• The Journal of the Korean dental association
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• v.34 no.5 s.324
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• pp.319-329
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• 1996

• The Journal of Korean Society for Radiation Therapy
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• v.31 no.2
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• pp.13-24
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• 2019

Purpose: CT scan range is insufficient for various reasons in head and neck Tomotherapy^®. To solve that problem, Re-CT simulation is good because CT scan range affects accurate dose calculations, but there are problems such as increased exposure dose, inconvenience, and a change in treatment schedule. We would like to evaluate the minimum CT scan range required by changing the plan setup parameter of the existing CT scan range. Materials and methods: CT Simulator(Discovery CT590 RT, GE, USA) and In House Head & Neck Phantom are used, CT image was acquired by increasing the image range from 0.25cm to 3.0cm at the end of the target. The target and normal organs were registered in the Head & Neck Phantom and the treatment plan was designed using ACCURAY Precision^®. Prescription doses are Daily 2.2Gy, 27 Fxs, Total Dose 59.4Gy. Target is designed to 95%~107% of prescription dose and normal organ dose is designed according to SMC Protocol. Under the same treatment plan conditions, Treatment plans were designed by using five methods(Fixed-1cm, Fixed-2.5cm, Fixed-5cm, Dynamic-2.5cm Dynamic-5cm) and two pitches(0.43, 0.287). The accuracy of dose delivery for each treatment plan was analyzed by using EBT3 film and RIT(Complete Version 6.7, RIT, USA). Results: The accurate treatment plan that satisfying the prescribed dose of Target and the tolerance dose in normal organs(SMC Protocol) require scan range of at least 0.25cm for Fixed-1cm, 0.75cm for Fixed-2.5cm, 1cm for Dynamic-2.5cm, and 1.75cm for Fixed-5cm and Dynamic-5cm. As a result of AnalysisAnalysis by RIT. The accuracy of dose delivery was less than 3% error in the treatment plan that satisfied the SMC Protocol. Conclusion: In case of insufficient CT scan range in head and neck Tomotherapy^®, It was possible to make an accurate treatment plan by adjusting the FW among the setup parameter. If the parameter recommended by this author is applied according to CT scan range and is decide whether to re-CT or not, the efficiency of the task and the exposure dose of the patient are reduced.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.394-400
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• 2009

Purpose : On outpatient facilities, our sedation protocol focuses on the intermittent bolus injections of midazolam intravenously, according to patient's and operator's needs during the dental treatment. This multicenter retrospective study was aimed to prove the efficiency and safety of our sedation protocol. Patients and Methods : In three centers using the same outpatient sedation protocol for dental treatment (Division of Oral and Maxillofacial Surgery/Department of Dentistry in Hanyang University Medical Center, S-plant Dental Hospital. and Grand Oral and Maxillofacial Surgery), total 937 patients had various dental treatments under intravenous conscious sedations with independent patient monitoring from March 2006 to March 2009. By reviewing charts, we analyzed the results of sedation and dental treatment, retrospectively. Results : Our sedation protocol had no severe postoperative complications requiring admission. while showing good compatibility with almost all dental treatments, with acceptable satisfaction of both patients and operators. Conclusion : We assure that our sedation protocol can be used efficiently and safely on routine outpatient basis. We also hope that this study will provide the concrete concepts to common dental practitioners, who desire to perform sedation for dental treatment.

• Journal of Acupuncture Research
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• v.22 no.5
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• pp.141-150
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• 2005

Objectives : This study was accomplished in order to find out how Korean medical doctors take acupuncture prescription for knee osteoarthritis in clinical practice Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. 206 persons having more than 10 years experience were randomly selected from a list of Korean medical doctors. Telephone interviews with them were conducted by the well-trained interviewers between May 21 and May 27 in 2005. Results : 139 of 206 Korean medical doctors made an acupuncture prescription prior to treatment of knee osteoarthritis. 103 of 139 Korean medical doctors used both local and remote points, and 26 of them used remote points only, and 10 of them used local points only. In case of doctors who use remote points, the five element (45 of 129) or Saam (28 of 129) acupoints were used dominantly, and its was based on the pattern identification of the Jangbu organs related with the pain (56 of 129) or of the pain location (35 of 129). Conclusion : This study showed that Koran medical doctors prefer to use remote points such as five element or Saam acupoints based on the pattern identification of the Jangbu organs related with the pain or the pain location. These result may be useful for developing protocols for clinical trial on acupuncture on knee osteoarthritis.

• Journal of Acupuncture Research
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• v.22 no.4
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• pp.197-204
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• 2005

Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture prescriptions for knee osteoarthritis in real clinical practice. Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. The questionnaires were distributed via e-mail to 3,306 members of Korea Oriental Medical Association from March 15th to March 23rd in 2005.84 members completed answers, and the computerized data were analyzed by ISP statistical program. Results : 1. 68 out of 84 Korean medical doctors used pattern diagnosis. 2. 61 out of 84 Korean medical doctors used both local and remote points, 20 doctors remote points only, and 3 doctors local acupuncture points only. 3. In case of doctors who use remote acupuncture points only, the acupuncture prescription principle was Saam or five element acupuncture (66%), along the meridian pathway (14%), Eight constitutional acupuncture (11%), Taegeuk acupuncture (2%), and miscellaneous (18%). Conclusion : In our e-mail survey, Korean medical doctors who experienced more than 10 year practice answered that they use five element acupuncture or Saam acupuncture according to meridian pathway theory as the most common principle of their acupuncture treatment prescription.

