• Korean Journal of Acupuncture
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• 제35권3호
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• pp.130-138
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• 2018

Objectives : The purpose of this study is to explore patients' perceptions that deserve attention when designing core questions for a clinical practice guideline of Korean medicine(KM) for degenerative lumbar spinal stenosis (LSS). Methods : Patients who had been admitted to Pusan National Korean Medicine Hospital from November 1, 2015 to October 31, 2016 were invited to the survey. Patients were eligible if they were both clinically and radiologically confirmed as degenerative LSS. The structured questionnaire was distributed by mail and outpatient visits. Questions included types of experienced Korean/Western medical interventions for LSS, their perceived effectiveness on symptoms, the necessity for studies of KM for degenerative LSS, the types of KM interventions to be investigated and the types of outcome measures after treatments. Data were descriptively analysed. Results : Twenty of thirty-one invited participants responded to the questionnaire. Acupuncture and herbal medicine were the most frequently used KM interventions. Eighteen respondents reported that KM treatments were helpful for their improvement. Sixteen patients who mentioned that research on KM is needed chose acupuncture as the top priority(88%) among KM interventions. The most important outcomes in the view of nineteen respondents included functional recovery (68%) and pain relief (53%). Thirteen respondents (65%) replied that both short-term and long-term outcome were important for them. Conclusions : Our findings may have limited validity due to the small number of respondents and the potential selection and information bias. Further qualitative studies and large-scale surveys to comprehensively identify patients' views are warranted.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.207-218
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• 2020

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.107-112
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• 2008

Diagnostic laryngeal electromyography (LEMG) relatively evaluates the electrophysiologic status of the larynx and provides critical clinical informations that no other tests can provide. However, LEMG is still not widely applied as a routine tool in clinical practice. One reason for this is the technical and interpretative difficulties of LEMG. But if LEMG is performed by a team approach consisting of an otolaryngologist and a neurologist, the technique and the interpretation of LEMG are not difficult to master. Another reason is that there is still not exact standard guideline for clinical application of LEMG. LEMG is an essential diagnostic test in evaluating patients with neuromuscular disorders, particulary vocal fold immobility, reduced mobility of vocal fold. The more we have used LEMG, the more we have found it useful in the evaluation and treatment of voice disorders, and the role of LEMG will be extended.

• Journal of Acupuncture Research
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• 제33권4호
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• pp.65-72
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• 2016

Objectives : While neck pain is highly prevalent in Korea, studies examining its Korean medical treatment are currently lacking. The aim of this study was to assess current Korean medical treatment practice patterns for neck pain. Methods : A preliminary questionnaire was developed to investigate current practice patterns of neck pain and cervical intervertebral disc displacement (IDD) treatment, and underwent further revision through external review. The final questionnaire was distributed as a web-based survey to 18,289 potential respondents by email. Results : The response rate was 3.34 %. Most participants replied that they received multiple Korean medicine interventions for neck pain treatment consisting of such methods as acupuncture, wet cupping, interferential current therapy and electroacupuncture. A total of 378 respondents acknowledged that diagnostic testing was needed for neck pain treatment. The most commonly used Korean Standard Classification of Diseases (KCD) principal diagnosis code for neck pain was M542, and for cervical IDD was M501. Conclusion : This survey study helps determine current practice patterns of neck pain, and recognizes the need for use of diagnostic devices in neck pain treatment. These results are further anticipated to provide basic data for clinical practice guidelines (CPGs) and future studies using Korean National Health Insurance and Health Insurance Review & Assessment Service data.

• The Korean Journal of Medicine
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• 제99권3호
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• pp.127-133
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• 2024

Subclinical hypothyroidism (SCH) is characterized by elevated serum thyroid-stimulating hormone (TSH) levels and normal free thyroxine levels. The Korean Thyroid Association recently issued guidelines for managing SCH. Based on the Korea National Health and Nutrition Examination Survey (2013-2015), a serum TSH level of 6.8 mIU/L is the reference value for SCH. SCH is classified as mild (TSH 6.8-10.0 mIU/L) or severe (TSH > 10.0 mIU/L), and patients are categorized as adult (age < 70 years) or elderly (age ≥ 70 years). Levothyroxine treatment (LT4-Tx) is not recommended for mild or even severe SCH in elderly patients. Immediate LT4-Tx can be given to adults in most cases, but not to women who are pregnant, patients with progressive disease, or patients with underlying coronary artery disease, heart failure, or dyslipidemia.

