• The Korean Journal of Pain
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• v.27 no.3
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• pp.200-209
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• 2014

Background: Spinal opioid administration is an excellent option to separate the desirable analgesic effects of opioids from their expected dose-limiting side effects to improve postoperative analgesia. Therefore, physicians must better identify either specific opioids or adequate doses and routes of administration that result in a mainly spinal site of action rather than a cerebral analgesic one. Methods: The purpose of this topical review is to describe current available clinical evidence to determine what opioids reach high enough concentrations to produce spinally selective analgesia when given by epidural or intrathecal routes and also to make recommendations regarding their rational and safety use for the best management of postoperative pain. To this end, a search of Medline/Embase was conducted to identify all articles published up to December 2013 on this topic. Results: Recent advances in spinal opioid bioavailability, based on both animals and humans trials support the theory that spinal opioid bioavailability is inversely proportional to the drug lipid solubility, which is higher in hydrophilic opioids like morphine, diamorphine and hydromorphone than lipophilic ones like alfentanil, fentanyl and sufentanil. Conclusions: Results obtained from meta-analyses of RTCs is considered to be the 'highest' level and support their use. However, it's a fact that meta-analyses based on studies about treatment of postoperative pain should explore clinical surgery heterogeneity to improve patient's outcome. This observation forces physicians to use of a specific procedure surgical-based practical guideline. A vigilance protocol is also needed to achieve a good postoperative analgesia in terms of efficacy and security.

• Journal of Digital Convergence
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• v.10 no.4
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• pp.243-250
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• 2012

This study proposes new protocol protecting patients' personal record more safely as well as solving medical dispute smoothly by storing the record not into a computer server in hospitals but into the National Health Insurance Corporation computer server. The new protocol for electronic medical record is designed using RSA public key algorithm and DSA digital signature. In addition, electronic medical record systems are built up with more safety and reliability through certificate authority. The proposed medical information systems can strengthen trust between doctors and patients. If medical malpractice occurs, the systems can also provide evidence. Furthermore, the systems can be helpful to reduce medical accidents. The systems could be also utilized efficiently in various applied areas.

• Journal of Climate Change Research
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• v.1 no.1
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• pp.1-11
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• 2010

This study is analyzed based on the statistical data for the effect of Kyoto Protocol which is adopted on 1997. The first greenhouse gas obligation reduction countries such as OECD (Organization for Economic Cooperation and Development), and the first non-obligated developing countries such as China and India, the increasing rate of carbon dioxide emission displayed -10.2% and 88.1% in 2005 with respect to 1990, respectively. This increasing rate is not only shows statistically significant differences but also shows significant meanings when we consider the global increasing rate of carbon dioxide is 29.1%. Changes in the carbon dioxide emissions are also analyzed based on the time of the adaptation of Kyoto Protocol, time of the publication of the second and third reports of IPCC, and withdrawal of the Kyoto Protocol of the United States. Withdrawal of the Kyoto Protocol of the United States is the most significantly affected to the differences in the carbon dioxide emission rates rather than the adaptation of Kyoto Protocol, international agreement on the greenhouse gas reduction, and belief on the scientific evidence for the reasons for increasing carbon dioxide concentrations. Therefore, acceptance of the post-Kyoto Protocol in the United States is very important in order to success as a climate regime.

• Korean Journal of Clinical Pharmacy
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• v.33 no.3
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• pp.153-167
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• 2023

Objective: Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally. Methods: This study compares Korea's bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches-expert consensus versus metaanalysis results-forming the primary differences between Korea and other countries. Results: Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions. Conclusion: Korea's unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.

• Journal of Korean Medical classics
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• v.23 no.4
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• pp.63-102
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• 2010

Purpose : To propose various types of clinical research which is feasible for botanical new drug (IND) development processes, and suggest essential steps to development of study protocol for IND. Methods : Literature-based discussions and one research group's experience is given regarding domestic act, regulation, and system. Results : In order to get an approval of IND for botanical drug in Korea there are several types of clinical research to conduct. In quality control steps for standardized medicinal herbs, case reports or case series can be conducted, and for good manufacturing practice(GMP) steps, we can conduct case reports, case series, and retrospective cohort studies. In addition, as long as we gathered good laboratory practice(GLP) data we can conduct up to quasi-experimental studies and clinical trials including investigator initiated trials. In order to conduct these studies development of study protocol is essential. First, we obtain historical evidence including target disease and indication, efficacy, safety, and endpoints by reviewing medical classics. Second, we obtain clinically and statistically important data by conducting non-clinical studies, observation studies, and quasi-experimental studies. Third, we generate research hypotheses and purposes and explore methodologies, endpoints, clinical practice guidelines, cost-effectiveness, and commercial potential. Finally, we develop study protocol with aid of biostatistician or expert in contract research organization. Discussions and conclusions : This study have obvious limitations in that most thoughts, suggestions, and proposes are from one research group's experience. Therefore, we hope to see various types of research in this topic and process from other research group as well.

