• Journal of Acupuncture Research
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• v.34 no.4
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• pp.169-171
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• 2017

Background: Many stroke patients receive traditional medical care in Korea and China. Stroke patients comprise the largest proportion of inpatients in traditional Korean medicine and traditional Chinese medicine hospitals. The purpose of this study is to identify the types and effects of Chinese medicine widely used in China and Korea, and to apply them to future studies of stroke. Methods: Nine Korean and Chinese databases will be surveyed for clinical studies of herbal medicines for stroke, published between the inception of the database and August 2017. Clinical studies of decoctions or modified decoctions will be included without restriction on study type. The frequencies and patterns of formulas or single herb usage and the any type of herbal medicine utilization will be analyzed. Dissemination: The results of the systematic review will be published in a peer-reviewed journal and disseminated electronically and in print. Updates of the review will be conducted to inform and guide healthcare practices.

• Investigative Magnetic Resonance Imaging
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• v.21 no.4
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• pp.233-241
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• 2017

Purpose: To report on the current practices in breast magnetic resonance imaging (MRI) in Korea. Materials and Methods: We invited the 68 members of the Korean Society of Breast Imaging who were working in hospitals with available breast MRI to participate in a survey on how they performed and interpreted breast MRI. We asked one member from each hospital to respond to the survey. A total of 22 surveys from 22 hospitals were analyzed. Results: Out of 22 hospitals, 13 (59.1%) performed at least 300 breast MRI examinations per year, and 5 out of 22 (22.7%) performed > 1200 per year. Out of 31 machines, 14 (45.2%) machines were 1.5-T scanners and 17 (54.8%) were 3.0-T scanners. All hospitals did contrast-enhanced breast MRI. Full-time breast radiologists supervised the performance and interpreted breast MRI in 19 of 22 (86.4%) of hospitals. All hospitals used BI-RADS for MRI interpretation. For computer-aided detection (CAD), 13 (59.1%) hospitals sometimes or always use it and 9 (40.9%) hospitals did not use CAD. Two (9.1%) and twelve (54.5%) hospitals never and rarely interpreted breast MRI without correlating the mammography or ultrasound, respectively. The majority of respondents rarely (13/21, 61.9%) or never (5/21, 23.8%) interpreted breast MRI performed at an outside facility. Of the hospitals performing contrast-enhanced examinations, 15 of 22 (68.2%) did not perform MRI-guided interventional procedures. Conclusion: Breast MRI is extensively performed in Korea. The indication and practical patterns are diverse. The information from this survey would provide the basis for the development of Korean breast MRI practice guidelines.

• Herbal Formula Science
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• v.32 no.3
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• pp.311-324
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• 2024

Objectives : Human body keeps balance through the interaction of various organs, especially the lungs and kidneys are closely connected in maintaining health and preventing disease. This study explores how the lungs and kidneys interact in terms of breathing and fluid balance and aims to find common ground between Eastern and Western medical practices. Methods : Similar explanations related to the interaction between the lungs and kidneys in the physiology and pathology of Traditional Korean Medicine(TKM) and biomedicine were compared. Results : In breathing, the lungs and kidneys work together by adjusting abdominal pressure with the diaphragm and maintaining acid-base balance, and hormones and enzymes secreted from the kidneys significantly affect lung function. This process corresponds to the concept of TKM that the kidneys control the reception of qi (腎主納氣). For fluid balance, the lungs help manage fluid levels through evaporation and sweating, interacting with the kidneys via the Renin-Angiotensin System (RAS), ACE, ACE2 enzymes, and antidiuretic hormone (ADH). This is similar to the theory in TKM that the lungs regulate human fluid (肺主通調水道). Conclusions : This research shows that by looking at the same physiological and pathological processes from different angles, we can reduce misunderstandings between Eastern and Western medicine. It helps improve the understanding of TKM's theories and supports building a unified framework for both medical traditions. Future work should focus on developing compatible theoretical systems across these fields.

• The Journal of Korean Medical History
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• v.30 no.2
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• pp.13-31
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• 2017

This study investigates research trends on the Convergence of Chinese and Western Medicine (中西醫匯通, CCWM), by first defining the concepts and the scope of this emerging field, identifying different types of convergence, and suggesting methods to evaluate the process. The author investigates the relationship of CCWM to the Self-Strengthening Movement and the doctrine of Zhongtixiyong (中體西用). Lessons that Korean Medicine (KM) can learn from this approachto help establish relationship between Korean and Western Medicine, are investigated. Proponents of CCWM suggest different types of convergence such as Zhongzhongcanxi (衷中參西), Zhongxizhezhong (中西折衷), and ZhongyiKexuehua (中醫科學化), to accommodate the change in the power dynamics between Chinese and Western medicines. The rigid dual medical system in Korea significantly hinders the potential for convergence. The current system is based on the relativistic model in which the scope of practice for the KM doctor and the Western Medicine doctor are mutually exclusive. Philosophically, the convergence of East-West medicine can be supported by pluralism and monism, while relativism sees it as impossible. A conservative pluralistic model might consider Bogu (補救) of Eastern Medicine, while a more progressive pluralistic model might build a New Medicine which combines the knowledge and techniques of Eastern and Western medicines. An example of monistic model is CAM (Complementary and Alternative Medicine), which aims to scientifically verify the efficacy and safety of the Eastern therapeutic practices and integrate them into Western medicine. This article proposes that as communication and fusion between medical disciplines are essential virtues of contemporary scholarly development, a change that enables the convergence of East-West medicine is needed.

