Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

This study was aimed to develop a new formula for herbal medicine-safety classification in terms of evidence-based medicine. Recently, human equivalent dose(HED)-based therapeutic index was developed for herbal medicine-safety classification by transforming $LD_{50}$ to HED. However, the use of the $ED_{50}$ and $LD_{50}$ to derive the therapeutic index may be misleading as to safety, depending on the slope of the dose-response curves for therapeutic and lethal effects. To overcome this deficiency, HED-based MOS(Margin of Safety)was developed and suggested in this study. The HED-based MOS developed by using $LD_1$, changing to ALD(approximate lethal dose), and $ED_{99}$. The HED-based MOS seems to be more useful and safer than HED-based therapeutic index since its values for several herbal medicines are basically two times less than the values from HED-based therapeutic index. Thus, HED-based MOS can be a good example of Evidence-based approach for herbal medicine-safety classification.

Objective : To find a collaboration strategy between western medicine and traditional Korean medicine (KM), this study aims to figure out the changes in the perception and attitude of medical doctors toward KM through systematic review. Method : Systematic literature searches were performed on six Korean databases. Studies were categorized according to the respondents and question items and analyzed by the context of questions, similarity of respondents and measurement scale. And we analyzed the changes of response regarding to medical doctors' and medical students' perspective and attitude to KM. Results : Eighteen survey studies including attitude of medical doctors and medical students toward KM were selected, which were conducted from 1993 to 2011. Although the attitude toward KM did not show any positive change, medical doctors have had more interest in acupuncture than herbal medicine and appreciated KM's treatment effect for musculoskeletal disease. In spite of little KM education experience, they had intentions for acupuncture education at least. Many medical doctors have listed the unscientific aspect as a major reason why they cannot trust KM. Medical doctors working for cooperative practice showed more positive attitude than other medical doctors and medical students had more positive attitude in general than medical doctors Conclusion : Though the growth of KM service and cooperative practice since 1990s, medical doctors' attitude toward KM seems to become more negative. To improve their attitude, making scientific evidences for KM is required as well as giving more education and treatment experience.

Objectives : This study was aimed at exploring career-related characteristics of premedical students in Korean Medicine college and those relationships with career development readiness and vocational value. Methods : A total of 140 premedical students participated in the survey. The questionnaire consisted of demographic characteristics and career-related characteristics such as motive for career choice, specialty preference after college graduation, and school life adaptation. Also they responded in the web-survey of career development readiness inventory and vocational value inventory developed by Korea Research Institute for Vocational Education & Training. Eight items of motive for career choice were collected from the pilot study from 70 premedical students. Results : 'Job stability' was the top motive for career choice(25.5%). The average college life adaptation score was relatively low(13.7) : higher in male(14.3) and the early career decision group(14.2) than female (12.9) and late decision group(12.9), which was statistically significant(p=0.019 and p=0.036, respectively) in the subgroup analyses. The result of career development readiness inventory showed that 'self-knowledge' (79.3) and 'confidence on career decision' (78.6) were the two highest, which is similar to the result of the vocational value inventory ('fulfilling abilities' and 'self-improvement'). More characteristics were also described. Conclusions : The results showed that Korean Medicine premedical students have high vocational identity. This study suggested that more specified studies for identifying career-related characteristics for Korean Medical students should be conducted in order to design systematic and professional medical education programs.

Objectives : The aim of the study was to investigate major satisfaction, career choices and perceived career barriers in college students majoring in alternative medicine. Methods : A total of 315 college students majoring in alternative medicine in 5 universities in K city and J province completed survey questionnaires. Results : The highest proportions of students (38.4%) chose alternative medicine major because of their aptitude and interest. Students (59.0%) were satisfied in general with their majors. Regarding career direction after graduation, the highest proportions 1st of and 2nd year students answered that they haven't decided yet (33.7%). In addition, they wanted to get a job in hospitals (24.6%) and have more education (21.9%). The highest proportions of 3rd and 4th year students wanted to get a job in hospitals (31.3%) and 27.3% of them wanted to have more education. The most important criterion for choosing a career was a career aptitude (38.7%) followed by professionalism, vision, pay, and social status in both groups. Regarding perceived career barriers, the highest proportions of 1st and 2nd year students (31.6%) answered the lack of social recognition about alternative medicine while the highest proportions of 3rd and 4th year students (55.5%) answered the lack of national certifications (P<0.001). Conclusions : In general, students majoring in alternative medicine were satisfied with their majors. They wanted to get a job at a hospital and have more education. They thought that the lack of social recognition and national certification of alternative medicine would be career barriers.

