• Korean Journal of Acupuncture
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• v.24 no.4
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• pp.13-24
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• 2007

Objectives : This article aims to give guidance on the conduct and reporting of case series and audits of acupuncture, based on common problems that have arisen in the past. This type of project, and particularly the prospective case series or pre- post-intervention study, may give valuable evidence of the overall effectiveness of acupuncture-for example in different situations and in different conditions- and provides one step in the research pathway before generating an hypothesis. Results & Discussion : The project should be designed with the aim of reducing bias as much as possible. Careful and detailed planning is essential for the project to produce worthwhile results that readers can evaluate and replicate. Ethical issues should be considered and formal approval may be necessary. The patient group should be recruited systematically and baseline data obtained. The treatment given should be systematic and decisions to change or end treatment made explicit. The outcome should be measured in ways that are known to be reliable and valid. Musculoskeletal problems can be evaluated with scales for pain and confirmed by measuring one other symptom such as stiffness or one other aspect such as bothersomeness. Global change scores also provide supporting information, and the MYMOP (Measure Yourself Medical Outcome Profile) measure is popular when patients with different conditions are included. The design of questionnaires for beliefs and attitudes is a specialised area that should not be attempted without expert help. Adverse events should also be recorded. Analysis of the data and the best way of summarising and presenting the results are also discussed.

• Journal of Acupuncture Research
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• v.29 no.3
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• pp.115-120
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• 2012

Objectives : This study was done for reporting the effect of acupuncture treatment on Ryodoraku score of the patients with chronic low back pain due to the kidney deficiency Methods : We investigated 37 cases of patients with chronic low back pain due to the kidney deficiency, and devided patients into two groups : We specially treated one group by acupuncture treatment, which was not applied to the other group we analyzed of each group the Ryodoraku score(F3) of each group before and after acupuncture treatment and compared it. Results : 1. In acupuncture treatment group compared with baseline, at final, Ryodoraku score(F3) was significantly increased. 2. At final, acupuncture treatment group showed significant increase on Ryodoraku score(F3) score compared with non acupuncture treatment group. Conclusions : It is suggested that Ryodoraku score(F3) should be available for diagnosing kidney deficiency-induced chronic low back pain as a promising diagnostic index and a outcome measurement.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.191-204
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• 2005

Traditionally, the implant treatment require load-free healing period of at least 3 months in the mandible and 6 months in the maxilla. But this long healing period provides patients with the discomfort and economical trouble. Many experiments has been attempted for the outcome of such disadvantage, so recently the immediate loaded implant is getting popularity. Several literature has been published for clinical success of immediate loaded implant. The studies for the success rate of immediate loaded implant in multi-way has been reporting, nevertheless, we don't have yet a probable success. Various studies have been practiced that the advantages and disadvantages associated with immediate loaded implant, and factors that may influence the success of immediate implant, including patient selection, type of bone quality, required implant length, structure of the implant, surgical skill, need for achieving primary stability, control of occlusal force, peri-implant bone activity. The objective of this study is to review the literature related to immediate loading of implants and to discuss factors that may influence this treatment modality, based on scientific evidence.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.110-116
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• 2022

Objectve: To inform a clinical usefulness of Nangan-geon (暖肝煎) decoction to treat a refractory abdominal pain especially in eldery. Methods: This case report presents an 85-year old male patient who had been suffered with a refractory abdominal pain without any abnormality in laboratory test and radiological examination for 5-years. The clinical outcome was observed by numerical rating scale (NRS) of self-reporting method. Results: Based on his previous multiple normal examination results from Western hospitals and clinical features including thin body (19.6 BMI), nocturnal pain around lower abdomen and cold-sensitivity, author diagnosed him as "deficiency and cold of liver-Qi (肝氣虛寒)" similar to intestinal spasm. After prescription with Nangan-geon (暖肝煎) for one month, all symptoms became improved notably (NRS 5), and almost completely recovered as a level of normal condition in 3 months (NRS 1). Conclusion: This study would show the potential of traditional Korean medicine (TKM) therapies for a refractory functional abdominal pain, and especially efficacy of Nangan-geon against cold-pattern of nonspecific abdominal pain in elderly patients.

• The Korean Journal of Pain
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• v.34 no.3
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• pp.346-368
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• 2021

Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.27 no.1
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• pp.28-39
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• 2023

We aimed to compare resection and survival outcomes of neoadjuvant chemoradiotherapy (CRT) and immediate surgery in patients with resectable pancreatic cancer (RPC) or borderline resectable pancreatic cancer (BRPC). In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards, a systematic review of randomized controlled trials (RCTs) was conducted. Random effects modeling was applied to calculate pooled outcome data. Likelihood of type 1 or 2 errors in the meta-analysis model was assessed by trial sequential analysis. A total of 400 patients from four RCTs were included. When RPC and BRPC were analyzed together, neoadjuvant CRT resulted in a higher R0 resection rate (risk ratio [RR]: 1.55, p = 0.004), longer overall survival (mean difference [MD]: 3.75 years, p = 0.009) but lower overall resection rate (RR: 0.83, p = 0.008) compared with immediate surgery. When RPC and BRPC were analyzed separately, neoadjuvant CRT improved R0 resection rate (RR: 3.72, p = 0.004) and overall survival (MD: 6.64, p = 0.004) of patients with BRPC. However, it did not improve R0 resection rate (RR: 1.18, p = 0.13) or overall survival (MD: 0.94, p = 0.57) of patients with RPC. Neoadjuvant CRT might be beneficial for patients with BRPC, but not for patients with RPC. Nevertheless, the best available evidence does not include contemporary chemotherapy regimens. Patients with RPC and those with BRPC should not be combined in the same cohort in future studies.

