options described in this report will be temporarily helpful until there is an accumulation of evidence for effective management under the new classification system for gliomas.

• The Journal of the Society of Korean Medicine Diagnostics
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• v.16 no.1
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• pp.1-8
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• 2012

Objectives Although the faith that pulse diagnosis via a thread, namely "Xuanxizhenmai", had been applied to some women in royal families, is widely spread in East Asian countries, but it is still controversial that whether this faith is based on historical facts or just originated from some folk tales. So we provided some reasonable clues to interpret that faith. Methods The digitalized Annals of Joseon Dynasty and Twenty Five Books of Chinese History were used for historical example search. Conventional internet search engines are widely used for investigation of other examples and related interpretations. Additionally, a pilot observation with nylon threads and optical vibration detection devices was performed to confirm it's feasibility. Results Although there are a few evidences supporting Xuanxizhenmai's existence in Qing dynasty, no evidence was found to show it's existence in authoritative annals of Korea and China. The pilot observation showed that in optimal environment, some intense arterial pulse could be propagated dozens of centimeter, but it was not applicable to clinical needs. Conclusions Pulse propagation via a thread was proved to be reproducible within limited extents, but pulse diagnosis via a thread, namely Xuanxizhenmai, seem to have never been used for proper clinical purpose.

• Journal of Veterinary Clinics
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• v.35 no.1
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• pp.26-29
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• 2018

A 6-month-old, female poodle presented with a three-month history of persistent regurgitation immediately after eating. On physical examination, the patient was emaciated and dehydrated. Thoracic radiography showed ventral displacement of the trachea and increased radiopacity in the mediastinum, cranial to the heart base. A severely dilated esophagus was identified cranial to the heart on esophagram. Computed tomography (CT) revealed the esophagus was filled with gas, fluid and a little of contrast and dilated from caudo-cervical to cranio-thoracic part. The esophageal diameter was markedly decreased at the heart base. In addition, the trachea was displaced to the left-ventral side of the right aortic trunk and an aberrant left subclavian artery originating from the aorta was identified. There was no evidence of abdominal vascular anomaly. Based on diagnostic imaging, persistent right aortic arch (PRAA) with an aberrant left subclavian artery was diagnosed. The patient did not undergo surgery and died at 15 days after diagnosis. This report describes imaging diagnosis, including CT and radiography in a weaned dog with regurgitation due to esophageal obstruction by PRAA. When PRAA is suspected and conventional radiography or contrast study is insufficient for diagnosis, CT may be helpful for diagnosing PRAA.

• Journal of Gastric Cancer
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• v.14 no.2
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• pp.87-104
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• 2014

Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.2
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• pp.52-58
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• 2018

Dry socket, also termed fibrinolytic osteitis or alveolar osteitis, is a complication of tooth exodontia. A dry socket lesion is a post-extraction socket that exhibits exposed bone that is not covered by a blood clot or healing epithelium and exists inside or around the perimeter of the socket or alveolus for days after the extraction procedure. This article describes dry socket lesions; reviews the basic clinical techniques of treating different manifestations of dry socket lesions; and shows how microscope level loupe magnification of $6{\times}$ to $8{\times}$ or greater, combined with co-axial illumination or a dental operating microscope, facilitate more precise treatment of dry socket lesions. The author examines the scientific validity of the proposed causes of dry socket lesions (such as bacteria, inflammation, fibrinolysis, or traumatic extractions) and the scientific validity of different terminologies used to describe dry socket lesions. This article also presents an alternative model of what causes dry socket lesions, based on evidence from dental literature. Although the clinical techniques for treating dry socket lesions seem empirically correct, more evidence is required to determine the causes of dry socket lesions.

• Journal of Physiology & Pathology in Korean Medicine
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• v.22 no.6
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• pp.1410-1415
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• 2008

Acupuncture and herbal treatment are based on diagnosis of cold and heat pattern in Traditional Korean Medicine. This diagnosis is accomplished through pulse, tongue and question examination, which are not objective. Quantification and objectification of this diagnosis process are required for efficacious treatment and traditional medicine development. In this study, we developed the cold-heat pattern questionnaire for this purpose. Seventy nine patients who visited oriental medical hospital were included in this study. The cold-heat pattern questionnaire was composed of many questions about patient's physical condition, which were derived from The Traditional Oriental Medical Literature with Delphi Technique. Patients filled out the cold-heat pattern questionnaire by themselves. Diagnosis of cold and heat pattern are conducted separately by oriental medical doctors with more than 5 years' clinical experience. Various physical condition factors were derived for the cold-heat pattern questionnaire. (Preference temperature, Body temperature, Pain type, Face color, Urine, Stool and secretion features) Each cold and heat symptoms group acquired internal consistency. (Cronbach's ${\alpha}$ : Cold - 0.605, Heat - 0.722) There were significant associations between doctor's diagnosis and cold symptoms in 'Aversion to cold', 'Desire for heat', 'Pale face', 'Loose stools'. (p-value < 0.05) There were significant associations between doctor's diagnosis and heat symptoms in 'Desire for cold', 'Body feverishness', 'Thirst'. (p-value < 0.05) The internal consistency results suggest that the cold-heat pattern questionnaire assured reliability. Besides, these results showed that cold-heat symptoms are apt to appear together with, and this can be indirect evidence that diagnosis of cold-heat pattern is valuable for comprehension about disease pattern. Moreover, respective symptoms of cold-heat pattern showed different significance with doctor's diagnosis. Consequently these significant symptoms can be more considered for comprehension of cold-heat pattern.