Objective : The purpose of this study was to investigate the effects of yoga program on depression, quality of life, and difficulty of daily activities in community elders. Methods : A Nonequivalent control group pretest-posttest design was used for this study. Elderly people who agreed to participated in the study were assigned to a experimental group(n=17) or a control group(n=17). The yoga program conducted 90minutes, 2times a week for 1 year. Study outcomes were measured by structured questionnaires from March, 2012 to Feb., 2013. For data analysis, Chi-square test, t-test, and Mann-Whitney U test were performed using SPSS version 17.0. Results : Depression was not significant difference between the two groups in pretest and posttest. But there was significant differences between the two groups in quality of life (t=3.984, p<.001), and difficulty of daily activities (t=-3.083, p=.004). Therefore, the experimental group showed significant improvement in quality of life and reduce difficulty of daily activities. Conclusion : The yoga program was effective in increasing quality of life and decreasing difficulty of daily activities in community elders. When developing exercise program to improve health in older adults, it is important to consider physical exercise plus general health management.

Objective : This study aimed to evaluate the relation ship between depression and anxiety, self esteem, BMI, blood types, blood pressure, scoliosis of spine. Method : We analyzed the results Health examination of 5619 university students (included BDI, BAI, SES, BMI, Blood Types, Blood Pressure, X-ray of whole spine). All the data were analyzed statistically by descriptive statistics, t-test, ANOVA and regression analysis. Result : Female's BMI score and BAI score are higher than Male's. And Senior Group showed higher score than Freshman Group. There were positive correlation between BAI, and BDI. but negative correlation between SES, Blood Pressure and BDI. BMI, Blood types and Scoliosis of spine were not related to depression. Conclusion : There were correlation between BAI, SES, Blood Pressure and BDI. It is necessary to study about depression with many other effective factors of various psychological and physical subjects.

Objectives : This study aimed to analyze the management efficiency of Korean Medicine hospitals for recent 10 years(2001~2010) using the Data Envelop Analysis(DEA) model. Methods : We collected the management data of 23 Korean Medicine hospitals for DEA model from the Korean Oriental Medicine Hospitals' Association (KOMHA). Input variables of DEA model are numbers of beds, numbers of doctors, numbers of nurses and numbers of other staffs of each Korean Medicine hospitals. Output variables are numbers of inpatients and numbers of outpatients of each Korean Medicine hospitals. Based on the DEA model, we calculated the efficiency score of each Korean Medicine hospital and compared it by hospital's ownership, location, and size. Results : Average DEA efficiency scores of Korean Medicine hospitals by year ranged from 0.86 to 0.92. Private owned hospitals showed higher efficiency scores than the university affiliated hospitals with statistical significance (p=0.001). And Korean Medicine hospitals located in capital region of Korea(Seoul City, Incheon City, Gyeonggi-do) and the rest Korean Medicine hospitals did not show statistical difference (p=0.516). Lastly, Korean Medicine hospitals with different size did not show statistical difference in management efficiency (p=0.499). Conclusion : We have found that Korean Medicine hospitals management efficiency have not changed throughout 10 years, and that different ownership forms of Korean Medicine hospital show statistical difference in management efficiency while location, and size do not.