• Tuberculosis and Respiratory Diseases
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• 제82권2호
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• pp.102-117
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• 2019

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.

• 대한의료기공학회지
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• 제23권1호
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• pp.1-9
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• 2024

Objective : This report is to introduce the clinical application of Whidam's Su-Gi therapy to shoulder pain. Methods : Whidam's Su-Gi therapy for shoulder pain first identifies for red flags in order to select a person to be treated in korean medicine. After performing shoulder joint mobility evaluation and Su-Gi treatment, determine the disadvantage, and determine the mobility evaluation and Su-Gi treatment route of the shoulder, the shoulder blade, and cervical vertebrae. The advantage and pain are evaluated by a manual exercise test. After performing Su-Gi therapy according to the evaluation at each stage, pain and dysfunction are reevaluated to check the negative and proceed to the next step. Conclusions : The clinical application of Whidam's Su-Gi therapy to shoulder pain was organized around the correlation between the shoulder joint, the shoulder, the shoulder blade, and cervical vertebrae, and a medical flow chart was constructed away from the listed description method.

• 동의생리병리학회지
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• 제35권6호
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• pp.211-218
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• 2021

In order to increase the clinical value of an identification of patterns according to the eight principles (IPEP) in Korean medicine practice, The research on the Clinical Practice Guideline (CPG) of IPEP should comprehend the situation of clinical usage of IPEP practiced by Korean medicine doctors at first. Google survey form were emailed to Korean Medicine doctors registered in the Association of Korean Medicine on 04/15/2021 and the survey was closed at 04/22/2021. Data of 505 answered cases were analyzed by Frequency analysis, Chi-Square analysis, correlation analysis for understanding differences by groups. Out of 505 respondents, 57.6% have answered that they are using IPEP. It means that 42.4% of KM doctors don't use in the medical practice reversely in spite of fundamental diagnostic theory. The 64.7% respondents of no using IPEP presented their opinion about the theoretical problem that it is difficult to use because the concept of IPEP is ambiguous. And next, the 52.1% of the respondents expressed that there is no objective tools to measure and record the IPEP evidences in actual implementation. And 49.6% of the respondents also suggested that it is hard to trust and use IPEP similar to the previous comment. Even about 50% of the respondents are carrying out diagnosis and treatment using IPEP, it showed that there were several unsolved problems such as lack of understanding and practical tools or objective indicators for diagnosis of IPEP. Through the above results, the concept, usage, measurement requirements with indices and discriminant logic of IPEP were manifested as the main hopes of attending members of Korean medicine in the survey, so the IPEP CPG should make clear about these difficult but necessary assignment in the near future.

• Radiation Oncology Journal
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• 제34권2호
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• pp.81-87
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• 2016

Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

• Radiation Oncology Journal
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• 제35권3호
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• pp.198-207
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• 2017

Purpose: Whether preoperative chemoradiotherapy (CRT) is better than postoperative CRT in oncologic outcome and toxicity is contentious in prospective randomized clinical trials. We systematically analyze and compare the treatment result, toxicity, and sphincter preservation rate between preoperative CRT and postoperative CRT in stage II-III rectal cancer. Materials and Methods: We searched Medline, Embase, and Cochrane Library from 1990 to 2014 for relevant trials. Only phase III randomized studies performing CRT and curative surgery were selected and the data were extracted. Meta-analysis was used to pool oncologic outcome and toxicity data across studies. Results: Three randomized phase III trials were finally identified. The meta-analysis results showed significantly lower 5-year locoregional recurrence rate in the preoperative-CRT group than in the postoperative-CRT group (hazard ratio, 0.59; 95% confidence interval, 0.41-0.84; p = 0.004). The 5-year distant recurrence rate (p = 0.55), relapse-free survival (p = 0.14), and overall survival (p = 0.22) showed no significant difference between two groups. Acute toxicity was significantly lower in the preoperative-CRT group than in the postoperative-CRT group (p < 0.001). However, there was no significant difference between two groups in perioperative and chronic complications (p = 0.53). The sphincter-saving rate was not significantly different between two groups (p = 0.24). The conversion rate from abdominoperineal resection to low anterior resection in low rectal cancer was significantly higher in the preoperative-CRT group than in the postoperative-CRT group (p < 0.001). Conclusions: As compared to postoperative CRT, preoperative CRT improves only locoregional control, not distant control and survival, with similar chronic toxicity and sphincter preservation rate in rectal cancer patients.