• The Journal of the Korea Contents Association
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• v.12 no.12
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• pp.345-355
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• 2012

Delayed treatment of acute cardiovascular and cereb-directrovascular diseases is related to poor prognosis and sequelae. For rapid and adequate treatment, role of prehospital emergency dispatchers for adequate triage and selection of hospital is important. In several advanced countries, emergency dispatchers use standardized protocols for decision of rescuer resources or distribution of patients at each hospital. ut, there has not been developed standardized protocol for emergency dispatchers in Korea. We developed standardized protocol based on NHS-direct and CTAS system for triage of symptoms of chest pain and Stroke. Groups with standardized protocol and without protocol was compared to triage result at emergency department which patient visited. The accuracy of triage on chest pain was 70.0% in group A, 94.0% in group B(p<0.01). The accuracy of triage in stroke symptoms was 64.2% in group A, 84.6% in group B(p<0.01). Conclusion: In this study, the accuracy of telephone triage with the protocol was more accurate than without the protocol. But, more studies are needed to generalize the protocol in South korea.

• Quality Improvement in Health Care
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• v.27 no.1
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• pp.20-25
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• 2021

Purpose: The ability to access clinical trials for cancer treatment is important. This study investigated whether regional differences exist in oncologic clinical trial protocols conducted in South Korea. Methods: Records of all approved oncologic clinical trials conducted in 2019 were downloaded from the Republic of Korea Ministry of Food and Drug Safety. The study covered Seoul, the capital area, other metropolitan cities, and provincial areas. Descriptive statistics summarized the distribution patterns of clinical trials by region. Results: A total of 202 oncologic clinical trials were conducted in 63 institutions in 2019. Of these protocols, 186 (92%) were available in Seoul, 120 (59%) in the capital area, 64 (32%) in metropolitan cities, and 66 (33%) in provincial areas. More regional differences in protocol availability were observed in domestic trials, investigator-initiated trials, phase 1 and 2 trials, and smaller-scale trials. Conclusion: Most oncologic clinical trials were conducted in medical institutions located in Seoul, with the rest conducted in the capital area, metropolitan cities, and provincial areas. The findings reveal clear differences in protocol availability between Seoul and the other regions. Measures designed to improve geographical access to oncologic clinical trials may be needed given their growing importance in cancer treatment.

• Communications for Statistical Applications and Methods
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• v.25 no.4
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• pp.341-354
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• 2018

The one of the principles described in ICH E9 is that only results obtained from pre-specified statistical methods in a protocol are regarded as confirmatory evidence. However, in multi-regional clinical trials, even when results obtained from pre-specified statistical methods in protocol are significant, it does not guarantee that the test treatment is approved by regional regulatory agencies. In other words, there is no so-called global approval, and each regional regulatory agency makes its own decision in the face of the same set of data from a multi-regional clinical trial. Under this situation, there are two natural methods a regional regulatory agency can use to estimate the treatment effect in a particular region. The first method is to use the overall treatment estimate, which is to extrapolate the overall result to the region of interest. The second method is to use regional treatment estimate. If the treatment effect is completely identical across all regions, it is obvious that the overall treatment estimator is more efficient than the regional treatment estimator. However, it is not possible to confirm statistically that the treatment effect is completely identical in all regions. Furthermore, some magnitude of regional differences within the range of clinical relevance may naturally exist for various reasons due to, for instance, intrinsic and extrinsic factors. Nevertheless, if the magnitude of regional differences is relatively small, a conventional method to estimate the treatment effect in the region of interest is to extrapolate the overall result to that region. The purpose of this paper is to investigate the effects produced by this type of extrapolation via estimations, followed by hypothesis testing of the treatment effect in the region of interest. This paper is written from the viewpoint of regional regulatory agencies.

• Korean Journal of Head & Neck Oncology
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• v.20 no.2
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• pp.172-176
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• 2004

Background and Objectives: Standard treatment of locally advanced laryngeal, hypopharyngeal, and some oropharyngeal cancers includes total laryngectomy. In an attempt to preserve the larynx through induction chemotherapy, we designed induction chemotherapy followed by definitive radiation in patients with potentially respectable head and neck cancer to determine whether organ preservation is feasible without apparent compromise of survival. Materials and Methods: The twenty-six patients diagnosed advanced head and neck squamous cell carcinoma, Stage III or IV (AJCC 2002) and performed organ preservation protocols in Ajou university hospital from 1994 to 2001 were included in this study. Results: Neoadjuvant chemotherapy showed an overall response rate of 84.6% and a complete remission (CR) rate was 59.1% following neoadjuvant chemotherapy and radiation. Seven of thirteen patients were able to preserve their larynges for more than two years by chemotherapy and radiation. There were no treatment related mortality after 2 cycles of induction chemotherapy. Conclusion: Although Organ preservation protocol through neoadjuvant chemotherapy and radiation need more controlled randomized study, it was considered alternative treatment modality in advanced head and neck cancer.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.4
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• pp.219-231
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• 2020

The objective of this study is to propose a Korean medical rehabilitation protocol for total knee replacement (TKR) and to report its effectiveness. This study was conducted as a retrospective study which analyzes the medical records of 4 patients undergoing Korean medical rehabilitation with protocol and continuous passive motion exercise for more than two weeks after TKR. We evaluated the outcome checking physical examination findings of the knee joint, numeric rating scale (NRS), Lysholm knee score (LKS) and walking state. After the treatment, we observed that the function of knee joint, NRS, LKS, walking state of patients were improved. This study showed that Korean medical rehabilitation protocol has effect on knee joint recovery after TKR. The limitation of this study was the insufficient number of cases and short-term follow up. Further studies should be done steadily to report the effectiveness of a Korean Medical rehabilitation protocol for TKR.