Objectives : This study was aimed to investigate burn out degree of K.M.D.s(Korean medicine doctors) who work at convalescent hospitals and to find contributional factors for the result. The relationship between burn out and job performance was also studied. Methods : 77 K.M.D.s(Male 49(63.6%), Female 28(36.4%)) participated in this survey that has 62 main questions about burn out, job performance, job environment and Social demographic characteristics. Survey was conducted from 19th Aug. 2013 to 6th Nov. 2013. Results : Average of burn out degree of K.M.D.s was 2.62 out of 5. Emotional exhaustion was highest (2.80) and depersonalization was lowest(2.20) among subordinate concepts of burn out. Work place location and average income of the subjective which are subordinate concepts of social demographic characteristics showed significant correlation with job performance. Role conflict, relation of co-worker, workload were significant factors for emotional exhaustion and meaning of the job, will of patient, challenge were significant factors for lack of feeling of accomplishment by multiple regression analysis. Relation of co-worker, aggression of patient and meaning of the job were also significant factors for depersonalization. Conclusion : Emotional exhaustion and lack of feeling of accomplishment among subordinate concepts of burn out were high in the subjective who participated this study. Significant factors that contribute to burn out of this study, shows different result compare to the studies that show other factors contribute to burn out who works at convalescent hospital or other place.

Objectives : Anorexia is the primary symptom impinging cancer patients' Quality of Life. It is usually accompanied by gastrointestinal symptoms(GI symptoms). Thus, to measure anorexia symptom precisely, assessing anorexia and GI symptoms together is recommended. This study was designed to analyze cancer-related anorexia assessment tools, extract GI symptoms included in these tools and investigate usefulness of instruments in clinical trials. Methods : Instruments were selected by searching PubMed, PROQOLID database. We analyzed instruments by number of items, assessment method, type of question, GI symptoms. Results : 9 instruments were selected to assess cancer-related anorexia symptom. Most tools adopt Likert scale as response scale and 'during past week' as recall period. Assessment method of all 9 instruments is the self-administration. Questions measuring anorexia are able to be sorted into 3 forms (frequency, severeness, distress of anorexia symptom). Among the GI symptoms, nausea is included in all 9 instruments. In clinical trials of cancer-related anorexia, Edmonton Symptom Assessment Scale(ESAS) and Functional Assessment of Anorexia/Cachexia Therapy Questionnaire(FAACT) were selected as endpoint measure. Conclusions : The result showed that FAACT is the only specialized tool to assess cancer-related anorexia. To measure cancer-related anorexia precisely, the need to develop new instrument exists.

Objective : This study was done to define the treatment protocol of Traditional Korean Medicine for persistent allergic rhinitis, which might be necessary for conducting PRCT study. Methods : Data were collected by questionnaire from Korean Medicine doctors participated in the Conference of The Korean Oriental Medical Ophthalmology & Otolaryngology & Dermatology Society in October 2012. We investigated their treatment procedures for persistent allergic rhinitis in ordinary clinical settings. Their treatment patterns including annual treatment period, frequencies and treatment times were also investigated. Finally, we combined the national insurance covered or out-of-pocket treatments as treatment packages according to the response rates of each contents, and displayed them as treatment protocols for PRCT study. Results : 50 Korean medicine doctors described the informed consent and questionnaire. Response rates of each treatment procedure were listed in Table 2 to Table 5. Treatment periods, frequencies and treatment time of each visit were listed in Table 6. Finally, treatment packages which would be defined for PRCT were listed in Table 7 as treatment package 1(response rates were over 50%), package 2(response rates were over 25%), package 3(response rates were over10%). Conclusion : These results provide the rational background and preliminary sources of defining treatment packages for developing PRCT protocols.

Purpose : This study was conducted to assess whether Korean medicine doctors' attire influences patients' preference (confidence, comfortability, neatness) in a university hospital. Materials and Methods : Employing a cross-sectional design, outpatients answered a questionnaire in a university hospital of Korean Medicine. Respondents were asked for completing the questionnaire to estimate their preference of doctor's attire for confidence, comfortability and neatness after watching 4 types of attire in both male and female Korean medicine doctors, including white coat, traditional attire, formal suit and casual clothes. Whether Korean medicine doctors' attire on a patients' preference is important was also asked for the respondents using a 5-point Likert scale. Results : All 175 patients were enrolled, of whom 38.9% were male respondents, 46.3% graduated from a university at least and mean age of responders was 47.1. Most had a tendency for preferring white coat followed by traditional attire and only a small portion of respondents preferred for formal suit and casual clothes. When comparing preferences in confidence between white coat and traditional attire only, male patients preferred white coat more than female patients did with statistical significance. In addition, 85.4% of respondents answered that Korean medicine doctors' attire is important to a clinical situation with higher ratio of female respondents (87.9%) than male respondents (80.9%). Conclusion : Patients preferred white coat and traditional attire mostly for the Korean Medicine doctor's attire with only small preference for formal suit and casual clothes. Also, Patients recognized that Korean medicine doctors' attire is important in the clinical situation.