• Journal of dental hygiene science
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• v.12 no.6
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• pp.545-557
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• 2012

Dental caries is biofilm induced disease throughout life and is recognized significant oral health problem. This article reviewed new trends in dental caries management by risk assessment, including history, protocol/guideline, and collaborated model. Dental caries prevention and treatment according to caries management by risk assessment (CAMBRA) model is patient-centered, risk-based, evidence-based practice. Team approach is necessary and clinician need to integrate science, practice and product. Dental hygienist take a important role in implementing CAMBRA. CAMBRA model could be incorporated into clinical dental hygiene education based on dental hygiene process of care as standard of dental hygiene practice and education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

• Journal of Acupuncture Research
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• v.41 no.2
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• pp.107-114
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• 2024

Background: Low back pain (LBP) is a common musculoskeletal disorder worldwide, with a lifetime prevalence of up to 80%. Among nonsurgical treatments for chronic LBP, Korean medicine treatments are highly preferred, and pharmacopuncture therapy combining acupuncture and herbal medicine is widely used. However, no evidence-based study has focused on the use of various types of pharmacopuncture. Methods: The pragmatic randomized controlled clinical trial will include 44 participants; recruitment will start in July 2023. All participants will receive integrated Korean medicine treatment including acupuncture, cupping, and infrared therapy, and the intervention group will also receive pharmacopuncture. After 16 treatment sessions, twice a week for 8 weeks, follow-up assessments will be performed at week 9. As a pragmatic randomized controlled clinical protocol, the type, dose, and acupoints of acupuncture and pharmacopuncture are not determined in advance but are selected and recorded according to the clinical judgment of the Korean medicine doctor. Results: The primary outcome will be measured using a visual analog scale score, and the secondary outcomes include the Oswestry disability index, patient global impression of change, no worse than mild pain, and range of motion. Safety will be assessed by examining participants' self-reported adverse events and vital signs and conducting blood tests before and after the test. Conclusion: This study aims to provide clinical evidence of the effectiveness and safety of pharmacopuncture for chronic LBP.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2022.05a
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• pp.147-149
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• 2022

This paper proposes a state machine design methodology in which an interactive robot that mimics discrete trial training (DTT protocol) can support social interaction training for children with autism. The robot applied to social interaction training uses the response to the provided training stimulus as a quantitative indicator by processing the data received from the sensors measuring the behavioral response of the child. In this process, the state machine is used as information that classifies the state of the acquired data and provides the subsequent stimulus for DTT protocol. Through the joint attentional training, it can be used as evidence-based treatment information by quantitatively classifying the data on the number of sustainable and DTT protocol and the child's response, as well as the current reaction status of the child to the observer performing remote monitoring. At the same time, it was confirmed that it is possible to properly respond to misrecognition situations.

• Korean Medical Education Review
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• v.10 no.2
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• pp.25-44
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• 2008

Objectives: Through using of the strong research method like a Randomized Controlled Trial: RCT, we have to heighten quality of Medical Education study. I'd like to introduce "CONSORT", which stands for Consolidated Standards of Reporting Trials. Contents: Preventive Service Task Force(200l) in USA proposed Levels of evidence for enlarging evidence-based Practice: EBP. And the CONSORT was introduced, which encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs). the CONSORT has 13 guides like these: 1. How participants were allocated to interventions 2. Scientific background and explanation of rationale 3. Eligibility criteria for participants. The settings and locations where the data were collected. 4. Precise details of the interventions intended for each group and how and when they were actually administered 5. Specific objectives and hypotheses 6. Clearly defined primary and secondary outcome measures, When applicable. any methods to enhance the quality of measurements (e.g., multiple observations, training of assessors) 7. How sample size was determined. When applicable, explanation of any interim analyses and stopping rules 8. Method used to generate the random allocation sequence, Details of any restriction [of randomization] 9. Method used to implement the random allocation sequence 10. Who generated the allocation sequence, who enrolled participants. and who assigned participants to their groups 11. Whether or not participants, those administering the interventions, and those assessing the outcomes were blinded to group assignment. If done, how the success of blinding was evaluated 12. Statistical methods used to compare groups for primary outcome(s), Methods for additional analyses, such as subgroup analyses and adjusted analyses 13. Flow of participants through each stage (a diagram is strongly recommended) Specifically, for each group report the numbers of participants randomly assigned. receiving intended treatment, completing the study protocol. and analyzed for the primary outcome. Results and Conclusion: Randomized Controlled Trial: RCT guided of CONSORT will contribute to do stronger evidence-based medical studies.

• Journal of Music and Human Behavior
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• v.15 no.1
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• pp.95-118
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• 2018

With the recent emphasis on evidence-based research and practice, the field of music therapy has called for rigorous reviews of the scientific data and for therapeutic rationales for research procedures. The purpose of this study was to review studies that used a rhythm task as a therapy intervention in terms of whether they provided a rationale for the components related to the intervention. The components included activity rationale, music rationale, intervention validity, intervention format (individual or group), intervention development (contour), duration, and intervention provider. A total of 41 studies were selected: 22 studies were implemented by music therapists and 19 by professionals in other related fields. In terms of seven assessment categories, only 10 studies were found to report more than four items which are related to a rationale of interventions. The 10 studies identified were further examined to determine if their intervention rationale differed depending on whether the study included a researcher-formulated intervention or an existing music therapy protocol. Of the 10 studies, six used a researcher-formulated rhythm intervention, and four used an existing music therapy protocol. Those studies that used an existing music therapy protocol also provided a clear rationale for music selection, whereas those that used a researcher-formulated rhythm task tended to provide an activity rationale. The results of this study suggest that researchers need to be clearer about their interventions and provide an evidence-based rationale for why and how they use a rhythm task.