• Quality Improvement in Health Care
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• v.25 no.1
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• pp.11-28
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• 2019

Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.30.1-30.8
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• 2019

Background: Advancements in the field of microvascular surgery and the widespread adoption of microvascular surgical techniques have made the use of osteocutaneous fibula free flaps the standard of care in the surgical management of segmental mandibular defects. Although the literature possesses abundant evidence to support the effectiveness of fibula free flaps as a reconstructive method, there are relatively few studies reporting on outcomes as objectively measured by videofluoroscopic swallowing studies (VFSS). The purpose of this study is to explore the potential correlation between early postoperative VFSS and the long-term swallowing outcomes in patients who underwent mandibular reconstruction with fibula free flaps. Methods: We performed a retrospective chart review of 36 patients who underwent mandibular reconstruction with osteocutaneous fibular free flaps between 2009 and 2012. Demographics, clinical variables, VFSS data, and diet information were retrieved. Penetration and aspiration findings on VFSS, long-term oral feeding ability, and the need for gastrostomy tube were statistical endpoints correlated with postoperative clinical outcomes. Results: Thirty-six patients were reviewed (15 females and 21 males) with a mean age of 54 years (7-81). Seventeen cases were treated for malignancy. The size of the bony defect ranged from 3 to 15 cm (mean = 9 cm). The cutaneous paddle, a surrogate for soft tissue defect, ranged from 10 to 125 ㎠ (mean = 52 ㎠). A gastrostomy tube was present in patients preoperatively (n = 8), and postoperatively (n = 14). Seventeen patients had neoadjuvant exposure to radiation. Postoperative VFSS showed penetration in 13 cases (36%) and aspiration in seven (19%). Overall, 29 patients (80.6%) achieved unrestricted diet, and this was statistically correlated with age (p = 0.037), radiation therapy (p = 0.002), and preoperative gastrostomy tube (p = 0.03). The presence of penetration or aspiration on VFSS was a strong predictor for long-term unrestricted oral diet (p < 0.001). Conclusion: Early postoperative VFSS is an excellent predictor for long-term swallowing outcomes in patients undergoing mandibular reconstruction with osteocutaneous fibula free flaps.

• Journal of Medicine and Life Science
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• v.19 no.3
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• pp.109-115
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• 2022

During emergencies, the time from symptom onset to definitive treatment determines the final outcome. Therefore, the emergency medical service (EMS) system in Korea, aims to transfer patients requiring emergency care to appropriate medical facilities within 30 minutes. This is in an attempt to improve the chances of survival and reduce sequelae. We attempted to locate areas vulnerable to prehospital transportation and identify hot spots with high demand for emergency medical helicopters in Jeju, by using a grid-based geospatial analysis. This retrospective cross-sectional observational study employed EMS data of 119 ambulance run sheets spanning from January 1, 2010 to September 30, 2018 in Jeju. The location data of emergency patients was superimposed on the spatial analysis frame using the geographic information system (GIS). Subsequently, the locations of long-distance transfer and delayed transfers to the hospital were analyzed, to identify hot spots where the demand for helicopter emergency services would be high. Of the total analysis targets, 42.2% (20,288 people) took more than 30 minutes from reporting to 119 dispatchers to hospital transfer. As the transfer time interval increased, the patient occurrence time increased in the city of Jeju, increased in Seogwipo, and the ratio of patients/guardians to select a transfer hospital rose with significant differences. This study identified the characteristics related to time delays in prehospital transfer of emergency patients in Jeju, and the areas vulnerable to prehospital emergency care were derived and visualized through spatial analysis using the GIS.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5939-5944
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• 2015

Background: There is still a great deal of controversy with regard to the prognostic role of chemotherapy-induced amenorrhea (CIA) in breast cancer patients. To confirm whether CIA can serve as a useful factor in predicting clinical effects of systemic adjuvant chemotherapy, we performed this meta-analysis. Materials and Methods: Relevant studies were identified using PubMed, and Embase databases. Eligible study results were pooled and summary hazard ratios (HRs) with corresponding confidence intervals (CIs) were calculated. Subgroup analyses and an assessment of publication bias were also conducted. Results: A total of 8,333 patients from 11 published studies were identified through searching the databases. The pooled HRs for disease-free survival (DFS) suggested that CIA was associated with a significant reduction in the risk of recurrence, especially in patients with hormone receptor-positive lesions (overall HR=0.65, 95%CI 0.53-0.80, $I^2=41.3%$). When the five studies reporting the HR for overall survival (OS) were pooled (n=4193), a favorable trend was found (HR=0.69, 95%CI 0.52-0.91, $I^2=51.6%$). No publication bias was observed in this study. Conclusions: This meta-analysis suggests that CIA predicts a better outcome in premenopausal hormone receptor-positive breast cancer patients.