Objective : The purpose of this study was to establish the simultaneous analysis for six compounds in Gumiganghwal-tang (GMGHT, Jiuweiqianghuo-tang) and to investigate the anti-atherosclerotic effects of GMGHT in vitro. Methods : The column for separation of six compounds was used Luna $C_{18}$ column and maintained at $40^{\circ}C$. The mobile phase for gradient elution consisted of two solvent systems, 1.0% acetic acid in water and 1.0% acetic acid in acetonitrile. The analysis was carried out at a flow rate of 1.0 mL/min with pothodiode array (PDA) detection at 254, 280, and 320 nm. The injection volume was 10 ${\mu}L$. The antioxidant activities of GMGHT were evaluated by measuring free radical scavenging activities on 2,2'-Azinobis-3-ethyl-benzothiazoline-6-sulfonic acid (ABTS) and 1-1-diphenyl-2-picrylhydrazyl (DPPH). The inhibitory effects on low-density lipoprotein (LDL) oxidation were evaluated by the formation of thiobarbituric acid relative substances (TBARS), relative electrophoretic mobility (REM), and fragmentation of apolipoprotein B (ApoB)-100. Results : Calibration curves were acquired with $r^2{\geq}0.9998$. The contents of liquiritin, ferulic acid, baicalin, baicalein, glycyrrhizin, and wogonin in GMGHT were 1.784, 1.693, 37.899, 0.258, 1.869, and 0.034 mg/g, respectively. The GMGHT showed the radical scavenging activity in a dose-dependent manner. The concentration required for 50% reduction ($RC_{50}$) against ABTS and DPPH radicals were 72.51 ${\mu}g/mL$ and 128.49 ${\mu}g/mL$. Furthermore, GMGHT reduced the oxidation properties of LDL induced by $CuSO_4$. Conclusion : HPLC-PDA is considered as an available and convenient method for quality control and standardization of GMGH and GMGHT has potentials on anti-atherosclerosis by anti-oxidative effect and suppressive effect on LDL oxidation.

Objective : Eucommiae Cortex is bark of Eucommia ulmoides Oliver, a deciduous tree native to China. Today, teas or herbal drugs made from E. ulmoides leaves are widely consumed as a healthy food especially in Eastern Asia including Japan, China and Korea. This study was aimed to verify the extraction efficiency of bioactive compounds from Eucommiae Cortex depending on characteristics of decoction water. Method : Six types of decoction water with various origin were prepared and the contents of minerals in water were analyzed by ICP-AES and ICP-MS. The contents of extracted bioactive compounds were analyzed by HPLC and the relationship between mineral contents and extracted bioactive compounds in the decoction water were analysed by multiple factor analysis. The decoction waters could be classified in three groups by hierarchical cluster analysis. Result : Extracted amounts of compounds in Eucommiae Cortex showed a positive relationship with Na, Si, K concentration in decoction water, while a negative relationship with Ca, Mg concentration. Conclusion : The study proved that the minerals in water influenced the extraction efficiency of bioactive compounds from Eucommiae Cortex.

Objective : This study was aimed to investigate the effective treatment for patients with thoracic outlet syndrome. Method : This study was carried out to established the clinical criteria of thoracic outlet syndrome. We collected and analyzed the data of patients had come to the GyeonWoo Oriental Medical Clinic after traffic accidents from January 1, 2011 to December 31, 2011. The patients with thoracic outlet syndrome were treated with acupuncture, chuna therapy for 4 weeks. Visual Analog Scale(V.A.S.) was used as the tools determining the effects of oriental medical treatment on neck pain. Result : The treatment of Korean Medicine(KM) including acupuncture, chuna therapy decreased V.A.S. significantly. Conclusion : Acupuncture, chuna therapy were useful treatment for relieving the hand paresthesia due to thoracic outlet syndrome.