• Journal of Preventive Medicine and Public Health
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• v.51 no.1
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• pp.15-22
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• 2018

Objectives: The use of administrative data is an affordable alternative to conducting a difficult large-scale medical-record review to estimate the scale of adverse events. We identified adverse events from 2002 to 2013 on the national level in Korea, using International Classification of Diseases, tenth revision (ICD-10) Y codes. Methods: We used data from the National Health Insurance Service-National Sample Cohort (NHIS-NSC). We relied on medical treatment databases to extract information on ICD-10 Y codes from each participant in the NHIS-NSC. We classified adverse events in the ICD-10 Y codes into 6 types: those related to drugs, transfusions, and fluids; those related to vaccines and immunoglobulin; those related to surgery and procedures; those related to infections; those related to devices; and others. Results: Over 12 years, a total of 20 817 adverse events were identified using ICD-10 Y codes, and the estimated total adverse event rate was 0.20%. Between 2002 and 2013, the total number of such events increased by 131.3%, from 1366 in 2002 to 3159 in 2013. The total rate increased by 103.9%, from 0.17% in 2002 to 0.35% in 2013. Events related to drugs, transfusions, and fluids were the most common (19 446, 93.4%), followed by those related to surgery and procedures (1209, 5.8%) and those related to vaccines and immunoglobulin (72, 0.3%). Conclusions: Based on a comparison with the results of other studies, the total adverse event rate in this study was significantly underestimated. Improving coding practices for ICD-10 Y codes is necessary to precisely monitor the scale of adverse events in Korea.

• KIISE Transactions on Computing Practices
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• v.21 no.7
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• pp.482-487
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• 2015

This paper presents the results and the process of extracting correlations between events of prescriptions and examinations using graph-modeling and node centrality measures on a medical dataset of 11,938 patients with diabetes mellitus. As the data is stored in relational form, RDB2Graph framework was used to construct effective graph models from the data. Personalized PageRank was applied to analyze correlation between prescriptions and examinations of the patients. Two graph models were constructed: one that models medical events by each patient and another that considers the time gap between medical events. The results of the correlation analysis confirm current medical knowledge. The paper demonstrates some of the note-worthy findings to show the effectiveness of the method used in the current analysis.

• Infection and chemotherapy
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• v.50 no.4
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• pp.319-327
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• 2018

Background: Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. Materials and Methods: We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. Results: There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. Conclusion: The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.

• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.157-174
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• 2010

Purpose: This study aims to develop, verify, and suggest outcome indicators for advanced practice nurses (APNs) in order to clarify their usefulness. Methods: To develop outcome indicators, the following methods were applied: reviewing literature intended to identify preliminary outcome indicators; surveying outcome indicators currently used for APNs and collecting the opinions from representatives of the professionals in clinical practice; verifying the content validity of preliminary outcome indicators by professionals and verifying the preliminary outcome indicators with 252 APNs. Results: Suggested outcome indicators are categorized into 84 items in total. Of these, the number of outcome indicators commonly appearing across disciplines was 18, mostly related to satisfaction and education. A majority of other outcome indictors exhibiting high relevance to individual disciplines are associated with care, including critical care (19 items), oncologic care (9 items) and emergency care (10 items). Conclusion: As the outcome indicators identified in this study are available to demonstrate the usefulness of APNs, it is recommended that future studies need to select and use appropriate outcome indicators according to characteristics and conditions of the discipline under examination. In addition, it is necessary to validate whether the suggested outcome indicators reflect adequately the practices of APNs.

• The Korean Society of Law and Medicine
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• v.18 no.1
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• pp.3-35
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• 2017

The Supreme Court of Korea first admitted compensation for damages caused by breach of informed consent in 1979. From then on, specific details of informed consent are shaping up and developing through court precedents. The duty of informed consent of doctor is based on article 10 of the Constitution and medical contract, and is expressly prescribed Article 12 of Framework Act on Health and Medical Services and other acts and regulations. By the way, the regulations about duty of informed consent of doctor have been established in Medical Law revised on December 20, 2016, and the revised Medical Law will be implemented on June 21, 2017. According to the revised Medical Law, medical practices subject to description and consent are operation, blood transfusion and general anesthesia that threaten to cause serious harm to human life or to the body. When performing these medical activities, the written consent must be explained and agreed upon in advance. If a doctor violates the law, he will incur fines of less than 3 million won. Comparing and viewing the revised Medical Law and existing legal principles about the duty of informed consent, we can confirm that there is a substantial difference between the two parties. Accordingly, despite the implementation of the revised medical law, the existing legal principles are unlikely to be affected. However, from the perspective of legal uniformity and stability, it is undesirable that legal judgments on the same issues differ from each other. The revised Medical Law about informed consent needs to be reformed according to existing legal principles. And, as in the case of Germany, it is desirable to include the matters concerning informed consent in the civil code.

• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.176-191
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• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.